SYSTEMIC ANATOMY

Dr. OMAR GABR

Part I.

Systemic anatomy is the study of system organs, such as the respiratory system or the digestive system

Aim of Studying Anatomy: - Is to help medical and paramedical personal to apply their medical knowledge correctly during practice.

Methods of Studying Human Body ?

1.Dissection: (SECT = cut, DIS = apart). 2.Living Anatomy: 3.Embryology: 4. Histology: 5. Endoscopy: 6. Radiology:

 Organization of human: the body is organized as follow :

Cells are the smallest living unit of body construction. Tissue is a grouping of like cells working together. Examples are muscle tissue and nervous tissue. .Organ is a structure composed of several different tissues performing a particular function. Examples include the lungs and the heart. Systems are groups of organs which together perform an overall function. Examples are the respiratory system and the digestive system. Organism is the individual human being.
You are a total organism.***

 A typical animal cell includes: Cell membrane, Nucleus, Nuclear membrane, Cytoplasm, Cell inclusions include; ribosomes, endoplasmic reticulum, mitochondria, Golgi apparatus, centrioles, and lysosomes.

Planes of the Body

1. Median Sagittal Plane:

2. Paramedian plane: 3. Horizontal plane:

4. Coronal Plane:

PLANES OF THE BODY

Median & Paramedian plane

Horizontal plane:

Coronal Plane

Anatomical Terms
A. Terms Related to the Position:
Anterior Posterior Superior. Inferior Medial: Lateral

Anatomical Terms
B. Terms Related to Movements:
Extension Flexion Adduction Abduction Rotation Circumduction:

Body Systems

 The body systems include are: 1. Intugmentry System: 2. Locomotor System: 3. Digestive System: 4. Respiratory System: 5. Urinary System 6. Genital System: 7. Cardiovascular System: 8. Nervous System: 9. Endocrinal System: 10. Immune System 11. Organs of Special Senses: -

I. Integumentary system
The skin and its derivatives (sweat and oil glands, hair and nails) are called the integumentary system which simply means covering. Structure of the skin The skin composed of two kinds of tissues: A) Epidermis: Is made up of stratified squamous epithelium that is capable of kertinizing, or becoming hard and tough B) Dermis Is made up of dense fibrous connective tissue. (The epidermis and dermis are firmly cemented together, however a burn or friction may cause them to separate. ) Subcutaneous tissue: Which contains many fat cells. It is not considered apart of the skin but it does anchor the skin to underlying organs. The subcutaneous tissue serves as a shock absorber and it insulates the deeper tissues from extreme temperature change occurring outside the body.

Functions of the skin

1-Protect deeper tissues from: 2-Aids in body heat loss or heat retention (controlled by the nervous system) 3-Aids in excretion of urea and uric acid. 4-Synthesizes vitamin

 Layers of the epiderm A) Stratum germinativum: .B) Stratum granulosum: .C) Stratum lucidum: D) Stratum corneum

 The dermis helps to hold the body together. Parts of the dermis: It consists of two major regions A) Papillary layer: B) Reticular layer:

 Melanin: Is a brown pigment, produced by melanocytes. Melanocytes: Special cells found chiefly in the stratum germinativum. They produce melanin. Tanning occurs when the skin is exposed to sunlight, which stimulates the melanocytes to produce more of melanin pigment. The stratum germinitavum cells phagocytize (eat) the pigment, and as it accumulates within them, the melanin forms a protective pigment over their nuclei and protect the DNA from the damaging effect of ultraviolet radiation in sunlight.

 Blood and nerve supply: The dermis is richly supplied with blood vessels that play a role in regulating body temperature. any restriction of the normal blood supply to the skin results in cell death and, if severe or prolonged enough, skin ulcers.

The dermis has a rich nerve supply, many of the nerve endings have specialized receptor organs that transmit messages to the central nervous system.

 The appendages of the skin include: 1.Cutaneous gland. 2..Hair. 3..Nails.

appendages of the skin

1) Cutaneous glands
A) Sebaceous gland: They are also named oil glands. They are distributed allover the skin except in palm of the hand and sole of the foot. Their ducts usually empty into a hair follicle but some open directly onto the skin surface. The product of the sebaceous gland is called sebum. Sebum is a mixture of oily substances and fragmented cells Function: A lubricant that keeps the skin soft and moist and prevent hair from becoming brittle. Contains chemicals that kill bacteria. (N.B): The sebaceous glands become very active when male sex hormones are produced in increased amount.

