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ANATOMY AND PHYSIOLOGY

Cardiovascular System
The heart is located in the chest between the lungs behind the sternum and above the
diaphragm. It is surrounded by the pericardium. Its size is about that of a fist, and its
weight is about 250-300 g. Its center is located about 1.5 cm to the left of the midsagittal
plane. Located above the heart are the great vessels: the superior and inferior vena
cava, the pulmonary artery and vein, as well as the aorta. The aortic arch lies behind
the heart. The esophagus and the spine lie further behind the heart.
The walls of the heart are composed of cardiac muscle, called myocardium. It also
has striations similar to skeletal muscle. It consists of four compartments:
the right and left atria and ventricles. The heart is oriented so that the anterior aspect is
the right ventricle while the posterior aspect shows the left atrium. The left ventricular
free wall and the septum are much thicker than the right ventricular wall. This is logical
since the left ventricle pumps blood to the systemic circulation, where the pressure is
considerably higher than for the pulmonary circulation, which arises from right
ventricular outflow. The heart has four valves. Between the right atrium and ventricle lies
the tricuspid valve, and between the left atrium and ventricle is the mitral valve.
The pulmonary valve lies between the right ventricle and the pulmonary artery, while
the aortic valve lies in the outflow tract of the left ventricle (controlling flow to the
aorta). The blood returns from the systemic circulation to the right atrium and from there
goes through the tricuspid valve to the right ventricle. It is ejected from the right ventricle
through the pulmonary valve to the lungs. Oxygenated blood returns from the lungs to
the left atrium, and from there through the mitral valve to the left ventricle. Finally blood
is pumped through the aortic valve to the aorta and the systemic circulation.

TORTUOUS AORTA
A tortuous aorta is an aorta with anatomical abnormalities which cause it to be distorted
in shape or path. Some people have a tortuous aorta and experience no ill health
effects as a result of their slightly unusual anatomy, while others can experience
complications. This condition can be diagnosed with the use of medical imaging studies
which reveal the structure of the aorta and other blood vessels in the body. Individuals
with this condition can be at risk for high blood pressure caused by the interruption to
their blood flow, and they can also experience atherosclerosis, in which the vessels are
lined with a layer of plaque which impedes the movement of blood through the vessels.

BLOOD PRESSURE
Blood pressure is a measurement of the force against the walls of your arteries as your
heart pumps blood through your body. Hypertension is another term used to describe
high blood pressure.
High blood pressure may be due to another medical condition, medicines taken or
ageing.

Respiratory System
The respiratory system is situated in the thorax, and is responsible for gaseous
exchange between the circulatory system and the outside world. Air is taken in via the
upper airways (the nasal cavity, pharynx and larynx) through the lower airways (trachea,
primary bronchi and bronchial tree) and into the small bronchioles and alveoli within the
lung tissue. The lungs are divided into lobes; The left lung is composed of the upper
lobe, the lower lobe and the lingula (a small remnant next to the apex of the heart), the
right lung is composed of the upper, the middle and the lower lobes.
Each branch of the bronchial tree eventually sub-divides to form very narrow terminal
bronchioles, which terminate in the alveoli. There are many millions of alveloi in each
lung, and these are the areas responsible for gaseous exchange, presenting a massive
surface area for exchange to occur over.
Each alveolus is very closely associated with a network of capillaries containing
deoxygenated blood from the pulmonary artery. The capillary and alveolar walls are very
thin, allowing rapid exchange of gases by passive diffusion along concentration

gradients.

CO2 moves into the alveolus as the concentration is much lower in the alveolus than in
the blood, and O2 moves out of the alveolus as the continuous flow of blood through the
capillaries prevents saturation of the blood with O 2 and allows maximal transfer across
the membrane

The Urinary System


The function of the urinary system is to remove waste products from the blood
and eliminate them from the body. The principal waste products being eliminated are
water, carbon dioxide and nitrogenous wastes including area, uric acid and creatinine.
Other functions of the urinary system include the regulation of the volume of body fluids,
the balance of pH and the electrolyte composition of these fluids.
Kidneys
The kidneys are retroperitoneal organs (i.e. located behind the peritoneum) situated
on the posterior wall of the abdomen on each side of the vertebral column, at about the
level of the twelfth rib. The left kidney is slightly higher in the abdomen than the right,
due to the presence of the liver pushing the right kidney down. The kidneys are located

in the back of the upper abdomen and are protected by the lower ribs and rib cartilage
of the back. The kidneys are involved with a number of bodily functions which include:

The filtering and excretion of unwanted waste products such as urea from the
body.

