Tutor: Mal. Sadiq Rabiu Umar (BSc (YUMSUK), MSc.

(BUK), PGDE (FUDMA)

Email: [email protected] Phone Number: +2348101821666

SKELETAL SYSTEM
• Skeleton: is a bony frame work which gives support to the body structures. The skeletal
system (osteology) consists of bones, joints and cartilages it provides shape, support,
protection and locomotion to the body.

• Bone: is a highly specialized, hard form of connective tissue that makes up most of the
skeleton. Its major constituent (65%) is a mixture of calcium salt, mainly calcium
phosphate.

• Cartilage: is a resilient, semi-rigid form of connective tissue that forms parts of the
skeleton.

• Ligament: are bands of tough, elastic connective tissue that surround a joint to give
support and limits the joint’s movement

• The periosteum and perichondrium are fibrous connective tissue that cover bone and
cartilage respectively and nourish the external aspects of the skeletal tissue.

BONE DEVELOPMENT

All bones derive from mesenchyme (embryonic connective tissue) by two different processes
Intramembranous ossification (directly from mesenchyme) and Endochondral ossification
(from cartilage derived) from mesenchyme. The histology of a bone is the same by either
process.

Type of Bones

1. Cancellous (spongy bone or trabecular bone)

2. Compact bone (dense bone or cortical bone)

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There are three types of bone cell

1. Osteoblasts, bone-building cells are are responsible for the deposition of both
inorganic salts and osteoid in bone tissue.

2. Osteocytes, mature bone cells these are mature bone cells that monitor and maintain
bone tissue, and are nourished by tissue fluid in the canaliculi that radiate from the
central canals.

3. Osteoclasts, bone-reabsorbing cells these cells breakdown bone, releasing calcium

and phosphate. They are very large cells with up to 50 nuclei, which have formed
from the fusion of many monocytes.

Note: A good balance of osteoblast and osteoclast activity, maintains normal bone structure
and functions.

Functions of Skeletal System

Besides contributing to body shape and form our body bones, perform several important body
functions.

1. It provides support to the body (forms the internal framework that supports the body
and houses its soft organs)

2. Forming the boundaries of the cranium, thorax and pelvis and protecting the organs
they contains

3. Haemopoiesis, the production of blood cells in red bone marrow

4. Minerals storage, especially calcium-phosphate

5. Allowing movement of the body as a whole and parts of the body, by forming joints
that are moved by muscles.

6. Provides place for attachment to muscles and tendons.

Hormonal Regulation of Bone Growth

There are some hormones that play a role in regulating the growth, size and shape of bones
and these includes:

 Growth hormone and thyroid hormones (thyroxine and tri-iodothyronine); its

important especially during infancy and childhood. Deficiency or excess secretions of
these hormones result in abnormal development of the skeleton.

 Testosterone and estrogen hormones: these hormones control the physical changes
that occur at puberty and help to maintain bone structure throughout life.

 Calcitonin and parathyroid hormones: these control blood levels of calcium by

regulating its uptake into and release from bone.

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  Calcitonin increases calcium uptake into bone (reducing blood calcium), and
parathyroid hormone decreases it (increasing blood calcium)

 Exercise and bone: weight-bearing exercise stimulates thickening of bone,

strengthening it and making it less liable to fracture. Lack of exercise reverses these
changes, leading to lighter and weaker bones.

 Diet and bone: healthy bone tissue requires adequate dietary calcium and vitamins A,
C and D. And smaller amount of other minerals such as iron and manganese are
essential for adequate mineralization of bone.

Classification of Bones

1. Long bones: These consist of a shaft and two extremities. As the name suggest, these
bones are longer than they are wide. Most long bones are found in the limbs;
examples include the femur, tibia and fibula, humerus and ulna etc.

2. Short, Irregular, Flat, and Sesamoid bones: These bones have no shafts or extremities
and are diverse in shape and size.

3. Short bone e.g. Carpals and tarsals of the feet, irregular bone e.g.. Vertebral bones and
bones of the skull.

4. Flat bones e.g.. Scapula, sternum, ribs and Sesamoid bones e.g.. Patella (knee cap)

Blood and nerve supply

• One or more nutrient arteries supply the bone shaft; the epiphyses have their own
blood supply, although in the mature bone the capillary networks arising from the two
are heavily interconnected.

• •Short, irregular, flat and sesamoid bones; these have a relatively thin outer layer of
compact bone, with spongy bone inside containing red bone marrow.

Division of skeletal system

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 The human skeleton is subdivided into two major divisions:-

1. Axial and

2. Appendicular Skeleton.

Axial skeleton: forms the vertical, central axis of the body and includes all bones of the
skull, sternum or breast bone, ribs, and vertebral column.

• It serves to protect the brain, spinal cord, heart, and lungs.

• It also serves as the attachment site for muscles that move the head, neck, and back,
and for muscles that act across the shoulder and hip joints to move their
corresponding limbs.

SKULL

• The cranium (skull) is the skeletal structure of the head that supports the face and
protects the brain. It is subdivided into the facial bones and the cranial vault.

• In the adult, the skull consists of 22 individual bones, 21 of which are immobile and
united into a single unit.

• The 22 bone is the mandible (only moveable bone of the skull).

Sutures of the skull (joint of the skull): there are four (4) in number

Coronal suture, Frontal suture, Sagittal suture, Lamboidal suture and Squamous suture

Bones of the cranium:

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1 frontal bone, 2 parietal bone, 2 temporal bone, 1 occipital bone, 1 sphenoid bone and 1
ethmoidal bone.

Vertebral Column

• It is also known as the spinal column or spine. It consists of a sequence of vertebrae,

each of which is separated and united by an intervertebral disc.

• The vertebral column in an adult typically consists of 33 vertebrae arranged in five

regions: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal.

• Significant motion occurs only between the 25 superior vertebrae. Of the 9 inferior
vertebrae, the 5 sacral vertebrae are fused in adults to form the sacrum, and after
approximately age 30, the 4 coccygeal vertebrae fuse to form the coccyx.

Thoracic Cage

• The thoracic cage (rib cage) forms the thorax (chest) portion of the body. It consists of
the 12 pairs of ribs with their costal cartilages and the sternum.

• The ribs are anchored posteriorly to the 12 thoracic vertebrae (T1–T12). The thoracic
cage protects the heart and lungs.

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Appendicular Skeleton

• The appendicular skeleton includes all the bones of shoulder region with upper limbs,
and pelvic region with the lower limbs.

The Pectoral Girdle

• The bones that attach each upper limb to the axial skeleton form the pectoral girdle
(shoulder girdle). This consists of two bones, the scapula and clavicle.

Bones of the Upper Limbs (Arms and Hands)

• Humerus is the single bone of the upper arm region. The head articulates with the
glenoid cavity of the scapula to form the glenohumeral joint.

• The margin of the smooth area of the head is the anatomical neck of the humerus. The
surgical neck is a common site of arm fractures.

Ulna and Radius

The ulna is located on the medial side of the forearm, and the radius is on the lateral side.
These bones are attached to each other by an interosseous membrane.

Carpals, Metacarpals and Phalanges

• 8 carpal bones in 2 rows of 4 bones form wrist.

