Anatomy Exam Notes

Nervous System
Function
Sensory Input: the nervous system has scattered throughout the body sensory receptors to detect
changes in the environment. Those receptors detect both external and internal changes.
Integration: the nervous system processes the sensory input and decides if a response is
required.
-

Sensory nervous system; process of information and decision on how to react

Motor Output: If a response is required, the nervous system sends down motor messages to
respond to the stimulus.
-

Sensory brain make decisions (fist is coming move the face

Telling body how to react in response

Organization
Central Nervous System (CNS): the central nervous system is made up of the Brain and the
Spinal Cord. Those parts of the nervous system are encased in the bone. Within the CNS
neurons can be functionally grouped into: Sensory, Motor, and Connector or Interneurons.
-

Central Nervous System is the decision making center

Interneurons have an integration component
Interneurons are connectors
Central Nervous System and the Peripheral Nervous System work together

Peripheral Nervous System (PNS): this is the part of the nervous system outside of the brain
and spinal cord. The Peripheral Nervous System can be divided functionally into 2 divisions:
Sensory (afferent) and Motor (efferent)
- Motor cranial nerves, spinal nerves, ganglia; exiting spinal cord
- Peripheral Nervous System is doing the signals
Sensory is responsible for receiving information from receptors and transmitting that
information to the Central Nervous System. The sensory division continues within the Central
Nervous System to transmit information.
The sensory division is subdivided into Sensory Somatic (Body) everything else of the body
external e.g., touch, pain, pressure and Visceral (organs) internal organs e.g, blood vessels,
digestive organs, respiratory organs the control is below our conscious level autonomic

Most of the time these visceral senses do not reach the conscious level. However, when they
become strong enough, as when your stomach is stretched because you have eaten too much, the
sensory information rises to a conscious level.
Motor is responsible for transmitting motor impulses from the Central Nervous System to
muscles or glands. The motor division is subdivided in to Somatic (body) e.g., conscious
contraction of striated or skeletal muscles and Visceral (organ) unconscious contraction of
smooth muscle, cardiac muscle or glands. The Visceral motor or Autonomic NS (nervous
system) is further subdivided into Sympathetic and Parasympathetic divisions.
- Somatic(body) is voluntary; examples: walking see the lowering on the ground send
message to the brain make decision motor systems sends message to the legs that
when taking the next step the person needs to step down a little
- Autonomic Nervous System involuntary motor innovation to organs and veins, etc.
(smooth muscles, etc.)
- Sympathetic Sensory Nervous System (fight or flight response); action situation
dependant
- Functional organization of the nervous system
- Somatic(Body) effectors(anything that needs to be effected to carry out brains will
- Autonomic = Visceral for motor and sensory
- Sympathetic and parasympathetic are most important
- Internal environment changes blood pressure
- External Environment changes temperature; fist coming at the face
Function Unit
Neuron the neuron is the functional unit of the nervous system. This is the cell that performs
the 3 functions: sensory input, integration and motor output.
Neuron Structure
Cell body round part (has nucleus, etc.)
Dendrite(s) dendrites are extensions of cytoplasm (from cell body) that are responsible for
directing information toward the cell body; help to bring the signal in
Axon an axon is an extension of cytoplasm (from cell body) that is responsible for directing
information away from the cell body (help to send signals out)
Non-Nervous Cells: Neurologlial Cells in the Central Nervous System
Astrocytes (green globby structures) these cells act as a blood to brain barrier; they are
positioned between the capillary and the neuron; have cytoplasmic extensions. They act to
regulate what substances come in contact with the neuron (by regulating nutrients and wastes
coming in and out of the neuron). They also act as the glue in the Central Nervous System by
holding structures together, giving structural support.

Oligodendrocytes (smaller then astrocytes; round and have cytoplasmic extension made up of
Myelin make myeline sheeths in CNS) these cells are responsible for the production of
Myelin around axons in the Central Nervous System. Myelin is a fatty coating around axons that
insulates the axon. Since the myelin appears a little lighter in color, axons that are myelinated are
said to be White Matter of the Central Nervous System.
Microglial Cells (very small and there are less of them) these cells act to destroy viruses and
bacterial infections that have invaded the CNS. They act much like the Lymphatic System does
for the rest of the body.
Ependymal Cells (cuboidal epithelial and cilia pointing inward) these are cells that line the
ventricles of the brain. These cells along with capillary networks (Choroid Plexi) are responsible
for the formation of Cerebrospinal Fluid (CSF within cavities of the brain and spinal cord)
Non-Nervous Cells-Peripheral Nervous System
Schwann (neurolemmocytes) cells (wraps around axons and makes myelin sheeths) these cells
are responsible for the formation of myelin around axons in the peripheral nervous system.
Satellite Cells these cells are responsible for surrounding and separating cell bodies in ganglia
(within peripheral nervous system). These cells are important in the regulation of exchange of
nutrients and wastes between the neuron and their surrounding environment (in and out).
- Myelin sheeths wrapped in little sections around axons; made up mostly of fat, so
insulating axons and help the signal travel faster signal can bounce from sheeth to
sheeth
- Some axons do not need myeline they are fast as they are and also dependent on their
function
- Ganglion communication center within the posterior roots
The brain in early development is divided into 3 regions: forebrain, midbrain and hindbrain.
These 3 areas further divide into 5 regions of the brain
The Brain
Forebrain
Cerebrum most of the forebrain is made up of the Cerebrum (the brain we are used to see). The
cerebrum is divided into 2 hemispheres.
- The outer covering of the cerebrum is termed the cortex. The cortex is made up of nonmyelinated cell bodies of neurons. (Non myelinated appear darker in staining and so are
classified as Gray Matter of the brain.)

The cortex is convoluted or folded. The grooves or valleys of the cortex are termed sulci
(sulcus/sing) and the hills between the grooves are termed gyri (gyrus/sing). The sulci
divide the cortex into lobes.
The longitudinal fissure is the groove separating 2 cerebral hemispheres (very deep
sulcus through cerebrum)
The central sulcus is the groove separates the frontal lobe from the parietal lobe
The lateral sulcus (superior to the temporal lobe) serves as the superior border for the
temporal lobe (dividing it from everything else)
The parieto-occipital sulcus separates the parietal lobe from the occipital lobe
The insula lobe is located deep to the temporal lobe
The gyrus immediately in front of the central sulcus is termed pre-central gyrus. The
gyrus is motor in function. The gyrus immediately behind the central sulcus is termed the
post central gyrus. This gyrus is sensory in function
White matter beneath the gray matter of the cortex are myelinated axons of neurons.
Those axons that join gyri in the same hemisphere are termed Association type tracts
(connect gyri within the same lobe which are different areas within the same hemisphere)
Those myelinated axons that join right to the left hemispheres are termed Commissural
tracts (in corpus callosum connect information on either side). The largest example of
commissural fibres is a structure termed the Corpus Callosum (white matter connecting
right and left parts)
Those myelinated axons responsible for transmitting sensory information up to the cortex
or those motor axons that transmit motor information down through the cerebrum are
termed Projection tracts (leaving the brain or bringing stuff back to the brain) or fibres
Grey matter is made up of no myeline cell bodies
White matter is made up of myelinated axons
Forebrain is made of cerebrum, thalamus, hypothalamus, basal ganglia
Autonomc = visceral
Association tracts connect different areas within the same hemisphere (connecting gyri
within same hemisphere); longitudinal fibres connect lobes within the same hemisphere;
arcute or acute fibers connect fibers within the same lobe

Deeper Gray Matter at the floor of the forebrain a number of nuclei of neurons group together
to form distinct structures. These structures include:
- Thalamus (one structure) the thalamus is a major relay center for almost all sensory
information that goes to the cerebral cortex (cerebrum)
- Hypothalamus the structure is the controller for the autonomic nervous system and the
endocrine system(motor/visceral; Control of organs and glands)
- Basal ganglia (motor signal away from the cerebrum) a grouping of cerebral nuclei that
receive information from the cerebral cortex to regulate skeletal movement (on either side
of the thalamus)

Midbrain (responsible for eye movement, visual and auditory reflexes) this as its name implies
is the part of the brain between the forebrain and hindbrain. Some of the functions of the
Midbrain include:
- The nuclei of 2 cranial nerves that control the movements of the eye
- Motor tracts that run back to the Cerebellum (from cerebellum to the midbrain) (Superior
Cerebellar Peduncles make the decision to carry out the motor signals; connection point
along with cerebral peduncle)
- Brainstem is made of midbrain and the hindbrain
- Visual and auditory reflex centers: centers that work when your turn your head when you
hear a loud sound or visually follow a moving object
Hindbrain the hindbrain is made up of 2 parts: the Pons and Medulla Oblangata
Pons some of the functions of the pons include (regulate our breathing)
- Contain nuclei of cranial nerves 5,6,7 and part of 8
- Fibers that travel back to the Cerebellum (Middle Cerebellar Peduncles bring motor
signals out from cerebellum with the decision)
- Centers that regulate breathing: rate and depth
Medulla Oblongata some of the functions of the medulla include (controls heart rate, blood
pressure and breathing):
- A connection to the cerebellum via the Inferior Cerebellar Peduncles (motor signals from
cerebellum)
- The nuclei for cranial nerves 8-12
- The reflexes centeres that regulate vital functions such as a Cardiac center, Respiratory
center, Blood Pressure Center.
- Need cerebral peduncle midbrain up to forebrain and cerebrum to send signals up
- Superior Cerebellar Peduncle from cerebellum to the midbrain
- 12 cranial nerves peripheral nervous system go from the brain; no labeling of the
nerves will be on the test
Cerebellum (at the back, below cerebrum) the cerebellum is like the cerebrum in that its outer
covering is Cortex and convoluted (wavy)
- The cerebellum has 2 hemispheres (right and left) and a midline narrow band of a cortex
termed the vermis (the band of cortex that divides the 2 hemispheres)
- The myelinated axons in the cerebellum resemble the branching of a tree and so were
termed Arbor Vitae(tree of life)
- The cerebellum serves as an area to co-ordinate motor movement
Meninges (protective layer around the brain) the brain in covered by 3 layers of tissue termed
Meninges
- The outer meningeal layer is termed the Dura Mater (tough mother, 2 layers), the middle
layer the Arachnoid (spider mother, deep to dura mater) and the inner layer the Pia mater
(tender mother, thin and inseparable extremely hard to do so)

Dura Mater the dura mater is the outermost covering. A vertical fold of dura located in
the Longitudinal Fissure forms the Falx Cerebri (splits 2 cerebrum the right and left
hemispheres if looking in a transverse section); there are 2 layers around the brain and 1
in the spine that split and then join back together on the anterior of the brain)
A vertical fold of dura between 2 lobes of the Cerebellum forms the Falx Cerebelli
(below falx cerebri and between 2 hemispheres of cerebellum; thin layer of dura mater)
A horizontal fold between the Cerebellum and the Occipital lobes forms the Tentorium
Cerebelli (between cerebrum and the cerebellum; tent over cerebellum; on both sides)
A roof of dura over the Sella Turcica(pituitary gland is sitting in it) of the sphenoid
bone forms the Diaphragma Sellae (covering Sella Turcica and covering the pituitary
gland) it is a dura fold
Venous Sinuses within the edges of the dural folds are venous channels or
sinuses(system of veins in the body where the deoxygenated blood will be drained;
within dura folds)
The Superior Sagittal Sinus is located in the top edge of the Falx Cerebri (collecting
deoxygenated blood; runs toward the back of the brain)
The Inferior Sagittal Sinus is located in the bottom free edge of the Falx Cerebri
(unidirectional; back and then down the straight sinus)
The Inferior Sinus continues posterior to meet the Superior Sinus (drain into it) via the
Straight Sinus
The Occipital Sinus is located in the Falx Cerebelli (comes up to meet superior
+straight+occipital sinusesmeet at the confluence of sinusesonce met continue to
either the right or the left transverse sinus
Dura folds/partitions membranous layers that divide parts of the
Subarachnoid space (under arachnoid brain) is continuous down around the spine where
cerebral fluid is going through
Infundibulum runs through the diaphragm sellae and connects the pituitary gland to the
brain above
2 dura layers in the brain where they split and join on anterior of the brain
Around spinal cord there is 1 dura mater
Pia Mater deep to arachnoid
Falx Cerebelli is below tentorium cerebella
Tentorium Cerebelli is superior to cerebellum and inferior to cerebrum

