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					Ear
         External- Auricle and external acoustic meatus
         * tympanic membrane*
         Middle- tympanic cavity and auditory ossicles (malleus, incus, stapes) Stapedius
                and tensor tympanic muscle, intervated by CN 7
         *oval window*
         Inner Ear- Vestibococular organs, bony/osseous labyrinth, perilymph (cochlea,
                vestibule [ membranous labyrinth- endolympth, ulticle and saccula- linear,
                dolls eye] semicicrcular canals [ angular, eye movement in the opposite
                direct as head movement]) innervated by CN 8

Heart-
        Tricuspid- AV valve
        Pulmonary valve- semi-lunar
        Mitral- AV valve, biscuspid
        Aortic-
S and I VC- R Atrium- pectinate muscle
Right Ventricle- less likely to cause pulmonary adema- Pulm A
4 Pulm Veins- Left atrium- base, smooth inside
Left ventricle- thickest- aorta
SA node (pacemaker in RA) to AV node (delay) to Bundle of His to Purkinji fibers

Liver-
On the right of the body, two lobes (R2/L1), separated by the falciform (round/ umbilical
cord reminant) and coronary ligament
Kupffer cells- phagocytic, stores BEAK (12)
Portal Triad- HA, PV, Biliary duct

Spleen- upper left side of the ab, 9th-11th rib, nodular within a BV (modified tunica
adventia) central A. White pulp- lymphocytes initiated immune response. Red pulp-
outside white pulp, has splenic cords, blood is filtered here before reentering circulation.
Splenic V foes to inferior VC

Pancrease- in front of left kidney

Plasma Membrane 7-10 nm thick, amphipathic, polar heads, nonpolar (hydrophobic tails)
Unicellular- one nuclei, most cells
Binuclear- Cardiac muscles, hepatocytes, urinary epith
Multicellular- skeletal muscle, osteroclasts
Anuclear- RBC

Ribosome- site of protein synthesis, no lipid bilayer, cytoplasmic basophilia, nissel
substance, free float (cell growth) and bound (make proteins for export, rER)
sER- detoxify drugs and make steroids, muscle cells Sarcoplasmic renticulum (store Ca)

Mitochondria- Own DNA, resp center, maternial inher, Krebs in Matrix, LHON
Microfilaments
Microvilli (actin) absorb, SI, epididymis
Microtubules
Cilia & flagella (tubulin), movement, trachea and resp tract, fallopian tubes, sperm cells

Epithelium-
Simple Squamous- Diffusion, alveolar, corneal endo, loop of Henle, Bowmans, vasc endo
Simple cuboidal- Secrete, PCT/DCT/CD, thyroid, salvary glands
Simple columnar- Absorb, colon, GI (except esophagus)
Pseudostratified columnar ciliated- Resp

Stratified Squamous NK- cornea epith, conj, esophagus, vagina
Stratified squamous K- (made by golgi, rER and rib- karolysis) thick skin
Stratified cuboidal- 2 layers, large ducts
Stratified columnar- 2 layers, large ducts, anus
Transitional epithelium- 3-7 layers in bladder

Communication or gap juctions- thur channels, connexons, allow ions to flow, cardia and
neurous tissue,
ZO- very tight, like a belt, lipids fuse, B/A barrier, Schlemms canal, iris vessels, NPCE
ZA- structural support, interweave fibers use tonofilaments and mucoproteins
MA (desm)- spot weld for reienforcement
Hemi- connects cell to BM

Endocrine *NO ducts*, invaginations in epith: pancrease, thyroid, adrenal, pit
Exocrine- use ducts based on
# cells- uni (goblet)
Shape- simple (LI, sebaceous gland, Brunners) vs compound (cardia region of stomach,
salivary, pancrease)
Mechanism- holocrine- secrete whole cell (sebaceous, Zeiss) apocrine- just a piece in a
PM (sweat, Moll, odor) and merocrine- exocytose out (temp regulating, salivary,
pancrease)

Salvary glands-
Parotid- less mucus, drain lateral orbit, largest
Submandibular- more mucus drain medial orbit
Sublingual- most mucus, smallest

