Peripheral Nervous System

Thursday, January 20, 2011

10:50 AM

PNS
- Consists of the …
○ 12 paired cranial nerves
○ 31 paired spinal nerves
○ Autonomic nervous system
- Terms Regarding PNS
○ Sensations- Awareness of changes in internal and external env't
○ Perception- Conscious interpretation of a stimulus or external world by the brain
○ Stimulus- A change in the env't that can activate sensory receptor
- Somato-sensory system
○ Receives all sensory information of the body (internal and external)
○ Located in the post central gyrus which is in the cerebral cortex
○ Information travels along a typical chain of 3 neurons
Chain of Neuron:
 1st order neuron- cell body in dorsal root ganglion (PNS to the CNS)
 2nd order neuron- cell body in dorsal horn or medulla (CNS to the Thalamus)
 3rd order neuron- cell body in thalamus ( Thalamus to the Post Central Gyrus)
- Sensation:
○ Sensory recptor- where the process of sensation begins
○ Processing Sensory Information
 Stimulate a sensory receptor
 Transduction of stimulus - stimulus is converted into energy
 Energy travels along axon as a nerve impulse or signal
 Impulse (singal) reaches brain and there is an integration of sensory input
- The Brain:
○ The integration center where information is perceived and interpreted
- Sensory Receptors Note:
○ Mechanoreceptor- movement (Ballerina) - When ice is pour in hot water, the first
○ Thermoreceptor - heat dip will become cold but as it becomes
 Cold Receptors - located in stratum basele, activated by temp btwn (50-105F) cold and the temperature drops below 50
 Warm Receptors- not as abundant as cold, located in dermis, activated by it will begin to hurt
temp btw 90-118F - Hypothermia causes pain
- temp below 50F and above 118F
► stimulate pain receptors
- Nociceptors - pain (free nerve endings
○ Photoreceptors - light found everywhere in body except brain)
○ Chemo-Receptors - chemicals
 I.E Perfume. Perfume will stimulates chemo-receptor, therefore over a short
period when will not be able to sense our perfume
○ Osmo-Receptors-osmotic pressure of body fluids
 When the body loses water, it will trigger the urinary bladder to retain the
water .
 If bp drops too low and Osmo-receptors are not being stimulated, it will tell the
urinary receptors to shut off.
○ Adapatation
 Rapid-Phasic receptors - receptors no longer respond to maintain stimulus and
develop quick adaptation
□ Receptors associated w/pressure, touch, smell
□ Pressure on the butt as one sits on the chair.
□ Perfume, as we can no longer smell it cause we've adapted it
 Slow-Tonic receptors- adapt slowly or not at all
□ Associated with pain, body position and chemical composition
□ When two pregnant woman are giving birth, one can have a less painful
birth because they have more pain receptors.
□ Brain can also be a factor of pain receptor
 Parent runs into a burning house to save their children. Brain
changes the receptor as they do not feel the pain till later
 Diabetes pt do not feel their legs when injured, because the
receptors are impaired
Example:
- Somatic Sensations
Crude: Standing outside and feeling the win
○ Touch- result from stimulation of tactile receptors in skin or subcutaneous layer
blow against the face. Not knowing what
 Crude- ability to perceive that something touched the skin
exactly is being blown at the face
 Fine- provides specific information about the touch, known exact location on
Fine: Someone touching your face with their
the body
fingers, known exactly what is touching
○ Pressure - sustained sensation over a larger area than touch
 Butt implying pressure to your seat

Example of Touch Receptor

- Hair receptor: senses hair movement when gently touched
Merkel Disc: detects light, sustained touch and texture (reading Braille)

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 - Merkel Disc: detects light, sustained touch and texture (reading Braille)
- Pacinian corpuscle: responds to vibration and deep pressure, rapidly adapting
- Ruffini Endings: responds to deep, sustained pressure and stretch of skin(massage)
- Meissner's corpuscle- sensitive to light, rapidly adapting

