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
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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
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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
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CAPP202 – Class Notes – Semester 2
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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
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CAPP202 – Class Notes – Semester 2
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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
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CAPP202 – Class Notes – Semester 2
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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)
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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
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CAPP202 – Class Notes – Semester 2
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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
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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
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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
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CAPP202 – Class Notes – Semester 2
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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)
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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
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CAPP202 – Class Notes – Semester 2
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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
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CAPP202 – Class Notes – Semester 2
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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)
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CAPP202 – Class Notes – Semester 2
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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
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
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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
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CAPP202 – Class Notes – Semester 2
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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
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CAPP202 – Class Notes – Semester 2
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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.)
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© 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
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CAPP202 – Class Notes – Semester 2
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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
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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
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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
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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
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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)
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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
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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.
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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.
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NOURISHING CYCLE
Wood 
11PM
Metal 
3AM
Earth 
7AM
Fire 
11AM
CONTROLLING CYCLE
Water 
3PM
Fire 
7PM
Wood
Relationships of the Five Elements
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Chakra
No.
Element
Color
Endocrine
Gland
Musical
Note
Psychological Function
Also see your current edition of this textbook,
pages 340 - 342
Physiological
Function
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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
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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.
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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
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