• 5 metacarpal bones, numbered 1 to 5 from thumb to little finger, join the wrist bones

• 14 phalanges (digits), 3 for each phalange except the thumb, which has only 2
(Proximal, middle, and distal)

• Thumb has a Sesamoid bone in its flexor tendon and other Sesamoid may occur in
joints of fingers.

The Pelvic Girdle and Pelvis

• The pelvic girdle (hip girdle) is formed by four bones: the right and left hip bones, the
sacrum, and the coccyx.

• It serves as the attachment point for each lower limb.

• It forms immobile, weight-bearing structure.

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Bones of the Lower Limb

• Like the upper limb, the lower limb is divided into three regions: thigh, leg and foot
regions.

• The lower limb contains 30 bones are the femur, patella, tibia, fibula, tarsal bones,
metatarsal bones, and phalanges.

Tibia and Fibula

• The tibia (shin bone) is the medial bone of the leg and is larger than the fibula, with
which it is paired the tibia is the main weight-bearing bone of the lower leg and the
second longest bone of the body, after the femur.

• The fibula is the slender bone located on the lateral side of the leg.

• The fibula does not bear weight. It serves primarily for muscle attachments and thus
is largely surrounded by muscles.

Tarsals, Metatarsals and Phalanges

• The posterior portion of the foot is formed by a group of seven bones, each of which
is known as a tarsal bone

• The mid-foot contains five elongated bones, each of which is a metatarsal bone.

• The toes contain 14 small bones, each of which is a phalanx bone of the foot.

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Joints and its classifications

• Joint: Is the site at which any two or more bones articulate or come of together (the
end or edges of the bones are held together by connective tissues).

• It allows flexibility and movement of the skeleton. In some joints the participating
bones are fastened together so firmly that no movement between them is possible.

Classification of joints

1. Fibrous joints

2. Synovial joints

3. Cartilaginous joints

Fibrous joints: The bones forming these joints are linked with tough, fibrous material. Such
an arrangement often permits no movement. For examples, the joints between the skull
bones, the sutures, are completely immovable. This fibrous joint allows a limited amount of
movement and stabilizes the alignment of the bones.

Synovial joints: Synovial joints are characterized by the presence of a space or capsule
between the articulating bones. The ends of the bones are held close together by a sleeve of
fibrous tissue, and lubricated with a small amount of fluid. Synovial joints are the most
moveable of the body

Cartilaginous joints: These joints are formed by a pad of tough fibrocartilage that acts as a
shock absorber. The joint may be immovable, as in the cartilaginous epiphyseal plates, which
in the growing child links the diaphysis of a long bone to the epiphysis.

Types of Synovial Joints

Ball and socket joints: The head of one bone is ball-shaped and articulates with a cup-
shaped socket of another. Examples include the shoulder and hip.

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Hinge joints: The articulating ends of the bones fit together like a hinge on a door, and
movement is therefore restricted to flexion and extension. Examples knee, ankle and the
joints between the phalanges of the fingers and toes (interphalangeal joints) and the elbow
joint.

Gliding joints: The articular surfaces are flat or very slightly curved and glide over one
another, but the amount of movement possible is very restricted; this group of joints is the
least movable of all the synovial joints. Examples include the joints between the carpal bones
in the wrist, the tarsal bones in the foot, and between the processes of the spinal vertebrae.

Pivot joints: These joints allow a bone or a limb to rotate. One bone fits into a hoop-shaped
ligament that holds it close to another bone and allows it to rotate in the ring thus formed.
Example rotation of the head.

Condyloid joints: A condyle is a smooth, rounded projection on a bone and in a condyloid

joint it sits within a cup-shaped depression on the other bone. Examples include the joint
between the condylar process of the mandible and the temporal bone, and the joints between
the metacarpal and phalangeal bones of the hand, and between the metatarsal and phalangeal
bones of the foot.

Saddle joints: The articulating bones fit together like a man sitting on a saddle. The most
important saddle joint is at the base of the thumb, between the trapezium of the wrist and the
first metacarpal bone.

Disorder of Bone and Joints

• Rickets and osteomalacia: In both conditions, bone is inadequately mineralised, usually

because of vitamin D deficiency, or sometimes because of defective vitamin D
metabolism.

• Paget’s disease: Paget’s disease is a disorder of bone remodelling, where the normal
balance between bone building and bone breakdown becomes disorganised and both
osteoblasts and osteoclasts become abnormally active.

• Other includes: Osteoporosis, Achondroplasia, Rheumatoid arthritis

NERVOUS SYSTEM

The nervous system is the most complex, widely investigated and least understood system in
the body. It along with endocrine system regulates the functions of all other systems of the
body. Hence nervous system is called master system of the body.

The functions of the nervous system include:

• Gathers information from both inside and outside the body - Sensory Function
• Transmits information to the processing areas of the brain and spine
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• Processes the information in the brain and spine – Integration Function
• Sends information to the muscles, glands, and organs so they can respond appropriately –
Motor Function
• It controls and coordinates all essential functions of the body including all other body
systems allowing the body to maintain homeostasis or its delicate balance.

Divisions of the Nervous System

The Nervous System is morphologically divided into two main divisions: Central Nervous
System (CNS) and the Peripheral Nervous System (PNS)

The central nervous system (CNS): consists of brain and spinal. The brain is located within
the cranial cavity and the spinal cord within the vertebral canal.
The CNS is responsible for integrating, processing, and coordinating sensory data, and giving
appropriate motor commands.
It is also the seat of higher functions such as intelligence, memory, learning, and emotions.

The peripheral nervous system (PNS) includes all the neural tissues outside the CNS, such
as 12 pairs of cranial nerves, 31 pairs of spinal nerves, and ganglia associated with cranial
and spinal nerves. The peripheral nervous system provides sensory information to the central
nervous system and carries its motor commands to the peripheral tissues and systems.

Functional Division of Nervous System

This also the nervous system is divided into two parts:
1. The afferent division that brings sensory information to the central nervous system.
2. The efferent division carries motor commands to the muscles and glands.

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Basic Cells of the Nervous System
The highly specialized and complex nervous system consists of only two principal categories
of cells,
1. Neurons: The basic structural and functional units of the nervous system. They are
excitable cells which are specialized for reception of stimuli and the conduction of
nerve impulses. Transmits impulses (up to 250 mph)
Parts of a Neuron
• Dendrite – receive stimulus and carries it impulses toward the cell body
• Cell Body with nucleus – nucleus & most of cytoplasm
• Axon – fiber which carries impulses away from cell body
• Schwann Cells- cells which produce myelin or fat layer in the Peripheral Nervous
System
• Myelin sheath – dense lipid layer which insulates the axon – makes the axon look
gray
• Node of Ranvier – gaps or nodes in the myelin sheath

NOTE: Impulses travel from dendrite to cell body to axon

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Classification of Neurons
The neurons exhibit considerable diversity in form and function. Therefore, they are
classified structurally as well as functionally.
1. Anatomical (morphological) classification
According to polarity:
Pseudo-unipolar neurons: it possess oval or rounded cell body, single process and T-
junction.
Bipolar neurons: they possess spindle-shaped cell body from each end and single process
emerges.
Multipolar neurons: have multipolar cell body from which emerges several dendrites and a
single axon.