- Somatic Sensations
- Itch- sensation results from stimulation of free nerve ending by chemicals or local
inflammation (injury)
 Chemical on skin will irritate the skin or it can be tissue damage
 Hepatitis: Inflammation of the liver
□ Pt who don't take care of themselves complain of itching because of
Biurubin (yellow pigment) that spills into the blood stream and cause
itching
□ Pt can test if they have it through chemical panel
- Tickle-only when someone else touches you
- Somatic Sensations=Pain (3 Types) Note:
- Fast- Occurs rapid (within 0.1 sec after stimulus) Slow: First you ask them their pain scale,
 Acute, sharp, prickling, not felt in deeper tissues of the body, myelinated fibers Then ask them to describe their pain
- Slow-Begins a second or more after stimulus Referred Pain: When a person has a heart
 Excruciating, burning, aching, throbbing pain, attack, they don't feel pain in their heart,
 Un-myelinated fibers, occurs in skin and in deep tissue or internal organs but their jaw, left shoulder and arm start to
- Referred pain-pain felt in area far away from stimulate organ feel pain.
- Pain
- Phamtom Limb sensations
 Severed (amputated) limb but still with sensation
 Person still feels itching, pressure, tingling and pain as if the limb was still there Example: Pt leg is amputated but pt still feels
 Brain still interprets impulses from the nerves that innervated the amputated their leg and denies that their leg is gone. They
limb say they can still feel their toe wiggling, known
Three Neuron: as phantom limb sensations.
1st order neuron- impulse from somatic sensory receptors to spinal cord of brain
stems, PNS to CNS Why? There are three neuron and only one
2nd order neuron-impulse from brain stem or spinal cord to thalamus, CNS to neuron has been destroy (1st neuron),
thalamus therefore brain is still sensing their leg
3rd order neuron-from thalamus to cerebral cortex

Decussate- crossing over happens in 2nd order neurons, happens in brain stem or
spinal cord before reaching the thalamus. Left brain always have problem because of
crossing over.
Note: motor tracts can also decussate at second order neuron
Pathway to the brain
- Lateral Spinothalamic- carries nerve impulses for pain and heat sensations
- Anterior Spinothalamic- impulses for tickle, itch, pressure and crude touch (ability to
perceive that something touched the skin)
- Pt is injured and no longer interpretating heart. A person w/nervous injurty has to
wait to see if it's PNS or CNS
- Posterior spinocerebellar: proprioception in truck and lower limbs, coordinates smooth and
refine skilled movements and maintains posture and balance
- Anterior spinocerebellar- proprioception in trunk and lower limbs, coordinates smooth and
refine skilled movements and maintains posture and balance

Untreated Syphilis
- Treponema pallidum
- Third stage causes damage to spinocerebellar tracts Note: If STD is not fixed then it will cause
- Sensation is lost and impulses do not reach the cerebellum Poster imbalance and impair muscle movement.
- Gait becomes uncoordinated and jerky Spinocerebellar track is damage.

Pathways from the Brain (located in the CNS)

- Lateral corticospinal tracts - precise and highly skilled movement ( playing piano)
- Anterior corticospinal tracts - control movement of neck and trunk
- Corticobulbar tracts - control skeletal muscle movement in head, provide input to cranial
nerves (3,4,5,6,7,9,10,11,12)
- Rubrospinal-skeletal muscles for precise movement of distal limbs Note:
- Tectospinal- move the head and eye in response to visual stimulus Cortico-Spinal
- Vestibulospinal- regulate ipsi-lateral muscle tone for maintaining balance in response to Cortex-Spine (Brain down to spine [motor])
head movement IE--> Spinalocerebellar: Spine Cerebellum
- Lateral reticulospinal(motor)
- For flexor reflexes and inhibit extensor reflexes
- Decrease muscle tone in axial skeleton and proximal part of libs
- Medial reticulospinal(motor)
- Facilitates extensor reflexes and inhibits flexor
- Increases muscle tone in axial skeleton and proximal part of limbs

Circadian Rhythm
- 24 hour of human sleep and wake cycle Note: Break fast is use to tell the body
Established by hypothalamus

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 24 hour of human sleep and wake cycle Note: Break fast is use to tell the body
- Established by hypothalamus that blood sugar level have dropped
- Under cortisol and blood sugar control and food is needed to produce fuel
- Blood sugar drops early AM causing you to awaken
- Also responds to sunlight and darkness
EEG
- Electro-encephalogram records brain activities
- Messures electrical potential differences between various areas of the cortex
 Alpha waves- low amplitude, indicate brain is calm (8-13Hz)
 Beta waves-rhythmic have higher frequency that alpha (1-25 Hz)
□ When we are awake or alert as when concentrating on something you
are looking at
 Theta waves - irregular, low frequency (4-7 Hz)
□ Abnormal in adults who are awake, see them in children and adults in
REM stage
 Delta waves- high amplitude, (4 Hz), see during deep sleep
Sleep
- Sleep = state of unconsciousness in which a person can be aroused
- Coma = state of unconsciousness in which a person canNOT be aroused
- Insomnia = inbability to obtain the amount of sleep needed to function adequately
during daytime
- Types:
- NREM-non-rapid eye movement
 Occurs during the first 30-45 minutes of sleep
- REM- rapid eye movement
 About 90 minutes after sleep begins EGG
 EEG patterns are more like a person is awake ○ Sleep
 Also called paradoxical sleep Memory
 Temperature, HR, RR, BP all increase
 GI motility decreases
- Non-rapid eye movement or slow wave sleep consists of four stages, each of which
gradually merges into the next
- Most dreaming occurs during rapid eye movement sleep

