KADUNA SCHOOL OF HEALTH INFORMATION

MANAGEMENT

PROFESSIONAL DIPLOMA IN HEALTH INFORMATION

MANAGEMENT

HIS 113: ANATOMY AND PHYSIOLOGY I

LECTURE GUIDE.
 GENERAL OBJECTIVES
By the end of this course students should be able to;
1. Understand human blood and other system of the body

2. Understand body resistance to infection

3. Understand types of immunity

4. Know blood groups

5. Understand the structure of the heart and blood vessels

6. Know the body lymphatic system

7. Know the respiratory system.

 INTRODUCTION TO ANATOMY AND PHYSIOLOGY.
Definition of terms:
Anatomy: this is a Greek origin word which is derived from the prefix ‘ana’
meaning ‘up’ and ‘tome’ meaning cutting. In essence anatomy means “cutting
up”. Anatomy can be defined as the scientific study of the structures of the body
including their arrangement and relationship to one another and the microscopic
aspects of each structure.
Physiology: this is the scientific study of the functions of the normal human body
structures.
Classification or branches of anatomy
a) Gross anatomy: this is the study of the various structures of the body as
seen by the naked eyes. The approaches to the study of gross anatomy
include;
 Regional or Topographical anatomy: this is the gross study of the
body region by region e.g. head, neck, thorax, abdomen etc.
 Systemic anatomy: this is the gross study of the body structures
system by system e.g. digestive, urinary, respiratory systems etc.
b) Microscopic anatomy: this is the study of the various structures of the body
with the help of a microscope. The approaches to the study of microscopic
anatomy include:
 Cytology: the microscopic study of body cells
 Histology: the microscopic study of body tissues
 Organology: the microscopic study of body organs.
c) Comparative anatomy: this is the scientific study of the gross structures of a
mammal in relation to the human body e.g. comparing the digestive system
of human and dog.
d) Developmental anatomy: this is the scientific study of the development of
the human body from the fertilization of the ovum (egg) by the
spermatozoon until the matured being is formed. This can be studied as:
 Embryology: the study of the origin, growth and development of an
organism from fertilization until birth.
 Postnatal: the study of the body development after birth to maturity.
 Anatomicomedical terminology.
1. Anatomical Position: this is the term used when the human body is in the
standing position facing forward with the two arms by the sides of the
body, the palms of the hands facing forward and the two feet are placed
together.
The position of the organs of the body are described in either:
 Supine position: this implies lying down with the face upward.
 Prone position: this implies lying down with the face downward.

2. Anatomical planes: these are imaginary lines that divides the body, these
include;
 Median plane: this is a vertical plane passing longitudinally through
the body or organ dividing it into two a right and left equal halves.
 Sagittal planes: these are vertical planes passing through the body or
organ parallel to the median plane dividing the into a right and left
half. However, a plane near to the median plane may be referred to
as a paramedian plane.
 Frontal (coronal) planes: these are vertical planes passing through
the body or organ at right angles to the median plane dividing the
body or organ into anterior and posterior parts.
 Transverse planes: these are planes through the body or an organ at
right angles to the median and frontal planes dividing the body or
organ into superior and inferior parts.

3. Terms of relationship and comparison:

 Superficial, Intermediate and Deep: this describes the position of
structures relative to the surface of the body or the relationship of
one structure to another underlying or overlying structures.
 Medial: is used to indicate that (in the anatomical position) a
structure is near to the median plane in relation to another organ
e.g. the eyes are medial to the ears.
 Lateral: this stipulates that a structure is farther away from the
media plane in relation to another structure e.g. the ears are lateral
to the eyes.
  External and Internal: means farther from and nearer to the center of
an organ or cavity respectively.
 Posterior (dorsal): denotes the back surface of the body or structure
and also when an organ or structure is near to the back in relation to
another organ e.g. the uterus is posterior to the urinary bladder.
 Anterior (ventral): denotes the front surface of the body or structure
and also when an organ or structure is near to the front in relation to
another organ e.g. the urinary bladder is anterior to the uterus.
 Rostral: is often used instead of anterior when describing parts of the
brain, it denotes nearer the anterior parts of the head.
 Inferior: this refers to a structure that is situated nearer or towards
the sole of the foot in relation to another structure e.g. the ankle is
inferior to the knee.
 Caudal: this is used in embryology which means toward the tail
region.
 Superior (cranial): refers to a structure that is near or towards the
head in relation to another structure e.g. the knee is superior to the
ankle.
 Proximal and Distal: are used when contrasting positions near to or
farther from the point of attachment of a limb or the central aspect
of a linear structure respectively.
 Bilateral: this means a paired structure having right and left e.g. the
lung.
 Unilateral: this implies occurring on one side of the body e.g. the
heart.
 Ipsilateral: this refers to something occurring on the same side of the
body with another structure e.g. right thumb and right big toe.
 Contralateral: means occurring on the opposite side of the body
relative to another structure e.g. right and left hands.

4. Terms of movement:
 Flexion: indicates bending or decreasing the angle between the
bones or parts of the body.
  Extension: indicates straightening or increasing the angle between
the bones or parts of the body.
 Abduction: moving away from the median plane in the frontal plane.
 Adduction: moving toward the median plane in the frontal plane.
 Circumduction: this is a circular movement that is a combination of
flexion, extension, abduction and adduction occurring in such a way
that the distal end of the part moves in a circle.
 Rotation: this involves turning or revolving a part of the body around
its longitudinal axis. Medial rotation and lateral rotation.
 Pronation: is the rotational movement of the forearm and hand that
swings the radius medially around its longitudinal axis so that the
palm faces posteriorly and its dorsum faces anteriorly.
 Supination: is the rotation movement of thee forearm and hand that
swings the radius laterally around its longitudinal axis so that the
dorsum of the hand faces posteriorly and palm faces anteriorly.
 Protrusion and Retrusion: means moving anteriorly and posteriorly
respectively.
 Elevation and Depression: means raises a part superiorly and
inferiorly respectively.