 B) Sweat glands: - They are widely distributed in the skin. - Their number is more than 2 million per person. - They are 2 types: a. Eccrine glands: b. Apocrine glands:
They are distributed in the axillary and genital areas of the

2-Hairs and hair follicles

- There are millions of hairs scattered allover the body

- Parts:

a) Root: It is that part of the hair enclosed in the follicle b) Shaft: It is that part projecting from the surface of the skin -- Structure: Central core called the medulla. Thick layer called cortex surround the medulla. The cortex is enclosed by the cuticle. - Arrector pili It is a small bands of smooth muscle cells connect each side of the hair follicle to the dermal tissue. When they contract, the hair is pulled upright and dimpling of the skin surface occurs. - Functions: Minor protective function such as: a) guarding the head against bumps. b) Shielding the eyes (via eye lashes) c) Helping to keep foreign particles out of the respiratoy tract (via nose hairs)

3-Nails
A nail is a scalelike modification of the epidermis. Parts: Free edge. Body (visible attached portion). Root (embedded in the skin). Nail fold (skin fold overlapping the border of the nail) commonly called cuticle. The stratum germinativum of the epidermis extends beneath the nail as the nail bed. Its thick-ended proximal area called the nail matrix. It is responsible for nail growth. Nails are transparent and nearly colorless, but appears pink because of the blood supply in the underlying dermis. The exception to this is the region over the thickened nail matrix, which appears as a white crescent called the lunula.

II.LOCOMOTOR SYSTEM

LOCOMOTOR SYSTEM: It consists of three important items: Bones. Joints. Muscles (skeletal or striated).

1. Bone
It is a living tissue; consists of cells, fibers and matrix. It is hard because of the calcification of its extracellular matrix. It has a degree of elasticity due to the presence of organic fibers.

Functions of the Bones: Protection: Support: Movement Storage: it acts as store for calcium and phosphorus salts. Blood cell formation Shape of the body

Types of Bones
A) According to the structure: there are two types. Compact bone: appears as solid mass. Cancellous bone: consists of a branching network of trabeculae to resist the stresses to which the bone is exposed. B) According to the shape: there are: Long bones:). Short bones: Flat bones: Irregular bones:. Sesamoid bones: Pneumatic bones: are found in the bones of the skull, it contains air cavities.

Structure of a long Bone

-The long bone has three parts; two ends and shaft The ends consist of a thin layer of compact bone enclosing an area filled with spongy bone and covered with articular cartilage. The shaft extends between the two ends. It is composed of compact layer of bone (cortex). It is covered from outside by fibrous tissue, periostium. It contains the bone marrow cavity, which is filled with either yellow or red bone marrow. In between the ends and shaft there is a flat plate of hyaline cartilage which changes into a bony line after puberty and stoppage of bone growth. ____________________________________________________________________
Clinical Notes: Bone Fractures: Fractures of the bones are not an uncommon condition. During youth, most fractures result from trauma as in sports activity such as football and car accidents. In old age, fractures are usually due to weakness and thinning of bones with age. Types of Bone Fractures: Many types of bone fractures could be detected, but there are two main forms: Simple fracture or closed fracture: in which bones break clearly but do not penetrate skin. Compound fracture or open fracture: in which the broken ends of the bone protrude through soft tissues and the skin.

A Long bone (Humerus)

A. Long bone 1 -Shaft (diaphysis) 2 -End (epiphysis) 3-Articular cartilage 4- Epiphyseal line 5- Cancellous (spongy) bone, containing red marrow 6- Compact bone 7- Medullary cavity containing yellow marrow
2

1 7

TYPES OF BONES

short

long

irregular

flat

sesamoid

SKELETON
SKELETON - It is comprised of the axial and peripheral skeletons. A. Axial skeleton; - It can be divided into three parts: The skull. The vertebral column. The bony thorax. B. Appendicular Skeleton; - It is the skeleton of the limbs.

skull
skull - The skull is formed of the cranial bones and facial bones. Cranial Bones: Are eight in number. They protect the delicate tissues of the brain and its meninges. They unite together by fibrous joints or "sutures". Facial Bones: The fourteen facial bones are all paired The facial bones enclose orbital, nasal and mouth cavities. Skull of Newborns: The skulls of newborns contain fontanels (membranous areas). Which allow brain growth. The size of the cranium is larger than the facial bones in infants.

SKULL

Vertebral Column
The vertebral column is formed of the vertebrae and discs in between the bodies of the vertebrae. The vertebrae are classified into: 1- 7 cervical vertebrae. 2- 12 thoracic vertebrae. 3- 5 lumbar vertebrae. 4- 5 sacral vertebrae fused together to form the sacrum. 5- 2-3 coccygeal vertebrae which are rudimentary structures.

STRUCTURE OF THE VERTEBRA

Structural Plan of the Vertebra

Each vertebra consists of the following parts... Body: Neural arch: Processes of the vertebrae:
Transverse process Spines: directed backward. Articular facets (processes): two facets in each side (superior and inferior) at the pedicles.