Stages of Sleep
- Stage 1: Transition stage - eyes closed, relaxation begins, vital signs normal, awaken
easily (alpha waves)
- Stage 2; Light sleep-first stage of true sleep, arousal more difficult, fragments of Note:
dreams, eyes move side to side (alpha waves) - Night terror: Extremely violent even though they
- Stage 3: Moderate deep sleep- sleep deepens, vital signs decrease, skeletal muscles are sleeping.
relaxed, dreaming, usually about 20 min after stage 1 (theta and delta wave)
- Stage 4: Deep sleep- vital signs reach their lowest, digestion increases, bedwetting Regular people should get 8 hours of sleep a day,
and sleep walking (delta waves) but 50% of people in LA do not get enough sleep.
- Memory: Sleep is use to repair the body, when not given
- Learning--> enough, body will get chronic disease
 Ability to acquire new information
- Memory-->
 Storage and retrieval of a previous experience or information
 Ability to recall thoughts

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Autonomic Nervous System
Monday, January 24, 2011
3:23 PM

Somatic Nervous System (NS)

○ Has sensory and motor division
○ Sensory convey input for the special senses (vision, hearing, smell,
equilibrium, pain, heat, proprioception (the perceiving the position of
the parts of the body)
○ Motor-neurons innervate skeletal muscles and produce voluntary
movements
Autonomic Nervous System
○ Sensory division
 Receptors located in blood vessels, organs, muscles
 The nervous system that monitors the internal environment
○ Motor division
 Parasympathetic
□ Rest and Digest
□ I.E--> During a late night of studying your brain Remember: Most organs
Gets the munchies and you eat at 1 am. have sympathetic and
You then go to bed and wake up at 5 am parasympathetic
Feeling hungry, the reason behind your Nervous system
Hunger is because you're body is in innervation to help
parasympathetic mode because you ate you are maintain homeostasis
putting it in sympathetic mode.
 Sympathetic
□ Fight or Flight

Neuron
○ Two types of neurons
 Cholinergic-release acetylcholine
 Adrenergic-release epinephrine (Epi) and Norepinephrine (NE)
□ Note: Epinephrine is also known as adrenalin and
Norepinephrine is known as noradrenalin
Receptors
○ Cholinergic
 Nicotinic
 Muscarinic
○ Adrenergic
 Alpha 1
 Alpha 2
 Beta 1
Receptors and Neuron
○ Cholinergic neuron (releases acetylcholine)
 Nicotinic receptor - binds acetylcholine
 Muscarinic receptor-binds acetylcholine
○ Adrenergic Neuron (release Epi and NE)
 Alpha 1 receptor-excitatory (turns things on)
 Alpha 2 receptor-inhibitory (turns things off)
 Beta 1 receptor-excitatory
Nicotinic Receptors
○ On plasma membrane of postganglionic sympathetic and
parasympathetic neurons
Muscarinic Receptors
○ Effectors innervated by parasympathetic post-ganglion
○ Sweat glands by cholinergic sympathetic post-ganglion neurons
○ Skeletal muscle blood vessels innervated by cholinergic sympathetic
Alpha Receptors
○ Alpha 1
 Produce excitation in smooth muscle, salivary glands, sweat
glands on palms and soles
○ Alpha 2
 Produce inhibition in smooth muscle in blood vessels,
pancreatic cell (exocrine and endocrine), platelets in blood
(forms platelet plug)
Beta Receptors
○ Beta 1
 Exitation in heart, posterior pituitary (ADH secretion) adipose
(break down of fat)
○ Beta 2
 Inhibition of sooth muscle in lungs (relaxation causing dilation
of airways), ciliary eye muscle (relaxation), liver (breakdown
glycogen to the glucose) Example: Pt is in the ER with a brain surgery. During the procedure
○ Beta 3 The heart stops . MD tells nurse to jab ephrinephrine pen into the heart
 Excitation-located on brown adipose tissue and their activation stimulating the heart with neurotransmitter that will attach to the
produces heat Adrenegic receptor to increase the heart
Receptors
○ Cells of most effectors contain alpha or beta receptors
NE stimulates alpha receptors more than beta receptors

