BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Clinical Anatomy, Physiology & Pathology – IV Urinary System CAPP202-IV Session 1 LEARNING OBJECTIVES: By the end of this session, the student will be expected to: 1. Define the roots & suffixes describing the Urinary System. 2. List & label the anatomical components of the urinary system; describe characteristics of each. 3. Specify the functions of the kidney; detail the signals & results of the renin/ADH cascade. 4. Label & specify the functions of each general kidney anatomy component. 5. Label & specify the functions of each nephron component; define the overall nephron function. 6. List the parts of the nephron that are influenced by ADH. 7. Describe the functions & holding capacity of the urinary bladder; define micturition. 8. Specify the function of the stretch receptor & the danger of driving with a full bladder. 9. Compare the length of the male & female urethra; describe the sphincters & their ANS input. 10. List the four body waste removal systems and their specific waste products excreted. 11. Describe urine composition; compare normal to abnormal urine components. 12. Briefly describe urolithiasis (& causes), UTIs, prostate pathology & renal failure. 13. Define cystitis, nephritis, prostatitis, incontinence. I. Medical Terminology: Roots: Azot/o = urea/nitrogen Calc/i = calcium Cyst/o = urinary bladder Glomerul/o = glomerulus Hydr/o = water Lith/o = stone Nephr/o = kidney Pyel/o = pelvis of kidney 8/12 Ren/o = kidney Trigon/o = urinary bladder Ureter/o = ureter Urethr/o = urethra Urin/o = urine Ur/o = urine/urinary tract Vesic/o = bladder Suffixes: -lapaxy = empty/ wash out -ptosis = falling / displacement -uresis = excrete in urine/urinate © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 1 II. ANATOMY: A. General Flow through system Kidneys (2): Retroperitoneal URETERS (2): 10-13” long, Retroperitoneal Urinary Bladder (1): Transitional epithelium URETHRA (1): Transitional epithelium B. Kidney: retroperitoneal 1. Functions: a. filter blood: remove waste (urea), salt, toxins b. produce urine c. maintain water balance (blood volume, water reabsorption/excretion) d. regulate acid/base balance e. produce hormones: 1) erythropoietin: stimulate RBC production 2) renin: regulate blood volume RENIN: Hormonal Cascade ** Signal: bp/bvolume: sensed by osmoreceptors in hypothalamus Posterior pituitary releases ADH (Antidiuretic Hormone) Target/Effector of ADH: Kidney Kidney secretes RENIN ** RENIN stimulates: 1) Vasoconstriction: arterioles 2) Thirst: hypothalamus 3) Water reabsorption & urination: kidney ** Ultimate result: bp/volume 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 2 2. Overall Kidney Anatomy: (External to Internal) a. Renal capsule: outer layer (reticular CT); protective membrane b. Renal cortex: outer zone c. Renal medulla: inner zone 1) Renal pyramids: triangular areas, contains nephrons a) apex: papillae where urine drains out of nephron d. Calyces (major & minor): inlets: renal pelvis, collect urine from pyramids e. Renal pelvis: expansion of ureter in kidney, collect urine from calyces f. Hilus: medial area; renal vein, artery, nerve (VAN) & ureter out of kidney HILUS To Bladder 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 3 3. Nephron anatomy: basic functional unit of kidney, filtration, 1 million/kidney (Listed according to flow through system) a. Glomerulus: capillary network; filtration of blood 1) afferent arteriole: larger, efferent arteriole: smaller 2) pressure difference: forces fluid/ particles thru pores (fenestrae) *No blood in urine: blood cells too large to pass thru fenestrae* b. Bowman’s capsule: encapsulates glomerulus, receives filtrate urine c. Proximal convoluted tubule (PCT): 1) reabsorbs: 65% of water & many nutrients: (glucose, amino acids, citric & ascorbic acids, calcium, potassium, sodium, phosphates, sulfates) 2) secretes substances into urine: (histamine, some drugs) d. Loop of Henle: 1) Descending limb: water permeable only; 15% of water reabsorption 2) Ascending limb: salt permeable only; sodium/chloride from filtrate e. Distal convoluted tubule (DCT): reabsorbs sodium & potassium 1) ADH: 10% water reabsorption here f. Collecting duct (CD): 1) ADH: 10% water reabsorption here 2) CD papillae minor/major calyces pelvis hilus ureter urinary bladder urethra = urine excreted (micturition) (DCT) (PCT) Loop of Henle Picture from Review for Therapeutic Massage and Bodywork Certification by Ashton and Cassel 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 4 C. Ureters: tubes channel urine from each kidney to urinary bladder D. Urinary bladder: transitional epithelium - stretching 1. functions: hold urine & expel urine (smooth muscle) = Micturition (urination) 2. capacity: 700-800 ml, 3-3.5 cups 3. Stretch receptors: “go off” at ½ full mark in order for us to find a bathroom Rubber band analogy: empty to extremely full bladder repeatedly: stretches out the bladder, incontinence Depends? Urinary Bladder: Stretch Receptor Transitional epi Fast fact: never drive with a FULL BLADDER (filled water balloon), if you get in an accident the seat belt could rupture your bladder peritonitis. E. Urethra: transports urine out of bladder, (males: also transports semen) 1. women:1 ½” long, men: variable, 5”+; women more Urinary Tract Infections 2. Internal urethral sphincter: INVOLUNTARY smooth muscle, neck of bladder 3. External urethral sphincter: VOLUNTARY skeletal muscle III. BODY WASTE REMOVAL SYSTEMS & SPECIFIC WASTE PRODUCTS: A. B. C. D. Respiratory: carbon dioxide Integumentary: sweat (urea) Urinary: urea Digestive: feces IV. URINE COMPOSITION: 65x more concentrated than blood filtrate A. Normal components: Sterile 1. Water: 95% of urine, (we excrete less than 1% of the water that enters the nephron) 2. Nitrogenous wastes: urea (NEVER reabsorbed), uric acid, creatine 3. Electrolytes: sodium, chloride, calcium, magnesium, potassium, sulfate, bicarb 4. Yellow pigment: RBC breakdown product (bilirubin) converted to