Apex

(Plural; apices)

• 2 lines intersecting at the ambilicus, dividing the abdomen into 4 equal areas
  • The Right Upper Quadrant (RUQ)
  • The Left Upper Quadrant (LUQ)
  • The Right Lower Quadrant (RLQ)
  • The Left Lower Quadrant (LUQ)

Shock Position

(modified Trendelenburg's Position)

• The head and torso are supine, and the lower extremities are elevated 6" to 12"
• Increases blood flow to the head

• Composed of:
  • Eyes
  • Ears
  • Nose
  • Mouth
  • Cheeks

• Composed of 6 bones
  • Nasal
  • 2 Maxilae (Upper Jaw Bones)
  • 2 Zygomes (cheek Bones)
  • Mandible (Lower Jaw Bone)

Orbit

(Eye Socket)

• Made up of 2 facial bones
  • Maxilla
  • Zygoma
• Includes the frontal bone of the cranium

• A prominent bony mass at the base of the skull
• About 1" posterior to the external opening of the ear

Mandible

(Lower jaw)

• The windpipe
• The midline of the neck
• Connects the larynx with the main air passage of the lungs

Adam's Apple

The upper part of the Thyroid Cartilage

• 33 Bones
• 5 Sections
  • Cervical Spine
  • Thoracic Spine
  • Lumbar Spine
  • Sacrum
  • Coccyc

• The 1^st 7 vertebrae 
• (C 1 - C 7)
• In the neck

• The next 12 vertebrae
• One pair of the ribs is attached to each of the thoracic vertebrae

• The 5 sacral vertebrae are fused together to form 1 bone
• Joined to the iliac bones of the pelvis with strong ligaments at the sacroiliac joints to form the pelvis

Coccyc

(Tailbone)

• The last 4 vertebrae
• Fused together

An extension of the brain

Composed of virtually all the nerves that carry messages between the brain and the rest of the body

• The anterior part of each vertebrae
• Consists of a round, solid block of bone

Thorax

(Chest)

• The cavity that contains:
• Heart
• Lungs
• Esophagus
• Great vessels
  • Aorta
  • 2 Venae Cavae
• Formed by the 12 thoracic vertebrae and their 12 pairs of ribs

Clavical

(Collar Bone)

• Overlies the superior boundaries of the thorax in the front and articulates (joins) posteriorly with the scapula

Scapula

(Shoulder Blade)

lies in the muscular tissue of the thoracic wall

• The inferior boundary of the thorax
• Separates the thorax from the abdomen

• 3 Components
  • Manubrium
  • The Body
  • Xiphoid Process

• A prominent ridge on the sternum
• The junction of the manubrium and the body
• Lies at the level where the 2^nd rib is attached to the sternum
• Provides a constant and reliable bony landmark on the anterior chest wall

• A bridge of cartilage that connects the ends of the 6^th - 12^th ribs with the lower portion of the sternum

• 11^th and 12^th ribs
• Are not attached to the sternum

• Costaverebral Angle
• lumbar vertebrae
• heart
• lungs

• Lies immediately under the sternum
• Extends from the 2^nd to the 6^th ribs anteriorly and from the 5^th to the 8^th thoracic vertebrae posteriorly

Anatomical Landmarks

(Palpable)

• Between each rib
• Both clavicles and the sternum
• Jugular notch
• Costal Arch, Inferiorly
• Midline the tip of the xiphoid process

• The second major body cavity
• Contains the major digestive and excretion

• Liver
• Gallbladder
• Portion of the Colon
• Most of the Liver

• Stomach
• Spleen - injured when ribs are broken
• Portion of the Colon

• 2 portion of the large Intestine
  • Cecum - 1st portion into which the small intestine  (ileum) opens
  • Ascending Colon
• Appendix - small tubular structure that is attached to the lower border of the cecum

• Descending and sigmoid portions of the colon

• Small intestines
• Large Intestines
• Pancreas - both upper quadrants
• Pubic symphysis - both lower quadrants + Pelvis

