This is an introduction to anatomy and physiology presented by Mary Elizabeth Regis on behalf of the American Association of Medical Assistants. Overview of this course, we're going to discuss body sections and then general disease categories and then the systems review with the anatomy and physiology of each system. Body planes and directions. A plane is an imaginary flat surface divides a body into two parts. We have three body planes. The coronal, also known as the frontal plane, divides the body into the front and the back or the interior and the posterior. Sagittal plane divides the body into the right and left halves. A mid-sagittal plane divides the body into equal right and left halves. Transverse plane divides the body into an upper and a lower or superior and an interior half. And then the body directions are going to represent movements toward or away from these planes. If you're talking about something that is proximal, that is away from the planes, pardon me, that is toward the plane, distal is away from the plane. Body cavities. A body cavity is a hollow space surrounded by bones or muscles that support and protect the structures inside. The human body has five main cavities. The cranial cavity inside the head, spinal cavity that runs down the back, thoracic cavity that's within the chest, the abdominal cavity is the upper abdomen, pelvic cavity is the lower abdomen. As you can see in this pictorial graph, the cranial cavity and the spinal cavity are along the back of the body. They hold the brain and the spine. Thoracic cavity is then separated from the abdominal cavity by the diaphragm. Diaphragm is a muscle that the body uses to breathe. The thoracic cavity holds the heart and lungs. The abdominal cavity and the pelvic cavity are a continuous cavity, sometimes called the abdominal pelvic cavity. And this is going to hold all other organs in our body. Cavity is also separated by body quadrants. Body quadrants or four quadrants are formed with a horizontal line and a vertical line cross at the umbilicus or the belly button. The liver can be felt in the right upper quadrant and the stomach in the left upper quadrant. A lot of times if people are having problems with their appendix, the patient with appendicitis will have pain in the right lower quadrant. Then there are regions of the body and this becomes more specific as far as where the organs are located in the abdominal pelvic region. If you've noticed the body quadrants and the body regions only cover the abdominal pelvic area. So these nine regions form a tic-tac-toe board where the center square is the umbilical region which is the belly button. We have the right hypochondriac region in the upper right corner, epigastric region up the top center and the left corner is the left hypochondriac region. The right middle is the right lumbar region. The left middle is the left lumbar. Right lower corner is the right inguinal region also can be called the right iliac region. Then we have the hypogastric region which is center bottom and then the bottom left is the left inguinal region also can be called the left iliac region. Some general disease categories. We have the congenital and this basically happens if there's a fetal abnormality or abnormal process during gestation or the pregnancy time the 40 weeks or birth during the birth process. So cleft lip and cerebral palsy are two examples of congenital diseases. Degenerative diseases are a progressive destruction of cells due to any kind of disease or aging process. Cerebral sclerosis would be a degenerative disease that's caused by destruction of cells whereas loss of hearing and arthritis could also be caught could are typically caused by the aging process. This isn't to say that a disease process couldn't cause them but these two would be examples of the aging process. Genital diseases are when you're exposed to something in the environment so breathing problems from smoking or if you have a pollen allergy that causes breathing problems or skin cancer. Genetic is when there's a mutation of genes or chromosomes during fetal development. Down syndrome is an example of this because with Down syndrome we have an extra chromosome that's a mutation of the chromosomes. Hereditary is a little different than genetic. This happens when we have inherited a defective gene by a parent who's a carrier. Some common examples of these are cystic fibrosis, hemophilia, and sickle cell disease. A hospital acquired infection also known as nosocomial infection is an exposure to a disease causing agent in the hospital environment. So if you have a wound infection after surgery you were there in the hospital for surgery and during your stay you acquired an infection. Iatrogenic is a little different. This is when the condition is caused by medicine or treatment that is received by the patient. So for example the wrong drug is given or surgery is done on the wrong part of the body or side effects of drugs. Idiopathic basically means they do not know. There's no identifiable cause. An example of that here is idiopathic thrombocytopenia which is a decrease in the blood clotting cells of our body and we just are not sure what has caused that. Another one that is common to a lot of people is urticaria which is also hives. Another disease category is infectious. This is one that most people are the most familiar with. It is caused by a pathogen which is either a bacterium, virus or fungus, gonorrhea, rabies, tuberculosis, influenza, COVID. Then we have neoplastic. This is a growth. Neoplastic literally means a new growth. So it could be benign or malignant, malignant meaning cancer. So you could either have a benign cyst or some cancerous skin tumors as examples. Nutritional category, you either have a lack of the nutritional food, an insufficient supply of that nutritional food, or your body has the inability to utilize the nutrients. So pernicious anemia is an example that when we do not get enough B12 or our body is unable to utilize it or malnutrition. The first system we're going to look at here is dermatology, pardon me, is the indigamentary system, but the specialty will be dermatology and it covers the skin. So the anatomy of the skin, we have the epidermis, which is the very top part of the skin. It contains the dead protective cells and its surface and living actively dividing cells at its base. Then we have the dermis, which contains sebaceous glands, sudiferous glands, which are your oil and your sweat glands, hair follicles, and then below that we have the subcutaneous tissue and this is a type of connective tissue that lies beneath the dermis. So for the skin anatomy, the epidermis, the outermost layer of skin, which is the thinnest layer, then we have the dermis and this contains the vessels and the different structures of the skin and then the subcutaneous tissue that lies beneath the dermis. Some skin diseases, dermatitis, this is just a general category, any infection or inflammation of the skin. Dermato means skin and itis, if you see i-t-i-s at the end of any word, it's just an infection or inflammation of that. Edema, swelling from an excessive amount of fluid. Now swelling is just when something gets bigger from fluid, the edema, and a lot of times it's because the fluid that moves from the blood to the dermis or the subcu is not being absorbed. Hemorrhage, it's an injury to a blood vessel that releases blood into the skin. Lesion, any area of visible damage on the skin or variation from the normal skin. Neoplasm, now neo means new and plasm means growth as we saw with neoplastic. It's just a new growth on the skin. Can be benign, which is non-cancerous or malignant, which means cancerous. Then we have poritis, poritis means itching, can be associated to a variety of things. Many diseases, an allergic reaction on the skin, or just an irritation. Then a rash, a rash is a red or pink skin lesion. It could be flat or raised, itchy or not itchy, and more times than not is stated to just be dermatitis of something. Xeroderma, xeroderma just is excessively dry skin, skin so dry that it's cracking. So it's not that you just have dry skin, it is cracking skin. These are some tips, some types of skin lesions and some pictures of those. A cyst, and this is normally elevated. It can be the skin color or it can have erythema or redness. It could have semi-solid or fluid filled, and normally you see this in an acne sebaceous cyst. Fissure, small crack-like crevice, dry chapped skin, you'll see this and it could be red. A macule, macule is a flat circle, normally it's pigmented brown or black. A freckle, think of a freckle or an age spot. A papule is like a pimple, it's not the sebaceous acne, but just an elevated, it could be skin color or sometimes it's red also. A pustule, now the pustule has a white top, it's elevated, but this would be an acne whitehead. A scale, these are flat, thin flaky parts of your skin, typically the color is whitish. Dandruff or psoriasis are examples. A vesicle, this is another elevated with a pointed top, normally has clear fluid in it. You'll see these with herpes, chicken pox, shingles. And then a wheel is the last one we're going to talk about. This is also elevated but flat, red, clear fluid, and a lot of times you see this with insect bites. So for example, a mosquito bite is a wheel. Now some injuries to the skin, an abrasion. This is when there's an injury, a sliding or scraping injury, mechanically removes epidermis like a skin knee. A blister, fluid filled sac, thin transparent covering caused by repetitive rubbing injury. So you have blisters on the back of your heel sometimes, if you're doing yard work your hands might get blistered. We have burns. Typically it was a first, second, and third degree burn is what they used, how they used to categorize those. Now we are just categorizing them according to the thickness of the skin that is affected. It's caused by heat, any hot objects, steam, boiling water, also through electricity, chemicals, and radiation. So superficial burn is only affecting the epidermis. You may have redness there and it hurts. Partial thickness will come down to the dermis. There's blistering now that starts to happen. And then the full thickness actually is also known as a third degree burn and you'll have limited pain here because it's now come down to the nerve endings and the nerve endings may be burned, therefore no pain. And that is the most dangerous and most risk of infection. A callus. Thickened elevated pads of the dermis caused by repetitive rubbing again, but instead of a blister, they're just the thickened pads. See those sometimes on your palms if people do a lot of heavy labor. Also on the bottom of your feet, on your toes, or your heels. Sychotrex is known as a scar, just another name for a scar. It's when collagen forms to an injury as it heals. Excretion, superficial injury. Now superficial just means it's near the surface. A scratch of the skin. Think of if you've been scratched by a cat or you're outside and in the woods going for a hike and a stick scratches you. A keloid. A keloid is a sychotrex, but it's larger. So there's an overproduction of the collagen and therefore it's a raised scar. Laceration, a linear penetrating wound. So just means it's a cut in the skin. It could have clean cut edges, could be torn or ragged depending upon what has cut the skin. And then we have a pressure injury, also known as an ulcer in the skin. Sometimes it's called a decubitus ulcer. If it's on a patient who has been lying in bed a lot and not the base of the spine, because where the body is meeting the bed on a patient who is bedridden, there's constant pressure there on the skin. Therefore we have a decrease in the blood flow over those bony areas, either the back of the heels or the lower spine, and the skin starts to break down. The next specialty we're going to look at is gastroenterology. And this is going to cover the gastrointestinal part of our body or the elementary canal. The anatomy portion of this, the elementary canal begins with the mouth and ends with the anus. So we're going to start from the top to the bottom. We have the oral cavity, contains the teeth, the tongue, the hard and soft palates, and you can tell the difference where the hard palate ends and the soft palate begins by just running your tongue from the back of your top teeth along the roof of your mouth. And when it becomes soft, that's where your soft palate begins. And the food is going to pass from the oral cavity into the pharynx. The pharynx is the general term for your throat. And then we're going to break the pharynx down into a couple different sections. We have the nasopharynx, which is right behind the nose. The oropharynx, right behind the mouth. The laryngopharynx, which is right behind the larynx. The larynx is your voice box. And then it breaks down into your esophagus and your trachea. The trachea we're going to talk about more in the respiratory system, but now the esophagus is what is pertained to the gastrointestinal. And then the esophagus will now run down to your stomach. The cardiac sphincter is a small area where the esophagus joins the stomach. The doctor calls it the cardia, but it's actually that cardiac sphincter that is joining the stomach and the esophagus. The fundus is rounded top of the stomach. And then we have the body of the stomach. And then at the end of the stomach, that is where we have the pyloric sphincter, another area. So the lower esophageal sphincter is also known as the cardiac sphincter. And that will control the food going in and out of the stomach on top. The pyloric sphincter is what controls the food going in and out at the bottom. And this connects to the first part of the small intestines, which is the duodenum. Now, going into the small large intestines starts with a duodenum, then the jejunum, then the ileum. The large intestine starts with the cecum, and right from the cecum, we have the appendix, a lot of times called the variform appendix. We have the cecum that begins the large intestine, goes into the ascending colon that goes up, the transverse colon goes across, and the descending colon that comes back down again reaches the sigmoid colon. And then from the sigmoid colon, we go to the rectum and then to the anus and then outside the body. This picture of the gastrointestinal system, I think, shows a really clear breakdown of how food goes through the body. And it starts in the oral cavity and salivary glands. And these side yellow boxes talk about the chemicals that are being used to break down the body in the digestive process. So we start with the oral cavity and the salivary glands start to break down the food. Then we have the pharynx, which is the throat, the esophagus, and the esophagus is on the backside, then the stomach. Then we