ORGAN SYSTEMS 1

The Nervous System

STRUCTURE OF THE NERVOUS SYSTEM
Central Nervous System is made of brain and spinal cord
Brain can be divided into:
cerebrum the top and the biggest part of the brain;
it has two distinct left and right hemispheres
brain stem hooks onto the spinal cord, is itself
divided into midbrain (top), Pons (middle), and
Medulla (bottom, also called medulla oblongata; this
connects to the spinal cord)
cerebellum sits behind the brain stem and is
connected to it
Brain structures are sometimes referred to by what they developed from in the embryo:
forebrain (aka prosencephalon) becomes cerebrum (temporal lobe, frontal lobe, occipital
lobe, parietal lobse)
midbrain (aka mesencephalon) becomes midbrain (top of the brain stem), substantia niagra
hindbrain (aka rhombencephalon) becomes the rest of the brain pons, medulla, cerebellum
Peripheral Nervous System is made of nerves and ganglia
Nerves carry the axons of neurons, while ganglia are lumps attached to nerves that contain the
somas of neurons
Afferent neurons carry information into the central nervous system
Efferent neurons carry information away from the central nervous system to the periphery.
An impulse moving through a neuron that carries info from PNS > CNS is an afferent neuron
impulse moving proximally
Nerves can be divided into different categories (and are in pairs on each side of the body):
Cranial Nerves exit the skull, primarily coming out of the brain and pass through the skull
on the way between the central and periphery nervous system. (12 pairs)
Spinal Nerves come out of the spinal cord and pass through the spine on their way between
the central and peripheral nervous systems. (23 pairs)
Spinal nerves form from spinal nerve roots.
Efferent neurons (carrying info away) go through spinal nerve root in the front while
afferent neurons (carrying into in) go through spinal nerve roots in the back.
These come together in the spinal nerves, which we call mixed nerves.
As any of the nerves travel from their proximal (close to center of the body) to their distal ends,
they branch repeatedly, getting smaller and smaller.

FUNCTIONS OF THE NERVOUS SYSTEM

Can be divided into basic (lower) functions and higher (complex) functions
Patterns of abnormal functions are called syndromes. Some syndromes are more common than
others because theyre caused by neurological or psychiatric disorders that occur more frequently.
Functions are performed by both
Cranial nerves primarily perform basic functions for the head and neck
Spinal nerves primarily perform basic functions for the limbs and trunk
Basic functions are performed by central and periphery nervous systems. Basic functions are associated
with the senses, movement, and automatic function. Three main categories:
Motor: control of skeletal muscle. These functions cause movement, tone, and posture.
Sensory: deals with all senses (more than 5!), anything that the nervous system can detect
ORGAN SYSTEMS 2
Automatic: dont require conscious involvement includes reflexes, control of some body
systems, etc. aka. Sweating
Higher functions are performed by parts of the brain. Higher functions are associated with cognition,
emotion, or consciousness.Three main categories:
Cognition: thinking functions of the brain thinking, learning, memory, language, exec.
functions
Emotions: feelings play a major role in our experience of life ex. fear
Consciousness: related to awareness of being a person, experiencing life, and controlling actions
MOTOR UNIT
Lower motor neurons efferent neurons of peripheral nervous system (carry info away); they
synapse on and control skeletal muscle, which is the main muscle type of our body.
One lower motor neuron unit = one lower motor neuron (soma, axon, and axon terminals) AND all the
skeletal muscle cells that it contacts and controls.
The place where a neuron contacts its target cell is a synapse.
The synapse between a lower motor neuron and skeletal muscle cell is specifically called the
neuromuscular junction. Lower motor neurons will typically have many neuromuscular
junctions.
When the neuron fires, all of these skeletal cells are activated and contracted together.
The somas of LMNs are in the spinal cord or in the brain stem. Their axons pass out of the spine /
brain stem from the spinal nerves / cranial nerves, respectively.
These axons then continue to branch until they reach and synapse on all the skeletal muscle cells in
their motor unit.
The lower motor neurons in the cranial nerves primarily control skeletal muscle in the head and neck,
while lower motor neurons in the spinal nerves primarily control muscles of the limbs and trunk.
Small muscles that need rapid precise control (e.g. in the eyes or fingers) tend to have small motor
units (synapse on few cells). Large muscles that dont need precise control (e.g. those in the trunk or
thighs) typically have large motor units may include up to control hundreds of skeletal muscle cells.
When there is any abnormality of a motor unit, symptoms may include weakness, or loss of strength of
contraction of skeletal muscle.
Abnormalities of the lower motor neurons, specifically, cause Lower Motor Neuron Signs (LMN
signs):
Atrophy decreased bulk of skeletal muscle
If muscle cells arent periodically stimulated by LMNs, the cells degenerate or are lost.
Extreme weakness and shrunken muscle is an example of atrophy, which is a sign of lower
motor neuron dysfunction.
Fasciculations involuntary twitches of skeletal muscle that can occur after some problem of the
motor neurons. The occasional fasciculation is normal, but if we see a lot in one spot that suggests
there could be something wrong with an LMN.
Apparently, if muscle cells dont receive periodic input from LMNs, the cells might start to
contract on their own, without any input.
Hypotonia decrease in tone of skeletal muscle. Tone is how much a muscle contracts when
youre trying to relax it. (Ex: Remember the old picture of a doctor and patient. In a normal patient,
even if doc tells the patient to relax, when he tries to move their leg he will feel a little resistance.
With hypotonia, the leg will be especially floppy and not resistant to movement.)
Hyporeflexia decreased muscle stretch reflexes (MSR), which normally happen if you rapidly
flex a skeletal muscle (like a pin hammer on a knee).
Note: ALS affects both upper and lower motor neurons.
PERIPHERAL SOMATOSENSATION
Somatosensation is simply senses of the body. We can divide this into five categories.
ORGAN SYSTEMS 3
Position sense of body parts relative to each other (ex: If we close our eyes and someone moves
our arm over our head, we can know its over our head without seeing it.)
Vibration can feel vibrations (may be tested on a patient with a tuning fork)
Touch Pain Temperature
To detect these things, we have a bunch of somatosensory receptors, which can be found in a number
of places. We group these into 3 categories:
Mechanoreceptors respond to stimuli. Can detect position, vibration, and touch.
These receptors have special structures (sort of look like a disc) at the end of the axon that help
take information back to the central nervous system.
Ex: Mechanoreceptors in the skin detect touch and vibration; those in the deep tissue of
muscles can detect stretch.
Other mechanoreceptors in the tendons and capsules around joints are important for position
sense because they can send info back to central nervous system about the position of joints
Nociceptors can detect a number of different stimuli that give rise to the experience of pain.
Thermoreceptors detect temperature.
Nocireceptor and Thermoreceptors dont usually have a specific structure at the end like
mechanoreceptors. Instead the axon just ends in uncovered terminals called bare nerve endings.
Once a somatosensory receptor detects a stimuli its specific for, it will send that information back to
the central nervous system in axons of the peripheral nervous system. These are a type of afferent
neuron called somatosensory neurons.
Most of these have their somas in ganglia close to either the spinal cord or brain stem,
depending on what theyre entering.
There are several different types of somatosensory neurons:
Position, vibration, and some touch information tends to travel in certain neurons with large
diameter axons, with a thick myelin sheath. The Schwann cells that create myelin sheath are thus
wrapped around the axon in many layers.
Pain, temp, and the rest of touch tend to travel in other specific neurons with a smaller diameter,
and either a thin myelin sheath (with less wrapping of Schwann cell membranes around the axon)
or no myelin sheath at all.
Because axons with a larger diameter and a thicker myelin sheath conduct action potentials more
rapidly, the somatosensory neurons for position, vibration and some touch will conduct action
potential much faster than the others.
The sense of touch is a funny one because it travels in both types of neurons. Fine touch sense
information tends to travel faster than larger, gross touch sense.

MUSCLE STRETCH REFLEX

Reflex is a response to a stimulus that doesnt require the involvement of consciousness.
All reflexes have two parts:
afferent brings info about the stimulus into central nervous system
efferent carries info away from CNS to cause a response/effect in the periphery.
Some reflexes, like the muscle stretch reflex, happen on the same side of the body. Others (especially
those in the brain stem) have an afferent limb that comes in on one side, and efferent responses that
come out to both sides.
If a muscle is rapidly stretched, the muscle stretch reflex will cause it to contract quickly. This type of
reflex is what is tested when the doctor hits the tendon just below your kneecap with a little rubber
hammer.
ORGAN SYSTEMS 4
Knee jerk reflex is a monosynaptic stretch reflex. A tap to the tendon that connects the
quadriceps to the patella activates a sensory neuron that directly snyapses with the motor
neuron in the spinal cord, causing the quadriceps to contract.

When your doctor hits you in the tendon, it actually stretches (not very far, but rapidly) the group of
muscles on the front of your thigh contract, the ones that make your leg extend.
The receptors in skeletal muscle are called muscle spindles. Specialized little fibers in the muscle
spindle get stretched when the muscle does, and special axons wrapped around these fibers can detect
the stretch. They then send that info back through nerves of the peripheral system and enter the spinal
cord or the brain stem.
This afferent (stimulus) part of the reflex is caused by somatosensory neurons.
Inside the central nervous system, these somatosensory neurons carrying muscle stretch info from an
excitatory stimulus synapse with another nerve whose soma is in the CNS. This neuron sends an axon
out through nerves of the PNS back to the same muscle that was stretched. It synapses on and excites
skeletal muscle cells there to contract, causing a response.
This efferent (response) is caused by the lower motor neurons.
Recall, one LMN sign is hyporeflexia occurs if LMN is unable to communicate with the muscle, so
it wont know to contact in response to the stimulus. But you can also have diminished muscle stretch
reflex if the somatosensory neurons arent functioning.
This is true of all reflexes. If there is an abnormality or malfunction in the afferent or efferent
part, you may have a diminished reflex response.
Higher parts of the nervous system (cerebrum, e.g.) dont ever have to get involved for a reflex like
this to occur.
When the muscles on the top of the thigh are contracted, the ones at the back that cause leg bending are
relaxing. This is because the same somatosensory neuron that sends info of stimulus back to CNS
inhibits the LMNs of the back thigh muscle.
This isnt necessary for the muscle to occur, but it does increase the response.

AUTONOMIC NERVOUS SYSTEM

ANS controls things without involving the consciousness.
It consists of efferent neurons in the peripheral nervous system that control three types of cells:
Smooth muscle
Cardiac muscle
Gland cells
We can divide the autonomic nervous system into sympathetic & parasympathetic.
The autonomic nervous system has two functional differences. The sympathetic nervous system is
associated with fight or flight, and the parasympathetic nervous system is associated with rest and digest.
Rest and digest means that body functions promoting homeostasis are activated.
Fight or flight means that body functions promoting survival are activated.
When one system is activated, the other decreases activities.
Sympathetic nervous system:
Starts in the middle part of the spinal cord
The first neuron off the soma of the spinal cord has a short axon and synapses in a ganglia
close to the spinal cord. The second neuron has a longer axon that then goes toward the desired
target i.e. a tissue that contains smooth, cardiac muscle, gland cells
The chain of ganglia coming out of the first, short axons off the spinal cord is called the
sympathetic chain.
ORGAN SYSTEMS 5
Sympathetic nerves originate in the center of the spinal cord and have a short axon to the
synapse of another neuron. From there, there is a long axon to the target neuron.
Parasympathetic nervous system:
Starts either in the brain stem or at the bottom of the spinal cord
First neuron sends a long axon out to synapse in a ganglion at a lengthy distance from the first
neuron soma. The second neuron then sends a shorter axon to the target cell.
The parasympathetic nerves originate in the brainstem or at the bottom of the spinal cord.
Parasympathetic nerves have long axons to the synapse of another neuron, then a short axon to
the target neuron.
Functions of sympathetic nervous system: Fight or flight
causes changes that will help us fight or run away when threatened
Functions of parasympathetic nervous system: Rest and digest
causes changes more important for homeostasis
Consider the blood flow to the the gastrointestinal system, which plays a big role in the amount of
digestion that can happen and the amount of blood available for other muscles.
When the sympathetic nervous system fight or flight is activated, blood flow to the intestines is
decreased and redirected towards skeletal muscle
Most of the time, though, when youre in a non-threatening situation and can rest and digest, the
parasympathetic nervous system is activated which diverts blood away from skeletal muscle and
brings it towards the intestines to help you digest food.
Consider the heart output, or how much blood is pumped out in a give time period:
When sympathetic nervous system is activated, heart output is increased to increased blood
availability for skeletal muscle.
When parasympathetic nervous system is activated, heart output is decreased because you dont
need as much blood flow to the rest of the muscles if youre not using them.
These examples of blood flow involve the activity of smooth muscle, which makes up blood vessels,
and cardiac muscle, which obviously affects the heart.
Consider the glands:
When sympathetic nervous system is activated, sweat glands are activated this cools us down
and allows us to move faster and farther.
When the parasympathetic nervous system is activated, salivary glands are activated helps us
digest food.
Most of the things the SNS does increases the ability of the body to turn stored energy into movement!
Whereas most of the paraSNS activities allows us to conserve energy and digest food.
Autonomic neurons also play a role in changing pupil size of the eyes, in sexual functions, and more.

GRAY AND WHITE MATTER GREY = SOMA; WHITE = AXONS

In the CNS, which is mostly the brain and spinal cord, gray matter contains most of the neuron
somas, and white matter contains most of the myelinated axons.
Looking at different cross-sections of the spinal cord, we see that most of the gray matter (butterfly or
H-shape) is on the inside of the spinal cord, and most of the white matter is on the outside.
Looking at cross sections of the brain, we see that gray matter is mostly on the outside of the brain!
This is called cortex. The gray matter over the cerebrum is thus called the cerebral cortex, while gray
matter on the cerebellum is called cerebellar cortex. Most of the neuron somas are here.
Most of the white matter of the brain is on the inside of the brain, under the cerebral cortex.
There are some other areas deep in the brain that have also gray matter, which we call nuclei.
ORGAN SYSTEMS 6
In the white matter of the CNS are collections of axons that travel together through the CNS; we call
them tracts. (One tract can have many axons in it, often carrying similar sorts of information from one
part of the CNS to another part).
In addition to neurons involved in motor, sensory, and automatic functions, the CNS also has many
neurons participating in higher functions of consciousness, cognition, and emotion. These take place
particularly in the cerebral cortex.

UPPER MOTOR NEURONS

Recall, the LMNs have their somas in the brain or spinal cord and they send nerves out to skeletal
muscles. LMNs that pass through spinal nerves primarily control cells in the limbs and trunk, while
LMNs that pass through cranial nerves primarily control cells in the head and neck.
Turns out that while the LMNs control what muscles contract and when, the Upper Motor Neurons
(UMNs) control the lower motor neurons!
Somas of the UMNs are found mainly in the cerebral cortex (gray matter over cerebrum), and their
axons descend down to synapse on LMNs in the brain stem or the spinal cord, depending on tract.
Lets think about a LMN at the top of a spinal cord on the left side. The soma will be in the spinal
cord, and send an axon out into the muscles. The UMN that controls this LMN will start in the cerebral
cortex on the opposite side, and send its axon down through the deep white matter, and into the brain
stem (through the midbrain, pons, and medulla). Where the brain stem meets the spinal cord, most of
these axons will cross over to the other side and travel down the appropriate left side until they reach
the LMN to synapse on it and control it.
We call this the corticospinal tract.
The left side of the brain controls, for the most part, the right side of the body.
Because of the crossover, we see that if theres dysfunction of a tract at the spinal cord site, there
will be weakness on that same side of the body. If, however, theres dysfunction in a neuron at the
site of the cerebral cortex, there will be weakness on the opposite side of the body.
Ex of LMN in the brain stem one extends to each side of the head or neck. To reach these, some
UMNs start in the cerebral cortex and send an axon down in a similar way as the corticospinal tract
and they will similarly cross over and affect the LMN on the other side of the brain stem. We also see,
however, that some UMNs will travel down to affect an LMN on the same side of the brain stem.
We call this the corticobulbar tract. It includes UMN axons that innervate LMNs in brain stem.
We can get different patterns of weakness with abnormalities of this tract.. more on that later.
Dysfunction in either the UMNs or the LMNs can cause weakness.
Upper Motor Neuron signs can occur with or without weakness. These signs can help us understand, if
a patient does have weakness, whether the problem is in the upper or lower motor neurons.
Hyperreflexia an increase in the muscle stretch reflexes (opposite of LMN sign hyporreflexia).
Would cause a patient to have an exaggerated response to a knee tap.
Cause of hyperreflexia is not known. But apparently when muscle spindles (receptors in
skeletal muscle which are activated and their info is carried back by somatosensory receptors to
elicit a response by UMNs), are not periodically stimulated by the UMNs, the LMNs may
become super sensitive. This may mean a normal signal from a UMN causes an LMN to have
an exaggerated reflex.
Clonus rhythmic contraction of antagonist muscles, which have an opposite effect on a joint.
ex: Antagonist muscles in the front of your shin cause you to pull your foot up, while the
counter muscles in the back of the leg cause you to push your foot down (like a gas pedal). If a
doctor grabs the foot of a patient who has UMN dysfunction and rapidly pulls it upward, the
foot may go into this involuntary movement (clonus) where it starts going up and down and up
and down over and over.
ORGAN SYSTEMS 7
The cause of clonus is likely just hyperreflexia each time the foot goes one way the muscles
on the other side are stretched; and the muscles end up triggering each other
The involuntary rhythmic contraction of antagonist muscles is known as clonus and is a sign of
upper motor neuron dysfunction.

Hypertonia Increased tone (resistance) of skeletal muscles (opposite of LMN sign hypotonia).
This can cause muscle spasms, different from the fasciculation of LMN degeneration.
Muscle spasticity is a feature of hypertonia, or increased tone of skeletal muscle, and is an upper
motor neuron sign.
Extensor Plantar Response (aka Babinski sign) If you take a hard object and scrape along the
bottom of the foot, the normal plantar response is flexor, to have the toes curl down towards the
bottom of the foot. If a person has UMN dysfunction and you do this to them, though, the foot will
respond with extensor, meaning the toes will extend away from the bottom of the foot. The
extensor plantar response (or babinski reflex) is a sign of upper motor neuron dysfunction and can be
seen when a noxious stimuli is placed on the bottom of the foot, causing the toes to go into extension
away from the bottom of the foot, rather than flexing down in the direction of the bottom of the foot.

SOMATOSENSORY TRACTS
Somatosensory tracks are groups of axons that carry information about the environment back to CNS.
Recall, the different types of somatosensory information tend to travel in different pathways:
Position sense, Vibration sense, and fine touch sense these signals travel in large diameter,
heavily myelinated axons. Fast response.
Pain sense, Temperature, and Gross, or less precise, touch sense these signals travel in smaller
diameter, thinly myelinated (if at all) axons. Slower response.
Somatosensory info from most of the body travels to CNS through (afferent) nerves in the PNS and
then through spinal nerves that enter the spinal cord and deliver that info.
Somatosensory info from the face will usually travel into the brainstem through cranial nerves.
What happens once the info is delivered into the brainstem or spinal cord?
For the somatosensory pain, temperature, and gross touch info Inside the spinal cord, neural
axons carry that information up to the brain in one of the somatosensory tracts thats specific to
that type of sensation.
If, e.g. a noxious stimuli is experienced on the left side of the body, an axon will carry that pain
sensation across to the right side of the spinal cord, and then up through the brain stem until it
comes to a place deep down in the cerebrum. It enters the cerebral hemisphere on the other side
from the part of the body where the receptor is on.
The same is true for the somatosensations of the other category (position, vibration, fine touch),
although their axons cross to the other side a little further up the body in the brain stem (instead of
in the spinal cord)
Pain, temp, gross touch, etc. sensations from receptors in the face (and some other parts of the head)
can come into the brainstem through cranial nerves that will travel through axons that go down first,
and then cross and then go up to about the same place in the cerebral hemisphere that the info from the
rest of the body came from.
This tract is also the case for position, vibration, and fine touch. They come into the brain stem
from cranial nerves, go down first and then cross and then go up to about the same place.
In this place deep in the cerebral hemisphere, all these different types of somatosensory information
come back together and stay close to each other as they send that information on to areas of the
cerebral cortex that will do more processing of the information.
Because these somatosensory tracts have this sort of anatomy, if theres an injury or disease to one side
of the brains hemisphere, the other side of the body can have somatosensory loss.
ORGAN SYSTEMS 8

CEREBELLUM
Recall, the cerebellum is behind the brainstem, underneath the cerebrum. It is also divided into left and
right hemispheres, and has many different functions.
Cerebellum is most notable for coordinating movement; it smooths moves out & increases accuracy.
Three parts to how information travels into and out of the cerebellum to let it coordinate movement:
Motor Plan this involves which muscles need to contract and at what intensity and duration.
While the movement is actually being executed by UMN through LMN, information about the
motor plan is delivered from the cerebrum to the cerebellum, as well.
Position Sense Muscle spindles, e.g. will send info through somatosensory neurons. Once it
enters brain stem and cerebellum, the latter can tell if its going according to plan or if corrections
are necessary. Usually that is the case, it needs some sort of correction to make the movement
match the motor plan, so the cerebellum needs to send feedback..
Feedback After receiving info about the position sense, the cerebellum may send feedback
back to the motor areas of the cerebrum, the areas that came up with the motor plan in the first
place, to try and correct the movement while its occurring by changing activity of the UMN.
Note: cerebellum is set up such that the middle of the cerebellum tends to coordinate movement of the
middle body, most notably walking. The part of the cerebellum more on the side is more involved in
movement of the limbs. Many parts of the cerebellum also coordinate movements of speech and of our
eyes.

BRAINSTEM
Brainstem basically connects all parts of the nervous system: the cerebrum, cerebellum, and spinal
cord. It also connects all the cranial nerves.
Inside of the brain stem has some similarities to the spinal cord, particularly in the medulla. Most of
the white matter is on the outside and most of the gray matter is on the inside, but its more mixed than
in the spinal cord.
Much of the brain stem gray matter are sort of distributed or scattered neurons not in distinct
groups or bundles. This is the reticular formation of the brain stem. It plays an important role in
many autonomic functions, such as circulation, respiration, and digestion.
Reticular formation also sends lots of axons up to the cerebrum and it plays a role in some of the
higher functions, as well, including cognition, emotion, and consciousness.
A lot of the white matter passing through the brain stem is actually connecting different parts of the
nervous system. Long tracts are collections of axons that often connect the cerebrum to the spinal cord.
Two big categories of long tracts to which the brain stem plays host:
Upper Motor Neuons (important for movement)
Somatosensory
Most of the 12 pairs of cranial nerves humans have are attached to the brain stem.
These nerves perform motor functions, sensory functions (many different kinds of sense functions),
and a number of automatic functions.
These nerves are related to a lot of the gray matter inside the brain stem. In addition to the reticular
formation, there are collections of neuron somas that are distinct nuclei. Cranial nerves often carry
info into or away from these nuclei. ex: nuclei have neuron somas and axons leave the brain
stem through cranial nerves to perform motor functions.
Cranial nerves mostly perform their functions in the head and neck, but there are a few that travel
down the brainstem all the way to the body and perform functions in the trunk and limbs
Ex of cranial nerve functions: sensation of the face, movements of the eyes / face / jaw / throat,
influence the heart and intestines.
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SUBCORTICAL CEREBRUM
This is the deep part of the cerebrum, under the cortex of gray matter. Deep white
matter and deep gray matter (which are called nuclei) are subcortical
Lots of white matter deep in the cerebrum, which contains axons going from cerebral
cortex gray matter and/or from deeper nuclei and/or to and from the brainstem
Internal capsule (pink) - subcortical band of white matter, shaped like a V (if looking
top-down). Contains corticospinal tract of UMN.
Basal ganglia (blue) collection of subcortical nuclei that function
together; play a major role in motor functions. (They dont contain UMN
themselves but help out the motor areas of cerebral cortex). Also
contributes to cognition and emotion.
Corpus callosum (purple) band of white matter connecting left and
right hemisphere, allows info to travel across them.
Thalamus (Diencephalon) (yellow) Under the corpus callosum.
Plays an important role in sensory functions. Almost all the senses have
pathways that travel to the thalamus for sensory processing and then
travel further on to areas of the cerebral cortex.
Thalamus is also very important for all higher functions of the brain (cognition, emotion, and
consciousness) bc it is connected to many brain areas and plays a role in passing info around
between them and other areas / subcortical structures.
Hypothalamus (green) Under the thalamus. It is connected to and controls the pituitary gland
(circled in green), aka the master gland that links nervous and endocrine systems and plays a major
role in controlling glands. The hypothalamus is also involved in higher functions.

CEREBRAL CORTEX
Cerebral cortex is layer of gray matter on outside of the cerebrum. It has many ridges called gyri
(sing: gyrus), and small grooves on either side of a gyrus called sulci (sing: sulcus).
Large grooves separating lobes are called fissures.
Cerebral cortex is divided into lobes, named for the bones of the
skull right above them.
Frontal logic and decision making
Parietal proprioception and sensory
Temporal language and memory, olfactory, auditory
Occipital vision
A few senses and motor functions of cerebral cortex on one side of
the brain tend to be involved with the other side of the body.
Visual information coming in on the right side of a body will be
processed on the left side of the brain (in the occipital lobe),
and vice versa
Somatosensory information, such as a hot or cold something applied to the skin on the right side,
will end up being processed and brought to consciousness in the parietal cortex
Motor functions for, e.g., the right leg will be processed on the left side of the brain (specifically,
the back part of the frontal lobe).
Other senses (besides vision and somatosensation) tend to get processed in areas of the cerebral cortex
on both sides
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We can divide the areas of the cerebral cortex based on the function of that area:
Primary cortex: performs basic motor or sensory functions
Association cortex: associates different types of info to do more complex processing and
functions.
ex: For areas of motor cortex, theres primary motor cortex/cortices that do basic motor functions,
and then association motor cortices do more complex functions like planning of movements. Some
areas of association motor cortices take in different types of information and integrate / process it
to do higher level complex motor or sensory functions, and to produce higher functions of the
nervous system such as cognition and emotion.
One aspect of cognition is language (ability to turn thoughts into words), performed by certain areas of
cerebral cortex in left hemisphere.
Cerebral cortex on both sides plays a role in attention but, for most people, the right cerebral
hemispheres cortex plays a role in paying attention to both sides of the body and the environment.
(The left hemisphere just seems to pay more attention to the right side of the body).

NEUROTRANSMITTER ANATOMY
Recall, neurotransmitters are molecules that communicate between neurons and their target cells at
chemical synapses.
Some neurotransmitters are released by neurons that are distributed throughout the nervous system.
Ex: glutamate (most common excitatory neurotransmitter), GABA (inhibitory, in the
brain), and glycine (inhibitory, in spinal cord)
Other neurotransmitters are more specific to certain areas.
Areas of the brain that have collections of neurons send axons diffusely to release specific
neurotransmitters into the cerebral cortex. (Also other areas, but mostly that)
These widespread projections coming up towards the cerebral cortex dump lots of a specific
neurotransmitter all over certain areas of the cerebral cortex; and theyre very important for
functions of the higher nervous system (i.e. cognition, emotion, and consciousness).
Glutamate Some particular areas in the reticular formation of the brain stem and parts of the
thalamus that project axons diffusely to cerebral cortex and release glutamate all over cerebral cortex.
Reticular activating system = collection of neurons that have diffuse projection of glutamate
Without this system, there is no consciousness
Acetylcholine The basalis and septal nuclei send diffuse projections of acetylcholine all over the
cerebral cortex. [affects peripheral nervous system.]
Lower motor neurons that come out of CNS and have axons that synapse on skeletal muscle cells
release acetylcholine
Most neurons of the autonomic nervous system also release acetylcholine, a smaller number release
norepinephrine as their neurotransmitter.
Histamine There are a number of neurons in the hypothalamus that send projections to release
histamine all over the cerebral cortex.
Norepinephrine The local ceuruleus is an area in the pons section of the brainstem that sends
neurons releasing norepinephrine all over the cerebral cortex. [affects peripheral nervous system]
Most neurons of the autonomic nervous system also release acetylcholine, a smaller number
release norepinephrine as their neurotransmitter.
Serotonin A number of raphe nuclei are present at all levels of the brain stem (midbrain, pons
and medulla) that release serotonin up to cortex and other parts of the immune system.
Dopamine The ventral tegmental area is in the midbrain, and it diffusely projects dopamine onto
the cortex. [affects central nervous system]
ORGAN SYSTEMS 11
There are also a couple of projection systems of dopamine that arent into the cerebral cortex but
that are important for functions of the central nervous system, and can become problems for
medications that affect dopamine neurotransmission.
One such collection of neurons in the midbrain is called the substantia nigra, and its projecting
dopamine to another part of the basal ganglia (specifically to a couple of nuclei deep in the cerebral
hemisphere) called the striatum.
Problems with this system of dopamine getting from substantia nigra to the striatum appear to
be a big part of what happens in Parkinsons disease.
There are also dopaminergic neurons in the hypothalamus that send dopamine down to the pituitary
gland to control the release of prolactin.
All these diffuse projection systems are very important to the higher functions of the nervous system.
Many psychiatric disorders appear to involve dysfunction of these neurotransmitter systems and thus,
many psychiatric drugs influence these systems.

Dopamine is released from the ventral tegmentum (also known as the ventral tegmental area) to the limbic system
through the nucleus accumbens. Dopamine is released from the substantia nigra to the striatum. Dopamine is released
from the hypothalamus to the pituitary gland.

One specific type of antidepressant medication works by blocking the removal of neurotransmitters. Which of the
following neurotransmitters is most likely the target of the antidepressant medication?
The neurotransmitter must be classified as one of the types that is associated with attention, cognition, and
emotion.
The medication works by blocking the removal of the neurotransmitter; acetylcholine is not removed from the
receptor, but is broken down by enzymes.
Selective Serotonin Reuptake Inhibitors (SSRIs) function by blocking the reuptake of serotonin, which
allows more serotonin to be present.

EARLY METHODS OF STUDYING THE BRAIN

Old study of phrenology thought brain areas were divided into different tasks / characteristics, and this
created bumps on the skull. By studying bumps, they thought they could learn about a person. Wrong.
Autopsies told scientists a lot about different structures of the brain, but was limited in that it cant
show how the brain functions or controls the body.
Wait until someone has some kind of brain injury and then study the effect it has on the
Ex: Phineas Gage in 1848 got a metal rod from the railroad through his head but survived!
Actually walked away from the accident despite losing brain matter and lots of blood. However,
the injury completely changed his personality (for the worse).
Scientists learned cerebral localization from these types of studies the idea that specific areas
of the brain control specific aspects of behavior and emotion, even personality.
We didnt have much control over these types of studies though. Because strokes / accidents typically
cause a lot of damage, its hard to tell what area is responsible for what behavioral change. But there
are some areas around it.
Paul Broca studied a patient he called tan who lost the ability to speak (except for that word), yet
didnt seem to suffer any other type of mental impairment. When the patient died, Broca discovered he
ORGAN SYSTEMS 12
had damage in a very particular part of the left frontal lobe. Broca then studied autopsied brains for
a number of patients with speech impairment and while the type of damage varied, it was all in this
particular region. He discovered this area must be involved in speech production.
We now call this region in the left frontal lobe Brocas area,
Aphasia = loss of ability to understand or express speech.
Brocas aphasia = trouble with speech production because of damage to Brocas area.
Problem with these methods is the long time span (waiting until someone dies means they may outlive
doctor, may sustain other brain injuries by then, may lose touch with doctor, etc) and the lack of
control over the types of injuries / damage done.