Inter vertebral disc:

The vertebrae are separated from each other by inter vertebral discs that allow the vertebral column to be flexible. Each disc is formed of two parts: Outer fibrous part called anulus fibrosis. Inner soft part called nucleus bulbosus. (N.B): Dislocation of the disc leads to pressure effect on the spinal cord and/or the spinal nerves. A condition which is associated with sever pain at the back radiating to the lower limbs (sciatica).

Curvatures of the Vertebral Column

There are two types of curvatures: 1) Primary Curvature: It is present at birth. It is c-shaped curve occupying the whole length of the vertebral column anteriorly. 2) Secondary Curvatures They appear after birth in the cervical region at 6 months of age, and at the lumbar region at 12 months, so the vertebral column becomes S-shaped. They allow for the upright posture.

Bony Thorax
Bony Thorax:

- It consists of the following: Sternum (anteriorly). Vertebral column (posteriorly). Ribs (laterally).

Sternum:

- Flat bone consists of three parts. Manubrium sterni: Body: Xiphoid process

RIBS

Ribs: - They are 12 pairs in both sides. - Each rib has; posterior end, shaft and anterior end. - All the ribs are attached posteriorly to the vertebral column. - Anteriorly the ribs are different in their attachment as follows: True ribs:First 7 ribs: attached to the sternum and are known as true ribs. False ribs from 8th rib to 10th rib: they are attached to costal cartilage of rib above and are known as the false ribs. Floating ribs:The 11th and 12th ribs: are free anteriorly and are known as floating ribs.

APPENDICULAR SKELETON
I.UPPER LIMB
clavicle

scapula hummerus

radius

ulna

hand

scapula

a) Bones of the shoulder girdle: The shoulder girdle is formed of the clavicle and scapula. The bones of the shoulder girdle connect the upper limb to axial skeleton to allow movements of the upper limb around chest wall. 1. The clavicle It is a long bone lying horizontally at the root of the neck. It has body which is concave anteriorly at its lateral third and convex at medial two thirds. 2. The scapula It is a flat bone, situated posteriorly opposite 2nd to 7th ribs. It is triangular in outline with anterior concave surface and posterior convex surface carrying the spine of the scapula. It articulates with the head of the humerus (shoulder joint).

b) Bone of the arm:

The skeleton of the arm is the humerus. It is long bone, which has the following: Upper end: Lower end: and Body.

c) Bones of the forearm: It consists of two bones; radius (laterally) and ulna (medially). 1. The radius It is long bone, it articulates with humerus (above), and ulna (medially). has the following: Upper end: Lower end: and Body. 2. The ulna - It is the medial bone and has: Larger upper end; articulates with humerus and radius. Lower end; carries the head and styloid process. Body; triangular in outline.

d) Bones of the hand: - They consist of: 1. Carpal bones Short bones. 8 in number arranged in two rows, 4 in each row. They are arranged in a curved line, to allow handgrip. 2. Metacarpal bones 5 in number, the 1st one is situated laterally and the 5th one lies medially. Each bone consists of a base, which articulates with carpal bones, body and head, which articulate with phalanges. 3. Phalanges 3 in each finger except the thumb, which has 2 phalanges only.

BONES OF THE LOWER LIMB

1 Ilium 1a Iliac crest 1b Anterior superior spine 1c Anterior inferior spine 2 Pubis 2a Obturator foramen 3 Ischium 3a Ischial tuberosity 4 Femur 4a Head 4b Neck 4c Greater trochanter 4d Lesser trochanter 4e Intertrochanteric line 4f Shaft 4g Lateral epicondyle 4h Lateral condyle 4i Intercondylar fossa 4j Adductor tubercle 4k Medial epicondyle 4l Medial condyle 4m Linea aspera 5 Patella 6 Fibula 7 Tibia

1a Medial epicondyle 1b Intercondylar fossa 2 Patella 3 Fibula 3c Lateral malleolus 4 Tibia 4a Lateral condyle 4b Medial condyle 4c Tibial tuberosity 4e Medial malleolus

1.Pelvic Girdle

Bones of the Lower Limb: a- Pelvic Girdle: The pelvic girdle is composed of the two hip bones. Each hip bone is formed of three parts, ilium, ischium and pubis.1 Sacrum 2 Sacroiliac joint 3 Ilium 3a Iliac crest 3b Iliac fossa 3c Anterior inferior iliac spine 4 Pubis 4a Iliopubic eminence 4b Symphysis pubis 4d Pubic tubercle 5a Ischial spine The pelvic girdle transmits the weight of the upper part of the body to the legs. It is less movable than the shoulder girdle. The pelvis is composed of two hip bones with the sacrum. The male pelvis is different from female pelvis in the following points:

1.Pelvic Girdle

DIFFERENCES BETWEEN MALE AND FEMALE PELVES??