urobilinogen B. Abnormal components: glucose, RBCs, protein, WBCs, ketones, bacteria (cloudy) (Adkins diet increases the amount of ketones in the urine) 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 5 V. PATHOLOGY: A. Urolithiasis: Kidney stones (think State Fair) in renal calyces/pelvis 1. dehydration (beer, not enough water) 2. calcium (fried cheese curds, pasteurized milk) 3. phosphorus (brats, meat) B. Urinary Tract Infections (UTIs): women> men due to the urethral length difference 1. Bladder inflammation = cystitis (bacteria can travel up ureter to kidney too) 2. Kidney inflammation = nephritis Sx: urgency of micturition, burning, impede urine flow, little urine flow/dribbling, painful urination, blood in urine, fever, pain Causes: STDs, bacterial/viral/microbial infection or yeast! C. Prostate: urethra in male passes through the prostate *Prostatitis, prostate cancer prostatectomy; lead to sphincter probs, incontinence D. Incontinence: inability to control micturition E. Renal failure: decrease or stopping glomerular filtration rate 1. acute causes: hemorrhage, CO, renal tubule damage, kidney stones, reaction to kidney/bv dyes, NSAIDS, antibiotics 2. Chronic causes: irreversible; glomerulonephritis, pyelonephiritis, polycystic kidney disease, uncontrolled diabetes type 2, loss of kidney tissue; dialysis Interesting Urine Facts: The urinary filtering system processes about 200 quarts of blood – the equivalent of 500 cans of soda – daily. Of that, about two quarts are discarded as waste and sent to the bladder. Readers Digest February 2000 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 6 BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Clinical Anatomy, Physiology & Pathology – IV Reproductive System: Male CAPP202-IV Session 2 LEARNING OBJECTIVES: By the end of this session, the student will be expected to: 1. Define the roots describing the Reproductive System. 2. Identify & label the components of the male reproductive system on a diagram. 3. Specify the four general functions of the male reproductive system. 4. Describe the anatomy, physiology & characteristics of the penis; define erection & ejaculation. 5. List the functions of the scrotum & Dartos muscle. 6. Describe the testes & ducts components; list how each relates to sperm production/transport. 7. Specify the functions of the accessory sex glands; quantify components of semen volume. 8. List the composition of the spermatic cord; describe the cremaster muscle’s function. 9. Sequence the events that comprise spermatogenesis. 10. Quantify the amount of sperm produced daily; identify the sperm anatomy & composition. 11. Describe the hormonal influences on the male reproductive system’s functions. 12. Summarize the composition of semen; define infertility in regards to sperm production. 13. Describe BPH, Prostate cancer & Prostatitis & STDs. I. MEDICAL TERMINOLOGY: Roots: Cervic/o = cervix Colp/o = vagina Endometri/o = Endometrium/uterus Fer/o = to carry Fet/o = fetus Gynec/o = female Hyster/o = uterus Lact/o = milk Mamm/o = breast 8/12 Metr/o = uterus Obstetric = pertaining to midwifery Oo- = egg Oophor/o = ovary Orchi/o = testis Phall/o = penis Posth/o = prepuce Salping/o = Fallopian tube Scrot/o = scrotum Vagin/o = vagina Vas/o = vas deferens Vesicul/o = seminal vesicle © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 7 II. ANATOMY (see diagram next page) A. General Functions: 1. produce sperm and testosterone (testes) 2. transport, store & assist in sperm maturation (ducts) 3. secrete liquid portion of semen (accessory sex glands) 4. passageway for ejaculation of semen & excretion of urine (penis) B. Anatomy & Physiology: 1. Penis: 3 caverns of erectile tissue (2 corpora cavernosa / 1 corpus spongiosum) a. function: transport urine & semen b. Glans penis: highest sensory nerve endings 1) prepuce (foreskin): cover glans; removal: circumcision Erection: parasympathetic reflex; sexual stim: arteries VD, veins shut = rigidity Ejaculation: sympathetic reflex; internal urethral sphincter closes; peristalsis of semen into ducts, semen eject from ejaculatory ducts thru urethra 2. Scrotum: bag that contains testes, outside the body, smooth muscle & CT a. Dartos muscle: spermatogenesis requires 2-4o lower than body temp *cold or sexual arousal: contract (up), hot: relax (down) * 3. Testes/Testicles: (gonads) sperm cells production a. Seminiferous tubules: functional unit of testis; produce sperm 1) Immature cells: outside, Mature cells: into lumen b. Epididymis: superior part of testis; sperm mature & transport c. Sertoli cells – support, protect, nourish sperm, fluid: transport, inhibin d. Leydig cells – secrete testosterone – promote masculine characteristics 4. Ducts: a. Epididymis: sperm motility (2 week), mature, store sperm (month), peristalsis b. Ductus deferens/Vas Deferens: ciliated tube + 3 layers of muscle (ejaculation), store sperm (several months) - *Sperm not ejaculated are reabsorbed* c. Ejaculatory Ducts: eject sperm into the urethra d. Urethra: last passageway for sperm & urine 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 8 Male Reproductive System Diagram – Bulbourethral gland Ejaculatory duct Epididymis Glans penis Kidney Penis Perineum Prostate gland Scrotum Seminal vesicle Seminiferous tubules Testis Ureter Urethra Urinary Bladder Vas deferens (16) Kidney (15) Ureter Urinary bladder (14) Pubic Bone Seminal vesicle Prostate gland (10) Ejaculatory duct Urethra (9) Bulbourethral Gland Vas deferens (6) Perineum Penis (12) Epididymis Seminiferous tubules Glans penis (13) Testis Scrotum (Language of Medicine © 1996 by W.B. Saunders Company. All rights reserved) 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 9 5. Accessory Sex Glands: a. Seminal vesicles: 60% of semen volume, secrete alkaline fluid 1) neutralizing acidity in male urethra & female reproductive tract so sperm is not killed or inactivated. 