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 ○ NE stimulates alpha receptors more than beta receptors
○ Epinephrine stimulates both alpha and beta
NT Inactivation
○ Inactivation of NE
 COMT (catechol-o-methyltransferASE)
 MAO (mono0amine oxidASE)
○ Inactivation of Ach
 Acetylcholine lingers in the synaptic cleft longer than NE
Receptors
○ Substances block or activate receptors in 2 ways
○ Agonist
 Binds to and activates a receptors
 Mimicking the effect of natural NT or hormone
○ Antagonists Note: Nicotine is a stimulant, it will initiate the sympathetic pathway.
 Binds to and block a receptor When people get high from smoking, they are going the parasympathetic way.

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Special Senses
○ Smell, taste, vision, hearing and equilibrium Note:
○ Housed in complex sensory organs Equalibrium: Cerebellum or the ear if balance is off
○ Ophthamology is science of the eye
○ Otolaryngology is a science of the ear
Chemical Senses
○ Interaction of molecules with receptor cells
○ Olfaction (smell) and gustation (taste)
○ Both project to cerebral cortex and limbic system
 Evokes strong emotional reactions
Anatomy of Olfactory Receptors
○ The receptors for olfaction, which are bipolar neurons, are in the nasal epithelium in superior
portion of the nasal cavity
○ They are first-order neurons of the olfactory pathway
○ Supporting cells are epithelial cells of the mucous membrane lining the nose
○ Basal stem cells produce new olfactory receptors
Olfactory Epithelium
○ 1 square inch of membrane holding 10-100 million receptors
○ Covers superior nasal cavity and cribriform plaste
○ 3 types of receptor cells
 Note: Chemical is inhale then goes to the nasal epithelium. The structure that it enter is call
the structure that it enter is call the nasal concha (to warm the air), air creates a
vortex and the air goes down. Cold air causes muscle contraction, when people
exercise in cold air they get a sore throat.
Cells of the Olfactory Membrane
○ Olfactory receptors
 Bipolar neurons with cilia or olfactory hairs
○ Supporting Cells
 Columnar epithelium
○ Basal cells = stem cells
 Replace receptors monthly
○ Olfactory glands Note: Stem cells replicate by
 Produce mucus mitosis. When taking chemo drug
○ Both epithelium and glands innervated cranial nerve VII it will destroy the stem cell
causing for Pt to lose their sense
Olfaction: Sense of Smell
of smell
○ Odorants bind to receptors
○ Na+ channels open
○ Depolarization occurs
○ Nerve impulses is triggered
Adaptation & Odor Thresholds
○ Adaptation= decreasing sensitivity
○ Olfactory adaptation is rapid
 50% in 1 second
□ People lose it instantly
 Complete in 1 minute
□ Their smell falls off of tem onto someone else
Gustatory Sensation: Taste
- Taste requires dissolving of substances
- Four classes of stimiuli- sour, bitter, sweet, and salty
 Other "tastes" are combination of the four taste sensations plus olfaction
- 10,000 taste buds found on tongue, soft palate and larynx
- Found on sides of circumvallate & fungiform papillae
- 3 cell types: supporting, receptor & basal cell
Anatomy of Taste Buds
- An oval body consisting of 50 receptor cells surrounded by supporting cells Note: Taste buds are always
- A single gustatory hair projects upward through the taste pore replaced every ten day
- Basal cells develop into new receptor cells every 10 days
Accessory Structures of the Eye-Overview
- Eyelids or palpebrae
 Protect and lubricate
 Epidermis, dermis, CT, orbicularis oculi m, tarsal plaste, tarsal glands and conjunctiva
- Tarsal Glands
 Oily secretions (preventing eye from sticking together)
- Conjunctiva