Male pelvis Weight: Heavier Inlet: Triangular in outline Cavity: Long and narrow Outlet: Narrow and fixed

Female pelvis Lighter Rounded or ovoid in shape Short and wide (to accommodate the fetus) Wide and movable (to allow delivery of the fetus)

b- Femur
It is the skeleton of the thigh, It is a long bone about 45-cm in length. has the following features: Upper end, Lower end and Shaft .

Bones of the leg

- Bones of the legs: Are two in number, tibia and fibula. 1. The tibia Lies medially and carries the weight of the body. It is one of the long bones. Shaft: triangular in outline. 2. The fibula Thin bone lies lateral to the tibia. The body is triangular in cross section. It is attached medially to the tibia by interosseous membrane.

Bones of the foot

The bones of the foot are arranged into three different groups: Tarsal bones: short bones and are 7 in number. Metatarsal bones: long bone and are 5 in number. Phalanges: 2 for the big toe, 3 in the other fingers.

Arches of the foot

The bones of the foot are arranged in the form of two types of arches: Longitudinal arch: from before backward. Transverse arch: from side to side. Functions of the arches of the foot Protection of soft tissues of the foot during walking and standing. Absorb shock during walking and running. Distribute body weight to the different bones of the foot. Transmit the body weight to the ground. Factors help maintaining arches of the foot Shape of the bones. Muscles of the foot. Ligaments and long tendons of the muscles of the leg. Flat foot is a condition, which occurs due to failure of the arches to do its function.The foot becomes flat and the person complains of pain during walking and standing.

JOINTS

- Joint acts to hold bones together and allows movements of the body. Types of joints: - The joints are divided into three big groups: Fibrous Joint: contains fibers tissue between the two ends of the bones. Cartilaginous Joint: contains either hyaline or fibrohyaline cartilage. Synovial Joint: contains synovial fluid inside the joint cavity. .

a- Fibrous joints Contain fibrous tissue between the articulating bones. They are immovable. They present in between the bones of skull and called sutures; and also between teeth and mandible

b- Cartilaginous joints
They contains cartilage (hyaline or fibrocartilage) between the articulating bones. They have slight amount of movements. Primary cartilaginous Joints: present at the epiphyseal lines of long bones. Secondary cartilaginous Joints: present at the joints of median Plane; for example joint between bodies of the vertebrae, symphysis pubis and symphysis menti.

C. Synovial joints

Most joints of the body are synovial. They are freely movable and have the following features: The articulating surfaces are covered with articular cartilage. The articulating bones are connecting together by a Fibrous "capsule" and "reinforcing" ligament. The "capsule" is lined from inside by a "synovial membrane" which secrete a thin film of serous fluid which prevent friction between the articular surfaces. The articular capsule encloses a cavity called the "joint cavity" which contains synovial fluid.

Subtypes of synovial joints

- According

to the shape of the articulating bones and the type of movements, the synovial joints can be divided into: Plane synovial joint: it allows gliding movement it present in the Intertarsal and intercarpal joints. Hinge synovial joints: it allows only movement of flexion and extension like elbow and neck joints. Pivot synovial joints: it allows rotatory movement like movement between two points of the forearm "radius and ulna" and head with the neck. Condyloid synovial joints: it allows the following movements; flexion extension and rotation, e.g. the temporomandibular joint. Saddle shaped synovial joints: it allows; flexion, extension, adduction and slight amount of rotation. It presents at the tarsometatarsal joint of big toe. Ball and socket synovial joints: it allows wide range of movements; flexion and extension, adduction and abduction, rotation and circumduction. They present at shoulder joint and hip joint.

A1 Ball-and-socket (spheroidal) joint mechanism A2 Shoulder joint B1 Hinge joint (ginglymus) mechanism B2 Elbow joint C1 Saddle (sellar) joint mechanism C2 Carpometacarpal joint of thumb D1 Ellipsoid joint mechanism D2 Wrist (radiocarpal) joint E1 Pivot (trochoid) joint mechanism E2 Median atlanto-axial joint F1 Plane (gliding) joint mechanism F2 Intercarpal joints

SKELETAL MUSCLES

They are attached to the skeleton. They also, are known as striated or voluntary muscles. They represent about 43% of body weight and responsible for movements of the body, maintain posture and generates heat.