LESION STUDIES AND EXPERIMENTAL ABLATION

Ablation studies method of deliberately destroying tissues (making lesions) in order to see what
effect this will have on an animalss behavior. (This research obviously not done with humans.)
Functions that can no longer be performed after the damage must be the ones that were controlled
by those damaged regions.
Different methods of creating lesions:
Surgical removal, with a scalpel or aspiration (literally sucking out brain tissue).
This is limited in that it can only remove structures on the surface of the brain.
Also, scientists arent always interested in actually removing tissue, but instead damaging the
tissue in place (e.g. through the following methods less invasive)
Severing the nerve with a scalpel inhibits signals from the nerves so it cant do its job
Radio frequency lesions can destroy tissue both on the surface and deep inside
A wire thats insulated except at the very tip, is inserted to a pre-determined area in the brain. Then
a high frequency current is passed through the wire, which heats up and destroys tissue just around
the wires tip.
This allows scientists to vary the intensity and duration of current to control size of resulting
lesion. However, it destroys everything in the area not just the cell bodies of neurons in that
area, but also the axons of other neurons just passing through. Hard to determine which is
responsible for any behavior change.
Neurochemical lesions very precise, and can be created through many different methods, including
excitotoxic lesions Excitotoxins are chemicals that bind to glutamate receptors and cause such an
influx of Ca2+ ions that it kills the neuron, essentially exciting it to death.
Ex: kainic acid. This method destroys cell bodies of neurons but not those of axons passing by, so
you dont need to worry about severing connections like in radio frequency lesions or knife cuts.
Ex: Oxidopamine (6-hydroxydopamine) selectively destroys dopaminergic neurons (release
dopamine) and noradrenergic neurons (release norepinephine or adrenaline).
Say you have a presynaptic cell thats releasing dopamine to the synaptic cleft between cells.
After dopamine binds with post-synaptic cell, the body wants to get rid of it or recycle it. It
does this through re-uptake, where basically a little vacuum on the pre-synaptic cell sucks all
the neurotransmitter back in. Oxidopamine looks a lot like dopamine, so when released into an
area, its also taken up by re-uptake channels.. then it kills those cells.
This is extremely useful because it gives us a lot of control, allowing us to destroy cell bodies
(not axons) and to target specific populations of neurons in specific areas of the brain.
Ex: researchers use this to model Parkinsons disease in lab animals (by targeting and
destroying neurons in substantia nigra)
ORGAN SYSTEMS 13
Cortical cooling (cryogenic blockade) cools down neurons until they stop firing / functions. Can
be done many different ways, including with use of a cryoloop. This device is surgically implanted
between skull and brain, and then a chilled liquid is circulated through the loop.
Unlike other ablation techniques mentioned thus far, this is reversible!!
Temporary lesions can also be created through neurochemical means
Ex: A drug called muscimol temporarily binds with GABA receptors and winds up temporarily
inhibiting those neurons so they cant fire.

MODERN WAYS OF STUDYING THE BRAIN

Can be divided into two types of studies: those that tell us structures and those that tell us function.
Structural Recording:
CAT scans or CT scans (Computerized Axial Tomography) Uses X-rays to create images of brain.
Can show us if theres a tumor or abnormal swelling in the brain.
Cant tell us what areas are active at a given time.
Magnetic Resonance Imaging (MRI) Uses radio waves to get picture of brain.
A persons head is exposed to a strong magnetic field, which aligns the atoms in their brain in a
certain direction. Then a radio wave is added to the magnetic field, which disrupts that alignment.
As the atoms then move back to realign with the magnetic field, they emit a signal. Different types
of atoms emit different signals!
This allows for a creation of a (much more) detailed picture of the brain.
Still cant tell us anything about brain function, though.
Functional Recording:
Electroencephalography (EEG) measures electrical activity generated by neurons in the brain
Done by placing electrodes on someones scalp at predetermined positions (usually by using a cap
with electrodes that are filled with a conductive gel.
Pro: non-invasive. Con: Because its non-invasive, EEGs cant really tell us anything about
specific neurons or groups of neurons; just looks at sum total electrical fields generated from the
brain.
Unlike structural methods (CT scans, MRIs), we dont get a picture of the brain- just lots of
squiggly lines that show if a person is awake/asleep or if theyre engaged in certain cognitive tasks
Magnetoencephalography (MEG) Records the magnetic fields produced by electrical currents in
the brain.
These fields are measured using SQUID (superconductive quantum interface devices).
Gives better resolution than EEG, but this method is also more rare (especially in social
sciences) It needs a much bigger and more expensive set-up.
Combined methods:
fMRI (functional MRI) gives the same structural images from the MRI, but can also look at which
structures are active.
Does this by measuring relative amounts of oxygenated / deoxygenated blood in the brain, because
neurons that are firing a lot require more oxygen than those that arent active. fMRIs thus tell us
what parts of the brain are active, what parts were using to do a certain task.
ORGAN SYSTEMS 14
Positron Emission Tomography (PET scans) On their own cant give us a detailed structure of
the brain, but are combined with CAT scans and MRIs.
Involves radioactive glucose thats injected into a person. Since active cells naturally use more
glucose because they need more energy, we can see (with CAT or MRI scans) what areas of the
brain are more active at a given point in time.
fMRI is more popular (at least in social sciences), probably because PET scans are more invasive.

Neural Cells
TYPES OF NEURAL CELLS
Two types of neural cells: neurons (aka nerve cells) and glia (aka neuroglia, glial cells).
Central nervous system = brain & spinal cord
Peripheral nervous system = nerves coming out of spinal cord
Nerves of PNS are made of neurons, glial cells, and other cells (which is why calling neurons
nerve cells is problematic)
Neurons are in both CNS and PNS, but different types of glial cells are just in one or the other.
Most neurons and glia found in the CNSs are derived from neural stem cells, while most neurons and
glia in the PNS are derived from neural crest cells.
Both types arise early in embryo development, in the ectoderm.
Most types of neurons and glia share structural features:
soma main body of cell that contains nucleus and most organelles
long processes / projections that come out of the soma and vary in number, length, thickness,
degree of branching, and terminal structures, as well as in their function.
Function of neurons is to process and transmit information. Function of glia is to support the neurons
in a variety of ways. (Even more glia than neurons.)

NEURON STRUCTURE
Neurons consist of soma and projections called neurites, which are divided into dendrites & axons.
Dendrites are short, branched projections often covered in small spines that increase their surface area
and perform other functions
Axons are longer and unbranched until it reaches its end. Might be short, or as long as 1 m or more.
The end of the axon branches to create multiple axon terminals.
Axon hillock = area where Axon leaves the soma
Axon initial segment (trigger zone) = right after hillock, the first part of the axon projection
Large axons are usually wrapped in a myelin sheath. Gaps that regularly interrupt the segments of
myelin are called nodes of Ranvier.
Axon terminals come close to the target cells (which might be another neuron, muscle cells, gland
cells, or even capillaries (if releasing hormones to bloodstream), but dont touch. This junction is
called a synapse.
Unipolar neurons have soma and one projection (and axon)
In the CNS these start as neural stem cells, which can become any cell of nervous system, and
then differentiate into (structurally similar) neuroblasts, which can only become neural cells.
Neuroblasts then migrate away from other neural stem cells to the location their soma will be
after development. They extend an axon, tipped with a growth cone, toward the target cell,
which grows by following guidance cues in the environment until it reaches the target cell.
In the PNS both the original and migrating cells are neural crest cells instead of neural stem
cells and neuroblasts
ORGAN SYSTEMS 15
Unipolar neurons are found in humans during fetal development, but not after.
Bipolar neurons have a soma, one axon, and one dendrite
Multipolar neurons have a soma, one axon, and multiple dendrites. This is most common type.
Pseudounipolar neurons have a soma, with short process coming out of soma that then divides
into two long processes going in different directions. These are axons and the one bringing information
in from the periphery is called peripheral axon, and axon bringing information into the CNS is called
central axon.
End of peripheral axon acts like dendrites do on other types of neurons. The part of the peripheral
axon near the end is the initial segment / trigger zone, and the axon terminals are at the other end of
the central axon.

Multipolar = motor neurons. motor neurons that conduct motor commands from the cortex to the spinal cord or from
the spinal cord to the muscles

Pseudo-unipolar = sensory neurons. sensory neurons that receive sensory signals from sensory organs and send
them via short axons to the central nervous system. Uni (one brain). Psuedo =PNS.

Bipolar neuron. Interneuron = . interneurons that interconnect various neurons within the brain or the spinal cord

NEURON FUNCTION
Function of neurons is to process and transmit information.
Most neurons have a resting membrane potential a stable electrical charge difference across their
membrane (more negative in the cell).
This potential is how the neuron is able to be excited and to respond to input.
Neurons receive excitatory or inhibitory input from other cells or from physical stimuli.
ORGAN SYSTEMS 16
Input info usually comes in through the dendrites, less often through soma or axon. The info from the
input is transmitted to the axon with graded potentials changes to membrane potential away from
the resting potential. These are small in size, brief, in duration, and travel short distances.
The size and duration of the graded potential is proportional to the size and duration of input.
Summation = adding together of all the excitatory and inhibitory graded potentials at any moment in
time. This summation occurs at the trigger zone, the initial axon segment, and is how neurons process
information from their input.
If the membrane potentials at the trigger zone crosses a threshold potential, information will be
fired down the axon.
Graded potentials are like a finger on the gun.. once pulled back a certain distance, information
(bullet) will be fired down the axon.
Action potential a different change in membrane potential that allows information to be fired down
the axon. These are usually large in size and brief in duration (they travel quickly), and can be
conducted down the entire length of the axon, no matter how long
Action potentials are usually the same size and duration for any particular of neuron. This is unlike
graded potentials, whose size and duration depend on size and duration of input
Action potentials travel faster down larger (bigger diameter) and more myelinated axons. When it
reaches axon terminals, information (i.e. neurotransmitters) crosses the synapse gap to target cell.
Neurotransmitters are released at axon terminal to bind to receptors on the target cell to maybe
change that target cells behavior.
Neurotransmitters are then removed from the synapse (via re-uptake channels) to reset system.
Input information that was converted to size and duration of graded potentials is converted to the
temporal pattern of firing of action potentials down the axon. This firing info is then converted to the
amount and temporal pattern of neurotransmitter release at the synapse.
Above is the general way neurons function, but there are multiple types of neurons:
Afferent / sensory neuron pseudounipolar that neuron brings info (about a stimulus) into CNS
Efferent neurons carry info away from CNS to PNS. Two main kinds of efferent neurons:
motor neurons (aka somatomotor neurons) control skeletal muscle
autonomic neurons (aka visceromotor neurons) control smooth muscle (e.g. around blood
vessels), cardiac muscle, and gland cells.
Autonomic neurons innervating the heart are responsible for releasing norepinephrine, a
neurotransmitter of the sympathetic nervous system
Most neurons of CNS arent like afferent/efferent, but are interneurons they connect other neurons
and form complex pathways for information to travel.

ASTROCYTES:
Astrocytes are star shaped glial cells in the central nervous system (come from neural stem cells)
Most common type of cell int the CNS
Have lots of highly branched processes, at the end of which are end feet.
They perform many many functions, possibly the greatest variety of functions, including the
following:
(1) Form the scaffold for the whole CNS - give structural support to other cells in brain/spinal cord.
(2) Gliosis / astrogliiosis - involved in the repair and scarring process of the brain and spinal cord
following traumatic injuries.
If theres an injury to the brain and/or spinal cord, astrocytes will divide and form more of
themselves, migrate over to site of injury, and surround it.
Their many projections then become hypertrophied and form a glial scar.
ORGAN SYSTEMS 17
(3) Homeostasis of interstitial fluid astrocytes take in or release necessary ions to keep
environment for neural cells in homeostasis.
Also release lactate (made from astrocyte glycogen) into interstitial fluid because neurons have
very little internal energy in their cells and need that for energy.
(4) Blood-brain barrier - The end-feet of astrocytes are plastered all over blood vessels of CNS.
These end-feet structures, along with components of the vessels themselves, form an effective
barrier that prevents large molecules from leaving blood to enter CNS unless they want it
(5) Clears out synapses between neurons Astrocytes place their end feet all over synapses and
clear out neurotransmitters to reset the synapse for the next signal.
(6) Influence neurons and other glia through exchanging substances.
Most common cell type in the brain.
Astrocytes have structural, metabolic, regulatory, and repair functions, and are the most
abundant cell in the brain.
Astrocytes are found in areas of brain scarring.
Astrocytes can supply lactate if the energy need arises.
Astrocytes are involved in strengthening the blood brain barrier, but do not monitor the interstitial
fluid for foreign pathogens. This is the job of the microglia.

MICROGLIA:
Derived from mesoderm, instead of the ectoderm like all the other neural cells.
Resting microglia have small soma and many highly branched processes heading out in every
direction. In this state, theyre basically just monitoring the interstitial fluid looking for inflammation
(from injury or infection). When they detect trouble, they convert to active microglia.
The active microglia are just larger and sort of blob shapes. They act like macrophages and
scavenge the CNS for plaques, damaged neurons, and infectious agents.
Microglia are the resident macrophages of the of the brain and spinal cord, and thus act as the first and
main form of active immune defense in the central nervous system. They do this by:
(1) Secreting cytotoxins If a microglia finds a foreign cell it can secrete cytotoxic substances like
reactive oxygen species that can kill a cell.
(2) Phagocytosis After macrophages kill the bacteria, it becomes debris. Microglia eat up all kinds of
debris, from foreign or from its own cell and break it all down. yum.
Note: these processes dont necessarily happen in order They could phagocytose something and
then secrete a cytotoxin.
(3) Antigen presentation After consuming debris, microglia will take a tiny pieces of it and stick
tjos antigen out on its surface for other cells (specifically those of the immune system) to see.
Ex: Lymphocytes can then recognize the antigens, and potentially increase inflammation and/or
make it more specific to whatever foreign cell the microglia has identified.
Thus microglia is both activated by inflammation and it contributes to it.
(4) other cells of the immune system through exchange of substances.
Microglia arise from monocytes, and are a part of the immune system, which arises from the
mesoderm. However, the majority of the nervous system arises from ectoderm (CNS) or neural crest cells
(PNS).
Microglia are the macrophages, or phagocytes, of the central nervous system (CNS, or the brain).
They will proliferate if there is an infection, such as bacterial meningitis.

EPENDYMAL CELLS:
These cells line the CSF-filled ventricles in the brain and the central canal of the spinal cord.
ORGAN SYSTEMS 18
Derived from neural stem cells
Ependymal cells are simple (one layer) columnar, cuboid epithelium-like cells.
The side of the ependymal cell that faces the cerebral spinal fluid has many microvilli and cilia.
Main functions:
(1) Form barrier between CSF and interstitial fluid of the tissue itself, though its a relatively leaky
area (this leakiness if helpful because it means doctors can sample it).
(2) Secrete CSF Specialized ependymal cells and capillaries form tufts in some of these brain
ventricles. This is where CSF is secreted across ependymal cells to create cerebral spinal fluid.
Ependymal cells help form the barrier that holds in and produces CSF, cerebrospinal fluid. Ependymal
cells not only help form the barrier that separates CSF from the rest of the body, but help secrete
it as well.
The brain and spinal cord are cushioned by cerebrospinal fluid (CSF), which is kept separate from blood
and lymph fluid.

OLIGODENDROCYTES:
Similar structure to astrocytes, but with fewer projections. Also in the central nervous system.
main function: produce myelin sheath in the CNS
Each oligodendrocyte has maybe a dozen projections that extend towards nearby axons of neurons.
The structure at the end of these oligodendrocyte projections is myelin sheath.
Each oligodendrocyte can produce myelin sheaths for multiple neurons (each projection makes one
segment of the sheath, but they have multiple projections)
The myelin sheath for a single neuron can come from multiple oligodendrocytes.
Myelin sheath is made mostly of a lipid, the same substance that makes up fat, of course. Its basically
the cell membrane for an axon sort of like the rubber coating on a wire.
Oligodendrocytes also influence other glial cells.
Each nerve cell can have multiple myelin sheaths, which help speed conduction. Oligodendrocytes are myelin
sheaths that wrap around nerve axons to help speed conduction.

SCHWANN CELLS:
Schwann cells are glia of the PNS, derived from neural crest cells. They come in different shapes.
Nonmyelinating Schwann cells are fairly shapeless, but have troughs on their surface. Small diameter
neurons can just sort of sit their axons in these troughs.
These types of Schwann cells provide some support for PNS axons, but dont myelinate them.
The main function of normal Schwann cells is to produce the myelin sheath for PNS neurons.
Not all peripheral neurons have a myelin sheath, but most of those with a larger diameter do. The
structure and function of these myelin segments are the same in the PNS and in the CNS, but are
produced by different cells.
Schwann cells are also different from the oligodendrocytes of the CNS in that a single Schwann cell
produces the myelin for a single segment of a single axon. Theyre not myelinating multiple neurons
like oligodendrocytes.
Almost all the cell membrane of a Schwann cell is the myelin wrapped around an axon. It has just a
little lump outside this wrapping, though, that contains the nucleus and cytoplasm for the Schwann cell
Schwann cells also influence neurons, and vice versa, through exchange of various substances.
Gangliosides are found on Schwann cells, the myelin sheath cells of the peripheral nervous
system
The majority of immune cells cannot cross the blood-brain barrier.
Conduction potential velocity increases with increased axon diameter and myelination.
ORGAN SYSTEMS 19
Multiple sclerosis is an inflammatory disease, and is characterized by an increase in antibodies and a
decrease in myelination.

Other:
Tetanus is the maximum sustained contraction of skeletal muscle cells.
Heart rate is controlled by the autonomic nervous system.
Afferent nerve fibers bring signals back to the central nervous system.
A local nerve block would be an anesthetic, as it would block sensation, but would not affect movement.
Sometimes a nerve block is used to dull tooth pain when pain medication is contra-indicated.

Neuron Membrane Potentials

NEURON RESTING POTENTIAL DESCRIPTION:
Positively charged cations are in layer all over outside of the cell membrane; negatively charged
anions are in a layer all over the inside of the cell membrane.
Well, really, there are anions and cations on both sides of the membrane but more cations on
the outside and more anions on the inside.
Outside is called 0, and difference between outside and inside is usually around -60mV
Resting potential is related to the concentration differences, or gradients, of different ions across the
membrane
Most important cations that are K+ Na+ and Ca+
Most important anions are chloride and organic anions (e.g. proteins)
Organic anions and K+ have a bigger concentration inside than outside the neuron.
Na+, Cl-, and Ca2+ have a bigger concentration outside than inside the neuron.
Each ion is therefore acted on by two forces:
Electrical potential ions will be attracted to the side with opposite charge
ex: OA- electrical force will try to drive it out of the neuron; K+ electrical force will try to
drive those ions in (because inside is more negative)
Diffusion potential ions will be attracted to the side with lower concentration
ex: OA- diffusion force has matched diffusion force with electrical force, wanting to drive it
out. K+ has opposite diffusion force to electrical force; diffusion force wants to drive it out of
cell (even though the inside is more negative.

NEURON RESTING POTENTIAL MECHANISM:

Lets consider a neuron with no resting potential its not more positive outside or more negative
inside the membrane, and all the key ions have the same [ ] inside and outside
Organic ions are created in the cell for release into the cytoplasm. As this happens, the OA- build
up in the cell, creating a small negative membrane potential, but not enough for neuron to function.
OA- ions now have electrochemical forces that make it want to leave but it cant. so there are not
further
For other ions, they can pass through the membrane (unlike OA- ions) through leak channels that
are open all the time.
ORGAN SYSTEMS 20
The Na+/K+ pump is also in the neuron membrane, and it transports 3 Na+ out and 2 K+ in. This
also makes the membrane potential more negative, and increases diffusion gradient/potential for
sodium and potassium as more K+ and less Na+ is inside the cell
The concentration changed inside the cell but not outside because the extracellular fluid is
huge, with tons of ions such that any movement into it is negligible.
For K+, at typical neuron ion concentrations its diffusion force is bigger than smaller electrical force,
causing a net movement of K+ out through the leak channels. As they leave, it makes the membrane
potential more negative; until equilibrium is reached with K+ ions. This typically occurs around -70
mV which is more than enough for the neuron to function.
Equilibrium potential / reversible potential = the membrane potential at which there is no net
movement of ions across the membrane.
Doesnt actually take much for this equilibrium potential to be reached with K+ (maybe 1% of all
K+ ions in the cell have to leave), but it does take some time for them to get through leak channels
For Na+, at typical neuron ion concentrations, Na+ diffusion force and electrical force drive Na+ into
the cell. If we had a cell that was only permeable to Na+, it would be driven into the cell to the extent
that the membrane potential would switch to positive.
It would have to be quite positive inside the neuron for the electrical force to balance this diffusion
force. Equilibrium potential of sodium is ~ +50 mV.
Without input, when membrane is at rest, the permeability of the membrane to sodium is much less
than permeability to potassium.. It does affect potential a little bit through, so the equilibrium
potential is around -60 mV instead of the -70 it would be with just potassium.
For a cell whose membrane is permeable to multiple ions with electrochemical driving forces, the
overall resting membrane potential is a weighted average of those ions equilibrium potentials.
(weighted by permeability).
The resting membrane usually has an intermediate permeability to Cl- ions. In contrast to Na+ and K+
whose concentration gradients determine resting membrane potential, the resting membrane potential
determines the concentration gradient of Cl- ions. Membrane potential drives Cl- out of the ions until
the concentration gradient is big enough to balance it.
So normally theres a very small concentration of Cl- inside the cell compared to outside.
One way chloride is driven out is by the Cl-/K+ symporter, drives Cl- out by harnessing K+ ions
diffusion force to leave the cell.
Because of this, equilibrium conc. for chloride is slightly less than resting potential, usually -
70mV.. this is usually negligible for overall resting potential, though.
Ca2+ is also driven out of the cell so that theres a small concentration of Ca2+ ions inside compared
to outside. One way this is down is by the Ca2+/Na2+ exchanger, which harnesses the electrical and
diffusion forces acting on Na+ (to bring Na+ in the cell) in order to pump Ca2+ out of the cell.
This creates strong electrical and chemical gradients for Ca2+ that want to drive it into the cell.
Equilibrium force of Ca2+ is ~ +120mV, very high, but permeability is very low, so it doesnt
really have an effect on resting potential.

A neuron at rest (or resting potential) has a stable separation of charges across the membrane.
At resting potential, there are more positive charges on the layer directly outside of the membrane, and more negative
charges on the inside of the membrane.
This separation of charges refers to polarization. The membrane potential of a neuron at rest is slightly negative, thus
it is polarized.

NEURON GRADED POTENTIAL DESCRIPTION:

ORGAN SYSTEMS 21
Graded potentials occur in response to input.
Resting neurons have a stable charge separation across entire membrane, where a layer of cations is on
the outside of the membrane (0) and a layer of anions is on the inside of the membrane (~ -60 mV)
These potentials can be graphed as time vs. potential.
Inputs from certain types of stimuli may increase or decrease the membrane potential for a brief period
of time before it goes back to the resting potential these are graded potentials
Tend to occur in the dendrites and soma of the neuron
Size and duration of graded potential is determined by size and duration of the inputs
Most graded potentials don't pass into the axons of neurons but instead most axons have a different
membrane potential change called the axon potential.
Axon potentials start at the trigger zone and occur when the combined effect (summation) of the
graded potentials brings the membrane potential of this trigger zone (the initial part of the axon)
across a certain value called the threshold potential.
Threshold potential varies between neurons (but a common one is around -50 mV)
Summation at the trigger zone is how neurons process information from their inputs.
Most neurons respond to inputs from other neurons in the form of neurotransmitter molecules released
at synapses. Neurotransmitters then bind to receptors on other neuron to produce a graded potential
called synaptic potentials.
Depending on the neurotransmitter and receptor, it could be an excitatory or inhibitory input.
Other neurons (and neuron-like cells) may also generate graded potentials from physical stimuli, such
a slight or odorant molecules. These are receptor potentials.
Depolarization / excitatory potentials = a graded potential that moves the membrane potential closer
to zero (less negative). This moves it closer to the threshold, increasing likelihood of response.
Hyperpolarization / inhibitory potential = graded potential that moves the membrane potential
further away from the threshold, or in the more negative direction. Increases charge separation of the
membrane, and decreases likelihood of an axon potential starting.
Graded potentials decay with time and distance, such that their effect is brief and localized.
The closer the potential is to the trigger zone, the greater likelihood there will be of it inducing an
action potential.
Therefore a synapse thats closer to the trigger zone will have a greater influence on the behavior
of the neuron
Temporal Summation:
If two depolarizations happen slightly separated from one another, they wont have any effect.
But if two happen right around the same time, we get an added effect called a temporal summation
that could produce a depolarization twice the size.
Spatial Summation:
As graded potentials spread from the dendrites that accepted the neurotransmitters across the soma,
they also decay.. so by the time the potential reaches the trigger zone it may not have much of an
effect.
If two graded potentials happen sort of far away from each other, they might not have any effect.
But if two graded potentials occur close to each other on the membrane, it could cause spatial
summation so you get a depolarization twice the size.
If you have excitatory input and inhibitory input at the same time and sort of the same place, they may
cancel each other out
Synaptic potentials tend to be quite small, < 1mV in size. So neurons require the temporal and spatial
summation of 10 synapses or more to reach threshold and have an effect.

Electrical synapses do not have a gap between the neuron and target cell - the cells are physically connected.
ORGAN SYSTEMS 22
Chemical synapses have a gap between the neuron and target to facilitate communication.
electrical synapses have very different mechanisms to relay information from the neuron to the target cell.

NEURON GRADED POTENTIAL MECHANISM:

Neurotransmitter receptors are found at synapses and are what the neurotransmitters released from
other neurons bind to.
Many neurotransmitter receptors are a type of ligand gated ion channel
The graded potential produced depends on:
What kind of ions pass into membrane (some channels allow just one type in, others allow
multiple)
How many channels are opened (depends on amount of neurotransmitter released into synapse and
how long it stays in the synapse)
If a channel opens that is selective for only one type of ion, the membrane permeability for that ion is
increased, which causes the membrane potential for that ion to change around that synapse.
If Na+ or Ca2+ channels cause a depolarization or excitatory potential, because the cations flow into
the neuron and bring positive ions into the more negative internal environment of the cell.
Force of diffusion and electrical difference drives it in.
Na+ channel is most common type of depolarization channel.
If Cl- channel, hyperpolarization usually occurs because it flows into the cell and makes it more
negative. (This is most common type of inhibitory channel.)
Force of diffusion ([ ] outside cell much bigger than in) overcomes the electrical force to drive
Cl ions in.
K channels also cause hyperpolarization because its larger diffusion overcomes small electrical
+

force to drive it out of the cell once the channel if opened, which again makes the internal
membrane more negative
When a neurotransmitter, such as Na+, binds to the receptor and allows, for example, Na+ inside, there
will be a small cluster of Na+ ions around that channel that causes membrane potential there to
increase.
It doesnt just continue increasing, though, because the neurotransmitter leaves and the ion channel
closes again. This causes the graded potential to plateau.
Why do they decay? The Na+ ions diffuse throughout the cell (because of electrical and chemical
diffusion) and the depolarization decreases. Eventually that piece of the membrane goes back to its
resting potential.

The sodium-potassium pump pulls potassium ions in and moves sodium ions out of the cell.
Because potassium is positively charged and the inside of the cell is negatively charged, the electrical gradient tends
to pull potassium in, not out.
When a membrane is at rest, sodium ions or more concentrated outside of the neuron; potassium ions are
more concentrated inside. Concentration gradients move potassium ions out of the cell.
negative sign on a resting potential signifies a relative difference in charge, not an absolute difference.
Potassium cation is found in greatest concentration inside a neuron in the resting state
At the resting potential, negatively charged ions will feel an electrical force pushing them out of the neuron,

Graded potentials cause action potentials.

The size of a graded potential must reach a certain threshold in order to cause an action potential.
ORGAN SYSTEMS 23
The size of the action potential is independent of the size of the graded potential (this is known as the all-or-nothing
rule). Amplitude doesnt change.
The best-fit line of the results most likely has the equation y = c.

Difference between action and graded potential:

All potentials are determined by the flow of charged molecules across the neuron membrane.
The difference between graded potentials and action potentials first and foremost has to do with where they occur.
Action potentials occur in axons, while graded potentials occur in the dendrites and soma.

NEURON ACTION POTENTIAL DESCRIPTION:

Multiple excitatory / depolarizing potentials are needed with temporal and spacial summation to push
the membrane of the trigger zone over its threshold potential. When this happens (often around -50
mV), an action potential well be conducted down the whole axon.
Axon potentials are unlike graded potentials in that theyre the same size for a given neuron (though
total size my vary between neurons), and that theyre unchanged (dont degrade) as they go down the
axon, no matter how long it is.
Shape of an action potential is fairly characteristic:
After graded potentials reach threshold potential, action potential begins with a rising phase that
depolarizes the membrane so much the charge inside the cell membrane is positive, ~ +40mV
Small plateau
Rapid falling phase that goes even more negative than normal resting potential, to ~ -70 mV
Slowly settles back up to resting potential of ~ -60 mV
All-or-none property of an action potential you either get one or you dont (b/c size doesnt vary
for a particular neuron. Doesnt matter how far over the threshold a graded potential gets, will cause
the same size action potential)
Duration of action potential is also pretty consistent for any particular neuron.
(Graded potentials have a wider range of duration depending on the duration of their inputs.)
Speed at which action potentials are conducted can be very fast (1 - 100 m/s).
Faster speeds usually happen in larger-diameter and more myelinated axons.
Saltatory conduction peed of an action potential down a myelinated axon is not consistent it is
conducted faster at the myelinated segments than through the nodes of Ranvier.