According to size of nerve fibre

Golgi type I neurons: this neurons have long axon and connect different parts of the nervous
system.
Golgi type II neurons: it is also called micro neurons, have short axon and found in large
numbers in cerebral cortex.

2. Functional classification
These types of neurons are classified into the following base on their contribution to the
nervous system.

1. Sensory neurons: they carry impulses from the receptor organs to the central nervous
system.
2. Motor neurons: they transmit impulses from central nervous system to the muscles
and glands (effector organs).

Neuroglia or Glial cells: These are supportive cells that support the neurons functions to
support, protection, insulation, aid in function of neurons both structurally and functionally.
These are:
• Astrocytes help to regulate flow into CSF, regulate chemical composition of tissue
fluid à when neurons are damage astrocytes form hardened masses of scar tissue and
fill in the space = sclerosis.
• Microglia (CNS) carry out phagocytosis of microbes and cellular debris microglia
also remove unused synapses.
• Ependymal Cells (CNS) helps to produce and circulate Cerebro Spinal Fluid.
• Oligodendrocytes (CNS)
• Schwann Cells (PNS) found only in PNS plays essential role in regeneration of cut
or injured neurons [CNS neurons don’t regenerate]
Brain
Is part of the central nervous system situated in the skull (cranial cavity). It is continued as
spinal cord in the vertebral canal through the foramen magnum of the skull bone.
Its weight about 1400g – 1500g in male and female 1200g – 1250g in females.

The functions of the brain are as follows:

 It receives information from, and controls the activities of trunk and limbs mainly through
its connections with spinal cord.
 It assimilates experiences, a requisite to higher mental process such as memory, learning
and intelligence. Etc.

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Lobes of the Cerebrum
 Frontal – motor area involved in movement and in planning & coordinating behavior
 Parietal – sensory processing, attention, and language
 Temporal – auditory perception, speech, and complex visual perceptions
 Occipital – visual center – plays a role in processing visual information

Regions of the Brain

• Cerebellum – coordination of movement and aspects of motor learning.
• Cerebrum – conscious activity including perception, emotion, thought, and planning
• Thalamus – Brain’s switchboard – filters and then relays information to various brain
regions
• Medulla – vital reflexes as heart beat and respiration
• Brainstem – medulla, pons, and midbrain (involuntary responses) and relays
information from spine to upper brain
• Hypothalamus– involved in regulating activities internal organs, monitoring
information from the autonomic nervous system, controlling the pituitary gland and
its hormones, and regulating sleep and appetite.

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SPINAL CORD
Spinal cord is an elongated, almost cylindrical part of the central nervous system, which is
suspended in the vertebral canal surrounded by the meninges and cerebrospinal fluid.

The spinal cord is continuous above with the medulla oblongata and extends from the upper
border of the atlas (1 cervical vertebra) to the lower border of the 1 st lumbar vertebra. It is
approximately 45 cm long in adult males and thickness of the little finger. It is the only
nervous tissue that connects between the brain and the rest of the body.

MENINGES/MENINGEAL LAYER
Meninges are the three coverings around the brain & spine and help cushion, protect, and
nourish the brain and spinal cord.
1. Dura mater is the most outer layer, very strong fibrous connective tissue.
2. Arachnoid mater is the middle layer and adheres to the Dura mater and has web-like
attachments to the innermost layer, the Pia mater.
3. Pia mater is very thin, transparent, but tough, and covers the entire brain, following it
into all its crevices (sulci) and spinal cord.

CEREBROSPINAL FLUID
Cerebrospinal fluid is a clear, slightly alkaline fluid with a specific gravity of about 1.005
consists of the following compositions: Water, Mineral salt, Glucose, Plasma proteins, small
amount of albumin and globulin, A few leukocytes, Small amount of creatinine, and Small
amount of urea.

Function of Cerebrospinal Fluid

Buffers, nourishes, and detoxifies the brain and spinal cord, flows through the subarachnoid
space, between the arachnoid mater and the pia mater, It act as a shock absorber, and It
supports and protects brain and spinal cord by maintaining uniform pressure.

The CSF contains four irregular shaped cavities or ventricles, containing cerebrospinal fluid. They
are the:

 Right and left lateral ventricles

 Third ventricle
 Fourth ventricle.
The average amount of cerebrospinal fluid formed per day is 500 ml. CSF is produced in the
brain by choroid plexus.

CRANIAL NERVES
The cranial nerves are set of 12 paired nerves that arise directly from the brain. The first two
(2) nerves (olfactory and optic) arise from the cerebrum, whereas the remaining ten (10)
emerge from the brain stem. The cranial nerves are numbered I-XII, from rostral to caudal.

They are called cranial nerves because they emerge through foramina of fissures in the
cranium. Some of these nerves are sensory cranial nerves, motor cranial nerves and mixed
cranial nerves
1. Olfactory nerve (CN) - control sense of smell

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2. Optic nerve (CN) - transmit visual information
3. Oculomotor nerve (CN) - supplies external muscles of the eye
4. Trochlear nerve (CN) - supplies muscles of the eye
5. Trigeminal nerve (CN) - control chewing and sensation in the face
6. Abducent nerve (CN) - controls lateral eye movement
7. Facial nerve (CN) - supplies muscles of facial expression and taste buds in the anterior 2/3
of the tongue
8. Vestibulocochlear nerve (CN) - control hearing and balance
9. Glossopharyngeal nerve (CN) - control swallowing, salivary gland and movement of the
tongue
10. Vagus nerve (CN) - controls organs of the thoracic and abdominal cavities
11. Spinal accessory nerve (CN) - supplies the sternocleidomastoid and trapezius muscles
12. Hypoglossal nerve (CN) - supplies the muscles of the tongue and the muscles surrounding the
hyoid bone, and contribute to swallowing and speech.

Mnemonic: Oh Oh Oh To Touch And Feel Very Good Valvet Ah Heaven

PLEXUS
There are five large plexuses of mixed nerves formed on each side of the vertebral column.
They are the:
Cervical plexuses
Brachial plexuses
Lumbar plexuses
Sacral plexuses
Coccygeal plexuses.

REFLEX ARC
• Reflex activity is the response to a peripheral nervous stimulation that occurs without
our consciousness.
• Reflex arc is the anatomical nervous pathway for a reflex action. For example, when
hand is placed on a hot object, it is withdrawn immediately.
A simple reflex arc includes five components:

1. Receptor (2) Afferent Nerve (3) Center (4) Efferent Nerve (5) Effector Organ

SYNAPSE
Synapses are the functional connection between neurons and a few other cells (e.g. muscles,
glands). It is the meeting point between a neuron and any other cells. Neurons generally are
not directly connected to each other but are separated by a small gap.