Skeletal muscle

Features of the skeletal Muscles:

All the muscles are attached to the bones at two points: Origin: is the immovable attachment. Insertion: is the movable attachment. When contractions occurs, the insertion moves towards the origin. The fleshy part of the muscle between the origin and insertion is called the belly of the muscle. The ends of the muscles are attached to the bones by cord of fibrous tissue called the tendons. They are supplied by a mixed nerve composed of motor fibers (60%) and sensory fibers (40%). The muscle fibers are bounded together with connective tissue, which protects and increases the strength of the skeletal muscle.

Types of the Skeletal Muscles

According to the direction of the muscle fibers: Straight muscles: in which the muscle fibers are parallel to each other (e.g. Sartorius muscle of the thigh). Oblique muscles: in which the muscle fibers run obliquely. They are either unipennate, bipennate or multipennate. According to the size of the muscles: Maximum: muscle of the largest size (e.g. gluteus maximus). Medius: muscle of medium size (e.g. gluteus medius). Minimus: muscles of small size (e.g. gluteus minimus). According to the length of the muscle fibers: Longus: muscles of long fibers (e.g. extensor pollicis longus). Brevis: muscles of short fibers (e.g. extensor pollicis brevis).

1 Sternocleidomastoid 2 Trapezius 3 Deltoid 4 Pectoralis major 5 Biceps brachii 6 Brachialis 7 Brachioradialis 8 Flexor carpi radialis 9 Palmaris longus 10 Flexor digitorum superficialis 11 Gluteus medius 12 Sartorius 13 Rectus femoris 14 Vastus medialis 15 Peroneus longus 16 Tibialis anterior 17 Soleus 18 Gastrocnemius 19 Vastus lateralis 20 Gracilis 21 Adductor longus 22 Tensor fasciae latae 23 Rectus abdominis 24 External abdominal oblique 25 Serratus anterior 26 Orbicularis oris 27 Orbicularis oculi 28 Occipitofrontalis

1 2 3 4 5

27 26

28

25

6
7 8 9 10 11 12 13 14 15 16 17 18 21 20 19

24
23 22

III. DIGESTIVE SYSTEM

Definition. is a group of organs designed to take in foods, initially process foods, digest the foods, and eliminate unused materials of food items. The organs of the digestive system can be separated into two main groups; alimentary (gastrointestinal) tract (G.I.T) and digestive organs

A) Alimentary (gastrointestinal) tract (G.I.T)

Mouth:
It is the first part of the G.I.T. It is bounded anteriorly by the lips and laterally by the cheeks. Roof of the mouth is formed by hard palate (anteriorly) and soft palate and uvula (posteriorly). The space between gum and teeth is the vestibule. The oral cavity is enclosed by the teeth and contains the tongue.

Pharynx
The oropharynx lies behind the mouth cavity. It contains the palatine tonsil. It is continuous below with the laryngeo-pharynx and the oesophagus and continuous above with nasopharynx.

Oesophagus
It is about 25 cm long. It runs from the pharynx through the diaphragm to the stomach. Its wall is formed of four layers; mucosa, submucosa, musculosa and serosa.

Stomach

It is a C-shaped organ located on left side of the abdomen beneath the diaphragm. The stomach is formed of two parts: cardiac part and pyloric part. A) The cardiac part: is further subdivided into: Cardiac end: junction between oesophagus and stomach. Fundus of the stomach: it is upper rounded part of the stomach. Body of the stomach: below the fundus and lies to the left. B) The pyloric part consists of: Pyloric antrum: variable dilation below the body. Pyloric canal: it is about 2.5-cm long, lies to the right. Pylorus: site of the pyloric orifice or the gastrodudenal junction. The stomach has two surfaces (anterior and posterior). It has two curvatures (lesser and greater), which give attachment to the omenta.

Small and large Intestine

Intestine (Small, Large)

The small intestine:

is twisted tube extending from pyloric sphincter to the ileocecal valve. It is the longest part of the G.1.T, with an average length of 6 meter in a living person. The small intestine has three subdivisions:

Duodenum:
It is C-shaped curve around head of pancreas. It is 25 cm long. It receives the common hepatopancreatic duct.

Jejunum
It is about 2.5 meter long. It extends from the duodenum to the ileum.

Ileum
It is about 3.6 meter long. It joins the large intestine at the ileocecal valves.

The Large Intestine:

It is about 1.5 meter long. It is subdivided into: caecum, appendix, colon, rectum and anal canal. The colon is divided into: ascending colon, transverse colon, descending colon and sigmoid colon. The sigmoid colon, rectum and anal canal lie in the pelvis. The anus is the terminal opening of the G.I.T, which has external voluntary sphincter and an internal involuntary sphincter.