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  Palpebral and bulbar
 Stops at corneal edge (pink eye and contagious)
Eyelids:
- The eyelids shade the eyes during sleep, protect the eyes from superficial to deep, each eyelid
consist of epidermis, dermis, subcutaneous tissue, fibers of the orbicularis oculi muscle, a tarsal
plate, tarsal glands, and conjunctiva
 The tarsal plate gives form and support to the eyelids
 The tarsal glands secret a fluid to keep the eye lids from adhering to each other
 The conjunctiva is a thin mucous membrane that lines the inner aspect of the eyelids and is
reflected onto the anterior surface of the eyeball
 Eyelashes and eyebrows help protect the eyeballs from foreign objects, perspiratio, and the
direct rays of the sun
Eyelashes and Eyebrows
- Eyeball= 1 inch diameter
- 5/6 of Eyeball inside orbit and protected
- Eyelashes and Eyebrows help protect from foreign objects, perspiration and sunlight
- Sebaceous glands are found at base of eyelashes (sty)
- Palpebral fissure is gap between the eyelids
Lacrimal Apparatus
- About 1 ml of tears produced per day. Spread over eye by blinking. Contains bactericidal enzyme
called lysozyme
- Always located on the lateral aspect of the eye
Retina
- Posterior 3/4 of eyeball
- Optic Disc
 Optic nerve exiting back of eyeball
- Central Retina BV
 Fan out to supply nourishment ot retina
Note:
 Visible for inspection
-CN2
□ Hypertension and diabetes
- symptoms of a detached
- Detached retina
retina, curtain closing
 Trauma (boxing)
□ Fluid between layers
□ Distortion or blindness
Photocreceptors
- Rods
 Specialized for black-and-white vision in dim light
 Allow us to discriminate between different shades of dark and light
 Permit us to see shapes and movement
- Cones
 Specialized for color vision and sharpness of vision (high visual acuity) in bright light
 Most densely concentrated in the central fovea, a small depression in the center of the
macula lutea
□ Cone are responsible for color blindness
Pathway of Nerve Signal in Retina
- Light penetrates retina
- Rods and cones transduce light into action potential
- Rods and cones excite bipolar cells
- Bipolars excite ganglion cells
- Axons of ganglion cells form optic nerve leaving the eyeball (blind spot)
- To thalamus and then the primary visual cortex
Lens
- The eyeball contains the nonvascular lens, just behind the pupil and irus
- The lens fine tunes the focusing of light rays for clear vision
 With aging the lens loses elasticity and its ability to accommodate resulting in a condition
known as presbyopia
Refraction Abnormalities
- Myopia is nearsightedness
- Hyperopia is farsightedness
- Astigmatism is a refraction abnormality due to an irregular curvature of either the cornea or lens
Correction for Refraction Problems
- Emmetropic eye (normal)
 Can refract light from 20ft away
- Myopia (nearsighted)
 Eyeball is too long from front to back
 Glasses concave
- Hypermetropic (farsighted)
 Eyeball is too short
 Glasses convex (coke-bottle)
- Astigmatism
 Corneal surface wavy Note:
 Parts of image out of focus Emmetropic: Directly on the orange
Constriction of the Pupil