The Right and Left Transverse Sinuses (become sigmoid sinuses) are located in the outer edge of
the Tentorium Cerebelli.
- The Transverse Sinuses continue anteriorly as the Sigmoid Sinuses (S shaped; turn
inferiorly south toward the heart)
- The Sigmoid Sinuses exit the cranial cavity as the Right and Left Internal Jugular Veins
(heading toward the heart)
- The Right and Left Cavernous Sinuses are located in the Diaphragma Sellae

Draining back to the Sigmoid Sinuses from the Cavernous Sinuses (one on each side) are
the Right and Left Inferior and Superior Petrocal Sinuses (cavernous drain into them;
connect to sigmoid sinuses toward the internal jugular vein)
Arachnoid the arachnoid layer (there is a very tiny space between them) follows the same
contour as the Dura Mater
- The arachnoid layer is connected to the underlying Pia Mater via strands termed
Trabeculae (connect the arachnoid to pia maer layer). The space between the arachnoid
and pia mater is termed the Subarachnoid Space (Cerebrospinal fluid (CSF) is running
through it)
- Extensions of the arachnoid into the Superior Sagittal Sinus forms structures termed
Arachnoid Granulations or Villi (exit for waste products; old cerebral spinal fluid exit).
These areas of the arachnoid are extremely permeable.
Pia Mater the Pia Mater is the delicate inner meningeal layer. This layer follows all the
contours of the Cerebral Cortex (no potential space there).
Ventricles within the brain are spaces or cavities termed Ventricles (spaces or cavities). These
spaces all communicate with each other.
- The (1) Right (cavities, open compartments within the brain) and (2) Left Lateral
Ventricles (open compartments where the cerebral fluid is made) are located in the
Cerebrum. These 2 spaces communicate with a midline (3) 3rd Ventricle (surrounded by
thalamus) via the (4) Interventricular Foramina
- The 3rd Ventricle is located between the 2 Thalami. The 3rd Ventricle continues in the
Midbrain region as the Cerebral Aqueduct.
- The Cerebral Aqueduct continues in the Pons region as the (5) 4th Ventricle (the end of
where Cerebrospinal Fluid is made from here it starts to get redistributed)
- The CSF is made in all of the 4 Ventricles
- The 4th Ventricle continues as the Central Canal of the Spinal Cord. At the level of the 4th
Ventricle 3 Apertures (openings) allow for the communication of the Ventricle system
with the Subarachnoid space
- Right and left lateral ventricles are connected to the 3rd ventricle through interventricular
foramina
- Confluence of sinuses from here it goes to the right or left transverse sinuses
- The pathway of blood from brain to heart:
- Drop of deoxygenated blood enters the inferior saggital sinus follow the path of the
blood from inferior saggital sinus to the straight sinus to the confluence of sinuses to
the right or left transverse sinuses to the sigmoid sinus and then to the internal jugular
vein and out
- If coming from the superior saggital or occipital then it goes to the confluence of sinuses
and then follows the same path as described above
- Anterior part of the brain: goes cavernous sinus inferior or superior petrosal sinuses to
the sigmoid sinus internal jugular vein

Arachnoid granulations or villi Projections of the arachnoid mater and the

subarachnoid space in to a venus sinus, does not have to be into superior saggital sinus
can be into any of them

Cerebrospinal Fluid Formation (CSF formation) cerebrospinal fluid is formed by the Choroid
Plexi (within 4 of the ventricles; singular plexi is plexus)
- The Choroid Plexus is made up of a Capillary network positioned on the roof of one of
the ventricles along with the Ependymal cells that line the ventricle.
- Plasma from blood is filtered through the Ependymal cells and trapped in the ventricle.
The fluid once in the ventricle is termed Cerebrospinal Fluid (CSF). CSF may exit the
ventricle system via the aperatures at the level of the 4th ventricle and then circulate in the
Subarachnoid Space.
- This fluid serves to:
1. Protect the brain
2. Provides buoyancy (resilience) for the brain (not a lot of stress on the muscles
relieves the stress of them) when we fall and hit our head the brain jumps forward
3. Serve as an excellent diagnostic tool for the health of the nervous system (marker
nutrient deficiency if we take a sample of CSF gives us an exact idea of what is going on)
- Plasma is pulled out of the capillary and crosses the Pia Mater and as it crosses the
ependymal cells extra fluid is added and then you get Cerebrospinal fluid
- Choroid Plexus within the 4 ventricles makes the Cerebrospinal fluid
- Plasma from the blood is pulled aside (crosses the pia mater) plus extra fluid from the
ependymal cells
1. Lateral Ventricle (choroid plexus) interventricular to 3rd ventricle (choroid plexus)
where we make more Cerebrospinal fluid
2. Come down through the cerebral aquedeoux to the 4th ventricle (choroid plexus)
3. Going into the central canal where we start exiting the new Cerebrospinal fluid is
getting into the subarachnoid space and flows all around the spinal cord
4. And around the brain the old Cerebrospinal fluid
5. Is travelling to the arachnoid granulation or villi to be pulled out into the veinous
system where then it can be closed away
Spinal Cord (unidirectional)
General Structures
The outer surface of the cord has 2 depressions: the anterior (insertions in front and back) and
posterior median fissures (central canal in between to help bring the cerebrospinal fluid
throughout the body)
The bottom of the cord is located at about the level of the 2nd Lumbar vertebra and is termed the
Conus Medullaris (the end of the solid spinal cord).
The cord is covered by the continuation of the same 3 meningeal layers that covered the brain.

The continuation of the Pia Mater from the Conus Medullaris to the Sacrum/Coccyx is termed
the Filum Terminale.
The Central Canal of the cord is the continuation in the spinal cord of the 4th Ventricle of the
brain
Internal Structures
-

The white matter make up the most of the cord (sensor in the back coming in and motor
in front coming out)
Gray Matter the Gray Matter of the spinal cord is located centrally. The gray matter can be
divided into the following parts:
- Posterior (Dorsal) Horn (unmyelinated axons sensory stuff) the posterior horn
contains the axons of sensory neurons (both Somatic Afferents and Visceral-Sympathetic
Afferents) bringing sensory information to the posterior of the spinal cord
- Anterior (Ventral) Horn (cell bodies of somatic motor neurons) the anterior horn
contains the cell bodies of Somatic Efferent (somatic motor neurons) neurons as they take
motor information away from the anterior of the cord
- Lateral Horn (on the side) the lateral horn in the region of T1-L2 contains sympathetic
(motor) neuron cell bodies. In the region of S1-S4 the lateral horn contains cell bodies of
parasympathetic neurons.
- Gray Commissural (in the middle) neurons are unmyelinated neurons that join the right
and left halves of the cord.
- Interneurons join the posterior horn with the anterior horn (decision making processing;
interneurons connects to the cell bodies so that the motor signal can go out)
- Sensory in posterior of the cord and motor in the anterior
- Messages come from the back (sensory) and come out in front (motor)
- Cervical (upper limb supply) enlargement (thicker to support the nerves) and lumbosacral
enlargement (lower limb supply) huge chunk of nerves come off
- Anterior/posterior median fissures
- At level of L2 comes medullaris the end of the solid spinal cord
- Cauda equine the point where the spinal nerves are gathered and spread out
- Extension of Pia Mater and it is anchoring the spinal cord to the coccyx terminal filum
made of Pia Mater
- Somatic is body and visceral are organs
- Afferent sensory and efferent is motor
- Motor neurons of the Autonomic Nervous System
- Sensory cell bodies: somatic and visceral
- Autonomic Nervous System: sympathetic and parasympathetic
White Matter the white matter of the cord is external to the gray matter.

This area is made up of the myelinated axons of neurons taking sensory information up the cord
and motor information down the cord. Although not totally correct, the posterior half of the cord
is made up of mainly sensory axons and the anterior half of the white matter of the cord is made
up of motor axons.
Spinal Nerves
There are in total 31 pairs of the spinal nerves. A spinal nerve has the following structures:
- Dorsal root (at the back of the spinal cord) the Dorsal Root of a spinal nerve is the
Afferent (both somatic and visceral sympathetic) axons, bringing sensory information
into the posterior of the spinal cord
- Dorsal Root Ganglion (the spread of small roots like fingers; posterior; leading from the
dorsal root into posterior horn somatic and visceral) - contain the cell bodies of the
afferent nerves (both Somatic and Visceral-Sympathetic) connection between peripheral
and central nervous system
- Ventral Root (motor axons are within them) the ventral root of a spinal nerve contains
the Efferent axons (both Somatic and Visceral motor axons, in the T1 L2 sympathetic
and the S2 S4 parasympathetic) taking information away from the cord
- Posterior Ramus the Posterior Ramus of a spinal nerve is the distribution of both the
afferent and efferent functions of the nerve to the posterior of the body
- Anterior Ramus the Anterior ramus of a spinal nerve is the larger of the distribution of
both the afferent and the efferent functions of the nerve to the anterior/lateral parts of the
trunk; they form the nerve plexi that supply the upper and lower extremities
- All the axons are in the spinal nerve in the same tunnel sharing it not connecting with
each other
- Spinal nerve then splits into posterior and anterior ramus have sensory and motor
neurons sharing the pathway
- Posterior path of the signal: sensory signal comes into dorsal root ganglion (all sensory
cell body) dorsal root/posterior root divides into posterior (dorsal) rootlets Comes in
the spinal root synapses with the cell bodies at the dorsal rootlets up through into
the posterior horn (sensory axons) processing and passing on of information (synapses
through the interneurons to the other cell bodies somatic motor cell bodies and
visceral) passing the signal to the anterior lateral horn that are efferent (motor) and their
axons are exiting through ventral (anterior) rootlets combine to form ventral (anterior)
root join to make the spinal nerve splits into posterior and anterior ramus (have
sensory and motor cell bodies)
- Dorsal or posterior has sensory axons
- Anterior or ventral has somatic (motor) axons
- Synapses passes on the signal
Spinal Nerve Plexi

There are 4 major nerve plexi:

1. Cervical (the neck and stuff around the tongue and the larinx and stuff like that) a
network of nerves that is formed by spinal nerves C1- C4 (anterior rami or ramus; 8
cervical nerves; 1 goes above the vertebra.
- The sensory and motor functions of this plexus are associated with the neck region.
The Phrenic Nerve (roots are anterior ramus C3- C5 keeps the diaphragm alive)
coming off the spinal cord in this region innervates the Diaphragm.
2. Brachial (anterior rami or ramus) a network of nerves that is formed by spinal nerves
C5-T1. Supplies upper limb and parts of the thoracic region.
- The nerves from this plexus serve both sensory and motor for the upper extremity.
- 3 of the largest nerves form the Brachial plexus are: Median, Ulnar and Radial.
Median a nerve that innervates the wrist and finger flexor muscles (supplies wrist
and finger flexers anterior)
Ulnar (in between electranon and the medial epicondyle; starts and ends in the
hand; intrinsic hand muscles; on the posterior side of the elbow the funny bone
tingling is the ulnar nerve)
Radial a nerve that innervates the muscles on the back of the arm and wrist/finger
extensor muscles (behind the ulnar, behind the arm (posterior) supplies triceps
brachii and extensors (wrist and fingers)
- RTDCB Randy Travis drinks cold beer the order of things: Roots, Trunks,
divisions, cords and branches
Thoracic Nerves nerves that come off the spinal cord in the thoracic region dont form a
plexus, but instead individually come off and pass between each rib
3. Lumbar (contributes to lower extremity; very thin) a network of nerves that is formed
by spinal nerves L1-L4.
- The Femoral (straight down the front of the leg quadriceps) nerve is a large nerve
from this plexus. The femoral nerve innervates the Quadricep muscle group.
- The Obturator nerve from this plexus innervates the Adductor (middle of the leg and
supply adductors) muscle group.
4. Sacral a network of nerves that is formed by spinal nerves L4-S4
- The Sciatic (out from muscles in the gluteal muscle and supplies ham strings; huge 2
fingers size) nerve from this plexus travels down the posterior of the leg and
innervates the Hamstring muscle group. Just above the knee this nerve splits (no
official location for the split) into its 2 parts: Common Peroneal (fibular) and Tibial
- The Common Peroneal (Fibular) nerve which supplies the lateral side of the leg
- Tibial nerve which eventually supplies all muscles on the anterior and posterior of the
leg as well as all the intrinsic muscles of the foot
- Musculocutaneous nerve supplies muscles of the anterior upper arm (M shaped
connections) then becomes cutaneous in the forearm (supplies skin)
- Nerves squashy and flat