Organization of the human body

Cell: this is the basic structural unit of the body which is capable of carrying out all
the vital functions of the body. The cell can only be seen with the aid of a
microscope.
Tissue: this is a collection of similar cells joined together either loosely or closely
to perform a specific function.
Organ: this is a collection of similar tissue for the performance of a specific
function.
System: this is a collection of organs of similar or related function working
together as a unit.
Assignment
a) Draw and label a human cell
b) State the different functions of the organelles
c) Write extensively on the different types of tissues

CARDIOVASCULAR SYSTEM.
This is the system that consist of approximately 5 liters of blood, blood vessels
and the heart responsible for the transportation and distribution of both wanted
and unwanted substances throughout the body.
 BLOOD AND ITS COMPOSITION.
Blood can be defined as the red liquid that circulates in the arteries and veins of
the human and other vertebrate animals, carrying nutrients and waste. Basically,
blood can either be oxygenated of deoxygenated. Oxygenated blood is the blood
that contains oxygen and all the nutrient required by the body for proper
functioning while deoxygenated blood is that blood that contains carbon dioxide
and all waste substance that needs to carry out of the body.
Functions of blood: the blood has the following major functions;
1. Transportation
2. Protection
3. Regulation
4. Blood clotting
5. Life saving
6. Diagnosis
Assignment
a) Write short note on the above functions of blood.
Composition of blood: the blood is made up of the following;
a. Plasma (55%)
b. Erythrocyte/Red Blood Cell (RBC)
c. Leukocyte/White Blood Cell (WBC)
d. Thrombocytes/Platelets

Plasma
This is the colorless liquid found in blood and is made up of the following chemical
components;
 i. Water: this dissolves all the other plasma materials and provides a liquid
medium in which blood cells can travel.
ii. Proteins: this include the following
 Albumins; they are the most abundant in the plasma and plays a role
of maintain osmotic balance.
 Globulins; these large proteins tend to act as carriers for other
molecules through the blood especially important for transporting
hydrophobic (lipid) materials. They are also the proteins that are
antibodies.
 Fibrinogen; this very large protein is not abundant in the blood but it
is important in blood clotting.
iii. Gases: this include oxygen, carbon dioxide and nitrogen.
iv. Nutrients: these are small dissolved organic molecules, monomers of
proteins, carbohydrates and nucleic acids travel through the blood. These
are used for producing energy and for building new macromolecules.
v. Vitamins: this include all vitamins.
vi. Lipids: these do not travel through the hydrophilic plasma unaccompanied
instead, they travel in association with proteins in special complexes called
lipoproteins and one of their major function is to be used for producing
energy.
vii. Hormones: some of these are proteins others are small dissolved organic
molecules (like amines and peptides) and some are steroids. Their general
function is homeostasis.
viii. Wastes: the cells produce many nitrogenous wastes as a result of
gluconeogenesis and are removed from the body by the excretory organs.
ix. Electrolytes: these are simply ions and are important for regulating osmotic
balance and maintaining pH.

Erythrocytes (Red Blood Cells (RBC)).

The erythrocytes are flexible and oval biconcave disks which lack a cell nucleus
and most organelles in order to accommodate maximum space for hemoglobin.
Approximately 2.4 million new erythrocytes are produced per second in human
adult in the bone marrow, liver and spleen. The cytoplasm of erythrocyte is rich in
hemoglobin which is an iron containing biomolecule that can bind oxygen and is
responsible for the red colour of the cell. Erythrocyte has an average life span of
120 days.
Functions of the erythrocyte
 To deliver to all the cells of the body oxygen.
 Release of ATP when they undergo shear stress in constricted vessels
 Erythrocytes release s-nitrosothiols which also act to dilate blood vessels
 They can synthesize nitric oxide enzymatically using L-arginine as substrate
as do endothelial cells
 They can also produce hydrogen sulfide a signaling gas that acts to relax
vessel walls.
Medical classification of erythrocyte
On microscopic examination, RBC may reveal variation in the following respect;
size, shape, staining reaction, structure and number. The following are types of
erythrocyte:
a. Achromatic: this type of erythrocyte which the hemoglobin has been
dissolved and is colorless cells.
b. Basophilic: an erythrocyte in which cytoplasm stains blue.
c. Crenated: an erythrocyte with a serrated or indented edge usually the
result of withdrawal of water from the cell as occurs when cells are placed
in hypertonic solutions.
d. Immature: any incompletely developed erythrocyte.
e. Orthochromatic: this stains with acid stain with only the cytoplasm
appearing pink.
f. Polychromatic: this type does not stain uniformly.
g. Hypochromic: one that contains less than normal concentration of
hemoglobin and as a result appears paler than normal.
h. Normochromic: one of normal colour with a normal concentration.
Note: Erythrocytes are produced by a process called erythropoiesis and controlled
by a hormone called erythropoietin produced by the kidneys.
 Leukocyte (White Blood Cells (WBC)).
These are colourless cell which circulates in the blood and body fluids. The normal
human blood contains about 4000-10,000mls of leukocytes. WBC are produced
and derived from a multipotent cell in the bone marrow known as hematopoietic
stem cell, they are found throughout the body. Leukocytes are the major cells of
the immune system that are involved in protecting the body against infectious
disease and foreign invaders. All white blood cells are nucleated.
Types of leukocytes: there are five different types of leukocytes which are
distinguished by their physical and functional characteristics which are;
a) Neutrophils (40-75%)
b) Eosinophils (1-6%)
c) Basophils (less than 1%)
d) Monocytes (2-10%)
e) Lymphocytes (20-45%)

Note:

i. Neutrophils, eosinophils and basophils are collectively known as

granulocytes due to the presence of granules in their cytoplasm.
ii. Monocytes and lymphocytes are known as mononuclear cells.
iii. Monocytes and neutrophils are phagocytic.