2) fructose: (ATP), prostaglandins: female organ contract (motility). b. Prostate gland: ring around urethra, 35% of semen volume, alkaline fluid 1) smooth muscle that contracts: force semen out upon ejaculation 2) citric acid: (ATP), protein-digesting enzymes (PSA): penetrate oocyte c. Bulbourethral/Cowper’s glands: 3% of semen volume 1) secrete lubricating fluid: released on excitation, clear out residual urine before ejaculation, sperm damage + lubricate end of penis 6. Spermatic cord: ductus deferens, blood vessels, nerve, cremaster M. & lymph vessels *cremaster muscle: helps dartos M. in adjusting testes temperature * C. SPERMATOGENESIS: process of making sperm (testes), begin puberty thru life. 1. Meiosis – 23 prs. Chromosomes; gametes: sperm cell 2. Spermiogenesis – head & tail added 3. Maturity of sperm = 2 month process D. SPERM: 300million/day produced, 1000/second!! 1. Only survive 48 hours in female reproductive tract once ejaculated 2. Structure: Highly specialized to penetrate the oocyte a. Head – DNA b. Acrosome – oocyte penetration enzymes c. Midpiece – mitochondria for locomotion d. Tail – flagellum (microfilaments) to propel sperm E. Hormonal regulation of Testicular function: NEGATIVE FEEDBACK SYSTEM 1. PUBERTY – Anterior pituitary secretes: a. LH – stimulate Leydig cells to secrete Testosterone b. FSH – acts with Testosterone to stimulate spermatogenesis c. Testosterone: devo/enlargement sexual organs, sex drive; anabolic *secondary sexual characteristics: body hair, hairline recession, thicken skin, sebaceous secretion, growth of skeletal muscles & bones, larynx, voice deepen d. Inhibin –Sertoli cells; FSH, regulate spermatogenesis 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 10 F. SEMEN: vol per ejaculation: secretions (2.5-5mL) and sperm (50-250million sperm/mL) 1. composition: water, electrolytes, nutrients, hormones from glands & 2% sperm 2. Infertility: below 20 million sperm/mL *Very large # of sperm required for fertilization, only tiny fraction reaches the oocyte* Males – retain reproductive capability into their 80s or 90s. The reproductive system is very much about environment. Just as a romantic evening is enhanced with soft music, low lights, etc., etc. – so the internal environment for fertilization is dependent on MANY factors that must be functioning optimally. Male hormones need to be within certain narrow limits & the scrotum at the right temperature to allow millions of viable sperm to be produced. The “tubing” of the male needs to be open & allow free movement of the sperm upon ejaculation. Female hormones need to be within certain narrow limits to 1.make a viable egg monthly, 2.prepare the implantation site of the embryo & 3.maintain pregnancy. The internal environment of the male urethra & female vaginal canal cannot be too acidic or the sperm will be killed off. The sperm needs to have enough energy to swim a long way through a hostile female (acidic) environment & enough chemicals (PSA) to dissolve some of the egg’s coating to allow fertilization. If there is a problem with just ONE of the above factors (or numerous others!) the result often leads to infertility or sterility (in other words – you ain’t makin’ babies!). III. PATHOLOGY: A. Benign prostatic hypertrophy (BPH) – enlargement of prostate, 2-4x normal Sx: frequent urination, bed wetting, decreased force of urination, dribbling B. Prostate cancer: leading cause of death SLOW growing, watchful wait – unless genetics. PSA: blood test to help determine & Digital exam (thru rectum) Tx: surgery, radiation, hormone therapy, chemo C. Prostatitis – enlarged, soft, tender prostate gland - inflammation of urethra IV. SEXUALLY TRANSMITTED DISEASES (STDs): Effects males & females 1. Chlamydia: cloaks itself & replicated inside cells Can lead to male & female sterility, leading cause of Pelvic Inflammatory Disease 2. Gonorrhea: pus drainage, painful urination Female infertility & blindness in newborn (traveling thru infected vaginal canal) 3. Syphilis: Primary stage: Chancre – painless open sore, heals within 1-5 weeks Secondary stage: systemic (6-24 weeks later) – infection all major body systems Tertiary stage (neurosyphilis) – extensive motor control damage, memory loss 4. Genital Herpes – Herpes Simplex Virus, type 2 Painful blisters on prepuce, glans penis & penile shaft, vulva & vagina Virus never disappears, reoccurs several times/year, No cure 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 11 BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Clinical Anatomy, Physiology & Pathology – IV Reproductive System: Female CAPP202-IV Session 3 LEARNING OBJECTIVES: By the end of this session, the student will be expected to: 1. Identify & label the components of the female reproductive system on a diagram. 2. Specify the five general functions of the female reproductive system. 3. Describe the anatomy, physiology & characteristics of the ovaries; define ovulation. 4. List the functions of the Fallopian tubes & vagina; specify functions and anatomy of the vulva. 5. Specify the function, layers & regions of the uterus; define implantation & stratum functionalis. 6. Describe the anatomy & functions of the mammary gland; define lactation & hormonal controls. 7. Sequence oogenesis – before birth, puberty & maturity; define fertilization. 8. Quantify the normal menstrual cycle & describe its functions. 9. List & describe the functions of the hormones that control the female reproductive system. 10. Define puberty, menarche, menopause & fertility. 