Arteries are round and thick to feel

Posterior Rami supply muscles at the back and anterior Ramus supply the front
muscles
Axillary artery huge artery that supplies the arm; like the nerves but in real life it is
solid because arteries have muscular walls while nerves are flimsy, squashy and flat
Autonomic Nervous System

The autonomic nervous system is a part of the nervous system that is responsible for:
- Picking up Visceral Sensory (Afferent) information
- Controlling Glands, Cardiac Muscle and Smooth Muscle (Visceral Motor Efferent)
This system is made up of 2 divisions: Parasympathetic and Sympathetic
-

Parsympathetic - the Parasympathetic division of the autonomic system is said to be

responsible for the Rest and Digest activities of the body. That is for example
parasympathetic to the heart would slow the heart rate down, parasympathetic to the
smooth muscle that lines the digestive system is responsible for contracting GI
muscle and opening and closing sphincters to move material along the digestive
system.
This system exits from the Central Nervous System in the Cranial and Sacral regions.
It should be remembered that there are no parts of the Parasympathetic system found
in the body walls or limbs. That is, the parasympathetic will not innervate structures
like the smooth muscle in blood vessels or sweat glands; this is the job of the
Sympathetic division.
Cranial nerves (come right of the brain) cranial nerves 3, 7, 9 and 10 (vagus nerve)
have as a part of their responsibility parasympathetic functions
Cranial nerve 10 (vagus; rest and digest stuff) is the most wide spread nerve of the 4
The Vagus nerve innervates parasympathetically all the organs in the thorax, and all
the organs in the abdomen up to the splenic flexure of the large intestine.
Parasympathetic afferent (sensory) responsibility is also incorporated in the same
cranial nerves
Sacral parasympathetic efferents exiting the spinal cord in the region where the
sacral nerves leave the cord (S2-S4 spinal nerves) supplies parasympathetic efferents
(motor) for the viscera located in the floor of the pelvis. That would include the last
part of the large intestine, the urinary bladder and most of the reproductive organs.
Somatic (non-internal organs) motor signal anterior horn cell body (motor)
muscle (effector organ)
Visceral coming from lateral horn exiting through the front
Autonomic ganglion are set of ganglia that are just for autonomic nervous system
(sympathetic or parasympathetic signals coming through)
Autonomic: preganglionic neuron at the autonomic ganglia synapses with another
neuron that becomes post ganglionic neuron 2 neurons involved in the signal

Autonomic: comes up from the organ or such through the spinal nerve back in the
same way as the somatic but it is coming into the lateral horn out the front white
ramus autonomic ganglion synapses with post ganglionic neuron and sends the
signal out

The Parasympathetic nerves exit the spinal cord out the ventral root and leave the ventral root to
accompany or catch a ride on arteries that go to organs in the floor of the pelvis. These same
nerves also carry visceral afferent (sensory) information back to the spinal cord through the
dorsal root of the spinal nerve.
Sympathetic the sympathetic division of the autonomic system is said to be responsible for the
Fight or Flight response
The cell bodies of nerves in the sympathetic system are restricted to the thoracic and upper
lumbar region of the spinal cord. (Recall the description of the spinal cord the lateral horn
located in the thoracolumbar region of the cord this is where the cell bodies of the sympathetic
nerves are located.) That means that sympathetic nerves can only exit from the spinal cord via
the ventral root of spinal nerves in the thoracolumbar region (T1-L2 sympathetic signal area).
Other sympathetic nerve cell bodies are located outside the spinal cord. These cell bodies are
termed Paravertebral Ganglia paravertebral because they are located against the bodies of the
vertebrae (para is Greek for at, or to one side of). These cell bodies are connected to each other
and stretch from the level of the 1st cervical vertebra to the sacrum where the right and left
Sympathetic chains (signals can travel up and down the chains; or sympathetic trunk outside the
vertebral bones, there is a chain on each side; they are ganglia that are attached to each other by
nervous tissue) unite in 1 ganglia termed Ganglia Impar (at the bottom where the chains
connect).
Sympathetic Pathways: Spinal Nerves (more blood, more oxygen comes in faster) the diagram
is on page 134 of the course kit
1. In the thoracolumbar region of the spinal cord the sympathetic nerves exit from the lateral
horn of the gray matter via the Ventral Root of the spinal nerve. The sympathetic travel
for a short distance in the spinal nerve, then leave the spinal nerve forming a myelinated
bundle termed the White Ramus. Nerves in the white ramus travel to the nearest
Paravertebral Ganglia and make a connection (synapse at the sympathetic ganglia). The
post ganglionic nerve then travels back to the spinal nerve by what is termed the Gray
Ramus (gray because it is not myelinated).
As mentioned above, because the sympathetic cell bodies are only found in the
thoracolumbar region of the spinal cord and therefore sympathetic nerves can only exit
from the spinal cord in this region, this area will be the only region where you will have
White Rami.

2. Spinal nerves coming off the spinal cord in the regions either above T1 (C1-C8) or below

L2 (L3-S5) need also to have as part of their make up sympathetic nerves. Sympathetic
nerves to these spinal nerves must exit the spinal cord in the thoracolumbar region, just
like in #1, and must leave the spinal nerve by means of the white ramus (same ones that
are used in #1) then instead of synapsing at the thoracolumbar level, the preganglionic
nerves travel either up or down the sympathetic chain, reach the ganglia at the proper
level and synapse. After synapsing the postganglionic nerves will join the spinal nerve at
that level by means of a Gray Ramus. That means that White Rami are restricted to the
thoracolumbar region, but Gray Rami are found at all levels.
- Parasympathetic are very internal
- Sweat glands and blood vessels are sympathetic only; superficial blood vessels are the
exceptions
- The example with the ramp: sensing it (ramp) at the white ramus communication and
then from here it off shoots from the spinal nerve to get to the autonomic ganglia
- Celiac Ganglia one of the Prevertebral Ganglia
- Post Ganglionic Fiber in Cadiac Nerves Sympathetic to heart
- Splanchnic general name of nerves carrying motor to and sensory from abdominal
organs
As an example: the sympathetic to reach the first cervical spinal nerve would come off the spinal
cord at the level of Thoracic spinal nerve 1, leave thoracic nerve 1 via the white ramus associated
with T1, travel up the sympathetic chain until it got to the level of C1, synapse with the ganglia
at the level of C1, then join C1 via the Gray Ramus of C1.
The same in reverse would occur with the sympathetic to go to Sacral spinal nerve 4 for example
except the sympathetic now would come off the spinal cord in spinal nerve L2, use the White
Ramus of L2 to travel to the sympathetic chain, travel down the chain to reach the level of S4
spinal nerve, synapse in the ganglia at that level and use the Gray Ramus of S4 to join spinal
nerve S4.
3. Sympathetic nerves must reach the head. For the most part there are no spinal nerves that
service the head region very well (both inside and outside the cranial cavity). To get
sympathetic to the head region sympathetic must take this route.
Sympathetic will come off the spinal cord in the upper thoracic region (same as in #1),
will leave the upper thoracic spinal nerve via its white ramus, travel up the sympathetic
chain, reach 1 of the top 2 or 3 ganglia in the chain and synapse. Since there are no spinal
nerves going to the head, these postganglionic nerves will leave the ganglion and now
catch a ride on 1 of the major arteries going to the head (Common Carotid, Internal
Carotid, External Carotid or Vertebral). These nerves would be the same as nerves found
in a gray ramus.

Nerves take routes 1, 2 and 3 provide (for the most part) sympathetic that control
1. Vasoconstriction of arteries
2. Control of sweat glands
3. Control of smooth muscle of body hair (like the hair on your forearm or the back of
your neck).
Sympathetic Pathways: Thoracic Organs
Sympathetic nerves must reach organs in the thorax. Once again there are no spinal nerves that
service the organs in the thorax. To get sympathetic to the thoracic region sympathetic must take
this route.
Sympathetic will come of the spinal cord in the thoracic region, will leave the thoracic nerves via
each nerves white ramus, travel up or down slightly in the sympathetic chain, reach the proper
level and synapse in the proper level ganglion, then leave the ganglion to service the thoracic
organs (eg. Heart, lungs, bronchii). These nerves would be the same as nerves found in a gray
ramus.
-

White ramus is for the signal that needs to get to the trunk T1-L2
Can go up or down and only then synapse
Thoracic region and abdominal region different set up
Thoracic region (path) spinal nerve exit at the white ramus synapse with
postganglionic neuron and leave from here (from sympathetic trunk straight to the
heart (heart is an effector ) does not go back to the spinal nerve because it has to
create its own path does not have any sensory components (it is all motor) does not
have somatic (only sympathetic identical to gray rami)
Cardiac plexus is separate (no need to know in depth)

Sympathetic Pathways: Abdominal Organs

Sympathetic nerves must reach organs in the abdominal cavity. Once again there are no spinal
nerves that service the abdominal organs. To get sympathetic to the abdominal organs
sympathetic must take this route.
Sympathetic once again will come off the spinal cord in the thoracolumbar region, use the white
rami of these spinal nerves to leave the spinal nerves, travel to the paravertebral ganglion chain,
but instead of making a connection in this set of ganglia, the preganglionic now pass through the
paravertebral ganglion and head for a set of sympathetic ganglia positioned around the 3 major
arteries that supply the abdominal organs (Celiac Trunk, Superior Mesenteric Artery, Inferior
Mesenteric Artery). These ganglia are termed Prevertebral or Collateral Ganglia. Once a
connection is made with one of these ganglia, the postganglionic nerves travel with or catch a
ride with the major arteries going to the abdominal organs. These nerves would be the same as
those found in the Gray Ramus. For example off the Celiac trunk is an artery that goes to the
Spleen. Travelling on the outside surface of the Splenic Artery you would find postganglionic

sympathetic nerves. Because so many nerves branch or radiate out from the Celiac Ganglia
(located just above the stomach) early anatomist termed this area as the Solar Plexus, the nerves
looking like the rays of the sun.
Abdominal: 1. Sympathetic signal comes out the spinal nerve gets to the white ramus no
synapse in the sympathetic chain paravertebral ganglia (right next to the vertebral column and
they make the sympathetic chains) autonomic system ganglia are further away closer to the
organs versus the vertebral column those are prevertebral ganglia (sometimes they can be
found inside the organs) 2. The signal exits and goes to the prevertebral ganglia closer or at the
effector organ 3. Then synapses with the postganglionic neuron (which is a lot shorter) 4. Then
goes to the effector (can travel up or down the chain before the synapse)
Circulatory System
Functions
The circulatory system (CO2, hormones, drugs if you have any in the system, etc.): the heart and
blood vessels supply nutrients and oxygen to cells. This is transport function (and waste removal
by bringing out of the system CO2, etc.)
The system is responsible for the remove of wastes generated by cells; the best example of this is
the carbon dioxide generated by cells, which has to be removed and eliminated.
The circulatory system vessels, by constricting (thinner) and dilating (wider) can shunt blood
around the body. If the body has to lose heat the vessels under the skin will dilate, this will
increase blood flow and bring heat to the surface where it can be released. If the body needs to
conserve heat the vessels in the core of the body will dilate and blood will be shunted to the core
to maintain body heat.
Blood and the circulatory system carry hormones that endocrine glands release. The system also
carries drugs that have been ingested.
Blood and the circulatory system (keeping the balance of the cells) assist in the maintenance of
proper fluid balances. There is a constant exchange of fluid between blood plasma and
intersititial fluid.
Heart
Location: the heart is located in an area of the thorax termed the Mediastinum.
Pericardial Sac the heart is encased in a double layered membrane (white layer).
- The outer layer of the sac is termed (1st) Parietal Pericardium. This layer is made of 2
layers, an outer Fibrous (thick, solid and physically protective) layer and an inner
Serous (secretes fluid) layer

The second layer of the double layer sac is termed the (2nd) Visceral Pericardium
(closer to the organ the heart; visceral serous pericardium). The inner layer is also a
serous membrane layer. The visceral pericardium is also termed the Epicardium. The
space between the serous parietal layer and the visceral layer (serous) is termed the
Pericardial Cavity.