NEURON ACTION POTENTIAL MECHANISM:

The membranes of axons have leak channels and voltage-gated channels (which open when the
membrane potential crosses a certain threshold potential)
Na+ channels are voltage-gated. So when a summation of graded potentials causes depolarization of
the trigger zone membrane past the threshold, Na+ flows in. This causes further depolarization at the
trigger zone membrane, which then leads to more Na+ channels opening a little further down, and this
effects cascades in a wave down the axon.
Trigger zone has greatest density of Na+ voltage gated channels, which is why the action potential
starts there.
Membrane potential dramatically rises as it tries to increase membrane potential to Na+ eq.
potential (around +50 mV). This is rising phase, and the inside of the cell membrane becomes
positive.
After the membrane potential gets depolarized to a certain extent, the Na+ voltage gated channels
close, so the membrane potential never actually reaches +50 mV, usually just to +40 mV.
ORGAN SYSTEMS 24
After they close, theyre in an inactivated state ion channels are unable to open for a certain
period of time.
After the rising phase and plateau, an exit of K+ through leak channels
and voltage gated channels causes the falling phase of the membrane
potential and it plummets to an even more negative potential (-70 mV)
than at resting state.
K+ leak channels some K+ leaves when the membrane is at rest
(without input), but after the membrane potential becomes so
positive, both electrical and diffusion force drive K+ out of the
membrane through leak channels quite quickly.
Voltage-gated K+ channels also open after membrane potential
crosses threshold, but do so more slowly than the Na+ ones.
So first, Na+ rushes in causing rising phase, then K+ voltage
channels open (and exit through leak channels increases), causing the falling phase
Once the membrane potential inside is negative again, it stops falling further because K+ leak channels
drive out K+ much slower then, and because the negative potential causes voltage gated K+ channels
to close automatically, though again a bit slower than Na+ voltage channels did at positive potential, so
the falling action extends past the resting potential for a bit until it settles back.
This extension past resting potential is called the after-hyperpolarization, or refactory period
(called refractory because its difficult or impossible to start a new action potential during this
period).
Refractory period has two parts: absolute and relative
absolute refractory period when the voltage gated Na+ channels are first closed and theyre in
an inactive state. No matter how strong a graded potential comes in, it wont trigger another action
potential.
relative refractory period when the voltage gated Na+ channels are functional again, but
membrane potential is hyper-polarized. It would take more excitatory input than normal to to cause
an action potential.
relative refractory periods can help us figure out how intense a stimulus is cells in your
retina will send signals faster in bright light than in dim light, because the trigger is stronger.
An effect of refractory period is that action potentials travel down the axon from the trigger zone, and
cant travel immediately back.
Refractory period determines the maximum frequency at which a single neuron can send action
potentials.
Movement of sodium and potassium ions across the membrane starts at trigger zone and spreads in
waves. First wave of depolarization all down the axon, then of hyperpolarization, & eventually
settling.

Resting potentials are not associated with refractory periods. Graded potentials are not associated with refractory
periods. Refractory periods (both relative and absolute) are times when a membrane is resistant to starting
another action potential.

EFFECTS OF AXON DIAMETER AND MYELINATION:

ORGAN SYSTEMS 25
Axon with larger diameter offers less resistance to ions moving down the axon (more pathways
through the cytoplasmic around other cell structures), and therefore allows action potential to be
conducted faster (because speed of action potential is related to speed of ions moving down axon).
Action potentials move faster in myelinated segments because the capacitance of the membrane is
reduced. This decreases the number of ions and the time needed to change the membrane potential in
these areas.
Capacitance (in this context) = total number of charges along the membrane, or number of ions
that can be stored in the layers on both sides of the membrane at any given potential (because
potential represents strength of the charge separation for any particular ion carrier).
The closer charges are to each other, the more charge can be stored.
At the nodes of Ranvier, an anion on the inside layer is strongly attracted to cation on opposite side; It
overcomes the repulsion of nearby like charges on either side of the membrane and thus in these nodes
(at resting potential) more cations/anions can be packed in on either side. (low capacitance)
In the myelinated segments, the membrane is essentially much thicker, so distance is much greater
between oppositely charged ions on opposite sides of the membrane and strength of that charge is
less. In myelinated segments you can thus put fewer cations/anions on either side. (high
capacitance)
This means that as an action potential comes rushing by, it is easier to depolarize the areas that are
sheathed, because there are fewer negative ions to counteract.
As our action potential travels down the membrane, sometimes ions are lost as they cross the
membrane and exit the cell. The presence of myelin makes this escape pretty much impossible, and so
it also helps to preserve the action potential.
Myelination also decreases the membrane permeability to ions, so fewer total ions cross the membrane
during an action potential. Thus fewer ions than normal need to be pumped out through Na+/K+ pump
after the action potential.
Recall that these pumps require energy, myelination actually increases the efficiency of action
potential conduction in terms of the energy needed to maintain these ion concentrations after action
potentials.
Myelinated axons have most of their voltage-gated ion channels at the nodes of Ranvier, so they can
regenerate the full size of the action potential and keep it strong all the way down the axon.
More myelin and larger = faster

Voltage-gated sodium channels are found in lower concentration towards axon terminals.
Voltage-gated sodium channels are found in greatest concentration in the trigger zones.

Reduced permeability of potassium leak channels would affect the time to reach maximum
repolarization in a neuron. (more K+ would remain inside).

In myelinated axons, action potentials only form in nodes.

Nodes that are close together might cause action potentials to slow down.
Nodes that are far apart might cause action potentials to stop.
Saltatory conduction refers to the the movement of action potentials from node to node.
Myelinated axons are axons covered with a myelin sheath.
Myelin sheaths are broken up by small nodes.
Saltatory conduction is the conduction of action potentials along myelinated axons.
ORGAN SYSTEMS 26

ACTION POTENTIAL PATTERNS:

Some neurons fire no action potentials until there is sufficient excitatory inputs. And then the size /
duration of depolarization over threshold is converted into the frequency and duration of a series, aka a
train of action potentials
Used by motor neurons that synapse on skeletal muscles.
Other neurons fire action potentials at a regular rate without any input. This happens because they have
differences in their leak channels and/or voltage-gated ion channels that spontaneously depolarize the
membrane to threshold at a regular interval.
Similar to pacemaker cells in the heart.
With these types of neurons, excitatory input will cause them to fire action potentials more
frequently when excited; and when that goes away they go back to their regular rate of firing.
Firing is slowed down during inhibition
During absence of input, some neurons fire clusters of bursts of action, pause for a bit, and then fire
more bursts.
Excitatory input can increases frequency of these bursts (and maybe increase space between them)
In the last two systems, where neuron fire regularly or in bursts, at resting potentials is that
information passed along to target cells can be fine tuned in either direction. (unlike first case, which
must be no action potential or train of action potential).
The last two systems can also pass along info in a more fine-grained fashion.
The different temporal patterns of action potentials are then converted to the amounts and temporal
patterns of neurotransmitter release at the synapse.

At the peak of an action potential, there is more sodium inside of the membrane than outside.
Resting potential is approximately -70mV.
Action potentials peak around 40mV.
Sodium equilibrium potentials are around 50mV. Thus, the membrane potential is slightly less positive than
the sodium equilibrium potential at the peak of an action potential.
Dendrites receive an action potential.
Axons transmit action potentials.

Potassium leak channels allow potassium to exit a neuron in response to depolarization.

Reduced permeability of a leak channel to its natural ion means that the rate the ions are able to cross the channel is
reduced.
Reduced permeability of potassium leak channels would affect the time to reach maximum repolarization in a
neuron.

Voltage-gated potassium channels play a central role in action potentials.

Voltage-gated sodium channels also play a central role in action potentials.
Voltage-gated calcium channels are central to the release of neurotransmitters into the synaptic cleft.

DEMYELINATION DISEASES:
Demyelination diseases degrade the myelin coating on cells.
ORGAN SYSTEMS 27
Ex: Guillain-Barre syndrome and Multiple Sclerosis.
Guillain-Barre syndrome is the destruction of Schwann cells (in the peripheral nervous system)
MS is caused by a loss of oligodendrocytes (in the brain and spinal column).
These disorders have different causes and presentations, but both involve muscle weakness and
numbness or tingling.
These symptoms occur because the nerves arent sending information the right way. When the myelin
coating of nerves degenerates, the signals are either diminished or completely destroyed.
If the nerves are afferent (sensory) fibers, the destruction of myelin leads to numbness or tingling,
because sensations arent traveling the way they should.
When efferent (motor) nerves are demyelinated, this can lead to weakness because the brain is
expending a lot of energy but is still unable to actually move the affected limbs.
Limbs are especially affected, because they have the longest nerves, and the longer the nerve, the more
myelin it has that can potentially be destroyed.

Neuronal Synapses
SYNAPSE STRUCTURE:
Recall, synapses are the junction between a neurons axon terminal(s) and the target cell.
Chemical synapses have a gap b/n the neurons axon and target. Neurotransmitters are used.
Electrical synapses are when the axon terminal and target cell are physically connected. Gap
junctions allow ions to flow between them. (These are fairly rare in humans)
A typical neuron receives up to thousands of signals from other neurons. These synapses most often
occur at the dendrites (part of the reason theyre branched is to increase surface area for synapses).
However, there can also be synapses on the soma or the axon (usually the axon terminals)
In the central nervous system, end feet of astrocytes cover most of the synapses.
Synaptic cleft = gap between axon terminal and target cell
It is bordered by the pre-synaptic membrane (of the axon terminal) and post-synaptic
membrane (of the target cell)
Just on the inside of the pre-synaptic membrane are synaptic vesicles, bubble-like structures that are
full of neurotransmitters.
The pre-synaptic axon terminal also has voltage-gated calcium channels that allow Ca2+ in.
On the post-synaptic membrane are receptors that are specific for the neurotransmitters.

NEUROTRANSMITTER RELEASE:
A protein known as complexin acts like a brake, and stop the vesicles from fusing into the membrane
and releasing their contents [remember: complexin complicates the process of vesicle fusion]
The vesicle protein synaptotagmin can bind and release complexin in the presence of calcium
As the action potential travels down the axon, positive ions continue to flood the cell. Eventually, this
influx reaches the very end of the neuron the axon terminal. When this happens, the membrane
potential of the axon terminal is depolarized.
This opens the Ca2+ to channels at the axon terminal; and calcium flows into the axon (because/c of
its diffusion gradient)
The calcium ions can then activate synaptotagmin to release the brake, and the vesicles fuse with the
cell membrane, and the vesicle contents (neurotransmitters) are released into the synaptic cleft.
Neurotransmitter then diffuses across the cleft and binds to receptors on the target cell.
An increased frequency of axon potentials reaching the terminal causes increased opening of Ca2+
voltage gated ion channels. This causes more Ca2+ to enter the cell, which means more synaptic
vesicles fuse and more neurotransmitter is released.
Increased duration of axon potential means neurotransmitter is released for a longer duration.
ORGAN SYSTEMS 28
These two things (frequency & duration) affect how much neurotransmitter is in the synaptic cleft
for how long, which in turn affects the cell it is firing on.
When the train of action potentials stops firing, voltage-gated ion channels will close, Ca2+ will stop
entering cell, and Ca2+ will start to exit via usual methods; neurotransmitter will stop being released.

Action potentials determine how much information is released into the synaptic cleft.
Action potentials also determine how long information is present in the synaptic cleft.
Action potentials open voltage gated calcium channels, which results in calcium flowing into the axon terminal.
Action potentials do not result in calcium leaving the target cell at the post synaptic membrane.

TYPES OF NEUROTRANSMITTERS:
Neurons tend to have just one type of neurotransmitter that they release, but many neurotransmitters
can bind to multiple types receptors.
Amino Acid Neurotransmitters:
Have an amino group and carboxylic acid group.
Glutamate most common excitatory neurotransmitter of the nervous system
GABA and Glycine most common inhibitory neurotransmitters of the nervous system.
GABA the most common inhibitory neurotransmitter in brain
Glycine is most common in spinal cord

Glycine is the most common inhibitory neurotransmitter in the spinal cord

Glutamate is the most common excitatory neurotransmitter in the nervous system.
Gamma-aminobutyric acid, or GABA, is the most common inhibitory neurotransmitter in the brain.

These AA neurotransmitters are involved in most processes of the nervous system
Peptide Neurotransmitters:
Peptides are polymers of amino acids; theyre much larger than other types of other neurotransmitters
One group of peptide neurotransmitters are called the opiods. (ex: endorphin)
These play a big role in our perception of pain, and thus those types of neurotransmitters are a
target for many pain meds.
Monoamine Neurotransmitters (aka biogenic amines):
Organic molecules with an amino group connected to an aromatic group by a 2-carbon chain.
Serotonin, Histamine, Dopamine, Epinephrine, and Norepinephrine
Three monoamines (dopamine, epinephrine, norepinephrine) are specifically called catecholamines;
they have a catechole group (benzene + two hydroxyl groups)
Are involved in many processes, especially in the brain; including process of consciousness, attention,
cognition and emotion
Norepinephrine in particular is released by some autonomic neurons in the PNS
Many disorders of the nervous system involve abnormalities of the monoamine transmitters; and thus
they are often a target for drugs.
Other:
Acetylcholine one of the most important nervous system that is not a monoamine or peptide.
Performs a number of functions in the brain of the CNS
In the PNS, this is released by most neurons in autonomic nervous system, and by motor neurons.
ORGAN SYSTEMS 29

TYPES OF NEUROTRANSMITTER RECEPTORS:

Combination of neurotransmitter released and receptor on post-synaptic membrane that determines
whether a signal to the target cell is excitatory or inhibitory
Many neurotransmitters can bind to multiple types of receptors; some cause excitatory response
and others cause inhibitory response.
When the target cell is another neuron, excitatory or inhibitory synapses can be scattered all over the
neuron, or there are many neurons where the dendrites receive predominately excitatory synapses and
the soma receives inhibitory synapses at the soma. And when the synapse happens on another neurons
axon terminal, theres a mix of excitatory and inhibitory synapses.
This allows fine-tuning of neuron output at multiple levels, from the dendrite to soma to the axon
terminals.
Two major types of neurotransmitter receptors:
Ionotropic ligated gated ion channels. When the ligand (neurotransmitter) binds to the receptor,
they open and let certain ions pass through.
These ionotopic receptors cause graded potentials (brief, local) when they open.
Excitatory response is usually caused in target cell if the ionotropic ion channel allows Na+ or Ca2+
in (because their positive charges cause depolarization)
Inhibitory response is usually caused in the target cell if the ionotopic ion channel allows Cl_ or K+
ions to pass. (Cl goes in to the already negative cell; K+ travels out)
Metabotropic When neurotransmitter binds, it activates second messengers inside the neuron
Second messengers can open ion channels, change protein activity, or affect gene transcription.
When metabotropic receptors are activated, the response is slower than with ionotropic ones, but
the overall effect may be larger and more widespread because of the amplification that secondary
messengers can cause.
Overall response of target cell after a metabotropic receptor binds a neurotransmitter may be brief,
or it may affect the cell permanently.

Metabotropic neurotransmitter receptors move more slowly than ionotropic neurotransmitter receptors.
Metabotropic neurotransmitter receptors move more slowly than ionotropic receptors, but their
results may be larger and more widespread.
Ionotropic neurotransmitter receptors are the type of receptor that directly allows ions to pass through the membranes.
Metabotropic neurotransmitter receptors are the type of receptor that activate a second messenger inside the neuron.

ORGAN SYSTEMS 30
NEUROTRANSMITTER REMOVAL:
As action potentials travel down axons, the information they contain is really contained in the
frequency of firing and duration of the chains of axon potentials.
When the action potential reaches the axon terminal, neurotransmitter is released to bind to receptors
on target cell. Eventually, it needs to be removed from the receptors and from the synaptic cleft:
If neurotransmitter lingers in the synaptic cleft, it will mostly continue to bind to the receptor, and
the duration of the trains of action potential signals wont be able to be transmitted.
The synapse will not be functional.
Structure of neurotransmitter may be changed before its removed, so that it is not recognized by
the receptor. Ex: acetylcholine (in motor neurons) is deactivated by acetylcholinesterase, which is
an enzyme that breaks down acetylcholine into choline and acetate.
Neurotransmitter removal can be by diffusion leftover neurotransmitter just passively diffuses out
of the synapse. This only works action potentials are firing slowly.
If action potentials are firing quickly, the rate of neurotransmitter release may be greater than the
rate at which neurotransmitters can diffuse.
Neurotransmitter removal can also be active:
(1) Enzymes break down the neurotransmitter
in the synapse into its component parts
(2) Reuptake pumps some pre-synaptic
membranes contain special active transport
channels that actively pump neurotransmitters
back into the axon, where it can be recycled &
used in future releases.
(3) Astrocyte end-feet in CNS, astrocytes
put their end feet all over synapses. The end
feet also contain pumps/channels that actively
pump the neurotransmitter out of synapse and into the astrocyte.
Sometimes the neurotransmitter will be broken down or used in the astrocyte, or parts of it may be
transferred by the astrocyte back to the axon terminal of the neuron so it can be recycled.
All these methods allow the synapse to be rapidly turned on and off, so it can convey more information
from neuron to target cell.

When the structure of a neurotransmitter is changed, it is not recognized by the receptor.

Acetylcholine is deactivated by acetylcholinesterase, which is an enzyme that breaks down acetylcholine into
choline and acetate.

NEUROPLASTICITY:
Neuroplasticity refers to how the nervous system changes in response to experience.
Nervous system is constantly changing (e.g. when we form new memories).
This involves changes in synapses and/or other parts of neurons that affect how information is
processed and transmitted int he nervous system
Potentiation increase in the strength of info flowing through a particular part of the nervous system
Each action potential has a larger effect on target cell
Happens with parts of neurons and chains of neurons that are used often; they grow stronger
Depression decrease in the strength of info flowing through a particular part of the nervous system
Each action potential has less of an effect on target cell
Happens with parts of neurons and chains of neurons that are used rarely; they grow weaker
ORGAN SYSTEMS 31
Amount of neuroplasticity is highest when the nervous system is developing (and lower afterward), but
its present throughout life. Also increases transiently in response to nervous system injury.
Synaptic neuroplasticity neuroplasticity changes that happen at the synapse
Potentiation changes from lots of activity: increase in target cell response for each action potential
For each action potential reaching the axon terminal, more neurotransmitter may be released in the
synapse, so a bigger response is seen in the target cell.
May be an increase in the number or type of membrane receptors in the post-synaptic membrane, or
in the responses that occur through second messengers so that for any given amount of
neurotransmitter released from the axon, the target cell has a bigger response because it is more
sensitive to that neurotransmitter
Seems like theres communication going from axon terminal to post-synaptic membrane and
backwards details havent been figured out yet.
Depression changes from inactivity: decrease in target cell response for each action potential
For each action potential reaching the axon terminal, less neurotransmitter may be released in the
synapse, so a lower / depressed response is seen in the target cell.
Neurotransmitter receptors may decrease in number, or change type to a less responsive receptor; or
there may be changes in the response of second messengers such that they elicit a weaker response
than they used to.
Structural neuroplasticity neuroplasticity changes that happen at the level of an entire cell, where
the total number of synapses between a neuron and its target cell are changed.
If two neurons are firing together frequently (one often stimulated by the other), we may see an
increase in the number of synapses between pre-synaptic neuron and post-synaptic neuron
Dendrites may get longer or growing more branches; dendritic tree becomes more complex
Pre-synaptic neuron may sprout more axon branches and terminals so it forms more synaptic
connections with dendritic tree.
If two neurons are not firing together very frequently, we may see a decrease in the number of
synapses between pre-synaptic neuron and post-synaptic neuron
Dendrites may get shorter or lose branches, such that the dendritic tree becomes simpler
Pre-synaptic neuron may lose some of its axon terminals.
If this neuron is not firing very often at all, we might even lose the whole neuron:
Pruning process of losing neurons or parts of neurons because theyre not very active
Potentiation and depression can happen over a wide spectrum of time.. We often categorize it into
short term changes (over the course of seconds or minutes) or long term (over months or years).
Synaptic neuroplasticity can contribute to both short term & long term potentiation and depression
Structural neuroplasticity tends to be more associated with long term potentiation and depression
By changing the strength of information flow between individual synapses or the between cells by
changing the total number of synapses, neuroplasticity plays a very important role in the development
of the nervous system as its wiring itself together based on the experience its receiving during its
formative time.
Neuroplasticity also plays a huge role in memory and learning, as well as recovery from injury to the
nervous system

Depression refers to neuroplasticity that results in activity and response growing weaker.
Potentiation refers to neuroplasticity that activity and response growing stronger.
Synaptic refers to neuroplasticity that occurs at a synapse.
Structural refers to neuroplasticity that affects whole neurons or groups of neurons.
In this example, the loss of entire neurons due to inactivity would refer to structural depression.
ORGAN SYSTEMS 32

Biosignaling
MEMBRANE RECEPTORS
Membrane receptors = integral proteins that interact with outside environment
Signaling molecules (aka ligands) such as neurotransmitters, hormones, etc. bind to the membrane receptor
(with specificity) and make a ligand-receptor complex.
This complex then triggers a response in the cell.
This process explains how hormones function, how / when cells divide, when they die, etc. Also explains
how cells communicate with each other
Membrane receptors are a common target for pharmaceutical drugs; this is why some cells can target specific
cells (like your liver or heart)
Signal transduction an extracellular signal molecule (ligand) binds to membrane receptor, which then
triggers an intracellular response
The binding causes conformational change in the protein, which induces other changes that eventually lead
to a cascade of signals in the cell, trigger a specific response.
Each receptor can only bind with specific / certain types of molecules. This is especially important in hormonal
signaling.
Used to be called lock-and-key, but induced fit is now the model, which means the ligand and receptor can
change shape to better fit one another.
Three main types of membrane receptors:
Ligand gated ion channels
G-protein coupled receptors
Enzyme linked receptors

LIGAND GATED ION CHANNELS

Also called ion channel linked receptors, these are transmembrane ion channels that open or close in
response to the binding of a ligand.
Commonly found in excitable cells like neurons, because these channels react quickly to binding of a
ligand, and thus the cells can respond quickly to a stimulus.
Only specific ligands can bind to specific channels (lock and key / induced fit)
Note that the binding site of a ligand is not in/on the actual ion channel the ligand binds to allosteric site on
the receptor, and causes opening / closing of the channel by conformational change.
The receptor allosteric binding site can also be inside the cell, but thats rare.
Its also possible for there to be multiple binding sites for ligands.
Once the ions move in or out of the cell, an intracellular electrical signal happens
Ligand gated ion channels are not the same as voltage gated ion channels.. those only depend on a
different in membrane potential, not the binding of a ligand
Ligand gated ion channels are also different from stretch activated ion channels.. which open / close
in response to deformation or stretching of the cell membrane.

Generally, ligands are not directly involved in any aspect of intracellular signaling.
ORGAN SYSTEMS 33
Ligands do not directly influence the production of cyclic AMP and do not hydrolyze GTP to GDP.
A ligand is a small molecule, usually a protein, that binds to a membrane-bound receptor, which
triggers downstream changes within the cell.
A molecule that attaches to a receptor, triggering changes within the cell is the correct answer.

Cells that respond to mechanic forces typically possess stretch-activated ion channels. An example would be a
cardiac cell.
Terminally differentiated cells comprise multiple cell types, some of which may possess ion channels, but this is
not the best choice here.
The importance of the ligand-gated ion channel is that it allows for rapid response to a stimulus, so cells that need
to respond quickly (like neurons) are those that possess ligand-gated ion channels.
Cells that need to respond quickly to external stimuli is the correct answer.
Allosteric binding is an important feature of ligand-gated ion channels.
Ligand-gated ion channels actually can have intracellular binding sites. React quickly to stimuli or ligand

G-PROTEIN COUPLED RECEPTORS

Only found in eukaryotes; are the largest class of membrane receptors. Each has a specific function
Ligands that bind to these range from light sensitive compounds to pheromones, hormones,
neurotransmitters, etc.
GCPRs can regulate immune system, growth, sense of smell / taste / behavioral / visual and our
moods. Many G-proteins and GCPRs still have unknown functions.
Most important characteristics:
GCPRs have 7 transmembrane alpha helices.
Theyre also linked to G-proteins, which have the ability to bind to GTP / GDP and be activated
G-proteins have 3 subunits: G, G, and G. G and G are attached by lipid anchors.
(1) When the ligand binds to the GCPR, it undergoes a conformational change.
(2) Because of the conformational change, the G exchanges its GDP for a GTP, becoming activated.
(3) The GTP causes the G subunit to dissociate and move away from G dimer.
(4) G subunit then goes on to regulate target proteins
(5) Target protein then relays signal via second messenger.
So target protein could be an enzyme that produces second messengers (e.g. adenylase making
cAMP), or an ion channel that lets ions be second messengers
Some G-proteins stimulate activity, others inhibit.
This chain of events, with a G protein subunit dissociating and going on to activate further response in
the cell, will happen repeatedly as long as the ligand is bound. So how do we turn it off?
(6) GTP on the G is hydrolyzed to GDP
ORGAN SYSTEMS 34
This often occurs internally, by GTPase
within the Gprotein itself, but can also
be regulated (accelerated) by RGS protein
Ex with epinephrine (aka adrenaline):
Epi binds to -adrenergic receptor (GCPR),
which causes it to undergo conformational
change and switch GDP to GTP on the G
subunit of the G-protein.
The G subunit dissociates and binds to adenylate cyclase, which then makes the secondary
messenger cAMP from AMP.
cAMP goes on to increase heart rate, dilate blood vessels, and break down glycogen > glucose

ENZYME LINKED RECEPTORS (aka catalytic receptors)

Enzyme-linked receptors are transmembrane proteins that uniquely function as receptors for signaling
molecules and enzymes binding of ligand activates enzymatic activity.
General structure includes extracellular ligand binding domain and intracellular enzymatic domain
Shaped sort of like a Y (the V part is extracellular, where ligand binds)
Most common enzyme linked receptors are tyrosine kinases (also called RTKs), which regulate cell
growth differentiation and survival; and they can bind and respond to ligands such as growth factors.
Unique because Tyrosine is on the enzymatic intracellular receptor.
RTKs have ability to transfer phosphate groups to intracellular proteins, which activates them, and
they go on to trigger additional change.
RTKs occur in pairs. When ligands bind, the RTKs come together and act together in a cross-linked
dimer. This helps activate the Tyr phosphorylation activity.

Each Tyrosine in one dimer activates a Tyrosine on the other dimer! This is cross phosphorylation.
Tyr causes an ATP > ADP + Pi
Other Tyr then pick up the free phosphate group.
Once activated, these phosphorylated Tyr allow different proteins to come by and attach
themselves to them.
The only thing these proteins need to dock is an SH2 domain, which allows them to bind.
Multiple docking of different proteins allows changes to multiple different intracellular signaling
pathways at the same time.
The cellular changes often end at nucleus, signal from docking protein affecting transcription.
ORGAN SYSTEMS 35

RTKs are useful / famous for their role in growth factors, such as in regulating surface proteins called
epinephrines, which can guide developmental processes in tissue architecture, placement of nerve
endings, and blood vessel maturation. Other growth factors (like platelet derived) and hormones (such
as insulin) also bind to RTKs.
When the RTKs fail to regulate properly, they can cause issues in cell growth and differentiation.
Many cancers involve mutations of RTKs
Many chemotherapies thus target RTKs. For example, the breast cancer drug Herceptin binds to
and inhibit an RTK that is overexpressed in many breast cancers.
RTKs are often associated with growth factors.
Endocrine System
ENDOCRINE GLAND HORMONE REVIEW
How do different parts of the body communicate with each other? Some communicate through nerves,
but not everything is connected by nerves. The endocrine system connects everything!
Endocrine system is a system of glands that secrete hormones (chemical messages) and release them
into the bloodstream so they can circulate to different parts of the body and initiate an effect.
Hypothalamus major endocrine gland in the forebrain, is about the size of a grape
As a member of the forebrain, it receives many nerve signals from the brain.
Called control center b/c it directs pituitary and plays a dual role b/n nervous & endocrine
system
In addition to stimulating the pituitary gland, the hypothalamus makes hormones:
ADH - antidiuretic hormone, mainly regulates fluid volume in our body
Oxytocin stimulates uterus to contract for females during pregnancy
note: although hypothalamus makes these, theyre stored in & secreted from posterior pituitary
Pituitary gland right below the hypothalamus, is about the size of a green pea
Called master gland because it takes signal from hypothalamus and directs it to almost all the
other endocrine glands, such that their function is ultimately dependent on the pituitary
Thyroid gland located in the neck, wraps around trachea (windpipe)
receives signal from pituitary and regulates metabolism through thyroid hormones T3
(triiodothyronine) and T4 (thyroxine); it uses these to stimulate the bodys metabolism
Parathyroid - four spots, right behind the thyroid
responsible for regulating our bodys blood calcium level. (recall: calcium is involved in muscle
contraction, bone growth, and other important, sensitive functions)
Adrenal glands located on top of the kidneys
cortex (outer part): makes adrenal cortical steroids, such as cortisol and aldosterone
ORGAN SYSTEMS 36
cortisol is a stress hormone that increases blood sugar in times of stress so we have energy;
also has anti-inflammatory functions
aldosterone is major regulator of our bodys blood volume
medulla (inner part): makes catecholamines such as epinephrine and norepinephrine, which are
involved in our bodys fight or flight response.
Gonads release sex hormones, which are mainly involved in development of secondary sex
characteristics and developmental stages associated with those characteristics (puberty, menopause)
Ovaries in females produce estrogen and progesterone; testes in male produce testosterone
Pancreas isnt as directly involved with the pituitary as other glands but still uses its hormones
(insulin and glucagon) to stimulate an effect: control of blood glucose levels.
How do hormones get to their destination organs when theres so many hormones around the body?
Hormones wont be received unless theres a specific receptor on the target cell
The receptor and its location are important in determining hormone function
Hormone classes help us identify which hormones have which functions:
autocrine hormones function at the cell that makes them
ex: T cells in the immune system secrete leukine hormones that signal the T cell itself to
increase effectiveness and immune function
paracrine hormones function regionally
ex: hormones released by hypothalamus that affect the pituitary
endocrine hormones function at a distance
ex: pituitary gland stimulating the gonads

HYPOTHALAMUS AND THE PITUITARY GLAND (AND THEIR HORMONES)