11. Briefly describe the pathologies that impact the female reproductive system. I. ANATOMY (see diagram next page) A. Functions: 1. produce ovum & hormones (estrogen/progesterone), inhibin & relaxin (ovaries) 2. transport egg to uterus where fertilization can occur (fallopian tubes) 3. where fertilized ovum implants, development of the fetus, labor contractions (uterus) 4. passageway for intercourse & delivery (vagina) 5. synthesize, secrete & eject milk (mammary glands) 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 12 Female Reproductive System Diagram – Bartholin’s glands Cervix Clitoris Cul-de-sac Fallopian tube Ovary Perineum Urethra Urinary bladder Uterus Vagina Ovary Fallopian tube Uterus Cul-de-sac Vagina Bartholin glands Clitoris Perineum The Language of Medicine 8th Edition by Chabner 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 13 B. Anatomy & Physiology: 1. Ovaries: female gonads a. Follicle: stores ovum (egg), matures egg in response to hormones b. Corpus Luteum: remainder of the developing follicle, secretes hormones Ovulation: when a mature follicle ruptures to expel ovum 2. Fallopian (Uterine) Tubes: a. ciliated tubes, transport ova from ovaries to uterus; fertilization occurs here 1) fimbriae (fingers) sweep ovum into uterine tubes. 3. Uterus: (womb) implants fertilized ovum, growth of embryo/fetus, delivery of baby a. Perimetrium (outer): serosa b. Myometrium (middle): smooth muscle c. Endometrium (inner): mucous membrane in two layers 1) stratum basalis – permanent, replaces the functionalis 2) stratum functionalis – nourish growing baby or is shed each month during menstruation if fertilization doesn’t occur d. Regions: fundus: bulge at top, cervix: (inferior), bulge into vagina Pap smear: *90% reliability: detect malignant cervical cancer cells * e. Implantation of fertilized ovum: fundus or body of uterus Ectopic pregnancy: implantation in fallopian tubes or perineum 4. Vagina: receives erect penis during intercourse; birth canal a. acidity of vagina: protective barrier against microbial growth / spermicidal. *Alkaline semen neutralize this acid* 5. Vulva: external genitalia of female a. labia majora – 2 large folds of hair covered skin; adipose tissue, protect b. labia minora – nonkeratinized tissue; blood vessels & nerves 1) vestibule – between labia minora folds; urethral & vaginal orifices c. Bartholin’s glands – mucus during arousal & intercourse – lubricate d. clitoris – erectile tissue, enlargement upon stimulation, & sensory nerves 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 14 6. Mammary glands (breasts) – secrete milk; modified sudoriferous glands a. Nipple: pigmented projection; milk ducts empty b. Areola: pigmented area around nipple, sebaceous glands: rough appearance c. Lactation: synthesis, secretion & ejection of milk 1) Prolactin: milk production 2) Oxytocin: milk ejection in response to suckling Pregnancy & lactation: adipose tissue, breasts increase in size C. Oogenesis: formation of ova (gametes) 1. Meiosis I: before birth (200,000 oocytes) *Leads to 1 huge cell (2x cytoplasm) & a small cell (polar body) 2. Meiosis II: puberty (40,000 oocytes left) – monthly stimulated by hormones: mature Fertilization: completes maturation: large ovum & a 2nd polar body *diploid zygote: unite nuclei of sperm + ovum, 24 hrs after ovulation Only 400 primary oocytes mature, the remainder degenerate D. Female Reproductive Cycle: 28 days Menstrual cycle – changes in endometrium to prepare for implantation of fertilized ovum; no fertilization – functionalis shed. Hormonal regulation. E. Hormonal Regulation: 1. FSH – initial secretion of estrogen 2. LH –devo of oocytes, ovulation, estrogen/progesterone/relaxin & inhibin secretion 3. Estrogen: maintain female anatomy, lower blood cholesterol levels *secondary characteristics: fat distribution, broaden pelvis, hair growth pattern 4. Progesterone: prepare endometrium for implantation, + mammary glands 5. Relaxin: relax uterus (implantation), flexibility of pubic symphysis, dilate cervix 6. Inhibin: regulation, inhibit FSH secretion (& some LH) Puberty: (“a ripe age”) – 10 years, secondary sex characteristics Menarche – first menses Menopause: permanent cessation of menses (hot flashes, night sweats, headache, hair loss) Fertility – ability to conceive offspring: Females – limited fertility time span – due to limitations of follicles 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 15 III. PATHOLOGY: A. Hysterectomy – surgical removal of uterus *Tx: PID, excessive uterine bleeding, cancer of cervix, uterus or ovaries B. Breast cancer: 2nd leading cause of female deaths from cancer, 1:8 women Dx: self exam, mammography Risk factors: family Hx, no kids, other cancer, radiation, alcohol, smoking, abortion Tx: lumpectomy, radical mastectomy, radiation, chemotherapy Hm – now you may be thinking, why is having an abortion a risk factor? Well during pregnancy the breast tissue morphs into milk making machinery. During the first two trimesters of pregnancy, the breast tissue is considered dysplastic– which means the cells are essentially changing, but they aren’t fully functional yet; it isn’t until the third trimester that the metamorphosis is complete. So an abortion stops this breast tissue change during the dysplastic time. In a nutshell, cells that have dysplasia are NON-functional, they undergo mitosis & duplicate themselves & often lead to CANCER. Spontaneous abortions (miscarriages), when they are allowed to fully heal themselves without help (like a D & C), are not linked to increased breast cancer rates. C. Cervical cancer: start with cervical dysplasia, detected by Pap smear Risk factors: HPV, many sexual partners, intercourse very young, smoking D. Endometriosis: growth of tissue out of uterus – still respond to hormonal regulation Sx: inflammation, pain, scarring, infertility, PMS, menstrual pain Essentially what is happening here – is that there is a reversal of the cilia’s movement in the Fallopian tubes that allow the stratum functionalis to migrate into the AP cavity, instead of expelling it out of the body. This uterine tissue is still responsive to monthly hormonal signals, so there will be periods of internal bleeding. This tissue becomes a nuisance because it has a bad habit of wrapping around the intestines, Fallopian tubes & gumming up the rest of the internal works – causing pain & scarring. Generally they take a specific laser in there, laproscopically to blast away this displaced tissue. After everything is cleaned up the egg is not hindered by functionalis tissue to travel from the ovary & waved by the fimbriae into the Fallopian tubes. It is much easier to conceive after the surgery! (Be forewarned! ) E. Female athlete triad – over a long period of time Triad: disordered eating, amenorrhea, osteoporosis F. Pelvic Inflammatory Disease (PID) – extensive bacterial infection of pelvic organs Sx: pelvic soreness, lower back pain, abdominal pain, urethritis Infection spreads – fever, painful abscesses of the reproductive organs G. Vulvovaginal Candidiasis: Candida – yeast-like fungus– inflammation of vagina Sx: severe itching, cheesy discharge, yeasty odor, pain Risk factors: antibiotics, the pill, cortisone-like meds, pregnancy, diabetes Tx: no sugar diet, probiotic, antifungal (grapefruit seed extract) OR lacto-fermented foods (like Kombucha, Kefir, Sauerkraut, etc.) 