Myocardium (myo is myscle; cardium is heart; will be sending blood out when contracting; the
actual muscle of the walls of the chambers) the myocardium is the actual heart muscle (deep to
the visceral pericardium; made of cardiac muscle)
Endocardium the endocardium is the epithelial layer (thin cell layer) that lines the inside of the
4 chambers of the heart, and lines the vessels that take blood away from the heart (Arteries) and
the vessels that bring blood to the heart (Veins).
Interstetual fluid fluid surrounding the cells
-

Blood vessels will constrict or dilate depending on where you need a lot or a little of
blood
Examples: you can have GI tract related issues if you eat a big meal and exercise right
after because blood has to go to GI tract to help move all of the stuff through but
instead it may go to your legs or hands ( depending on the exercise at the time)
Heart is at the mediastinum (between the lungs) and mediastinum is above the
diaphragm
Right side of the heart has deoxygenated blood

Heart Structure the heart is composed of 4 chambers: Right Atrium, Right Ventricle, Left
Atrium and Left Ventricle
Blood Circulation in the Heart
Venous blood is brought back to the Right Atrium by means of the Superior and Inferior Vena
Cava. The venous blood then flows down into the Right Ventricle. From the Right Ventricle the
blood is pumped out the Pulmonary Artery to the lungs for oxygenation. The oxygenated blood
from the lungs is brought back to the Left Atrium by the Pulmonary Veins. The blood from the
Left Atrium flows into the Left Ventricle. The Left Ventricle contacts and pumps the oxygenated
blood out the Aorta.
Heart Chambers
Right Atrium the right atrium has the following structure associated with it:
- Superiror Vena Cava this large vein is the final vein in a system that brings venous
blood from areas above the heart and the upper extremity back to the right atrium.

Inferior Vena Cava this large vein is the final vein in a system that brings most of
the venous blood from areas below the heart to the right atrium
Cardiac Blood Supply the heart has its own circulatory system
The myocardium is supplied with arterial blood by the Right (supply oxygenated
blood to the heart itself) and Left Coronary Arteries 2 arteries that come off the
aorta as the aorta leaves the left ventricle.
The coronary veins responsible for bringing venous blood back to the heart empty
into a collecting vein located on the posterior surface of the heart termed the
Coronary Sinus. The opening for the Coronary Sinus (huge blood vein; major venus
sight; drains into the right atrium the deoxygenated blood) is located in the Right
Atrium.

Atrial Septum the top right chamber the right atrium is separated from the left
atrium by a wall termed septum. Located in this septum is a depression termed the
Fossa Ovale. This depression is a remnant of fetal circulation.
Deoxygenated blood flows into the right atrium then into right ventricle
Deoxygenated blood is coming back from the tissues, back from the body, muscles,
etc. through superior vena cava and inferior vena cava drains into the right
atrium flows through valve (tricuspid or right atrioventricular valve) into the right
ventricle leave through left and right pulmonary arteries (pulmonary means lungs
so headed for the lungs) to the lung get the blood and come back through the
pulmonary veins (left and right) drain into the left atrium through the valve into
the left ventricle that ventricle pumps oxygenated blood now to the body through
the aorta
Interatrial septum: is the wall inside the right atrium between 2 atrias; also there is
one in the ventricles
Fossa Ovale thumb print looking thing should be closed in adults
In fetus there is a hole between 2 atrias because the oxygenated blood is gathered
from mothers heart

Right Ventricle the right ventricle has the following structures associated with it:
- Right Atrioventricular [AV] (Tricuspid) Valve (this is how we are getting blood into
the right ventricle) this 3 cusp valve has the superior edge of the valve cusps
attached around the circumference of the opening between the atrium and ventricle
- The inferior edge of the valve cusps attached to them strands of collagen fibres
termed Chordae Tendineae. The Chordae Tendineae (responsible for holding the
valves sheet: attaching the cusps of the valve to the papillary muscles) are attached at
their inferior end to cone shaped muscular projections from the wall of the ventricle
termed Papillary Muscles (attach to the cardiac muscles of the wall; assist Chordae

Tendineae to hold valves shut). Both ventricles have Chordae Tendineae and Papillary
Muscles.
When the right ventricle contracts to push blood out the Pulmonary Artery to the
lungs, the increased pressure of the blood moves the cusps of the valve so that the
valve blocks the opening back into the atrium
At the same time as myocardium of the ventricle is stimulated to contract, the
papillary muscle is also stimulated to contract. The tension on the chordate tendineae
caused by the papillary muscle contraction prevents the valve cusps from everting
back up into the atrium (like an umbrella goes the wrong way in the wind).
-

Pulmonary Artery the Pulmonary Artery is the vessel that takes the venous blood
from the right ventricle to the lungs.
The Pulmonary Semilunar Valve (blood will push them open and will go to the
pulmonary arteries) is a 3 cusp valve that is located at the base of the pulmonary
artery (closed because the cusps get filled with blood)
This valve has 3 half moon shaped cusps that attach around the circumference of the
pulmonary artery. When the blood flows up the Pulmonary artery out of the ventricle,
the cusps of this valve are pushed against the wall of the artery. When the ventricle
relaxes and the pressure decreases, blood will fill the cusps of the valve, and thus seal
off the opening back into the ventricle.

Interventricular Septum the right ventricle is separated from the left ventricle by the
interventricular septum
Heart: arteries away leaving the heart; arteries have oxygenated blood, exception
pulmonary artery
Atrioventricular valves and semiunar valves
AV valves go from atrium to ventricle and attach to the chordate tendineae and the
papillary muscles; papillary muscles are not responsible for closing or opening the
valve
Right atrium right ventricle 3 cusps valve
Right atrium is closed between atrium and the ventricle as the atria fills with blood
getting deoxygenated blood from SVC and IVC gets that full of blood the
pressure of the blood in there pushes the valve open blood comes through so the
atrium is empty ventricles start filling with blood blood in the ventricle pushes
on the valve and pushes from below it shut
We cannot has this push so much that it opens the other way will have aback flow
of blood and the system is shut to prevent that we have chordate tendineae and
papillary muscles
Pulmonary veins are coming back with oxygenated blood to the left atrium

Left Atrium (more posterior) the left atrium receives the oxygenated blood that comes back
from the lungs via the Pulmonary Veins.
Left Ventricle (big and thick muscles of the ventricles; pushes to the whole body) the left
ventricle has the following structures:
- Left Atrioventricular [AV] (Bicuspid) Valve (only valve that has 2 cuspids) this
valve has the same construction as the right AV valve except that this 1 is composed
of only 2 cusps. All the other construction and workings of this valve are the same as
described for the right AV valve. Blood from the left ventricle will be pumped out of
the Aorta.
Aorta the Aortic Semilunar Valves (goes to the body the blood with oxygen, nutrients, etc.) are
located at the base of the Aorta as the aorta leaves the Left Ventricle. The design and functioning
of these valves is identical to that of the Pulmonary Semilunar Valves.
- When the left ventricle relaxes and the pressure decreases, blood will start to flow
back to the ventricle in the aorta. The aortic semilunar valves will fill with that blood,
the valve will close and blood will be prevented from going back into the ventricle.
- When blood is passing from the left ventricle out the aorta the aortic semilunar valves
are pressed against the wall of the aorta, and by their positioning cover over the
openings to the right and left coronary arteries.
- When the left ventricle relaxes and the blood flows back, the valves are filled with
blood; it is this blood that the coronary arteries use to supply the heart.
Heart Surface Markings the heart as on its outside surface the following landmarks:
- Base the base is the superior border (posterior; where all the vessels are)
- Apex the apex is the inferior pointed end (mostly left ventricle)
- Coronary Sulcus the coronary Sulcus is an external groove around the heart that
marks the division between the 2 atria and the 2 ventricles. The Coronary Sinus
(posterior surface) is located in the Coronary Sulcus.
- Anterior and Posterior Interventricular Sulci (sulcus made of several veins) these
2 external grooves mark the location of the interventricular septum.
- Aorta is getting the blood from the left ventricle with strong contraction at the
beginning of aorta left and right coronary arteries come off and leave the heart
when left ventricle gets full of blood it contracts and pushes the aortic semilunar
valve open and the cusps cover up the openings to the coronary arteries blood
cannot get to them now back flow fills up the cusps and goes to the coronary
arteries (a lot of blood goes into aorta that is thick and very little back flow goes to
the coronary arteries that now can handle it; not overloaded due to that)
- Right ventricle takes a lot of the anterior surface of heart
- Auricle of left or right atrium (mostly posterior left atrium) flap that comes of each
atria and helps cover up coronary arteries to keep them safe and protected

Coronary Arteries (outside) right coming off the aorta down the right side
between the atria and ventricle the same on the left side

Excitability of the Heart the following are the structures associated with the electrical
conductive pathway through the heart muscle:
- Sinoatrial Node (SA Node) (made of modified cardiac muscle have sympathetic
neuronal signals, has nervous tissue) the Sinoatrial node is the pacemaker for the
heart
- This structure of modified cardiac muscle located at the junction of the Superior
Vena Cava and the right atrium, has the ability to generate an electrical signal about
70 times (the number of nodes sent per minute) per minute; hence the pacemaker
function (sends signals so both atria contract, which sends blood down to ventricles)
- This node also has the autonomic nerves (both sympathetic, to speed the heart up, and
parasympathetic via the Vagus nerve to slow the heart down) synapsing within it
- Atrioventricular Node (AV Node) ( the signal travels toward the interventricular
septum towards the interventricular bundle) the AV node is modified cardiac muscle
located at the floor of the right atrium (takes the signal down to the ventricles)
- Once the electrical signal has passed from the SA node and caused the right and left
atria to contract the signal is then picked up by the AV node
- Interventricular Bundle (Bundle of His) between ventricles; splits so the signal can
go to each ventricle this is the part of the conducting pathway that takes the
electrical signal from the AV node down the interventricular septum to the apex of the
heart toward atrioventricular bundle
- Punkje Fibres (loop around ventricles and ventricles contract; picks up signal from
the Bundle fibers; deposit the signal into the ventricles to contract) these fibers
course through the muscle of the ventricle and conduct the electrical signal to the
myocardium of the ventricle. Purkinje fibers (run parallel to the papillary muscle)
also run to the papillary muscle on the inside of the ventricle
Blood Vessels
Arteries arteries are constructed of 3 layers or coats (tunics):
- Tunica Intima (most internal: intimate with the inside of the vessel in veins very thin)
this is the inner layer of the vessel made up of simple squamous epithelial with
areola connective tissue. At the capillary (need very thin walls; gas exchange take
place between cells and the circulatory system) level of the vessel only the epithelial
layer with basement membrane (stuff has to cross the walls) is present
- Tunica Media (thick in arteries) this is the middle, smooth muscle layer. Contraction
of the smooth muscle via stimulation of sympathetic nerves causes vasoconstriction
(arteries only when less of blood required) reducing the size of the vessel. When the
sympathetic is not stimulated the vessel relaxes or dilates (vasodilation absence of
the signal). This layer is the thickest of the 3 in the arteries.

Tunica Externa (furthest out) this layer is the out areolar connective tissue layer.
This connective tissue (protective) helps to anchor the artery to the other structures
(the vessel). (Thicker on the veins than on the arteries.)
Endocardium lines the heart, arteries and veins, except for capillaries
Blood flow deoxygenated blood coming from superior vena cava, inferior vena
cava andcoronary sinus (from heart to the heart) to the right atrium tricuspid valve
right ventricle pulmonary arteries to the lungs (to get oxygen) pulmonary
veins bring blood back to the left atrium bicuspid valve left atrium sends
blood through aortic semilunar valve out through the aorta to the body
capillaries dump oxygen and back to the beginning
Control of the heart beat SA node (depolarization) atrium contracts AV node
at slower rate allows for complete emptying of the atrium action potential goes
to the bundle of his that is located in the interventricular septum purkinje fibres

Aterioles are smaller diameter arteries. They have a Media layer and can vosaconstrict and
vasodilate.
Capillaries are the smallest and thinnest of the vessels.
- Capillaries consist of only the Intima layer of epithelial cells with a basement
membrane. It is at the capillary level that exchange occurs between the vascular
system and the interstitial fluid around cells.
Venules are small diameter vessels that take venous blood away from the capillaries.
Veins generally veins have the same 3 layers as arteries except veins have a relatively thicker
External layer.
- Veins rely on a couple of mechanisms to help return venous blood to the heart.
Veins have 1 way valves (similar to semilunar valves in the heart) that prevent blood
from back-flowing and pooling and thereby assist the return of blood to the heart.
Veins rely in part on the massaging action of muscles to help propel blood back to the
heart (when muscles contract or move pushes on the vein and constricts the vein
pushing blood back to the heart can see this during exercise)
Arteries Upper Torso and Limbs
Aorta: Arterial blood out of the Left Ventricle passes in the aorta. The following are the arteries
that come off the aorta when tracking the aortic arch from right to left:
- Right and Left Coronary Arteries these arteries come off the aorta almost as soon as
the aorta leaves the left ventricle. These arteries supply the heart muscle.
- Barachiocephalic Artery (brachio means arm) the brachoicephalic artery comes off
the arch of the aorta. It bifurcates into the Right Common Carotid Artery and the
Right Subclavian Artery