The maintenance of water balance, the regulation of the acid-base balance of


body fluids and the production of renin, which is important in the regulation of
blood pressure.

The production of the hormone erythropoietin, which stimulates the production of


red blood cells.

The kidneys are essentially regulatory organs which maintain the volume and
composition of body fluid by filtration of the blood and selective reabsorption or
secretion of filtered solutes.
They take their blood supply directly from the aorta via the renal arteries; blood is
returned to the inferior vena cava via the renal veins. Urine (the filtered product
containing waste materials and water) excreted from the kidneys passes down the
fibromuscular ureters and collects in the bladder. The bladder muscle (the detrusor
muscle) is capable of distending to accept urine without increasing the pressure inside;
this means that large volumes can be collected (700-1000ml) without high-pressure
damage to the renal system occurring. When urine is passed, the urethral sphincter at
the base of the bladder relaxes, the detrusor contracts, and urine is voided via the
urethra.
They are essential in the urinary system and also serve homeostatic functions such
as the regulation of electrolytes, maintenance of acidbase balance, and regulation of
blood pressure (via maintaining salt and water balance). They serve the body as a
natural filter of the blood, and remove wastes which are diverted to the urinary bladder.
In producing urine, the kidneys excrete wastes such as urea and ammonium, and they
are also responsible for the reabsorption of water, glucose, and amino acids. The

kidneys also produce hormones including calcitriol, erythropoietin, and the enzyme
renin. Thus the kidney continuously regulates the chemical composition of the blood
within narrow limits. The kidney is one of the major homeostatic devices of the body.
The Structure of the Kidney

On sectioning, the kidney has a pale outer region- the cortex- and a darker inner
region- the medulla. The medulla is divided into 8-18 conical regions, called the renal
pyramids; the base of each pyramid starts at the corticomedullary border, and the apex
ends in the renal papilla which merges to form the renal pelvis and then on to form the
ureter. In humans, the renal pelvis is divided into two or three spaces -the major
calyces- which in turn divide into further minor calyces. The walls of the calyces,
pelvis and ureters are lined with smooth muscle that can contract to force urine towards
the bladder by peristalsis.
The cortex and the medulla are made up of nephrons; these are the functional
units of the kidney, and each kidney contains about 1.3 million of them.
The nephron is the unit of the kidney responsible for ultrafiltration of the blood and
reabsorption or excretion of products in the subsequent filtrate. Each nephron is made
up of:

A filtering unit- the glomerulus. 125ml/min of filtrate is formed by the kidneys as


blood is filtered through this sieve-like structure. This filtration is uncontrolled.

The proximal convoluted tubule. Controlled absorption of glucose, sodium, and


other solutes goes on in this region.

The loop of Henle. This region is responsible for concentration and dilution of
urine by utilizing a counter-current multiplying mechanism.

The distal convoluted tubule. This region is responsible, along with the
collecting duct that it joins, for absorbing water back into the body. Ninety-nine
percent (99%) of the water is normally reabsorbed, leaving highly concentrated
urine to flow into the collecting duct and then into the renal pelvis.

Ureter
The ureters are two slender tubes that run from the sides of the kidneys to the
bladder. Their function is to transport urine from the kidneys to the bladder.
Bladder
The bladder is a muscular organ and serves as a reservoir for urine. Located just
behind the pubic bone, it can extend well up into the abdominal cavity when full. Near
the outlet of the bladder is a small muscle called the internal sphincter, which contract
involuntarily to prevent the emptying of the bladder.
Urethra
The urethra is a tube that extends from the bladder to the outside world. It is
through this tube that urine is eliminated from the body.