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 Parts of image out of focus
Constriction of the Pupil
- Constrictor pupillae muscle contracts
- Narrows beam of light that enters the eye
 Prevents light rays from entering the eye through the edge of the lens
 Sharpening vision by preventing blurry edges
 Protects retina very excessively bright light
Processing of Image Data in the Brain
- Visual information in optic nerve travels to
 Hypothalamus to establish sleep patterns based upon circadian rhythms of light and
darkness
 Midbrain for controlling pupil size coordination of head and eye movements
 Occipital lobe for vision
Anatomy of the Ear Region
- Ear is the last sense.
Notes: Fluid in the inner ear moves which causes your little
- Out of the ear is filled with AIR.
Brother to become dizzy. As the fluid slow down, the dizziness
- Middle ear is filled with AIR
goes away.
- Inner ear is filled with FLUID
Hearing and Equilibrium- Overview
- The external (outer) ear collects sound waves
- The middle ear (tympanic cavity) is a smaller, air-filled cavity in the temporal bone that contains
auditory ossicles (middle ear bones, the malleus, incus, and stapes=smallest bones in the body),
the oval window, and the round window
- The internal (inner) ear is also called the labyrinth because of its complicated series of canals
External Ear
- The external (outer) ear collects sound waves and passes them inward
 The sound of teacher is going into ear
- Structures
 Auricle of pinna
□ Elastic cartilage covered with skin
 External auditory canal
□ Curved 1" tube of cartilage and bone leading into temporal bone
□ Cerminous glands produce cerumen = ear wax
 Tympanic membrane or eardrum
□ Epidermis, collagen and elastic fibers, simple cuboidal epith
- Perforated eardrum (hole is present)
 At time of injury (pain, ringing, hearing loss, dizziness)
 Caused by explosion, scuba diving, or ear infection
Middle Ear Cavity
- Air filled cavity in the temporal bone
- Separated from external ear by eardrum and from internal ear by oval and round window
- 3 ear ossicles connected by synovial joints
 Malleus attached to eardrum, incus & stapes attached by foot plate to membrane of oval
window
 Stapedius and tensor tympani muscles attach to ossicles
- Auditory tube leads to nasopharynx
Note: Kids get ear infection when they lay flat because liquid
 Helps to equalize pressure on both side of eardrum
is going up in their middle ear which becomes a nice warm
- Connection to mastoid bone = mastoiditis
moist environment in which bacteria begins to form
Inner Ear---Membranous Labyrinth
- Membranous labyrinth = set of membranous tubes containing sensory receptors for hearing and
balance
 Utricle, saccule, ampulla, 3 semicircular ducts and cochlea
 Lateral (balance)
 Medial(hearing)
Semicircular Canals
- Projecting upward and posteriorly from the vestibule are the three bony semicircular canals
 Arranged at approximately right angles
 The anterior and posterior semicircular canals are oriented vertically; the lateral semicircular
canals are oriented vertically; the lateral semicircular canal is oriented horizontally.
 Two Parts
□ One end of each canal enlarges into a swelling called the ampulla
□ The portions of the membranous labyrinth that lie inside the semicircular canals are
called the semicircular ducts (membranous semicircular canals)
 Balance or equalibrium
Cranial Nerves of the Ear Region (CN 8)
Nerve
- Vestibulocochlear nerve=CN VIII
 The vestibular branch of the vestibuloocochlear nerve consists of 3 parts
□ Ampullary, utricular, and saccular nerves
 Cochlear branch has spiral ganglion in bony modiolus
Cochlear Anatomy- Zoom in
- Section thru one turn of Cochlea
 Partitioons that separate the channels are Y shaped
Bony shelf of central modiolus

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 □ Bony shelf of central modiolus
□ Vestibular membrane above and basilar membrane below from the central fluid filled
chamber (cochlear duct)
 Fluid vibrations affect hair cells in cochlear duct
Hearing - Overview
- Auricle collects sound waves
- Eardrum vibrates
 Slow vibration in response to low pitched sounds
 Rapid vibration in response to high-pitched sounds
- Ossicles vibrate since malleus is attached to the eardum
- Staples pushes an oval window producing fluid pressure waves
 Oval window vibration is 20x more vigorous than eardrum (but the frequency of vibration is
unchanged)
- Pressure fluctuations inside cochlear duct move the hair cells against the tectorial membrane
- Microvilli are bent producing receptor potentials
Anatomy
- Resting on the basilar membrane is the spiral organ (organ of Corti), the organ of hearing
- Projecting over and in contact with the hair cells of the spinal organ is the tectorial membrane, a
delicate and flexible gelatinous membrane
Anatomy of the Organ of Corti
- 16,000 hair cells have 30-100 stereocilia (microvili)
- Microvilli make contact with tectorial membrane (gelatinous membrane that overlaps the spiral
organ of Corti)
- Basal sides of inner hair cells synapse with 1st order sensory neurons
Deafness
- Nerve Deafness
 Possibly nerve damage (CN VIII), but usually damage to hair cells from antibiotics, high
pitched sounds, anticancer drugs, etc.
□ The louder the sound the quicker the loss of hearing
 Person may fail to notice loss until they have difficulty hearing frequencies of speech
- Conduction deafness
 Perforated eardrum
 otosclerosis

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 Endocrine System

- Endocrine glands release substances into the blood (hormones)

- The substances travel through the blood and attach to other organs, nerves or glands
- Their attachment can do two things:
○ Activate the receiver (turn it on)
○ Inhibit the receiver (turn it off)

Major Endocrine Organs

○ The Pituitary Gland
○ Thyroid Gland
○ Parathyroid Gland
○ Adrenal Gland
○ Pancrease
○ Gonads
○ Thymus
○ Pineal Gland