Neutrophils: these are the most abundant WBC circulating in the body. They
defend against bacterial and fungi infections. They are usually the first responders
to microbial infection, their activity and death in large numbers forms pus. They
are commonly referred to as polymorphonuclear (PMN) because they have a
multi-lobed nucleus which consist of three to five lobes connected by slender
strands. Their cytoplasm may look transparent because of fine granules that are
pale lilac when stained. These cells are not able to renew their lysosomes and die
after having phagocytosed a few pathogens and they are the most common cell
type seen in the early stages of acute inflammation. They have a life span of 4-
5days.
Eosinophils: their count fluctuates throughout the day, seasonally and during
menstruation. It rises in response to allergies, parasitic infections, collagen
diseases, disease of the spleen and central nervous system. They are rare in the
blood but numerous in the mucous membranes of the respiratory, digestive and
lower urinary tracts. Their nucleus is bi-lobed and the lobes are connected by thin
strand.
Basophils: they are the rarest of the white blood cells and share physicochemical
properties with other blood cells this make them difficult to be studied. Their
nucleus is bi or tri lobed but it’s hard to see because of the number of coarse
granules that hide it. Basophils are chiefly responsible for allergic and antigen
response by excreting two chemicals histamine and heparin which aids in the
body defenses.
Monocytes: these are the largest type of WBC which share the vaccum cleaning
(phagocytosis) function as neutrophils but are much longer lived as they have an
extra role, they present pieces of pathogens to T-cells so that the pathogens may
be recognized again and killed. Monocytes eventually leave the blood stream and
become tissue macrophages which remove dead cell debris as well as attacking
microorganisms. Unlike neutrophils, monocytes are able to replace their
lysosomal contents and are thought to have a much longer active life. Monocytes
have a kidney shaped nucleus and are typically agranulated. Once monocytes
move from the blood stream out into the body tissues they undergo changes
(differentiate) allowing phagocytosis and are then known as macrophages.
Lymphocyte: these are much more common in the lymphatic system than in
blood. They are distinguished by having a deeply staining nucleus that may be
eccentric in location and a relatively small amount of cytoplasm. Lymphocytes
include;
 B-cells: which make antibodies that can bind to pathogens, block pathogen
invasion, activate the complement system and enhance pathogen
destruction.
 T-cells: these include;
 T helper (CD4) cells which activate and regulate T and B cells
  Cytotoxic (CD8) cells which deals with virus infected and tumor cells
 Yd T cells which bridge between innate and adaptive immune
responses.
 Regulatory (suppressor) T cells which returns the functioning of the
immune system to normal operation after infection preventing
autoimmunity.
 Natural killer cells: these are involved with virus and tumor infected
cells.

Thrombocytes (platelets)
These are small colourless disc-shaped cell fragment without a nucleus found in
large numbers in blood and involved in clotting. They are the lightest and the
smallest components of blood, they are fragments of cytoplasm which are
derived from the megakaryocytes of the bone marrow and then enter the
circulation and they circulate as intact mononuclear cells. The ratio of platelets to
red blood cells in a healthy adult is 1:10 to 1:20.
The role of platelets in blood clotting: the main function of thrombocytes is to
contribute to hemostasis by the process of stopping bleeding at the site of
interrupted endothelium. They gather at the site and unless the interruption is
physically too large, they plug the hole.
First, platelets attach to substances outside the interrupted endothelium
(adhesion). Second, they change shape, turn on receptors and secrete chemical
messenger (activation). Third, they connect to each other through receptor
bridges (aggregation). Formation of this platelet plug (primary hemostasis) is
associated with activation of them coagulation cascade with resultant fibrin
deposition and linking (secondary hemostasis), these processes may overlap. The
spectrum is from a predominantly platelet plug or “white clot” to a predominantly
fibrin clot or “red clot” or the more typical mixture and the final result is the clot.
Thrombocytes structure: the platelet can be divided structurally into four zones
from peripheral to innermost;
 Peripheral zone: is rich in glycoproteins required for platelet
adhesion, activation and aggregation.
  Sol-gel zone: is rich in microtubules and microfilaments allowing the
platelet to maintain their discoid shape.
 Organelle zone: is rich in platelet granules like;
i. Alpha granules containing clotting mediators such as factor V, VII,
fibrinogen, fibronectin, platelet derived growth factor and
chemotactic agents.
ii. Delta granules or dense bodies containing ADP, calcium, serotonin
which are platelet-activating mediators.
 Membranous zone: contains membranes derived from megakaryocytic
smooth endoplasmic reticulum organized into a dense tubular system
which is responsible for thromboxane A2 synthesis. This dense tubular
system is connected to the surface platelet membrane to aid thromboxane
A2 release.

THE BLOOD GROUPING SYSTEM.

ABO blood grouping: the ABO blood types are the most well-known and
medically important ones. The four principal type are A, B, AB and O. An
individual’s blood type is determined by a combination of two antibodies and two
antigens namely antibodies A and B and antigens A and B.
Groups Group A Group B Group AB Group O
Red blood cell A B AB O
type.
 Antibodies in B A None A and B
plasma.
Antigens in A B A and B None
RBC.

Rhesus (Rh) blood grouping: blood can be Rh+ (rhesus positive) or Rh- (rhesus
negative) and should not be mixed. A Rh incompatibility often occurs in
pregnancies where the mother blood is Rh- and the fetus is Rh+, this causes
destruction of red blood cells in the fetus and an exposure of both bloods can also
occur accidentally through transfusion. To be Rh+ or Rh- refers to whether one
has Rh factor or not respectively. Whether one has Rh factor or not it doesn’t
affect one’s general health. However, it can cause problems during pregnancy, in
the pregnancy blood from the baby can cross into the mother’s blood stream
especially during delivery. If the mother is Rh- and baby Rh+, the mother’s body
will react to the baby’s blood as a foreign substance thereby creating antibodies
(proteins) against the baby’s Rh+ blood. These antibodies usually do not cause
problem during the first pregnancy however, the antibodies stay in the mother’s
body once they have been formed.
Rh incompatibility is more likely to cause problems in later pregnancies, the Rh
antibodies can cross the placenta and attack the baby’s RBC leading to hemolytic
anemia in the baby. Without enough RBC the baby won’t get enough oxygen
which can lead to the dead of the baby.

Donor-Recipient blood compatibility.

Donor Recipient
A- and O- A-
A+, A-, O+ and O- A+
 B- and O- B-
B+, B-, O+ and O- B+
AB-, B-, A- and O- AB-
AB+, AB-, B+, B-, A+, A-, O+ and O- AB+
O+ and O- O+
O- O-

BLOOD VESSELS
These are the body’s highways in which blood flow through quickly and efficiently
from the heart to every region of the body and back to the heart again. All blood
vessels contain a hollow area called the lumen through which blood is able to
flow, around the lumen is the wall of the vessels which may be thin as in the case
of capillaries or thick in the case of arteries. The blood vessels are lined with a thin
layer of simple squamous epithelium known as the endothelium that keeps blood
cells inside of the blood vessels and preventing it from clotting. There are three
types of blood vessels which are;

Arteries
These are the blood vessels that transport blood away from the heart to other
part of the body. All arteries transport oxygenated blood except the pulmonary
arteries. Irrespective of their size all arteries are made up of three layers which
are;
 Tunica adventitia: is the outermost layer made up of fibrous tissue to
prevent over distension of the artery.
 Tunica media: is the middle layer that consist of elastic tissue and smooth
involuntary muscle.
 Tunica intima: is the inner most layer which is made up of squamous
epithelial cells called endothelium. This layer surrounds the lumen for the
passage of blood.
Note: Arterioles are narrow arteries that are attached to capillaries.