Left Common Carotid Artery this artery comes off the arch of the aorta immediately
after the Brachiocephalic Artery
Left Subclavian Artery this artery comes off the arch of the aorta immediately after
the Left Common Carotid Artery
Common Carotid Artery (Right and Left) the common carotid arteries course up the
side of the neck. At about the level of the top of the thyroid cartilage of the larynx the
common carotid artery bifurcates into the Internal Carotid (inside the skull) and the
External Carotid Arteries (to the skull; external to the skull)
Away from the heart: large elastic arteries like aorta takes all the blood that is
required muscular arteries branch (arterioles) smaller because branched a lot
capillaries (have very thin walls for gas exchange and other) venuoles join
to make bigger veins bigger veins like superior vena cava and inferior vena cava
and back to the heart we go
All have the same layers
Ascending aorta (when it goes up) arching aorta (loops back to go behind the
heart) descending aorta (leads down)
Abdominal Cavity the abdominal aorta (the location of the aorta)
Arching aorta branches of brachiocephalic artery or trunk splits into right
subclavian (heads toward the right arm) and right common carotid artery (heads
towards the skull up the neck)
Other side: 1. Left common carotid artery 2. Left subclavian artery
If problem in the heart it is more noticeable on the left side

Internal Carotid Artery (Right and Left) the internal carotid artery travels up until it reaches the
base of the skull. This artery enters the cranial cavity through an opening in the base of the skull.
External Carotid Artery (Right and Left) the external carotid artery as the name implies, stays
on the outer surface of the face and skull. At about the level of ramus of the mandible this artery
divides into the Superficial Temporal Artery (heads superior toward temporal region) and the
Maxillary Artery (anteriorly heads towards maxilla)
Subclavian Artery (Right and Left) the subclavian artery passes under the clavicle (deep to it)
and over the 1st rib (superficial to it). In this area it gives off a number of branches including the:
- Vertebral Artery the vertebral artery passes in the transverse foramina of the
cervical vertebra to reach the foramen magnum. The vertebral artery (1 on each side;
goes inside the skull and contributes to blood supply of the brain) then enters the
cranial cavity through the foramen magnum.
After the Subclavian artery passes under the clavicle and over the 1st rib the artery changes its
name and is termed the Axillary Artery (same artery, different name because it is now travelling
in the arm pit or axillary region).

Axillary (Right and Left) under pectoralis minor the axillary artery is the
continuation of the subclavian artery. In this region a number of branches come off
the axillary:
The Lateral Thoracic Artery (dumps blood on everything it passes) supplies the
front of the thorax

The Subscapular Artery supplies the posterior surface of the scapula.

Brachial (Right and Left) once the axillary artery passes the level on the humerus
where the Teres Major (bottom of it) muscle inserts, the continuation of the artery is
termed the Brachial Artery (ends at the radial tuberosity).
The Deep Brachial Artery (or Brachial Profundus Artery)is a major branch coming off
the Brachial.
The Deep Brachial passes behind the humerus.
Once the Brachial Artery reaches about the level of the Radial Tuberosity the artery
bifurcates into the Radial Artery and Ulnar Artery (run by radian and ulna)
Radial (Right and Left) the Radial Artery passes down the radial or lateral side of
the forearm. At the level of the wrist this arter becomes very superficial (an easy place
to feel a pulse). A the wrist the Radial Artery divides into a Superficial branch and a
Deep Branch.
Ulnar (Right and left) the Ulnar Artery is the largest of the divisions. It passes under
the Flexor Carpi Ulnaris muscle. It too, at the wrist, divides into Superficial and Deep
branches.
Superficial Palmar Arch (Right and Left) the Superficial Palmar Arch is an arterial
loop created mostly by the Superficial branch of the Ulnar Artery. A little contribution
to the loop comes from the Superficial branch of the Radial Artery. The arch is termed
superficial because it lies superficial to the long tendons that pass through the palm of
the hand.
Deep palmar arch (Right and Left) the Deep Palmar Arch is a loop of artery mainly
made up of the deep branch of the Radial artery. The deep branch of the Ulnar artery
comes across and completes the loop. This arch is located deep to the long tendons in
the palm of the hand.
Digital Branches (Right and Left) supply digits digital branches radiate from the
Superficial and Deep Palmar Arches.

Arrteries in the Thorax

As the Aorta passes through the thorax it gives off branches that supply organs in the thorax;
these branches could be classified as Visceral type branches. An example of a Visceral artery
would be the ones to the Esophagus or Bronchi. While in the thorax the aorta also gives off
branches that supply muscles. These arteries could be classified as Parietal type branches. AN
example of parietal branches would include the arteries that go between your ribs: the
intercostals arteries to the intercostals muscles.
Arteries in the Abdomen
These arteries can be classified as either Visceral (organs internal) or Parietal (muscles
further away from the center intercostals muscles, etc.).
- Visceral arteries come off the Aorta in the abdomen and supply the organs in the
abdomen. There are 3 major arteries or trunks that supply the abdominal organs:

Celiac Trunk superior to the stomach positioned just above the stomach.
Superior Mesenteric Artery (behind stomach; comes off the abdominal aorta; 2 or 3
fingers below ciliac trunk) positioned just below the stomach
Inferior Mesenteric Artery below superior mesenteric artery positioned just above
the divide of the aorta
Abdominal Aorta: under small intestine, liver and stomach: celiac trunk, superior
mesenteric artery and the inferior mesenteric artery
Parietal type arteries off the aorta in the abdomen would supply muscle. The aorta for
example gives off 4 pairs of lumbar arteries to supply the lower back muscles.

Arteries Lower Extremity

The abdominal aorta at about the level of the 4th lumbar vertebra bifurcates (divides into 2) into
the Right and Left Common Iliac Arteries (by the ilium L4).Each Common Iliac Artery divides
into an Internal Iliac (within pelvis; branches supply organs in the pelvis; bladder + reproductive
organs) and External Iliac Artery (heads toward the legs; when passes the inguinal ligament it is
called femoral artery)
- Internal Iliac Artery (Right and Left) the internal Iliac Artery, as the name implies,
mainly give off arteries that stay in the pelvic region and supply the organs that are
positioned in the floor of the pelvis; i.e. the urinary bladder and internal reproductive
organs.
- External Iliac (Right and Left) The External Iliac Artery passes under the Inguinal
Ligament. After passing this structure the artery is then termed the Femoral Artery
(main blood supply to the lower limb).
Femoral Artery (Right and Left) the Femoral Artery passes down the medial side of
the thigh.

Just after passing under the Inguinal Ligament the Femoral artery gives off a deep
branch that passes behind the femur. This branch is termed the Deep Femoral Artery
(or deep profundus artery).
After the femoral artery passes through an opening in the Adductor Magnus muscle
(the opening is called adductor heatus to the back of the knee and becomes
Popliteal), just above the medial part of the knee, and goes behind the knee it is then
termed the Popliteal Artery.
Popliteal (Right and Left) Artery this is the continuation of the femoral artery
behind the knee. This artery gives off branches to supply the knee. Once this artery
descends to the level of the bottom edge of the Popliteus muscle it divides (bifurcates)
into the Anterior Tibial Artery (in front of the leg and becomes Dorsalis Pedis Artery)
and the Posterior Tibial Artery.

Anterior Tibial Artery (Right and Left) this artery passes over the edge of the
interosseous membrane and passes down the anterior of the leg. When this artery
passes on the dorsal surface of the foot it changes name and becomes termed the
Dorsalis Pedis Artery (pedis is a foot).
Inguinal ligament from anterior superior creates tunnel between itself and the leg
(the bone) External Iliac Artery runs below
Adductor Heatus is the opening in the adductor magnus muscle
Posterior Tibial artery (Right and Left) this artery passes down the posterior of the
leg deep to the Soleus muscle. The Posterior Tibial gives off a branch:
Peroneal (Fibular*) artery this artery courses down the lateral side of the leg.
The Posterior Tibial Artery passes behind the medial malleolus and divides into the
Lateral and Medial Plantar Arteries. The Plantar arteries form an arterial loop on the
plantar surface of the foot (call plantar arch)

Deep Veins of the Upper Extremity (further from the heart and then back to the heart)
Veins in both the upper and lower extremity are positioned at both the deep and superficial
(subcutaneous) level. The deep veins of the upper extremity parallel in name and location the
previously described arteries.
The Radial Artery would have right beside it a Radial Vein. Similarly the Ulnar Artery would
have right beside it an Ulnar Vein.
The Radial and Ulnar veins (join) unite to form the Brachial Vein

The Brachial Veins pass the lower edge of the Teres Major (where they join; at the
same place where the arteries change name) muscle to become the Axillarly Vein
(where the brachial vein join)
The Axillary Vein passes under the clavicle and over the 1st rib to become the
Subclavian Vein.

Veins of the Head (Right and Left)

The External Jugular Vein (external to the skull; drains into subclavian vein) is the vein that
drains venous blood from the face and scalp.
- The External Jugular travels down on the surface of the sternomastoid muscle to meet
the Subclavian vein
The Internal Jugular Vein (drains blood within the skull) drains venous blood from inside the
cranial cavity. This vein descends down the neck along with the Common Carotid Artery.
- This vein empties into the Subclavian Vein. Once the Internal Jugular Vein meets the
Subclavian Vein the continuation of the vein towards the eart is termed the
Brachiocephalic Vein.
- The Right and Left Brachiocephalic Veins unite to form the Superior Vena Cava.
- Common carotid artery and internal jugular veins travel down from the skull down
into subclavian
Superficial Veins Upper Extremity (Right and Left)
Veins just under the skin (subcutaneous) in the upper extremity start from a venous network on
the dorsal surface of the hand. The Cephalic (travels up the lateral way and lateral side) and the
Basilic Veins drain this venous network.
-

Cephalic (Right and Left) (doesnt change names) this vein travels up the lateral
side of the forearm and arm. Tis vein goes between the Deltoid and Pectoralis Major
Muscles to enter into the Axillary Vein.
Basilic (Right and Left) (medial side of the arm; doesnt change names) this vein
travels up the medial side of the forearm and arm. This vein empties into the first part
of the Axillary Vein. At the elbow the Cephalic and Basilic veins are bridged by the
Median Cubital Vein. (The Median Cubital Vein is often used to take blood because it
is large and close to the surface.)

Deep Veins Lower Extremity (Right and Left)

Veins travel at the deep and superficial level. Veins at the deep level parallel arteries in location
and name.

The Posterior Tibial artery has travelling with it the Posterior Tibial Vein; the
Peroneal Vein accompanies the Peroneal Artery; the Anterior Tibial Vein accompanies
the Anterior Tibial Artery.
The meeting of the Posterior and Anterior Tibial Veins forms the Popliteal Vein.
- The Popliteal vein (switch to the anterior going through adductor hiatus) continues as
the Femoral Vein up the medial side of the leg
- Once the Femoral Vein passes under the Inguinal Ligament it becomes the External
Iliac Vein.
- The External Iliac vein meets the Internal Iliac Vein (in the pelvis area) to form the
Common Iliac Vein
- The Right and Left Common Iliac Veins unite to form the Inferior Vena Cava
- Fibular veins and fibular artery
Superficial Veins Lower Extremity
A similar pattern in the lower extremity as in the upper extremity.
A venous network is located on the dorsal surface of the foot. Draining this network from the
medial side is the Great Saphenous Vein (runs medially up the leg and thigh).
- The Great Saphenous Vein courses anterior to the medial malleolus, up the medial
side of the leg, passing about a hands breadth medial to the patella, then courses up
the medial side of the thigh.
- Just befor the Inguinal Ligament the Great Saphenous Vein empties into the Femoral
Vein.
- The Small Saphenous Vein drains the lateral side of the dorsal venous network. The
Small Saphenous travels up posterior to the lateral malleolus, up the lateral aspect of
the leg to get as high as the Popliteal Vein behind the knee. The Small Saphenous
Vein drains into the Popliteal Vein
Other Veins
The vein that parallels the Superior Mesenteric Artery is the Superior Mesenteric Vein (doing
draining from the ground 0), and the vein that parallels the Inferior Mesenteric Artery is the
Inferior Mesenteric Vein; these meet with the vein that drains the Spleen, the Splenic Vein, to
form the Portal Vein.
- The Portal Vein directs venous blood from the intestines to the liver. Once this venous
blood has filtered through the liver it will leave the liver by means of the Hepatic
Veins (hepatic means liver).
- Hepatic Veins drain blood from the liver back into the Inferior Vena Cava (it can go
back to the heart and from the heart to the rest of the body) as the Vena Cava passes
up the back of the liver.
- The Azygos Vein is a smaller vein that travels up the right side (right side of the
vertebral column) of the thorax; it receives small intercostals veins (in between each

rib; drain into Hemi Azygos Vein and Azygos Vein) and eventually empties into the
Superior Vena Cava.
There is a somewhat similar vein on the left side termed the Hemi Azygos Vein which
empties into the Superior Vena Cava.