CT- all from Mesenchyme- tendons, ligaments, muscle, cartilage, bone, blood, fat
Loose (more cells) Dense (less cells) elastic, reticular
Fibroblasts, Mast cells, Plasma cells, Macrophages, pericytes, endothelial

Collagen- Most abundant protein in body, 8 types, 1/3 glycine, chain of 3 disulfide bonds
formed extracellularly, need Vit C (Scurvy), fibrous- water insoluable *osteogenesis
Imperfecta G replaces by A, blue sclera*
Elastic fibers, reticular

GAGs- keratin sulfate (66) chondro sulfate (33) hyaluronic acid, heparine sulfate
Diasccharids, AA, uronic acid

Blood-
RBC- 45%, Plasma 55%, WBC 1%
Plasma 55%- water, albumin
RBC 45%- biconcave, 280 hemoglobin (2 alpha and 2 beta chains, with Fe, binds 4
oxygen when relaxed) located on
WBC 1%- gran- BEN Agran- M, L
        Basophils- gran, <1%, anaphylaxis, like mast cells, bilob
        Eosinophils- gran 1-6%, phag, parasite and stop allergic rxn, bilob
        Neutrophils- gran 50-70%, phag, nonspec single immunity, pus, multlob
        Monocytes (macrophages in tissue) 2-10%, largest 20um, phagocytic, APC
        Lymphocytes (T and B) 20-40%, specific, fight viral
                T- cell mediated response, Helper T (CD4, Class 2), Cytotoxic (CD8,
                Class 1), suppressor T, does type IV reactions,
                Natural Killer cells- tumor fighters, don’t need APC
                B- humoral immunity, plasma cell makes Ab
Platelets <1%, smallest 3um, anulcear, megokeryocytes, used in the clotting pathway
Clotting factor IX converts Prothrombin to Thrombin and then Thrombin turns
Fibrinogen (in blood stream) to Fibrin

Blood cells formed in Bone Marrow by Hemopoiesis from stem cells

Woven bone- primary immature, fractures
Lamellar bone- secondary, mature

Osteocytes (no division), osteoblasts (product matrix) osteoclasts (remodeling,
multinucleates)
Haversian system- rings of lamella, osteons, canaliculi within, volkman canal, lots of gap
junctions

Types of ossification:
Intramembranous ossification- flat bones, no cartilage precursor, apposition growth,
widen
Endochrondrial ossification- long bones, begins as cartilage, appositional and interstitial
growth, widen and lenghten

Cartilage- type II cartilage, chondrosulfate GAG
Chondrogenic cells- chondroblasts- chondrocytes (can divide)
Types:
Hyaline- fetal, type II
Elastic- Type II
Fibrocartilage- interveterbal disks, type I and hyaline- No periochonrium
Types of Growth-
Appositional- chondrogenic cells add to edges, widen
Insterstitial- chondrocytes undergo mitosis and increase from within

Fat-
Unilocular and multilocular

Muscle- mesoderm
Z- M to M
A- Actin and Myosin
I- only Actin (double helix)
H- only myosin
When contract, only A stays same, I shrinks

Skeletal Muscle- voluntary, striated, multinucleated, t-tubules at A/I jxn, when depolized
Ca released from SR, tropomysin has myosin binding site, actin binding site and Ca
binding site. When Ca binds, shift exposes Myosin binding site, and myosin binds actin,
thin over thick.
Cardiac muscle- binucleated, striated, intercalated disks, gap jxns, purkinji used for
conduction not contraction
Smooth muscle- nonstraied, involuntary, central nuclei, use calumodule instead of
tropomysin, when Ca binds get MLPK and then pho to get cross bridges. Substained
contractions.