Capillaries
These are the smallest of the blood vessels which are found running throughout
almost every tissue of the body and border the edges of the body’s avascular
tissues. Capillaries connect to arterioles on one end and venules on the other,
they carry blood very close to the cells of tissues of the body in order to exchange
gases, nutrients and waste products. The walls of capillaries consist only a thin
layer of endothelium so that there is minimum amount of structure possible
between the blood and the tissues. The endothelium acts as a filter to keep blood
cells inside of the vessels while allowing liquid dissolved gasses and other
chemicals to diffuse along their concentration gradients into or out of tissues.
Note: Precapillary sphincters are bands of smooth muscle found at the arteriole
ends of capillaries, these sphincters regulate blood flow into the capillaries. Since
there is a limited supply of blood and not all tissues have the same energy and
oxygen requirements, the precapillary sphincter reduce blood flow to inactive
tissues and allow free flow into active tissues.

Veins
These are blood vessels that transport blood from the body back to the heart. All
veins transport dark purplish-red deoxygenated blood except the pulmonary
veins. Veins rely on gravity, inertia and the force of skeletal muscle contractions
to help push blood back to the heart. Some veins contain many one-way valves
that prevent blood from flowing away from the heart. Veins also are made up of
three layers as follows;
 Tunica adventitia: is the outermost layer of a vein which is made up of
more fibrous tissue than that of an artery.
 Tunica media: is the middle layer which is made up of less muscular tissue
and elastic tissue than those of an artery. These make the vein to be
thinner and weaker than an artery.
 Tunica intima: is the innermost layer of a vein which is made up of
enthothelium that provides a smooth inner lining for easy flow of blood.
This layer surrounds the lumen, the lumen of the veins of the limbs
possesses semi-lunar valve and these valves are absent in the veins of the
thorax and abdomen.
Note: venules are similar to arterioles.

Differences between an artery and a vein.

Artery Vein
Carry blood away from the heart Carry blood back to the heart
All carry oxygenated blood except All carry deoxygenated blood except
pulmonary arteries pulmonary veins
Tunica adventitia has less fibrous Tunica adventitia has more fibrous
tissue tissue
Tunica media is thicker containing Tunica media is thinner and weaker
more smooth muscles and elastic containing less smooth muscle and
tissue elastic tissue
Lumen is smaller in size because of Lumen is larger in size because of
thicker tunica media thinner tunica media
Absences of valves Presences of valves in some

Similarities between artery and vein

1. Both have three layers
2. Both transport blood
3. Both possess lumen for passage of blood

CIRCULATION OF BLOOD
These are the different ways how blood is circulated within the body
 1. Coronary circulation: this deals with the circulation of blood around the
layers of the heart.
2. Portal circulation: this deals with the circulation of blood from the digestive
tract and spleen with the liver.
3. Systemic circulation: this deals with the circulation of blood between the
heart to all parts of the body.
4. Pulmonary circulation: this deals with the circulation of blood between the
heart and the lungs.
Pulmonary circulation: this is the circulation of deoxygenated blood from the
right ventricle through the pulmonary arteries to the lungs for oxygenation and
the circulation of oxygenated blood from the lungs back to the left atrium.
Deoxygenated blood enters the right atrium of the heart through the superior and
inferior vena cava and from there it passes through the tricuspid valve into the
right ventricle from here the deoxygenated blood passes through the pulmonary
valve into the pulmonary trunk and through the left and right pulmonary arteries
into the left and right lungs respectively were the blood gets oxygenation within
the alveoli of the lungs. The oxygenated blood leaves the lungs through the left
and right pulmonary veins into the left atrium and from here the blood passes
through the bicuspid valve into the left ventricle and from here into the aorta
through the aortic valve to all part of the blood.
Assignment
a. Explain the systemic circulation.

Some major arteries supplying blood to all major body structures.

Aorta: this is the largest artery of the body that is directly from the heart. All
arteries are branches either directly or indirectly from the aorta.
Abdominal artery: this is the fourth segment of the aorta supplying blood to all
the organs and to the walls of the abdomen and it branches into the common iliac
arteries.
Internal iliac artery: this is a branch of the common iliac artery flowing to the
pelvis, genital organs and the inner thigh.
Superior mesenteric artery: this is a branch of the abdominal aorta that supplies
blood to the ascending colon and half of the transverse colon.
Renal artery: branch of the abdominal aorta supplying blood to the kidney.
Pulmonary artery: this carry blood poor in oxygen to the lungs.
Dorsalis pedis artery: this supply the ankle and the back of the foot.
Arch of foot artery: this is the continuation of the dorsalis artery which supply the
arch of the foot and divides into the arteries of the metatarsus which supply the
metatarsus.
Anterior tibial artery: this supply the anterior part of the leg and the extensor
muscles.
Femoral artery: main artery of the lower limb and supplies the femoral area.
Common iliac artery: this is a branch of the abdominal aorta that supply blood to
the pelvis and lower limbs.
Brachial artery: supplies the flexor muscles of the arm and it divides into the
radial and ulnar arteries at the bend in the elbow to supply the radial and ulnar
regions respectively.
Axillary artery: it supplies the axillar, thoracic wall and shoulder region.
Subclavian artery: this supplies the upper limb through it branches and the lower
section of the neck.
Common carotid artery: this is a branch of the aorta flowing to the head and
upper portion of the neck supplying them. This is divided into internal and
external carotid arteries.

Some major veins draining major organs of the body.