The pituitary has 2 parts, which the hypothalamus interacts with in different ways.
Hypothalamus gets signals from the brain and sends hormones / signals to different parts of the
pituitary. Hormones it sends include:
Gonadotropin releasing hormone (GnRH)
Corticotrophin releasing hormone (CRH)
Thyrotropin-releasing hormone (TRH)
Growth hormone releasing hormone (GHRH)
Prolactin inhibitory factor (PIF) unlike other hormones, PIH is constantly being released and
when it stops being released, the pituitary gland is signaled to release prolactin
Anterior pituitary hypothalamus interacts with this primarily through the hypophyseal portal
system, a capillary system into which the hypothalamus secretes hormones [paracrine signaling]
Some anterior pituitary hormones go on to stimulate other endocrine glands; others have a direct effect
on parts of the body. Use the pneumonic FLAT PEG to remember which is which.
FLAT hormones (FSH / LH, ACTH, and TSH) are tropic hormones - they stimulate other
endocrine glands
PEG hormones (Prolactin, Endorphins (which are not unique to the anterior pituitary), and GH) are
direct hormones - they directly stimulate a part of the body
ORGAN SYSTEMS 37
GnRH received by anterior pituitary stimulates release of follical stimulating hormone (FSH) and
luteinizing hormone (LH), which travel to the gonads & stimulates them to release their hormones
CRH from the hypothalamus stimulates the release of adrenocorticotrophic hormone (ACTH),
which travels to the adrenal gland and stimulates it to release its own hormones
TRH from hypothalamus stimulates anterior pituitary to release thyroid stimulating hormone (TSH),
which travels to thyroid and stimulates it to release its own hormones (T3 & T4, namely)
When PIH stops being released from the hypothalamus, the pituitary gland is then stimulated to release
prolactin, which is involved in milk production in moms
GHRH from hypothalamus stimulates anterior pituitary to release growth hormone (GH), which
travels directly to the long bones and big muscles in our body to stimulate growth
Posterior Pituitary hypothalamus interacts with this primarily through the stimulation of nerves that
run down the pituitary stalk.
The nerve stimuli from the hypothalamus causes the posterior pituitary to release hormones that are
actually made in the hypothalamus but stored in the pituitary, including:
ADH (antidiuretic hormone) stimulates collecting ducts in the kidneys to retain water
Oxytocin involved in uterine contractions in women

HORMONE METABOLISM AND REGULATION

One of the ways hormone concentration is controlled is through metabolism and excretion:
liver metabolizes extra / unneeded hormones and turns them into bile, which is ultimately
excreted in the digestive system
kidneys filter your blood all the time and remove waste products in the blood through urine
blood some hormones are just broken down in the blood (and their products go on to the liver or
kidneys)
sweat some hormones can just be sweat out
Concentrations are also controlled through negative feedback loops conditions resulting from the
hormones action suppress further release of those hormones
Example of negative feedback loop with thyroid hormones:
The hypothalamus releases TRH (thyrotropin releasing hormone) into the pituitary gland and, in
response to TRH, the pituitary then releases its hormone TSH (thyroid stimulating hormone) which
travels to the thyroid gland.
The thyroid gland then releases its hormones T3 (triiodothyronine) and T4 (thyroxine), which
travel all throughout the body in search of their receptors to, e.g., upregulate metabolism.
Some of the receptors of T3 and T4 are located on the pituitary gland and hypothalamus. When/as
the thyroid hormones reach those receptors, it signals the hypothalamus and pituitary to stop
producing TRH and TSH, respectively; more thyroid hormones are clearly not needed.
Why does the pituitary gland need to be turned off if the hypothalamus is? Redundancy is just
indicative of how important feedback regulation is, to keep level of hormones in the body controlled.
TYPES OF HORMONES
Hormones can be classified by where they function (autocrine, paracrine, endocrine) and, more
importantly, can also be classified by their structure.
Structure is key to how a hormone works.
There are three major types of hormones based on structure:
1) Proteins and Polypeptides
ORGAN SYSTEMS 38
Made of amino acids linked by peptide bonds
P & P type hormones are most of the bodys hormones
They range in size from small (3 AA) to large (many hundreds of AA). After about 50 AAs, we go
from calling them polypeptides to proteins.
These are made in the rough endoplasmic reticulum (RER) of the cell and then go to the golgi
apparatus, where theyre repackaged into vesicles that can eventually be excreted from cell.
Because proteins and polypeptides are made of AAs, theyre typically charged. This makes them water
soluble but also makes it difficult to cross cell membranes. For this reason, P & P hormone receptors
are usually located in or on a cell surface
When they bond to a receptor, P & P hormones can initiate a response inside the cell by initiating
of a cascade of secondary messengers
ex: insulin is a relatively large protein hormone
2) Steroids
largely used for signaling
made from lipids (mostly from cholesterol), and thus have a characteristic structure that they all share:
a four-ringed carbon backbone (three cyclohexane, one cyclopentane)
Because theyre made from lipids, steroids can enter a cell without much trouble. Unlike proteins and
polypeptides, the receptors for steroid hormones are thus located inside the cell.
Steroids act as primary messengers; theyre doing the signaling themselves. Receptors are often in the
cytoplasm or the nucleus of the cell.
Steroids can effect change at the level of DNA transcription and translation, make new proteins form.
ex: hormones from adrenal cortex (cortisol, etc) and from gonads (testosterone, estrogen, etc.)
3) Tyrosine Derivatives
Recall: Tyrosine is an amino acid.
Why is it not of the polypeptides and proteins type, then? Well, theyre only
made of derivatives from a single amino acid. Additionally, they
sometimes act like P & P hormones, but other times act like steroids.
Theyre a class of their own.
ex: thyroid gland hormones like T3 (triiodothyronine) and T4 (thyroxine); these stimulate metabolism
act very similarly to steroids, and bind to receptors inside the cell
ex: catecholamines like epinephrine and norepinephrine, which are produced in the medulla and are
involved in our fight or flight response.
act very similarly to P & P proteins in that they bind to the outside of a cell and stimulate
secondary messengers inside the cell.
Act like proteins

CELLULAR MECHANISM OF HORMONE ACTION

After traveling through the body, a hormone eventually reaches the receptor on a target cell
ORGAN SYSTEMS 39
One mechanism: action by secondary messengers Hormone binds to a receptor on the outside of a
cell. Instead of stimulating an effect directly, it sets off a chain of secondary messengers within the cell
that themselves stimulate the effect.
When hormone binds with receptor, it causes the receptor to change conformation and interact with
the G-protein to form a complex. When this happens, the GDP bound to G-protein is transformed
to GTP .
This transformation to GTP allows the G-protein to move through the membrane and activate the
adenylate cyclase. The adenylate cyclase then transforms ATP > cyclicAMP (cAMP).
cAMP is then what triggers the effect inside the cell that the hormone is targeting in the first place.
Signal amplification: in theory one hormone can bind to a receptor, which sets off chain reaction
leading to a lot of cAMP being produced.
Because we are unable to communicate directly
Second mechanism: action by primary messenger Certain hormones like steroids and thyroid
hormones can cross the cell membrane and effect change themselves.
Steroid and thyroid hormones can typically cross the membrane on their own because, unlike other
polypeptide hormones, e.g., they are lipid based.
Hormone crosses cell membrane and binds to a receptor in the cytoplasm or the nucleus.
When the hormone binds to this receptor, it directly affects transcription (if receptor is in nucleus)
or translation (if in cytoplasm) of the protein thats being activated by the hormone.

TERPENES, CHOLESTEROL, AND STEROIDS

Terpenes are a class of lipid molecules made from repeating isoprene units
An Isoprene unit has 5 carbons 4 are bonded in a chain, the 5th branches off a middle carbon
monoterpene = 2 isoprene units, forming 10-C molecule (ex: menthol)
sesquiterpene = 3 isoprenes form a 15-C molecule (ex: ginger)
diterpene = 4 isoprenes (essentially 2 monoprenes) form 20 carbon molecule
sesterterpene = 5 isoprenes form a 25 carbon molecule
triterpene = 6 isoprenes form a 30 carbon molecule (ex: squalene)
Biosynthesis of steroids uses isoprene pyrophosphate (recall: pyrophosphate is a weak base and makes
a good leaving group)
Dimethylallyl pyrophosphate and isopentyl pyrophosphate combine head-to-tail (displacing a
pyrophosphate in the process) to make geranyl pyrophosphate, a 10-C molecule
Geranyl pyrophosphate then combines head-to-tail with a third isoprene to make 15-C farnesyl
pyrophosphate; another pyrophosphate is released.
Two farnesyl pyrophosphates combine head-to-head to make 30 carbon squalene. Squalene is the
precursor for all the steroid hormones.
After a series of ring-closing reactions, squalene turns into cholesterol, a four-ringed molecule.
In the case of endocrine organs that use steroid hormones to communicate, cholesterol can be altered
to form the characteristic steroid backbone
Two important classes of steroids for endocrine glands: sex hormones and adrenal cortex steroids:
ORGAN SYSTEMS 40
Sex hormones: estrogens (estradiol and estrone, made in ovaries); progesterone (pregnancy
hormone); androgens (testosterone, androsterone)
Adrenal Cortex: cortison and cortisol (stress hormones, have various effects from anti-
inflammatory to increasing carbohydrate metabolism); aldosterone (one of the main hormones that
regulates blood pressure and fluid volume).

Circulatory System
THE HEART
Intro
Thorax = includes heart enclosed within ribcage, a lung on either side, & diaphragm muscle
underneath
Jobs of the heart:
(1) Systemic flow Delivers the oxygen, nutrients, and other things that the cell needs to live; and
takes away its waste (like CO2).
Blood enters hear through the superior / inferior vena cava; the aorta sends it back out.
Systemic flow includes coronary blood vessels around the heart that serve the heart cells itself.
(2) Pulmonary flow Before sending blood out through the aorta, the heart sends it through the right
and left lungs so it becomes oxygenated.

Flow through the Heart

Blood comes down from arms, neck, head (upper half) into superior vena cava of the heart, while
blood from the legs, belly (lower half) into inferior vena cava. Both enter into the right atrium.
After the right atrium, blood flows down into the right ventricle (through the tricuspid valve).
From the right ventricle, blood passes through the pulmonary valve into left and right pulmonary
arteries. These arteries travel through the lungs, where CO2 is exchanged for O2.
The newly oxygenated blood then re-enters the heart through the pulmonary vein to enter the left
atrium, after which it flows through the mitral valve to enter the left ventricle.
From the left ventricle, blood flows through the aortic valve to enter the aorta, which sends it out to the
body (aorta has branches into head/neck and each arm, through the midsection and then into each leg).

Layers of the Heart

Blood flow: RA > RV > lungs > LA > LV
Atrioventricular valves help keep blood flowing (theyre the two valves between atria and ventricles).
tricuspid RA/RV
mitral LA/LV
These valves face downward; are tethered to the walls by chordae tendinae (chords) and papillary,
that keep the valves from flapping back and forth. Without these, blood would flow back in wrong
direction during systole (ventricular contraction).
The intraventricular septum is basically a wall that divides the left and right ventricles of the heart
Has two different areas: membraneous area closer to the atria, and muscular area.
ORGAN SYSTEMS 41
One of the most common heart defects in infants is a hole in the membraneous intraventricular
septum, so blood flows from left ventricle to right ventricle (big problem) this is a called VSD.
Heart muscle has three layers (starting inside heart > out)
Endocardium thin layer thats very similar to the lining of blood vessels; is what the red blood
cells bump up against
Myocardium thickest layer. This is where all the contractile muscle is, and thus where a lot of
the energy is being used up.
Pericardium a little thinner, has two layers with a gap in between them. There might be a little
fluid in that gap, but no cells.
This happens when the heart is growing in a fetus, it grows into a sort of ballon sac so a
pancaked balloon surrounds the heart
Visceral pericardium layer closer to the heart
Parietal pericardium layer further from the heart

Lub Dub of the heart:

Four valves of the heart: tricuspid, pulmonary, mitral, aortic.
As blood flows from RA > RV, blood (from a previous cycle) also flows form LA > LV
Mitral and tricuspid valves [atrioventricular valves] thus open simultaneously. And when these are
open, the pulmonary and aortic valves [semilunar valves] are closed.
Ventricles are then filled with blood, and so they squeeze (contract) to pump it out.
Blood then flows through pulmonary and aortic valves from the ventricles. When those are open, the
pulmonary and aortic valves snap shut.
The shutting of valves makes the lub dub noise.
Lub = first heart sound (S1) > caused by T and M valves snapping shut
S1 is when semilunar valves open; blood has just emptied from the atria into the ventricles.
Dub = second heart sound (S2) > caused by P and A valves snapping shut
S2 is when tricuspid and mitral (atrioventricular) valves open. Immediately after S2, the atria
and ventricles fill with blood.
S2 indicates the beginning of diastole, so at the end of it; all valves are closed.
Diastole is a complete relaxation of the ventricles, and represents the time lag between pairs of lub
dubs, when the blood refilled from the atriums into ventricles
Systole is the time lag between S1 and S2, during which heart pumps blood from the ventricles out, so
AV valves are closed to prevent regurgitation into the atria..

BLOOD VESSELS
Layers of a Blood Vessel
Tunica Intima The lumen of the blood vessel is surrounded by a layer of endothelial cells. These
are the first type of cells that blood will interact with. Outside of that layer of endothelial cells is a
layer of protein (e.g. collagen), called a basement membrane, that keeps everything from falling out
of place.
Tunica Media (middle) a layer of smooth muscle cells outside the basement membrane
ORGAN SYSTEMS 42
Tunica Externa (adventia) on the very outside is another layer of protein. Its like the basement
membrane but a different composition (still lots of collagen though).
On larger vessels, you sometimes find vasa vasorum, tiny blood vessels that supply the tunica
externa itself. It also has nerve endings.
Veins have all three layers, pretty straight forward.
Large / middle size arteries Have a normal tunica intima layer, but the tunica media is much
larger; a thick layer of smooth muscle that also contain elastin, a protein that makes arteries more
elastic for high pressures. Tunica externa is then pretty normal (with vasa vasorum and nerve endings)
Small arterioles Also have a normal tunica intima and a large tunica media. Instead of having
elastin in the media layer, though, it just has a ton of smooth muscle cell which makes it very strong.
Makes sense because arterioles are the vessels that create resistance to change blood pressure. Tunica
externa is also pretty normal (with vasa vasorum and nerve endings)
Capillary unlike the veins and arteries, this is down to the single cell level. So the endothelial layer
is made of just one cell that envelopes the lumen.

Arteries vs Veins
Systemic circulation: Arteries take blood from the heart out to all the capillary beds in all parts of the
body; then veins bring the (now deoxygenated blood) back to the heart.
Pulmonary circulation: Pulmonary artery takes deoxygenated blood to the lungs; pulmonary vein
brings it back. arteries take blood
Note: In the lungs there is mixing b/n pulmonary & systemic circulation - lungs receive oxygenated
blood from Bronchial Arteries, which are a part of the systemic circulation. Some of the blood drains
back through the Bronchial Veins, but some of it joins the deoxygenated blood in the lungs from the
Pulmonary Arteries, becomes re-oxygenated, & re-enters heart through Pulmonary Veins..
Direction of flow between arteries and veins is different:
Arteries take blood away from heart. Veins take it towards the heart.
Type of blood the arteries and veins carry is different:
Usually Veins carry deoxygenated blood, and Arteries carry of oxygenated blood.
exception: Pulmonary artery carries deoxygenated blood; pulmonary vein carries oxygenated
blood.
Pressure and volume in veins and arteries different:
Arteries are high pressure (like a fast flowing river), and dont carry much volume.
Veins are low pressure, and carry a lot of volume.
How much blood is where in your body? ~ 5% in the heart, ~ 5% in the capillaries, & 10% in the
lungs. Only 15% is in the arteries, then the remaining 65% of bodys blood is in the veins at any given
time.
Veins have valves; arteries do not.
In veins, the valves keep the blood flowing in the right direction.
This is not really necessary for arteries because the pressure is so high. But that means if you cut an
artery, you just have a fountain of blood spewing out. If you cut the vein, you get more of a pool of
blood that eventually clots.
ORGAN SYSTEMS 43
The papillary muscles contract during systole to prevent blood from flowing backwards within
the heart.
Semilunar valves are not actively closed.
Instantly after second heart sound, all valves are closed
All blood vessels have a tunica intima. This layer is made of endothelial cells, and is an essential
structural component.
Intracellular calcium is the cellular messenger resulting in the contraction of smooth muscle.
The tunica media is a muscular layer, which can be contracted and relaxed to enact changes in blood
pressure.
A thick tunica media is characteristic of large systemic arteries.
A thick tunica media explains the responsiveness of large systemic arteries to changes in
intracellular calcium concentrations.
P =QR

PRESSURE, FLOW, RESISTANCE

Dr. Poiseuille: If you know the length (L) and radius (r) of a tube, as well as the viscosity (eta, ) of the
fluid, you can calculate the resistance (R) of flow through that tube.
R = 8L / r4

So, if two tubes have same length and are carrying the same fluid, resistance is proportional to 1/r4
So for a tube with half the radius (r/2) of another tube with radius r, resistance will be 16 times
greater in the smaller radius tube.
In arterioles, when smooth muscle is relaxed (vaso-dilation), the radius of the tube is much greater
than when it is constricted (vaso-constriction). This means we have low resistance of blood flow
during vaso-dilation, and high resistance during vaso-constriction.
Flow: blood flows from aorta to brachial artery, then to an artery, eventually a capillary bed where it
comes out the other side, now deoxygenated, in a venule and then a vein, and eventually gets back to
the heart through the superior vena cava.
The pressure that blood is exerting at any given point on the blood vessel walls can be described by
systolic vs. diastolic pressure, upper and lower range. Below, lets look at average pressure over time
as the blood flows through the body:

Overall pressure continues to

decrease as blood flows through the
body.
The biggest drop occurs when
flowing from the arteriole into the
capillary bed.

Consider resistance to flow? P = Q x R

P = pressure at the beginning of a tube (PS) pressure at the end of the tube (PE)
Q is blood flow in volume / min
Q = stroke volume x heart rate, aka the volume of blood thats pumped out in each beat, and the
beats per min. (volume / beat) x (beat / min) = volume / min
For an average male, there are 70 mL / beat, and 70 beats / min, so Q = 4900 mL/min = 5L/min
R is proportional to 1 / r4
ORGAN SYSTEMS 44
What is total body resistance? Well we know that when blood comes out the aorta, the pressure is 95
mmHg, and when it goes back in through the vena cava, it is about 5 mmHg.
P = Q x R
95 5 mmHg = 5L/min x R
R = 90/5 = 18 mmHg*min / L

THERMOREGULATION IN THE CIRCULATORY SYSTEM

How does your body maintain its core temperature when, e.g. youre exercising under the hot sun?
One way is by sweating. Another way involves in the skin.
Below the skin is blood vessels, an arteriole supplies your skin with blood and oxygen through
capillary beds, very fine blood vessels with high surface area.
For our purposes, the skin acts as insulation. [Think of a house, with walls that insulate it] But
capillaries go into the skin layer and lose heat easily. [windows in the house]
When your body is hot, it will dilate the capillaries in your skin [open the windows] to allow more heat
out. When capillaries are vasodilated, more blood can pass through them, and thus more heat is lost to
the surroundings.
When its cold out, your capillaries will vasoconstrict, so you lose less heat to the environment. This
also means you have less heat at the surface of your skin, then, which is why partly your skin gets so
cold.
Body regulates the size of blood vessels through the smooth muscles cells, which are told to contract or
relax through nerves.

Hematologic System

WHATS INSIDE OF BLOOD?

Blood is drawn into a tube thats lined with a chemical so the blood doesnt clot, then its centrifuged
so the blood parts separate out. There are now three different layers.
Plasma is the least dense and the largest layer, making up about 55% of the blood.
Its made of 90% water, 8% proteins (Albumin, antibody, fibrinogen [+ other clotting factors]) and
2% hormones, electrolytes, nutrients.
Note: Plasma and serum are very similar, but serum does not have fibrinogen.
The next layer (< 1%) is white blood cells / platelets.
Hemoglobin is the last, most dense layer, making up about 45% of the blood (lots of hemoglobin)
Hematocrit = volume of RBC / total volume. What a normal hematocrit level is changes
depending on your age, sex, and even if you live at a high altitude.
polycythemia = person has a really high level of red blood cells
anemia = person has a really low volume of red blood cells.
HEMOGLOBIN
Oxygen enters a blood vessel from the alveolus in the lung, and within blood vessel diffuses into a
RBC.
Hemoglobin protein has 4 parts to it, and each part can bind a protein.
Once a single O2 is bound, its easier for other O2 to bind. (cooperativity)
Two ways O2 transported in blood: HbO2 (oxyhemoglobin; most common) or O2 dissolved in plasma.
A muscle cell has high pC O2, and low p O2 - so when oxyhemoglobin enters it releases O2
Also inclined to released O2 because protons (H+) and CO2 compete with O2 for hemoglobin:
ORGAN SYSTEMS 45
When CO2 enters the red blood cell, it reacts with a water molecule (catalyzed by carbonic
anhydrase in a reversible reaction) to become HCO3- and H+
The HCO3- exits the cell, and the H+ binds to hemoglobin, causing the oxygen to fall away.
Note: An increase in HCO3- would remove free H+ ions from blood and thus increase its pH,
ultimately increases O2 affinity for Hb.
When CO2 binds to red blood cells (competing with O2), a proton is also created.
When blood is returning to the lung, what is it carrying with it?
Hb-COO- (carbaminohemoglobin)
H+Hb (with corresponding HCO3- in the plasma)* biggest way CO2 comes back
CO2 dissolved in plasma.
When in the lung, an oxygen rich tissue, O2 diffuses into the red blood cell and tries to enter
hemoglobin; we basically push the reactions to the left and O2 competes for hemoglobin again.
When carbaminohemoglobin enters the lung, with high pO2 and low pCO2, it releases CO2
Also inclined to release CO2 because O2 competes with H+ / CO2 for Hb
In the lungs, HCO3- reenters RBC and re-combines with H+ to form the CO2 (through a couple
intermediates) that diffuse out into the alveolus, and can be expelled through the lungs.

BOHR EFFECT VS HALDANE EFFECT

Bohr effect: CO2 and H+ affect the affinity of Hb for O2
As pO2 is increased, the O2 content bound to Hb slowly
increases until Hb gets saturated (O2 content starts to plateau).
The amount of O2 that has been delivered in the tissue by Hb
can be determined by subtracting the O2 content from a place
of low pO2, (e.g. thigh tissue) from a place of high pO2 (e.g. lungs)
The Bohr effect (right shifted green curve) says that increased
CO2 and H+ (e.g. in muscle tissue) makes O2 delivery higher
than it would be just from low pO2 there.

Haldane effect: O2 affects the affinity of Hb for CO2 / H+

As you increase pO2, the content of CO2 increases. (Note: Not S shaped like O2 b/c theres no
cooperative binding.)
Can determine the amount of CO2 delivered in the same
way as O2 before, by subtracting the CO2 content at two
different pCO2s
Haldane effect says that with increased O2 (like in the lungs),
the affinity of Hb for CO2 and H+ is decreased, so more CO2
content will be delivered there than it would from just the high
pO2 there.

BLOOD TYPES
Embedded in the cell membranes of red blood cells are all kinds of proteins and molecules two of
which are very important for determining blood type: A and B glycolipids.
Some people have both A and B glycolipids (AB blood type), others have just A (A type) or B (B
type), and others have none of these glycolipids (type O).
Recall: antibodies of the immune system tag specific foreign bodies (like bacteria) for destruction, but
theyre careful not to make antibodies for its own helpful molecules.
For this reason, a person with type AB blood does not have
A or B antibodies. Meanwhile, a person with type A blood
does not have A antibodies, but will have B antibodies.
ORGAN SYSTEMS 46
Those with B type blood have A antibodies, but no B ones.
A person with type O blood has both A and B antibodies,
because their body doesnt recognize either type of glycolipid.
If a person with type A blood receives a transfusion from
AB blood, that persons antibodies would bind to this
transfused blood and his body would start to destroy it,
causing a huge amount of inflammation.
The chart to the right shows which blood types can donate
to which. O is universal donor; AB is the universal recipient.

HOW WE MAKE BLOOD CLOTS

Blood vessels are made of endothelial cells (each with a nucleus). What happens if a blood vessel breaks?
Part 1 Platelet plug: when/where theres a break, platelets come together to coagulate & block
hole.
Platelets are tiny pieces of cells - with no nucleus - floating around in your blood all the time
How do they know to clump up at the break and not elsewhere in the blood? The environment in
the blood vessel is different than the environment outside of the blood vessel.
Outside of the blood vessel there is collagen, which chemically interacts with platelets and causes
them to stick together to plug the hole.
Part 2 Fibrin enters to strengthen platelet plug; forms mesh of protein that holds platelets together.
Fibrin strands are made of subunits that naturally like to polymerize, or stick together.
How does fibrin not polymerize while floating around in blood? Because we dont exactly have
fibrin floating around, but fibrinogen (basically fibrin, with an extra bit that keeps it from
sticking).
Fibrin is turned into fibrinogen at the site of break, thanks to a whole cascade of coagulation factors
that starts with tissue factors (e.g. factor III like collagen, which are only found outside blood
vessel), and ends with activated thrombin (aka factor II) coming into site of break to catalyze
fibrinogen > fibrin.
Note: a lot more thrombin is activated that there is/was tissue factor, because of the cascade
Details on coagulation cascade:
Thrombin is itself activated from its inactive form prothrombin.
Intrinsic pathway: XII > XI > IX + VIII > X + V > II (thrombin) > I (fibrin)
Note: This is not XII becoming XI, becoming IX Instead, activated XII catalyzes the conversion
of XI from its inactive form into its active form, and active form of XI catalyzes IX into its active
form, etc
Factor X is the very important enzyme that activates thrombin
As you move down the intrinsic pathway, the amount of each enzyme present increases, thus
increasing the active forms of each until you end up with a ton of thrombin (and thus lots of activated
fibrin)
Extrinsic pathway: III (tissue factor) > VII > X + V > II (thrombin) > I (fibrin)
The extrinsic pathway is the original spark that sets off the cascade, while the intrinsic pathway is the
workhouse that gets most of the coagulation done. How?
Tissue factor III sets off a little bit of VII, which activates a little X, which then activates a little bit
of thrombin. Thrombin is then what really gets the workhorse going by activating many other
enzymes
[Think of thrombin activating 5 odd numbers starting with 5: 5 7 9 11 13 but actually it activates 8, not 9.
almost.]
ORGAN SYSTEMS 47
What is factor XIII? Well, factor I activates fibrinogen > fibrin so the fibrin can form strands,
but then factor XIII comes in to connect the fibrin strands together (cross-links them) so they
actually form a tight mesh.
Negative feedback loops (governed by thrombin) prevent the enzyme activation pathways from
spiraling out of control such that you become one walking blood clot.
Thrombin helps create plasmin from plasminogen, which works directly on on the mesh of fibrin to
break the cross-links apart. Helpful, but doesnt prevent the rest of the enzyme pathways from
continual activation.
Thrombin also stimulates production of antithrombin, which decreases the amount of thrombin
produced from prothrombin, and impedes the production of activated X from inactive X.
If these pathways arent working you cant clot very well and have haemophilia, aka you bleed a lot.
There are three different types of haemophilia, associated with 3 different factor deficiencies
A VIII B IX C XI

Plasmin breaks down fibrin and fibrinogen, which serves to limit clot formation.
The intrinsic pathway is initiated by components which are already in the blood.
Factor XII is associated with the intrinsic pathway, and catalyzes the formation of factor XI, which catalyzes the
formation of IX, which catalyzes the formation of X.
Factor X is common to both pathways, but is not upstream so to speak.
The extrinsic pathway proceeds in the presence of tissue factor (TF) which is released in response to tissue injury or
insult.
Endothelial cell insult is the principal component which activates and drives the extrinsic pathway of the
coagulation cascade.
ORGAN SYSTEMS 48

RED BLOOD CELLS AND PLATELETS

Red blood cells last ~120 hours, which is about 4 days. Platelets last even less time, only 1-2 days..
So your body constantly needs to produce more of these which it does in the bone marrow.
Erythropoiesis: Red blood cells are made from a precursor cell which has a nucleus (RBCs dont).
The precursor divides many times, and eventually some of the daughter cells turn into erythrocytes /
RBCs
Platelets are fragments of cells that bud off from a huge cell called a megakaryocyte. So platelets are
basically bits of cytoplasm surrounded by a membrane. A megokaryocyte can yield many platelets.
What does your body do with old RBCs and platelets it doesnt want? Breaks them down via the
spleen.
When blood (coming from the heart) passes through the spleen, a spleen cell called a monocyte (which
is basically a macrophage) will recognize and engulf any old red blood cells, chew them up, and
recycle anything important (such as iron, and some amino acids).
Most of the old RBC and platelet breakdown happens in the spleen, but some also happens in the
liver, through a similar process.
How does the body know how many new RBCs and platelets to make?
Low oxygen levels stimulates the release of a hormone called erythropoietin (aka EPO) in/from
the kidney, which tells the bone marrow to produce more RBCs via erythropoiesis.
Some athletes take EPO so their body makes more RBCs and they get more oxygen to their
muscle.
If you need more platelets, your body releases the hormone thrombopoietin, which signals the
megokaryocytes to make more.

BLOOD CELLS LINEAGES

In the blood vessels, you have about 10 different kinds of blood cells, from RBCs to T-cels, to B-cells,
to platelets, and more where do they all come from? Bone marrow! Specifically from the heads of
long bones and from different flat bones (like the sternum) throughout the body.
All blood cells have a single precursor: a pluripotent hematopoietic stem cell
This pluripotent cell gives rise to two different lineages: myeloid and lymphoid
Myeloid lineage yields red blood cells
and megakaryocytes (from which platelets
are made), as well as mast cells (which
release histamines in allergic reactions)
The myeloid lineage also yields monocytes,
which then become macrophages (part of
the immune system) when they settle in
the tissues.
This monocyte lineage also yields three
other types of cells: neutrophils (most
common immune cell), eosinophils,
and basophils.
Lymphoid lineage yields B-cells (which
make antibodies), T-cells, and
natural killer cells.
Dendritic cells can come from either
lymphoid or myeloid (monocyte) lineages.
ORGAN SYSTEMS 49
Respiratory System

THE LUNGS:
Whether you breathe in through your nose or mouth, it will follow a path to the back of your throat to
the Adams apple, or the voice box. Air passes through the voice box into the trachea.
From the trachea, air goes into the right and left lungs.
The right lung has three lobes (upper, middle, lower) and the left lung has two lobes.
The left lung also has a cardiac notch, where the heart sits.
Around the lungs are the ribs and rib muscles. Below the lungs and the heart is the diaphragm muscle.
Within each lung are many branches (basically an upside down tree), which we call the bronchial
tree.
If we zoom in on a little branch, we would see a bunch of sacs called the alveoli. The air you inhales
runs into the alveoli, takes a U-turn, and you exhale it back out. Before you exhale, your lungs give up
O2 and take away CO2 from tiny blood vessels that run next to to the alveoli.
Note: the conducting zone is simply a series of tubes through which gases travel, while the
respiratory zone directly participates in gas exchange.
INHALING AND EXHALING:
Whether you breathe in through your nose or mouth, it will follow a path to the back of your throat to
the Adams apple, or the voice box. Air passes through the voice box into the trachea.
Recall, the more frequently collisions are happening between air molecules, the higher the pressure is.
For the general atmosphere, P = 760 mmHg.
When you inhale:
Volume of the lungs increases, which causes pressure of molecules inside the lungs to decrease (bc
there are fewer collisions). P = ~757 mmHg now, which some call negative, by comparison to
760.
Air molecules move into the lungs, causing pressure to increase back up to 760 mmHg.
When you exhale:
Volume of the lungs decreases, which cause pressures to increase because now there are more
molecules than before (763 mmHg) for the same initial volume.
This pressure causes air molecules to leave until you have about the same amount as before, and
pressure decreases back to 760 mmHg.