go into the small intestines. Those side ones there, the liver, gallbladder, and pancreas are known as accessory organs to the gastrointestinal system. So the small intestine starts with the duodenum, jejunum, and ileum, then it starts into the larger intestines, the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and then anus. Some diseases associated with the gastrointestinal is anorexia. Now, anorexia nervosa is the psychological disorder where people view in their mind that they are larger than they are, and they starve themselves, and that's more of a psychological disorder than a gastrointestinal disorder. Anorexia alone just means there's a decreased appetite. Many times anorexia is a side effect of medications. So remember, if the word nervosa is behind anorexia, that's the psychological condition. Just anorexia would be a loss of appetite. Dysphagia, when you have difficult or painful swallowing or eating, and it's just hard to do that. Many times people have this when they have sore throat, that swallowing. Other times it could be due to other disease conditions. Polyphagia is overeating. This could be a psychiatric illness. A lot of times it is due to overactive thyroid, also diabetes mellitus. Dyspepsia, indigestion, so difficult or abnormal indigestion for whatever reason, and it's typically temporary epigastric pain. Esophageal varicose. This is when there's a swollen or protruding vein in the esophageal mucosa, so basically varicose veins in the esophagus. Gastritis. Remember when I had talked about before, when itis is at the end of the word, it's just an inflammation of that, so this is an inflammation of the stomach. It could be acute or chronic. Acute meaning it's short-lived, typically less than six months. Chronic, typically longer than six months or longer. Gastroenteritis. This includes the intestines with that inflammation, so it's the stomach and the intestines that are inflamed. Gastroesophageal reflux disease, also known as GERD. This is typically chronic, which means it's longer lasting, six months or longer, due to reflux of the stomach acid in the esophagus. Now that lower esophageal sphincter, also I called it the cardiac sphincter, that is not stopping any of the acid coming from the stomach back into the esophagus. This can lead to ulcers, the wearing down of the lining of the esophagus, or cancer. Now heartburn is the temporary irritation of that acid coming up into the esophagus from the stomach. He met emesis, a vomiting of blood, and if you're vomiting blood, there's another condition that's happening, maybe due to the esophageal varices, or there could be bleeding in another area. Nausea and vomiting. Nausea and vomiting is the most common side effect of most oral medications. Nausea is an unpleasant, queasy feeling, whereas vomiting is when contents of the stomach are then expelled through the mouth. Peptic ulcer disease. This is chronic, so again something that has been lasting longer than six months. Chronic irritation, burning pain, and there could be erosion of the mucosa, again due to an ulcer. And ulcers are typically caused by H. pylori when it occurs in the stomach, but can also be caused by hydrochloric acid, stress, or any kinds of drugs. And drugs here, we're going to probably talk about medication, but it could also be illicit drugs. Stomach cancer, and this is when the cancerous tumor begins in the stomach. Cancer is normally named after the organ where it has started. Some cecum and colon, or large intestine diseases. The appendicitis is one of the most common ones people have thought of. Inflammation of appendix, inflammation and infection of the appendix by waste material. So what actually happens is at the end of the small intestine, where it starts and meets the cecum, the fecal matter starts to gather itself. And if any of that gets into the appendix and then the bacteria in there causes a problem and it becomes inflamed, that's when the appendix starts to inflame and it could burst. If it does, there are other issues that can happen, including death. Colon cancer, cancerous tumor, the colon that develops from polyps. And polyps are just extra growth that occurs, or it could happen from ulcerative colitis. Polyps, I sort of associate them with skin tags. If you've ever heard of a skin tag from the outside, they're just tags on the inside of the body. Diverticulum, this happens when there's a weakness in the wall of the colon and it forms sort of a pouch. So you've expanded it and then it forms just a pouch that doesn't seal. When different foods, maybe seeds or even tomato seeds, strawberries, little bits of food get into those little pouches and then they become inflamed, that would be diverticulitis. Gluten sensitivity and triopathy, including celiac disease. So this is an autoimmune disorder. Autoimmune means the body is fighting against itself. It's a toxic reaction to gluten in certain grains. So the body, there's an inflammatory response and it damages the small intestines. Inflammatory bowel disease and irritable bowel syndrome, two different processes. A lot of people associate them together, but IBD is typically chronic inflammation of parts of the small and large intestines. Crohn's disease affects the ilium and the colon, so the ilium is one part of the small intestine and the colon, which is the large, whereas ulcerative colitis affects the large intestines and the rectum and can cause ulcers. Irritable bowel disease, pardon me, irritable bowel syndrome is when there's any syndrome is a group of symptoms that come together and we've now grouped them into this syndrome. This can be acute or it can be chronic, but it normally comes with cramping and pain. It could be either diarrhea or constipation. If you've heard IBSD would predominantly have diarrhea, whereas IBSC would predominantly have constipation and those are treated differently. But both have cramping, pain, bloating, and excessive mucus, but typically no inflammation like IBD has. Then we have polyposis. This is when there's numerous polyps in your colon and they're just fleshy benign growths. Normally when they're seen during a colonoscopy is when they look and view inside the colon, they will take those and do biopsies just to make sure they can be indicative of some sort of cancer. However, they're normally benign. The next specialty we're going to talk about is pulmonology and this concerns the respiratory system or how we breathe. We're going to begin with our nasal cavity. Air normally enters the nasal cavity and swirls around these terminates and what the terminates are doing are warming and moistening that air before it goes into the lungs. It's also trapping any inhaled particles and bacteria and that's what the cilia is doing. They're like hairs and they just wave through and they're going to collect and clear out any mucus and debris. We go into the larynx, again the throat, and we talked about this in gastrointestinal system. Again, three parts that we talked about before the nasopharynx, the part of the throat that's behind the nose, the oropharynx, part of the throat that's behind the mouth, and the laryngopharynx, part of the throat that's behind the larynx or the voice box. So during swallowing, muscles in the neck are going to pull the larynx up to meet the epiglottis. The epiglottis we didn't mention last time but this is that the flap that's in the back of your throat. That's not the uvula but it's another flap below that and it covers the larynx so that swallowed food doesn't enter the lungs. This is why we can't eat and breathe at the same or swallow and breathe at the same time I should say. Now the trachea is the windpipe. It's a passage for inhaled and exhaled hair. It's got a column of c-shaped cartilage. It's on the anterior side so the anterior is the front side and it's rigid so you cannot collapse because we need to have the trachea open for life. The posterior has no cartilage and is soft and for this reason allows food to pass through the esophagus more easily. The trachea or the windpipe is the largest of the tubes here and then it divides down into the bronchi the right and left bronchi that goes into the right lung or the left lung and then those break down into bronchioles which are just smaller tubes and at the end of each of these bronchioles are alveoli and as you see in the circle inset there are clusters of microscopic air sacs and this is where oxygen and carbon dioxide gases are exchanged. So the bronchi is the branches of the trachea divides into the right into the left bronchi and each of these bronchi are supported by rings of cartilage or the hardened circles similar to the trachea and that's this ensures that those tubes do not collapse. Now the lungs are these spongy air-filled structures. Now the right lung contains three lobes or divisions and the left lung contains two divisions. The reason for this is the heart has to have a place to sit and it typically sits on the left side of a person's chest and therefore just two lobes to allow for that space. The top of the lung is called the apex. So inside these lungs the bronchus branches or the bronchus is the plural of bronchi branches into the bronchioles and ends in the alveoli. The alveoli that exchange the oxygen and carbon dioxide with nearby capillaries and the capillaries are the smaller parts of the blood system and this is where the oxygen and carbon dioxide exchange. Collectively the alveoli form the pulmonary perinechia. Physiology of respiration. So breathing is normally involuntary. A lot of times you could hold your breath just so long but the respiratory control centers of the brain will receive information about oxygen and carbon dioxide and you can only hold your breath for so long. There's many different extreme divers who have trained their body not to breathe for a certain amount of time but typically over time information will be sent to the phrenic nerve that will then stimulate the diaphragm and then you will take a breath in. Breathing is inhalation or inspiration and breathing out is exhalation or expiration. During inhalation the air is or expiration. During inhalation the diaphragm contracts and moves downward so those intercostal intercostal are between the ribs pull the ribs up and out enlarges the thoracic cavity and negative internal pressure causes inflow of air. During exhalation the diaphragm relaxes and moves upward those intercostals allow the ribs down and in thoracic cavity shrinks and the positive internal pressure causes the outflow flow of air. The diseases in the respiratory are asthmas a very common one hyper reactivity of the bronchi or bronchioles to any kind of allergen or inhaled substance what happens is there's an inflammation there in the bronchi or the bronchioles excess mucus production and bronchospasms. If it is a prolonged asthma attack it's called status asthma addicts and people have died of an asthma attack so we need to keep those bronchi bronchioles open but if there's mucus production in there that narrows that that pathogen way. Bronchitis is an inflammation of the bronchi could be acute bronchitis due to infection or chronic bronchitis a chronic infection due to smoking or pollution and that happens over time. Chronic bronchitis in many specialty respiratory offices is not a condition they call it COPD which we will talk about in a moment. Bronchiextasis this isn't a permanent enlargement and loss of elasticity of the bronchioles. The problem with this is because you would think that a large passageway would be very conducive to breathing but it allows secretions to accumulate and that can also be a problem. Then a reactive airway disease basically this is a general category for any kind of breathing condition with reversible airway narrowing and wheezing. If a person is not diagnosed with asthma because they don't meet the criteria of that diagnosis they could be diagnosed with reactive airway disease that may then lead to asthma. Adult respiratory distress syndrome a serious lung condition typically caused by a severe infection or burns or any kind of lung injury and the alveoli fill with fluid and collapse. Remember at the alveoli is where there's the exchange of oxygen and carbon dioxide. Atelectasis this is a complete or partial collapse of the lung. Chronic obstructive pulmonary disease now this is a very um this is an umbrella term that covers a lot of different lung diseases um it's chronic meaning it has happened and developed over a long period of time includes the chronic bronchitis sometimes asthma is also put in there with emphysema due to chronic air pollution or smoking characterized by chronic inflammation severe coughing shortness of breath and this sometimes leads to a barrel chest what's happening is people are having a hard time taking a breath in and they keep on trying to take that breath in and the chest starts to barrel out with the the chronic deep breaths. Cystic fibrosis this is an inherited condition remember an inherited means that it has come from a biological parent. It's caused by a recessive gene um causes problems with respiration digestion and sweat secretions. There's a lot of mucus that is secreted and it is too thick and it blocks the alveoli. There's constant coughing bronchiextasis occurs which then you lose the elasticity and therefore the secretions are not being coughed out. Lung infections are frequent and there's often a lack of oxygen. Empyema different than emphysema but empyema is localized pus in the lung due to a bacterial infection and this typically is acute take care of the bacterial infection you can get rid of the pus. Influenza we have it every year respiratory infection infection caused by a virus. Mild forms have fever muscle aches there are some life-threatening cases most times that when someone passes or there it's a life-threatening condition they have a comorbidity meaning they have another additional disease condition. Legionnaires disease severe sometimes fatal bacterial infection can start with flu-like symptoms but progresses to severe pneumonia and then it goes into the liver and kidney degradation. Lung cancer it's most common among smokers does not mean that people who don't smoke don't get lung cancer but it is most common among smokers and this happens when the tar deposits in the lungs become cancerous and spread. There's different types here that are listed adenocarcinoma bronchogenic carcinoma and large and small cell carcinoma and those are just designating where the cancer actually started. Then we have occupational lung diseases this group of diseases caused by constant workplace exposure to inhaled particles um anthracosis at best asbestosis pneumoconiosis pneumonia pneumonia is a very general umbrella term refers to any infection of the lobes of the lungs um fluid or white