Respiratory System
Nose the nose is one of the 2 principle airways for inhaled air. The following structures are
components of the nose:
- Nasal Septum (has projections coming in from the walls) the nasal septum divides
the nose into 2 nostrils. It is anteriorly composed of cartilage and posteriorly is
formed mainly by the perpendicular plate of the ethmoid bone and the vomer.
- Conchae/Meati the lateral wall of each nostril is mainly made up of parts of the
ethmoid bone. This part of the ethmoid bone has medial projections, or scrolls, of
bone termed Chonchae. In total there are 3 chonchae per nostril
The superior and middle chonchae are part of the ethmoid bone, while the inferior
chonchae (nasal) is a separate individual bone.
The areas immediately lateral to the chonchae are termed Meati. The nose therefore
has a superior, middle and inferior (tunnels beneath the chonchae) meatus.
Functions of the nose the mucous membrane of the nose is responsible for filtering,
humidifying and moistening the air as it passes through (especially when it is cold or if foreign
particles come in)
The nose is also responsible for the olfactory (smell) sense. The olfactory receptors are
positioned high up in the top of the nose. The axons from these receptors pass through holes in
the bony top of the nose to synapse in OlfactoryBulbs located immediately above the inner nose
(nasal cavity), inside the cranium (the brain as we know it). The Olfactory nerves is the 1st
Cranial Nerve. Molecules bind to receptors and send the signal.
Pharynx (behind the nose and mouth) is a C shaped muscular tube. The open part of the tube is
facing anteriorly. The pharynx stretches from the back of the nose down to the back of the mouth
(throat) down to the larynx (voice box) where it divides into a Trachea and an Esophagus.
The pharynx is divided into 3 sections:
- The Nasal Pharynx (behind nasal cavity) which is back of the nose.
- The Eustachian Tube or Auditory Tube is located in the nasal pharynx. This tube
connects the nasal pharynx with the Middle Ear. Opening this tube by yawning or
swallowing helps sometimes to equalize air pressure on either side of the ear drum.
- The Adenoids or Pharyngeal Tonsils are located in the top back part of the nasal
pharynx. Tonsils are lymphatic tissue that serve to protect the body against infection

(trap the foreign particles that could continue down the respiratory system
(molecules) to the lungs.
Nasal cavity lungs
When the pressure is not equal across the ear drum open the tube so that the air
can move in both directions between the middle ear and the nasal pharynx (connected
to the oral cavity and the nasal cavity) by opening the tube we allow the air to
equalize
By swallowing or moving the jaw up and down to pop the ear (in the airplane)

Paranasal Sinuses (holes in the bones near nasal cavity) bones of the face and skull have
mucous lined cavities termed paranasal air sinuses. These sinuses all communicate, or have an
opening into the nose. The sinuses are located in the Frontal bone, Ethmoid bone, Sphenoid bone
(behind nasal cavity) and Maxilla (all is in paires and connected to the nasal cavity; Possible
functions: humidifying, etc.; decreasing the weight of the skull).
The Oral Pharynx which is back of the mouth
The oral pharynx includes the following structures:
- Soft Palate (anteriorly is the hard palate and then more posteriorly) the soft palate is
the muscle and membrane (the end of the soft palate is uvula) that is attached to the
posterior edge of the hard palate (roof of the mouth). In the process of swallowing the
soft palate is elevated and closes off the passage back up to the nasal pharynx and
nose.
- Palatine Tonsils this grouping of lymphatic tissue is located on the back lateral
walls of the oral pharynx. Once again this lymphatic tissue is present to protect the
body against infection. Chronic infection and swelling of the palatine tonsils may lead
to the tonsils being removed.
The Laryngeal Pharynx (past epiglottis and the pharynx) which is associated with the larynx and
esophagus.
The principle structure in this region is the Larynx (epiglottis is on top and trachea is
underneath). The Larynx is made up of cartilage pieces, membrane and muscle.
- Larynx Cartilages the following are the cartilage pieces of the larynx:
1. Thyroid Cartilage there are 2 thyroid cartilage plates (in man it is more on the
angle and is more visible; in females it is more straight and less prominent;
females and males have them) that meet anteriorly to form the Adams Apple or
Thyroid Prominence. The thyroid cartilages do not form a complete ring of
cartilage; the posterior is open.
2. Cricoid Cartilage (broader in the back and thinner in front) this piece of
cartilage is positioned immediately inferior to the thyroid cartilages. The cricoids
cartilage looks like a signet ring, that is, it forms a complete ring of cartilage with
the signet portion of the ring (the wider part) posterior. The thyroid cartilages

articulate with the cricoids cartilage by an inferior horn (attach to croid cartilage;
vocal cords are inside vocal ligaments attaching to the cricothyroid joint).
-

Pharynx (as a whole) is a part of the respiratory and digestive systems not all 3
parts are involved in both systems
Nasal pharynx part of the respiratory but not digestive (unless by accident)
Oral pharynx and laryngeal pharynx part of both digestive and respiratory systems

Arytenoid Cartilages (on top of cricoids cartilage at the back) there are 2 arytenoid cartilages
that sit on top back edge of the cricoids cartilage. The arytenoids cartilages are triangular or
pyramid in shape. They hace an anterior point, the Vocal Process and a lateral point, the Muscula
Process (where muscles attach; posteriorly).
Epiglottis the Epiglottis is a Paddle shaped piece of cartilage. The handle of the paddle is
attached to the inside surface of the thyroid cartilages where the 2 thyroids meet anteriorly. The
blade of the paddle projects upward (helps close down the larynx when there is food coming
down).
Larynx Membrane a membrane termed the Criothyroid Membrane is (attaces cricoids to
thyroid cartilage superior lateral surface) inferiorly attached to the top lateral edges of the
cricoids cartilage. The superior anterior attachment of the right and left membranes is on the
inside surface of the thyroid cartilage where the 2 thyroid plates meet.
- The superior posterior attachments of the 2 membranes are to the right and left of the
Vocal Processes of the arytenoids cartilages.
- The top free edge of the Cricothyroid membrane forms the True Vocal Cords (vocal
ligaments; thickened). Since you have 2 Cricothyroid membranes you will have 2
Vocal Cords. The vocal cords plus the space between the cords is termed the Glottis.
- Laryngeal Muscles (effect breathing, swallowing and making of the sound) a
number of muscles attach to the pieces of cartilage. Movement of the cartilage pieces
allows the vocal cords to stretch, relax, spread apart or come together. Some of these
muscles attach to the Muscular Process of the arytenoids cartilages (when they are
open or closed).
Trachea/Bronchi/Branchioles/Alveoli
At the level of the larynx the common tube of the pharynx divides to form the Trachea
(membranes between rings; tube made of cartilaginous rings help keep the solid ring structure
round) and the Esophagus.
The trachea extends inferiorly to about the Sternal Angle where it divides into the Right and Left
Primary Bronchi (1 Bronchus for each lung).
- The Primary Bronchus on the right side divides into 3 (has 3 lobes of the right lung)
Secondary Bronchi

The Primary Bronchus on the left side divides into 2 (has 2 lobes of the left lung)
Secondary Bronchi.
The bronchi branch and get smaller in diameter until they are termed Bronchioles
(much the same idea as Arteries become Arterioles).
The end of the conducting air pathway is termed an Alveolus. Gas exchange occurs at
the level of the alveoli (capillaries of the lungs; tiny sacks with thin walls)
Cricothyroid membrane attaches to inside of thyroid cartilages and the vocal
processes of the arytenoids cartilages
When the glottis is open the air can get in
Closing the vocal cords most of the way and sending the air up to make vibrations of
them against each other and that makes the sound
To change the sound we do it with the oral cavity
Glottis covers when we swallow and so does the epiglottis

Lungs the lungs in the thorax are enclosed in a double layer pleural serous membrane. This is
much the same as the serous membranes around the heart (Parietal and Visceral Pericardium).
- The Parietal Pleura (lines the pleural cavity) is a serous membrane that lines the
inside surface of the thoracic cavity. This pleural membrane covers the inside of the
rib cage, covers the diaphragm, and covers the lateral side of the mediastinum.
- The Parietal Pleura when reflected around the outer surface of the lung is termed the
Visceral Pleura. He change in name of this continuous membrane occurs at the Root
of the lung (the root is the location where the Primary Bronchus and Pulmonary
Artery enter the lung and where the Pulmonary Veins leave the lung).
- The space between the Parietal and Visceral Pleura is termed the Pleural Cavity.
When the lung is totally inflated the moist Parietal layer comes in contact with the
moist Visceral layer and thus the Pleural Cavity becomes what is called a Potential
Space (the space is there when you exhale).
The Right Lung has 3 lobes, thus 3 secondary bronchi. The Left Lung has 2 lobes (due to heart
being on the left and taking up the space) and 2 secondary bronchi.
-

Each lung is within the pleural cavity

Visceral pleura is right against the lung
Capillaries that are coming from the heart that need to get oxygen into the blood will
surround the alveoli sacks oxygen comes across into capillaries then they take
the blood back to the heart
From right ventricle pulmonary artery (right) side capillaries get oxygen from
the alveoli sacks capillaries lead back into the pulmonary veins left atrium
Capilarization (marathon runner) improve efficiency of getting oxygen to the
tissues is by increase in capillarization, not just at the muscle level but also in the
lungs more oxygen can move across faster
Digestive System

Mouth (oral cavity) the following structure are located in the mouth:
- Teeth most people have a total of 32 permanent teeth
- The permanent teeth in the top row are duplicated by the same named teeth in the
bottom row. From anterior to posterior in the top row the teeth are: 2 central incisors
(middle and in the front), 2 lateral incisors (font and on the side of the 2 central
incisors), 2 canine (on the side of the lateral insicor), 4 premolars( 2 on each side;
beside the canine), and 6 Molars (3rd molar on each side is the wisdom tooth)
Salivary Glands the body has 3 pairs of salivary glands.
- Parotid Gland (produces saliva) the Parotid Gland is located outside the mouth. The
gland is like a pice of putty pushed into a cavity just in front of the ear. The gland has
a fibrous capsule. The duct (Parotid Duct) from the gland goes forward across the
Masseter muscle, pierces the cheek muscle (bucanator) and empties into the mouth
(as saliva).
- Submandibular Gland the Submandibula Gland lies on the inside surface of the
mandible around the angle. Its duct opens into the floor of the mouth around the
Frenulum (lingual; attaches to the bottom of the top of the mouth from underneath) of
the tongue.
- Sublingual Gland the Sublingual Gland lies on the floor of the mouth (lateral side)
following the contour of the inside of the mandible. This gland has numerous ducts
that release the saliva onto the floor of the mouth.
Tongue the tongue is anchored to the floor of the mouth by a fold of mucous membrane, the
Lingual Frenulum. The dorsal surface of the tongue (top) is not smooth but has a series of
bumps termed papillae (ducts on the tongue release the saliva on the top of the tongue).
Esophagus the esophagus is a smooth muscle tube that starts at the bottom of the Larynx. This
tube tracks down the thorax, through a hole in the diaphragm and empties into the Stomach.
Stomach the stomach is an expanded portion of the digestive system. Parts of the stomach
include:
- Greater Curvature (along the inferior surface) this is the bottom curve of the pouch
that is directed downward and to the left
- Lesser Curvature (opposite to greater curvature) this is the top curve of the pouch
that is directed upward and to the right
- Fundus (ballony side on the top closer to diaphragm) this is the superior/lateral
dome shape portion of the stomach.
- Digestive system: oral cavity down esophagus (tube through thorax)diaphragm
behind liver drops food into the stomach has a lot of digestive fluids (braks the
food down) small intestine duodenum (C shaped) jeojenum ilium (no

need to distinguish beteen ilium and jeojenum) large intestine (colon) that is more
structure than small intestine and a little rectangular
Runs up the right side, across and then down the left side, then out
Pancreas behind stomach (dumps stuff into duodenum, so does the liver and gall
bladder) help with the digestion
Salivary gland (inside) you have mucous cells and serous cells that dump their
fluid into the middle of the gland fluid flows through the duct into oral cavity