HOW DOES LUNG VOLUME CHANGE?

In the middle of the chest is a large bone called the sternum (aka breast bone); 7/12 pairs of ribs attach to the
sternum. Between the ribs are intercostal muscles.
When you start to inhale:
Your intercostal muscles contract and your ribs move outwards.
At the same time, your diaphragm contracts and goes from being curved upwards to flattened out.
As these muscles contract, your lungs and heart will physically be drawn downwards and out.
The expansion of your lungs is really all your alveoli expanding (you have ~500 million of them);
theyre pulled outwards as your muscles move down and out.
Note that the muscles do not physically pull open the alveoli; their enlargement is caused indirectly
through a decrease in pressure and influx of air.
Alveoli are covered in elastin, a protein that helps them stretch open.
The energy for contraction / inhalation comes from chemical energy, ATP.
When you exhale, your muscles relax.
The alveoli then recoil (the elastin molecules snap back into their original size).. which is the
driving force behind brining lungs back open to normal size.
ORGAN SYSTEMS 50
The energy for relaxation / exhalation comes from elastic potential energy.

HENRYS LAW AND THE SOLUBILITY OF O2 AND CO2

Look at the interface between a gas and a liquid, H2O what happens at that surface layer?
Total pressure is 1 atm = 760 mmHg, but if were just looking at green molecule,s which make up
about 50% of the air, we say its partial pressure = 760mmHg(.50) = 380mmHg
If the number of green molecules increases, thats basically saying the partial pressure increases.
As partial pressure rises, more of those green molecule will enter the water. So partial pressure tells
you about likelihood that a molecule will enter the solvent.
Meanwhile, the constant KH tells you the likelihood of a solute leaving the liquid layer. It takes into
account solute, solvent, and temperature.
The concentration of a solute dissolved in solvent can be determined by the equation: C = Psolv / KH.
This is Henrys law. It basically says theres a relationship between partial pressure and
concentration.
Now lets look at two cups of water placed in two different atmospheres: One is made of 21% O2, the
other is made of 21% CO2, both at 25 C.
The concentration of O2 that dissolves in the surface layer of water is much lower (0.27 mmol/L)
than the concentration of CO2 that dissolves (7.24 mmol / L).
We can even rearrange Henrys law to KH = Psolv / C and calculate that the KH of O2 is 769 Latm /
mol, while the KH of CO2 is lower: 29 Latm / mol.
Henrys law tells us that the partial pressure is a measure of whats going into the water, while the
constant is a measure of whats going out So it whats going in on both sides is equivalent, the
difference is in whats leaving.
With O2, there was low concentration, so O2 was constantly leaving the water.
Not much CO2 went out of the water though; its concentration was higher. Recall,
CO2 + H2O> H2CO3 (reversible) > HCO3- + H+ (reversible)
We can directly compare KH values, and say 769 / 29 = 26, so CO2 is about 26 times more soluble
than O2 in water
In our lungs, which are about 37 C, and have a solvent of blood instead of water, CO2 is about 22
times more soluble.
FICKS LAW OF DIFFUSION
Consider a bunch of molecules trying to diffuse over a short distance (like from one wall to another)
over time how can you maximize the number that diffuse across? Some ideas:
Less thick wall
Smaller molecular weight (MW) molecules (We know from Grahams law that smaller molecules move
faster)
Increase partial pressure P1 of molecules
Increase surface area for molecules to diffuse across
Ficks law: V = [(P1 P2) x A x D] / T
V is rate of particles moving (amount like moles, or volume)
P1 is pressure on first wall, while P2 is the pressure on the second wall. Of course, if the pressure of
P2 is < P1, more molecules will want to diffuse from wall 1 to wall 2.
A is surface area, the higher it is the more molecules that can get across.
D is diffusion constant, which is basically a ratio of solubility (from Henrys law) by molecular
weight; D = KH / (MW)
T is thickness of the wall.
This formula can also be written as [V/A] = [(P1 P2)/T] x D, or [flux] = [gradient] x D.
ORGAN SYSTEMS 51
Flux can be defined as the net rate of particles moving through an area.
Gradient is the change in pressure (or in particles in a volume)
over a distance.

OXYGEN MOVEMENT FROM ALVEOLI TO CAPILLARIES

Recall, after oxygen enters through your mouth/nose and
eventually gets to either your left or right lungs, it will
enter the alveoli. What happens then? >
The O2 molecules leaves the alveolus lumen and enters a layer of fluid lining before passing through
into the epithelial cells of the alveolus.
After leaving the epithelial cells, O2 encounters the basement membrane of the alveolus (which
provides support), a thicker layer of connective tissue (more structural support), and then a 2nd
basement membrane.
After passing through the basement membrane of the capillary, O2 goes through the endothelial
cells of the capillary wall and finally enters the lumen, where it can bind to a red blood cell (at 1 of 4
spots).
Note: all these layers are basically liquid, and are made of mostly water so O2 goes from gas phase
and must diffuse across lots of liquid before reaching the capillary.
Ficks law can be used here to figure out the amount of O2 diffusing over time.
P1 of this equation can be found from the alveolar gas equation, which takes into account the
percent of O2 in the air theyre breathing, atmospheric pressure, PH20, and more.
Area can be affected by how effectively a persons alveoli is
working; if half don't work then not as much O2 can get across.
Thickness is also very important if the amount of fluid in the
layer increases (such as with infection), then the O2 that can get
across will be lower
Diffusion constant will stay the same, though.
Basically, if a person is not getting enough oxygen, there could be many factors affecting the problem.

THE RESPIRATORY CENTER

The respiratory center of the brain is in the brain stem. There are two clustered areas in the respiratory
center, with neurons that communicate between them.
Respiratory gathers information from different places and executes commands (such as how fast and
how deep you breathe) based on that info
Central and Peripheral chemoreceptors send info on different chemicals to the respiratory center.
Central chemoreceptors are adjacent to the respiratory center. They gather info on CO2 levels,
pH (but not O2 levels) and send it to the respiratory center for processing.
Peripheral chemoreceptors (outside the brain) detect O2 levels as well as CO2 and pH. These
include CN 9 (glossopharngeal) nerve from the carotid body chemoreceptor, and CN 10 (vagus
nerve) from the aortic body which send their info through nerves into the brain.
Mechanoreceptors send information about pressure to the respiratory center.
Mechanoreceptors are found all over, in the lungs, nose, GI tract, etc; and they send their
information through a bunch of different pathways.
Those in the lungs and GI hitch a ride on the vagus nerve, while the one in the nose connects to
the respiratory center via CN 5 (trigeminal nerve).
Ex: If you inhale some pollen, that will trigger the mechanoreceptor in your lung, which will send
info through CN 5 to trigger a response from the respiratory center.
Ex: Lungs have smoke receptors, stretch receptors, and more.
ORGAN SYSTEMS 52
Hypothalamus also sends information to the respiratory center things like fear which may trigger a
change in breathing.
The cerebrum which controls all voluntary actions including things like yelling, or singing, where
you would need to control your breath also sends info to the respiratory center.
What does the respiratory center do with all this information? It executes changes in breathing by
controlling different muscles through motor nerves in the spinal cord:
Motor nerves Muscles
C1 C3 accessory muscles
C3 C5 diaphragm
T1 T11 intercostal muscles
T6 L1 abdominal muscles

THERMOREGULATION IN THE LUNGS

Humans lose heat by sweating and also by, like furry animals, taking in cool air and expelling hot air.
When we inhale cool air, it enters into the lungs and alveoli, and will equilibrate with the temperature
of the blood that's passing by the capillaries.
The air we exhale will thus be about our internal body temperature, 98.6 F.
This coincides well with oxygen because well need to breathe more heavily to thermoregulate from
the heat of exercising, but we also need more oxygen, which breathing heavily will allow us to get!

CONSIDER:
Two broad categories must be considered which may affect hemoglobin saturation: 1. Is there
enough oxygen present to saturate the hemoglobin, and 2. physiological factors which affect Hbs
oxygen affinity.
An increase in temperature, pCO2, 2,3-BPG concentration, or a decrease in pH will decrease O2
affinity.
If the pO2 in the afferent capillary is low (the capillary coming TO the alveoli), concentration
gradients will favor greater diffusion of oxygen into the vessel, thereby increasing the amount of
oxygen available to bind.
Factors affecting gas diffusion into the capillaries include wall thickness, wall surface area, partial
pressure difference, and the ventilation-perfusion ratio.
The longer blood hangs around in the alveolar capillaries, the longer the hemoglobin has to
recruit oxygen. If blood is flowing too quickly for ventilation to match it, the hemoglobin
saturation will decrease.
Many respiratory diseases affect pulmonary function by altering the ability of alveoli to participate in
gas exchange. What physical change would most greatly reduce the degree to which a particular
alveolus is ventilated?
Ventilation would be decreased in any setting which does not allow adequate airflow, including
obstruction and structural/mechanical changes to the lung which prevent alveolar filling.
Increased pressure within an alveolus would prevent airflow into the alveolar space.
Gas pressure is increased with increasing temperature and decreasing container volume.
Increased elastic recoil of the alveolar wall would increase the inward force of the wall on the gas
as the wall tried to collapse, which would increase the pressure of gases within an alveolus, which
would hinder airflow into the space. This would most greatly reduce ventilation of an alveolus.

Lymphatic System

WHAT IS THE LYMPHATIC SYSTEM:

ORGAN SYSTEMS 53
High pressure in blood vessels forces fluid out through the endothelial cells (particularly in capillaries).
Big particles like red blood cells cannot get out, but other fluid (water, small proteins) then
accumulates extracellularly around the capillaries.
The lymphatic system is just another plumbing system made of vessels that sort of start in the
middle of nowhere and collect the accumulated fluid, and then bring it back into the blood.
Unlike blood vessels, the lymphatic system is not a closed loop. It starts at the lymph region, where
fluid is collected, and then ends where it reenters the blood vessel to deposit said fluid.
Shortly after the lymph region, after some fluid has left the vessels, the capillary vessel is left with a
higher concentration of red blood cells and solutes than the extracellular space with the lymph fluid.
Consequently, some fluid actually flows back into the capillaries.
This is because of this concentration gradient (aka this increase in osmotic pressure pushing fluid
into the vessels), as well as the fact that the overall hydrostatic pressure in capillaries is lower here
compared to earlier.
Overall, though, more fluid still goes out than comes in so the net result is lymph squeezed out.
Why dont these cells just tighten up connections to prevent things from getting out? Well, the cells
around the blood vessel need the nutrients (glucose, etc.) and they get that from the lymph. The
lymphatic system also has important immune system and circulatory (for fats/proteins) functions.
Lymph vessels are all over your body, and are similar to capillaries / blood vessels in that different
branches come together to eventually dump all the lymph back into circulation.

HOW LYMPHATIC VESSELS MOVE FLUID:

How can lymphatic vessels pump all the fluid up your body in one direction? How do they pump it
back into the high pressure system? Two answers:
(1) Location of re-entery The lymph vessel re-enters the blood at the very end of the venous
system, which has about the lowest pressure of anywhere in your body. (120 mmHg in arteries out
of your heart, ~5 mmHg where lymphatic vessels reenter.)
(2) One-way valves Within the lymph vessels, valve structures prevent fluid from moving in the
opposite direction.
But how does motion begin?
a) Smooth muscle at the beginning of the lymph system small contraction of this pushes fluid on
b) Skeletal muscle throughout the body the natural movement / contraction of our muscles
throughout the day is bound to affect some nearby lymph vessels, helps push fluid on its way.
Lymph vessel starts at what looks like closed ends, but theyre very porous these ends sort of act
like valves themselves, allowing fluid to enter, but (when pressure builds up), these ends prevent fluid
from going out.
Lymph re-enters the circulatory system at subclavian veins, which are right near the superior vena
cava.

LYMPHATIC SYSTEMS ROLE IN IMMUNITY:

Infection is when your body gets attacked by a foreign invader, e.g. bacteria or virus.
Infections arent usually in the blood itself, but in the tissues around it (proof: infections stay
localized; if it was in your blood it would go all over the body)
Local immune cells called macrophages fight the bacteria present in that tissue area, but the body also
pulls in more powerful T-cells and B-cells that react to the specific invader. Problem: These immune
cells arent just sitting around everywhere.
In order for them to specialize, a special environment is required that cant occur in the tissues
where any bacteria may enter. So how do we get B and T-cells to see the bacteria and react to
them? Lymphatic system!
ORGAN SYSTEMS 54
Any bacteria present in the tissue, as well as some macrophages that may have gobbled up the bacteria
are swept into the lymphatic vessel along with fluid. It takes them to the lymph node, where B and T-
cells are stored. There, those immune cells will basically ready themselves to fight the specific
bacteria.
The lymph vessel also continues on after the nodes so a side effect of the lymph system is that it
basically filters the fluid / blood in the body. If bacteria were to flow through the lymphatic system and
then deposit bacteria at the subclavian veins, it could infect the blood and get all over the body.
Lymph nodes are very small, and not considered organs. There are about 600 of them in the body, and
some are so close to the skin you can feel them (particularly those between the thigh and abdomen, and
along your clavicle / neck).
Any lymph coming out of any tissue in your body will pass through at least one lymph node before
depositing back into the blood.

LIPID AND PROTEIN TRANSPORT IN THE LYMPHATIC SYSTEM:

We know lymphatic system aids in fluid collection and deposit, as well as in immunity. A third
function is in the transport of important molecules from digestions . . .
Consider the small intestine, which carries food (glucose, fats, etc) that the body needs for energy.
Glucose diffuses into the cells lining the small intestine, and then is pumped out, where it can then
diffuse into the capillaries.
Fatty acid chains are pumped into the cells of the small intestines wall, where they are packaged
and exit as chylomicrons those are too big to diffuse into capillaries.
The lymphatic vessels in the small intestine, called lacteal, allow chylomicrons to diffuse in, travel
through the lymphatic system, and be deposited back into the circulatory system.
A little further away from the small intestine, you may have other cells proteins, waste products, etc.
that have difficulty entering the capillaries. But the body needs them in blood circulation so it can
deposit the hormones (or whatever) where needed, deposit waste products in the liver / kidneys, etc.
So these peptides and waste products and other necessary molecules that are too big to enter the
capillaries will be picked up by the lymphatic system!
They, too, will eventually be deposited back into the circulatory system at the subclavian vein.
Lymph from the lower body, the left arm, and the left side of the head drains into the circulation via
the largest lymph vessel, the thoracic duct. Lymph from the right arm drains into circulation via the
right lymphatic duct. These ducts then enter systemic circulation at the junction of the left (or right)
subclavian vein and the jugular vein.

WHAT IS ACTUALLY IN LYMPH:

Note: lymph is only called lymph once it enters the lymphatic system; before that its just extracellular
fluid the makeup is basically the same, though.
We know that lymph comes from blood vessels originally; its the fluid squeezed out between the cells
in the capillaries. But blood has a lot of different molecules in it (~45% red blood cells, water, proteins
of varying sizes, etc.)
Lymph has 0% red blood cells, and only about 1/2 1/3 the amount of protein as blood does (you
might think the percentage is more, but water diffuses out much more easily than proteins, thus
diluting any proteins present in lymph.)
Note: this 1/2 - 1/3 ratio is just an average really, concentrations differ throughout different
branches of the lymph system. Ex: liver makes a lot of proteins, so the lyphatic vessels around it
will have a much higher concentration of protein than elsewhere in the system. Similarly, the
concentration of fats in the lacteal (small intestine area) part of the lymphatic system is going to be
much higher there than elsewhere.
ORGAN SYSTEMS 55
Smaller proteins also have an easier time getting out of the blood vessels and into lymph. The ratio of
small protein (albumin, e.g.) to big protein (like immunoglobin) is greater in the lymph that in the
blood, even if you have more albumin molecules in the blood.
Why is it important there be less protein in the lymph? Recall, some fluid goes back into the blood
vessel after it exits in capillaries, instead of being absorbed by the lymph. This is because of a higher
osmotic pressure pulling fluid back in because theres more protein in the blood than in the lymph.
About 3L of net lymph is produced in a day! (much more is initially squeezed out, then reenters.)
Immune System

INNATE / NONSPECIFIC IMMUNITY:

Immune system has two lines of (nonspecific or innate) defense:
first: Keep pathogens out skin (and oils on the skin), mucous membranes, acidic stomach acid
second: If pathogens enter, kill them to prevent widespread infection. inflammatory
response (brings blood and fighter cells to site of infection), phagocytes, white blood cells.
Phagocytes are a class of cell that can eat up other things, most namely pathogens.
It has receptors that respond to foreign things. Once the pathogen binds to these receptors, it is
engulfed by the the phagocyte and enters the cell in a vesicle called a phagosome.
Then other vesicles that contain things that can destroy phagosomes (such as lysosome, reactive
oxygen species) then merge with the phagosome and break up the pathogen.
Some of those constituent molecules of the consumed pathogen are then taken and attached to other
proteins, in phagocytes its the major histocompatability complex type II, and presented onto the
membrane surface of the phagocyte.
These antigens are crucial to our immune system, because they allow specific immune cells to
know what is in the body and to come up with a specific response to that threat. Thus many
phagocytes are also called antigen presenting cells.
There are many types of white blood cells, aka leukocytes, some of which are also phagocytes:
Neutrophils (most common; fast and abundant) phagocytic cells that are also classified as
granulocytes because they contain granules in their cytoplasm. These granules are very toxic to
bacteria and fungi, and cause them to stop proliferating or die on contact
Macrophages
Mast Cells important for wound healing & defense against pathogens via inflammatory response.
Found in mucous membranes and connective tissues
When activated, they release cytokines and granules that contain chemical molecules to create an
inflammatory cascade. Mediators, such as histamine, cause blood vessels to dilate, increasing blood
flow and cell trafficking to the area of infection.
Cytokines released during this process act as a messenger service, alerting other immune cells, like
neutrophils and macrophages, to make their way to the area of infection, or to be on alert for
circulating threats.
Eosinophils granulocytes that target multicellular parasites. They secrete a range of highly toxic
proteins and free radicals that kill bacteria and parasites. Can also phagocytose.
use of toxic proteins & free radicals also causes tissue damage during allergic reactions, so
activation and toxin release by eosinophils is highly regulated to prevent unnecessary damage.
found in many locations, including the thymus, lower gastrointestinal tract, ovaries, uterus, spleen,
and lymph nodes.
Basophils also granulocytes that attack multicellular parasites. They release histamine like mast
cells. The use of histamine makes basophils and mast cells key players in mounting an allergic
response.
ORGAN SYSTEMS 56
Natural Killer cells (NK cells) do not directly attack pathogens, but instead destroy infected host
cells in order to stop the spread of an infection. Infected or compromised host cells can signal natural
kill cells for destruction through the expression of specific receptors and antigen presentation.
Dendritic cells antigen-presenting cells that are located in tissues, and can contact external
environments through the skin, the inner mucosal lining of the nose, lungs, stomach, and intestines.
Since dendritic cells are located in tissues that are common points for initial infection, they identify
threats & act as messengers for the rest of the immune system via antigen presentation.
These are most effective at eliciting adaptive immune response.

THE COMPLEMENT SYSTEM:

Also called the complement cascade, this is a mechanism that complements other aspects of the
immune response. Typically, the complement system acts as a part of the innate immune system, but it
can work with the adaptive immune system if necessary.
The complement system is made of a variety of proteins that, when inactive, circulate in the blood.
When activated, these proteins come together to initiate the complement cascade, which starts the
following steps:
1. Opsonization: A process in which foreign particles are marked for phagocytosis. All of the
pathways require an antigen to signal that there is a threat present. Opsonization tags infected cells
and identifies circulating pathogens expressing the same antigens.
2. Chemotaxis: The attraction and movement of macrophages to a chemical signal. Chemotaxis uses
cytokines and chemokines to attract macrophages and neutrophils to the site of infection, ensuring
that pathogens in the area will be destroyed. By bringing immune cells to an area with identified
pathogens, it improves the likelihood that the threats will be destroyed and infection will be treated.
3. Cell Lysis: The breaking down or destruction of the membrane of a cell. The proteins of the
complement system puncture the membranes of foreign cells, destroying the integrity of the
pathogen. Destroying the membrane of foreign cells or pathogens weakens their ability to
proliferate, and helps to stop the spread of infection.
4. Agglutination: Agglutination uses antibodies to cluster and bind pathogens together. By bringing as
many pathogens together in the same area, the cells of the immune system can mount an attack and
weaken the infection. Other innate immune system cells continue to circulate throughout the body in
order to track down any other pathogens that have not been clustered and bound for destruction.

ADAPTIVE IMMUNE RESPONSE: HUMORAL VS. CELL-MEDIATED:

Unlike the innate immune system, which attacks only based on the identification of general threats,
adaptive immunity is activated by exposure to pathogens, and uses an immunological memory to learn
about the threat and enhance the immune response accordingly.
ORGAN SYSTEMS 57
The adaptive immune response (which uses B and T cells) is much slower to respond to threats and
infections than the innate immune response, which is primed and ready to fight at all times.
Lymphocytes (another type of leukocyte) can be divided into B lymphocytes and T lymphocytes.
B-cells are produced in bone marrow. T-cells also start off in the bone marrow, but mature and become
what they are in the thymus.
B-lymphocytes participate in the humoral response; while T-cells participate in cell-mediated response
(include helper T-cells).
Humoral refers to the bodily fluids where these free-floating serum antibodies bind to pathogens
(before they infiltrate cells) and assist with elimination.

Someone who has never been exposed to a specific disease can gain humoral immunity through
administration of antibodies from someone who has been exposed, and survived the same disease.
Cell-mediated refers to the fact that the response is carried out by cytotoxic cells. Much like
humoral immunity, someone who has not been exposed to a specific disease can gain cell-mediated
immunity through the administration of T cells from someone that has been exposed, and survived
the same disease.

B-CELLS
B-cells have many protein complexes on their surface (up to 10,000 of them!) called membrane
bound antibodies. (antibodies are also called immunoglobulins).
Each B-cell has one type of membrane bound antibodies on it. There is a variable portion of the
antibody structure that is different between B-cells. Theres 1010 combinations of variable portions!
During development, potential self-responding combinations, for your own cells, are weeded out.
How do all these combinations arise if they come from the same B-cells with the same DNA? In the
development of the B-cells (hematopoesis), theres a lot of intentional reshuffling of DNA that codes
for the different variable parts.
These different combinations practically ensure that some B-cell will bind to a foreign pathogen,
even if its never been seen before. The part of the bacteria / pathogen it binds to is the epitope.
As soon as one of these epitopes are bound, the B-cell becomes activated (though in order to really
become activated, helper T-cells are needed), and starts cloning himself, repeatedly!
When the specific B-cell divides over and over, the daughter cells start to differentiate. They become:
ORGAN SYSTEMS 58
Memory cells these cells stick around a long time, with the perfect variable receptor on them (these
are in higher quantities than the original B-cell, so if this pathogen ever re-enters, there are more
specific B-cells to recognize it.)
Effector cells These turn into antibody factories; they start spitting out tons and tons of the
variable proteins that can uniquely bind to the infecting pathogens. When these antibodies bind, they:
(a) Cause opsonization: tag pathogens for pick up, make it easier for phagocytes to identify /
engulf
(b) Might make it harder for the pathogen to function viruses, e.g., wont be able to enter a host
cell as easily with a big antibody hanging off of it.
(c) Can join pathogens together on each antibody is two identical heavy chains and two
identical light chains, with a specific variable portion on each one. Each of these branches can bind
to the epitome, so one branch may bind to one virus, and another to a second virus, effectively
joining them (which makes it harder for the viruses to infect, and easier for the phagocytes to
identify.
The TH cells act to activate other immune cells, while the TC cells assist with the elimination of
pathogens and infected host cells.

SOME VOCABULARY:
Self particles, such as proteins and other molecules, that are a part of, or made by, your body. They
can be found circulating in your blood or attached to different tissues.
Something that is self should not be targeted and destroyed by the immune system.
The non-reactivity of the immune system to self particles is called tolerance.
Non-self particles that are not made by your body, and are recognized as potentially harmful (aka
foreign bodies). Non-self particles can be bacteria, viruses, parasites, pollen, dust, and toxic chemicals.
The non-self particles and foreign bodies that are infectious or pathogenic, like bacteria, viruses,
and parasites, make proteins called antigens that allow the human body to know that they intend to
cause damage.
Antigens anything that causes an immune response. Can be entire pathogens, like bacteria, viruses,
fungi, and parasites; or smaller proteins that pathogens express.
Antigens are like a name tag for each pathogen that announce the pathogens presence to your
immune system. Some pathogens are general, whereas others are very specific.
A general antigen would announce Im dangerous, whereas a specific antigen would announce
Im a bacteria that will cause an infection in your gastrointestinal tract or Im the influenza
virus.
Cytokines molecules that are used for cell signaling, or cell-to-cell communication. Cytokines are
similar to chemokines, wherein they can be used to communicate with neighboring or distant cells
about initiating an immune response.
Cytokines are also used to trigger cell trafficking, or movement, to a specific area of the body.
Chemokines are a type of cytokines that are released by infected cells. Infected host cells release
chemokines in order to initiate an immune response, and to warn neighboring cells of the threat.

PROFESSIONAL ANTIGEN PRESENTING CELLS (APC) AND MHC II COMPLEXES:

Recall, that when a phagocyte engulfs a pathogen, they take some of digested pieces of it and attach it
to the major histocompatability complex type II, then present this onto the phagocytes membrane.
A very similar process happens in B-cells, which have certain variable ends on membrane-bound
antibodies that are specific to the epitomes of certain pathogens.
ORGAN SYSTEMS 59
After a specific pathogen binds to a specific B-cell, it gets engulfed, which starts the activation
process. The B-cell then proliferates itself and activates (usually with helper T-cells) into memory
cells and plasma / effector cells that produce lots of antibodies
The B-cell will also take pieces of the broken down pathogen, attach them to MHC II proteins, and
present them on their membrane.
Cells that use MHC II to present bits of pathogen are called professional antigen presenting cells,
this includes phagocytes and B-cells.

HELPER T CELLS:
Adaptive immune system has humoral response (pathogens floating around) & cell-mediated response
B-cells are humoral response; T-cells are involved in cell mediated response
T-cells mature in the thymus. Well focus on two types of T-cells: helper and cytotoxic
When activated, helper T-cells sound an alarm to generate antibodies, which go on to disable a
specific pathogen (that is still floating around, not in cells)
Cytotoxic T-cells attack cells that have been infiltrated (or are abnormal in some way, like cancer
cells) and kill them to prevent spread of the pathogen / cancer.
Once an antigen is presented on a macrophage or a B-cell, the helper T-cell recognizes it.
Lets say we have a dendritic cell (phagocyte) and its already consumed a pathogen and put an antigen
from it on an MHC II complex on its membrane.
The helper T-cell has a T-cell receptor on it that bonds to the MHC II + antigen complex. Just like
the B-cell, this T-cell receptor has a variable portion, so different T-cells are specific to certain
MHC II complexes and certain parts of the pathogen.
Once the T-cell identifies and bonds its receptor to the MHC II complex, it is activated.
Note: Dendritic cells are actually the best at activating helper T-cells, especially naive helper T-cells
(means theyre non-memory, non-effector and have never been activated nor had anything bound to it).
When a helper T-cell is activated, it divides into many many copies, and starts to differentiate into:
(1) memory T-cells: Like memory B-cells, these stay around for many years in case the pathogen
returns. They have the same receptor as their parent, but last much longer.
(2) effector T-cells: These release cytokines. There are many types of cytokines (which are
peptides), but they all essentially raise the alarm of the immune system. When cytokines enter
other immune system cells, it makes them multiply or strengthen their immune response.
This is a central role, tells both activated cytotoxic T-cells to get in gear, and activated B-cells.
The effector T-cells also activate the B-cells (for the same species of virus) so they start
proliferating and differentiating. The variable portion of the T-cell connects to the same
specific virus as the B-cell that engulfed the pathogen; the combination of antigen + MHC II is
the same.
That combination is usually what activates the B cell and allows it to divide and differentiate.
Why do we have this double system? A fail safe mechanism The likelihood of both the T-cell and
B-cell having the same variable receptor + MHC II for a specific pathogen is very small; this prevents
lymphocytes from accidentally mutating a receptor / trying to kill one of your own cells.

CYTOTOXIC T CELLS:
Recall, antigen presenting cells (like various phagocytes, B-cells) present pieces of a pathogen theyve
consumed from the humoral space just floating around on their membrane with MHC II.
All nucleated cells in the human body have another major histocompatibility complex type I, or MHC
I
even cells with MHC II also have this
ORGAN SYSTEMS 60
Because its on pretty much every cell (except RBCs), any cell in the human body that has wacky
stuff going on (cancerous cells, or ones that have been taken over by a virus), will take parts of
those proteins (from the cancer cell, virus, etc.) and present them on MHC I.
Helper T-cells (with the correct variable portion) bond to MHC II complexes, get activated, divide and
differentiated, and effect a specialized immune response to them.
Cytotoxic T-cells bond with MHC I complexes (also with a specific variable portion), get activated,
and differentiates and divide. Like the other T-cells, these differentiate into
memory: stick around in case this mutation / cancer / pathogen shows up again
effector: go on to kill any infected / mutated cells with that specific MHC I complex they recognize
effector cytotoxic T-cells work by exocytosing perforin proteins that make holes in the
membrane of the infected cell, or releasing granzymes that induce mechanisms for cell death.

REVIEW OF B CELLS, CD4+ T CELLS, CD48+ T CELLS:

B-cells each one has uniquely specific membrane bound antibodies (bc of unique variable portion)
For activation, the B-cell needs binding of a pathogen /antigen on to its antibody and helper T-cell
stimulation. (helper T-cells come in because B-cell consumes the pathogen and presents a piece of
it on an MHC II complex, which the helper T-cell recognizes)
Once activated, the B-cell starts dividing and differentiating into memory cells (so theres more of
this variable receptor / a faster response if this pathogen were to return), and effector B-cells
(which basically turn into antibody making machines these are commonly called plasma cells).
The antibodies made from these plasma cells then go around and kill or impede growth of those
specific pathogens floating around, tag them for pickup from macrophages, etc.
T-cells two main types. All have T-cell receptors, and either CD4 receptors or CD8 receptors.
Unlike antibodies, which can bind to pathogens directly, T-cell receptors can only recognize
antigens that are bound to MHC I or MHC II membrane surface receptor molecules.
The CD4 receptor helps bind the MHC II complexes; so most CD4+ T cells are helper T cells.
Likewise, CD8+ T-cells bind to MHC I complexes, so most CD8+ T-cells are cytotoxic.
Recall, every nucleated cell can present antigens on MHC I complexes, the CD8 protein recognizes
that and kills infected / bad cells.
And CD4 proteins bind to MHC II complexes that have bits of pathogens on them.
When these T-cells get activated, they divide and differentiate into effector and memory cells
effector [CD4] helper T-cells can activate B-cells, and also releases cytokines alarm bells
that tell other immune cells to get in gear.
effector [CD8] cytotoxic T-cells kills cells with the specific MHC I complex on them
memory CD4 and CD8 T-cells stick around in case that specific pathogen / cancerous mutation
comes up again.