• Lie behind the abdominal cavity
• Kidneys
• Pancreas

• Costal Arch
• Umbilicus - constant structure, same horizontal plane as the 4th lumbar vertebrae & the superior edge of the iliac crest (rim of the pelvic bone)
• Anterior Superior Iliac Spines - the bony prominences of the pelvis
• Iliac Crest - rim of the pelvis
• Pubis Symphysis (pubic bone)

• 3 bones
  • Sacrum
  • 2 pelvic bones

• Ilium
• Ischium
• Pubis
• Held together by ligaments
• Acetabulum - Lateral sides -hip joint (depression) 

Pubic Symphysis - in the middle

Anterior Superior iliac spines

• Ischial tuberosities - prominences in the middle of each buttock when sitting
• Sciatic nerve lies just lateral to the tuberosities

• Thigh 
• Leg
• Foot
  • Joints:
    • Hip 
    • Knee 
    • Ankle

• Greater Trochanter(hip bone) -A bony Prominence on the Proximal later side of the thigh
• The Femur (thigh bone) - longest & 1 of the strongest bones
• Femoral Head (top of the femur) forms the hip joint with the acetabulum of the pelvis
• Ball-and-socket joint Allows:
  • Flexion
  • Extension
  • Motion toward (Adduction) the midline
  • Motion away (Abduction) the midline
  • Allows for internal and external rotation of the entire lower extremity

• Hinge Joint - allowing only flexion and extension
• Largest Joint
• Kneecap - lies within the tendon of the quadriceps muscle and protects the front of the knee from injury

• Lies between the knee and ankle joint
  • Tibia (shin bone)
  • Fibula - lateral side of the leg

• Ankle - Large hinge joint (flexion and extension)
• Foot
  • 7 Tarsal bones
  • Talus - one of the largest
  • Calcaneus- prominence of the heel
  • 5 Metatarsals
  • 14 Phalanges
• Achilles tendon inserts into the back of the calcaneous

• Extends from the shoulder girdle to the fingertips
• Composed of:
  • Arm
  • Forearm
  • Hand
  • Fingers
• Joints:
• Elbow
• Wrist
• Finger Joints

• Where the upper extremity attaches to the trunk
• The proximal portion of the upper extremity
• Consists of 3 bones:
  • Clavical - palpable for its entire length
  • Scapula (shoulder blade) -large, flat, triangular bone
  • Humerus - supporting bone of the arm

Humerus

• Straight shaft
• Few landmarks:
  • Bicepts in the front
  • Triceps in the back
• Distal ends:
  • Radius - larger bone, Proximal forearm, closest to thumb
  • Ulna - larger in the distal forearm

• Wrist:
  • Modified ball-and-socket joint
  • 8 carpal bones
• Fingers:
  • 5 metacarpal bones - the base for each of the 5 fingers
  • Carpometacarpals joint (thumb joint) - modified ball-and-socket

• Wherever 2 bones come in contact
• The ends of the bones that make up the joint and the surrounding connecting and supportive tissue

• Ball-and-socket (eg. shoulder)
  • Allows rotation as well as bending
• Hinge
  • Motion is restricted to 1 plane; They can only:
    • Flex (bend)
    • Extend (straighten)

• Provide:
  • Form
  • Upright Posture
  • Movement
• Bones and voluntary muscles
• Protects the vital internal organs
• more than 600 muscles

Skeletal Muscles (Striated)

(Voluntary Muscles)

• Attaches the bones of a skeleton with tendons
• Facia encases the muscle tissue
• Responsible for motion
• Proximal point of attachment = musculotendinous unit
• Distal boney attachment = insertion of the muscle
• Supplied with arteries (carries oxygen and nutrients) and veins (carry waste) and nerves
• Under the direct control of the nervous system
• When nerve supply is lost - voluntary control of the muscle is lost = paralyzation

Smooth Muscle

(Involuntary)

• Specially adapted involuntary muscle
• Property of automaticity - heart muscle can set its own rhythm and rate without influence from the brain
• Can tolerate interruption of its blood supply for only a few seconds
• Requires a continuous supply of oxygen and glucose