Functions of the synapses:

1. Triggers release of chemical (neurotransmitters) exocytosis e.g. GABA, glycine,
glutamate (glutamic acid) and aspartate, noradrenaline, adrenaline, dopamine,
serotonin, histamine, and acetylcholine, nitric oxide; diffuses across synapse and
binds to receptor Proteins in cell membrane of target cell
2. Triggers response in target cell

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RETICULAR ACTIVATION SYSTEM (RAS)

Is a collection of neurons in the core of the brain stem, surrounded by numerous and diffuse
neural pathways that conduct ascending and descending nerve impulses between the brain
and the spinal cord.
Function of Reticular activation system:
 helps control muscle tone, balance and posture during body movements
 filters flood of sensory input
 Sleep and consciousness

ENDOCRINE SYSTEM

Endocrine tissue is made up essentially of cells that produce secretions which are poured
directly into bloodstream. Endocrine tissues are highly vascular. Therefore Endocrine system
consists of glands, which are widely separated and have no physical connections with each
other. The endocrine system is the collection of glands that produce hormones (chemical
messengers) that regulate metabolism, growth and development, tissue function, sexual
function, reproduction, sleep, and mood, among other things. They are also referred as
ductless glands because hormones diffuse directly into bloodstream to the target tissues and
organs that may be distant, where they influence growth, cell growth and metabolism.

Pituitary Gland
The pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and weights
500 mg in humans. Together with hypothalamus act as unit, regulating the activity of most of
the other endocrine glands. It is a protrusion off the bottom of the hypothalamus at the base of
the brain
The hypophysis rests upon the hypophysial fossa of the sphenoid bone in the center of the
middle cranial fossa. It is surrounded by a small bony cavity (sella turcica) covered by a fold
of Dura mater.

Pituitary gland consists of two main parts that originate from different types of cell
1. The Anterior Pituitary gland and,
2. The Posterior Pituitary gland
Anterior Pituitary Gland
 It is also called “Adenohypophysis” an outgrowth of pharynx.

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  This produces hormones six (6), and they perform the stimulation and inhibition
function.
The following are functions of Adenohypophysis:
1. Promote mammary gland development and milk productions.
2. Increase rate of protein metabolism in most of the cells in the body. Etc.

Anterior Pituitary Gland and Hormones Secreted

S/ Hormone Functions
N
1. Growth hormone(GH) Promotes tissue growth especially bone and
muscles. Cellular differentiation

2. Thyroid stimulating hormone Stimulates growth and the activity of thyroid gland
(TSH) and secretions of T3 and T4

3. Prolactin hormone (PRL) Stimulates milk production in the breast after birth

4. Follicle stimulating hormone Stimulates production of sperm in the testes,

(FSH) secretion of estrogen by ovaries and ovulation
5. Luteinizing hormone (LH) Stimulates secretion of testosterone by the testes
and secretion of progesterone by corpus luteum

6. Adrenocorticotrophic hormone Stimulates growth and activity of the adrenal

(ACTH) cortex.

POSTERIOR PITUITARY GLAND

 It is also called “Neurohypohysis”
 Arises from nervous tissue, which consists of large number of Glial cells in gland (Down
the growth of nervous tissues from the brain).
 It produces two hormones [ Oxytocin and Vasopressin/Antidiuretic hormones]

The Following Are Functions of Neurohypophysis:

1. Helps in the delivery of baby at the end of gestations by (Oxytocin)
2. Controls the rate at water excretion into the urine by Vasopressin/ADH

HYPOTHALAMUS:
Hypothalamus is a brain structure that is found in all vertebrate nervous systems. It is
located below the thalamus, in human brain. It is the size of an almond. One of the most
important functions of the hypothalamus is to link the nervous system to the endocrine
system. Hypothalamus synthesizes and secretes certain neuro-hormones, called releasing
hormones or hypothalamic hormones, and these in turn stimulate or inhibit the secretion of
hormones from the pituitary gland.
The hypothalamus controls body temperature, hunger, and important aspects of parenting and
attachment behaviors, thirst, fatigue and sleep.

PINEAL GLAND:
Is a small endocrine gland in the brain of most vertebrates and is a midline brain structure
that is unpaired. The gland is reddish-gray and about the size of a grain of rice in humans also

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this gland is part of the epithalamus, and lies between the laterally positioned thalamic
bodies.

It is also located posterior to the third ventricle. The pineal gland secretes melatonin, a
serotonin-derived hormone which modulates sleep patterns.

Thyroid Gland
Thyroid gland is a H-shaped gland that is located in the neck in front of the larynx and
trachea at the level of 5-7th cervical and 1st thoracic vertebrae. It has two large lateral lobes
which comprise the bulk of the gland and are connected in the center by a structure called
isthmus.
It resembles a butterfly in shape. The thyroid gland in the normal human being weighs about
20 – 25 g but is capable of enormous growth.

Hormones produced by the thyroid gland

1. T3 (tri-iodothyronine) and
2. T4 (thyroxine)
The release of T3 and T4 into blood is stimulated by thyroid stimulating hormone (TSH)
from the anterior pituitary gland. They regulate metabolism of carbohydrates, proteins and
fats. They increase the metabolic rate and heat production
3. Calcitonin: it lowers blood calcium (Ca2+) level by acting on bone cells, promoting their
storage of calcium. And kidney tubules, inhibiting the reabsorption of calcium.

PARATHYROID GLAND
The parathyroid glands are two pairs of glands usually positioned behind the left and right
lobes of the thyroid. Each gland is a yellowish-brown flat ovoid that resembles a lentil seed,
usually about 6 mm long and 3-4 mm wide, and 1 to 2 mm anterior-posteriorly. There are
typically four parathyroid glands: they secretes parathyroid hormone.

The two parathyroid glands on each side which are positioned higher are called the superior
parathyroid glands while the lower two are called the inferior parathyroid glands.

Parathyroid glands generally weigh about 30 mg in men and 35 mg in women. The major
function of the parathyroid glands is to maintain the body's calcium and phosphate levels
within a very narrow range, so that the nervous and muscular systems can function properly.
The parathyroid glands do this by secreting parathyroid hormone (PTH).

ADRENAL GLAND
 The Adrenal glands are located on both sides of the body in the retroperitoneum, above
and slightly medial to the kidneys.
 The right adrenal gland is pyramidal in shape, whereas the left is semilunar or crescent
shaped and somewhat larger.
 The adrenal glands measure approximately 3 cm in width, 5 cm in length, and up to
1.0 cm in thickness.
 Each gland has an outer cortex which produces steroid hormones and an inner medulla
 The adrenal cortex secretes the hormone, cortisol which regulates carbohydrates, fats and
proteins.
 Arterial supply: Superior, middle and inferior suprarenal arteries

Hormones Secretes by Adrenal Gland

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Adrenal Medulla: It release the hormones
1. Adrenaline (epinepherine) and
2. Noradrenaline (norepinepherine)
They potentiate the fight or flight response by:
 Increasing heart rate, blood pressure
 Increasing metabolic rate, dilating of pupils and
 Diverting blood to essential organs
Adrenal Cortex: this produces three (3) group of steroid hormones from cholesterol,
collectively called Adrenocorticoids
Glucocorticoids, Mineralocorticoids and Sex hormones (Gonadocorticoids).

The hormones in each group have different actions, but as they are structurally similar.
Glucocorticoids:
1. Have widespread metabolic effects, generally concerned with catabolism of protein and
fat that makes glucose and other substances available for use to help the body combat
stress.
2. Anti-inflammatory actions
3. Suppression of immune responses
4. Delayed wound healing.

Mineralocorticoids: Aldostrone is the main mineralocorticoid. It is involved in maintaining

water and electrolyte balance.