CLONAL SELECTION: How are the B and T cells prepared to fight infection?
(1) They are made, and are very specific.
B-cells divide and form millions of descendants in the bone marrow.
Unlike other parts of the body, each daughter cell that grows up is different from its parents and all
of the other daughter cells, because each daughter cell has a different / unique receptor (which
eventually becomes their antibody). This is because in the process of being made, theres a
shuffling of DNA that codes for this variable receptor.
T-cells divide and form millions of descendants in the thymus, which has 2 lobes and is located behind
the sternum. Similar to B-cells, they have a unique receptor. Each daughter T-cell also has a unique
receptor that identifies a unique antigen.
ORGAN SYSTEMS 61
So we end up with many many genetically different T-cells and B-cells that are responsive to many
things that may or may not even exist, because the creation of the variable receptor piece is sort of
random. After this, the B- and T-cells go to the lymph nodes.
In the lymph nodes, the B and T cells are essentially just waiting for that specific pathogen, which they
can identify, to enter the body.
(2) They recognize a specific invader
Lets say a part of tissue gets infected. Dendritic cells engulf and digest them, and present the antigen
from it on their membrane with MHC II. They, along with some of the bacteria, get swept into the
lymph system and eventually end up in the lymph nodes.
In the lymph nodes, only the specific T-cells, which can recognize the very specific pathogen on
the dendritic cell (or other antigen presenting cells), will bind to the antigen and become activated.
B-cells react directly to the specific bacteria, not to antigen presenting cells, by binding with their
antibody.
None of the other B and T-cells do anything about the infection because they cant bind to these
specific pathogens that were brought into the lymph node.
(3) After binding their antigen, the B and T cells jump into action, replicating like crazy, differentiating
into effector / memory cells, etc. and do their thing.
This process is called clonal selection (because the B and T cells select specific antigens and then
clone themselves to respond.
SELF VS. NON-SELF IMMUNITY:
How does your immune system know not to attack itself? How does it distinguish foreigners?
This answer is not always obvious. Think back to the B-cell and its receptor antibodies, which bind to
foreign pathogens (specific receptors for specific pathogens those are generated at random).
The fact that the variable receptors are created at random means they might create an antibody that
reacts to something important in your own body.
Theres no way to keep the B-cell from creating antibodies that would react to yourself, so we need to
figure out the self-antibodies are and kill them. (This is applicable for both T and B cells, of course.)
In the bone marrow is where B cells get their unique (randomized) receptor. How can we figure out if a
B-cell has an antibody that reacts to self (e.g. say it reacts to insulin)? Keep around various proteins
your body uses in the bone marrow that the body uses while these B-cells are being vetted.
Your body can then respond and kill any B-cell that binds to anything while still in the bone
marrow. [ex: youll have a little bit of insulin, hemoglobin, etc. floating around in the bone marrow
and one B-cell with a randomized variable receptor might recognize and binds to that insulin. As a
result, that B-cell dies.]
A similar process happens for T-cells in the thymus.
In order to make sure T cells will perform properly once they have matured and have been released
from the thymus, they undergo two selection processes:
Positive selection ensures MHC restriction by testing the ability of MHCI and MHCII to
distinguish between self and nonself proteins. In order to pass the positive selection process, cells
must be capable of binding only self-MHC molecules. If these cells bind nonself molecules instead
of self-MHC molecules, they fail the positive selection process and are eliminated by apoptosis.
Negative selection tests for self tolerance. Negative selection tests the binding capabilities of CD4
and CD8 specifically. The ideal example of self tolerance is when a T cell will only bind to self-
MHC molecules presenting a foreign antigen. If a T cell binds, via CD4 or CD8, a self-MHC
molecule that isnt presenting an antigen, or a self-MHC molecule that presenting a self-antigen, it
will fail negative selection and be eliminated by apoptosis.
After positive and negative selection, we are left with three types of mature T cells: Helper T cells
(TH), Cytotoxic T cells (TC), and T regulatory cells (Treg)
Helper T cells express CD4, and help with the activation of TC, B cells, and other immune cells.
ORGAN SYSTEMS 62
Cytotoxic T cells express CD8, and are responsible for removing pathogens and infected host cells.
T regulatory cells express CD4 and another receptor, called CD25. T regulatory cells help
distinguish between self & nonself molecules, and by doing so, reduce risk of autoimmune
diseases.
The B-cells and T-cells that have been vetted can go on to a lymph node or somewhere where it waits
to recognize pathogens.
Sometimes, a B cell that reacts to self will escape, though. (Maybe you dont have all the possible
proteins in your bone marrow / thymus, maybe the body made a mistake, whatever).
When this happens, that B-cell will find the protein it was made to react with (which is a part of
your own system), bind to it, ingest it, and present a piece of it on an MHC II complex. It then
needs a T-cell with the same receptor to come along that will recognize the same piece in order to
activate.
Without that T-cell, nothing will really happen. So even if a B cell escapes, unless a T-cell with the
same specific receptor has also escaped (which is even more unlikely, of course), theres not an
issue.
Ways it can go wrong:
What if bacteria got into the bone marrow? The B-cell will bind to it and be killed as if it responded to
self thus it wont get out into the lymph system to trigger immune response to that bacteria.
Not too much of an issue, because even if you have bacterium in the bone marrow for a couple
weeks or a month, it will eventually go away and your bone marrow can make those specific
antibodied B-cells again. (and hopefully you already had some B-cells for that pathogen in your
lymph nodes).
When the process goes wrong, you get an autoimmune disease, where the body attacks itself.
Ex: Myasthenia Gravis:
Muscle fibers have receptors on them that receive neural stimulation to activate/contract the fiber.
In myasthenia gravis, you develop antibodies against that muscle receptor. When those antibodies
bind, it either stops the muscle fiber from functioning or destroys the receptor. So its harder for
muscles to contract and be stimulated. You slowly become paralyzed.

HOW WHITE BLOOD CELLS MOVE AROUND:

Neutrophils circulate in the blood, but only do their work in the tissues at the site of an infection.
How do they know where to squeeze out of the blood vessels into tissues?
Macrophages at the site of infection will gobble up bacteria and release chemical signals that tell
endothelial cells of a nearby blood vessel that theres an infection there.
As a result, the endothelial cells express proteins that stick to the neutrophils. And then, because
theyre stuck, the neutrophils squeeze through endothelial cells in an active process. In the tissue,
they phagocytose the bacteria and then die. (When they die neutrophils become pus.)
Immune cells only ever cross from the blood into the tissue; its impossible for them to go the other
way. To enter circulation (such as for macrophages to present antigens to T and B cells), they must
enter the lymphatic vessel and go to the lymph nodes. In the lymph node is antigen presentation, which
causes B and T cells to activate and go to the side of the infection. How do they get there?
The activated T cells enter the thoracic duct (final, fat lymphatic vessel) and eventually drain back into
the blood. Once in circulation, those cells act similarly to neutrophils; they can see from endothelial
proteins where the infection is, and then squeeze out between cells to fight bacteria in the tissue.
B cells dont really need to be in the tissue, though, so they mostly hang out in the lymph nodes. Their
job is to release antibodies that can float around the body themselves and go to the infection site on
their own.
ORGAN SYSTEMS 63
BLOOD CELLS LINEAGES
In the blood vessels, you have about 10 different kinds of blood cells, from RBCs to T-cels, to B-cells,
to platelets, and more where do they all come from? Bone marrow! Specifically from the heads of
long bones and from different flat bones (like the sternum) throughout the body.
All blood cells have a single precursor: a pluripotent hematopoietic stem cell
This pluripotent cell gives rise to two different lineages: myeloid and lymphoid
Myeloid lineage yields red blood cells and megakaryocytes (from which platelets are made), as well
as mast cells (which release histamines in allergic reactions)
The myeloid lineage also yields monocytes,
which then become macrophages (part of the
immune system) when they settle in the tissues.
This monocyte lineage also yields three
other types of cells: neutrophils (most
common immune cell), eosinophils,
and basophils.
Lymphoid lineage yields B-cells (which
make antibodies), T-cells, and
natural killer cells.
Dendritic cells can come from either
lymphoid or myeloid (monocyte) lineages.
Renal System

KIDNEY FUNCTION AND ANATOMY
Humans have 2 kidneys, each about the size of a fist, that sit around the midsection
(closer to the back than the front of the body).
Kidneys receive blood from the heart (over a liter per minute!), filter it and reabsorb
what is needed, then produce urine with the waste products to expel from the body.
Kidneys can hold about 22% of your whole bodys blood supply!
Each kidney has an oxygenated blood vessel (renal artery) and a renal vein.
The artery holds onto everything in the blood, from nutrients (Na+ ions, AA,
glucose, etc.) to oxygen, to waste products (urea, toxins, extra electrolytes like
Na+ that we dont need, etc). Note: if you have too much of a nutrient, it becomes waste
product.
The vein then takes filtered blood, which still has the nutrients and some (but less) oxygen, away.
Kidneys are critically important in maintaining homeostasis by regulating pH level (via H+ ions),
blood pressure (via Na+ and Cl- ions), as well as osmolarity and expulsion of waste. It also makes
hormones!
How is it that the kidneys do this? Each kidney has two capillary beds:
The Vasa Recta delivers O2 to kidney tissue
The Peritubular Capillaries recollect nutrients
to filter and then return via the veins.
Two main functions of the kidney: filtration (gets
rid of waste products) and collection of those waste
products into the urine.
ORGAN SYSTEMS 64
The nephron is the functional unit of a kidney
its responsible for both functions.
The nephron is situated in both renal cortex
(the outside area / shell of the kidney) and the
renal medulla (middle area).. It sort of dances
between the cortex and medulla and where it
is determines what role its playing: reabsorption
of nutrients or collection of waste.
The nephron part thats situated in the renal medulla is called the renal calyx (plural: calyces). This is
the first part where urine is present.
The renal pelvis is a central area where all the calyces collect together.
Urine exits the kidney through the ureter off the renal pelvis and sends it into the bladder.
For any organ with tubes (artery, vein, and ureter in this case), the tubes are collectively known
as the hilum.

THE KIDNEY AND THE NEPHRON OVERVIEW OF THE FILTRATION PROCESS

Each kidney contains around a million nephrons!
The blood enters the kidney through the afferent arterial, goes into a windy place called the
glomerulus, and leaves through the efferent arterial.
Kidneys have two arteries, in contrast to other capillary systems where blood enters by an artery
and leaves by a vein. This maintains necessary pressure.
The glomerulus is surrounded by a structure called the Bowmans
capsule, which has many cells called podacytes.
When blood enters the glomerulus, about a fifth of it goes into the
Bowmans space. This fluid is the filtrate, & contains things that are
easily dissolved (ex: Na+, glucose, amino acids, etc.). Things that do
not dissolve easily (ex: RBCs) arent filtered into Bowmans space.
Bowmans capsule is sort of the beginning of the nephron. From there, the filtrate enters the proximal
tubule (this has a convoluted part, then becomes straight), where important nutrients are reabsorbed.
[ATP is used to pump out Na+, which helps bring in other things.]
Close to the cells that line the proximal tubule is another capillary system that pumps blood that
doesnt go into the filtrate (and a little water from the filtrate) back to the body.
After the proximal tubule, the blood enters the Loop of Henle. This section makes up most of the
nephron, and extends into both the renal cortex and the renal medulla.
One function of the loop of Henle is to make the renal medulla space salty, or hypertonic, by
actively pumping out salts (Na+, K+, Cl-, etc). It uses ATP to do this.
The ascending part of the Loop is only permeable to salts, whereas the descending part is only
permeable to water.
The descending part is thus where H2O molecules diffuse out; thats where/how a lot of our water
that is initially filtered out in the Bowmans space is gained back. (This explains why the loop of
Henle is so long, to allow enough H2O to diffuse out see countercurrent mult. section for more)
After the Loop of Henle, our blood reaches the distal convoluted tubule, which actually loops around
close to the Bowmans capsule again. This is where more nutrients (& a bit more water) are
reabsorbed.
ORGAN SYSTEMS 65
After going through the distal tubule, our filtrate has been processed. A lot of the water has been taken
out / reabsorbed (so the filtrate is more concentrated), and weve reabsorbed the nutrients we dont
want to lose. Its now mainly waste products and water we dont need any more.
This processed filtrate is then dumped into collecting ducts, which go back down to the medulla.
Anti-diuretic hormones dictate how porous the collecting duct is.. if its more porous then we lose
more water from the filtrate into the medulla (b/c of concentration gradient). This makes the filtrate
even more concentrated.
Eventually, the collecting ducts dump this concentrated filtrate into the ureter, where it exits the
kidney.
Main substances excreted in urine are:
Metabolic waste products (e.g. urea, creatinine),
Electrolytes inorganic compounds (eg. sodium, potassium, calcium, chloride, and bicarbonate)
that your body uses to control the fluid content / levels inside your body fluids.
Water
Urine production is obligatory, it happens regardless of what is going on with your body because of the
need to remove various solutes in order to keep internal conditions stable and relatively constant
(homeostasis). This ensures that the bodys physiological processes continue operating effectively.

GLOMERULAR FILTRATION IN THE NEPHRON DETAILS

The first step in making urine is for the glomerulus to separate the liquid part of your blood, from your
blood cells and turn it into filtrate, and then let the rest of the blood go on.
Filtrate contains all sorts of ion and nutrients, basically anything that can be dissolved in water.
Things that cannot be dissolved in water, such as red blood cells, do not leave the capillary.
Blood that is about to be filtered enters the glomerulus, which is basically a tuft of blood capillaries.
The glomerulus is nestled inside a cup-like sac located at the end of each nephron, called the
Bowmans capsule, or the glomerular capsule.
So, how does the Glomerulus capillary actually determine what is filtered and how much is filtered
into Bowmans capsule? Capillary walls are made up of three layers of filtration:
Endothelium - this has relatively large pores (aka fenestrations, 70-100 nm in diameter), which
solutes, plasma proteins and fluid can pass through, but not big things like red blood cells.
Basement membrane - this membrane is also made up of three layers, and is fused to the
endothelial layer. Its job is to prevent plasma proteins from being filtered out of the bloodstream.
Epithelium (Tubular cells) - this layer consists of
specialized cells called podocytes, which are attached
to the basement membrane by foot processes (pedicels)
Podocytes wrap around the capillaries, but leave
slits between them, known as filtration slits.
A thin diaphragm between the slits acts as a final
filtration barrier before the fluid enters the
glomerular space to the Bowmans capsule.
Together, the glomerulus and Bowmans capsule filtering
unit are known as a renal corpuscle.
In addition to the unique glomerular capillary bed, the
kidneys have other specialized capillaries called peritubular capillaries tiny blood vessels that run
ORGAN SYSTEMS 66
parallel to and surround the proximal and distal tubules of the nephron, as well as around the loop of
Henle, where they are known as the vasa recta.
The vasa recta is important for countercurrent exchange, the process that concentrates urine.

CHANGING GLOMERULAR FILTRATION RATE

Recall that the glomerulus is sandwiched between two arterioles - afferent arterioles deliver blood to
the glomerulus, while efferent arterioles carry it away.
This is unlike most capillary beds, which are are sandwiched between arterioles and venules rather
than two arterioles.. In those, the hydrostatic pressure usually drops as blood travels through the
capillary bed into the venules and veins.
The constriction of efferent arterioles as blood exits the glomerulus provides resistance to blood flow,
preventing a pressure drop, which could not be achieved if blood were to flow into venules, which do
not really constrict. The two arterioles change in size to increase or decrease blood pressure in the
glomerulus.
In addition, efferent arterioles are smaller in diameter than afferent arterioles This means
pressurized blood enters the glomerulus through a relatively wide tube, but is forced to exit through
a narrower tube
If diameter of efferent arteriole is bigger, filtration rate is lower. If diameter of efferent arteriole
is smaller, filtration is higher!
These unique features (plus the heart supplying the kidneys with > 1L blood per min), maintain a
high glomerular capillary pressure filtration function, regardless of fluctuations in blood flow.
Example: the sympathetic nervous system can stimulate the efferent arteriole to constrict even
during exercise when blood flow to the kidney is reduced.
ORGAN SYSTEMS 67
Example: In renal artery stenosis, we have a very narrow/stenosed renal artery, there is less blood
that runs across our capillaries and is filtered away.. theres going to be some blood / nutrients
backed up, which is bad.
Glomerular Filtration Rate = rate at which kidneys filter blood
The main driving force for the filtering process, or outward pressure, is the blood pressure as it enters
the glomerulus. This is counteracted to some extent by inward pressure due to the hydrostatic pressure
of the fluid within the urinary space, and the pressure generated by the proteins left in the capillaries
that tend to pull water back into the circulatory system (colloidal osmotic pressure).
The net filtration pressure is the outward pressure minus the inward pressure.

Regulation of glomerular filtration rate: Its normal for your blood pressure to fluctuate throughout the
day, but this has no effect on the glomerular filtration rate.. how?
Renal autoregulation the kidney itself can adjust the dilation or constriction of the afferent
arterioles, which counteracts changes in blood pressure. This intrinsic mechanism works over a large
range of blood pressure, but can malfunction if you have kidney disease.
Neural (nervous system) control and hormonal control these extrinsic mechanisms can override
renal autoregulation and decrease the glomerular filtration rate when necessary.
Ex: If you have a large drop in blood pressure, which can happen if you lose a lot of blood, your
nervous system will stimulate contraction of the afferent arteriole, reducing urine production. If
further measures are needed your nervous system can also activate the renin-angiotensin-
aldosterone system, a hormone system that regulates blood pressure and fluid balance.
Hormonal control The atrial natriuretic peptide hormone can increase your glomerular filtration
rate. This hormone is produced in your heart and is secreted when your plasma volume increases,
which increases urine production.
Glomerular filtration rate (GFR) can be estimated by measuring creatinine!
Creatinine is a waste product made in muscle when it is metabolized to
generate energy.
Creatinine is not reabsorbed or secreted, but is then exclusively filtered
through the kidneys. Its rate of excretion from your blood is directly
related to how efficiently your kidneys are filtering!
By measuring the amount of creatinine in a blood sample, and combining this with other
information (e.g. age, ethnicity, gender, height, weight), the GFR can be estimated, which gives
doctors a good idea of how well your kidneys are working.

TUBULAR REABSORPTION IN THE NEPHRON

If the fluid that filters through the glomerulus and Bowmans capsule (glomerular filtrate) flowed
straight to your bladder and then out your body, you would lose more than 10-times the entire volume
of your extracellular body fluids (plasma and interstitial fluid) every day.
Fortunately, tubular reabsorption mechanisms in the
nephrons move solutes and water out of the filtrate
and back into your bloodstream. [Its called
reabsorption because the first time these nutrients/
solutes were absorbed was into the bloodstream
from the digestive tract after a meal.]
ORGAN SYSTEMS 68
Recall, nephrons are divided into five segments, with
different segments responsible for reabsorbing
different substances >
Reabsorption is a two-step process:
(1) Passive or active movement of water & dissolved solutes from the fluid inside the tubule through
the tubule wall into the space outside.
(2) Movement of water and these substances through the capillary walls back into your bloodstream,
again, either by passive or active transport.
The walls of the nephron are made of a single layer of cuboidal epithelial cells; their ultrastructure
changes depending on the function of the segment they are in.
Ex: The surface of the cells facing the lumen of the proximal convoluted
tubule are covered in microvilli (tiny finger-like structures); called a
brush border. This border (along with the extensive length of the
proximal tubule) dramatically increases the surface area available for
reabsorption of substances into the blood. (~80% of the glomerular
filtrate is reabsorbed in this segment.)
Cuboidal epithelial cells are also densely packed with mitochondria (the
cells energy generators), which ensure enough energy is available to fuel
the active transport systems needed for efficient reabsorption.

Recall, sodium is the major positively charged electrolyte in extracellular body fluid.
The amount of sodium in fluid influences its volume, which in turn determines blood volume and
blood pressure.
Most of the solute reabsorbed in the proximal tubule is in the form of sodium bicarbonate and
sodium chloride, and about 70% of the sodium reabsorption occurs here.
Sodium reabsorption is tightly coupled to passive water reabsorption, meaning when sodium
moves, water follows.
Reabsorption of Na+ in the early proximal convoluted tubule: The most essential substances in the
filtrate are reabsorbed in the first half of the proximal convoluted tubule (early proximal tubule). These
include glucose, amino acids, phosphate, lactate and citrate, which piggy-back on Na+ co-
transporters that move sodium down its electrochemical gradient into tubule epithelial cells.
For this to continue, the sodium gradient must be maintained, which means sodium cannot be
allowed to build up inside the epithelial cells of the proximal tubule wall. This is achieved using:
Sodium/potassium ATPase, a sodium pump (active transporter) moves 3 Na+ ions out of the
cell for reabsorption, and 2 K+ ions in. This is located on the opposite side of the epithelial cell.
Sodium/proton exchanger enables reabsorption of bicarbonate. Glucose, AAs and other
substances passively diffuse out of the epithelial cells and are then reabsorbed by the blood
capillaries. By the time the filtrate has reached the mid part of the proximal tubule, 100% of the
filtered glucose and amino acids have been reabsorbed, as well as large amounts of sodium,
bicarbonate, phosphate, lactate, and citrate ions.
Reabsorption of Na+ in the late proximal convoluted tubule: The fluid entering the late proximal tubule
has been depleted of the essential substances, and chloride ions have been left behind in the tubule.
Due to extensive reabsorption of water in the early section of tubule, the concentration of chloride ions
is high and its ions are highly concentrated, and it is now their turn for reabsorption.
Chloride is transported into the tubule epithelial cells through the following processes:
ORGAN SYSTEMS 69
Chloride/formate anion exchangers driven by the high concentration of chloride in the filtrate.
Chloride diffuses out of the cell through channels in the cell wall, then on into the bloodstream.
Passive movement through spaces between epithelial cells of the tubule wall, aka tight
junctions.
This is another important route for reabsorption of small solutes such as NaCl and H2O.
Sodium continues to be reabsorbed in this part of the tubule via sodium/proton exchangers, and
actively transported through the tubule wall to the bloodstream by the sodium/potassium
ATPase.
After proximal convoluted tubule, ~15% of phosphate is reabsorbed in the proximal straight tubule.
Reabsorption of Na+ in the loop of Henle: The filtrate then enters the loop of Henle (descending and
ascending limbs), which is responsible for concentrating or diluting the tubular fluid using a process
called countercurrent multiplication.
The distal convoluted tubule and collecting ducts are then largely responsible for reabsorbing water
as required to produce urine at a concentration that maintains body fluid homeostasis.
Reabsorption of Na+ in the thick ascending limb: A further 25% of the Na+ and K+ is reabsorbed
through walls of the thick ascending limb of the loop of Henle via the three-ion cotransporter
(sodium/potassium/chloride); Na+/K+ ATPase again maintains the Na+ concentration gradient.
Sodium is actively pumped out, while potassium and chloride diffuse through channels in the
tubule wall and into the bloodstream. Recall, the walls of the thick ascending limb are
impermeable to water, so none is reabsorbed here.
Reabsorption of Na+ in the distal tubule and collecting duct: The tubular fluid now enters the distal
tubule and collecting duct, or terminal nephron. The early distal tubule reabsorbs a further 5% of
the sodium, and the late distal tubule and collecting duct fine tune reabsorption of the last little bit
(around 3%), determining exactly how much sodium will be excreted.
These segments of the nephron have slightly different transporters, as well as the
sodium/potassium ATPase that drives reabsorption of calcium and chloride.
Sodium reabsorption in the late distal tubule and collecting duct is regulated by hormones,
which stimulate or inhibit sodium reabsorption as necessary.

Other ions: Calcium reabsorption throughout the nephron is largely similar to sodium reabsorption
with over 99% being reabsorbed, while phosphate reabsorption is similar to that of glucose in that it
ORGAN SYSTEMS 70
primarily occurs within the proximal tubule. Reabsorption of magnesium differs in that the majority of
the reabsorption occurs in the ascending limb of the loop of Henle.

Consider: The importance of the kidneys in maintaining body fluid composition is clear when we look
at what the impact on the body when our kidneys start to fail. Retention of waste products causes
disturbances in multiple organ systems. Loss of water and electrolyte homeostasis lead to elevated
extracellular body fluid volume, which may produce edema and hypertension, reduced phosphate
excretion, loss of bone calcium, and symptoms of lethargy, nausea, diarrhoea and vomiting.
Diabetes insipidus is a rare disorder that causes you to feel very thirsty (despite drinking a lot),
and to produce large amounts of urine. It is usually caused by a malfunction in the production of
antidiuretic hormone (ADH), a hormone that prevents the production of dilute urine (i.e.,
retains water in the body). This can happen for a number of different reasons, including damage to
the pituitary (e.g., caused by a tumor, surgery, or infection) that disrupts the normal production,
storage and release of ADH. However, it may also occur due to a defect in the tubules themselves
that prevents them from responding to ADH, or during pregnancy, when a placental enzyme
destroys ADH in the mother.

COUNTER CURRENT MULTIPLICATION IN THE KIDNEY

Countercurrent multiplication in the kidneys is the process of using energy to generate an osmotic
gradient that enables you to reabsorb water from the tubular fluid and produce concentrated urine.
The kidneys contain two types of nephrons, superficial cortical nephrons (70-80%) and
juxtamedullary nephrons (20-30%).
These names refer to the location of the glomerular capsule, which is either in the outer cortex of
the kidney, or near the corticomedullary border.
Loop of Henle of cortical nephrons penetrates only as far as the outer medulla of the kidney, but
that of the juxtamedullary nephrons penetrate deep within the inner medulla, so the latter is largely
responsible for countercurrent multiplication. (although both types regulate solute / water levels)

Overview of Countercurrent Multiplication

Blood comes into to a nephron through the afferent arteriole, circles around the glomerulus, and exits
through the efferent arteriole. In circling around the glomerulus, a ton of fluid filters out of the blood
and into Bowmans capsule.. this fluid is then filtered to become urine.
After the fluid enters the Bowmans capsule, it flows into the proximal convoluted tubule, where ions
(Na+, Cl-, etc) and other builders of macromolecules (AAs, glucose) are reabsorbed, along with water.
Proximal convoluted tubule reabsorbs about 65% (most, by far) of the nutrients from the filtrate.
From the proximal convoluted tubule, the filtrate flows into the loop of Henle, which has two limbs
going in opposite directions the descending limb and the ascending limb.
This portion of the nephron extends into the renal medulla of the kidney, which is very salty
Descending limb is only permeable to H2O.
Ascending limb is the exact opposite; its
impermeable to water but allows
reabsorption of ions such as Cl-, K+, Na+
These characteristics lead to counter-current
multiplication, a process by which actively
ORGAN SYSTEMS 71
reabsorbing ions in the ascending limb
makes the medulla salty (b/c it doesnt allow
reabsorption of H2O, and this saltiness of the
interstitium allows H2O to be reabsorbed
passively in the descending limb.
The amount of water passively absorbed is
multiplied by the saltiness of the medulla,
which occurs as a result of actively pumping
ions out of the ascending limb.
After the ascending loop of Henle, the filtrate enters the distal convoluted tubule (DCT), which is
responsible for the reabsorption of other ions / important nutrients.
Note the scientific kiss that occurs here, where the DCT comes back towards the glomerulus.
This produces the juxtaglomerular apparatus, responsible for controlling blood pressure.
After leaving the distal convoluted tubule, this more concentrated filtrate gathers in the collecting duct.
Note that there are many DCTs which feed into a single collecting duct.
The collecting duct also descends into the renal medulla, and allows for further reabsorption of
H2O and urea. Urea is one of the main waste products we pee away, but sometimes kidneys like to
hold onto it (by reabsorption) to increase the osmolarity in the medulla to help drive water
reabsorption in the loop of Henle. From here, it goes into urea recycling.
From the collecting duct, this filtrate (now urine!) enters renal calyces and is sent off to be peed out.
After reabsorption, the efferent arteriole collects, via small peritubular capillaries (purple) across the
nephron, all the nutrients that have been reabsorbed! These capillaries then feed into the renal vein.
Details of Countercurrent Multiplication in the Loop of Henle
The 3 segments of the loop of Henle have different characteristics that enable countercurrent mult:
Thin descending limb passively permeable to both water & small solutes (ions, urea, etc.).
Water and solutes move down their concentration gradients until their concentrations within the
descending tubule and the interstitial space have equilibrated.
As such, water moves out and solutes to move in. This means the tubular fluid becomes
steadily more concentrated or hyperosmotic (compared to blood) as it travels down.
Thin ascending limb passively permeable to small solutes, but impermeable to water, which
means water cannot escape from this part of the loop.
As a result, solutes move out of the tubular fluid, but water is retained and the tubular fluid
becomes steadily more dilute or hyposmotic as it moves up the ascending limb of the tubule.
Thick ascending limb (sometimes called diluting segment actively reabsorbs Na+, K+ and Cl+.
This segment is also impermeable to water, which again means H2O cannot leave.
Countercurrent multiplication moves sodium chloride from the tubular fluid into the interstitial space
deep within the kidneys. Although its really a continual process, the way countercurrent multiplication
process builds up an osmotic gradient in the interstitial fluid can be thought of in two steps:
1. The single effect. The single effect is driven by active transport of sodium chloride out of the
tubular fluid in the thick ascending limb into the interstitial fluid, which becomes hyperosmotic.
As a result, water moves passively down its concentration gradient out of the tubular fluid in
the descending limb into the interstitial space, until it reaches equilibrium.
2. Fluid flow. As urine is continually being produced, new tubular fluid enters the descending limb,
which pushes the fluid at higher osmolarity down the tube. An osmotic gradient begins to develop.
ORGAN SYSTEMS 72
As the fluid continues to move through the loop of Henle, these two steps are repeated over and over,
causing the osmotic gradient to steadily multiply until it reaches a steady state. The length of the loop
of Henle determines the size of the gradient - the longer the loop, the greater the osmotic gradient.
Although the loops of Henle are essential for concentrating urine, they dont
work alone. The specialized blood capillary network (the vasa recta) that
surrounds the loop is equally important for countercurrent exchange:
The vasa recta returns absorbed water to the circulatory system.
Consists of long, hairpin-shaped capillaries that run parallel to the loop.
These hairpin turns slow the rate of blood flow, so any solutes that are
reabsorbed into bloodstream have time to diffuse back into interstitial
fluid, maintaining the hyperosmotic medulla for H2O reabsorption.
The concentration of urine is controlled by ADH, which can increase water
permeability in the late distal tubule and collecting ducts. This increases
active transport of NaCl in the thick ascending limb, and enhances
countercurrent mult. and urea recycling, thus increasing H2O reabsorption.
Urea recycling in the inner medulla also contributes to the
osmotic gradient generated by the loop of Henle. ADH
increases water permeability, but not urea permeability, in
the cortical and outer medullary collecting ducts, causing
urea to concentrate in the tubular fluid in this segment.
In the inner medullary collecting ducts, ADH increases
both water and urea permeability, which allows urea to
flow passively down its concentration gradient into the
interstitial fluid, also adding to the osmotic gradient that
helps drive water reabsorption.
SECONDARY ACTIVE TRANSPORT IN THE NEPHRON
The proximal tubule has a brush border, with the glomerular filtrate entering the lumen of the
nephron. This lumen/tube is surrounded by cells.
note: membrane of cell side facing the lumen is apical, while that facing the capillary is
basolateral.
Adjacent to proximal tubule is the peritubular capillary, where reabsorbed nutrients re-enter the blood.
On the basolateral side of the proximal convoluted tubule is a sodium/potassium pump! Sends 3 Na+
out (using ATP) and takes in 2 K+.
This active pumping out of Na+ means well have a lower Na+ concentration inside the cells of the
tubule wall than inside the lumen. Na+ wants to leave the lumen, then, to go into the cell.
A co-transporter symporter on the apical membrane takes advantage of this concentration gradient.
As Na+ leaves the lumen to enter the cell(s) of tubule wall, moving down its concentration gradient,
a glucose molecule is simultaneously transported up its concentration gradient without using ATP.
This same process happens in the loop of Henle with other ions the basolateral cell wall of the
ascending limb of the loop has a Na+/K+ pump, which reduces Na+ concentration in the cell(s) of the
tubes wall. Na+ then wants to move from the lumen to those cells, down its concentration gradient,
and with it (via the Na+/K+/Cl cotransporter) takes another ion up its concentration gradient.
Use of cotransporters after Na+ has already been pumped out is called secondary active transport.
In the distal convoluted tubule, Na+ is again pumped out via a Na+/K+ pump in the basolateral cell wall
of the tubule, lowering Na+ concentration in the cell(s) of DCTs wall. In this case, it drives
ORGAN SYSTEMS 73
reabsorption of Ca2+ through an antiporter. (The apical membrane of the cells of the tubule wall is
porous to Ca2+)
Recall that the peritubular capillaries run parallel to these tubules.. Thanks to the Na+/K+ pump, the
concentration of Na+ in the capillary blood is higher than in the cell, so Na+ will want to go back in.
When Na+ moves in, the Ca2+ is simultaneously moved up its gradient (in opposite direction).