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 16 BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Clinical Anatomy, Physiology & Pathology – IV Final Exam/NESL Review CAPP202-IV Session 5 LEARNING OBJECTIVES: By the end of this session, the student will be expected to: 1. Describe the organization, processes, feedback systems of the body; define vocabulary. 2. Describe the components, movement, division & cycle of the cell. 3. Describe the four different types of tissue & membranes. 4. Summarize the anatomy, physiology & pathology of the: a. Integumentary System b. Skeletal System c. Muscular System d. Nervous System e. Endocrine System f. Cardiovascular System g. Lymphatic/Immune System h. Respiratory System i. Digestive System j. Urinary System k. Reproductive System 5. Summarize the resources available for NCB exam information. 6. Describe the format of the NCB exam. 7. List the study techniques & stress reduction strategies that can be used in taking the NCB. 8. Summarize additional massage therapy techniques that were not covered extensively: a. Eastern medicine – Shiatsu: meridians & Chakra’s 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 17 I. INTRODUCTION TO THE BODY: A. Anatomy, Physiology, Pathology B. Organization: Chemical – cellular – tissue – organ – system – organism C. Life processes: Metabolism (Catabolism & Anabolism), Responsiveness, Motion, Growth, Differentiation, Reproduction D. Homeostasis = Balance, Endocrine (slow) & Nervous (fast) E. Negative Feedback (constant regulation – like body temp & blood glucose) F. Positive Feedback (amplification – like labor, clotting, immune response) G. Health, Dis-ease = Stress = imbalance, Signs, Symptoms H. Body Cavities: examples of organs in each 1. Dorsal: cranial, vertebral 2. Ventral: thoracic, pleural, mediastinal, pericardial, abdominal, pelvic a. AP Regions: Hypochondriac, Epigastric, Lumbar, Umbilical, Inguinal/Iliac, Hypogastric b. AP Quadrants: RUQ, LUQ, RLQ, LLQ I. Serous membranes: pleura, pericardia & peritoneum J. Retroperitoneal area: kidneys, ureters, pancreas & parts of the large intestine II. CELLS: A. Components: 1. plasma membrane 2. cytoplasm 3. inclusions 4. organelles: functions of each a. cytoskeleton (microtubules, intermediate filaments, microfilaments + cilia & flagella) b. nucleus, ribosomes, ER, Golgi, lysosomes, peroxisomes, mitochondria B. Movement of Substances: energy used & concentrations & functions 1. Passive processes: Simple diffusion, osmosis, bulk flow/filtration, facilitated diffusion 2. Active processes: Active transport (primary & secondary), Vesicular transport (endocytosis: phagocytosis, pinocytosis; exocytosis) C. Cell Division – Mitosis (body cells) vs. Meiosis (sex cells) D. Cell Cycle stages: IPMAT III. TISSUES: A. Epithelial: 1. characteristics, functions, AVASCULAR 2. cell types & examples: squamous, cuboidal (gland types), columnar, transitional, simple/stratified B. Connective: 1. characteristics, functions, VERY VASCULAR except: tendon, cartilage & ligaments 2. loose (areolar, adipose, reticular) vs dense (DICT, DRCT, Elastic) & examples 3. cartilage, bone, liquid (blood, lymph) & characteristics C. Muscle: smooth, skeletal & cardiac tissue: location, striations?, voluntary? D. Nervous: 1. Parts of Neuron: dendrites, nucleus, cell membrane, axon, myelin, Node of Ranvier, axon terminals, synaptic vesicles, synapse E. Types of membranes: mucous, serous (pleura, pericardial, peritoneal), synovial - & examples 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 18 IV. INTEGUMENTARY SYSTEM: A. 7 functions (PROTECT, excrete, secrete, vitamin A & D, sensation, immunity, blood reservior) B. layers: epidermis (stratum corneum & basale), dermis & hypodermis – characteristics & functions C. keratin, Langerhans cells, nerve endings (Merkel discs, Meissner & Pacinian) – function & location D. pigments (melanin, carotene, hemoglobin) – colors & functions E. epidermal derivatives (hair, nails, glands) & functions; goose bumps, arrector pili muscles F. glands (sebaceous, sudoriferous (eccrine, apocrine) ceruminous, mammary) products, location & job. G. pathology: candidiasis, inflammation, burns, cancer, herpes (cold sore), impetigo, tinea (athlete’s foot), warts – cause & brief description V. SKELETAL SYSTEM: A. 6 functions (support, protect, assist in movement, mineral homeostasis, blood cell production, fat store) B. bone classification (short, long, flat, irregular, sesamoid) – location C. parts of long bone: epiphysis, metaphysis, diaphysis, articular cartilage, periosteum (osteogenic & fibrous), marrow cavity, endosteum, nutrient artery) – location & function D. osteogenic cells (osteoprogenitor, osteoblasts, osteocytes) & functions E. BREAK down bone = osteoCLASTS & function F. bone structure: compact (dense) vs. spongy (cancellous) – location, description & functions G. characteristics: immature bone more cells than mature, remodel due to mechanical stress, etc. H. ossification types: endochondrial vs. intramembranous – description & examples I. bone growth: appositional (width) vs. interstitial (length) – important areas J. hormones (hGH, Estrogen, Testosterone, PTH) - bone growth & remodeling, time of influence? K. composition of bone : 25% water, 25% protein/collagen, 