Nervous tissue- all from ectoderm
Myelin- oligodendrocytes and schwann cells, nodes of Ranvier, salutatory conduction

Epidermis- Melanocytes (tanning increases melanosome)
Malignant melanoma eye to liver, from breast or lung
Layers corneum (ZO) lucidum (thick) Spinosum (desm) and basal (mitotic)
*Squamous cell carcinoma is the most common metastatic tumor of eyelid*
*Basal cell carcinoma is the most common malignant tumor of the eye*

Dermis- Pars papillaris, Par Reticularis (cutaneous and suprapillary plexus), hypodermis
(cutaneous glands, receptors- open (RUffini/merkle, nocioreceptors) and encapsuled
(panician)

Blood Vessel-
Endothelium- Simple Squ (expect in lymphnods where cuboidal)
Tunica Intima- more prominent in Arteries, elastic fibers, *atherosclerosis*
Tunica Media- collagen 3, middle SM in circular, thickest in arteries, thin in veins, not in
capillaries
Tunica Adventia- outer, mainly in veins
Vaso Vasorum- blood vessels in the adventia supply outer layer, DM effects
Capillaries- single layer of simp squam and thin adventia
Continuous- ZO in iris and retina, lungs, muscle, nervous tissue
Fenestrated- Ciliary body, Choroid, kidneys, GI
Sinusoidal- liver, spleen, bone marrow

Lymph- MALT- Mucous associated lymphatic tissue Peyers Patches in SI

Thymus- decreases after puberty, reticular cells form Hassal corpuscles as they
degenerate.

Respiratory system-
Conduction- terminal bronchi and up
Respiratory- respiratory bronchi and down

Nasal cavity- Pharyn- Laryna (Simple Squamous) Trachea (Trachealis muscle- SM)
Bronchi (1 R3L2, 2 R10L8) Broncho- pulmonary Segment (smallest independent unit of
the lung)- Respiratory bronchioles (no hyaline cartlage) – terminal bronchioles

Respiratory Bronchioles- alveolar ducts- sacs- alveoli 300 million (type 1 gas exchange
and type 2 surfactant, release surface tension)

Digestive system-
Lumen
Mucosa- epithelium, lamina propria, muscularis mucosa (inner circ, outer long)
Submucosa- glands- Brunners in SI (neutralize HCL, controlled by Meissner’s plexus)
Muscular Externa- inner circular and outer long, Auerbauch’s plexus- Hirschsprung’s
disease
Adventia

Stomach- 1- 1.5
Cardiac- branched mucus
Fundus- straight, HCl (parietal) pepsinogen (chief)
Body- straight, HCl (parietal) pepsinogen (chief)
Phyloric- branched, mucus

SI- microvilli,
Crypts of Lieberkuhn, enterocytes, lamina propria (peyers patches)
Duodenum- sphincter of Oddi
Jejunum
Ileum- No Brunners

Large intestines- Water absorption, no villi,
Cecum (lower right) Appendix
Asending
Transverse
Descending
Sigmoid
Rectum
Thyroid gland-
Follicular cell- simple cuboidal cells
Colloid- modified to mature hormones T3 T4
Parafollicular Cells- produce calcitonin

Parathyroid gland- 4 on back on thyroid
Chief- PTH
Oxyphils- ?

Adrenal gland- on top of kidney
Medulla- NCC
Chromaffin- ep and NE
Cortex- Diencephalon
ZG- Aldosteron
ZF- Corticol
ZR- Adregens

Pituitary Glands
Anterior- edtodermal pouch, Rathke’s
Acidophiles GH, Prolactin
Basophiles- FSH, LH, TSH, ACTH,
Chromophobes- ?
Posterior- diencephalons
Herring Bodies, Pituicytes
Stores- Oxytoxin, ADH

NEUROSCIENCE-
Resting potential- -60 mV
K higher inside
GABA, glycine- inhibitor
Glutamate- excitory

Gastrulation- ectoderm (CNS) mesoderm (notochord) endoderm
Neurulation Neural fold- groove- tube
Ependymal- innermost layer
Mantle- alar- sensory, basal- motor
Marginal- outer (white)

Procephalon- Telecephalon- cerebral (lateral)
              Diencephalon- Thalamus, eye (third- interventricular Monroe)
Midbrain-     Mesencephalon-
Rhombinceph- Metencephalon- Pons (4th b/w Sylvian aqueduct, CSF in chorid plexus.
              Myencephalon- Medulla
Gray Matter- cell bodies in butterfly region of center
White matter- myelinated tracts