Sex hormones (Gonadocorticoids): Sex hormones secreted by the adrenal cortex are mainly
androgens (male sex hormones)

Pancreas

The pancreas, located in the abdomen, inferior and posterior to the stomach

The pancreas is divided into a head, neck, body, and tail. The pancreas stretches from the
inner curvature of the duodenum, where the head surrounds two blood vessels, the superior
mesenteric artery, and vein.

The longest part of the pancreas, the body, stretches posterior to the stomach, and the tail of
the pancreas ends adjacent to the spleen.

The pancreas functions mostly to regulate blood sugar levels and its secretions is directly into
the bloodstream and circulate throughout the body, it secretes the following hormones:

 Glucagon secrete by (Alpha cells) – increases blood glucose level

 Insulin the most numerous which, secrete by (Beta cells) – reduces blood glucose level

 Somatostatin secrete by (Delta cells)

Insulin and glucagon are controlled blood glucose level mainly by the opposing actions of
these two hormones.

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GONAD

 A gonad is a mixed gland that produces the gametes (sex cells) and sex hormones of an
organism. In female, the reproductive cells are the oocytes found in the ovaries, and in the
male the reproductive cells are the spermatozoa found in the testes.

 The ovaries of the fem ale release two main hormones. Secretion of estrogens by the
ovarian follicles begins at puberty under the influence of follicle stimulating hormone
(FSH)

 Estrogens stimulate maturation of the female reproductive system and development of the
secondary sexual characteristics

 Progesterone is released in response to high blood levels of luteinizing hormone (LH).

It works with estrogens in establishing the menstrual cycle.

 The testes of the male begin to produce testosterone at puberty in response to luteinizing
hormone (LH)

 Testosterone promotes maturation of the male reproductive organs, development of

secondary sex characteristics such as beard, hoarse voice, etc. and production of sperm by
the testes.

Disorders of Endocrine System

Diabetes mellitus, Thyroid disease, and obesity, Pituitary adenoma: Tumor on the pituitary,
Hypothyroidism, Gigantism or acromegaly, and Goiter e.t.c.

URINARY SYSTEM

The urinary system plays a vital role in maintaining homeostasis of water and electrolytes
within the body.

20
Kidney plays a dominant role in regulating the volume and composition of the extracellular
fluid (ECF)/Homeostasis.

The kidneys produce urine, which contains metabolic waste products, including the
nitrogenous compounds urea and uric acid, excess ions and sometimes, excreted drugs.,

The kidneys are found in the abdominal cavity attached to the posterior wall on both sides of
the vertebral column. Each kidneys weights about 150g and measures about 1x2x3 inches
(thickness x width x length).

Functions of the Urinary System

1) Formation of urine, maintaining water, electrolyte and acid-base balance

2) Excretion of waste products

3) Production and secretion of erythropoietin; the hormone that stimulates formation of

red blood cells (erythropoiesis)

4) Production and secretion of renin, an important enzyme in the long-term control of

blood pressure.

5) Secretion of hormone

6) Regulation of vitamin D activity

A kidney is a reddish-brown, bean-shaped organ with a smooth surface. An adult kidney is

about 10 -12cm long, 5 -7cm wide, and 3cm thick. Outer reddish brown granular layer
called cortex and inner layer called medulla. Hilus/Hilum is dimpled part of the kidneys that
serves as exit and entry to some structures these structures include the renal vessels, nerves,
lymphatic and ureters.

The medulla consists of triangular renal structures renal pyramid. Tips of the pyramids form
the renal papillae, the papillae drain their contents into renal calyces (major and minor) and
the calyces drain into renal pyramid and then to the ureter.

21
Relationship of the Kidney

RIGHT KIDNEY

Superiorly – the right adrenal gland

Anteriorly – the right lobe of the liver, the duodenum and the hepatic flexure of the colon.

Posteriorly – the diaphragm and muscles of the posterior abdominal wall.

LEFT KIDNEY

Superiorly – the left adrenal gland

Anteriorly – the spleen, stomach, pancreas, jejunum and splenic flexure of the colon

Posteriorly – the diaphragm and muscles of the posterior abdominal wall.

BLOOD IN FLOW OF THE KIDNEY

MICROSCOPIC STRUCTURE OF THE KIDNEY

Nephron is the functional unit of the kidney. Each of the two kidneys consists of 1 million
nephrons. Nephron has two main parts:

1. Renal corpuscle that consists of; a tuft of capillaries and glomerulus that is
surrounded by an expanded double walled cup-shaped structure called Bowman’s
capsule

2. Renal tubule consisting of

• Proximal Convoluted Tubule

• Loop of Henle’s (thin & thick limbs which are of ascending and descending
portions)

• Distal Convoluted Tubule

• Collection Ducts

THERE ARE TWO TYPES OF NEPHRONS

1. Cortical Nephron (85%)

2. Juxtamedullary Nephron (15%)

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URINE FORMATION

Three (3) basic processes are involved in urine formation. These are

Glomerular Filtration,

Tubular Reabsorption

Tubular Secretion

1. Glomerular Filtration

This is a non-selective process. Most of the valuable constituents of the filtrate, such as salts,
water, electrolytes and other metabolites are returned to the blood by the tubules.

• It is achieved by high hydrostatic pressure of about 60 mm Hg.

2. Tubular Reabsorption

This is the process in which substances are transferred out of the tubular fluid and returned to
the capillaries surrounding the kidney tubules.

• In this way substances that have been temporarily lost from the plasma in the process
of glomerular filtration are returned to the circulation.

• Reabsorption is a selective process, and the tubules handle different substances

differently.

3. Tubular Secretion

It is the movement of substances across the tubule epithelium in a direction opposite to that of
reabsorption.

• Certain substances such as p-amino hippurate (PAH) are taken up by the tubules
surrounding the tubules and deposited in the tubular fluid.

• Other substances such as H+ and NH3+ are generated within the kidney tubule cells
and then secreted into the tubular urine.

• The terms reabsorption and secretion simply indicate the direction of transport across
the tubular epithelium, either out of or into the tubular urine, respectively.

Ureters: They are hollow muscular tubes about 20-30cm long with a diameter of
approximately 3mm, attaching the kidney to the bladder then continuous with the renal pelvis
and enter the posterior aspect of the bladder it runs behind the peritoneum and peristalsis aids
gravity in urine transport

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Urinary Bladder: The urinary bladder is a hollow, distensible muscular organ situated in the
pelvic cavity posterior to the pubic symphysis. In males, it is directly anterior to the rectum.
And in females, it is anterior to the vagina and inferior to the uterus. Wall consists of 4 layers
(same as GI tract)

Mucosa, Submucosa, Muscularis and Serosa

The two ureters open into the urinary bladder by passing obliquely through the posterior wall
which makes a valve mechanism that prevents reflux. Urine enters the bladder by rhythmic
peristaltic waves in the ureters that occur about 1 – 5 times/min.

Urinary bladder has three (3) major parts: Body, Trigone and the Neck

The wall of the bladder contains smooth muscles fibers arranged spirally, circularly and
longitudinally. These are called the detrusor muscles and their contraction evacuates the
bladder.

Urethra: The urethra is a canal extending from the neck of the bladder to the exterior, at the
external orifice. There are two sphincters around the inlet of the urethra.