Differences between small and large intestine

Small Wall: smooth Length: 6 meter Muscle layer: continuous bands Fat: less amount of Function:absorption & digestion

Large - Irregular - 1.5 meter_ - arranged into - large amount fat - feaces formation

B) Accessory Digestive Organs

Pancreas: Is a soft, pink, triangular gland that extends from the duodenum to spleen. It crosses the posterior abdominal wall behind the stomach and is separated from it by the peritoneum. It has two types of secretions: exocrine secretion rich in enzymes and an endocrine secretion contain 2 hormones (insulin and glucagon).

liver

pancreas Langrhan,s islets

Liver and gall Bladder

The liver is the largest gland in the body. Site: It is located to the right side of the body.

Shape:
It is pyramidal in shape having apex, base and four surfaces. The base is directed to the right side. Apex, lies to the left side below left nipple.

Surfaces:
Its surfaces related to the diaphragm and other viscera like right kidney and right suprarenal, duodenum and stomach.

Lobes:
- The liver has four lobes; right, left, cudate and quadrate.

Functions:
It has many metabolic functions beside its role in bile secretion.

The gall bladder:

- is a small green sac embedded in the inferior surface of the liver. Clinical notes:Obstruction of bile flow from liver lead to yellow coloration of skin, mucosa membrane and sclera, a condition clinically known as "Jaundice".

Salivary Glands
- Three pairs of salivary glands empty their secretion into the mouth:

Parotid:
Lies anterior to the ears. Its duct opens at the vestibule of the mouth. Inflammation of the parotid gland is known as "mumps".

Submandibular:Lies under the body of the mandible. Its duct opens at the floor of the mouth.

Sublingual: It is the smallest salivary gland. It lies under the tongue and pours its secretion at the floor of the mouth. Function of saliva: Help swallowing. Contain amylase enzyme which help digestion of carbohydrate. It contains antibodies which guard against infection. Essential for taste sensation as it dissolve food chemicals in their watery secretion.

Teeth

Two sets of teeth have been formed: Decidous teeth: They are also called baby teeth or milk teeth. They begin to appear around 6 month. The first one to appear are the lower central incisors. The baby has 20 teeth by the age of 2 years. Permanent teeth: There are 32 permanent teeth, 16 in each jaw. They are classified according to shape and function into: 4 incisors: are adapted for cutting. 2 canines: for tearing or piercing. 4 premolars: 6 molars: are best suited for grinding. The last molar tooth is called "wisdom tooth" which emerges at the age of 17-25 years. Clinical notes:When teeth remain embedded in the jaw bone; they are said to be impacted. Impacted teeth causes sever pain and must be removed surgically. Wisdom teeth are most commonly impacted.

IV. RESPIRATORY SYSTEM

The organs of the respiratory system are: 1)The nose. 2) The pharynx. 3) The larynx. 4)The trachea. 5) The bronchi and the bronchial tree. 6) Lungs.

Respiratory organs

1. Nasal cavity 2. Pharynx 3. Epiglottis 4. Larynx 5.Trachea. 6. Right bronchus 7. Left bronchus 8.Right lung 9.Left lung 10.Diaphragm 11.Ribs

The Nose

The Nose: It is formed of two parts: External part: it is cartilaginous part covered with skin and carries the nostrils or external nares. Internal part: bounded with the skull bones. It is formed of two compartments separated by the nasal septum. Each compartment is lined with mucus membrane rich in blood vessels and olfactory receptors at the upper part of the nasal cavity. The lateral part of the nose shows 3 elevations or conchae and receives the openings of the nasal sinuses and the nasolacrimal duct. Function of the nose Smell. Respiratory air passage. Warms, humidified and purified air entering the lungs.

2- The Pharynx:

It is a muscular tube about 13 cm long. It acts as air passage and food passage. It is divided into: Nasopharynx: which receives the opening of the auditory tube, and pharyngeal tonsils. Oropharynx: which contains palatine tonsils. Pharyngeal larynx: behind the laryngeal inlet. Terminates opposite 6th cervical vertebra to be continuous as oesophagus.

3- The Larynx

It connects the pharynx above with the trachea below. The junction between the larynx and pharynx is guarded by the epiglottis, which prevents entry of food or drink into respiratory passages during swallowing. The most prominent cartilage of the larynx is the thyroid or (Adam's apple). The larynx contains the vocal cords. It ends opposite the 6~ cervical vertebra. It acts a respiratory passage beside its role in phonation and the expulsive act (act of defecation and micturation).

4- The Trachea

It extends from the larynx to primary bronchi. The trachea contains incomplete tracheal rings which are deficient posteriorly to help the act of swallowing. It is lined with ciliated mucosa which help expectoration. It ends by dividing into right and left primary bronchi, at the level of the lower border of the 4th thoracic vertebra.

5- The Primary Bronchi:

The right and left primary bronchi are formed by the division of the trachea. Each primary bronchus runs obliquely before it enters the hilum of the lung. The right pulmonary bronchus is wider and straighter than the left.