• To provide the body with oxygen and eliminate carbon dioxide
• All the structures of the body that contribute to respiration
• Includes:
  • Nose
  • Mouth
  • Throat
  • Larynx
  • Trachea
  • Bronchi
  • Bronchioles
  • Lungs
  • Diaphragm

• Includes the:
  • Nose
  • Nostrils lead to the nasopharynx (soft palate)
  • Mouth lead to the
  • Throat (orthopharynx)
• 2 Passageways are located at the bottom of the pharynx:
  • Esophagus
  • Trachea (wind-pipe)
• Protecting the trachea - epiglottis (valve) that allows air to pass into the trachea, but prevents food or liquid from entering the airway

• 1st part - Larynx (voice Box)
• 2nd - Thyroid cartilage (Adam's Apple)
• 3rd - Trachea
• The Trachea ends at the Carina and divides into smaller tubes, which enter the lungs:
  • Right Bronchi (3 major)
  • Left Bronchi (2 Major)

• Held in place by the:
  • Trachea
  • Arteries and veins
  • Pulmonary Ligaments
• Each lung is divided into lobes
  • 3 right lobes
  • 2 left lobes
• Main bronchi divide until they become Bronchioles - where about 700 million alveoli (grape-like sacs) exchange O and CO₂

• Have no muscle - cannot expand and contract on their own
• Pleura - tissue that covers the lungs
• Pleural Space - between the pleural and visceral pleura
• Potential space - layers are in close contact everywhere, sealed together with fluid

• Dome-shaped muscle that divides the thorax from the abdomen
• Pierced by the Great Vessels and the Esophagus
• Both Smooth (Involuntary) 
  • We breathe while sleeping (Automatic Function)
•  Striated Muscle - Skeletal (Voluntary)
  • We control how we breathe
• Attached to the costal Arch and the lumbar vertebrae

• Inhalation
  • The diaphragm and intercostal muscles contract to enlarge the chest cavity
  • Pressure within the cavity falls
  • Air rushes into the lungs
• Exhalation
  • The diaphragm and intercostal muscles relax
  • Volume of chest cavity decreases
  • Pressure within the cavity increases
  • Air is pushed out through the trachea

• Heart - may be damaged if blood supply is interrupted for more than a few seconds
• Brain and nervous system - may die after as few as 4 - 6 minutes
• Other organs - can tolerate short periods of no oxygen
• Air is Usually
  • 21 % Oxygen
  • 78% Nitrogen
  • 1% other gases

• Alveoli - receive oxygen-rich air
• Oxygen passes into pulmonary capillaries located in the alveoli
• Walls of the capillaries and alveoli are very thin - air in the alveoli and capillaries are separated by 2 very thin layers

• Oxygen and CO₂ pass across these layers by Diffusion
• A Passive process in which molecules move from an area of higher concentration to an area of lower concentration
• There are more Oxygen molecules in the alveoli than in the blood, so they move into the blood
• There are more CO2 molecules in the blood, so they move into the alveoli

• Exhaled air contains:
  • 16% oxygen
  • 3% - 5% CO₂
  • The rest is Nitrogen
• Give a 16% concentration of Oxygen for ventilation

• Brain Stem (one of the best-protected parts of the nervous system - deep within the skull) controls breathing
• Nerves in the brain stem act as sensors of the CO₂ level in the blood
• When CO₂ becomes too high - Brain stem sends nerve impulse to the diaphragm and intercostal muscles to contract (increase our breathing)
• Hypoxic Drive - "back-Up System" - less sensitive
• Senses when Oxygen levels are too low

• A Normal Rate (Tidal Volume)
• A regular Rhythm of inhalation and exhalation
• Good Audible Breath Sounds on both sides
• Regular Rise and Fall Movements on both sides
• Movement of the Abdomen

• Adults
  • 12 - 20 Breaths/min
• Children
  • 15 - 30 Breaths/min
• Infants
  • 25 - 50 Breaths/min

• Labored Breathing
• Faster or Slower than normal breathing
• Muscle retractions above the clavicles, between the ribs, below the rib cage (esp. in children)
• Pale or cyanotic (blue) skin
• Cool, damp (clammy) skin
• Tripod postion (patient is sitting, leaning forward onto 2 arms stretched out)
• Agonal Respirations (After the heart has stopped)
• Slow and shallow
• Assist Ventilation