1. Internal urethral sphincter is smooth and involuntary

2. External urethral sphincter is striated and voluntary

The urethra is five times longer in males than in females.

 Females 3 – 4mm

 Males 20mm

The urethra is a common duct for the urinary and reproductive systems in males. These two
systems are entirely separate in females.

MICTURITION

This is the process of emptying/evacuation of the urinary bladder through the urethra
otherwise known as Urination. There are two processes involved in micturition

1. Progressive filling of the bladder until when the pressure rises to a critical value.

2. A neuronal reflex called the micturition reflex which empties the bladder.

Clinical Relevance of the Urinary System

ANURIA: Absence of urine due to failure of kidney function or to an obstruction in a

urinary pathway.

CYSTECTOMY: Surgical removal of the urinary bladder.

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CYSTITIS: Inflammation of the urinary bladder.

DYSURIA: Painful or difficult urination.

NEPHROPTOSIS: Movable or displaced kidney.

Nephritis and polyuria, Acidosis e.tc.

REPRODUCTIVE SYSTEMS

The reproductive system is a collection of internal and external organs in both males and
females that work together for the purpose of procreating. The function of reproductive
system is replication; reproduction by means of sexual intercourse produces new human
beings and hereditary traits to be passed from both parents to their children’s.

The sex hormones play an important role both in the development and function of the
reproductive organ and in sexual behavior. Overall function is to produce offspring. Testes
produce sperm and male sex hormones. Ovaries produce eggs and female sex hormones and
Mammary glands produce milk

The male reproductive system is responsible for delivering sperm to the female
reproductive system. The male reproductive system comprises of the following organs:

A. Primary sex organs or gonad in male (Testes)

B. Accessory sex organs in males are: Scrotum, 2 Epididymis, 2 Deferent ducts (Vas
deferens), 2 Spermatic cords, 2 Seminal vesicles, 2 Ejaculatory ducts, 1 Prostate
gland, Urethra, and 1 penis

Scrotum: is a pouch of deeply pigmented skin, fibrous and connective tissue and smooth
muscle. It is divided into two compartments each of which contains one testis, one
epididymis and the testicular end of a spermatic cord. It lies below the symphysis pubis, in
front of the upper parts of the thighs and behind the penis.

25
Testes: They are about 4.5 cm long, 2.5 cm wide and 3 cm thick and are suspended in the
scrotum by the spermatic cords. They are surrounded by three layers of tissue. It has three
layers (Tunica Vaginalis, Tunica Albuginea, Tunica Vasculosa)

Spermatic cord: It helps to suspend the testes in the scrotum.

Seminal vesicles: Are two small fibromuscular pouches lined with columnar epithelium,
lying on the posterior aspect of the bladder. It secretes viscid fluid rich in fructose,
prostaglandins, ascorbic acid and falavins.

Their ducts join the ends of the vas deferens forming the Ejaculatory duct which pass through
the prostate and open into urethra.

Prostate gland: It lies in the pelvic cavity in front of the rectum and behind the symphysis
pubis, surrounding the first part of the urethra. It secretes a thin, milky fluid that makes up
about 30% of semen, and gives it its milky appearance. It is slightly alkaline, which provides
a protective local environment for sperm arriving in the acidic vagina.

Epididymis: Each epididymis is a single long coiled tubule in which the sperms are store and
become more mature and release.

Vas deferens: Is a long muscular duct that conducts the sperm from the epididymis to the
urethra by peristaltic movements.

Cowper’s gland: This secretes mucous during intercourse which neutralizes the acidity
inside the urethra and lubricates the sexual movements.

Penis: This is formed of erectile tissue that can accommodate a great amount of blood,
resulting in its erection (which is necessary for introduction of the seminal fluid deep into the
female genital tract).

Female Reproductive System

The female reproductive system functions to produce gametes and reproductive hormones,
just like the male reproductive system.

However, it also has the additional task of supporting the developing fetus and delivering it
to the outside world.

Unlike its male counterpart, the female reproductive system is located primarily inside the
pelvic cavity.

The Female reproductive system comprises of the following organs:

Internal Genitalia

A. Primary sex organs or gonad in female (2 Ovaries)

B. Accessory sex organs in females: Vagina, Uterine cervix, Uterus, Female breast, and
2 uterine tubes (fallopian tubes or oviducts).
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External Genitalia

Are known collectively as the vulva, and consist of the labia majora and labia minora, the
clitoris, the vaginal orifice, the vestibule, the hymen and the vestibular glands (Bartholin's
glands).

The vestibule: is a space between the labia minora. Its floor contains the greater vestibular
glands and the opening for the urethra & vagina. During sexual arousal the greater and lesser
vestibular gland secrete alkaline mucous for lubrication to aid penetration.

The Mons pubis: Mound of fatty tissue covers pubis symphysis. It is covered with hair at
puberty.

Hymen: The hymen is a thin layer of mucous membrane which partially occludes the
opening of the vagina.

Labia majora: These are the two large folds which form the boundary of the vulva. They
are composed of skin, fibrous tissue and fat and contain large numbers of sebaceous glands.

Labia minora: These are two smaller folds of skin between the labia majora, containing
numerous sebaceous glands. The cleft between the labia minora is the vestibule. The vagina,
urethra and ducts of the greater vestibular glands open into the vestibule.

Clitoris: The clitoris corresponds to the penis in the male and contains sensory nerve endings
and erectile tissue but it has no reproductive significance. It’s very sensitive organ.

Vestibular glands: The vestibular glands (Bartholin's glands) are situated one on each side
near the vaginal opening. It secretes mucus that keep the vulva moist

INTERNAL STRUCTURES

Vagina: It is a fibro-muscular tube lined with stratified squamous epithelium, connecting the
external and internal organs of reproduction.

 It runs obliquely upward and backwards at an angle of about 45° between the bladder
in front and rectum and anus behind.

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  In the adult the anterior wall is about 7.5 cm (3 inches) long and the posterior wall
about 10 cm long.

 It is the site where semen deposits during sexual intercourse; it is a canal for
menstrual flow and a birth canal during childbirth.

Uterus: A hallow muscular organ located in front of the rectum and behind the urinary
bladder. It is like an inverted pear when viewed anterior and is pear size as well, during
pregnancy it increases 3 - 6 times. It is somewhat pear-shaped

Uterus has three (3) parts:

1. Fundus: the upper, doom shaped part

2. Body: the tapering middle portion

3. Cervix: the body terminate to narrow portion

Uterus is a thick muscular chamber that opens into the roof of the vagina and usually tilts
forward over the urinary bladder. Its function is to harbor the fetus, provide it with a source
of nutrition (the placenta, composed partially of uterine tissue), and expel the fetus at the end
of gestation (pregnancy).

Ovary

Ovaries: Are females’ gonads that produce ova and female hormones. It is about the size of
unshelled almond. The ovaries are located in the pelvic cavity one in each side of the uterus.

 Each ovary is attached by a mesentery called mesovarium to the backside of each

broad ligament.

 A thickening border of the mesovarium called ovarian ligament extends from the
ovary to the uterus.

 The ovary is suspended from the pelvic wall by the suspensory ligament.

Ovulation

An ovary contains thousands of immature egg cells. During each menstrual cycle, follicle
stimulating hormone (FSH) causes one egg to begin development; this takes place inside a
primary follicle.