blood cells microorganisms fill the passages white blood cells are immune response so when white blood cells are increasing they're there because there's an infection and there is a long list here of different types of pneumonia so bacterial or viral depending upon what is what the pathogen is there's double pneumonia means it's affecting both lungs aspiration a lot of times if somebody reads in something we have aspirated bronchopneumonia infects is affecting not only the lungs but also the bronchial tubes lobar maybe it's just in one of the five lobes or pan lobar means the the infection is through all five lobes the pneumocystis girobecki basically that's the type of pathogen that is causing it or walking pneumonia we have pulmonary edema this is when there's been buildup of fluid in the alveoli caused by left-sided heart failure and we'll talk about that in the cardiology section chest wall trauma or pneumonia now pulmonary embolism an embolism is a traveling clot meaning that the clot is moving through the system whereas a thrombus is just a clot that's stationary so a pulmonary embolism is a traveling clot or could be a fat globule that lodges in the lungs and when it lodges in the lungs it's blocking blood flow causes shortness of breath and often occurs in patients on bed rest so they're not really getting up and moving or taking a deep breath in many patients that are on bed rest due to a variety of situations the the respiratory team will come in and have them breathe into it a tube we're trying to get them to take a deep breath that they normally would not do if they're just laying in bed severe acute respiratory syndrome communicable viral illness that can be fatal also known as SARS if you've heard that it's associated a lot of times with close contact and enclosed spaces TB tuberculosis everyone in the health career should be getting tested for this yearly it should be a requirement it is a CDC requirement but should be a requirement in every office and it's caused by the mycobacterium tuberculosis causes nodules or tuberculous in the lungs it's a waxy coating on them which makes bacterium resistant to different medications but it is treatable with a nine-month course of drugs apnea apnea is the absence of spontaneous respiration so it could be due to respiratory failure or arrest in infants it may be due to an immature central nervous system and a lot of times SIDS or sudden infant death syndrome is caused by apnea they just stop breathing because the nervous central nervous system doesn't tell the body to breathe middle-aged adults may cause obstructive sleep apnea where when they're sleeping there's an obstructive force either they're overweight or some structural obstructiveness in them that they're they stop breathing when they're sleeping bradypnea brady means slow anything with pnea after it means breathing so bradypnea is just an abnormally slow rate of breathing could be due to brain damage could be due to chemical imbalance there's a lot of different reasons why people may have a slower respiration but those are the most common cough if we have something in our lungs or in our respiratory pathways that should not be there our body is going to get it out so it's a protective mechanism to forcefully expel things from the lungs if someone asks if you have a dry cough or a wet cough they're asking if you have expiration it's coughing up sputum so are you coughing up something when you cough or hemoptysis is coughing up sputum that contains blood dyspnea is an abnormal or difficult labored or painful breathing now dyspnea on exertion normally happens with people patients who have lung disease so they call it d o e a proximal nocturnal dyspnea sometimes happens when fluid builds up in the lungs at night while people are lying supine or they're lying on their back orthopnea this is difficulty breathing when lying on their back as people age you may know somebody in your family even that sits that sleeps in a recliner or they sleep sitting up or semi upright and they sleep better that way tachypnea it's an abnormally fast rate of breathing fast rate of breathing so the normal rate of breath breathing is between 12 and 20 it depends on what textbook you're looking at but that is the the normally agreed upon normal respiration rate so anything below 12 or above 20 is considered either bradypnea or tachypnea we're going to move to the specialty cardiology we're going to cover the cardiovascular system or the heart so the surface of the heart there's internal chambers of the heart and they're reflected on the surface of the heart as elevated mounds grooves there's an apex of the heart here which is actually at the bottom of the heart where which is opposite from the lungs and then there's four chambers of the heart that we're going to talk about the chambers and the valves of the heart the heart's four chambers are the right atrium right ventricle left atrium and left ventricle and then it has the four valves tricuspid valve which is between the right atrium and the right ventricle pulmonary valve which is between the right ventricle and the and the left pulmonary artery the mitral valve which is between the left atrium and the left ventricle and the aortic valve which is between the left ventricle and then the aortic the aorta which is the largest artery in the body there's a lot of different parts in this picture here we don't have time here to cover the flow of the blood how each part works but if you go online and look at the flow of blood in any youtube video there's that come from an educational body you will see there's a lot of good videos out there about that but we just do not have the time to cover that here now the conduction system now the conduction system is our electrical part of our body we do not have to be plugged up or charged up for our heart to work most times people who are healthy we have spontaneous electrical pulses that occur and they start in the SA node at the top of the right atrium and it when that electrical impulse happens at the SA node or the pacemaker of the heart so when someone needs a pacemaker the SA node is not working like it should that initiates the electrical impulse travels then to the AV node which is the bottom of the right atrium and then you have through the septum of the heart here right and left bundle branches that take that electrical current down and around through the ventricles the right and the left ventricle the SA node will also come across to the left atrium these will contract those chambers of the heart which then encourages blood flow or pumps the blood the diseases of the heart uh cardiomegaly megaly means an enlargement of the heart this is usually due to congestive heart failure which we'll talk about in a moment cardiomyopathy myo part of that myo of that word just means muscle so the heart there's a disease in the heart muscle it can include cardiomegaly and heart failure congestive heart failure CHF is when the heart is not able to pump the blood as it should there's not sufficient amounts of blood that are being pumped and remember blood is carrying both the oxygenated and deoxygenated blood through the body so it is carrying both the oxygen oxygen or bringing the carbon dioxide back to pick up more oxygen so if the heart is not able to pump it we have problems a lot of times it's caused by coronary artery disease or hypertension hypertension is high blood pressure involves cardiac hypertrophy hypertrophy means growth extended growth followed by loss of contractile ability we have right-sided CHF or left-sided right-sided is characterized by jugular venous distension your jugular is in your in your neck so if you can actually see the jugular distending out liver enlargement or peripheral edema edema remember we I stated that it's when the tissues cannot let the fluids go and they stay in the tissue peripheral means your arms and your legs left-sided CHF characterized by pulmonary edema coughing and shortness of breath endocarditis there's different layers of the muscle in the heart endo is the inner lining of the heart valve so the infection and inflammation of the endocardium that lines the heart valves normally occurs in patients who have structural defects of the valve mitral valve prolapse it's when the leaflets or the parts of the valve do not close tightly it can be congenital or result of an infection a murmur is an abnormal heart sound it's heard as blood leaks through a defective valve valve myocardial infarction also known as a heart attack this is when there's a death of tissue of the myocardium or of the heart muscle due to severe lack of oxygen it occurs when blood flow in a coronary artery is blocked by a clot or atherosclerosis now atherosclerosis is a hardening of the arteries it's normally accompanied by angina which is heart pain ingestion like symptoms so they feel like they're real nauseous or there may not be any symptoms if the area of the dead tissue or that the severe lack of oxygen of the heart muscle that area is small the heart can keep contracting scar tissue may develop if it happens too much then the area of the dead tissue is larger the heart may not be able to contract and death will result the next um especially we're going to talk to is hematology and immunology or the blood and lymphatic system now the two body systems that are responsible for many of the important functions producing blood cells clotting the blood and coordinating the body's immune system are the blood and the lymphatic system hematopoiesis is the making of the blood all the form elements of the blood begin in the red bone marrow it produces a stem cell we've heard in the news a lot and we haven't heard as much lately in the news but stem cells are very important in the treatment of a lot of different conditions all blood that starts starts with the stem cell and then our blood is then forms into the different formed units first one red blood cells the erythrocytes thrombocytes these are also known as partial formed units but they are formed units these are the platelets that deal with the clotting and then the white blood cells there are five different white blood cells that each have their own jobs to do but this is the third element this deals with the immune system different blood diseases hemorrhage loss of a large amount of blood due to a disease or injury and the injury is typically arterial. Venous or veins that are injured normally clot and heal faster than an arterial injury. Pancytopenia, this is when there's a deficiency in all the cell types. So the red blood cell is not, red blood marrow, pardon me, red marrow, is unable to produce sufficient amounts of stem cells to be able to develop all of these blood cells. Septicemia, this is a severe bacterial infection in the blood. Emia, E-M-I-A, the end of the word, says it's a blood condition. Sepsis is an infection. It can cause severe symptoms, inflammation, and blood clots. A lot of times it is known as blood poisoning. It just really depends on what specialist is talking to you. Anemia, there's many different kinds of anemia. They're gonna talk about a few here, but it's typically a decrease in the number of erythrocytes. Can have several causes. So the anemia is named for what causes it. So it could be an insufficient consumption of amino acids, which is proteins, folic acid, iron, vitamin B6, or vitamin B12. The red bone marrow may be damaged from cancer, radiation therapy, or chemotherapy drugs. There could be a destruction of the erythrocytes, which is called hemolysis, and they become increasingly fragile for whatever reason. Or it could be excessive blood loss. So aplastic anemia happens when the bone marrow produces too few erythrocytes. And it could be from cancer, or the cancer therapy, or for many other diseases. Folic acid deficiency anemia. And this happens when there's too little folic acid in the diet. Typically it happens in older adults, or malnourished individuals, or patients with alcoholism, or those who are unable to process the nutrients in their body. Can also occur in pregnant women. The March of Dimes encourages most women who are trying to become pregnant to increase their folic acid just to make sure that there's not issues with this. Iron deficiency anemia. This is the one that most people have heard of. This is when there's too little iron in the diet, or too much iron is lost from bleeding. When this happens, your skin or mucous membranes become pale, and you're very fatigued, very tired all the time. Pernicious anemia. This occurs when there's too little vitamin B in the diet, or the person is unable to absorb the vitamin B12. Sickle cell anemia. This is an inherited genetic abnormality. So when there's a recessive gene in one or both of the parents, it's typically the recessive gene is in both parents, then sickle cell anemia occurs. What's happening here is when the blood oxygen levels are low, cells take on a crescent or sickle shape. That's why it's called sickle cell. These sickle cells then tangle in the vessels and cause extreme pain. The cells are then fragile and have a shortened lifespan. Acquired immunodeficiency syndrome, or AIDS. It's a severe infection that's caused by human immunodeficiency virus, or HIV, in which infects the helper T cells. Now, there are a lot of different cells in our body, and we don't have time to go over all the different kinds that are in our immune system, but T cells are normally what you're gonna hear about patients have tested if they have AIDS or HIV positive. Helper T cells are then infected and destroyed, and because that happens, the suppressor T cells dominate. A suppressor T cell will then take over the normal immune response, and it will suppress what the normal immune response is supposed to do. Patients will become immunocompromised and susceptible to opportunistic infections and cancer. If you've ever heard of or known anybody that has been HIV positive and then developed AIDS, more times than not, what actually will end their life is not AIDS, but pneumonia, or the flu, or some other opportunistic infection because their body cannot fight it off. HIV, though, is only transmitted through bodily fluids and often through sexual intercourse, but it cannot be passed through tears, saliva, unless it has blood in it, and urine. Those are the three that research has now found unless there is blood in it. Leukemia. Leukemia is also known as the cancer of the blood. It's the cancer of the lymphocytes, which is a type of white blood cell. What's happening is there's an excessive number of immature leukocytes in the red marrow. It leads to anemia or too few erythrocytes, causes hemorrhaging, too few thrombocytes, increases the susceptibility to infection, too few mature leukocytes or white blood cells. You can have easy