6- The Lungs

Paired organ, responsible for gaseous exchange. Site: thoracic cavity surrounding heart within the pericardium. Shape: conical in shape has the following: Apex: directed upward above the level of the 1st rib. Base: directed downward and it rests upon the copula of the diaphragm. Surfaces: two surfaces: Lateral surface: convex and is related to the ribs. Medial surface: concavo-convex surface related to the heart (anteriorly) and vertebral column (posteriorly). Lobes of the lung: In the right lung there is three lobes, while in the left lung there is two lobes. Fissures separate the lobes from each other. Each lobe is divided into segments (10 in the right lung and 8 in the left). Each segment contains segmental bronchus with its subdivisions (bronchioles, respiratory bronchioles, and alveolar duct alveoli) and its own arterial supply. The alveoli are lined with respiratory membrane, through its wall gaseous exchange take place with the blood of the pulmonary capillaries.

Right and left lungs

Comparison between lungs

Right lung Short Wide 3 lobes 2 fissures (oblique and transverse) 10 bronchopulmonary segments Foregin body usually passes to the right bronchus

Left lung Longer Narrower 2 lobes One (oblique fissure)

8 segments

Rarely passes to the left bronchus

V. URINARY SNYSTEM

It comprises of the following organs. Kidneys. Ureters. Urinary bladder. Urethra.

Kidneys

- They

are paired organs (right and left), Color; brown reddish in coloi Site: it is located at the posterior abdominal wall in both sides of the median plane, opposite the last thoracic vertebra and upper three lumbar vertebrae. Size: 12.5 cm length and 7 cm breadth. Shape: the characteristic kidney-shape, with the outer convex border and an inner concavoconvex border. Surfaces: anterior convex surface related to the abdominal viscera and posterior flat surface related to the diaphragm and posterior abdominal wall. Peritoneal covering: it is a retroperitoneal structure, has only the anterior surface which is covered with peritoneum. Hilum of the kidney: it is a vertical slit at the middle of the medial border. From the hilum emerges the pelvis of the ureter, and through the hilum the renal vessels enter the kidney. Internal structure of the kidney: when the kidney is cut lengthwise three distinct region become apparent: Cortex: outer region. Medulla: with medullary pyramids at the middle. Renal pelvis and calyces: at the inner region Blood supply: Renal artery: arises from the aorta and terminates inside the kidney into; lobar arteries which give interlobar, arcuate and interlobular arteries. Renal vein: receive the same tributaries like the renal artery. It ends into the inferior vena cava.

Ureters

They are slender tube, about 25 cm in h ureter runs behind the peritoneum from the hilum of the kidney to enter the posterior aspect of the bladder. It carries the urine from the kidney to the urinary bladder. (N.B): Along wise the course of the ureter there are many constriction which is the site of the impaction of the renal calculi; a condition which causes a sever pain in the region of the lion radiating to the inner side of the thigh or "renal colic".

3- Urinary Bladder

It is a smooth muscular sac collecting the urine from the kidney. It is located in the pelvis behind the symphysis pubis. It is pyramidal in shape having an apex, base and three surfaces. It receives the openings of: Two ureters on each side of the base (angels). Opening of the urethra (at the neck). The triangular region of the bladder mucosa, which is outlined by these three openings is the "trigone". The bladder wall contains three layers of smooth muscles, and mucosa lined with transitional epithelium.

4- Urethra

It is a thin-walled tube that transmits urine from the bladder to the outside of the body. Urethral sphincters: at the urethral-bladder junction there is thickening of the smooth muscle fibers forming: The internal urethral sphincter. The external urethral sphincter: is a second sphincter, which is formed of striated (voluntary) muscle fibers and surrounds the pelvic part of the urethra. The length and relative function of the urethra differs in the two sexes. In female, it is about 3-4 cm (1.5 inches) in length, and its function is to transmit urine to outside the body. In male, it is approximately 20 cm (8 inches) long and it can be subdivided into three parts: Prostatic part: 3-4 cm long and traverse the prostate. Membranous part: 1-2 cm long and passes through perineum. Penile part: 15 cm in length and passes through the body of the penis. The functions of the male urethra are: It transmits urine outside the body. A passage for the sperms to eject from the body.