• Entirely closed system
• Connective Tubes
  • Arteries
  • Arterioles
  • Capillaries
  • Venules
  • Veins

• 2 Circuits
  • Systemic circulation in the body
    • gives oxygen and nutrients
    • absorbs cellular waste (Eliminated in liver and kidneys)
  • Pulmonary circulation in the lungs

• Systemic Circulation (body)
  • Carries oxygen-rich blood from the Left Ventricle through the body
  • Back to the Right Atrium
• Pulmonary Circulation (Lungs)
  • Carries the oxygen-poor blood from the right ventricle through the lungs 
  • Back into the left atrium

• Involuntary Muscle
• Has its own electrical system
• Hollow muscular organ
• Size of an adult clenched fist
• Myocardium - Cardiac Muscle
• Left Ventricle - more muscular, as it pumps blood to the entire body
• Septum - wall of tissue that separates the right and left sides

• 4 chambers
• 2 Upper chambers
  • Atrium
• 2 Lower Chambers
  • Ventricle

How the Heart Work

(1 way valves - to keep blood flow going in the proper direction - only 1 direction)

• Receives the 1st blood distribution from the Aorta
• The blood enters from the Superior and Inferior Venae Cavae into the Right Ventricle
• After the Right Ventricle is filled, the tricuspid valve closes to prevent backflow after the Right Ventricular Muscle contracts
• The Left side receives oxygenated blood from the lungs through the Pulmonary Veins into the Left Atrium where it passes through the Mitral Valve into the Left Ventricle
• Then into the Aorta and into the body

Normal Heartbeat

(At Rest)

Blood is pumped through the entire body (5L - 6L) in 1 minute

• Adults
  • 60 - 100 Beats/min
• Children
  • 70 - 150 beats/min
  • 70 + 2 times their age
• Infants
  • 100 - 160 Beats/min

• Network of specialized tissue capable of conductiong electrical current
• Flow causes smooth, coordinated contractions
• 2 Electrical Processes:
  • Depolarization 
    • The Electrical charges on the surface of the muscle cell change from positive to negative
  • Repolarization
    • The heart returns to its resting state
    • Positive charge is restored to the surface

• The Electrical impulse begins high in the atria at the
  • Sinoatrial Node (SA)
• Travels through the 
  • Atrioventricle node (AV)
• Moves through the 
  • Purkinjie Fibers to the Ventricles

• Characteristically Bright Red - oxygenated
• Carry blood from the heart to all body tissues
• Branch into
  • smaller arteries
  • Arterioles
  • Capillaries
• Contract to accommodate loss of blood volume and increase blood pressure

• Aorta - The Principle Artery
• Leaves the Left Ventricle to carry oxygenated blood to the body
• Found just in front of the spine in the chest and abdominal cavities
• Coronary Arteries - Supply the Heart
• Carotid Arteries - Supply to the Head
• Heptic Arteries - supply to the Liver
• Renal Arteries - Supply to the Kidneys
• Mesenteric Arteries - supply to the Digestive System

• Aorta-
• Divides at the level of the Umbilicus into the 2 common Iliac Arteries that lead to the lower extremities
• Pulmonary Artery-
  • Begins at the Right Side of the heart and carries oxygen-poor blood into the lungs
• Carotid Artery-
  • Major Artery that supplies blood to the Head and Brain
• Can be felt even when distal extremity pulse is too weak

• Femoral Artery
• Supplies blood to the lower extremities
• Palpable in the groin
• Divides at the knee into 2 branches
  • Posterior Tibial Artery - behind the medial prominence of the ankle (medial malleous)
  • Dorsalis Pedis Artery - the anterior surface of he foot

• Bracial Artery
  • Supplies blood to the arms
  • 2 Branches at the elbow
  • Used to assess Blood Pressure
• Radial Artery - supplies blood to the hand
  • Major forearm vessel
  • Palpable at the wrist on the thumb side
  • Ulnar Artery - supplies blood to the hand
  • Palpable at the wrist on the opposite side, but weaker
• Arterioles
  • Smallest branches leading to the capillaries