bruising, fever. Normally, the type of leukemia you have is named to the prevalent type of lymphocyte, or if it's acute or chronic, and it occurs in adults and children. It is not a respecter of persons. Mononucleosis, also called the kissing disease, but it's an infectious disease caused by the Epstein-Barr virus. This will cause lymph node enlargement, fever, and fatigue. Multiple myeloma, another form of a blood cancer per se. It's a cancer of the B lymphocytes. So we have T and B. The B lymphocytes, which multiple bone tumors destroy the red bone marrow, causes weakness, anemia, increased susceptibility to infections or different symptoms. Bone fractures are common. There's a specific protein, Ben's Jones protein, that appears in the urine also. Coagulopathy, it's a disease, a clotting disease. So the body is not able to clot normally. So the blood is just not clotting normally. Deep venous thrombosis, DVTs. These are a thrombus or a blood clot. Remember, a thrombus is a stationary blood clot, whereas a embolus is a traveling blood clot where it moves. So deep vein thrombosis is when a stationary blood clot forms in a deep vein of the lower leg. Many times occurs post-surgery or often during bed rest or immobility. It can break free, and if it breaks free and travels, it's now an embolism. Through the bloodstream, can move through the heart, lodge in the pulmonary artery, and cause a pulmonary embolism. The lymphatic system consists of lymphatic vessels, nodes, fluid, tissues. Tonsils and the adenoids are two examples of parts of it. We will see in this picture where the different nodes are, lymph nodes. A lot of times, if you have known anybody who has had biopsies, they're looking at their lymph nodes a lot of times to see if any cancer has metastasized or spread there. The spleen is also part of this system. Some autoimmune diseases that are listed here. Now, autoimmune means that the body is actually attacking itself. Now, diabetes mellitus type one. There's different types of diabetes, which we will look at in a minute, but this is when the pancreas is not working as it should or the body is attacking the pancreas. Graves' disease affects the thyroid. Same with Hashimoto thyroiditis. The intestines are affected when we see gluten sensitivity, enteropathy, celiac disease, or inflammatory bowel disease. Multiple sclerosis affects the nerves. Myasthenia gravis affects the muscle. Psoriasis, scleroderma, vitiligo, and lupus all can affect the skin. Rheumatoid arthritis affects the joints. And then lupus also, systemic lupus affects the connective tissues, skin, kidneys, and lungs. But especially orthopedics, it's the skeletal system. This is a lateral view of the bones of the skull. All of the cranial bones and most of the facial bones can be seen in this lateral view. There's a couple that you're not gonna see we'll see in the next view. But the joints that you're gonna see here are a little different. These squiggly lines along the bones, the frontal bone, parietal bone, temporal bone, those are called suture lines. But those are the joints of the skull. The frontal bones, this is where you're gonna see the vulva here and the lacrimal bone that's by the nose. Again, you'll see the suture lines from here and those again are immovable joints. The mandible, which is the jaw bone, is the only movable bone in the skull. Then we have the bones of the chest and the shoulder. The sternum and the ribs form the thorax or the chest. A bony cage that protects the heart and the lungs. The clavicle is across the top of your, in front of your shoulder. And the scapula, they're parts of the bones of each of the shoulders. As you see each of the ribs here, there are 12 ribs. One, two, three, four, five, six, seven are actually called true ribs. Eight, nine, and 10 are called false ribs because they don't connect directly to the sternum. And then 11 and 12 are called floating ribs because they do not connect to the sternum. We have the bones of the spine. The vertebral column consists of five different regions. We have the cervical spine, which is in the neck area. One through seven. Thoracic spine covers the chest area or the thorax, one through 12. Lumbar spine, one through five, covers the lower back. Sacrum, which are fused. There are five fused vertebrae. And then the coccyx, which is the tailbone. And again, those are fused vertebrae also. Now this area between each of the vertebrae are the intervertebral discs. So there's cushions. The bone of the shoulders. This is a posterior view or view from the back showing the clavicle joining the scapula. And allows it to move freely in several directions as a shoulder moves or allows a rotating. There's a rotating joint there. The humerus is the start of the upper arm. Now we have the bones of the upper extremities. Upper extremities would be the arms. The humerus is the upper arm joint. And then the radius and the ulna are the lower ones. Notice the radius aligns with the thumb. The ulna aligns with the pinky. We have the carpal bones. Carpal means wrist. Metacarpals. And then phalanges are your fingers. Bones of the hip. The ilium, ischium, and pubis on each side of the hip flow into one another without a visible structure or joints. However, there's landmarks and this is where you can see them. The ilium is this broad area within here. The iliac crest is out above it. The pubis is the bone that's rounds it out. And the ischium also called the butt bones. Bones of the lower extremities are the legs. We have the femur, which is the strongest bone of the body. The fibula, the smaller of the two bones of the lower leg, and then the tibia. The fibula is on the pinky side of the foot. Tibia is on the greater toe portion. And then we have the patella. That is the knee, it's the knee bone. Bones of the ankle and the foot, whereas the carpals were the wrist bones, the tarsals are the ankle bones. Then the metatarsals and then the phalanges are the toes. The calcaneus is the heel bone. Some diseases for the bones and cartilage. We have avascular necrosis. What's happening is there is no blood flow now in the long bones. So there's death of the epithelial cells in the long bone. A bone tumor means the cancerous growth or a new growth has started in the bones. An osteoma is the bone that's in the bone. An osteoma is benign, which means it's non-cancerous. Whereas osteosarcoma, a malignant growth of osteoblasts. Osteoblast, a blast means a new bone cell. Ewing sarcoma is a malignant growth that typically occurs in young men. Chondroma, a benign tumor of the cartilage. So it's non-cancerous, but it's still a new growth in the cartilage that can cause movement problems and pain. Chondromalacia patella. Malaysia means softening or an abnormal softening. So this is an abnormal softening of the patella due to thinning and uneven wear. Typically what's happening is the thigh bone is pulling on the patella. Fracture, the broken bone. It's abbreviated either FX, both capitalized, or an F and a lowercase x. Depends on what your specialty prefers. Typically caused by an accident or injury. If it's caused by a disease, it's typically due to osteoporosis or any other pathological condition that affects the bones. So stress fractures caused by force or torsion, a lot of times during sport or activity. The pathological fractures caused by disease processes like osteoporosis or a thinning of the bones. And fractures are typically categorized by how the bone breaks. So no matter the cause of the fracture though, if a bone heals without treatment, it may show malunion or malalignment. So these are just pictures of what some of the fractures are. A Collis fracture. Now this is at the wrist. On the left side of this picture is the hand, and on the right side is the radius and ulna of the lower part of the arm. So a Collis fracture is seen more times than not in child abuse case. That does not mean if you see a Collis fracture, it's an automatic abuse. But this is where this is seen often. Comminuted fracture. It's almost like a crushing fracture. It's at the head of the bone here, the end of the bone. And then you just see it's fractured off into pieces. A compression fracture is typically seen in the vertebral column, which is what you see here. And it is when the vertebral discs or those white areas between the bones there in the picture do not protect one bone from another. And they just, they're not complete fractures, but it does break apart the bones. Depressed fracture is, as you see, typically in the skull or in a hollow bone is when an outside force hits down on it due to car accident. This happens often. Greenstick fracture. It's called a greenstick fracture because it doesn't, it's an incomplete break. Just like if you were to go get a branch off a tree that is still new or living and it won't break easily. It's a greenstick. Hairline fracture is a break. It has broken fully through. It's a complete fracture, but it is a hairline. So the parts of the bone have not moved out of line. It's also very difficult to see on an X-ray. So it has to be done very carefully. An oblique fracture. This is when it slides. So it's a slanted or an oblique, a slant line across the bone. And it has, it's now misaligned. So this bone has to be lined up again. A spiral fracture. This happens a lot of times in auto accidents where there's a twisting. Transverse fracture. Again, a complete break where the bone is apart from each other. But if you can see, they're still aligned. So they just have to be brought together. Some other diseases that affect the bone. Osteomalacia. The, malacia is the abnormal softening. So this is typically osteomalacia is abnormal softening of the bone due to vitamin D deficiency or a lack of sun exposure. A lot of times it's causing, causes rickets. Osteomyelitis. Miel is bone marrow. Osteo is bone. So this is an inflammation caused by an infection of the bone and bone marrow. And this is when bacteria typically enters the bone following injury or surgery. A lot of times you will see this if there hasn't been a surgery, then somebody has had a wound or an ulcer near the bone. Sometimes in diabetics, you'll see this in ulcers on the bottom of their foot that have now developed into osteomyelitis. Osteoporosis, abnormal thinning of the bone structure. Typically it's because there's a lack of calcium and phosphorus and they become the, the structure of the bone just becomes thinner, more porous. Some chest and spine diseases. Pectus excavitum, a congenital deformity where the sternum is bent inward. A lot of times this has been called pigeon chested and it creates a depression in the chest. Ankylosing spondylitis, a chronic inflammation of the vertebrae. It leads to a fusion. So there's a spinal motion restriction. So instead of being able to bend at the vertebral column, they become straight or fused straight without any movement. Kyphosis, lordosis and scoliosis a lot of times are clumped together, but they all pertain to a abnormal curvature of the thoracic lumbar or part of the spine. The kyphosis is typically in the thoracic spine in the upper thoracic spine, right under the cervical. It's called humpback. It's a posterior curvature. So it comes out. Lordosis is an abnormal interior curvature, sometimes called swayback. And it's when there's an inward curvature of the lumbar spine. Scoliosis, typically an abnormal C or S shaped lateral curvature of the spine. Could be on the right or the left side. Dextroscoliosis means it curves abnormally to the right side. Levoscoliosis curves abnormally to the left side. Arthralgia. Arthralgia, arthra is joint. Algia means pain. So this is just pain in the joint. Could be due to a lot of things. This is a very umbrella term, due to injury, inflammation, or an infection. Arthropathy, any disease of the joint. A dislocation when the end of the bone is out of its normal position in a joint. Gout. Gout is a metabolic disorder. And this is when there's hot, the crystallization of the uric acid is high in the joint. And it's a form of arthritis. The most often occurs in the great toe. It's also known as the rich man's disease. Hemarthrosis, it's when there's blood in the joint cavity. There's not supposed to be blood in the joint cavity, but this is typically due to a blunt trauma or a penetrating injury. Lyme disease. Lyme disease is caused by bacterium in the bite of an infected deer tick. So it happens out in nature. Arthritis that is caused by that begins with a bullseye rash or joint pain. So if you've been out in the woods, if you've been hunting, or if you've gone on nature hikes, make sure you look over your skin, especially in an area that's populated by ticks. You can take them out and it can be treated. It's when it's not treated that it starts to affect your heart and your nervous system. Osteoarthritis, another umbrella term, but it's basically chronic inflammation, pain and stiffness in the joint. What has happened over time is the cartilage that is around your joints, it wears away and then bone is rubbing on bone and it's very painful. Rheumatoid arthritis is an acute chronic inflammatory disease. It's an autoimmune disease also that we had seen before. It's when your own body is attacking the cartilage and the tissues in your joints. Joints become red and swollen, and there is also progressive deformity that also occurs. A sprain is when you have an overstretching or tearing of the ligaments. Very common sprains happen on your wrists or on your ankles. Subluxation is when there's a partial dislocation of the bone ends from the joint. So it's not a full dislocation where it can be popped back in, but partial can still cause an enormous amount of pain. A torn meniscus happens a lot of times in the knees, tearing the cartilage pad in the knee joint because of an injury. Doesn't mean it can't happen in other joints, but it's most common in the knee joint. Now, we're gonna still keep with orthopedics as the specialty, but now we're gonna look at the muscles. So there's three types of muscles in the muscular system. We have the skeletal muscles, and these are the only voluntary muscles we have. So we can voluntarily, consciously move these muscles. The cardiac muscle, it makes up the heart, and smooth muscles that take over all the other organs and structures are both involuntary. So in this course, we are going to focus on skeletal muscles that belong to the muscular system. So this is another overview of the different kinds of muscles. You can tell there's different appearances underneath a microscope in these artistic renderings. It just depends on what their purpose is and how they need to be, but we're gonna be looking mostly at the skeletal muscle in this part. Atrophy, some of the diseases of the muscles. The atrophy is when you have a loss of bulk in one or more of the