50% mineral salts L. pathology: osteoarthritis, osteoporosis, osteomalacia, rickets VI. MUSCULAR SYSTEM: A. 5 Functions (move body, regulate organ volume, move substances in body, stabilize, thermogenesis) B. characteristics (excitability/irritability, conductivity, contractility, extensibility, elasticity) description C. cross section of skeletal muscle (muscle – fascicle – muscle fiber – myofibril – myofilaments) D. connective tissue surroundings: epimysium, perimysium, endomysium E. parts of skeletal muscle: sarcoplasm, myoglobin, sarcolemma, sarcoplasmic reticulum F. parts of sarcomere (Z disc, heavy, light, M line, H zone, A band, I band) G. types of myofilaments (thick = myosin, thin = actin, troponin & tropomyosin, elastic = titin) H. motor unit description I. all or none principle for muscle J. NMJ – what meets here & function. K. muscle tone – description & hypertonic vs. hypotonic & hypertrophy vs. atrophy L. Absolutely necessary for muscle contraction: only ATP & calcium M. types of skeletal muscle (I, IIa & IIb) – location & function N. cardiac muscle – involuntary & striated – function & location; intercalated discs O. smooth muscle – involuntary & nonstriated – function & location P. skeletal muscle – voluntary & striated – function & location Q. pathology – fibromyalgia, muscular dystrophy, myesthenia gravis 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 19 VII. NERVOUS SYSTEM: A. General & ANS: 1. 3 functions: sensory, integration, motor response 2. Divisions (CNS, PNS, ANS, SNS, parasympathetic, sympathetic, ENS) 3. reflex arc diagram (receptor, SA, integrating center, ME, effector) 4. SAME = sensory afferent, motor efferent 5. Neuron: dendrites, nucleus, cell membrane, axon, myelin, Node of Ranvier, axon terminals, synaptic vesicles, synapse 6. Neuroglia: astrocytes, ependymal, microglia, oligodendrocytes, Schwann cells – functions 7. Myelin – functions/purpose 8. AP diagram (stimulus, depolarization, AP, repolarization, refractory period, resting, threshold) 9. All or none principle for the nervous system 10. Sympathetic (E-situations, Fight or flight) vs. Parasympathetic (SLUDD, rest or recover) B. Spinal Cord: 1. surroundings: meninges (dura, arachnoid, pia), spaces (epidural, subdural, subarachnoid – CSF) 2. length: medulla oblongata to L2; cauda equina 3. 4 plexuses (& nerves) – origin, location & function a. cervical (phrenic) b. brachial (median, radial) c. umbar (femoral) d. sacral (sciatic) 4. 31 pairs of spinal nerves, CT covering: epineurium, perineurium, endoneurium 5. reflexes: stretch, tendon, extensor, flexor – function, receptors 6. Pathology: shingles, polio C. Sensation: 1. Receptors & stimuli: a. Thermoreceptors = temp b. Nociceptors = pain & characteristics c. Photoreceptors = vision d. Gustatory receptors = taste e. Proprioceptors = pressure/touch 2. ear anatomy: external, middle, inner ear 3. eye anatomy: sclera, optic disk, retina, iris, pupil, fovea centralis, rods & cones, blind spot 4. pathology: vertigo, tinnitus, otitis media, glaucoma, cataracts – cause & description D. Brain & Cranial Nerves: 1 functions of CSF (mechanical protect – shock absorber, chemical protect – right environment) 2. Lobes of the brain & general function: frontal, parietal, temporal & occipital 3. parts of the brain & their major functions: a. brainstem (medulla oblongata, pons, midbrain, reticular formation) b. cerebellum – balance, posture, fine motor skeletal muscle sequences 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 20 c. diencephalon (pineal gland, thalamus, HYPOTHALAMUS – 6 IMPORTANT FUNCTIONS) d. cerebrum (basal ganglia, limbic system) 4. cranial nerves (name, number, S/M/B, function) 5. Pathology (MS, Epilepsy, Alzheimer’s, Parkinson’s, CVA, CP, coma, hydrocephalus) – description VIII. ENDOCRINE SYSTEM: Know Glands location, hormones, functions, pathology (hyper/hyposecretion) A. Hypothalamus: control of pituitary B. Pituitary Gland 1. Anterior Lobe (hGH, TSH, FSH, LH, PRL, ACTH, MSH); Gigantism, Grave’s, sterility, Cushing’s & Addison’s 2. Posterior Lobe (Oxytocin, ADH/vasopressin); Diabetes Insipidus C. Thyroid gland (Thyroid hormones, calcitonin); osteoporosis, Grave’s D. Parathyroid gland (PTH); osteoporosis E. Adrenal gland 1. Adrenal Cortex (Aldosterone, Cortisol, Androgens); Addison’s, Cushing’s 2. Adrenal Medulla (Epinephrine/Adrenaline, Norepinephrine); Sympathomimetic effects F. Pancreas (Glucagon, Insulin, Somatostatin); Diabetes Mellitus: NIDDM vs. IDDM G. Ovaries (Estrogen, Progesterone); Sterility H. Testis (Testosterone); Sterility I. Pineal gland (Melatonin); SAD J. Thymus Gland (Thymosin); immunity IX. CARDIOVASCULAR SYSTEM: A. Blood: 1. functions: transportation, regulation, protection 2. Blood composition: 55% plasma, 45% formed elements (99% RBCs, 1% WBCs & platelets) 3. cells: erythrocytes (hemoglobin), leukocytes, thrombocytes – function & characteristics 4. Normal blood volume: 4-6L/min; universal donor = type O blood 5. Pathology: hemophilia, hemorrhage, anemia (pernicious, sickle cell), embolus B. Heart: 1. Location: ventral, thoracic, mediastinum, pericardial body cavities 2. layers of the heart (endocardium, myocardium, epicardium/pericardium) - composition 3. blood flow: SVC/IVC, R atrium, (av valve) tricuspid valve, R ventricle, (semilunar valve) pulmonary valve, pulmonary ARTERIES, lungs, pulmonary VEINS, L atrium, (av valve) Mitral/Bicuspid valve, L ventricle, (semilunar valve) aortic valve, aorta, to body 4. AV valves vs. Semilunar valves 5. types of circulation (systemic, pulmonary, coronary, hepatoportal); pressure differences R vs. L heart 6. Heart rhythm/conduction: SA NODE (Main), AV node, bundle of His, bundle branches, Purkinje fibers 7. Cardiac cycle: Systole, Diastole, heart sounds 8. Cardiac output (CO) = Stroke Volume (SV) x Heart Rate (HR) 9. Pathology: MVP, ischemia, MI, CAD, CHF, atherosclerosis, hypertension, heart disease, cholesterol 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 21 C. Blood vessels: 1. Layers: lumen, tunica interna, media & externa – composition & function 2. Comparison: Arteries, veins & capillaries – location, blood %, flow, pressure, muscle, valves, etc. 3. vasoconstriction vs. vasodilation – description & influences 4. pathology: aneurysm, DVT, shock, varicose veins X. LYMPHATIC SYSTEM: 1. 