• fine end-divisions of the arterial system
• Allows contact between the blood and the cells of the tissue
• Connect directly at one end with the flow-regulating arterioles at the other end of the venules

• Generally dark bluish-red - deoxegenated
• Thinner walls than arteries
• Larger in diameter
• oxygen-poor blood passes through the network of capillaries - into the venules-smallest branches of veins
• Returns to the heart through Larger and larger veins

• Ultimately form 2 Major Vessels located in the midline, just to the left of the spine,which join at the Right Atrium
  • Superior Vena Cava-
    • Carries blood returning from the Head, Neck, Shoulders, Upper Extremities
  • Inferior Vena Cava-
    • Carries blood returning from the Abdomen, Pelvis, Lower extremities

• Solid Organ located under the rib cage in the Left Upper Quadrant (LUQ)
• All blood passes through it where it is filtered
• One of the most frequently injured organs in a Blunt Force Trauma, as it is directly under the flexible ribs
• Highly Vascular - severe internal bleeding
• Delayed Rupture should be suspected 1 - 2 days after a trauma if abdominal pain or signs of internal bleeding

Components of Blood

Clotting takes 6 - 10 Minutes

• Plasma
  • Sticky yellow fluid that carries the blood cells and nutrients
  • Transports waste material to excrement organs
  • Needed to produce Blood Clots
• Red Blood Cells (erthrocytes)
  • Give color
  • Carry Oxygen
  • 45% of the blood
• White Blood Cells (leukocytes)
  • Role in the Immune System
• Platelets
  • Disk shaped elements (smaller than a cell)
  • Role - formation of a blood clot

• Most Palpable, where the larger arteries are closer to the skin,at the
  • Neck
  • Wrist
  • Groin
• Central Pulses
  • Carotid Artery Pulse -felt at the upper portion of the neck
  • Femoral Artery Pulse - felt in the groin

• Peripheral Pulses
  • Radial Artery Pulse - felt at the wrist and base of the thumb
  • Brachial Artery - Felt on the medial aspect of the arm, midway between the elbow and shoulder
  • Posterior Tibial Artery Pulse - felt posterior to the medial malleous
  • Dorsal Pedis Artery Pulse - felt on the top of the foot

• Blood Pressure (BP)
• The Pressure that the blood exerts against the walls of the arteries as it passes through them
• Systole
  • Muscle contraction as blood pumps from the Left Ventricle into the Aorta
• Diastole
  • The Ventricle relaxes and fills with blood

• Systolic Blood Pressure - High Point
  • Measured as the heart muscle is contracting
• Diastolic Blood Pressure - Low Point
  • Measured when the heart is at rest

• Automatically adjusted and readjusted constantly so that 100% of the capacity of arteries, veins, and capillaries hold 100% of the blood at that moment
• Never are all of the vessels fully dilated or constricted
• Perfusion
  • The ciculation of blood within an organ or tissue in adequate amount to meet the cells' current needs
  • Loss of normal blood pressure indicates that blood is no longer circulating effectively to every body organ
• Shock (Hyperfusion)
  • The state of inadequate circulation to the entire body

• Loss of too much blood - Patient goes into shock
• Small losses of blood - the vessels constrict to provide a smaller bed for the reduced volume of blood to fill
• Heart pumps more rapidly to circulate the remaining blood more efficiently

• Controls virtually all activities of the body, both voluntary and involuntary
• Somatic Nervous System
  • Regulates Voluntary Control
• Automatic Nervous System
  • Regulates Involuntary Control

• Anatomically divided into 2 Parts
  • Central Nervous System
  • Peripheral Nervous System
• Can be divided into 4 parts
  • Central Nervous System
  • Peripheral Nervous System
  • Somatic Nervous System- Voluntary
  • Automatic Nervous System- Involuntary