Pituitary Gland aka Hypophysis

- Called the master endocrine gland-secretes hormones that control various areas of the body
- Located in the sella turcica
- Pea shaped structure approximately 1-1.5cm (0.5 iches)
Pituitary
- Located below the hypothalamus
- Controlled by the hypothalamus- which is the master of the pituitary Note:
- Hypothalamus connected to pituitary by a stalk called the infundibulum Master of the Hypothalamus is the
- Arterial blood is delivered to the pituitary via two branches of the internal carotid artery Thalamus
- Veins leaving the pituitary drain into the cavernous sinus
Parts of the Pituitary
- Anterior pituitary-adenohypophysis
 Pars Distalis-larger tubular portion
 Pars tuberalis - portion that forms a sheath around the infundibulum The Pituitary waste away during fetal
- Posterior pituitary development
 Pars nervosa - the larger bulbar portion
- Pars Intermedia - 3rd region, atrophies during fetal development
Hypophyseal Portal System
- Bed of capillaries called a capillary network
- Hypothalamus hormones reach the pituitary thru this portal system
- Blood flows from the hypothalamus thru a portal system into the anterior pituitary Note:
- Neuro-secretory cells-clusters of neurons, synthesize hypothalamic releasing and inhibiting Exocytosis happens when talking about
hormones in the cell bodies and packages them for release by exocytosis muscles and ANS
Anterior Pituitary
- 7 hormones released
 Hgh-human growth hormone or somatotropin, secreted by somatotrophs, hGH stimulates
tissue to secret insulin-like growth factors
 TSH-thyroid stimulating hormone or thyrotropin, secretd by thyrotrophs

- hGH-for growth, mitosis and repair, also regulates some metabolism

- TSH- activates thyroid to release T3 and T4
- LH- stimulates estrogen and progesterone production in females, stimulates testosterone
production in males
- FSH-stimulate ovarian follicle maturation and estrogen production in females, stimulates
sperm production in males
- PRL- promotes lactation (breast feeding)
- ACTH-controls salt, sugar and sex hormone levels
- MSH-causes darkening of the skin in excess

- Different cells in the anterior pituitary may be classified according to their staining
- Basophills (thyrotrophs, gonadotrophs, corticotrophs) - stain blue with basic dyes and contain
secretory granules
- Acidophils-(somatotrophs, lactotrophs)-stain red with acidic dyes and contain secretory granules

Posterior Pituitary
- Also called neurohypophysis
- Does not synthesize hormones
- It only stores and releases hormone in the posterior pituitary
- The cell bodies of the neurosecretory cells begin in the hypothalamus and end in the posterior
pituitary
- 2 hormones are then produced in the cell bodies of the neurosecretory cells
- Oxytocin - causes uterine contractions
□ Example:
When a woman is in labor, the posterior pituitary releases Oxytocin causing the
muscle to contract. Because her labor becomes too long, the MD will put artificial
Ptocin to help the mother contract her muscle to help get baby out.

□ If a women went through C-section, she receives a bag of Ptocin to help contract the
uterus into its original size. When the uterus was cut, it was still large. Once Ptocin

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 uterus into its original size. When the uterus was cut, it was still large. Once Ptocin
has been placed into the body, it cannot be stopped.

- ADH (anti-diuretic hormone)