Generally, the systemic veins are divided into superficial veins (cutaneous veins),
deep veins and venous sinuses. The superficial veins reside just beneath the
surface of the skin.
Great saphenous vein: is a superficial vein collecting blood from the inner leg and
thigh and receiving blood from certain veins of the foot.
Femoral vein: collect blood from the deep structures of the thighs and receives
blood from the greag saphenous vein among others.
Renal vein: collecting blood from the kidney.
Basilica vein: large superficial vein of the inner surface of the arm.
Cephalic vein: superficial vein of the outer arm and also receives blood from the
superficial veins of the shoulder.
Axillary vein: deep vein that receives blood from the shoulder and thorax veins.
Cephalic vein empty into axillary vein.
Subclavian vein: collects blood from the arm and part of the neck and face. Also
receives blood from external jugular vein among others.
External jugular vein: vein carrying blood from the cranial walls, deep regions of
the face and outer walls of the neck.
Internal jugular vein: vein collecting blood from the encephalon and from one
portion of the face and neck.
Superior mesenteric vein: vein collecting blood from a section of the intestine
(small intestine, right colon). It flows into the portal vein.
Inferior vena cava: vein carrying blood deoxygenated in the lower portion of the
body (below the diaphragm) in the right atrium, it is the largest vein in the
organism.
Superior vena cava: vein carrying deoxygenated blood from the upper body
(above the diaphragm) back to the right atrium.

Mechanism by which exchange of nutrients, gases and waste occur between the
blood and the tissues.
There are 3 mechanisms which are;
 1. Diffusion: Is the first and most important mechanism that allows the flow
of small molecules across, capillaries. This process depends on the
difference of gradients between the interstitium and blood with molecules
moving to low concentrated spaces from high concentrated one’s glucose,
amino acids, oxygen (O2) and other molecules exit capillaries by diffusion to
reach the organism’s tissues. Contrarily, carbon dioxide(co2) and other
wastes leave tissues and enter capillaries by the same process but in
reverse. Diffusion through the capillary walls depends on the permeability
of the wall to which exchange materials, this permeability depends on the
endothelial cells forming the capillary walls which maybe continuous,
discontinuous and fenestrated.
2. Bulk flow: This is the second mechanism of capillary exchange. It is used by
small lipid-insoluble substances in order to cross. This movement depends
on the physical characteristic of the capillaries. In this case, the exchange of
materials is determined by changes in pressure. When the flow of
substances goes from the bloodstream or the capillary to the interstitial
space or interstitium the process is called filtration, otherwise, if the
substances move from the interstitial fluid to the blood in capillaries, the
process is called reabsorption.
3. Transcytosis: This is the third capillary exchange mechanism also called
vesicular transport. By the process, blood substances move across the cells
that compose the capillary structure. Finally, these materials exit by
exocytosis a process in which vesicles go out from a cell to the interstitial
space. Transcytosis is mainly used by large molecules that are lipid-
insoluble such as the insulin hormone. A minimum amount of substances
cross by transcytosis.

THE HEART
The heart is a hollow, cone-shaped muscular organ that lies within the thoracic
cavity occupying the greater part of the mediastinum in between the two lungs. It
lies obliquely to left side of the thoracic cavity with its base above and the apex
below. It measures 10cm in length, between 9cm across and 6cm thick. It weighs
about 270g in an adult and is about the size of the owner’s fist.
The heart is located posterior to the sternum with its apex lying about 9cm to the
left of the sternum in the fifth intercostal space but on the midclavicular; while
the base is about 1.5cm to the left of the sternum in the second costal cartilage.
Structures of the heart: the structures of the heart can be described under the
following:
Layers: the heart is made up of 3 layers;
a. Pericardium: this is the outermost layer which is made up of an outer
fibrous pericardium which prevents over distension of the heart muscle due
to over filling with blood and an inner serious pericardium.
b. Myocardium: this is the middle and muscular layer of the heart. This layer is
made up of a special type of muscle called the cardiac muscle which has
been described as pseudo-syncytial mass.
c. Endocardium: this is the innermost layer of the heart. It is made up of
squamous epithelium called endothelium.
Chambers: the heart is made up of four chambers and four valves which are;
a. Right atria
b. Left atria
c. Right ventricle
d. Left ventricle
Valves: the heart is made up of the following valves;
 Tricuspid (right atrio-ventricular valve) which is found or located between
the right atrium and ventricle.
 Bicuspid (mitral or left atrio-ventricle valve) this guards the opening
between the left atrium and left ventricle.
 Pulmonary valve; this guards the opening between the right ventricle and
pulmonary trunk.
 Aortic valve; guards the opening between the left ventricle and the aorta.
 Coronary valve; guards the opening of the coronary sinus into the right
atrium.
 Blood flow through the chambers of the heart
Deoxygenated blood from all parts of the body is emptied into the right atrium by
the superior and inferior venae-cavae. The right atrium then contracts when full
and pumps the blood through tricuspid valve into the right ventricle. The right
ventricle contracts when full and pumps the blood through the pulmonary valve
into the pulmonary trunk and through the right and left pulmonary arteries to the
lungs for oxygenation. In the lungs, carbon-dioxide and water vapour are released
to the lungs while oxygen is absorbed into the blood in the pulmonary capillaries.
The oxygenated blood leaves each lung through two pulmonary veins and flows
into the left atrium.
As the left atrium fills up with oxygenated blood, it contracts pouring the blood
through the bicuspid valve into the left ventricle. The left ventricle later contracts
driving this oxygenated blood through the aortic valve into the aorta for onward
circulation to all parts of the body.
Note;
1.The two atria contract at the same time pumping blood into the ventricles.
2.The ventricles also contract at the same time.
3.The tricuspid and bicuspid valve opens during atrial contraction.
4.The pulmonary and aortic valves also open during ventricular contraction.
Assignment
a) Draw and label the heart indicating the chambers and valves of the heart.
b) Draw and label the heart indicating the flow of blood within the chambers of
the heart.