• Made up of the
  • Brain
  • Spinal Cord
• Covered and protected by bone

• The controlling organ of the body
• Center of consciousness
• Responsible for all voluntary and involuntary actions
• 3 Major subdivisions
  • Cerebrum
  • Cerebellum
  • Brain Stem

Brain

(Cerebrum)

• The cerebrum on 1 side controls the opposite side of the body
• (Grey Matter)
• Largest part of the brain 3/4 of the brain
• Composed of 4 lobes
  • Frontal
    • Responsible for all voluntary muscles
  • Parietal
    • Receive sensory impulses from the peripheral nerves
  • Temporal
    • Responsible for emotions, personality
  • Occipital
    • Vision
    • Hearing
    • Balance
    • Speech

• Major Function -
  • To coordinate the various activities of the brain
  • Particularly body movements
• Located underneath the great mass of the cerebral tissue
• "Little Brain"

• The most Primitive part of the CNS
• Best protected part of the CNS
• Controls all body functions that are necessary for life (cardiac, Respiratory, Basic Functions)

Bathes the brain and spinal cord

Serves as a cushion

Filters out impurities and Toxins

AS EMT - significant finding in trauma indicating skull fracture is cerebrospinal fluid leaking from the ears

• Major potion of the CNS
• Contains nerve cell bodies
• Major portion made up of nerve fibers that extend from the cells of the brain 
• Principle function:
  • Nerve fibers transmit information to and from the brain
• Fibers join together just below the brain stem
• Extends through the Foramen magnum

• Allow sensory and motor impulses to be transmitted from 1 nerve cell to another within the CNS

Peripheral Nervous System

(composed of 31 pairs of Peripheral nerves

Called spinal nerves and 12 pairs of Cranial Nerves - specialized)

• Nerve fibers that link the CNS to the various organs of the body
• 3 Major types of nerves:
  • Sensory Nerves
    • Carry information from the body to the CNS
  • Motor Nerves
    • Carry information from the CNS to the muscles of the body
• Connecting Nerves

• Quite complex
• Lie within the:
  • Skin
  • Muscles
  • Joints
  • Lungs
  • Organs
• Detect heat, cold, position, motion, pressure, pain, balance, Light, Taste, smell, other sensations
• Transmits its own sensory message
• Many different types
• Cranial - supply sensations directly to the brain
• Optic Nerve - vision

• Each muscle has its own motor nerve
• The cell body for each motor nerve lies in the spinal cord and the fiber from the cell extends as part of the peripheral nerve to its specific muscle

• Largest single organ in the body
• 3 Major Functons:
  • Protect the body in the environment
  • Regulate body temperature
  • Maintain Metabolism within a narrow temperature range
  • Transmit information from the environment to the brain
• Skin is water tight (Body 70% water)
  • Serves to keep the balance of internal solution intact
• Protects the body from invasion of infectious organisms (bacteria, viruses, fungi)

• Major organ for regulation of body temperature
  • When the outside environment is hot, the vessels dilate, skin becomes flushed, heat radiates from the body, which must then evaporate
• Information from the environment is carried to the brain through a rich supply of sensory nerves 
• Palpable

• Divided into 2 parts:
• Superficial Epidermis - composed of several layers of skin
• Deeper Dermis - contains specialized skin structures
• Subcuntaneous tissue layer- Below the skin 

• Epidemis:
  • Composed of several layers
  • Cells are held together by an oily substance called the Sebum - secreted by the Sebaceous Glands of the Dermis
• Dermis:
  • Deeper part of the skin
  • Separated from the Epidermis by the layer of Germinal Cells
• Contains
  • Sweat Glands
  • Seaceous (oil) Glands
  • Hair Follicles
  • Blood Vessels
  • Specialized Nerve Endings

• Sweat Glands
  • Produce sweat for cooling the body
• Sebaceous Glands produce Sebum (oil):
  • Provide waterproofing
  • Keeps the skin supple

• Hair Follicles
• Small organs that produce hair
• Subcutaneous Tissue
• Composed largely of fat:
  • Insulator
  • Reservoir to store energy
• Mucous Membranes - Secrete Mucus
  • Provide a protective barrier against bacterial invasion
  • Line the entire GI tract