muscles. This happens when a muscle is not being used. In orthopedics, you might see it if someone breaks a bone and that part of the body is casted up and it has to be immobile. They're not using their muscles because the bone is trying to heal. And so when the cast is then removed, you might see a difference in the size of one arm or another or one leg or another avulsion this is when a muscle tears away from a tendon or the tendon tears away from the bone compartment syndrome a condition in which severe injury causes bleeding and the fascia acts as a compartment so it's now compartmentalizing or holding that accumulated blood and when there's blood in there that's not supposed to be in there it places pressure on the surrounding tissues contracture it's when a muscle sticks into a nearly movable position sometimes people say they have trigger fingers where they go to bend their finger and it's and it won't bend out unless they move it so the muscle becomes progressively more flexed and eventually sticks fibromyalgia this is a condition that used to be a syndrome and now they've the research has shown that it's associated with pain at specific trigger points in the muscles of the neck hips and back a hyperextension or hyperflexion injury this happens also known as whiplash occurs when a person's head snaps backward and then forward again in response to a sudden change of speed most often associated with car accidents however people on roller coasters can also experience this this involves muscle strain muscle tear and or nerve damage muscle contusion a contusion is a bruise bleeding inside a muscle due to blunt trauma a muscle spasm also called a muscle cramp it's a painful but temporary condition where a muscle suddenly severely involuntary contracts if you've ever had what's called a charlie horse or a foot cramp or your calves cramp that's what's happening muscle strain this is when there's an over stretching or tearing of muscle or tendon often called a pulled muscle md muscular dystrophy is a group of muscle disease what is happening is there's been a mutation in the gene for the protein dystrophin so without dystrophin the muscles will progressively weaken and atrophy remember we said atrophy means there's you can't move the muscles you can't you can't move the muscles you can't exercise the muscles and they just wear away well they don't you know they don't go away but they're unable to be used most common form is duquesne's muscular dystrophy ataxia coordination of the muscle in coordination of the muscles during movement especially when walking so these are the voluntary muscles you cannot move you're there's a lack of coordination bradykinesia brady we learned earlier meant slow kinesia means movement there's an abnormally slow muscle movement or a decrease in the number of spontaneous movements usually this is seen in neurological conditions such as parkinson's disease dyskinesia an abnormal motion it occurs because of difficulty controlling these involuntary muscles may include ticks spasms a jerking of hands or slow writhing of the hands also a jerking of the feet or twitching also hyperkinesis an abnormal increased amount of muscle movements restless leg syndrome uncomfortable restlessness and twitching of the leg muscles along with tingling aching or crawling insect sensation and this usually occurs at night we have tremors small involuntary back and forth movements of the hand head jaw extremities this can also be seen in parkinson's disease or any other kind of neurological condition or a shaking of the head also um neurology is going to be the next especially we're going to look at and this is going to talk about the nervous system now we sort of started mentioning some neurological conditions when we talked about orthopedics and muscles so we're going to continue on that the nervous system widespread body system the brain is the headquarters then it goes down the spinal cord and the nerves form a connective pathway in which nerve impulses travel through the body brain is the largest part of the central nervous system it's located in the cranium in the skull made up of several structures um cerebrum ventricles thalamus hypothalamus hippocampus amygdaloid bodies brain stem and cerebellum the meninges is the gray matter but that's what surrounds the brain lobes of the brain each lobe takes on the name from the bone of the cranium so as we had the frontal bone we have the frontal lobe parietal bone parietal lobe etc the anatomy of the brain the left hemisphere handles memories language reasoning and problem solving so this helps you write emails helps you um have a conversation with someone helps you solve the math problems whereas the right hemisphere handles environmental analysis emotions or understanding you know what you recognize a friend when you see them someone with alzheimer's the right hemisphere is affected because they cannot recognize their environmental analysis and understanding is skewed the anatomy of the brain the brain stem connects the brain and the spinal cord there are three parts the midbrain and that maintains your consciousness and coordinates your reflexes so if any of these are affected this is the part that is affected the pons relays impulses from the spinal cord the medulla oblongata regulates respiration and heart rate so the medulla oblongata is what tells you it's time to breathe or it's time for your heart to beat so the anatomy of the spinal cord long narrow cord begins at the medulla oblongata it travels inferiorly through the spinal canal of the vertebrae so inferiorly means towards the feet and it's protected and nourished by the mengeal layers and then there's an epidural space that lies between the dura mater and the vertebrae the spinal cord so this is now a transverse plane looking and superiorly looking towards inferiorly the posterior means it's on the back of our body so the spinal cord passes through the foramen or the opening within each vertebrae it's protected by the bony vertebrae a layer of fat in the epidural space then the dura mater and the rest of the meninges so the nervous system is divided basically into two major systems the central nervous system which is the brain and the spinal cord and then the peripheral nervous system which is the where the cranial and spinal nerves branch off into the system and then the peripheral nervous system then has their separation of the autonomic nervous system and the somatic nervous system somatic nervous system is just our voluntary skeletal muscles when we think of doing something with our hand if you want to raise your hand you raise your hand that's your somatic nervous system raising your hand but if your heart beats or the digestive system is working that's the autonomic nervous system your heart muscle smooth muscles and your glands and then this autonomic nervous system is now broken down into two more divisions parasympathetic and sympathetic your parasympathetic just your rest digest whereas if your sympathetic nervous system the division of your nervous system is activated that's your fight or flight some different brain diseases amnesia you can have partial or total loss of the memory and this is when your hippocampus is damaged anencephalia this is a rare condition it's a very sad condition but a rare condition in which all or parts of the cranium or cerebrum are missing when the babies are born with this condition they survive only a few days and it is not due to heredity it is not due to a genetic heredity it is not due to a genetic condition it's just congenital aphasia aphasia is a loss of an ability to communicate verbally or in writing so expressive aphasia you cannot express what you're trying to say receptive you may not understand what somebody is trying to tell you or global is both a brain tumor again tumors are named from when they from where they arise these brain tumors normally arise in the neuroglia or the meninges benign tumors are still dangerous because they still increase the pressure edema and seizures malignant tumors may be secondary because they've metastasized from somewhere else and in general tumors don't typically begin in the brain malignant tumors don't typically begin in the brain that doesn't mean they can't but typically they don't so in general tumors are going to be the the cancer that you may have is going to either be lung cancer that is metastasized to the brain liver cancer metastasize or wherever the astrocytoma this is a malignant tumor but this is describing the type of cells in the cerebrum that it has started from ependiderma benign tumor and then a glioblastoma multiforme malignant tumor the glioblastoma is normally a fast-moving tumor also a coma someone's in a coma deep unconsciousness and unresponsiveness there's much research done on people who are in comas whether they really can be aware of what's happening around them sometimes they say it's due to what causes that coma but comas can be caused by trauma emotional trauma physical trauma a disease state metabolic imbalances or people can be put in medical comas for healing also if there's another comorbidity occurring a concussion it's an immediate loss of consciousness typically due to a sudden impact a lot of times this happens due to an accident or an injury car accident what's happening is your brain inside your actual brain inside your cerebrum is shaken so shaken baby syndrome is accompanied by the contusion concussion and hemorrhage we have delirium an acute confusion disorientation and agitation and it could be due to a lot of different things if someone's delirious it could be due to toxic levels of chemicals or illicit drugs or prescribed drugs or alcohol symptoms typically subside as the substance is metabolized so if it does not subside then it's probably something else besides delirium epilepsy is a recurring condition what's happening is there's a group of neurons in the brain spontaneously send out abnormal uncontrolled electrical impulses and it can be triggered by flashing lights by stress lack of sleep alcohol or drugs the type and extent depend on the number and location of the affected neurons so normally an eeg has to be done to find that out a lot of people with epilepsy say that they can sense it coming there's a warning that they have and it's called an aura now a tonic-clonic seizure this is when the patient is unconscious with excessive motor activity if you've ever seen anyone have a seizure when their body alternates between excessive muscle tone tonic or jerky muscle contractions clonic last one to two minutes but can seem like forever if you're watching it an absent seizure this is when there could just be vacant staring or blinking or some facial ticks the patient is conscious though sometimes people don't even realize it happened muscle tone is retained but the patient typically does not remember what happened and afterwards they may become extremely fatigued and not know why then we have a complex partial seizure and a simple partial seizure now the difference between these are the degrees of impairment whether they become unconscious or not sometimes there is involuntary contractions and sometimes they're not it depends on those two things whether it does have consciousness or not hematoma a localized collection of blood due to cranial trauma or hemorrhage it could be within the ventricles or within this the subdural part of the brain huntington korea it's an inherited degenerative disease so there's progressive brain deterioration and typically this starts during middle age around 40 50 years old hydrocephalus hydrocephalus also called waterhead when there's excessive cerebral spinal fluid on the brain or it's blocked so there it's not really water it's cerebral spinal fluid but it causes increased pressure and it can cause problems with your voluntary muscles also you're walking sometimes you're talking thinking especially if the pressure occurs over years meningitis meningitis is an infection and inflammation of the meninges due to the bacterium or virus this is why we have the meningitis vaccine migraine headache recurring headaches with severe throbbing pain on one side of the head many times they found that it's caused by constriction and sudden dilation of arteries in the brain there's many different reasons or could be causes for these narcolepsy brief episodes of involuntarily falling asleep while engaged in daytime activities they're still researching this they're still researching narcolepsy it's believed to have a hereditary hereditary component but they're not sure parkinson's disease chronic degenerative disease typically causes imbalance caused by the imbalance of dopamine imbalance of dopamine and acetylcholine levels patients struggle with voluntary movements swallowing isn't is a voluntary movement sometimes they are unable to eat or drink certain things and some foods have to be thickened for them you'll see people shuffling when they're walking rolling a pill they call it rolling a pill is when their thumb and forefinger rub against each other like they're rolling a pill syncope is fainting there's a temporary loss of consciousness a lot of times it's just associated with a decreased blood flow to the brain or somebody could be sick high fever or a shock could happen too the next especially we're going to look at is urology the urinary system urinary system consists of six macro structures or larger structures there's macro structures and micro structures in the urinary system so the macro structures are going to be the two kidneys the two ureters that come from the kidneys we have a right ureter and a left ureter comes down to the bladder that is the reservoir for the urine and then we have a urethra that goes from the bladder out the body men and women both have different urinary system structures so when the male urinary system structure we have the kidney with the urethra and it comes down to the bladder and then after that it's different underneath the bladder the men have prostate glands so the urethra goes through the prostate gland and then it comes down out through the penis the urethra in the male therefore is much longer than the female so the female urethra after the bladder just comes out through the urethral meatus which is much shorter so the pathway of urine production the urinary system is our filtration so we have the gastrointestinal tract then we have the circulating blood that picks up the nutrients that we need then we go to the kidney where we have the renal artery the nephron which is the filtration part of our body they filter they collect the filtrate and then it's reabsorbed if the nutrients need to be reabsorbed that's when it's done then we have the calyx the renal pelvis then we go through to the ureter the ureter takes it from the kidney