3 Functions (drain interstitial fluid, transport dietary fats, immunity) 2. characteristics: LOW pressure, one way movement, dump into cardiovascular system through ducts 3. Anatomy: lymph capillaries, vessels (lacteals), nodes, ducts, cisterna chyli – location & function 4. Left lymphatic/Thoracic duct: drainage L side (legs, torso, L arm – 75%) 5. Right lymphatic duct: drainage R side (R arm, head, neck – 25%) 6. Lymph flow: skeletal muscle pump, gravity, respiratory pump, massage 7. Lymph organs/tissues: a. Thymus: mature T-cells b. nodes (axillary, inguinal, cervical) c. spleen: 4 functions (filter blood, produce RBCs, destroy old RBCs, store blood) d. MALT: tonsils e. Appendix 8. pathology: edema, Hodgkin’s, mono, tonsillectomy – description & causes A. Immune System: 1. Nonspecific resistance: skin, mucus, cilia, flora & fauna, inflammation – location, function 2. Specific immunity: a. components: T cells (thymus: helper, killer), B cells (Bone marrow: plasma - Ab, memory) b. types: active vs. passive, artificially vs. naturally 3. Antigens (types) vs. antibodies 4. Pathology: AIDS, HIV, autoimmune diseases, allergies XI. RESPIRATORY SYSTEM: A. Anatomy: 1. URT: Nose (warm, filter, moist, smell, resonance), pharynx (throat), larynx (voice box), epiglottis 2. LRT: trachea (windpipe), lung, bronchi (PCCE), bronchioles, alveoli (simple squamous) B. Lung characteristics: 3 right lobes, 2 left; R primary bronchi – more foreign objects stuck C. Bronchoconstriction vs. bronchodilation – influences D. Alveoli: functions (gas exchange), high surface area, external respiration, surfactant (functions) E. Lung volumes/capacities: tidal, residual, vital, total lung; respiratory rate (resting) = 12 breaths/min F. Inhalation vs. exhalation G. Primary/external respiration (alveoli & capillaries) vs. Secondary/internal (capillaries & tissues) H. Breathing regulation: medulla oblongata & pons I. Muscles of inspiration (primary: diaphragm, ext. intercostals, secondary: SCM, scalenes) J. Muslces of expiration (1o: none/elastic recoil - diaphragm, 2o: abdominals, internal intercostals) 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 22 K. pathology: COPD, Asthma, emphysema, pleurisy, pneumonia, SIDS, Tb – causes & description L. smoking – resulting pathology XII. DIGESTIVE SYSTEM: A. Functions: ingestion, salivation, mastication, deglutition, mech./chem. digestion, peristalsis, segmentation, absorption, defecation; control points (sphincters, muscle, etc.) B. cross section: lumen, mucosa, submucosa, muscularis (skeletal or smooth muscle), serosa composition C. Anatomy: Where, functions, secretions, what & how much absorbed, mech v. chem digestion 1. Mouth: salivary glands (parotid, submandibular, sublingual), teeth, tongue 2. Throat: uvula, ESOPHAGUS, cardiac sphincter 3. Stomach: regions, secretions, functions; pyloric sphincter; chyme 4. Small intestines: DJI: duodenum, jejunum, ileum, (villi) 90% of absorption; ileocecal valve 5. Large intestine: cecum, asc., transverse, desc. & sigmoid colon, rectum, anal canal & sphincter D. Associated organs: 1. Pancreas: pancreatic juice – emulsify fat, neutralize stomach acid 2. Liver: 6 Functions: bile SECRETED (emulsify fat, neutralize stomach acid & stimulate BM); detoxify blood; phagocytosis of worn out RBCs/bacteria; store glycogen, vit ADEK & B12, copper, iron; make blood proteins/clotting factors; synthesize urea 3. Gallbladder: bile stored, concentrated & released (NOT secreted); gallstones causes (cold fat) E. Enzymes that catabolize: carbohydrates, proteins & fats – where are these building blocks absorbed? F. Pathology: hepatitis, ulcers, GERD, Crohn’s disease, cirrhosis Metabolism: 1. Minerals, vitamins (fat: ADEK vs. water soluble: B,C; antioxidants: C,E, beta carotene) 2. Carbohydrates (glucose), Lipids (LDL vs. HDL cholesterol) 3. Proteins (amino acids, enzymes – protease, lipase, amylase) 4. Excess dietary carbohydrates, lipids & protein are ALL stored as FAT. XIII. URINARY SYSTEM: A. Anatomy: Retroperitoneal: Kidney & ureters; transitional epi.: urinary bladder, urethra- functions B. Kidney functions (filter blood, make urine, water, electrolyte & acid/base balance, secrete hormones) C. Hormones: Erythropoietin – stimulate RBC production, RENIN - regulate blood vol./blood pressure D. Renin signal: LOW bvol/bp; results: VC, thirst, low pee; ultimate result: increase bp/bvol. E. Kidney anatomy: renal capsule, calyces, pyramids, pelvis & hilus F. Nephron:functional unit:Glomerulus, PCT (65% water/nutrients), Loop of Henle, DCT, collecting ducts G. ADH influences: water reabsorption at DCT & collecting ducts H. Bladder functions: hold & expel urine, micturition = urination; stretch receptors (signal - ½ way mark) I. results of full bladder & MVA J. excretory systems & products: Respiratory: CO2, Integumentary: sweat, Urinary: urea, Digestive: feces 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 23 K. urine: normal (H2O, urea, yellow pigment, ions) vs. abnormal (glucose, blood cells, bacteria, protein) L. Pathology: kidney stones (no water, too much calcium/phosphorus), UTIs (cystitis, nephritis) XIV. REPRODUCTIVE SYSTEM: A. Male: 1. Functions: secrete hormones, make & transport sperm & semen; erection vs. ejaculation 2. Anatomy: testis (secrete testosterone), seminiferous tubules (produce sperm), Seminal vesicle, Prostate & Cowper’s glands (alkaline semen), penis 3. Hormones: testosterone: regulate sperm production 4. Pathology: Infertility: below 20 million sperm/mL, prostate cancer, Genital Herpes B. Female: 1. Functions: make & transport eggs; menarche; ovulation; menstruation; fertilization; implantation; pregnancy; childbirth; lactation; menopause, secrete hormones 2. Anatomy: Ovaries, fallopian tubes, uterus (endometrium: stratum functionalis vs. basalis), vagina (acidic to inhibit bacterial growth), mammary glands (secrete & eject milk) 3. Hormones: progesterone & estrogen: regulate menstrual cycle, pregnancy; relaxin 4. Pathology: Endometriosis, Candidiasis, breast cancer A. Resources for studying for NCB Exam: 1. Review guide(s) 2. Class notes 3. CAPP Project 4. websites: www.massagereview.com www.examreviews.com B. Board Exam Format: 3 hours, 160 questions, all multiple choice on computer 1. It is difficult to condense 10 months of material in 160 questions. 