• Complex message and control system
• Integrates many body functions
• Release hormones 
  • Target organs
  • Bloodstream
• Each Endrocrine Gland produces 1 or more hormones
• Each hormone has a specific effect on some organ, tissue, or process
• Brain controls the release of hormones
• Hormones have either effect:
  • Stimulating
  • Inhibiting
• Feedback Loop - keeps the body's systems and functions in balance

• Composed of:
  • GI Tract (stomach & Intestines)
  • Mouth
  • Salivary Glands
  • Pharynx
  • Esophagus
  • Liver
  • Gallbladder
  • Pancreas
  • Rectum
  • Anus
• Function:
• Digestion - processing food that nourishes the individual cells of the body

How Digestion Works

(8L - 10L of fluid are secreted daily into the GI Tract)

• Essential Compounds are extracted and delivered by the circulatory system to nourish all of the cells in the body
• Complicated chemical process:
  • Succession
  • Different Secretions (Primarily Enzymes) added to the food to convert food into: 
    • Basic sugars
    • Fatty Acids
    • Amino Acids 
• By the :
  • Salivary Glands
  • Stomach
  • Liver
  • Pancreas
  • Small intestines

• Adrenal - Kidneys - Adrenaline
  • Regulates salt, sugar,
  • sexual function
• Ovary - 2 Glands in Female Pelvis
  • Estrogen and others
  • Regulates sexual Function, characteristics, reproduction
• Pancreas - Retroperitoneal Space
  • Insulin and others
  • Regulates glucose metabolism and other functions
• Parathyroid - Neck behind and beside Thyroid
  • Parathyroid Hormone
  • Regulates Serum Calcium
• Pituitary - Base of the skull
  • Multiple hormones
  • Regulates all other endocrine glands
• Testes - Male Scrotum
  • Testosterone and others
  • Regulate sexual function, characteristics, Reproduction
• Thyroid - Neck - over Larynx
  • Thyroxine and others
  • Regulates Metabolism

• Consists of:
  • Lips
  • Cheeks
  • Gums
  • Teeth
  • Tongue
• Soft palate: 
• Designed to hold food that is being chewed within the mouth and to initiate swallowing

• Located under the tongue
  • 1 on each side of the lower jaw
  • 1 inside each cheek
• Produce 1.5L of Saliva daily
• Saliva = 98% water
• Saliva:
  • Binder for the chewed food that is being swallowed 
  • Lubricant within the mouth

• A tubular structure about 5" long that extends vertically from the back of the mouth to the esophagus and trachea
• Automatic movement of the pharynx during swallowing:
  • Lifts the larynx to permit the epiglottis to close over it so that liquids and solids are moved into the the esophagus and away from the trachea

• A Collapsible tube about 10" long that extends from the pharynx to the stomach
• Lies just anterior to the spinal column in the chest
• Contractions propel food
• Liquids pass with little resistance

• A hollow organ located in the upper left quadrant (LUQ) in the abdominal cavity
• Largely protected by the lower left ribs
• Convert ingested food to a throughly mixed semi-solid mass by:
• Muscular contractions
• Gastric Juices (1.5L gastric juice produced daily)
• Principle Function:
  • Receive food in large quantities, intermittently
  • Store food
  • Provide for its movement into the small bowel in regular and small amount

• A flat, solid organ
• Lies below and behind the liver, stomach, and peritoneum
• Firmly fixed in position- deep, so not easily damaged
• Contains 2 types of glands:
  • 2L of Pancreatic Juice/daily
    • Contains enzymes that aid in the digestion of fat, starch, and protein
  • Islets of Langerhans
    • Produces insulin which regulates glucose in the blood

• A large, Solid organ that takes up most of the area immediately beneath the diaphragm in the Right Upper Quadrant (URQ) and extends into the Upper Left Quadrant (ULQ)
• Largest solid organ in the abdomen
• Principle organ for the storage of sugar or starch for immediate use for energy
• Functions:
• Poisonous substances are rendered harmless
  • Factors necessary for blood clotting
  • Production of normal plasma
  • Bile production (0.5 -1L/daily)
  • Assists in the digestion of fat
  • Produces many of the factors that aid in the proper regulation of the immune system
  • Fragile - easily injured
• Blood flow - high, as all blood that passes through the GI tract passes into it
• GI arterial blood supply of its own (25% of cardiac output of blood (1.5L) passes through the liver each minute