Spinal nerves   31            Vertebral 33
8               Cervial       7
12              Thoratic      12
5               Lumbar        5
5               Sacral        5
1               Cocci         4

Pyramidal tract- Descending
Precentral motor gyrus internal capsule in forbrain  cerebral peduncles, pons, form
medulla pyramids (break away of the Corticobulbar tract to CN) crosses in the pyr
decussation in caudal medulla 85% cross Lateral corticospinal
                              15% uncrossed Anterior corticospinal

Anterolateral/ Spinothalamic pathway- ascending pain and temp
Nerves synapse in the substantia gelatinosa cross b/c lateral spinothalamic VPLT

Trigeminothalamic- Ascending pain and temp from face
Trigeminal ganglia to BS at level of the pons medulla (Spinal tract of CN V) syn in
trigeminal complex cross in the medulla and remain contralateral to VPMT

Medial Leminiscus- Ascending, touch, pressure, vibration.
Upper body to cuneate (lateral) and lower body from gracilis (medial) cervical lumbar
regions to nuclei in caudal medulla cross midline in medulla Internal arcuate fibers
contra to VPLT.

Visual Pathway-
Fibers nasal cross in chiasm
LGN- lateral upper VF, medial lower VF, parvo dorsal 3-6, mango ventral 1-2, C I I C I
C (isp 2, 3, 5; contra 1, 4, 6)
meyers loop, temporal superior VF (pie in sky) , parietal lobe- inferior VF(pie on the
floor)) 
V1, Area 17 (binocularity) Calcarine Fissure top- cuneus (inferior VF) bottom lingual
(superior VF), receptive fields: simple elongated stimulus in certain orientation make up
complex cells specific to certain direction (also hypercomplex deal with length)
Higher cortical areas (V2, V3, V4 Area 18, 19

Anopsias- large VF defect
Scotoma- smaller VF defect

Pupillary Pathways-
Light response- Tectotegmentom nucleus,
Near response- FEF
1. Fibers from temporal brain go to ips pretectum, nasal fibers to contra pretectum
Edinger- Westphal Necleus ciliary ganglia iris sphincter and ciliary body (Para)
2. Fibers to reticular formation in midbrain lateral horn of the spinal cord iris dilator.
Blood supply to the Brain-
Mainly from Vertebral and Internal Carotid (b/c anterior and middle)
Circle of Willis

BIOCHEMISTRY
Protein (4 cal/g)- AA covalently bound by peptide bounds, amino group and carboxyl
group, made in ribosome
Amino Acid- 20 types, coded by mRNA, degenerative
Primary (sequence) Secondary (beta sheets, helix) Tertiary (globular (water sol) and
fibrous (insoluable) 3D) quandary (subunits hemoglobin, insulin)

Antibodies
IgM- made first, blood
IgA- saliva, tears, breast milk
IgD- ?
IgE- allergic
IgG- Girth, most, cross placenta

Energenonic- require energy (so these reactions need to be coupled with other exergoinc
(give off energy) in order to proceed.
Want:
Exergonic, - G
- H Enthalph (give off heat)
+ Entropy (disorder)

Oxidative- reduction rxn- transfer of e-
Greater difference in redox potentions reaction favorable
NADH, NADPH and FAHD (coenzymes) are reducing agents, RED: Reducers are E-
Donors. Give up electrons in CAC

pH= - log (H+)
Ka= measure of acid strength, high Ka= strong acid, wants to give up H+
pKa is inverse of Ka
pKa= - log (Ka)

Henderson Hasselbalch
pH= pKa + log (A-/HA)

Michaelis-Menten Equation= Vo= V max (s) / Km + (s)
Km is substrate concentration at ½ Vmax
A large Km means low affinity, if the substrate has a high affinity (more tightly bound),
you do not need a lot of substrate, thus a low Km.
Lineweaver Burke Plot m=Km/Vmax, linear MM,
Allosterism- binding changes things + or –
Competetive inhibition- bind and prevents substate from binding, get no change in Vmax,
increase in Km (need more substrate) , crossed
Non-Competetive inhibitor- bind separate site, no effect on affinity, no change in Km
(don’t need more), but Vmax is lowered, does Not cross
Feedback Moderation- series of reaction that may effect later step.