Body the main portion of the stomach

Pyloric Region this is the distal end of the stomach where the stomach narrows.
Cardiac Orifice (opening)/Sphincter (to close the stomach off so once it is there it doesnt go
back up) the cardiac orifice (opening) is located where the esophagus enters the stomach. Here
the smooth muscle thickens to form a valve or sphincter (involuntarily controlled) to prevent
stomach contents from regurgitating back into the esophagus.
Pyloric Orifice (opening)/Sphincter the pyloric orifice is located at the distal end of the
stomach where the stomach continues as the Duodenum, the first part of the Small Intestine. Tis
opening has a thickening of the smooth muscle to form the Pyloric Sphincter. This sphincter
regulates the emptying of the stomach contents into the Duodenum.
Gastric Glands (folds) gastric glands are located in depressions in the inner lining of the
stomach. These glands contain 3 types of cells:
- Mucous Cells to produce mucous to protect the stomach lining (acidic mucin)
- Parietal Cells to produce Hydrochloric acid (helps break down proteins)
- Chief Cells to produce digestive enzymes (such as pepsinogen)
Small Intestine the small intestine has 3 sections. The 1st section is termed the Duodenum, the
2nd section the Jejunum and the 3rd Ileum.
- Duodenum the 1st section of the small intestine is about 10 inches in length. The
duodenum wraps itself around the head of the Pancreas (so the duodenum is
Cshaped). The duct from the pancreas opens into the duodenum (Pancreatic Duct).
- The Common Bile Duct (need bile to help break down lipids (fats)) from the liver
also opens into Duodenum using the same opening as the pancreatic duct.
- The inner lining of the Duodenum (as well as the Jejunum and Ileum) contain
fingerlike projections termed Villi (all through the intestine). The villi increase the
surface area of the intestines
- Within each villus (increase probability for nutrients to get into the circulatory
system) are capillaries to absorb nutrients and a part of the lymphatic system termed
Central Lacteal (lymphatic system), which absorbs some lipids too large to be picked
up by the capillary.
- Vestigeal organs those that we do not need anymore as evolution progressed
(Palmaris longus, wisdom teeth, appendix, etc.)

Pyloris lower part after the end of the lesser and greater curvature of the stomach
Gastric folds wavy lines inside the stomach (stomach wall)
The goal of the intestine is to absorb nutrients from the food into the bloodstream

Jejunum/Ileum the jejunum is the middle portion of the small intestine. It measures about 7-8
feet (2.13 2.44 meters).
The last portion of the intestine is the Ileum. It measures about 11 feet (3.35 meters).
- The Ileum empties into the first part of the large intestine termed the Cecum.
- The Ileocecal Valve is located at the junction of the Ileum and Cecum. This smooth
muscle sphincter regulates the emptying of the small intestine into the large intestine.
Large Instestine
Cecum the Cecum is the 1st portion of the large intestine. It is located in the lower right
quadrant of the abdominal cavity. A blind pouch, the Vermiform Appendix (vestigial organ) is
attached to the posterior medial part of the cecum.
Rest of the Large Intestine
The cecum continues up the back right wall of the abdominal cavity as the Ascending Colon.
The Ascending Colon reaches the Liver and turns 90 degrees. This bend is termed the Hepatic
(Liver) (right by the liver) or Right Colic Flexure. The colon continues from this bend across the
abdominal cavity as the Transverse Colon.
The Transverse Colon stretches across to the Spleen in the upper left quadrant of the abdominal
cavity. There the colon turns 90 degrees to descend down the back left wall of the abdomen. The
bend at the Spleen is termed the Splenic(Spleen) or Left Colic Flexure.
The Descending Colon reaches the top the ilium and then follows the inner contour of the ilium.
To do this the colon takes on a somewhat S shape. This portion of the colon is termed the
Sigmoid Colon.
The Sigmoid Colon because of its shape moves the colon to the midline of the body. At this point
the sigmoid colon continues as the Rectum.
The last 1- 1.5 inches of the Rectum is termed the Anal Canal. A thickening of the smooth
muscle of the anal canal forms the Internal Anal Sphincter (involuntarily controlled).
- The anal canal passes through the Levator Ani muscle, a skeletal muscle that forms
the posterior floor of the pelvis. As the canal passes through the muscle the Levator
Ani forms the Striated (Skeletal) muscle External Anal Sphincter (voluntarily
controlled have control over it).

Accessory Digestive Organs Accessory organs of digestion include:

- Pancreas, Gall Bladder and Liver.
Pancreas (releases into duodenum) the head of the pancreas fits in the C shape of the
duodenum. The main portion of the gland is termed the body.
- The distal end of the gland that reaches over and touches the spleen is termed the tail
(comes sometimes as far left as the spleen)
- The exocrine function (secrets something through a duct) of the pancreas is to
produce digestive enzymes. These enzymes are transported by a duct in the pancreas
to the duodenum
- The cells in the pancreas also perform an endocrine function (directly into the blood
stream) and produce the hormones Insulin and Glucagon. These hormones are
essential for the maintenance of blood glucose levels and the utilization of glucose by
cells. The hormone is distributed around the body from the pancreas by the vascular
system.
Liver (have right and left lobes) the liver as one of its functions is responsible for the
production of Bile. Bile is a substance that emulsifies (breaks down lipids or fats) fat in the
duodenum.
- The Right and Left Hepatic Ducts transport bile from the Right and Left Lobes of the
liver. The 2 Hepatic ducts unite to form the Common Hepatic Duct (takes to gall
bladder for storage or to the duodenum when we ate a lot of fatty foods to break down
fat).
Gall Bladder (Posterior side of the liver; storage facility of the bile) the gall bladder is a smooth
muscle pouch attached to the underside of the liver just to the right of the center. The Gall
bladder is responsible for the storage of bile.
The Gall Bladder has a bottom rounded portion termed the Fundus, a main portion termed the
Body, and narrowing of the body to form the Neck; the neck continues as the Cystic Duct.
- The Cystic Duct meets the Common Hepatic Duct to form the Common Bile Duct.
The Common Bile Duct empties into the duodenum using the same opening as the
pancreatic duct. There are smooth muscle sphincters at the distal end of the Common
Bile duct to regulate the emptying of the bile from the gall bladder into the
duodenum.
- Left and right hepatic ducts take bile from the liver join to form common hepatic
duct leads to the cystic duct goes into the gall bladder from here or from
liver the bile can come straight to the duodenum
- Gall bladder out through the cystic duct cystic duct and common hepatic duct
join to make the common bile duct there is a sphincter here to duodenum
enters the same hole as the pancreatic duct there is involuntary sphincter in the
duodenum

We can have bile coming from gall bladder and liver but this happens rarely

Mesentery (made of parietal peritoneum, whenit leaves the wall (back) goes towards the organs
(the part in between); between parietal and visceral: attaches organs to the posterior wall) the
abdominal cavity has a double layered serous membrane just like the membranes around the
heart (Pericardial) and membranes around the lungs (Pleural). The membranes in the abdominal
region are termed Peritoneum.
- Peritoneum has 2 layers: Parietal and Visceral
- Parietal/Visceral Peritoneum/Peritoneal Cavity (between parietal and visceral
peritoneum)
Parietal Peritoneum is a serous membrane that lines the inside of the abdominal
cavity. When the parietal peritoneum reaches the middle of the posterior abdominal
wall about where the aorta is located, the membrane projects forward to surround the
stomach, small intestines and large (T12 area) intestines.
The membrane that surrounds the intestines is termed the Visceral Peritoneum. It is
the portion of the serous membrane that runs from the back abdominal wall to the
intestines; it supports the intestines and is termed Dorsal Mesentery.
The dorsal mesentery associated with the stomach has a specific name: Greater
Omentum (big membranous fatty blanket hanging over abdomen, attaches to stomach
flops down, then goes back up and attaches to the transverse colon of the large
intestine extension of peritoneum (visceral))
The dorsal mesentery associated with the small and large intestines is simply referred
to as dorsal mesentery of the small or dorsal mesentery of the large intestine.
The space between the Parietal Peritoneum and Visceral Peritoneum is termed the Peritoneal
Cavity. The cavity contains most of the abdominal organs.
-

Greater omentum if infection is in the abdomen the greater omentum will move to
surround it to prevent all other organs from being infected.
Urinary System

Kidney (make urine; blood is filtered here water, solutes (calcium, etc.) can be removed or
added) the kidneys major function is to filter and purify blood. The kidney is encased in a
fibrous protective capsule. Perirenal fat surrounds the kidney and anchors the kidney in position
as well as helps to protect the organ. The kidney has the following structures:
- Hilum (opening in to the kidney where things go in and out of the kidney; medial
surface) the hilum is the concavity on the medial border of the organ. This is the
location where the vessels, nerves and ureter connect to the kidney. The extension of

the hilum internally forms a space termed the Renal Sinus (open space filled with
blood vessels, nerves and ureter; coming out or in through hilum; within kidney)
Minor Calyx/Major Calyx/Pelvis/Ureter
The minor calyx is the smallest of a tube system located in the Renal Sinus. Each kidney has
about 8-15 minor calyces. Minor calyces merge to form Major Calyces. Each kidney has about 23 of these.
Major Calyces merge to form the Renal Pelvis (becomes the ureter).
The Ureter (carries them down to the bladder; depend on gravity) is the tubular extension of the
Renal Pelvis that exits the kidney at the hilum and transports urine formed to the Urinary Bladder
(stores urine and then sends it on its way).
Kidney Tissue a frontal section of the kidney reveals that kidney tissue is located around the
outer portion of the organ. The tissue can be divided into 2 categories: Cortex and Medulla.
- Cortex the cortex is the more superficial of the 2 regions.
- Medulla (renal) the medulla is located deep to the Cortex. The medullary tissue is
pyramid or triangular in shape. The apex or point of the triangle projects internally
toward the renal sinus and is termed the Papilla (leads into minor calyx). The base of
the triangle abuts against the Cortex. Each renal pyramid is enclosed by a Minor
Calyx.
- Renal Columns renal columns are cortex that have extended inward between
adjacent medullary pyramids.
- Urethra out door for the urine toward the urinary bladder
- Functions of urinary system is to filter and purify blood
- Fibrous capsule surround kidneys and give them solid outer shape
- Perirenal fat surrounds kidneys and helps protect them and anchor them to the back
wall so they stay in place
- Path of the urine: made comes out into the minor calyx major calyx renal pelvis
ureter (also all of the compounds of the renal sinus)
Nephron (performs filtration; filtering blood and making urine; pulls out water and solutes)
/Blood Supply the Nephron is a filtrating tubular unit of the kidney. Te following are the
components of the nephron and the blood supply to the approximately 1 million nephrons per
kidney:
- Afferent Arteriole (going toward nephron; coming of intertubular artery) this
arteriole brings blood (oxygenated) to the initial section of the nephron.
- Glomerulus (capillary system; drops off filtrate;1st where blood is connecting to
nephron (blood portion) 2nd part pulling filtrate out glomerular capsule (Bowmans
Capsule) this is the capillary network supplied by the afferent arteriole.

Efferrent Arteriole this arteriole takes blood away from the Glomerulus and is the
origin of a network of capillaries that surround the nephron.
Bowmans Capsule this is the initial section of the filtration tube. Bowmans
Capsule surrounds the glomerulus.A portion of blood will filter from the glomerulus
into Bowmans Capsule.
Proximal Convoluted Tubule (here we start to put things back into the blood) this is
a continuation (whatever wad collected at the Bowman s capsule) of the tube from
Bowmans Capsule. This portion of the nephron is surrounded by a network of
capillaries termed the Peritubular Capillary Network. Exchange occurs between the
fluid in the tube and the capillary vascular network surrounding the tube.
Loop of Henle (more re-absorption of stuff into the blood) is the continuation of the
proximal convoluted tubule. This portion of the nephron has a descending loop that
loops from the cortex down into the medulla and an ascending limb or loop that goes
back to the cortex. This loop is also surrounded by capillaries.
Distal Convoluted Tubule this tubule is the continuation of Henles Loop. It too is
surrounded by the peritubular capillary network.
Collecting Duct the collecting duct receives the distal convoluted tubules from a
number of nephrons. The collecting duct courses through the medulla and terminates
at the papilla of the medulla. The urine formed by absorption and secretion as the
filtrate passes through each portion of the nephron will be transported finally to the
Minor Calyx by collecting duct.