• Binary System:
  • Liver is connected to the Intestine by the Bile Duct
  • Gallbladder - an outpouching from the bile ducts that serve as a reservoir and connecting organ for bile production in the Liver
• Discharges stored and concentrayed bile into the Duodenum through the common bile duct
• Commonly 60 - 90mL of Bile

• Major hollow organ of the abdomen
• Cell lining produces enzymes and mucus to aid digestion
• More than 90% of the products of digestion are absorbed across the wall of the lower end of the small intestine to be transported to the Liver:
• Amino Acids
• Fatty Acids
• Simple sugar
• Together with water
• ingested vitamins
• Minerals

• Composed of:
  • Duodenum - (about 12' long) 
  • receives food from the stomach
    • Food is mixed with secretions from the pancreas and liver for further digestion
  • Jejunum and Ileum (20') make up the rest of the intestine

• Major Hollow Organ (about 5' long)
• Consists of:
  • Cecum
  • Colon - extends from the Cecum to the Rectum
    • Absorbs the final 5% - 10% of digested food and water
  • Rectum
    • Where solid stool is stored and passed out of the body

• 3" - 4" tube that opens into the Cecum
• Right Lower Quadrant (RLQ) of the abdomen
• May become easily Inflamed and Infected
• Appendicitis - Inflammation 
• 1 of the major causes of severe abdominal distress

• Lowest end of the colon
• Large hollow organ that is adapted to store quantities of feces until expelled
• Anus (2" canal) - terminal end 
• Supplied with circular muscles called sphincters
  • Control:
  • Voluntary
  • Automatically
    • escape of liquids, gases, and solids

• Kidneys- solid organs
• Ureters - hollow organs
• Bladder-hollow organ
• Urethra - hollow organ
• Controls the discharge of certain waste materials filtered by the blood by the kidneys

• 2 Kidneys
• Lie on the posterior muscular wall of the abdomen behind the peritoneum in the retroperitoneal space
• Rid the blood of toxic waste products
• Control the balance of water and salt
• High blood flow (20% of the output of blood from the heart/min)
• Attach to the Aorta and Inferior Vena Cava
• Continuously concentrate filtered urine by reabsorbing water

• Renal Pelvis - a cone-shaped collecting area that connects the ureter and the kidneys
• Each kidney drains its urine into 1 ureter through which urine passes to the bladder
• Ureter hollow tubes ( 0.2" in diameter):
• Passes from the renal pelvis of each kidney along the surface of the posterior abdominal wall, behind the peritoneum to drain into the urinary bladder
• Peristalsis:
  • Wave-like contraction of smooth muscle (to move the urine to the bladder)
• Urinary Bladder (smooth muscle):
  • Located immediately behind the pubic symphysis in the pelvic cavity
• Urethra:
  • Where urine is emptied through

• Controls Reproductive processes
• Male Genitalia, except for the Prostrate Gland and Seminal Vesicles, lie outside the pelvic cavity
• Female Genitalia, are contained within the pelvis, except the clitoris and labia

• Testivcle - contains specialized cell and ducts
• Vas Deferentia (Vas Deferens) - ducts that travel from the testicles up beneath the skin of the abdominal wall for a short distarnce
• Carry the sperm from the testicles to the urethra
• Seminal Vesicles- small storage sacs for the seminal fluid
• Semen - contains sperm
• Prostrate Gland - surrounds the urethra
• Priapism - painful, continual erections from spinal injury

• Female reproductive organs include:
• Ovaries - produce sex hormones
• Fallopian tubes - connect the uterus and carry the ovum into the uterus
• Uterus - pear-shaped and hollow
• Cervix - narrow opening from the uterus to the vagina
• Vagina - (birth canal) - muscular distensible tube that connects the uterus with the Vulva (external female genitalia)