The follicle enlarges as its cells proliferate, and begins to fill with fluid, becoming a
secondary follicle that moves to the ovary’s surface.

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It also increases its production of the hormone estrogen. The lining of the empty follicle
thickens into a corpus luteum a temporary source of hormones.

Function of the Ovary

Ovaries have two functions, gametogenic and endocrine functions.

 Gametogenic function is the production and release of ovum or egg, which is the
female gamete (reproductive cell).

 Endocrine function of ovaries is the secretion of female sex hormones.

Uterine Tube: Are a pair of tubes one in each side of the uterus. The uterine tube (fallopian
tube) conveys the oocyte to the uterus. One of the paired tubes receives the oocyte from the
ovary to take to the uterus.

It has 3 distinct portions.

 Infundibulum: funnel shaped, near the ovary

 Ampulla: thin walled middle portion

 Isthmus: opens in to the uterus

Puberty in Female

Puberty is the age at which the internal reproductive organs reach maturity, usually between
the age of 12 and 14. This is called menarche and marks the beginning of the childbearing
period.

It is characterized by a rise in the production of reproductive hormones and initiation of

female reproductive cycle. The activity of ovary leads to the secretions of estrogens, which
are the main stimulus for the development of the physical changes associated with puberty.

These changes are also called the secondary sexual characteristics and include:

 Growth of pubic and axillary hair

 Development and enlargement of the breasts

 Maturation of the uterus, uterine tubes and ovaries

 Increased fat deposition in the subcutaneous tissue, especially at the hips and breasts.

Menstrual cycle:
A menstrual cycle consists of natural changes that occur in a woman’s body every month in
preparation for pregnancy. Menstruation starts at puberty and ends at menopause.

The cycle lasts an average of 28 days but may vary between 20 and 40 days. The first day of
a cycle is the first day of a menstrual period and the last day is that of the following period.

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First menstrual period:
The menstrual cycle often begins at puberty between the ages of 8 and 15 (average age of
12). It usually starts two years after breasts and pubic hair start to develop.

Phases of the menstrual cycle:

There are four phases: menstrual phase, the follicular phase, ovulation phase and the luteal
phase.

Menstrual phase:
Menstruation is the elimination of the internal lining of the uterine wall along with other
secretions from the body through the vagina. It usually lasts three to seven days but this could
change to more or less days from month to month and depending on each woman.

The follicular phase:

The follicular phase starts on the first day of menstruation and ends with ovulation. During
this phase the pituitary gland (situated at the base of the brain) releases a follicle (cyst)
stimulating hormone. This hormone produces 10 to 20 follicles in the ovary and each follicle
houses an immature egg.

These follicles produce the hormone estrogen, which in turn thickens the lining of the
endometrium in preparation to receive a fertilized egg. Often, only one follicle keeps growing
and travels to the ovarian surface while the remaining follicles gradually fade and are
absorbed back into the body.

Ovulation phase:
Ovulation occurs 12 to 16 days before the following period but not necessarily in the middle
of the cycle. The term “ovulation” indicates the formation of a mature egg by one of the
ovaries. The release of estrogen during the follicular phase causes the brain to produce a
gonadotrophin releasing hormone that prompts the pituitary gland to produce raised levels of
luteinizing hormone.

This extracts the mature egg from the follicle (cyst) and transports it from the ovary to the
fallopian tube. If fertilization does not occur during this phase, the egg continues to the uterus
and dissolves within 6 to 24 hours.

The luteal phase:

During this phase, the follicle from which the mature egg burst out (now called the yellow
body of the ovary or corpus luteum) released a large quantity of progesterone and some
estrogen. The two hormones help thicken the lining of the endometrium and maintain its
thickness.

If fertilization does not occur, the yellow body degrades and progesterone levels decrease,
leaving the lining unstable. The lining then falls away and a new menstrual cycle period
begins.

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Menopause

The menopause (climacteric) usually takes place between the age of 45 and 55 years,
marking the end of the childbearing period.

It may occur suddenly or a period of years, sometimes as long as 10 years and is caused by
progressive reduction in estrogen levels as the number of functional follicles in the ovaries
declines with age.

Several other phenomena may occur at the same time, including:

1. Shrinkage of the breasts

2. Loss of bone mass, predisposing to osteoporosis

3. Gradual thinning of the skin

4. Sparseness of axillary and pubic hair

5. Atrophy of the sex organs

6. Uncharacteristic behavior e.g. irritability, mood changes

7. Slow increase in blood cholesterol level and this may lead to risk of cardiovascular disease.

Female Breast

The breasts or mammary glands are accessory glands of the female reproductive system.
They also exit in the male but only in a rudimentary form. Breast contains varying number of
glandular tissue, supported by fatty tissue and fibrous connective tissue that anchor the breast
to the chest wall.

Each breast contains about 20 lobes, each of which contains a number of glandular structure
called lobules. Where milks are produced and lobules open into tiny lactiferous ducts, which
drain the milk towards the nipple.

Nipple is a small conical eminence at the center of the breast surrounded by pigmented area
called Areola. On the surface of the areola there are numerous sebaceous glands, which
lubricate the nipple during lactation.

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Diseases/Disorder of the reproductive system

Below here are some of the associated diseases of the reproductive sytem:

Gonorrhoea, Acquired immune deficiency syndrome (AIDS), Hepatitis B infection,

Trichomonas vaginalis, Cervical carcinoma, Ectopic pregnancy, Gynaecomastia, and Prostate
tumor etc.

DIGESTIVE SYSTEM

Digestion is defined as the process by which food is broken down into simple chemical
substances that can be absorbed and used as nutrients by the body.

Most of the substances in the diet cannot be utilized as such. These substances must be
broken into smaller particles, So that they can be absorbed into blood and distributed to
various parts of the body for utilization.

Digestive system is responsible for these functions. Digestive process is accomplished by

mechanical and enzymatic breakdown of food into simpler chemical compounds.

32
All these food materials are subjected to digestive process, before being absorbed into blood
and distributed to the tissues of the body. Digestive system plays the major role in the
digestion and absorption of food substances.

Functions of the Digestive System

1. Ingestion or consumption of food substances

2. Breaking them into small particles

3. Transport of small particles to different areas of the digestive tract

4. Secretion of necessary enzymes and other substances for digestion

5. Digestion of the food particles

6. Absorption of the digestive products (nutrients)

7. Removal of unwanted substances from the body.

Digestive system is made up of gastrointestinal tract (GI tract) or alimentary canal and
accessory organs, which help in the process of digestion and absorption. GI tract is a tubular
structure extending from the mouth up to anus, with a length of about 30 feet. It opens to the
external environment on both ends.

GI tract is formed by two types of organs:

1. Primary digestive organs.

2. Accessory digestive organs.

33
1. Primary digestive organs are the organs where actual digestion takes place. These
includes: i. Mouth ii. Pharynx iii. Esophagus iv. Stomach v. Small intestine vi. Large
intestine.

2. Accessory digestive organs are those which help primary digestive organs in the process
of digestion. These includes: I. Teeth ii. Tongue iii. Salivary glands iv. Exocrine part of
pancreas v. Liver vi. Gallbladder.