SOME DISEASE CONDITION OF THE BLOOD AND THE CIRCULATORY SYSTEM

1. Leukaemia; this is an abnormal production of immature leukocytes into the
blood stream because of immature leukocytes production they are unable to
perform their phagocytic and immunological roles in the body, the victim
becomes prone to secondary infection. Leukaemia is also referred to as cancer of
blood because it abnormally high and synonymous to the uncontrolled production
of cells in malignant neoplastic disease.
2. Hypertension; this can be defined simply as a persistent rise in the blood
pressure above the individual’s normal limit. The manifestation of hypertension
therefore depends on the effects of prolonged elevated pressure on blood vessels
in various organs and tissues as well as the increased workload on the heart.
Hypertension could be either primary or secondary hypertension.
3. Thrombocytopenia; this is the reduction in the number of platelets in the blood
resulting in bleeding into the skin, spontaneous bruising and prolonged bleeding
after injury. Thrombocytopenia may result from failure of platelets production or
excessive destruction of platelets (thrombocytopenic)
4. Cardiac failure; this can be said to be the inability of the heart to pump blood
for circulation. Heart failure can be caused by conditions that interfere with its
pumping functions such as hypertension, ischaemic heart disease, valvular heart
disease, pulmonary heart disease e.t.c. cardiac failure (arrest) could either be
“ventricular fibrillation” which is the muscle fibers of the ventricles start to beat
rapidly without pumping any blood or “asystole” when the heart stops beating
completely.
5. Anaemia; this is a situation where either the level of red blood cells or the level
haemoglobin is lower than normal which deprives the body of adequate oxygen.
Causes of anaemia
1.Dietry deficiency like vit. B12, Iron.
2. Malabsorption.
3. Inherited disorder e.g. sickle cell anaemia.
4. Autoimmune disorder e.g. autoimmune haemolytic.
5. Chronic diseases e.g. tuberculosis.
6. Hormone disorders e.g. hypothyroidism.
7. Bone marrow disorder e.g. cancer.
8. Blood loss e.g. truma (accident).
9. Drugs and medications e.g. anticoagulant.
10. Infection e.g. malaria
Types of Anaemia
1.Iron deficiency anaemia; this is usually due to chronic blood loss caused by
excessive menstruation.
2. Aplastic anaemia; is a blood disorder in which the body’s bone marrow does
not make enough new blood cells.
3. Haemolytic anaemia; is a condition in which red blood cells are destroyed and
removed from the blood stream before their normal lifespan is up.
4.Thalassaemia; this is an inherited blood disorders which cause the body to make
fewer healthy red blood cells and less haemoglobin.
5.Pernicious anaemia; this is a condition in which the intestine can not properly
absorb vit. B12.
6.Megaloblastic anaemia; here body produces red blood cells that are larger than
normal size and cannot be able to exit the bone marrow to enter the blood
stream and deliver oxygen.
ASSIGNMENT
a) Explain sickle cell anaemia.

LYMPHATIC SYSTEM.
This is the system that is concerned with transportation of colorless or faintly
yellowish fluid called lymph from the body tissues to the blood circulatory system
through the right and left subclavian veins. This system is sometimes called a one-
way system because it does not form a complete circuit like the cardio-vascular
system.
The lymphatic system consists of the following;
- Lymphatic capillaries
- Lymphatic vessels
- Lymph nodes
- Thoracic duct
- Right lymphatic duct
The right lymphatic and the thoracic duct represent the terminal part of the
lymphatic system, emptying their contents into the large veins above the heart,
hence, the lymphatic system communicates with the blood circulatory system.

Lymphatic capillary
These are fine capillary vessels that serves as the specific functional unit of the
lymphatic system which commence the lymphatic system within the interstitial
spaces, helping to drain the waste product and water in form of a fluid from the
interstitial spaces. The moment this fluid enters the lymphatic capillary and
vessels; it is then referred to as lymph.
The lymphatic capillary helps to absorb or drain toxic waste products as well as
protein containing fluid which have escaped from the blood capillaries back into
the blood stream through the thoracic duct and the right lymphatic duct.

Lymphatic Vessels
These are formed as a result of the joining together of the lymphatic capillaries.
They help to transport lymph from the lymphatic capillaries into the lymph nodes.

Lymph node (lymph glands)

The lymph nodes like the lymphatic vessels are located both deeply and
superficially and in strategic positions throughout the body. There are cervical
lymph nodes (draining lymph from head and neck), axillary lymph nodes (draining
lymph from upper limbs), tracheo-bronchial and intercostal lymph nodes
(draining lymph from pelvic and abdominal cavities), popliteal and inguinal lymph
nodes (draining lymph from the lower limbs and the groin).
The lymph node has the following functions;
a) Helps to filter the lymph passing through it.
b) Helps to manufacture lymphocytes.
C)Helps in the formation of antibodies and antitoxins.
d)Helps to break down dangerous materials thereby providing body defense
against these materials.
Note;
1)Inflammation of the lymph node is called lymphadenitis.
2)A collective term for all lymph node diseases is called lymphadenopathy.

Lymphatic ducts
These are the two large lymphatic vessels in the body and they include the
thoracic duct and the right lymphatic duct. These two helps to return the lymph
from the whole body into the blood stream.

Lacteals
These are special lymphatic capillaries that extend as blind ends into the intestinal
villi of the small intestine and which drain milky lymph from the small intestine.
Larger proportion of fat absorbed from the small intestine passes into the
lymphatic capillaries giving the lymph a milky appearance. The milky lymph is
called chyle. In summary, the lymphatic capillaries containing milky lymph are
called lacteals.

Major functions of the lymphatic system

1.It aids the return of tissue fluid into the blood stream.
2.It contributes to the immunological activity of the body.
3.It receives the fatty food absorbed from the small intestine.
4.It filters the lymph and thus keeps the foreign materials out of the blood.
5.It produces the lymphocytes.
Note;
The blockage of the lymphatic drainage system of any reason, result in oedema in
the area served by the blocked lymphatic vessels. This blockage may be due to
surgical procedures such as when lymph nodes are removed or from infection and
parasitic inversions as seen in elephantiasis.
ASSIGNMENT
a) Explain the structure of a lymphatic capillary.
b) Explain the structure of a lymphatic vessel.
c) Explain the structure of the lymph node.
d) Explain the structure of the lymphatic ducts.
e) Describe the location, structure and functions of the spleen and thymus
gland.

RESPIRATORY SYSTEM.
This is the system that is made up of group of organs which are concerned with
the distribution of oxygen to the body cells and the removal of carbon dioxide
from the body cells to the atmosphere. Respiration is the process of breathing in
oxygen and the giving out of carbon dioxide which can either be internal or
external respiration.
Internal respiration; is the exchange of gases between the blood in the capillaries
and the blood in the body cells.
External respiration; is the exchange of gases between the blood in the alveoli of
the lungs and the blood within the capillaries surrounding the alveoli.
Organs of the respiratory system
The organs here include the conducting portion consisting of nose, pharynx,
larynx, trachea and bronchi and the respiratory portion consisting of the lungs
containing the bronchioles, alveolar ducts and alveoli.
The respiratory system is divided into;
a. Upper respiratory tracts; the organs here include the nose, air sinuses,
naso-pharynx and larynx.
b. Lower respiratory tract; the organs here include trachea, bronchi and the
lungs.