2. Some questions will be very easy, others will be super difficult. 3. The lowest section is thrown out, the rest is averaged for PASS/FAIL status. a. don’t expect to get detailed feedback on how you did on each section. b. the test site will only give you a basic level of passing (high, medium or low) per section 4. There will be plenty of questions on oriental medicine (chakras, meridians, etc) – don’t be surprised a. they say that these sections are not counted toward your total score, but if not familiar with this section it can easily decrease your confidence in the questions that you do know. b. Therefore, study the summary pages handed out. 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 24 5. Recommendations: a. take the time to learn how the computer system works (practice test) so that you are comfortable with the mouse, computer, format, etc. (it does NOT subtract from your time) b. WRITE DOWN ALL OF YOUR ANSWERS on the scratch paper they give you. *Some testing sites have not upgraded & have had trouble with the touch screens recording the answer selected (you choose B and the computer records A). *Sometimes the computer system freezes (or dies) and they have to reset the program. c. Mark the questions that you do not know & come back to them to ensure that you budget your time accurately. d. DON’T CHANGE YOUR ANSWER unless you are SURE that you read the question wrong, (if you are guessing – than your first answer is best) e. Techniques for reducing stress: *STUDY, STUDY, STUDY *take rescue remedy before the tests starts (if needed) *get enough sleep the night before *eat a good meal & drink WATER before the test *go to the bathroom BEFORE the test begins *take a practice run to the test site before test day – so you know where you are going *arrive EARLY! *Breathe! *Access the visual & auditory parts of your brain with your eye patterns. 6. You will be able to take a bathroom break or get a drink of water during the exam but it will take away from your total test time. 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 25 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 26 NOURISHING CYCLE Wood 11PM Metal 3AM Earth 7AM Fire 11AM CONTROLLING CYCLE Water 3PM Fire 7PM Wood Relationships of the Five Elements 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 27 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 28 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 29 Chakra No. Element Color Endocrine Gland Musical Note Psychological Function Also see your current edition of this textbook, pages 340 - 342 Physiological Function 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 30 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 31 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 32 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 33 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 34 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 35 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 36 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 37 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 38 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 39 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 40 Final Review – Answers Page 1: 1. Integumentary 2. Skeletal 3. Muscular Page 6: Metabolism Build up Breakdown 1. Nervous 2. Endocrine Membrane Parietal – line body cavity Visceral – cover organ Mucus – line cavities opening out Synovial – line joints Serous – line cavities opening in Thoracic (lungs) Abdominopelvic Kidney, pancreas, ureter, adrenals, part of large intestines Between lungs, contains heart & tubes Skin Hair, nails, glands Page 2: 4. Nervous 5. Endocrine 6. Cardiovascular 7. Lymphatic Page 3: 8. Respiratory 9. Digestive 10. Urinary Cytoplasm Nucleus Page 4: Endoplasmic Reticulum Golgi Lysosomes Mitochondria Flagellum Cilia Diffusion Osmosis Filtration Active vs. Passive Page 7: 1. Stratum corneum 2. Stratum lucidum 3. Stratum granulosum 4. Stratum spinosum 5. Stratum basale/germinativum Page 5: Cell eating Cell drinking Meiosis – sex cells, gametes Mitosis – somatic, exact duplication Know order: IPMAT 1. chemical 2. cellular 3. tissue 4. organ 5. system 6. organism 1. Protect 2. Absorb 3. Secrete Endothelium or tunica intima/interna 8/12 1. Subcutaneous tissue 2. Hypodermis 3. Superficial fascia Outermost layer, Epidermis Inner layers, Dermis & Hypodermis Connective only Keratin Melanin Vesicle/Blister Brain & Spinal Cord PNS ANS Parasympathetic Sympathetic Myelin All or None: Once an Action Potential is generated, it travels at a constant speed and a maximum strength or not at all. © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 41 Page 8: Information about body position, muscle tension and joint position Rami 1. Cervical 2. Brachial 3. Lumbar 4. Sacral Sensory Motor Cerebellum Dermatome 31 Sciatic Page 10: Emulsify fat, stimulate BM, neutralize acid Endocrine vs. Exocrine Sweat Oil Wax Decreases Islets of Langerhans Decrease Page 11: Pituitary Above kidney Sudoriferous Pharynx Larynx Trachea GI tract Page 9: Deglutition Mastication Small Intestine Large Intestine/Colon Peristalsis Segmentation Peritoneum Stomach and Duodenum Ileum and cecum Acidic Bile 1. Duodenum 2. Jejunum 3. Ileum Ileum Liver Liver Gallbladder 8/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork CAPP202 – Class Notes – Semester 2 2
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