to the bladder and then the from the bladder once the bladder fills enough that it is released through the urethra and then we urinate kidney stones are a condition where many sharp jagged edges it's cause causes hematuria blood in the urine vomiting renal colic severe pain this is inch two inches so they don't seem so big but when they're bigger than the tube that they're trying to go through from your kidney through the ureter then it reaches your bladder and then when it comes through the urethra so the travel in the ureter or the urethra is where the pain occurs nephropathy is a general term for any disease of the kidneys diabetic neuropathy is involved because we have uncontrolled diabetes mellitus uncontrolled diabetes mellitus means blood sugars have been in the high range over a period of time it's not an occasional the blood sugar goes high it's a continuous high blood sugar glomerulosclerosis is when there's an infection causes the capillaries of the glomerules to harden and that's part of the filtration system inside the kidneys nephroptosis that's when the kidneys droop down they're not high where they need to be and there's a drooping nephrotic syndrome this is a condition in which damage pores in the capillaries of the glomerulus allow large amounts of albumin or protein to enter the urine and this changes the pressure of the blood polycystic kidney disease it's hereditary characterized by cysts in the kidneys and eventually these start to destroy the nephrons and cause kidney failure renal failure is kidney failure you have aki or acute kidney injury curse suddenly usually um drama blood loss overwhelming infection a kidney infection if a uti or urinary tract infection moves into your bladder that moves into your kidneys this could cause that or you could have or you could have chronic kidney disease and this occurs gradually normally there's renal insufficiency over time and then it causes renal failure treatment for chronic kidney disease or renal failure is dialysis uremia this is emia is in the blood and this is a condition where there's an excessive buildup of urea in the blood and this is happening because of renal failure your kidneys are unable to filter out urinary tract infection bacterial infection somewhere in the urinary tract usually in the urethra and it involves the an e coli that has traveled e coli is a bacterium and that we only have in our intestines so the only way for the e coli to travel from the intestines to the urethra is from the rectum rectum into the urethra bladder cancer when the cancer's tumor begins or is found in the bladder and it's in the epithelial cells of the bladder cystitis cystitis is an infection or inflammation of the bladder often due to a bladder infection it can be the result of a uti that is not treated interstitial cystitis this is a chronic progressive infection in which the bladder mucosa becomes irritated and red and there's bleeding in there there is treatment but a lot of times interstitial cystitis the inside of your bladder almost looks like hamburger meat it's not pleasant but that is what it is radiation cystitis side effect caused by radiation therapy treatment for bladder cancer however the result is greater than the side effect cystoseal cele means herniation what's happening in a cystoseal is the bladder is bulging through the weakest weakness in the muscular wall of either the vagina or the rectum so there's it's causing retention and you can't empty the bladder so the the organ has actually gone through or herniated through the muscular wall incontinence and this can be caused by a lot of different things it's the inability to voluntarily keep the urine in the bladder it's normal in young children because the nerve connections may not be developed yet and this is where nocturnal incontinence occurs with young children stress urinary incontinence can happen because of weakness in the pelvic floor muscles caused by aging caused by multiple pregnancies but it can also be caused by any injury surgery or dementia inability to know when you are not to go neurogenic bladder it's when the nerves in the bladder are not working they don't tell you when you have to go this can cause urinary retention and and more conditions due to that we're going to move to the male genital urinary system the male reproductive system typically a male genital urinary system is dealt with in urinal in urology and the specialty of urology so the external and internal male genitalia we have the ureter that came from the kidneys then we have the urinary bladder and on the back of the urinary bladder we have the seminal vesicle the seminal vesicle is where sperm are or the seminal fluids pardon me where the seminal fluids come from and it comes across the top of the bladder down to the epididymis which is on top of the testes where the sperm occur then the test then it comes around this is where it meets the urethra the urethra is shared by both the male genital urinary system and the urinary system crypto orchidism this is crypto means hidden orchid is testes failure of one or both of the testes to move down through the inguinal canal into the scrotum It can result in low sperm count and fertility if it's not taken care of, but typically, crypto-organism is found early on in childhood, and once puberty hits, and if they're not falling down, there's normally surgeries that can help that. Epididymitis, this is inflammation or an infection of the epididymis, could be due to a urinary tract infection or sexually transmitted disease. Infertility is the inability of a male to impregnate a female after one year of regular sexual intercourse. A lot of times it could be hormone imbalance, an undescended testes due to crypto-organism that we mentioned, any testicular damage or infection, there could be a low sperm count, or abnormal sperm. Oligospermia. Oligo means scanty or few. So this can happen when there's fewer than the normal number of spermatozoa are produced in the testes. Orchiditis is when the testes are inflamed or infected, typically caused by bacterial or viral infection, mumps during childhood. This happens a lot more in third world countries where vaccines are not as prevalent as they are here, or trauma to the testes through athletics. Testicular cancer. Cancer is tumor of one or both of the testes. It is the most common type of cancer in men ages 15 to 35. But just as we will discuss with breast cancer, this also can be prevented with self-examinations. So a primary care physician or a urologist physician should be able to talk to a young man and let them know how to do a self-examination. Brachycele, varicose veins in the testes. This happens when there's an accumulation of blood and it causes the testes to become distended and painful. This can lead to low sperm count or infertility. Now the prostate. Now this is that organ that is right below the bladder. Benign prostatic hyperplasia, benign meaning non-cancerous, but it's a gradual enlargement of the prostate gland that is normal and occurs as a man ages. What's happening is this growth of the prostate compresses the urethra, so therefore the urine cannot pass with as much force as it has before. So there's a hesitancy sometimes, a dribbling, or there's a narrowed urine stream. There's also cancer of the prostate gland. So it's a form of adenocarcinoma. Adeno is the gland. That's the most common type of cancer in men. There's a slow term tumor growth, means that there are a few early signs and symptoms. Treatment sometimes involves a watch and wait, but it is treated easily if treated early. Prostateitis, it can be acute or chronic. It's a bacterial infection. Typically caused by urinary tract infection or sexually transmitted diseases. Now we'll continue into female genital and reproductive system, and we're gonna talk about the specialty gynecology and obstetrics together. The ovaries, uterine tubes, and uterus are the internal reproductive parts of a woman. Uterine tubes are also called fallopian tubes. So the ovaries and uterine tubes or fallopian tubes lie on either side of the uterus, and they are suspended within the abdominal pelvic cavity. So this puts the abdominal pelvic cavity together by ligaments. And then the cervix of the uterus protrudes down into the vagina. So inside the uterus, this is the ovary where the ovum is produced, comes up through the fallopian tube or the uterine tube into the inner uterine cavity. Now the muscle of the uterus, the outside of it is the perimetrium. The myometrium is the muscle. The endometrium is the lining of the uterus. So if an ovum comes into the uterus and is implanted into the, it is impregnated with a sperm that it is implanted in the endometrium, then a baby will develop. However, if there is no implantation, the endometrium, the inside will then slough off, and that is where a menstrual cycle occurs. And then down at the neck of the vagina at the end of the uterus is the cervix. The external female genitalia, the anterior part is where the monpubis is, and the posterior part is where the buttocks is. We have the labia majora, labia minora, and those labia means lips. And the difference between the male genitalia and the female genitalia is the male genitalia has a urethra meatus at the end of the penis, and then it has the anus. But the woman then has the vaginal intra-oidus, or is the entrance to the uterine cavity. The breast or the mammary glands develop then during puberty, but the lactiferous lobules that would feed a baby are not, do not produce milk until after childbirth. There are times that during pregnancy, some milk product of sorts can be released, but normally the milk is not produced until after childbirth. The obstetrics part of it, we have the labor and the delivery. Now, once the ovum is implanted, impregnated by the sperm and starts to develop into the baby after 40 weeks approximately, the fetus goes into the vertex presentation. Now, these are normal presentations or there's a lot of different presentations that the baby can, how they're born. Head first, butt first, shoulder first. We're gonna look at just the head first presentation here. The cervical os, or the cervix, is now closed. That's the neck of the uterus and it is closed. Gradually, as labor develops, effacement occurs, which means there's a thinning out of that, and the cervix begins to dilate or open. And when it's 10 centimeters dilate and its wall thins until it's 100% effaced, that's when the delivery begins. The head of the fetus that moves through the cervical canal, and when the baby's head is seen, it's known as crowning. And then after the baby comes out, there's still the placenta. The placenta was what was around the baby and was feeding the baby and providing oxygen to the baby during pregnancy. So the umbilical cord and the placenta are what is finally expelled. Some diseases that are associated with the ovaries and the fallopian tubes are anovulation. An means without. Anything that has an A or an AN before it means without or none. And what's happening here is the ovaries are unable or do not have any mature ovum even though a menstrual cycle is normal, they may not have any mature ovum. Therefore, it causes infertility. Ovarian cancer. Cancerous tumor of the ovary, it's rarely symptomatic until it is quite large and metastasized, which means it is most dangerous to women. There have been new discoveries in genetic research where women can be tested to see if they have the gene that could cause ovarian cancer or not. And there's much discussion about it. But that is out there. Polycystic ovary syndrome. Well, there's a lot of cysts around your ovaries. Cysts eventually fill the ovaries and it can be very painful, especially if a cyst ruptures. Salpingitis. Salping is the fallopian tube or the uterine tubes. If there's an infection or inflammation of these uterine tubes, you can have hydrosalpinks or pyosalpinks. Basically, is it a water-like fluid that is causing it or is it pus? Endometrial cancer. The cancerous tumor of the endometrium of the uterus or the inside. Earliest symptom is abnormal bleeding. Endometriosis. The endometrial tissue that lines the uterine tubes in the pelvic cavity. When this goes outside of the uterus and into the pelvic area, it can feel as if there's barbed wire strangulating your insides, is what I've been told. Very painful. Endometrium tissue has been found all over the body, but it basically stays within the pelvic cavity. Leomyoma. This is when you have a benign, which is non-cancerous, fibrous tumor. The smooth muscle of the uterus can be small or very large, but a leomyosarcoma is a cancerous tumor of the uterus. Myometriitis. Inflammation of the uterine muscle. If it's accompanied by pulse, it's myometriotis. So it's an infection or inflammation of the uterus. Pelvic inflammatory disease or PID. This is an infection that spreads from the cervix to the uterus. So the cervix is the neck. You have the vagina, comes up, you hit the cervix. Cervix begins the uterus. It's when an infection is typically caused by a sexually transmitted disease and is not treated. That's when it spreads from the cervix to the uterus, to the fallopian tubes and the ovaries. Uterine prolapse. Prolapse means a downward movement or a drooping. This is when the uterus is drooping due to ligament stretching or pelvic floor muscle weaknesses often associated with childbirth and age. Then menstrual disorders. Abnormal uterine bleeding. This is when there's sporadic menstrual bleeding without a true menstrual period. A lot of times related to anovulation and a lack of progesterone from the corpus luteum. Corpus luteum is what begins an ovum. It's the early stages of egg development. Amenorrhea is an absence of the menstrual period. And this is during the years of a woman when they should be having a period. Now this could be due to hormone imbalance, a disease or stress. Amenorrhea is not caused by someone who has a hysterectomy or a removal of the uterus or it is not what happens at menopause. This happens during the years that they should be having a menstrual period. Dysmenorrhea is painful menstruation normally due to excess prostaglandin, which is a hormone, endometriosis, which is when the endometrial tissue is outside the uterus, pelvic inflammatory disease or uterine fibroids. Menopause is the normal cessation of menstrual periods in middle age. It occurs when ovulation stops and the menstrual period then ceases. Menorrhagia. If you think of the term hemorrhage, it's a bursting forth of blood. Menorrhagia is when a menstrual period with excessively heavy flow of menstrual period, normally lasting more than seven days and it can be caused by hormone imbalance, fibroids or endometriosis. Oligomenorrhea. Very light menstrual flow or infrequent menstrual periods and this is