Nose and Nasal cavity

The nose is the first part of the respiratory system which consist of two large
irregular nasal cavities that are separated by a nasal septum. The nasal cavities lie
in the skull between the base of the cranium and the roof of the mouth but in
front of the naso-pharynx.
The nose consists of internal and external portions. The external portion is the
part that protrudes from the face and is considered smaller than the internal
portion. The internal portion is the part forming the two irregular nasal cavities
lying over the roof of the mouth but the base of the cranium. The right and left
nasal cavities communicate with the outside world by means of the opening
called the anterior nares(nostrils). These cavities communicate posteriorly with
the naso-pharynx by means of the openings called posterior nare or choanae.
Arterial blood supply: - branches from the external and internal carotid arteries.
Venous drainage: - jugular veins.
Nerve supply: - trigeminal nerve.
Functions of the nose.
1. It serves as a passage way for the air going to and from the lungs.
2. It helps to moisten, filter and warm the air.
3. It serves as an organ of smell.
4. It aids in phonation.

Pharynx(throat)
This is a tube-like path that is common to both the respiratory and the digestive
system.it is 12-14cm long which lies anterior to the cervical vertebrae extending
to the level of c6 and has the shape of an inverted cone. The pharynx is divided
into;
a) Naso-pharynx; this is located behind the nose and extending from the posterior
nares to the level of the soft palate. The four openings into the naso-pharynx
included the two posterior nares and the openings of the auditory tubes
(Eustachian tubes) which extend from the naso-pharynx to the middle ear.
b) Oro-pharynx; is located behind the mouth and extending from below the level
of the soft palate above to the level of the hyoid bone below(c 2). The oro-pharynx
also contains two lingual tonsils which are located in the mucosa at the base(root)
of the tongue.
c) Laryngo-pharynx; is the part that extends from the level of the hyoid bowl
above to the esophagus below from C2-C6.
The pharynx is made up of three layers and their arrangements from the inner
part outward; mucous membrane, fibroid tissue and muscular layer.

Functions of the pharynx.

1. Passage way for air and food
2. It helps to warm and moisten air
3. It takes part in phonation
 Larynx (voice box)
Tt serves as the air passage way from the pharynx to the trachea. The Larynx lies
opposite C3-C6 vertebrae and between the carotid sheaths that contain the
common carotid arteries, the internal jugular views and vagus nerves. The Larynx
is also referred to as the “watch dog” for the lungs. It measures about 3.5cm long
in females and 4.5cm long in males. The Larynx is made up of nine irregular
cartilages which are;
- Thyroid cartilage
- Cricoid cartilage
- Arytenoid cartilage
- Corniculate cartilage
- Cuneiform cartilage
Functions of the Larynx.
1. It is concerned with voice production.
2. It serves as a passage way for air in and out of the lower respiratory system.
3. It protects the airway within the lower respiratory tract against the entrance of
foreign matter.

Trachea(windpipe)
This is a fibro-elastic tube which is about 11cm long, it extends from the larynx at
c6 to T5 where at divides into the night and left bronchi, it lies in the midline of
the neck and anterior to the Oesophagus. The trachea is made up of 16 to 20
incomplete c-shape hyaline cartilage, the inner lining of the trachea is made up of
ciliated epithelium with goblet cells that help to secrete mucus.

Bronchi
They are two in number (i.e. right and left) which are branches of the trachea at
T5.the right primary bronchus is shorter, wider and maintains a more vertical
position than the left, it is about 2.5cm long. The left primary bronchus is longer
and narrower than the right and is about 5cm long. Each primary / principal
bronchus has the incomplete cartilaginous rings like the trachea before entering
the lungs at the hilus. On the entering the lungs each bronchus presents complete
cartilaginous rings, the right bronchi divide into three secondary bronchus while
the left divides into two secondary bronchus on each entering the right and left
lungs respectively.
Functions of bronchi.
1.Passage way for air.
2.They help to warm, moisten and filter the air.

Bronchiole
These are smaller branches of the secondary bronchi with a diameter of about
1mm. each bronchiole has no cartilage but is made of smooth muscular tissue and
fibro-elastic tissue with inner part lined with ciliated epithelium. As the
bronchioles becomes smaller and smaller there is disappearance of both muscular
and fibrous tissue and ciliated epithelium changes to simple squamous
epithelium. The first bronchiole from the secondary bronchi branch to give rise to
terminal bronchiole which also branch to form the respiratory bronchiole which
also branch to form the alveolar ducts and the alveolar duct terminates in a sac-
like structures called the alveoli (air sac). The alveoli are made up of a single layer
of squamous epithelium which permits the exchange of gases and there are 300
million alveoli present in each lung.

Lungs
These are cone-shaped, light, porous, spongy and elastic organs which are located
within the thoracic cavity. The apex of the lung is located superiorly and the base
inferiorly, each apex extends to the root of the neck about 1.5 to 2.5cm above the
sternal end of the clavicle while the base is broad and concave resting on the
convex surface of the diaphragm. Each lung is enclosed in the pleura having three
surfaces and three borders. The surfaces include the costal, diaphragm and
mediastinal surfaces while the borders include the anterior, posterior and inferior
borders. On the mediastinal surface is a concavity just above which is a triangular
depression called Hilus through which structures forming the root of the lung
enter and leave the lung. The structures entering each lung include one primary
bronchus, one bronchial artery, pulmonary artery, sympathetic and
parasympathetic nerves, while the structures leaving each lungs includes; two
pulmonary veins, bronchial veins and the lymphatic vessels.
The right lung is divided into three lobes called superior, middle and inferior
lobes. The superior lobe is separated from the middle lobe by the horizontal
fissure while the middle lobe is separated from the inferior lobe by the oblique
fissure. The left lung is divided into two lobes called superior and inferior lobes
separated by the oblique fissure. Each lobe is further divided into lobules.

Function of the lungs.