Carbohydrates- 4cal/g
Monosaccharides- glucose, fructose, galactose
Di- sucrose (G and F) Lactose (G and Gl) Maltose (G and G)
Poly- 3 or more, starch, glycogen, GAG, proteoglycan

Glycolysis- breakdown of glucose to 2 pyruvate 2 ATP and 2 NADH
Located in cytoplasm
Rate Limited step: Phos Fruc Kinase, - feedback on PFK, + NADH
Glucose into cell (can’t cross lipid membrane) use GLUT 4 channels (don’t use ATP)

No Oxygen b/c lactic acid
Oxygen TCA in mitochondria Matrix, Acetyl CoA to Citrate (oxaloacetic acid), makes
6 NADH, 2 FADH, and 2 GTP these then go to the electron transport chain in the inner
mit matrix for Oxidative Phosphorylation (protons move from inside to outside, O2 is
final e- receptor, makes 30 ATP.

Pentose Phosphate Shunt- in cytosol, make NADPH used for syn of nucleotides, fatty
acid, reduce glutathione and steroids.

Gluconeogenesis- in liver and kidneys (not in muscle), make glucose from proteins,
sugars, lactose, pyruvate, AA, glycerol. (NOT from FAT!) increased by glucagon

Glycogenesis- in muscles and liver, storage of glucose as glycogen (b/c can’t store
glucose b/c osmotic P), Glucose is stored everywhere in body, but mostly in the liver,
increased by insulin, inhibited by stress hormones

Glycogenolysis- muscle and liver, breakdown of glycogen into glucose, increased by
glucagons.

Brain uses glucose but can use ketone bodies (NOT FAT)

Lipids (9 cal/g) - Non polar, nonionized, insul in water.
Fatty acids are required in diet
Shorter are usually liquid, longer are solid
Saturated are usually solid (all single bonds)
Unsaturated are usually liquid (double bonds- lower melting point)
Triglyceride- 3 FA and glycerol
Phospholipids- polar head (electrostatic and H bond), non polar tail (hydrophobic and
Van der walls) Fluid Mosaic ,
Sphingomyelins- type of phospholipids in nerve cells, myelin sheath
Isoprenoids- lipids in plants animals and bacteria

Cholesterol- precursor for steroids and major structural comp on the membrane.
Made in the cytosol from Acetyl CoA, uses NADPH, rate limiting step is HMG-CoA
reductase (blocked by –statins)

Lipid Digestion- bile salts emulsify, pancrease lipase, chylomicrons, lipoprotein lipase
into liver broken down into FA and Trig (insol) VLDL leave and recognized by
adipose tissue LDL
HDL- healthy, transfere and scav of free chol, returns it to liver

FA metabolism- Beta Oxidation- bkdw of lipids-
Done in mitochondria
FA Acetyl CoA and generate NADH and FADH
Move fatty acid in the blood, Albumin in cells

Ketone Bodies- made in liver when excess Acetyl CoA
2 Acetyl CoA 1 Ketone Body. Make more when DM crisis, Adkins diet, starvation.
(end up with acidosis) Used by all cells (except liver) for energy

FA Synthesis- when you have enough energy, body stores fat
Done in cytosol, 4 step process, uses NADPH
4 CCondenstation, reduction, dehydration, reduction X4= 16 C

Minerals needed: Na Ca, Mg, K> Fe, CU, I, Zn

Water soluable-
B1 Thiamine (coenxyme in glycolysis) BeriBeri alcohols= Wernick-Kor, Neuro dis.
B2 Riboflavin anemia, cracking of skin
C Ascorbic Acid- Anti-oxidant, collagen syn (scurvy), cofactor DO and NE
B12 Folic Acid, bkbone of DNA and RNA, intrinsic factor, maintain myelin pernicious
       anemia, most common disorder
B3 Niacin, needed for NADPH