only with women who've had normal periods in the past. So some women have very light menstrual flow, some don't. A lot of times it's caused by a hormone imbalance and this could be a precursor to menopause also. Premenstrual syndrome. A syndrome is when there's multiple symptoms that happen at one time and these symptoms happen days before menstruation. It's normally caused by high hormone levels. So as a woman's body is getting ready for menstruation, the hormone levels increase and it causes some breast tenderness, fluid retention, sometimes bloating and mild mood changes. Cervical diseases can include cervical cancer. Now, I think they're put this way due to alphabetical order, but cervical dysplasia is normally the precursor to cervical cancer. Dysplasia just means there's a difficulty or an abnormal growth and it's an abnormal growth of the squamous cells in the surface of the cervix. It's precancerous and it can be caused by HPV infection. Now, research had shown that cervical cancer, it's hard for me to say 100%, but most cervical cancer is caused by HPV infection. If it's localized to one site though, it is considered carcinoma in situ or in place, which means it's not spreading. Breast cancer, as with testicular cancer that I had stated, breast cancer is also something where we can do self-examinations for. Physicians, it's advisable if physicians or healthcare workers would explain to a patient what they're looking for when this happens, but it's cancerous adenocarcinoma, so glandular cancer of the lactiferous lobules, maybe swelling in large lymph nodes, nipple discharge, not from milk or not from nursing. Failure of lactation, not every woman is able to nurse after they give birth. Sometimes it's idiopathic, which means we do not know the cause, but there would be a lack of milk production. Sometimes it's a hyposecretion of prolactin. Prolactin is a hormone that is needed from the anterior pituitary gland for this. Fibrocystic disease, numerous fibrous fluid-filled cysts, they're benign, which means non-cancerous. They can be painful though because they're filling up a space that you're not supposed to have cysts there. Galacteria, sometimes there is a discharge from breast when a woman is not pregnant or breastfeeding. Abnormal presentation, and this is what I had stated before when we talked about the actual labor and delivery. It's when the birth position in which the head is not presenting first. So it could be breech, a transverse lie, which means on their side, and it can cause other situations with delivery. Abruptoplacentia, the placenta should remain engaged with the uterine wall up until labor. Because when that detaches, abruptoplacentia is when there's a partial or complete separation of a placenta, we're going to have problems with the blood flow and the oxygen to the fetus. And the nutrients. Cephalopelvic disproportion, it's when the fetal head is larger than the opening in the mother's pelvic bones. The answer there would be a cesarean section. Dysotia, any type of abnormal or difficult labor and delivery. So this is a very general term. Ectopic pregnancy, this is when a pregnancy in which a fertilized ovum implants outside of the uterus. So when the ovum is released from the ovary, travels through the fallopian tube to the uterus, if it's implanted there, it will then implant itself into the endometrium of the uterus. But if it is implanted outside of the uterus and it will implant where it is, it can be an ectopic pregnancy. And unfortunately, those are typically non-viable. Gestational diabetes mellitus. So diabetes mellitus is a metabolic condition, but this is a temporary disorder of the glucose metabolism during pregnancy. And it normally corrects itself. When the baby is born. Hydotidiform mole. It's an abnormal union of an ovum and a sperm that produces hundreds of small fluid-filled sacs, but no embryo. Incompetent cervix. The cervix should remain engaged until labor. And then it starts to become dilated. But this is when there's a premature dilation during the second trimester. This often results in miscarriage of the fetus, unless it can be taken care of. And the woman is typically put on bedrest if that happens and they can prevent the miscarriage. Endocrinology is going to be the next specialty we're going to talk about. This is dealing with the endocrine system or our hormone system. So the endocrine system consists of glands that perform different functions located in different areas of the body. All the endocrine systems share three traits. They secrete chemical messengers called hormones. They secrete hormones directly into the blood. And their hormones regulate specific body functions. Not all hormones do everything. So the functions of the endocrine system are to use hormones to stimulate specific organs and to maintain homeostasis. Homeostasis is that state of equilibrium. So it's the balance of the internal environment and the external environment. It's a state of health. Several endocrine glands can also do double duty in different parts of the body depending upon what they are. So the different glands in the endocrine system, the pituitary gland. This is also known as the master gland. It's located in the brain. It's only the size of a pea, but the pituitary gland is what controls all others. The hypothalamus gland, hypothalamus gland also located in the center of the brain, just below the thalamus. And this works with the nervous system and the endocrine system as a whole. Pineal gland. Pineal gland is a small round gland located between the lobes of the thalamus. Pineal gland will secrete a hormone called melatonin. And this regulates the body's circadian rhythm. Regulates when we sleep. Thyroid gland consists of two lobes connected by a thin bridge of tissue lies across the front of the trachea. It secretes three different hormones. The T3, which increases the rate of cellular metabolism. C4 is changed by the liver into C3. And then calcitonin regulates the amount of calcium in the body. Parathyroids are located on the posterior or the back surface of the thyroid. These glands secrete parathyroid hormone, which regulates the amount of calcium in the blood. Thymus gland located in the thoracic center, posterior to the sternum. So it's behind the sternum or the breastbone. The thymus is large during childhood, but shrinks during adulthood as the functions as part of the immune system and the endocrine system. The pancreas, yellow elongated triangular gland, posterior or behind the stomach. It secretes three hormones. Glucagon, which stimulates glycogen breakdown when the blood glucose is low. So glucagon will help with our blood sugar levels. Insulin also works with our blood sugar levels, but that moves the glucose from the blood to the body cells and then somatostatin. So this can inhibit secretion of glucagon and insulin and the growth hormone. This is a picture version of our endocrine system and where everything is. The difference between a man and the woman is their reproductive organs. The men have the testes, the women have the ovaries. The endocrine glands in the brain, the hypothalamus has a stock of tissue that goes into the pituitary gland. The pituitary gland sits in a bony cup and the pineal gland is located between two lobes. Now the pancreas is composed of small groups or islands of cells known as the isolates of Langerhans. And what they do depends, what cell they affect depends on what hormone's being excreted. Glucagon deals with the alpha cells, insulin the beta cells, and somatostatin to the delta cells. The adrenal gland sits on top of each kidney. So each kidney, we have two adrenal glands and they sit on the two kidneys. Whereas the kidney belongs to the urinary system, the adrenal glands function as two separate endocrine glands. So the hormones from various endocrine glands affect body metabolism or how the nutrients are broken down in our body. Blood glucose, blood calcium, and blood sodium. T3 and T4 increases metabolism. Then blood glucose, we have the cortisol, epinephrine, glucagon, and insulin. Cortisol, epinephrine, and glucagon increase the blood glucose, but the insulin decreases the glucose. So what it does is it transports it into the cells to be metabolized. Blood calcium, parathyroid hormone increases that blood calcium, calcitonin decreases it. And then aldosterone increases blood sodium also. Some diseases of the different glands, the anterior pituitary gland, hyperpituitarism, and hypopituitarism. They're both general terms, ones for hypersecretion, ones for hypo. So hypersecretion means there's too much secretion of this hormones from the anterior. Treatment normally is to suppress the hormone, either to remove the adenoma, which is a gland tumor, and then radiation treatment. But if there's hyposecretion, it's typically caused by an injury or defect. And treatment is basically to replace the deficient hormones. Giantism, this is when there's a hypersecretion of growth hormone during childhood and puberty. This causes then an excessive growth of bones and tissues, but everything is a normal relation to each other. Acromegaly is a hypersecretion during adulthood. And this is when there's not a normal proportion. So the person's facial features, the way they look, the way they talk, facial features, the jaws, the hands become abnormally large. Dwarfism, hyposecretion of that growth hormone during childhood and puberty. The lack of growth in short statute, but with normal body proportions. Penial gland, seasonal affective disorder. This happens a lot of times with people when there's a decreased hours of sunlight during the fall and winter. A lot of times there's hyper secretion of melatonin accompanied by a decrease of serotonin levels. Serotonin levels, when they're decreased, they can cause depression, decrease energy and weight gain. So treatment can involve phototherapy, possible drug therapy with antidepressant medicines. Hyperthyroidism, so when the hormones from the thyroid are being secreted too much, can be caused by a nodule or by an adenoma. Symptoms can include tremors, tachycardia, fast heartbeat, palpitations, restlessness, nervousness, diarrhea, insomnia, fatigue, weight loss, goiter, which is a large growth on your it's like an enlargement of the thyroid gland of growth on your throat. Dry eyes or slow eyelid closing. Most common form is Graves' disease. Treatment can involve antithyroid drugs or even a thyroidectomy where they remove the thyroid followed by radiation. So a goiter that I had mentioned is a chronic progressive enlargement of that thyroid gland known as thyroid megaly. The adenomatous goiters or nodular goiters caused by usually benign growths. They could have many nodules. They can be caused by thyroid cancer or chronic inflammation or lack of iodine in our diet. When there's too little iodine, the thyroid gland enlarges to help capture more iodine. Hypothyroidism. When the thyroid is not secreting enough of the hormone, usually is caused by iodine deficiency. It may result from a congenital defect or Hashimoto's thyroiditis, an autoimmune disorder. Includes fatigue, low body temperature, dry hair and skin, constipation, weight gain. Severe cases involve myodexmia, tingling in hands and feet, lack of menstruation, hair loss, slow speech and mental impairment. Treatment is a levothyroxine or thyroid therapy. Thyroid carcinoma, cancerous or malignant tumor of the thyroid gland causes enlargement of the thyroid gland with hoarseness and neck pain. Usually slow growing and has a high cure rate. Hyperinsulinism. This is when the insulin is not able to pass through the cell walls and break down the glucose as it is supposed to. It can include, it can lead to low blood glucose levels called hypoglycemia, which includes shakiness, headaches, sweating, dizziness and fainting. Then there's insulin resistance syndrome. And this is when there's hypersecretion of insulin because the cell receptors develop a resistance to the insulin. So there needs to be something to help the insulin pass through the cell walls. Eventually the pancreas can become exhausted trying to get this taken care of and the patient develops diabetes mellitus. Diabetes mellitus is a condition in which the beta cells of the pancreas are unable to secrete enough insulin. If you have low insulin levels and it causes high blood glucose or blood sugar levels. Glycosuria, meaning the sugar is spilling over into your urine because the kidneys cannot filter it out. Polyuria, because you have large high glucose levels. It's a higher production of urine. So you're urinating more often. Excessive urination that leads to polydipsia, which means you're thirsty a lot. And inability to metabolize the glucose leads to polyphagia, which means you are always hungry. Different types of diabetes mellitus. And this has been debated amongst health professionals for years. Type 1, previously known as juvenile onset diabetes. The pancreas just does not secrete any insulin and the patient must receive insulin injections. It's an autoimmune disease. And it is called juvenile onset because it develops during childhood or adolescent or young adulthood. Now type 1.5, similar to type 1, but the difference is it occurs when they're adults. So it's latent autoimmune diabetes. The pancreas still secretes some insulin early on, but it's just not enough as they get into adulthood. Type 2 is non-insulin dependent. It's not the result of the autoimmune disease. Instead, it's insulin secretion is decreased because the patient is obese and has developed insulin resistance. And then there's gestational diabetes mellitus. In some realms, I've heard this called type 3, but not always. And this will occur in some women during pregnancy. And what's happening is the increased level of estradol and progesterone that happens during pregnancy is blocking the action of the insulin. But this is then resolved upon delivery of the baby. Next specialty is ophthalmology, dealing with the eyes. So with the structure of the eyes, we have the eyelids and eyelashes. It's the fleshy structures located above and below each eye and it's used to protect the eye. The iris and the pupil, the iris is the colored circular structure in front of the eye and the pupil is the round opening. So the iris controls, if the pupil becomes larger, the iris is widening. Lacrimal glands, and these are our tear ducts. Tears moisten the eye, washes out foreign substances and kills any bacteria. Conjunctiva and sclera. The conjunctiva is the transparent mucous membrane covers the inside of the eyelid. The sclera or the white of the eye lies beneath that conjunctiva. Then the cornea is across the anterior or the front surface of the eye. The sclera changes in the transparent cornea. The cornea contains the nerves and is the most sensitive