1. They are concerned with the distribution of air to the alveoli through the
bronchial trees.
2. The lungs permits the exchange of gases to take place between the alveolar
and the blood within the capillaries surrounding the alveoli.

Difference between the left and right lungs.

Right Lung Left Lung.
Has three lobes Has two lobes
 Shorter in size Longer in size
Wider in size Narrower in size
Absence of cardiac notch Presences of cardia notch
Heavier in weight Lighter in weight
Possess two fissure Possess one fissure
Higher in position Lower in position

Assignment
a) Write short note on the following;
i. Mediastinum.
ii. Pleura
b) Draw and label the respiratory system.
c) Explain the mechanism of respiratory.
d) State and explain factors controlling respiration

Approximate composition of air

Inspired air Expired air
Oxygen 21% 17%
Nitrogen 78% 78%
Carbon dioxide 0.04% 4.04%
Inert gases e.g. helium 1% 1%
Water vapour Variable Variable
Temperature Variable Body temperature
 Differences between inspiration and expiration.
Inspiration Expiration
An active process A passive process
Contraction of external intercostal Relaxation of external intercostal
muscles and diaphragm muscles and diaphragm
Relaxation of internal intercostal Contraction of internal intercostal
muscles muscles
Rib cage moves forward and outward Rib cage moves backward and inward
Increase in thoracic volume Decrease in thoracic volume
Expansion of lungs Reduction of lungs
Decrease of intrapleural pressure Increase of intrapleural pressure
Oxygen is taken in Carbon dioxide is taken out

IMMUNITY.
Immunity can be defined as the ability of the body to fight or resist infection or
pathogens. Immunology can be said to be the study of the structure and function
of the mechanism responsible for the body’s immunity.

Types of immunity
Immunity
Non-specific/innate/Natural Adaptive/Specific/Acquired

Natural Artificial

Active Passive Passive Active

Non-specific /innate/natural
In this type of immunity, the body’s immunity treats all pathogens equal, an
individual is born with and it comprises of the first and second line of defence.
examples of first and second line of defence include;
First line of defence
 Barriers e.g. skin
 Mucous membrane e.g. epithelium
 Mechanical e.g. cilia, nasal hair
 Body secretion e.g. saliva, tears, acidic nature of vagina
Second line of defence
 Phagocytes e.g. microphages
 Natural killer cells
 Certain cells in the body e.g. kuffer cells in the liver, langahens cells in the
skin, osteocytes in the bone, microcyiat in CNS, m-cells in GTT.
 Inflamentory responses
 Antimicrobial protein e.g. properdin, interferons
 Fever

Specific/Adaptive/Acquired
This is the type of immunity that an individual acquired after birth as a result of
interaction with the environment. This type of immunity is specific in action and
mediated by antibodies or lymphocytes or both. This type of immunity does not
only relieves an individual of the infectious disease but also prevents its further
attack in future with the help of memory cells. specific immunity is further divided
into 2 which are;
Natural specific immunity
Here the body develops it without the help of medical intervention, i.e. antibodies
are formed by the body without medical help. This type is further divided into;
Natural active; this the body develops antibodies as a result of interaction with
the environment and last for a life time.
Natural passive; here the body acquires it from the mother either through the
placenta during intrauterine life or through breast milk after birth, this do not last
for a life time.
Artificial specific immunity
Here the body develops antibodies with the help of medical intervention. This
type of immunity is further divided into;
Artificial passive; here already developed antibodies are inoculated into an
individual to trigger an immune respond, this type do not last for a life time e g
antetanus, anti-riebbies.
Artificial active; here attenuated (weak) antigens are inoculated into an individual
to trigger an immune respond leaching to the production of antibodies by the
body, this type of immune can last for a life time e g B C G
Vaccine
This can be said to be a drug which is prepared to be administered to an
individual to stimulate an immune response.
Assignment;
a) List diseases that can be prevented by vaccines and the name of vaccine
administered.

Auto-immunity
It is an attack of body tissues by the body’s immune system. Some examples
include;
 Graves diseases
 Hashimoto’s thyroiditis
 Addison’s diseases
 Insulin dependent diabetes mellitus (type I)
 Hematosin urtikaria

Possible causes of autoimmune diseases

 Loss of suppressor T-cell
 Infection e.g. A-haemolytic streptoeoccoci
 Drugs e.g. methyldopa taken for hypertension
 Genetic factors e.g. insulin diabetes dependent mellitus (type I)
 Associated with endocrine factors e.g. Graves and Hashimoto’s diseases
Assignment
a) Write short note on the above types of auto-immune diseases.

Allergic reactions
This is a number of conditions caused by hypersensitivity of the immune system
to something in the environment that usually causes little problem in most people
e.g. hay fever.

Degrees of allergic reaction

 1st degree/light/localized; unpleasant symptoms are observed only in
allergen exposure e g bee sting.
  2nd degree/moderate/non-localized; unpleasant symptoms are not limited
to bite site but can be observed in all parts of the body. symptoms may
take time to manifest e g food allergies, drug allergies.
 3rd degree/severe/anaphylactic shock; unpleasant symptoms are observed
in all parts of the body and the reaction develops is seen immediately e g
animal allergies.
Types of allergic reactions
Gell and Combs classified hypersensitivity reaction into four types.
 Type I hypersensitivity; - is called the anaphylactic(antagonistic) reaction, it
is an immediate type of reaction, it caused by Ig E and mast cell. It may be
localized or systemic e.g. bee sting, penicillin allege. It is mediated by
antibodies.
 Type II (cytotoxic reaction); - is caused by antibodies binding to cell/tissue
antigen e g mis-match blood reaction it is mediated by antibodies. The
whole system is active.
 Type III hypersensitivity; - this occurs when one has a high quantity of
soluble antigen getting into the body and combines with the antibody
forming immune complexes and they are precipitated. This is mediated by
antibodies e.g. septic shock, post complication in kidney failure.
 Type IV hypersensitivity; - this is cell mediated reaction (it is delay type) it
develops over 24-72hrs. is a mixed cellular reaction that involves
lymphocytes and macrophages, e.g. tuberculosis, ingurated inflammatory
reaction (response) in the skin.
Causes of allergic reaction
a. Food.
b. Insect
c. Medication
d. Animal
Signs and symptoms
 Red eyes
 Itchy rash
 Runny nose
 Shortness of breath
 Swelling.