Fat Soluable- DEAK
D- increase Ca and P abso (UV light) rickers, osteomalacia, pagents +
E- antioxidant, protect RBC hemolysis, no if +
A- beta carotene, anti-oxidant, vision/wrinkles nightblindness, xerophtalmia, toxic+
K- blood clotting, needed for syn of prothrombin hem, no if +

DNA-
Pyridimines C, T (U in DNA)
Purines G A
5 carbons, has 2 or 3 H bonds

RNA- mRNA (largest) rRNA (most, made in nucleous), tRNA (smallest)
Protein syn is done in the ribosome, 64 possible codons, degerate b/c only 20 AA

Transcription- nucleus, make mRNA modified GTP cap on 5, poly A tail, remove
introns, semi-conservative
Translation- in cytosol (on ribosome) tRNA anticodon accepts mRNA, makes protein
chain.
DNA polymerase- extends DNA 5-3 (must have primer)
DNA ligase- connects 2 strands together
Primase (RNA P) makes primer for the DNA
Helicases- unwind DNA

Cell Cycle-
G1 (growth)  S (DNA synthesized and DNA replication occurs) G2
Mitosis- Prophase (condense) metaphase (align) anaphase (split) and telophase
(cytokinesis)

Mutations- mis-sense (different AA, sickle cell), non-sense (stop codon, none fxn
protein), no effect, frame shift
PCR- amplify DNA
Southern Blot- see if DNA present

GENERAL PHYSIOLOGY
Body 60% water
Intracellular 25 L, main one is K 120
Extracellular- main one is Na 140
        Interstitial 12 L
        Plasma 3 L
Transcellular 3 L

B/c ions charge of cell is more – inside = -65 to -80 mV, need Na/K pump to maintain
3 Na out, 2 K in

Transport-
Uphill- requires energy, Primary uses ATP directly, secondary uses indirectly
       co-transport- same direction (Na/AA, Na/K/2CL)
       Counter-transport- opposite (Na/Ca)
Downhill- no energy, simple or carrier (facilitated- glucose, AA and other polar)

Receptors-
Adrenergic- increase sym and decrease para
Alpha 1 Gq increase IP3, increase Ca dilate radial, VC
Alpha 2 Gi decrease AC, decrease cAMP
Beta 1 Gs increase AC, increase cAMP, increase heart contraction
Beta 2 Gs increase AC, increase cAMP, BC, increase heart contraction

Cholinoreceptors- increase para
M1 Gq increase IP3, increase Ca
M2 Gi inhibitor cAMP
M3 Gq increase IP3, increase Ca
Nicotinic- open K and Na channels

Diffusion- move from higher concentration to lower concentration
Higher diffusion at: lower thickness, lower velocity, higher perm, higher temp
Osmosis- diffusion of water

Breathing-
Inspitation- contract external intercostals and diaphragm, increase V
Expiration- passive, contract internal intercostals and relax diph, decrease V

Lung Volume- about 6 L, measure with Spirogram, FEV/FLC, if less then 70%, COPD
Tidal Volume- in and out each breath 0.5 L
Inspiratory Reserve volume- amount in (over TV) when deep breath
Expiratory RV- amount out (over TV) when deep breath 1.2 L
Inspiratory capacity- total in with deep breath (TV + IRV) 3 L
Vital Capacity- total out after deep breath (TV + IRV + ERV) 4.5 L
Residual volume- amount always left in lungs 1.2 L
Function residual volume- left after normal breath out ERV+ RV 2.4
Total lung capacity- entire volume lungs can exchange VC + RV
Forced lung capacity- volume out after max in, 4.8 L
7.5% air changes with one breath
Anatomic Dead space- in conduction zone
Functional dead space- in alveoli
Physiological Dead space – both of above

O2 in body- 98% bound to hemoglobin (prop to PP), 2% in plasma
CO2 in body- 20X more then O2, 90% HCO3(uses CA) 5% carbominohemoglobin, and
5% dissolved.

Air in at 760 mmHG, 21% O2 (160 mmHg) , none CO2, in arteries PP is 100, in veins is
40 mmHG because passed throughout body.

				
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