□ AKA Vasopressin
□ Causes increase in blood pressure by allowing the body to hold onto water
Thyroid Gland
- Located in the anterior neck
- Has two lateral lobe and they are connected by a tissue mass call the isthmus
- Internally composed of follicles
- Follicles is where the hormones that are released from the thyroid are made
- The thyroid hormone (TH) is referred to as the body's major metabolic hormone
- 2 types released from the thyroid gland
- T4 thyroxine (major hormone released from the gland)
- T3 tri-iodothyronine
- Affect body's metabolism (chemical processes occurring in all body cells)
Problems
- Exopthalmos, eyes are bulged out because of the fat pack develop behind the eyeball
pushing the eyeball forward.
- Abnormal metabolizing, fat does not get broken down or distribute properly therefore a fat
pack is develop behind the neck
- Goiter, lack of Iodine
Parathyroid Gland (regulate blood calcium)
- Smell glands located in the posterior side of thyroid gland
- Contains oxyphil cells and chief cells
- Chief cells secrete parathyroid hormone
- Oxyphil cells function is unclear
- When pt remove thyroid gland, they accidently remove the parathyroid glands which regulate the
blood Ca level. Heart need a sufficient amount of Ca to contract, the lack of Ca will cause cardiac
arrest. When removing the parathyroid gland, it impairs the heart from receiving Ca
Adrenal Glands
- 2 parts to the adrenals
- Adrenal cortex secretes three zones with separate functions; Note:
- Mineralcorticoids - secrete aldosterone to control Bp (Salt) Adrenal Fatigue - body keeps switching from
- Glucocorticoids - secrete cortisone to control blood sugar levels and respond to stress Sympathetic to Parasympathetic
- Gonadocorticoids - secrete androgens or sex hormones to control testosterone and
estrogen
Pancreas
- Both endocrine and exocrine Note:
- Flattened organ that measures about 4-6 inches Glucagon:
- Located posterior and slightly inferior to the stomach • Ate at 7 am (Bagel and Grapes). Break Fast
- Contains the head, body and tail
by supplying the body with Glucose
- 99% is arranged in clusters called acini (produce exocrine substances)
• From 7 am to 10:15, using glucose. Using
- Scattered among the exocrine acini are 1-2 million of clusters of endocrine cells called pancreatic
islets of islets of Langerhans the glucose that have been stored.
- Abundant capillaries serve endocrine and exocrine portions of the pancreas Glycogen stored lucose G-G-G-G-G, in liver
Cells and in muscles. Store glucose to have a
- Alpha cells or A cells - 15% of islets, secretes glucagon constantly supply in the blood stream even
- Beta Cells or B cells - 80% of islets, secrets insulin when you are not eating. The body take
- Delta cells or D cells - 5% secrets somatostatin some of the energy from break fast to start
- F cells - less than 1% secret pancreatic polypeptide the day, then the rest of it will be stored as
- Glucagon-raises blood sugar levels by breaking down stored glucose called glycogen GLYCOGEN to have a constantly supply.
- Beta cells secrete insulin Beta Cell
- Insulin causes blood glucose levels to decline
• Digestive system will break the food down
- Insulin allows glucose to move from the blood stream into the cell so that it can be broken down
for fuel (ATP)
Diabetic:
- Somatostatin - inhibits insulin secretion and glucagon, slows absorption of nutrients from the GI • Pt do not have enough glucose
tract Blood glucose is high because its not
- Pancreatic polypeptide-inhibits somatostatin and secretion of digestive enzymes (digestive moving from the blood stream into the cell
enzymes are used to break down food into molecules)
Gonads
- Male and female gonads are the sex organs
- Male = testes (located in the scrotum)
- Produce Sperm
- Produce testosterone Give men their masculinity
- Female = ovaries (located in the female abdomino-pelvic cavity)
- Produce ova or eggs
- Produce estrogen and progesterone Femininity
Thymus
- Located deep to the sternum in the thorax
- Large in infants and diminishes in size in adults
- For maturation of T-lymphocytes
- Major hormones produced include:
- Thymopoietins - used for normal T-lymphocyte development
- Thymosins- used for normal T-lymphocytes development Note:
Example: T cells are made in the bone then dumped
- When comparing to AIDS pt, the main concern is the viral lobe and the T cell count. T cell count is into the blood stream and move into the

Exam 3 Page 11
 into the blood stream and move into the
the ability to fight infection as oppose to the Viral Lobe which shows how much of the virus are Thymus to become mature.
replicating. A person with a high level of viral lobe are more prone to infection and die quicker.
Individual with a high T cell count and a low viral lobe will live longer because their body will be
able to fight off infection.
Pineal
- Tiny gland that hangs from the roof of the third ventricle
- The secretory cells are called pinealocytes
- Function is a mystery
- Secrets melatonin which gives skin its color
- Known to other culture as the third eye
- When person is sleeping and all of a sudden someone open up the curtain and you wake
up it is known as Pinealocytes

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Blood

Introduction:
○ Blood inside blood vessels, interstitial fluid around body cells, and lymph inside lymph vessels constitute
one’s internal environment.
○ To obtain nutrients and remove wastes, cells must be serviced by blood and interstitial fluid.
○ Blood, a connective tissue, is composed of plasma and formed elements.
○ Interstitial fluid bathes body cells.
○ The branch of science concerned with the study of blood, blood-forming tissues, and the disorders
associated with them is called hematology.
Fluids of the Body
○ Cells of the body are serviced by 2 fluids
○ blood
□ composed of plasma and a variety of cells
□ transports nutrients and wastes
○ interstitial fluid
□ bathes the cells of the body
○ Nutrients and oxygen diffuse from the blood into the interstitial fluid & then into the cells
○ Wastes move in the reverse direction
Functions of Blood
○ Transportation
○ O2, CO2, metabolic wastes, nutrients, heat & hormones
○ Regulation
○ helps regulate pH through buffers
○ helps regulate body temperature
□ coolant properties of water
□ vasodilatation of surface vessels dump heat
○ helps regulate water content of cells by interactions with dissolved ions and proteins
○ Protection from disease & loss of blood

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