WALL OF GASTROINTESTINAL TRACT

In general, wall of the GI tract is formed by four layers which are from inside out:

1. Mucosa layer

2. Submucosa layer

3. Muscular layer

4. Serous or Adventitial layer.

Nerve Supply to the GIT

GI tract has two types of nerve supply:

Intrinsic nerve supply and Enterinsic nerve supply

1. Intrinsic nerves to GI tract form the enteric nervous system that controls all the secretions
and movements of GI tract.

2. Enteric nervous system is present within the wall of GI tract from esophagus to anus.
Nerve fibers of this system are interconnected and form two major networks called:-

• Auerbach plexus or myenteric (between circular and longitudinal muscles layer)-

contraction/movements of the GIT

34
 • Meissner plexus or submucosal (muscle layer and submucosa)- secretions of the
GIT

DIGESTIVE PROCESSES

The activities of the digestive system can be grouped under five main headings.

1. Ingestion. This is the taking of food into the alimentary tract, i.e. eating and drinking.

2. Propulsion. This mixes and moves the contents along the alimentary tract.

3. Digestion. This consists of:

• mechanical breakdown of food by, e.g. mastication (chewing)

• chemical digestion of food into small molecules by enzymes present in

secretions produced by glands and accessory organs of the digestive
system.

4. Absorption. This is the process by which digested food substances pass through the walls
of some organs of the alimentary canal into the blood and lymph capillaries for circulation
and use by body cells.

5. Elimination. Food substances that have been eaten but cannot be digested and absorbed
are excreted from the alimentary canal as faeces by the process of defaecation.

Primary digestive organs

Mouth: is otherwise known as oral cavity or buccal cavity. It is formed by cheeks, lips and
palate. It encloses the teeth, tongue and salivary glands.

Mouth opens anteriorly to the exterior through lips and posteriorly through fauces into the
pharynx.

Functions of the mouth

1. Appreciation of taste of the food

2. Transfer of food (bolus) to the esophagus by swallowing

3. Role in speech

4. Social functions such as smiling and other expressions.

5. Ingestion of food materials

6. Chewing the food and mixing it with saliva

35
Pharynx: This is the second part of the alimentary canal. It is funnel shaped, muscular and
lined with mucous membrane that is continuous with the mouth, esophagus and respiratory
tract.

Parts of the Pharynx:

1. Nasopharynx

2. Oropharynx

3. Laryngopharynx

Esophagus: this is a narrow muscular tube that passes down through the thorax to open into
the stomach. The esophagus is about 25 cm long and about 2 cm in diameter and lies in the
median plane in the thorax in front of the vertebral column behind the trachea and the heart.

It is continuous with the pharynx above and just below the diaphragm it joins the stomach.

Function of the esophagus:

• It has sphincter which opens when food is swallowed and helps to transport food from the
pharynx to the stomach.
• Stomach: is a hollow organ situated just below the diaphragm on the left side in the
abdominal cavity.
• Volume of empty stomach is 50mL
• Under normal conditions, it can expand to accommodate 1L to 1.5L of solids and liquids.
• However, it is capable of expanding still further up to 4L.

Parts of stomach

In humans, stomach has four parts:

1. Cardiac region 2. Fundus 3. Body or corpus 4. Pyloric region.

Functions of the stomach

• Temporary storage allowing time for the digestive enzymes, pepsins, to act
• Chemical digestion – pepsins break proteins into polypeptides

36
• Mechanical breakdown – the three smooth muscle layers enable the stomach to act as a
churn, gastric juice is added and the contents are liquefied to chyme. Gastric motility and
secretion are increased by parasympathetic nerve stimulation
• Limited absorption – water, alcohol and some lipid soluble drugs

Small intestine: is the part of gastrointestinal (GI) tract, extending between the pyloric
sphincter of stomach and ileocecal valve, which opens into large intestine.

It is longer than large intestine. Its length is about 6 meter. Important function of small
intestine is absorption. Maximum absorption of digested food products takes place in small
intestine.

Small intestine consists of three portions:

1. Proximal part known as duodenum

2. Middle part known as jejunum

3. Distal part known as ileum

Wall of the small intestine has all the four layers as in stomach

Large intestine or colon extends from ileocecal valve up to anus. It has a larger diameter
than the small intestine.

Parts of the large intestine:

1. Cecum with appendix

2. Ascending colon

3. Transverse colon

4. Descending colon

5. Sigmoid colon or pelvic colon

6. Rectum

7. Anal canal.

MOVEMENTS OF THE DIGESTIVE SYSTEM

Mastication or chewing: is the first mechanical process in the gastrointestinal (GI) tract, by
which the food substances are torn or cut into small particles and crushed or ground into a
soft bolus.

37
Deglutition or swallowing: is the process by which food moves from mouth into stomach.

OTHER MOVEMENT INCLUDES

• Movement of the stomach

• Filling and emptying of the stomach
• Vomiting
• Movement of the small intestine
• Movement of the large intestine
• Defecation
• Evacuation of gases from gastrointestinal tract

ACCESSORY ORGANS OF DIGESTIVE SYSTEM

Salivary gland:

Digestive juice present in the mouth is saliva, which is secreted by the salivary glands. In
humans, the saliva is secreted by three pairs of major (larger) salivary glands and some minor
(small) salivary glands.

Major Salivary Glands are:

1. Parotid glands 25%

2. Submaxillary glands 70%

3. Sublingual glands 5%

Composition of saliva

Saliva is the combined secretions from the salivary glands and the small mucus-secreting
glands of the oral mucosa. About 1.5 litres of saliva is produced daily and it consists of:
Water, Mineral salts, Salivary amylase; a digestive enzyme, Mucus, Antimicrobial
substances; immunoglobulin and the enzyme lysozyme.

38
Liver: Liver is a dual organ having both secretory and excretory functions. It is the largest
gland in the body, weighing about 1.5 kg in man.

It is located in the upper and right hypochondric region of the abdominal cavity, immediately
beneath diaphragm.

Functions of the liver:

• Carbohydrate metabolism

• Fat metabolism

• Protein metabolism

• Storage

• Detoxification against microbes

• Defence against microbes

Pancreas: The pancreas is a pale grey gland weighing about 60grams. It is about 12–15cm
long and is situated in the epigastric and left hypochondriac regions of the abdominal cavity.

It consists of a broad head, a body and a narrow tail. And it has two functions; exocrine and
endocrine function

Biliary tract: This involves the route taken by bile from the liver, to the gall bladder and then
to the duodenum.

DISORDERS OF THE DIGESTIVE SYSTEM

Peptic ulceration: ulceration of the gastrointestinal mucosa is caused by disruption of the

normal balance of the corrosive effect of gastric juice and the protective effect of mucus on
the gastric epithelial cells.

39
Appendicitis: this is the inflammation of the appendix cause by microbial infection mostly.

Cholera: the disease is caused by vibrio cholera and is spread by contaminated water, food
and hand. Symptoms include persistent diarrhea and severe dehydration.

Hepatitis: this refers to inflammation of the liver and can be caused by viruses, drugs and
chemicals including alcohol.

Exam format covers 70%

1. Short essay
2. Objectives
3. True / False
4. Fill in the space

Continuous Assessment 30%

1. Group Presentation
2. Attendance
3. Test

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