area on the eye's anterior surface. This is just a picture of what the eye is. The sclera is the white of the eye. Conjunctiva, the cornea, lens, pupil, and iris. Now the internal structures, the posterior cavity is filled with vitreous humor. The retina contains the macula, the sharpest area, sharpest vision, and the optic disc where the optic nerve enters. Now the disease of the parts of the eyes, we have blepharitis. Blephar is the eyelid. So if the eyelid, just the eyelid is red, crusty, or there's scales at the base of the eyelashes, could be acute or chronic, there's just an infection or inflammation there. It normally will go away in time unless it's chronic. Blepharoptosis is when that eyelid, the upper eyelid, it's drooping either from excessive fat or the collagen has just weakened out and it's sagging because of age. And it's drooping and falling in your vision. And then you could actually have it lifted. And that is not a surgery done because of vanity, that's a surgery done so you can see. Actropin, a condition where there's an injury or growth on the lower eyelid, causing it to be outturned. And this can lead to chronic dry eye or inflammation of the conjunctiva. Conjunctivitis, which is the inflammation of the conjunctiva, happens with inflammation, redness. A lot of times it's referred to as pink eye when there's a bacterial infection and with mucus discharge. Corneal abrasion, very painful. Damage to the cornea due to trauma or repetitive irritation. Could be as small as a piece of dust that got in there. Sometimes people have corneal abrasions because something gets under their contact lens if they have that. Exophthalmos, you see this in Graves' disease. A pronounced outward bulging of the interior surface of the eye with a startled staring impression. If it's only one eye that's affected, there's typically a tumor growing behind that eye. But if it's both eyes, they usually have hyperthyroidism or Graves' disease. Scleral icterus, it's a yellow discoloration of the conjunctiva. It's typically caused by jaundice as a result of liver disease. Nystagmus, this is an involuntary rhythmic motion of the eye when the eyes are twitching. A lot of times it's caused by multiple sclerosis or Meniere's disease. Strabismus, a general term, deviation of the eye. You could have a medial deviation known as cross-eye, lateral deviation known as wall-eye. A lot of times there can be a surgical reposition of the extraocular muscles during childhood, which helps that because it's a muscle. It deals with the muscles that are holding the eye. Anus corea, aniso means unequal, and corea means pupil. So it's when the sizes of the pupil are unequal. Glaucoma, it's a common eye disease that involves the intraocular pressure. And it depends on if it's open angle or closed angle, where that pressure is occurring. Open angles when the trabecular mesh work is blocked. And this form of glaucoma is normally painless, but it destroys the peripheral vision. Closed angle is when the edge of the iris meets the cornea when it's too narrow. This form is painful and leads to blurred vision and photophobia. Ephema is a presence of blood in the interior chamber. So the interior chamber just should have vitreous humor. Photophobia, abnormal sense of the eye to bright light. So photo is, this happens typically if you go to the eye doctor and your eyes are dilated, you will then have photophobia because if you go outside into the bright sunlight, everybody's sensitive to the bright sunlight. But this is abnormal sensitivity to just normal light. Uveitis is an inflammation of the uvea. If only the iris is affected or the cornea is affected, then they might not have uveitis. But this is when the iris, cornea, and the ciliary body is all affected. Now the lens of the eye, the faecia. The condition which the lens has been surgically removed because of a cataract. Most patients will then have an artificial lens implanted. If you don't, then you remain aphacic and must wear special eyeglasses. But most people do have an artificial lens. And that cataract is when the lens becomes cloudy because there's protein molecules in the lens and they clump together. So it has to be removed because your vision decreases with cataracts. Crespiopia. Crespi is old age. So this is a condition in which age-related loss of lens flexibility leads to blurry vision and lack of accommodation. So your eyes cannot accommodate too far vision or near vision as they used to be able to. Next specialty we're gonna look into is otolaryngology, also known as ENT or ears, nose and throat. We have the external ear composed of several layers and shapes of tissue. The purpose of all these is for sound to get inside your ear. Then the structures of the middle ear and the inner ear. The three smallest bones in our body are in the inner ear. They are the malleus, the incus and the stapes. So we have the external ear, the middle ear that goes from the external auditory canal to the tympanic membrane, also known as the eardrum. Beyond the eardrum, the middle ear. And then the inner ear is after the malleus, the incus and the stapes that includes the cochlea, the cochlear branch, the vestibular cochlear nerve. And if someone is hard of hearing or they have limited hearing, sometimes they will have a cochlear implant and that's replacing this cochlea in the inner ear. We have structures of the internal nose, mouth and throat again. This is all part of the ear, nose and throat. We have talked about this with respiratory and gastrointestinal. We have your sinuses here is what we're including. We have six different sinuses. They here show the frontal sinus and the sphenoid sinus. We have a eustachian tube. Eustachian tube comes from the ear. We have the soft palate and hard palate that we discussed. Then the nasopharynx, the oropharynx, the laryngopharynx. Diseases of the ear, we have an acoustic neuroma. This is a benign tumor of the vestibulocochlear nerve can cause pain, dizziness, hearing loss. Cerumen impaction, cerumen is earwax. Earwax is normal in all of our ears. It's epithelial cells and hairs form that mass and includes or blocks the external auditory canal. Cholestioma, this is benign non-cancerous but slow growing tumor made of cholesterol and epithelial cells forms in the middle ear. And it usually is caused by chronic middle ear infections. Hearing loss can be caused by numerous things. Can be temporary or progressive, permanent. It's the ability to hear sounds in one or both ear. We can have conductive, sensoroneural, mixed hearing loss, high frequency, low frequency hearing loss. Presbycusis, this presbycusis is just like the presbyopia, old age or age-related hearing loss. We have anacusia and deaf mutism. Hemotympanum, this is when there's blood in the middle ear that can be seen behind the tympanic membrane. So when you're looking into the external ear canal, you should see a tympanic membrane. You can see the blood behind that and that's hemotympanum. Labyrinthitis, when there's a bacterial or a viral infection in the inner ear where the cochlea is. Mastoiditis, a bacterial infection of the air cells in the bone of the mastoid process. It can be caused by untreated or chronic infection of the middle ear. Meniere's disease, edema or fluctuating pressure of the fluid in the inner ear that causes vertigo, hearing loss, tinnitus, and a feeling of fullness in the ear. Motion sickness, it's going to happen a lot of times when people are riding in a car, in a boat or a plane, their equilibrium may be off and it can cause dizziness, nausea, vomiting, and a headache. Over-the-counter medicines, dromamine works very well with us. We have otitis externa, which is a bacterial infection of the external auditory canal. So you can have otalgia, which is, algia means pain, ear pain, swelling, or drainage. This is oftentimes also called swimmer's ear. You don't have to be a swimmer to get it though. Then we have otitis media, the most common ear infection. It's the middle ear infection. Chronic otitis media can result in hearing loss. Otorea, so rea is a flowing from or a drainage. So if there's any kind of fluid or pus, it can be caused by otitis externa, otitis media, or a fracture of the temporal bone. Otosclerosis, so this is a hardening, literally a hardening of the ear is what it means, but it's resulting in conductive hearing loss. So the stapes becomes immovable. So the bones that help us to hear become immovable therefore hardening. Ruptured tympanic membrane, also called a perforation of the eardrum. It's a tear perforation due to excessive pressure or middle ear infection, or putting things in your ears that you shouldn't put in your ears. One time I had a doctor say, the only thing that you should put in your ear is your elbow, which as you know, you can't put your elbow up to your ear. Tinnitus is a constant, can be intermittent ringing in the ears because by a lot of things more times than not caused by loud noises that have then caused this tinnitus. We see this a lot in people who are returning from war, from in veterans. Vertigo, just a sense of dizziness, sensation of motion when the body is not moving. We have diseases in the sinuses, nose and nasal cavity. Allergic rhinitis, very common. There's an area in Southern Ohio that's known as Allergy Valley and it's high environmental allergens. Symptoms include stuffiness, sneezing, rhinorrhea, which is a runny nose and post nasal drip. Allergic rhinitis in the spring or fall is known as seasonal allergy or hay fever. And this is due to environmental allergens. There are many internal inside allergens, dust mites, orthopnea, which is not what I had stated it was before. Anosmia, loss of sense of smell. Can be good, can be bad. Many times it is caused by allergic rhinitis. Epistaxis, sudden, sometimes severe bleeding from the nose. Typically they say if your nose bleeds less longer than five or 10 minutes, you need to go get some medical help. Nasal polyps. These are benign, just like in the colon when we talked about polyps before, polyps can happen in the nose and it's just a soft excessive growth of the mucous membranes in the nose or the sinus, but it can impair your airways. Rhinophyma. This is a redness and hypertrophy of the tip of the nose with irregular lumps. Many times associated with rosacea and is usually seen in men. A septal deviation. This is a condition in which the septum is not in the center of the nasal cavity. It's displaced to the right or the left. Sinusitis, an acute or chronic bacterial infection in one or more of the sinus cavities accompanied by headaches, sinus pain, post-nasal drainage. And because of all that, we have fatigue. And if it's a bacterial infection can include a fever. Upper respiratory infection. So URI, bacterial or viral infection of the nose can spread to the throat and to the ears. Also known as a common cold or a head cold. A cancer of the mouth and the neck. Now, remember I said cancers are named from where they're initiated or where they start. So this is a malignant tumor of any of the mucous membranes in the oral cavity, pharynx, throat, or the larynx, which is the voice box. It is commonly caused by smoking or use of smokeless tobacco. Also vaping, persons who vape, we found an increase in cancers of the mouth and neck also. And the treatment involves surgical removal of the affected structures. Cleft lip and palate. This is a congenital deformity. So this is something that's occurring in utero in which the skin of the lip or the bones of the right and left maxilla fail to join in the center before birth. Could be unilateral, just on one side. It could be bilateral, both sides. It affect the nose, lip, teeth, gums, or hard and soft palate. These affected individuals may have difficulty speaking and eating and require surgery to repair the cleft or the separation. Many times these surgeries will occur early on in infancy. Cold sores, herpes simplex virus type one, also known as fever blisters. They're painful. They can be recurring blisters. They're caused by a virus, so they can come back on the lips or nose, but they're treatable and very communicable. So you can pass those on easily to people. Glossitis. Gloss, G-L-O-S-S is for the tongue. So glossitis is an infection or inflammation of the tongue, and it may be caused by irritation, allergies, infections, or a vitamin B deficiency. Leukoplakia, thickened irregular white patches on the tongue, mucous membranes of the oral cavity. It may be caused by chronic irritation or infection with Epstein-Barr virus. It can also be a side effect of chemotherapy and radiation too. Pharyngitis, also called strep throat. It is called strep throat if it is caused by streptococcus, which is the bacteria, but it can be a viral infection also. Temporomandibular joint syndrome, or TMJ. This is when the temporomandibular joint in our face isn't moving right. There's a dysfunction in it. So it involves the joint clicking, pain, sometimes difficulty opening the jaw. Thrush, this is an oral infection. So it's in your mouth in which the yeast or the Canada albacines coats the tongue and the mucus of the oral cavity. Yeast is a fungus that can occur. And if it happens in the mouth, it's thrush. This is often seen when people are taking oral steroids, such as inhalers for asthma. It is changing those medications or changing the natural flora of the mouth. So most often to avoid thrush, they can rinse out their mouth or even brush their teeth after they take the medicine, the inhaled steroids or any inhaled medications. Tonsillitis, this is an acute or it can be chronic bacterial infection of the pharynx and palatine tonsils. If it's chronic, normally the answer is surgery or you'll have a tonsillectomy. But if it's acute, they try not to do the tonsillectomy due to the fact that the tonsils and the adenoids are part of our immune system. Cervical lymphanopathy. Now, last time we talked about cervical or cervix, it would be the neck of the uterus. Well, cervical means neck, period. So the enlargement of any lymph nodes in the neck is caused by an infection, cancer, or spread of any cancerous tumors from another site. Laryngitis, laryngo is for larynx. Larynx is your voice box. So this is caused by a bacterial or viral infections of the larynx. Symptoms can include swelling, inflammation, hoarseness or loss of voice, difficulty swallowing, also cough. Laryngitis can also be caused by an overuse of your voice. Vocal cord nodule. This is when there's a small fibrous growth, typically benign on the surface of the vocal cords caused by strain or chronic irritation.

anatomy

physiology

body sections

body planes

cavities

disease categories

hematology

immunology

orthopedics

muscular system

skeletal muscles

vocal cord nodules

laryngeal polyps

sleep apnea

treatment options