URINATION
After we concentrate urine in our nephrons, it flows through the collecting duct to the renal calyx at the
tip of the medulla. Several renal calyces come together to make the renal pelvis, and from there our
urine flows out of the ureter into the bladder.
Ureters attach to the back of the bladder. They have valves that prevent backflow of urine up the
ureter towards the kidneys.
The ureters spray urine into the bladder with the ureter jet, one at a time (recall ultrasound video)
Looking at the bladder from the side, the anterior (front) has a sort of point and both interior and
posterior sides funnel down.
The bladder is lined with transitional epithelium, which is structurally somewhere in between the flat
squaemous epithelium and taller columnar epithelium. These types of cell allows the bladder to
expand!
The bladder then funnels into the urethra, controlled (at the top of the urethra / bottom of the bladdar)
by the internal urethral sphincter (IUS). This sphincter is involuntary & thus made of smooth
muscle.
In women, after the IUS, we have the external urethra sphincter (EUS), a membranous part
surrounding the urethra. This is in our control (unlike IUS) and thus its made of skeletal muscle. This
is the muscle we learn to control in potty training. After the EUS, the urethra is fairly short (much
shorter than in men), and it leads to the outside world.
In men, after the IUS there is the prostatic urethra (named because it passes through the prostate,
which circumscribes the urethra), and then the EUS. After the EUS, the urine will travel through a
urethra section called the spongey urethra, which is in the penis. After this, the urine leaves the world.
Note: If our ureter valves (which are normally one-way and prevent backflow) malfunction, we can get
whats called stasis, where the urine basically sits in the ureter. This can be a problem, and even cause
infection, if theres any bacteria there, which is not unlikely seeing as our urethra is connected to the
outside world. [Women are much more susceptible to these UTIs bc their urethra is so much shorter.]
Renal Regulation of Blood Pressure

OVERVIEW OF THE RAAS SYSTEM AND RENIN PRODUCTION
RAAS = Renin Angiotensin Aldosterone System. It begins with a set of cells that releases messengers.
The key cell is the juxtaglomerular cells, which are in the blood vessels of the kidney. Theyre
made of smooth muscle, and release renin: an endocrine peptide hormone that helps raise blood
pressure.
Recall that in the kidney, the afferent arteriole leads in to the glomerulus, and the efferent
arteriole leaves. In between these arterioles, the distal convoluted tubule crosses over. >
The distal convoluted tubules are partly made of some special macula densa cells.
The arterioles are made of the inner layer (aka the tunica intima) of endothelial cells,
then a layer of smooth muscle cells (tunica media).
 ORGAN SYSTEMS 74
On the afferent arteriole side (well, both sides, but mostly afferent), the tunica media also
has clusters of juxtaglomerular cells - also called granular cells because they all have little
granules in them. After this layer is the tunica externa layer, which is home to many nerve
endings for a nearby sympathetic nerve (will be important later)
In the arterioles are also mesangial cells, which are mostly there for structural support.
Together, this is all called the juxtaglomerular apparatus, whose goal is to release renin.
The granules of the JG cells are filled with renin. When released, renin enters afferent arteriole,
goes through the glomerulus, and exits through the efferent arteriole. But how / why is renin
released?
Triggers for JG cells to release renin include:
(1) Low blood pressure
JG cells directly sense low blood pressure in the afferent arteriole
(2) Sympathetic (fight or flight) nerve cell stimulation
Major stressor events cause this nerve cell to fire on the afferent arteriole, which in turn causes
the release of renin from JG cells
(3) Low Na+ concentration in the distal convoluted tubule, sensed by macula densa cells.
Macula densa cells sense concentration of sodium ion in glomerular filtrate.
Macula densa cells (which form the lining of the distal convoluted tubule) are part of the juxtaglomerular
apparatus, which regulates blood pressure.

A component of blood pressure is blood volume: higher blood volume means higher blood pressure.
A decrease in sodium ion in the distal convoluted tubule implies low blood pressure.
Macula densa cells send local, short-range signals to juxtaglomerular cells via release
of prostaglandins.
Prostaglandins are molecules that send short-range signals between cells; unlike hormones,
they are not produced by specific organs, but rather throughout the body.
Renin is released in response to signals that represent low mean arterial pressure.
The sympathetic nervous system innervates the juxtaglomerular apparatus and can signal in response
to low blood pressure.
Macula densa cells detect low blood pressure by sensing sodium concentration in the glomerular
filtrate, not in the blood plasma.
Renin is not released in response to detection of low plasma electrolyte levels by macula densa
cells.

If BP is low, not a lot of blood is moving through the glomerulus, so not a lot of fluid is moving
through the nephron, and thus a lot of salt is being reabsorbed. Macula Densa cells taste the
fluid going by and sense that theres not much salt in it (bc blood pressure is low), so they
signal JG cells to release renin through paracrine (short-ish distance) prostaglandins.

ANGIOTENSINOGEN > ANGIOTENSIN 1 > ANGIOTENSIN 2 > INCREASED BLOOD

PRESSURE
ORGAN SYSTEMS 75
In addition to the kidney, with its juxtaglomerular apparatus (and sympathetic nerves), the liver is also
involved in raising blood pressure.
Liver cells release angiotensinogen, a large (~450 AA) hormone precursor, or inactive hormone.
When angiotensinogen meets up with renin in blood vessels (all over body), renin cleaves that long
AA chain into just about 10 AA, effectively converting angiotensinogen into its active form:
angiotensin 1
Angiotensin 1 now floats through capillaries, tiny blood vessels that are so small theyre basically just
made of a layer of endothelial cells. In these endothelial cells is ACE: Angiotensin Converting
Enzyme.
ACE cuts another 2 amino acids off angiotensin 1 making it into the 8 AA hormone, angiotensin
2.
Note: It used to be thought that ACE was only present in the lung capillaries, but is now widely
recognized that ACE is in a lot of different vessels / organs, including the kidneys.
Angiotensin 2 ultimately raises blood pressure through four different cell types:
(1) Vasoconstriction causes smooth muscle cells of blood vessels to constrict and increase
resistance
Angiotensin = blood vessel tension
Recall, blood pressure can be measured with P = Q x R > PA - PV = (SV x HR) x R, so it
makes sense that if you increase resistance, arteriole blood pressure will also be increased (because
venous blood pressure doesnt really change).
note: SV = stroke volume = mL of blood pumped out of the heart with each beat
(2) Increases Na+ reabsorption in the kidneys by reabsorbing Na+, the kidneys also end up
absorbing and retaining more water with it.
When your blood has this increased Na+ and increased water, it will cause the stroke volume to go
up and, as we saw above in PA - PV = (SV x HR) x R, by increasing stroke volume (SV), blood
pressure will be increased
(3) Causes pituitary gland to secrete antidiuretic hormone ADH also accomplishes (1), making
blood vessels constrict. And it sort of accomplishes (2), making kidneys retain H2O instead of Na+.
[Water retention also makes SV increase, and thus pressure.]
(4) Causes adrenal gland (on top of kidney) to secrete aldosterone, which also accomplishes (2) -
increases reabsorption of Na+ in the kidneys (and thus increases SV).
Whats the difference between salt and water reabsorption?
When Na+ is reabsorbed, the medulla gets salty, so H2O absorption will follow as long as the
tube is permeable to H2O. [Where
If the tube is impermeable to H2O, though, obviously this will not work. Instead, the tube uses a
bunch of special channels to allow H2O through.
The area of the nephron where angiotensin 2 and aldosterone affect reabsorption is permeable to
water, so causing Na+ reabsorption works to retain water, too.
But the area where ADH affects the nephron is impermeable to water, so it must directly cause
H2O reabsorption through channels.

DETAILS OF ALDOSTERONE FUNCTION IN RAISING BP:

Aldosterone is released by the adrenal gland, which has two parts: cortex (outer) and medulla (inner).
ORGAN SYSTEMS 76
Adrenal cortex cells are provided nutrients / oxygen by small capillaries, and theyre filled
with cholesterol. The cholesterol is very useful in making the hormone aldosterone.
Triggers for adrenal cortex to make aldosterone:
(1) Angiotensin 2
(2) Increase in K+ concentration
Aldosterone affects the late distal convoluted tubules and the collecting ducts of nephrons.
These tubules are lined with principal cells, which are adjacent to the peritubular
capillary. (the side of peripheral cells facing the capillary is the basolateral surface; that
facing the lumen is the apical surface)
There are lots of K+ ions inside the principal cell, and lots of Na+ in the blood flowing through the
capillaries. These two ions are exchanged through the sodium-potassium pump on the basolateral
surface 3 Na+ ions move out of the cell as 2 K+ ions are pumped in.
Aldosterone works by:
1. Making the sodium-potassium pump in the basolateral surface of the tubule / duct work harder.
2. Opening potassium channels on the apical surface, so K+ flows out of the principal cells into the
fluid (soon to be urine) flowing through the tubule. This increases drive to get K+ into the cell.
3. Opening Na+ channels, moving Na+ into the principal cell from the urine, which again makes
the Na+/K+ pump work even harder to pump Na+ out of the principal cells (where concentration
is increasing) into the capillaries. When Na+ enters the capillaries, water follows.
TL:DR Aldosterone works on the principal cell and causes blood to lose K+ and gain Na+ (and
thus gain water) this leads to increased stroke volume and thus increased blood pressure

ALDOSTERONE ALSO REMOVES ACID FROM THE BLOOD:

Aldosterone also works on -intercalated cells, whose main job is to get rid of protons (and thus
acid).
Alpha intercalated cells are in the collecting duct; they secrete hydronium ion (acid) and absorb
bicarbonate.
[The -intercalated cell, by contrast, tries to hold onto acid.]
The -intercalated cell is also bordered by a peritubular capillary on the basolateral side.
Recall: all cells make CO2 and H2O through glycolysis, and are then turned into H+ and HCO3- by
carbonic anhydrase.
Lets say the blood is getting a bit too acidic and H+ starts building up. What happens?
In the -intercalated cells basolateral side, there is a channel that allows HCO3- to travel from the
cell into the capillary and simultaneously brings a Cl- into the cell. In the blood, the HCO3-
combines with H+ to make CO2 and H2O.
In the -intercalated cell, that Cl- that entered when HCO3- left can leave the cell through a channel
on the basolateral side.
But were still left with the H+ from the initial rxn with carbonic anhydrase For every H+ we
remove from the blood, we have one in the cell, and these start to build up.
How do we get rid of the acid from -intercalated cells? 4 main transporters
ORGAN SYSTEMS 77
On the apical side, theres an active transporter (requires ATP) that will send the H+ from the -
intercalated cell into the urine, and it can just be peed out. Aldosterone makes this transporter work
super well.
A second transporter on the apical side can send out H+ without using energy; instead it uses the Na+
concentration gradient. Aldosterone also makes this transporter work super well.
Recall that cells have a lot of K+, but not a lot of Na+. (Most of the Na+ is in the blood.) The
entrance of Na+ down its gradient fuels the movement of H+ against its gradient.
A third type of transporter on the apical side also requires energy (is active transporter) to allow H+
out. As H+ leaves the cell, K+ is driven back in, against its gradient (which is why energy is required).
In -intercalated cells, there are also (like all cells) sodium-potassium pumps on the basolateral side
that bring 2 K+ in and force our 3 Na+; this also takes energy.
TL;DR Acid is removed from the blood by bringing in HCO3- from -intercalated cells to
neutralize it, but that leaves H+ (from the same rxn) in the -intercalated cells. H+ is then removed
from those cells by several transporters, two of which are driven by aldosterone.

ANTI-DIURETIC HORMONE (ADH) SECRETION:

ADH is sometimes called vasopressin.
Consider the pituitary/hypothalamus structure: There is the hypothalamus (at the top), the
infundibulum in the middle, and then the two lobes of the pituitary: anterior and posterior.
On this structure is also a little nodule called the optic chiasm, above which sits the supraoptic
nucleus (recall that a nucleus is a collection of cell bodies / somas).
The nerve cells in the supraoptic nucleus start there and travel all the way down to the posterior
pituitary; this is how the hypothalamus and pituitary are connected.
There are lots of tiny capillaries and venules in the posterior pituitary, as well.
ADH is a peptide hormone made in the nerve cells of the supraoptic nerve cells.
When theres a trigger, these nerve cells fire off ADH and signal the capillaries to release ADH
hormone into the body.
What are the triggers for ADH release?
*High blood concentration (aka high osmolarity, meaning level of solutes in the blood) this is
most important trigger
Body likes to stay in the 280 - 300 mOsm/L range. If it gets above 300, its a little salty / too
osmotic and ADH is triggered to be released (by osmoreceptors in unknown locations)
Low blood volume
This is sensed by nerve endings in the walls of the vena cava blood vessels and the right atrium
(because, recall, the venous system is very large volume.. If the cells of those walls sense that
they are less stretched, they know blood volume is low and they trigger ADH release.
Low Blood Pressure
This is sensed by arteriole baroreceptors in the aortic arch and the carotid sinuses on both sides.
Angiotensin 2 also triggers release of ADH.

ANTI-DIURETIC HORMONE (ADH) EFFECTS ON INCREASING BLOOD PRESSURE:

ORGAN SYSTEMS 78
ADH signals all arteriole vessels of the body, with their smooth muscle, to constrict. This increases
resistance, which in turn increases blood pressure. PA - PV = (SV x HR) x R
It also causes the kidneys to retain / reabsorb water by affecting the collecting duct, specifically, which
causes stroke volume to increase.
As you go deeper in the medulla (from bowmans capsule down the loop of Henle), there is an
increasing gradient of mOsm concentration. It gets salty
In the collecting duct cells, there are little vesicles called aquaporins, which do not allow water to
go through, except through their aquaporin channels.
Note, though, that they are not close to the wall, so H2O cannot enter the collecting ducts.
ADH will float through the blood (which flows in opposite direction to the urine in the
collecting duct that the capillary is next to), and signals the collecting duct cells to merge
aquaporin vesicles with the apical wall of the cell, so channels allow water in and out.
After opening the aquaporin channels, lots of H2O flows into the cell and then basically straight into
the adjacent peritubular capillary, significantly increasing blood volume and thus stroke volume, and
thus blood pressure.

ALDOSTERONE AND ADH:

Aldosterone: uses an osmole to pull H2O into the blood
The tubules it affects are water permeable. It pulls Na+ into the capillary and sends in K+ through
an active transport pump.
Recall, Na+ is not able to cross membranes; which means it is a big contributor to tonicity; it cant
leave the blood vessel. By comparison, K+ can slightly cross membranes, but net tonicity still
increases. This increase in tonicity pulls in water.
Increases osmolarity and also increases volume.
Because they both increase proportionally, we dont think of osmolarity really being affect.
ADH: uses channels to pull H2O into the blood
The tubules it affects are not water permeable, so it opens aquaporin channels that allow H2O
across.
Increases volume, but not osmols, so overall osmolarity (fraction of osmole / vol.) decreases.
Given this information and the changes the hormones make, think about a situation where you want to
increase volume but maintain osmolarity: increase ADH
increase volume, regardless of osmolarity: increase aldosterone and ADH
decrease osmolarity, regardless of volume: ADH
decrease osmolarity, maintain volume: increase ADH, decrease aldosterone

Gastrointestinal System

OVERVIEW OF THE GASTROINTESTINAL TRACT
Mouth: chewing + hydrolysis (enzymatic breakdown) = bolus.
Esophagus: propela bolus
ORGAN SYSTEMS 79
Stomach: churning (like chewing, but more dimensions) + hydrolysis + storage = chyme.
Small Intestine: hydrolysis + absorption
Large intestine (colon): absorption (not of nutrients, but ions, water, vitamin K, etc.)
Rectum: storage of processed food until we expel it
Anus: expulsion
MOUTH (ORAL / BUCCAL CAVITY)
Goal of the mouth is to convert food into bolus, which we do in two steps:
(1) Chewing (mastication) accomplished by teeth and the tongue.
The tongue is made of extrinsic and intrinsic muscles.
Extrinsic tongue muscles cause elevation, depression, protrusion, retraction
Intrinsic tongue muscles (only inside the tongue) shorten & widen (run A/P), and lengthen &
narrow (R/L)
(2) Breakdown of food particles by hydrolysis. The enzymes in our mouth that do this come from
glands.
Glands release: Serous content (for enzymes) - breakdown / cut food by hydrolysis, and
mucinous (musin) content - wet the food to make it easier to form bolus)
Parotid glands (mainly serous) release about 25% of saliva content
Submandibular (also mainly serous) - 70% of saliva
Sublingual gland (mainly releases mucin) - 5% of saliva
Von Ebners gland (mainly at the tip of the tongue, also serous) - less than 5% of saliva
Von Ebners gland is important in that is releases lingual lipase, which breaks down triglycerides into
free fatty acids, diglycerides, and monoglycerides.
The other three glands (parotid, submandibular, and sublingual) release -amylase, which breaks
down starch into smaller carbs
Note that the amount of hydrolysis and breakdown that occurs in the mouth is very insufficient for
digestion; its basically just so we can taste things (e.g. enjoy the sugars in our soda)
The mouth normally is at a pH of ~7, but if we eat a lot of sugar (which, recall, has a lot of hydroxyl
groups), it can actually lower the pH of your mouth to as low as 5.5! This acidity will start to break
down your teeth.

TEETH
mandible = lower jaw; maxilla = upper jaw. There is
symmetry both on the left/right sides, as well as
between the mandible and maxilla.
The textbook picture to the right with 4 central incisors,
4 lateral incisors, 8 premolar, and 12 molar teeth is
actually only what 28% of peoples teeth look like.
Why? Your 3rd molars are your wisdom teeth, and
most people (72%) have them removed.
Wisdom teeth are often removed because teeth come up
through little holes in your gums (aka gingiva). In most
people, the hole for the 3rd molar is very small too
ORGAN SYSTEMS 80
small for the 3rd molar to get through. So the tooth ends up twisting and trying to erupt through the
gingiva in a such bad way that it can cause inflammation and tearing.

ESOPHAGUS
There are sphincters circular localizations of muscle at the very top and very bottom of the
esophagus. These keep food moving in one direction.
The upper esophageal sphincter only opens when we tell it to, and is thus made of skeletal muscle.
The lower esophageal sphincter doesnt really look like a sphincter, because its not a ring of muscle
that opens and closes when we want. Instead its really the diaphragm a sheet of muscle that lines
the connection between the thoracic cavity (lungs, heart, etc), and the abdominal cavity, and helps our
lungs expand to breathe.
This diaphragm forms a ring around the base of the esophagus and holds it in place.
Over time, humans can get a hernia where the esophagus moves up through the diaphragm (aka
lower esophageal sphincter) and causes acid reflux.
The esophagus works as a passageway for food, and doesnt do much except peristalsis the
wavelike propulsion of food. Contraction of the muscle above + simultaneous relaxation of muscle
below.
Esophageal tract is not made of 100% skeletal or 100% smooth muscle; instead its split into thirds.
top-third: all skeletal muscle, which is completely in our control
middle-third: combination of skeletal and smooth
last-third: all smooth muscle, 100% not in our control.

STOMACH
Stomach is primarily responsible for 3 steps:
(1) receives bolus of food
(2) churns the bolus / food to break down the food even more
(3) hydrolysis (enzyme assisted breakdown) of the bolus
These steps end with making chyme, which just sort of sits there for a little bit (the stomach also
stores food, up to 4 L at a time!) before moving on to the small intestine.
The stomach is lined with many infoldings of the gastric wall that help to increase surface area. The
folds are lined with cells that secrete enzymes. Three main types of cells:
Parietal cells release HCl
Chief cells release pepsinogen (inactive form of pepsin. HCl turns pepsinogen into pepsin)
Pepsin break down proteins by cleaving peptide bonds; thus, peptin is the only type of molecule
broken down in the stomach.
Note: with just these two secretions, HCl and pepsin, your stomach would basically eat itself!
This is what is happening when we get gastric ulcers.
Mucous cells make mucous to line the stomach wall and protect it from pepsin and HCl.

SMALL INTESTINE
The small intestine has three different parts to it:
ORGAN SYSTEMS 81
(1) Duodenum receives chyme from the stomach. Most of the digestion occurs here.
(2) Jejunum most absorption happens here
(3) Ileum absorbs important things like vitamins
The Duodenum is very busy with four key processes:
Receives chyme and HCl from the stomach
Liver and gallbladder send bile to the duodenum
Pancreas also delivers some important enzymes
The duodenum itself has brush border enzymes, which are important for absorption and for
enzymatic activity.
The brush border is basically in-foldings on the wall of the duodenum (bumps face in), called villi.
Within each villus is even more in-foldings, microscopic projections of tiny bumps called
microvilli
All these increase surface area for absorption and digestions, because the projections have
enzymes.
Digestion (in the duodenum):
Protein is broken down by several enzymes in the small intestine into constituent amino acids
Peptidase is found on the brush border.
The pancreas sends trypsinogen and chymotrypsinogen, which an enzyme called
enteropeptidase turn into their active forms of trypsin and chymotrypsin.
Carbohydrates are broken down by: amylase (sent by the pancreas) and lactidase (can only break apart
lactose this is found on the brush border).
When you get a stomach bug, it can inflame the duodenum and actually knock off some of the
lactidase enzymes. Thus, you may be temporarily lactose intolerant.
Eventually youre left with just monosacharides.
Nucleotides are broken down by nucleosidases on the brush border, which cleaves basepentose bond.
Fat is broken down by lipase, which is released by the pancreas and cleaves triglycerides into the
glycerol backbone and 3 fatty acids.
Bile released by the liver / gall bladder to organize the fatty acids.
Absorption (mostly in the jejunum)
After digestion, we have all out monomers (AA, monosaccharides, nucleobases, fatty acids, etc.)
Amino acids are funneled into intestinal cells with primary active transport (uses ATP) >
eventually enters a blood capillary.
Sugar monosaccharides are funneled into and eventually out of the intestinal cells with secondary
active transport This is when an ion like Na+ flows down its concentration gradient into the cell
from the lumen (or out of the cell into the capillary), which allows the monosaccharide to also enter (or
exit)
The P-pentose and nitrogenous base also enter/exit the cell with primary active transport and
eventually end up in the blood capillary.
Because of their nonpolar tail, fatty acids can just diffuse across the membrane into the enterocyte
(intestinal cell). There, they are organized into chylomicrons, which are too big to go to the blood
ORGAN SYSTEMS 82
capillary. Instead, chylomicrons are absorbed into the lymphatic capillary (aka lacteal), where they are
further digested into smaller bits and can then get into the veins and eventually the blood capillaries.

LIVER
The liver is responsible for for main things:
(1) Metabolism involves catabolism and anabolism
(2) Storage
Carbs are stored as glycogen, while fats can be stored as lipoprotein and triglycerides.
Proteins are also seen in the liver, but arent really stored.. instead theyre turned into molecules
like albumin and sent off into the bloodstream until they need to be retrieved back to the liver
(3) Detoxification achieved mainly by cytochrome P450. Unlike other enzymes, they can take
many different kinds of substrates and react with them.
This detoxification process causes a problem when we take medications, it decreases the drug
efficacy.
(4) Bile production needed for fat absorption
Uniquely, the liver has two separate blood supplies going to it, and one that leaves it. These three
vessels make up the portal triad.
The portal vein supplies the liver with nutrient rich blood (The nutrients come from food
absorbed in the intestinal track, which go through circulation to end up in the portal vein.)
The proper hepatic artery supplies the liver with arteriole, oxygen-rich blood.
The hepatic vein carries away nutrient- & oxygen-poor blood. This blood then travels to the
heart to be oxygenated, goes past intestines to gain nutrients, then re-enters liver through portal
vein.
The other output from the liver is bile, which leaves through the common hepatic duct.

Hepatic lobule
The portal triad is important to identify in surgery, and is easy to identify when we look at pieces of the
liver called hepatic lobules.
In the hepatic lobule, there are many lot of liver cells, or hepatocytes, and around them three distinct
branches that make up the portal triad. Theres actually bunches of portal triads surrounding
hepatocytes this leads to 6 distinct sides of the hepatic lobule.
The portal vein is how we get nutrient rich blood to enter the hepatic lobule (portal vein branches
are called sinusoids), where hepatocytes then break those nutrients down for storage or whatever is
needed. The proper hepatic artery brings in oxygen to the hepatic lobule.
Once those have been extracted, we need to send the blood out to be oxygenated and get nutrients
again.. so the blood collects in the center of the hepatic lobule, into the central vein, which then
becomes the hepatic vein. (which sends blood back to the heart > intestines, etc)

Biliary tree
Bile is composed of bile pigments (make the color and arent really important for function) and bile
salts (very important, help us emulsify fat into miscelles, which can then be absorbed in the ileum).
Bile thats made in the liver travels through the common hepatic duct into the cystic duct, which
then leads it to be (temporarily) stored in the gall bladder, a blind pouch..
ORGAN SYSTEMS 83
The singular purpose of the gall bladder is to store the bile.
The hormone that causes bile to be released from the gall bladder is cholecystokinin (CCK); it causes
the gall bladder to contract, and in doing so all the bile is squeezed back through the cystic duct and
then into the common bile duct.
The common bile duct travels to the duodenum of the small intestine and releases its bile there. In the
duodenum, fats are emulsified.
Note, though, that fat is not absorbed in the duodenum. Instead, the bile salts with the emulsified
fat travel along to the ileum (last part of the small intestine) for absorption.
What happens to bile salts after theyre absorbed in the ileum? They circulate back to the liver to
repeat the process.

EXOCRINE PANCREAS
The pancreas sits below and behind the stomach, and sort of hugs the duodenum of the small intestine.
Some say its in a completely different section of the body, not in the peritoneum (abdominal
cavity with the stomach, intestine, etc.), but is instead is in the retroperitoneum (along with some
big blood vessels)
The pancreas releases powerful enzymes that digest lots of macromolecules things we eat
as well as some that make up parts of our body. It also is unique in that its un-encapsulated;
its just a slurry of cells (which makes it difficult especially for surgeons operating nearby).
Many consider the pancreas to be the lion of the abdomen because of its importance and power.
There are two main components to the pancreas:
Exocrine pancreas takes salts and enzymes and releases them in the duodenum.
Endocrine pancreas releases hormones.
The exocrine pancreas releases four main things:
(1) Bicarbonate neutralizes gastric acid (HCl with chyme from the stomach)
(2) Amylase breaks down starch into monosaccharides.
(3) Lipase breaks down triglycerides into free FAs, monoglycerides, diglycerides, and glycerol.
(4) Proteolytic enzymes includes trypsinogen and chymotrypsinogen.
Trypsinogen is turned into its active form trypsin by anteropeptidase enzyme in the
duodenum. Chymotryspinogen is then turned into its active form chymotrypsin by trypsin!
What happens when the bonds of trypsinogen are broken while its still in the pancreas? e.g.
if you get hit in the abdomen really hard and trypsinogen ends up turning into trypsin? Well,
because the pancreas is un-encapsulated, that trypsin would just travel around and digest all
sorts of proteins (in membranes, in our food, in other organs, etc) not good.
The endocrine pancreas is more famous it releases hormones rather than enzymes and salts. Those
hormones enter the blood stream and move all over the body.
The endocrine pancreas is composed of many islet cells that sit in islands.
Three main types of islet cells (all are present to some extent in each island):
(1) -islet cells: release glucagon [breaks down many macromolecules, e.g. glycogen >
glucose]
ORGAN SYSTEMS 84
(2) -islet cells: release insulin [builds up / stores macromolecules, e.g. glucose >
glycogen.
Its also the hormone responsible for diabetes, aka eye nerve & kidney disease, which is
caused by too much glucose in the body bc insulin isnt working.
Type I diabetes: no insulin
Type II diabetes: insulin receptors are broken
(3) -islet cells: release somatostatin [stops the effect of other hormones in the GI tract]

COLON, RECTUM, AND ANUS

After food is absorbed in the small intestine, it travels to the large intestine (which is bigger in
diameter, but actually much shorter).
At the end of the small intestine / beginning of the large intestine is the ileocecal valve.
The first main part of the large intestine is the cecum (with appendix tail hanging off). It then goes
up through the ascending colon, then goes across through the transverse colon, and then down the
descending colon. The last part of the large intestine is the sigmoid colon (has an S shape to it).
The large intestine is most responsible for absorbing:
Water
If we absorb too little water, the output of our body would be a little watery. This is diarrhea.
If we absorb too much water, well get constipated.
The disease cholera attacks certain proteins / receptors in the intestinal lining that cause you to
lose tremendous amounts of fluid and eventually lead to death by dehydration. If, however, you
can keep a person very hydrated throughout the whole disease manifestation, theyll end up
passing the bacteria and be okay.
Inorganic Ions includes Na+, K+
Like other organs (the small intestine and, more notably, the kidney), Na+ and K+ are absorbed
with transport mechanisms. The kidney is much more important for inorganic ion absorption
than the large intestine, so even if you have to have a colonectomy, youll be okay.
The large intestine is also home to lots of micro-organisms that assist in digestion of things like
carbohydrates, making byproducts of methane (CH4) and dihydrogen sulfide (H2S)
After the sigmoid colon is the rectum, whose main function is storage. It holds onto stool until its an
appropriate time to go to the bathroom.
The anus comes next, and is composed of two sphincters:
Internal anal sphincter is made of smooth muscle that is involuntary.
External anal sphincter is made of skeletal muscle; its under our control.
When its time to release stool, the internal anal sphincter will relax and the stool will move
forward to push on our external anal sphincter, so we know its time to go. But we can wait until
we get to a bathroom b/c the external sphincter is under own own control.