Urinary Bladder
The ureters from each kidney transport the urine formed by the nephron of the kidney to the
Urinary Bladder.
The bladder is smooth muscle that stores urine (as the bladder gets full or stretched a signal is
send to the brain to empty it out; similar to gall bladder)
The Urethra (from bladder out) is the muscular tube positioned on the inferior surface of the
bladder responsible for transporting urine to the exterior of the body. A thickening of the smooth
(involuntary control) muscle as the urethra leaves the bladder forms the Internal Sphincter of the
Urethra.
- Stuff pulled from the blood is called the filtrate
- Kidneys do not remove toxins it is livers job
1. Glumerulus and Bowmans Capsule: Taking stuff out of the nephron or out of the
blood
2. Putting a few things back or if needed taking out a little more (peritubular
capillary network)
- Glomerulus capsule surrounding glomerulus, sack surrounding the blood leaving
glomerulus glomerulas capsule (Bowmans Capsule)
- 25 % is heading to the kidney

Filtrates that are left (urine) go into collecting ducts go towards the renal
papilla empties into minor calyx
Path of urine: afferent arteriole (brings oxygenated blood) continues at glumerulus
Bowmans capsule surrounds glumerullus and is the start of the nephron (pulls out
filtrate such as water and solutes) efferent arteriole leaves glumerulus filled with
oxygenated blood either to:1. The nephron and supplies it with oxygen 2. The other
part from the peritubular capillary network that surrounds nephron and re-absorbes
iltraate filtrate continues throughproximal convoluted tubule (1st re-absorbing
things back into the blood) into peritubular capillary network continues as the
loop of Henle then as distal convoluted tubule both passing things back into
blood done with re-absorption from distal convoluted tubule (whatever was left
becomes urine) collecting ducts renal papilla minor calyx --? On its way to
the urethra or ureter

Reproductive System
Perineum (broader in females because once a baby will have to pass through) this region of the
body in both males and females is the floor of the pelvis.
This space is diamond shaped. The boundaries of the diamond are:
- Anteriorly the Symphysis Pubis (the front where 2 pubic bones attach)
- Laterally the Rami of the Pubis and Ischium, and the Ischial Tuberosity ( 2 bones
you sit on)
- Posteriorly the Coccyx (or tail bone)
The Diamond shape can be divided into 2 triangular regions:
-

Anal Triangle (where anal canal in exiting) a skeletal/striated muscle termed the
Levator Ani (floor of the anal triangle; Ani muscle comes down to anus to make the
external anal sphincter (involuntary)) forms most of the posterior floor of the Anal
Triangle. This muscle is funnel shaped with the top wide portion of the funnel
attaching to the inside lateral walls of the pelvis and the inferior narrow portion of the
funnel projecting downward. In the region of the anal canal some of the circular
smooth muscle thickened to form the Internal Anal Sphincter (smooth muscle is under
autonomic/unconscious control). The portion of the Levator Ani that surrounds the
anal canal forms the External Anal Sphincter. Since this muscle is skeletal muscle we
have conscious control of the external sphincter.
Urogenital Triangle the floor of the anterior triangular portion of the perineum is
formed by membrane and muscle. A skeletal muscle termed the Sphincter Urethra
Muscle forms large part of the floor. This muscle attaches to the inside of the pelvic
bones almost as far inferiorly as the ischial tuberosity.

The Urethra in both the male and female pass through the Sphincter Urethra muscle.
The Sphincter Urethra Muscle (originates on the inside of the pelvic bones; forms
most of the floor of urogenital triangle) forms the External Sphincter for the Urethra
The Sphincter Urethra muscle also serves as a sphincter for the Vagina.
The underside of the Sphincter Urethra muscle is covered with a very dense layer of
connective tissue termed the Perineal Membrane (made of dense connective tissues
and makes the floor of the Urogenital Triangle). The space immediately above the
perineal membrane is termed the Deep Pouch (above membrane; a space between
levator ani sphincter urethra muscle and perineal membrane). The space inferior to
the membrane is termed the Superficial Pouch (below perineal membrane).
Interlobar artery on the sides of the medullary pyramids wraping around the
pyramids and giving out branches of branches (interlobarular arteries) branch into
afferent arterioles (go toward the nepheron)

Male Reproductive System the following are the anatomical structures of the male
reproductive system:
- Scrotum (surrounds testies; temperature control) the scrotum is a skin covered,
double pouched, sac that contains the male gonad the Testicle. Sperm production
requires slightly cooler temperatures than are found in the abdomen. The scrotum
provides this cooler environment.
- Testicle the testicle is the male gonad. This organ is responsible for the production
of Sperm and the male sex hormone Testosterone.
- Sperm is produced and matures in a tubular system in the testicle. The initial section
of the tube is termed the Seminiferous Tubule.
Seminiferous Tubules continue as Straight Tubules
A number of Straight Tubules merge to form the Rete Testis
Efferent Tubules drain the Rete Testis.
Efferent Tubules empty into the Epididymis.
The Epididymis (C shaped) continues as the Ductus Deferens or Vas Deferens. The
Vas Deferens is a component of the Spermatic Cord (initially in the development they
are lifted up but then when a person is born fall down; where the blood vessels are to
supply the testicles) and as such the Vas deferens penetrates through the abdominal
wall to go inside the abdomen (loops over the ureter).
- Accessory Glands the following are aaccessory glands of the male reproductive
system:
Seminal Vesicles (produces fluid full of nutrients for sperm to keep them alive and
happy) these 2 structures are positioned behind the urinary bladder. They are
responsible for the production of fluid that will be added to the ejaculate and helps
provide nutrients for the sperm. A seminal vesicle merges with the Vas Deferens to
form the Ejaculatory Duct. This duct pierces through the posterior of the Prostate
Gland

Prostate Gland this gland is positioned immediately below the urinary bladder. The
urethra as it passes through the prostate gland is termed the Prostatic Urethra. The
Ejaculatory Duct empties into the Prostatic Urethra (when we are in the prostate).
The prostate gland is responsible for the production of fluid that helps supply
nutrients for the sperm.
It is warm in the abdomen area and sperm requires a colder temperature so they are
surrounded by the scrotum to provide this temperature ( if it is too cold the muscles
surrounding testies can pull them a little upward closer to the abdominal area to bring
some heat in)
Testicle sperm production: maturation very important 1. Seminiferous tubules
(maturation) within the lobule straight tubules joining of the sperm from
different tubules straight tubules straight tubules join to form Rete Testis
out of the testicle through efferent ductile (or tubules) epididymis
Can take 2 to 3 month in the epididymis
Ductus deferens forms spermatic cord
Seminal vesicles and vas deferens join to form ejaculatory duct

Bulbourethral Glands (at the level of the membranous urethra) these are positioned
immediately below the prostate gland in the sphincter urethra muscle (the muscle that formed the
anterior floor of the pelvis). The Prostatic Urethra continues through the sphincter urethra muscle
as the Membranous Urethra (under sphincter urethra muscle; left prostate).
Positioned in the sphincter urethra muscle on either side of the urethra are BUlbourethral Glands.
These glands are responsible for the production of a mucous like fluid that serves as a lubricant
during sexual intercourse and cleanses te urethra of urine. The glands have ducts that empty into
the urethra as the urethra passes in the bulb of the penis.
Penis the penis is divided into 2 parts, a Root (internal (within pelvic bone) and a Body (is an
extension of root components; external).
- Root of the Penis the root of the penis consists of 2 parts:
The Bulb (just under sphincter urethra muscle; bulbourethral glands are going to
empty into the bulb) of the penis is erectile tissue that is attached to the under side of
the sphincter urethra muscle (recall the perineal membrane). The ducts from the
bulbourethral glands empty into the urethra in the area of the bulb.

The other components of the root of the penis is erectile tissue termed Crura (right
and left). This erectile tissue attaches to the underside of the Conjoint Ramus (a bit
of the bone). (The Conjoint Ramus is the meeting of the Inferior Ramus of the Pubis
and the Ramus of the Ischium; it is the bottom boundary of the oturator foramen).
Body of the Penis the body of the penis consists of the 2 parts that made up the
Root.

The bulb (1 bulb; part of the root internally) of the penis continues in the body as the
Corpus Spongiosum.
The urethra while in the spongiosum is termed the Spongy Urethra (once we are in
the body of the penis).
The expanded end of the Corpus Spongiosum is termed the Glans.
The continuation of the 2 crura of the root of the penis into the body is termed the
Corpora Cavernosa.
- Bulb Corpus Spongiosum Glans all continuous structures
- Spincter urethra muscles below prostate within which is bulbourethral glands are
- Before they were fully developed they were the same female and male reproductive
organs
Female Reproductive System the following are the anatomical structure of the female
reproductive system:
-

Vagina (under uterus; behind the opening of the urethra) the vagina is a
fibromuscular tube that connects the uterus to the outside of the body.
Uterus (above bladder posterior; sits on top of bladder) the uterus is a thick walled
smooth muscle organ that has an internal cavity. Parts of the Uterus include:
Fundus the fundus is the top rounded portion of the uterus
Body the body is the middle, main portion of the uterus
Cervix the Cervix (leaving the uterus and heading to vagina) is the inferior of the
uterus that protrudes into the vagina.
Uterine/Fallopian Tubes (lateral wall) the hollow tubes extend laterally to the side
wall of the pelvis from just inferior to the fundus. The expanded end of the tube is
termed the Infundibulum (where fallopian tubes get wider) and the inner fingerlike
folds in this region are termed Fimbriae (attachment point to the ovaries).
Ovary (honologues to male testes; lateral wall) the ovary is the female gonad
responsible for the production and ovulation of an oocyte (the egg).

Support of the Uterus/Ovary (anchored to posterior and lateral walls) the uterus is anchored in
position by a series of ligaments:
-

Broad Ligament (attachment to the posterior wall) the Parietal Peritoneum (forms
double sheeth; coming of posterior wall), as it comes over the top of the urinary
bladder, course up the front of the uterus, over the fallopian tubes and back down the
back side of the uterus, then back up the posterior wall of the abdomen. This double
layer of peritoneum associated with the uterus forms the Broad Ligament.

Suspensory Ligament (attachment to the lateral wall) this ligament is a lateral

extension of the broad ligament (lateral extension) that attaches the Ovary to the side
wall of the pelvis. Within this ligament run the artery and vein of the ovary.
Ovarian Ligament (ovary to the wall of the uterus attachment) this ligament runs
from the ovary to, and though, the wall of the uterus. The continuation of this
ligament out the anterior of the uterus forms the Round Ligament.
Round Ligament (heads out through the abdominal wall) the round ligament is an
extension of the ovarian ligament. The round ligament courses out through the
abdominal wall and anchors in the Labia Majora.
Urethra in females is a shelter more chances to get infection in the bladder than in
males
In the male the 2 exit points are combined (vagina and urethra females) and in
females they are separate

Female External Genitalia the following are the anatomical structures of the female external
genitalia (Vulva):
-

Bulb (internal but are attached along with Crura to the external structures) the bulb
is erectile tissue attached to the perineal membrane (urogeneal triangle bottom) on the
underside of the sphincter urethra muscle (in both male and female).
Crura the crura are erectile tissue attached to the Conjoint Rami of the hip. The
meeting of the crura form the copora cavernose. The meeting of the copora cavernous
from the Clitoris.
Labia Majora (honologues to scrotum in males) the labia majora are folds of skin
and connective tissue. These paired folds are the homologue to the male scrotum.
Labia Minora (medial to major; forms borders) the labia minora are folds of skin
medial to the labia majora. These skin folds form the boundaries of a space termed
the Vestibule. The vestibule contains openings for the vagina and the urethra.
Greater Vestibular Glands (posterior of vestibule) these are a pair of glands located
in the posterior lateral wall of the vestibule. They are the homologue to the
bulbourethral glands in the male. These vestibular glands secrete a lubricant into a
vagina.

Female Breast/Mammary Gland the base of the breast extends vertically from the 2nd rib to the
6th rib. Laterally to medially the base goes from the medial margin of the edge (probably will not
be asked) of the Pectoralis Major; this portion is termed the Axillary Tail (following path of
pectoralis major).
The breast is composed of adipose tissue and lactiferous (has lactiferous glands; fat protects it)
glandular tissue. Lactiferous Ducts (carry the milk out through the nipple) from the lactiferous
glands carry breast milk produced during lactation to the Nipple of the breast. The nipple is

surrounded by a pigmented area termed the Areola (case in the male as well but not as
functional).