VI. REPRODUCTIVE SYSTEM

It is the system responsible for the formation of new baby. It is comprised of the following organs. Male: Primary sex organs:Testis. Duct system:ductus deferens, urethra. Accessory glands: Seminal vesicle.Prostate.Bulbourethral gland. Female : Primary sex organ: Ovary. Duct system: Uterine tube.Uterus.Vagina. Accessory glands: Greater vestibular gland.Female pelvis1

HUMAN MALE GENITAL ORGANS

Male reproductive organs

Testis: Site: suspended in the scrotal sac outside the body. Size: 4 cm long and 2.5 cm breadth. Structure of the testis: The testis is surrounded from outside by connective tissue capsule called "tunica albuginea". The testis is divided into many lobules. Each lobule contains from 1 to 4 seminephros tubules. The seminephros tubules connected medially with another tubules called "rete testis". The rete testis is connected to the epididymis outside the testis. In the soft connective tissue surround the seminephros tubules are lying the "interstitial cells".

Function of the testis:

Production of sperm from the seminephros tubules. Production of androgenic hormone (testosterone) from the interstitial cells.

Structure of the testis

A Section through the layers of the scrotum B Cross section through testis and epididymis 1 Tunica vaginalis 2 Cremaster muscle and fasciae 3 Dartos muscle 4 Skin 5 Testis 5a Tunica albuginea 5b Septula 6 Epididymis 7 Septum of scrotum 8 Spermatic cord

2- Duct System

The male duct system which transports sperm includes:a- Epididymis Is the first part of the duct system, It provides a temporary storage site for immature sperm to complete their maturation (a trip that takes about 20 days). It is about 6 meters (20 feet) long. It lies at the upper posterior part of the testis. b- Ductus deferens: It connects the tail of the epididymis with the ejaculatory ducts inside the prostate. The main function of the ductus deferens is to propel live sperm from the epididymis into the urethra. 3- Urethra: It extends from the base of the urinary bladder to the tip of the penis. It has 3 parts; prostatic part, membranous part and penile part. The prostatic part of the urethra receives the ejaculatory duct from the right and left side.

4- Accessory Glands

a) Seminal Vesicles: Sacculated pouch lies behind the urinary bladder. It produces about 60% of the fluid volume of semen. The duct of each seminal vesicle joins that of the ductus deferens on the same side to form the ejaculatory duct. b) Prostate Gland: Single gland about the size and shape of a walnut. It surrounds the prostatic urethra. C) Bulbourethral Glands or (Cowpers gland): Pea-sized glands below the prostate. Its secretion may play a role in cleaning the urethra of traces of acidic urine and lubricate urethra before ejaculation.

FEMALE GENITAL ORGANS

Female Reproductive Organs

1. Ovaries: They are almond-shape, located inside the cavity of the pelvis, and are attached to lateral wall of the pelvis by "suspensory ligament" and to the uterus by "ovarian ligaments". The ovaries are filled with many ovarian follicles at different stages of development. Usually one mature ovum is expelled from the ovary every 28 days. Function of the ovaries: Ova production. Hormone secretion, e.g. estrogen and progesterone.

Female genital tract 1. Uterine tube. 2. Ovary. 3. Uterus. 4. Vagina.

2- Duct System

It includes the followings: uterine tube, uterus&vagina a- Uterine tubes: It is the first part of the duct system. It lies between the ovaries and the uterus. It is about 10 cm (4 inches) long. The uterine tubes are lined with ciliated epithelium which help the movements of the ovum into the uterine cavity. They provide a site where fertilization

b- Uterus

It is located in the pelvic cavity between urinary bladder and rectum. It is about the size and the shape of a pear (1x2x3 inches). During pregnancy its size increases greatly to accommodate the growing foetus. The uterus is formed of three parts: Fundus: upper rounded part which is the best site for implantation (growing of the foetus). Body: triangular portion below the level of the fundus. Cervix: cylindrical canal below the body. It is inserted to the anterior wall of the vagina. The uterus is lined from inside by mucosa or "endometrium". NB .1-Cyclic changes occur in the endometrium of uterus every 28 days which is known as "uterine or menstrual cycle". 2. During pregnancy, the fertilized ovum become implanted in the endometrium which now becomes changed into the decidua (lining mucosa of the pregnant uterus).

c- Vagina

c- Vagina: It is a thin-walled muscular tube, about 8 to 10 cm long. It lies between the bladder and rectum. It extends from the cervix of the uterus above, to the vaginal orifice below. The vaginal orifice is partially closed by thin fold of mucosa called " hymen ", which is avascular but it may bleed at its rupture. Function of the vagina: Provides a passage for delivery of a baby. It is a passage for the menstrual flow. It is the organ of copulation.

External genital organs

Male Scrotum: which is divided incompletely into two compartments. Each one contains:Testis.Epididymis.D uctus deferens. Penis: formed of three bodies and it contains the penile urethra.

Female Vulva: contains the following:Labia majora.Labia minora.Vestibule, which contains:Urethral orifice.Vaginal orifice.Greater vestibular glands. Clitoris: formed of three bodies, except that it does not contain the urethra which has its own separate orifice in the vestibule in front of the vaginal orifice.

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