CONTROL OF THE GI TRACT

The GI tract has sort of its own brain! Its called the enteric nervous system, because it can act on its
own without having to send neuronal signals to the brain or spinal cord to regulate its action.
ORGAN SYSTEMS 85
ex: When we consume a meal, we initiate the gastrocolic reflex. The presence of food in your
stomach is signal 1 tells your colon its time to make way for food thats coming down; so it
pushes the food/stool thats currently in there out.
The GI tract is also under hormonal control. Important hormones include:
Gastrin: released from mucosal cells when we notice theres food in the stomach. Its initially
released into bloodstream, then comes back into stomach to stimulate secretion of digestive juices.
Gastrin causes secretion of HCl from the stomachs parietal cells and pepsinogen from chief cells.
Gastrin also increases stomach motility (churning power of the stomach to produce chyme).
Gastrin is checked by low pH (~3) this decreases gastrin release.
When chyme is delivered to the duodenum, it causes release of secretin hormone into the bloodstream.
Secretin first goes to the pancreas and cause the release of bicarbonate rich solution (involves
pancreatic enzymes and bicarbonate, which will neutralize the acid of chyme.
Secretin also goes back to the stomach to inhibit stomach motility and acid / pepsinogen release (it
counters gastrin)
Because of the acidic chyme, we also see the release of cholosystokinin (CCK) from our intestinal
mucousa into our bloodstream where it travels to:
(1) The pancreas, to stimulate release of pancreatic enzymes, such as lipase.
(2) The gall bladder, to cause it to contract, sending bile back into the cystic duct and down and
out of the common bile duct into the duodenum. There it helps emulsify fat
(3) Cholosystokinin also goes into the stomach and decreases stomach motility to slow the
release of chyme.
Note: Its not just chyme as a whole that requires CCK to be released, its the fat in our chyme that
specifically causes the release of CCK.
Similarly, its not a macromolecule that causes secretin to be released, but the HCl that comes in
along with chyme.
The pancreas also is a big player of hormones, causes glycogen build up and break down.

Muscular System

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MYOSIN AND ACTIN

Myosins comprise a family of ATP-dependent motor proteins. Theyre known for their role in muscle
contraction and their involvement in a wide range of other motility processes.
Myosin 2 (has two heads) is an ATPase involved in actin-based motility (muscle contraction)
Contraction of muscle:.
(1) Myosin is bound to the actin filament. ATP then binds to myosin head & myosin releases
actin.
(2) ATP hydrolyzes (> ADP + Pi + energy). This cocks the myosin protein to high energy
conformation (loads the spring)
(3) Phosphate group is released from myosin, which releases the energy of the cocked position and
causes it to push on the actin filament, it releases the
spring as a power stroke that creates mechanical energy.
ORGAN SYSTEMS 86
(4) ADP released, and myosin is still bound to the actin
so were where we were in step 1, but one stroke further
along the actin filament. Chemical energy (ATP) has turned into mechanical energy.
This action contracts the muscle cell, and through the synchronous process in many muscle cells,
contracts the entire muscle.

TROPOMYOSIN AND TROPONIN AND THEIR ROLE IN REGULATING MUSCLE CONTRACTION:

When the myosin releases the actin after ATP binds, why wouldnt the actin just go back to where it
was before, because of the tension? How does myosin keep pulling it along when its not on the actin
filament 100% of the time?
You have many myosins working on one actin filament at once! So when one pair of heads is off
the actin, others might be in the process of pulling it; they all work together.
How do we stop this movement of myosin along actin when we dont want to contract our muscle?
Tropomyosin and Troponin!
Tropomyosin protein coils around the actin, and its attached by the protein complex troponin.
When a muscle is contracting, tropomyosin keeps the myosin from crawling up the actin.
Blocks the myosin from being able to attach to the actin in its usual place OR if myosin is already
bound, tropomyosin keeps it from moving and walking up the actin.
The only way to make the troponin unblock myosin is for the troponin to change its shape; this only
happens with a high concentration of calcium ions in the cell.
Ca2+ binds to troponin and changes its conformation enough that the tropomyosin is moved out of
the way and myosin can bind and walk up the actin. [contraction]
If Ca2+ concentration gets low, the troponin will go back to standard conformation and that makes
the tropomyosin block the myosin again, so contraction does not happen. [relaxation]

SARCOPLASMIC RETICULUM:
How does the nervous system tell the cells to make its Ca2+ concentration high and contract muscle, or
make the Ca2+ concentration low and relax muscle? The sarcoplasmic reticulum
The membrane of the muscle cell is the sarcolemma, and in it is a fold called the T-tubule.
Inside of the muscle cell is an organelle called the sarcoplasmic reticulum, whose function is
purely storage. ATP-fueled channels on the SR pump in lot of Ca2+, so in a resting muscle, you
have a very high concentration of Ca2+ concentration within the SR.
A protein complex connects the T-tubule to the sarcoplasmic reticulum.
When a muscle is contracting, the SR will release the Ca2+ into the cell (where actin/myosin/etc.
are)
How does the sarcoplasmic reticulum know when to release the Ca2+? Motor neuron synapse!
A motor neuron synapses on the muscle cell. Recall that for a neuron to be synapsed, it sends an action
potential down its axon. Na+ voltage gated channel open and depolarizes membrane in one place,
which causes Na+ voltage gated channels to open up further along and depolarize the membrane there .
. . etc. Eventually at the axon terminal, Ca2+ gates are opened and Ca2+ floods into the axon terminal
body. The Ca2+ binds to vesicles that are holding neurotransmitters, the vesicles bind to the membrane
of the neuron, and neurotransmitters are released into the synaptic cleft.
ORGAN SYSTEMS 87
In motor neurons, the neurotransmitter released is acetylcholine.
Acetylcholine binds to receptors on the muscle cell, which opens gated channels that allow Na+ inside
the muscle cell, which causes membrane depolarization and action potential in that cell!
The action potential travels along the membrane as subsequent channels are opened, and eventually
reaches the T-tubule.
When the action potential gets far enough down the T-tubule, the protein complex triggers all
the Ca2+ ions to be dumped from the sarcoplasmic reticulum into the cell.
Of course, this Ca2+ in the cell then binds to troponin, which changes conformation to release
tropomyosin, and myosin can start walking along the actin filament to contract the muscle cell.
Once the signal goes away, the door releasing Ca2+ closes & SR gains back all Ca2+ in just 30
millisec!

ANATOMY OF A MUSCLE CELL:

Tendons on either side of the muscle anchor it to bone. The tendon is just a type of connective tissue,
and its somewhat continuous with the connective tissue that forms the outer layer of the muscle, the
epimysium. The epimysium protects the muscles.
A second layer of connective tissue, called the perimysium, is right under this protective layer. The
perimysium covers subunits of muscle, including the fascicle (aka fassiculus).
Within each fasicle theres another layer of connective tissue called the endomysium, which covers
individual muscle cells (aka myofibers)
The myofiber has bumps on the outside, which are where nuclei sit on the periphery of the cell.
The cytoplasm of the myofiber is called the sarcoplasm. (myo = muscle; sarco = flesh)
Within the myofiber is a further division called a myofibril this is where contraction actually
occurs.
If you look at a myofiber under the microscope, youll see striations (another name for skeletal
muscle is striated skeletal muscle). These striations are the z-lines, or z-disks, and the space
between two z-lines is called the sarcomere its the most basic unit of muscle contraction.
Actin filaments are anchored to the z-line, and myosin
is attached to the actin. (Myosin is anchored in the
sarcomere by the protein titin.
The sarcomere has 2 different parts: A-bands & I-bands.
The part thats myosin and actin is the A-band.
The part that is solely actin is the I-band.
In contraction, its the actin filaments that move. So the
Z-lines move closer together, towards the center of the
sarcomere, and the I band is shortened but the A-band
remains the same length.

THREE TYPES OF MUSCLE:

There are three types of muscle smooth, skeletal, & cardiac which are involved in basically all
movement of the body.
ORGAN SYSTEMS 88
Skeletal muscle: most are attached to tendon and bone, but not all are (e.g. external oblique muscles
are not attached to a tendon, or the tendon is just a sheet of fibrous tissue called aponeurosis).
Skeletal muscles are voluntary, and are the fastest type of muscle
Theyre also straight, and have many nuclei that show up as bumps (theyre on the periphery rather
than in the middle) on the cell.
Cardiac muscle is in the heart; this is only where you can find these special cells. involuntary
Cardiac muscles are branched (which makes them easy to spot), and have 1-2 nuclei, also in the
middle of the cell.
Smooth muscle: largely found in the walls of hollow organs (e.g. stomach, bowels, etc) & blood
vessels
Involuntary; slowest muscle
Often described as spindle-shaped; smooth muscle cells have just one nucleus in the middle
Ex: Involuntary processes like vasodilation take a lot longer than than the active, voluntary process of
using skeletal muscles to jump, e.g.
Skeletal and cardiac muscle is striated; smooth muscle is not.
A general rule of thumb is that smooth muscle is often found in hollow organs, like stomach and intestine.
(esophagus etc) + helps dilate blood vessels.
MOTOR NEURONS:
Upper motor neurons (in the brain) send a signal to lower motor neurons (in the PNS).
UMNs tell the LMNs when to start and when to stop contracting. LMNs directly signal muscle
cells.
The soma is the body of the lower motor neuron. Dendrites of the LMN receive signals from the
UMN; then the LMN then sends out the signal through the axon.
If you have a lower motor neuron injury, your muscle(s) experience weakness because they cant
contract like theyre supposed to. If you have an upper motor neuron injury, you would also experience
weakness in the muscle(s), but this time because your muscle never receives the signal to contract.
The key thing we look for with UMN injury, though, is not a weakness due to muscles not
receiving start signal; its a constant spasticity because the muscles dont receive the stop signal.
To make sure that signals arent dissipated and instead stay in the axon going down, some neurons are
insulated with a fatty myelin sheath. Action potential jumps down those axons along nodes of Ranvier.
In the CNS, myelin is produced by oligodendrocytes. In the PNS, its produced by Schwann cells.
NEUROMUSCULAR JUNCTION, MOTOR END-PLATE:
The neuromuscular junction is where motor neurons talk to muscle cells.
Involves the axon terminal and the receiving muscle cell. In the receiving portion of the muscle cell
there are many folds, which increase the surface area available for Na+ and Ca2+ channels.
The axon terminal receives action potential in the opening of Na+ channels so sodium floods into the
cell and depolarizes the membrane. At the same time (and only in the terminal), Ca2+ channels open so
Ca2+ floods into the axon terminal body.
The Ca2+ then binds to vesicles that are holding neurotransmitter, acetylcholine the vesicles bind to
the membrane of the neuron, and lots of acetylcholine is released into the synaptic cleft.
 ORGAN SYSTEMS 89
On the receiving muscle cell are nicotinic acetyl-choline receptors; when ACh binds, it opens the Na+
channels so Na+ floods the cell and depolarizes. After the cell is sufficiently depolarized, the
sarcoplasmic reticulum is triggered to open its floodgate and send lots of Ca2+ into the cell.
Note: In cardiac muscle, intracellular Ca2+ is a trigger for the release of even more calcium from the
SR. This mechanism doesnt occur in skeletal muscle, though.
Gap junctions connect adjacent muscle cells, and allow for synergy between muscle fibers when
one muscle cell contracts, many groups of muscle cells are triggered to contract.

TYPE 1 AND TYPE 2 MUSCLE FIBERS:

Golden rule: mitochondria are more prevalent in type 1 muscle than type 2
Color: Type 1 muscle fibers are red, because their increased mitochondria means they produce more
energy from oxygen (in oxidative phosphorylation) than type 2 fibers, which are white.
Contraction Speed: Because type 1 muscle fibers rely on mitochondria, they have a very involved
energy making process (glycolysis, krebs, electron transport, etc.) & thus have slower contraction
speed
Conduction Velocity: This is also slow in type 1 (slow twitch), compared to type 2s fast twitch.
Activity: Type 1 fibers (bc mitochondria) undergo aerobic respiration. Type 2 use anaerobic
respiration.
Duration of contraction: Type 1 fibers, bc they can make a lot of ATP, will have a long duration
contraction. Type 2 cant make as much ATP, so they have shorter duration contractions.
Long duration contractions are used in places like your back or thigh muscles, which are used to
stand for long periods of time and to walk at an even pace.
Short duration fibers are found in places like the arms, so you can quickly shake someones hand;
or in the fingers used to flick something if you do those things all day long youll get very tired!
Fatigue: Because type 1 muscle fibers have a lot of energy, they are resistant to fatigue. In contrast,
type 2 muscle fibers dont have as much mitochondria or energy so they are easily fatigued.
Power: Type 2 fibers generate more instantaneous force than type 1 fibers. Type 1 fibers have more
energy overall, though, and more fibers contracting for longer durations, so type 1 is more powerful.
Storage: Both fast twitch (type 2) and slow twitch (type 1) use ATP to contract, but they use different
mechanisms to produce it. ATP is a very reactive molecule if we have it we expect it to be used
right away So type 2 muscle fibers, with their faster contractions, use ATP as the main energy
storage, in addition to creatine phosphate. In type 1 muscle fibers, triglycerides are the main energy
storage.
Type 1 Type 2

color red white

contraction speed slow fast

conduction velocity slow twitch fast twitch
activity aerobic respiration anaerobic respiration
duration long short
fatigue resistant to fatigue easily fatigued
power strong power less power
 ORGAN SYSTEMS 90
storage triglycerides ATP and creatine
phosphate

CALCIUM PUTS MYOSIN TO WORK:

Lets zoom into the heart wall. You see cardiac cells, with branches and 1-2 nuclei. Inside that heart
cell, there are many proteins, most notably actin fibers and - in the middle of that actin - myosin.
The z-lines (or z-disks) are pulled towards each other when muscle cell contracts.
Binding sites for myosin are cover up with tropomyosin, bound to the actin fiber by
troponin (which is really a protein complex, with subunits C, I, and T).
When troponin-C binds Ca2+, it moves the whole complex out of the way and myosin
can then bind to the actin.
TL;DR myosin likes when Ca2+ is around because then it can do work
How do we increase inotropy, i.e. increase muscle contraction
(1) Increase Ca2+ in the cell
(2) Get troponin-C to be more sensitive, and bind Ca2+ more easily

MUSCLE INNERVATION:
Voluntary contractions are those of the skeletal muscle.
These are controlled by me, so I use the cerebral cortex or the spinal cord.
Involuntary contractions include those of cardiac and smooth muscles. We dont need to think about
when to beat our heart, or when to vasoconstrict our capillaries in our hand when its cold.
These are beyond me, so I use the brainstem or ganglia beside the spinal cord.
The brainstem is responsible for involuntary contractions through sympathetic or parasympathetic
mechanisms. The sympathetic ganglia (i.e. cell body/soma of neurons) that sit outside the brain and
spinal cord) are also involved in involuntary contractions.

AUTONOMIC VS. SOMATIC, DIVISIONS OF THE PERIPHERAL NERVOUS SYSTEM:

The autonomic system is under involuntary control; the somatic is under voluntary control
Somatic nervous systems use acetylcholine as neurotransmitters.
There are two subdivisions to the autonomic nervous system: sympathetic and parasympathetic.
Sympathetic = fight or flight response
ORGAN SYSTEMS 91
The pre-ganglionic nerves of the SNS use acetylcholine still, but the post-ganglionic nerves use
epinephrine (aka adrenaline) as an endocrine hormone, with norepinephrine as neurotransmitters
Parasympathetic = rest and digest response
Also uses acetylcholine.

THERMOREGULATION:
When the skin perceives that its hot outside (or wherever you are), it will send a neuronal signal to the
hypothalamus in the brain.
The anterior (front) part of the hypothalamus responds to hot temperatures.
The posterior (back) part of the hypothalamus responds to cold temperatures.
The brain then sends a signal back to smooth muscles (which line our blood vessels) and skeletal
muscles (particularly in our core) as needed to help us maintain our core body temperature.
In a hot environment, smooth muscle relaxes and vasodilates the arterioles. This allows the blood
flow to the skin to increase which allows us to dissapate heat.
In a cold environment, smooth muscle will contract and vasoconstrict the arterioles. This shrinks
the heat filled blood vessels away from the skin so less heat is lost.
Our skeletal muscles (particularly those in the core) shiver when were cold. This is because when
skeletal muscle contracts, ATP > ADP + energy.. so our body shivers to increase this exothermic
reaction and release energy into the cells as heat.

Skeletal System

SKELETAL STRUCTURE AND FUNCTION:
Arthropods have exoskeletons. Humans, and all vertebrates, have endoskeletons!
Our skeleton provides a variety of functions:
Supports / structures the body, and provides a framework for movement
Protects vital organs
Performs a variety of physiological functions (most notably, storage of Ca2+ and hematopoiesis,
or the production of cellular components of our blood RBCs, WBCs, and platelets).
The axial skeletal is our skull, ribcage, and vertebral column down the midline of our body.
The appendicular skeleton is everything else limbs, hip / pelvic area, metatarsals, etc.
Another classification of our skeletal system is between flat bones and long bones.
Flat bones = skull, rubs, and bones in the pelvis
Made of an inner spongey / cancellous bone, and an outer shell of compact bone
Protect organs and serve as site of hematopoiesis.
Long Bones = humerus, femur
The long middle portion of long bones is the diaphysis; the ends are called epiphysis.
In between the diaphysis and epiphysis (or where they connect) is the metaphysis, which
is where the growth plate is found.
Long bones are also made of same inner spongey bone, and an outer shell of compact bone
ORGAN SYSTEMS 92
These provide the framework for movement, and also serve as a site of hematopoiesis.
There are two types of bone marrow: red and yellow.
Red bone marrow serves as site of hematopoiesis. (red = blood) found in flat bones and in the
epiphysis of long bones
Yellow bone marrow is the site of fat storage found in diaphyses of long bones.

MICROSCOPIC STRUCTURE OF BONE THE HAVERSIAN SYSTEM:

The innermost part of a bone is made of spongey bone, which is filled with cavities called trabeculae.
Surface area of spongey bone is 10x that of outer compact bone. Its purpose is to make bone light.
Compact bone has fewer gaps and spaces than spongey bone, but what really makes it different is that
it has a specific type of organization made of osteon functional units (aka the Haversian system).
Each osteon looks sort of like a cylinder, and it has multiple concentric layers of bone (sheets) that
wrap around to form the osteon. Each of these layers is called a lamellae.
In the center of the lamellae layers is the Haversian canal, or central canal. Blood and lymph
vessels, as well as nerves, travel through this canal.
In between the sheets of lamellae are tiny channels
called canaliculli. They branch out from the central
canal to empty spaces called lacunae. Each lacunae is
just an empty space for osteocytes, or bone cells.
The osteocytes have long cellular processes that
branch through the canalliculi to contact other
osteocytes via gap junctions, which allow the cells
to communicate and exchange nutrients / signals.
Volkmanns canals run perpendicular to the Haversian
canals, and they connect osteons to one another.
They also carry their own set of small blood vessels.
The outermost superficial layer of bone is called
the periosteum.

CELLULAR STRUCTURE OF BONE:

Bone is mostly made up of the bone matrix, and then the cells that help to form this bony matrix.
The bone matrix consists of two principal building blocks:
Osteoid forms the organic portion of the matrix
Hydroxyapatite forms the inorganic portion of the matrix
Osteoid consists of a soft but highly ordered structure of proteins and type 1 collagen fibers.
Together, this gives bone its tensile strength.
Tensile strength refers to how much an object can be stretched before breaking. This is different
from compressive strength, which is how much the object can be compressed before breaking.
Hydroxyapatite is made of calcium phosphate crystals. These make up the mineral content of bones,
and give them their rigid strength and density.
There are four different types of cells we should know in bone:
ORGAN SYSTEMS 93
(1) Osteoprogenitor
These cells are basically an immature version, or the precursor to, osteoblasts. They differentiate
into osteoblasts under certain growth factors
(2) Osteoblasts
These are responsible for synthesizing collagen and proteins (specifically, osteocalcin and
osteopontin, which together make up osteoid, the organic part of bone matrix).
Osteoblasts also synthesize alkalaine phosphatase, which is responsible for forming
hydroxyapatite.
Once osteoblasts have synthesized enough collagen, proteins, and alkaline phosphatase to form the
organic and inorganic portions of the bony matrix around them, they mature into the osteocyte.
(3) Osteocytes
The spaces osteocytes occupy are called lacunae (lakes of empty space in bone)
They have little branched projections that reach out to communicate with other osteocytes or
osteoblasts, which give them a star-like appearance.
(4) Oxteoclasts
Derived from monocytes
These are responsible for bone resorption; they break bone back down (using an enzyme called
tartrate resistant acid phosphotase).
Bone is constantly being remodeled its built up with osteoblasts (using alkaline phosphatase), and
broken down by osteoclasts (using tartrate resistant phosphotase).
As osteoclasts are resorbing bone, they start to form empty spaces. Recall, empty spaces are lacunae;
osteoclasts form a special type of lacunae called Howships lacunae.

SKELETAL ENDOCRINE CONTROL:

One of the main functions that bone performs is storage of calcium.
Calcium homeostasis (the flow of calcium between the bloodstream and bone) is under endocrine
hormone control. These hormones alter the ratio of osteoclast activity to osteoblast activity.
As osteoclast activity increases (more bone resorption / break down) relative to osteoblast activity,
theres an increase in the liberation of calcium and phosphate into the bloodstream from bone.
The opposite happens with an increase in osteoblast activity - Ca2+ & PO43 levels in blood
decrease.
Main hormones responsible for maintaining calcium homeostasis are: parathyroid (PTH), calcitonin,
and calcitriol (which is basically the active form of vitamin D).
These hormones help to regulate the amount of calcium absorbed from the gut or reabsorbed from
the kidneys. They also help regulate osteoblast / osteoclast activity in bone.
Calcitonin decreases the amount of calcium and phosphate in the blood. (calcitonin tones down blood)
Parathyroid hormone (PTH) and calcitrol both increase calcium in the blood; but PTH decreases
phosphate levels, while calcitrol increases them.
General themes of calcium homeostasis:
(1) Each time calcium increases in the blood, you have a concurrent increase in phosphate. Same
thing if Ca2+ decreases, phosphate will decrease.
ORGAN SYSTEMS 94
(2) If calcium + phosphate increases in the blood, it decreases in bone; and vice versa.

PTH increase Calcitonin increase Calcitriol increase

osteoblast activity decreases increases decreases

osteoclast activity increases decreases increases

intestinal / renal increases decreases increases

Ca2+ absorption

Why does the concentration of free Ca2+ in the blood matter so much? Why the elaborate system?
Too much free Ca2+ ions in the blood leads to hyper-excitable cell membranes. Can cause lethargy,
fatigue, and memory loss.
Too little calcium in the blood leads to muscle cramps and convulsions.

CARTILAGE:
Cartilage is, at the most basic level, an extracellular connective tissue found throughout the body. Its
created by cells called chondrocytes, which derive from the same precursor cells as bone
(fibroblasts).
Chondrocytes secrete collagen (fibrous protein) and elastin (elastic protein)
These two proteins give cartilage strength and flexibility.
Cartilage is not innervated (no nerve cells) and its avascular (doesnt have arteries, veins, or blood
vessels). Instead, cartilage receives its nutrition and immune protection from the surrounding fluid.
There are three main types of cartilage in the body:
(1) Hyalin (articular) cartilage found in the larynx, trachea, all the joints (where the surfaces of
bones are articulating each other).
Its main purpose is to reduce friction and absorb shock.
(2) Elastic cartilage found in the shape of the outer ear and in the epiglottis (which protects your
airway when youre swallowing food.)
Its main purpose is to provide shape and support
(3) Fibrous cartilage found in the intervertebral discs of the spine, and where the two halves of
your
pelvic bone come together to form a joint (pubic symphysis)
Main purpose is to provide rigidity and absorb the shock transmitted between these joints.

LIGAMENTS, TENDONS, AND JOINTS:

Ligaments and tendons are types of extra strong and dense connective tissue
Ligaments connect bone to bone; tendons connect muscle to bone.
A joint is the point where one bone meets up with another there are different joint types in the body:
Synarthroses joints immovable; where two bones are fused together (ex: in the skull)
Antiarthroses joints both stiff, but slightly moveable (ex: vertebral joints)
ORGAN SYSTEMS 95
Synovial joints (aka diarthroses) includes ball and sockets joints (ex: shoulders and hips) which
have many degrees of motion, and hinge joints (ex: elbow or knee) which have one plane of
movement.
These are lubricated by synovial fluid, contained within synovial capsule that surrounds the joint.
The surfaces of bones that meet up in a joint are lined by a special kind of smooth cartilage: articular
(aka hyalin) cartilage. Like all cartilage, its avascular and not innervated so it has a hard time
getting the nutrients it needs to heal and recover if it were to become damaged by overuse or infection.
Overuse of joints over time can lead to inflammation, which causes arthritis. (This can cause
permanent destruction of articular cartilage, which leads to the pain and stiffness).
Ossification is the process in which cartilage is transformed into bone. Bone grows in three stages:
first, tissue forms a mesh of collagen fibers, then the body creates a polysaccharide that acts like
cement to hold the tissues together. Finally, calcium crystals salts are deposited to form bone.

Integumentary System

SKIN OVERVIEW
The integumentary system comprises the skin and appendages. The appendages include nails,
hair, and sweat glands.
The skin is the largest organ of your body, weighing approximately 21 pounds.
The skin has several functions: it serves as an impermeable surface to the outside, serves as a
structural barrier, serves as an immunological barrier against pathogens such as viruses, can
perceive stimuli from the environment via receptors, conducts sensation, and cools the body via
sweating (thermoregulation) by evaporative cooling

WHAT IS SKIN? (Epidermis)

There are three distinct layers to the skin. In order from outermost to innermost, the order is:
epidermis, dermis, and hypodermis (subcutaneous tissue).
The epidermis is composed of five strata (latyers). The stratum basale is the most inferior strata
of the epidermis and is composed of keratinocytes, which secrete cytokeratin, giving skin its
toughness to protect skin. The stratum basale also is known for rapid cell division, and where
we get our skin color. The cells that give skin color are called melanocytes. The melanocytes
secrete melanin, which causes skin color.
The amount of melanin determines the darkness of skin.
The layer on top of the stratum basale is called the stratum spinosum, or the spiny layer. It is
composed of desmosomes, which permit water loss. This layer also includes Langerhans cells,
which are part of the immune system.
Above the stratum spinosum is called the stratum granulosum. This is composed of granules
called keratohyalin granules. These granules hold proteins which help handle keratin. They
move cytokeratin around the cells. These cells also release lamellar bodies, which secrete lipids
that give skin its water-tight capability.
The layer above is the stratum lucidum, or the clear layer. This layer is composed of dead
keratinocytes, which are clear. These cells have lost their nuclei and organelles.
The outermost layer is the stratum corneum, composed of stacked layers of dead keratinocytes.
15-20 layers of these cells which randomly and continuously slough off.
ORGAN SYSTEMS 96

WHAT LIES BENEATH THE EPIDERMIS (Dermis and Hypodermis)

The dermis is composed of two strata and sits below the epidermis. The bottomost layer of the
epidermis is the stratum basale. Immediately underneath that is the first layer of the dermis, or
the papillary dermis. Underneath that is the bottomost layer of the dermis is the reticular
dermis.
While the epidermis is composed of epithelial tissue, the dermis and hypodermis is composed of
connective tissue. Connective tissue contains proteins like actin, collagen, and structural
proteins. Its primary purpose is to hold things together.
In the papillary dermis, there is thin, loose connective tissue. In the reticular dermis, there is
thicker and denser connective tissue to anchor things down.
The thin connective tissue of the papillary dermis allows for movement of structures like blood
vessels and diffusion of oxygen. This layer must be flexible to allow for this.
The papillary dermis also contains nerve endings.
The reticular dermis contains thick dense tissue for anchoring structures down. This layer also
anchors glands, which extend outward toward the epidermis, and also anchors follicles form
which hairs protrude. The hair follicle is anchored within the reticular dermis.
The reticular dermis also contains an arrector pili muscle, which allows for hair to stand on end
when you are cold.
The hypodermis is the bottommost layer of skin. It is also known as subcutaneous fat. This layer
is composed of many layers of fat. Fat is used to absorb shock and insulates tissue.
ORGAN SYSTEMS 97

WHERE DO OUR HAIR AND NAILS COME FROM?

Nails and hair are part of our appendages, the second component of the integument. The nail
root is attached to the epidermis. Cells emerge from the stratum basale and other layers of the
epidermis and extend to form the nail.
The nail is therefore considered a part of the epidermis. It is made up of keratin packed into dead
cells. This is what keeps the nail strong. The fingernails grow 4x faster than the toenails.
The hair is another appendage. Hair grows from the dermis, the middle layer between the
epidermis and the hypodermis. The dermis has two layers (papillary and reticular layer).
The follicle originates in the reticular dermis, and the shaft of the hair emerges outwards through
the other layers.
The hair also is composed of keratin. There is a band of muscle in the papillary dermis called the
arrector pili muscle, a smooth muscle which causes hair to stand on end when it contracts. This
is what causes goosebumps as well.
Hair standing on end creates a bed of warm, insulating air to protect polar bears from the cold. In
humans, the hair is not long enough so this phenomenon does not occur, so the hair can be
considered a vestigial structure.
WHATS IN SWEAT? (HOLOCRINE, APOCRINE, MEROCRINE GLANDS)
There are three kinds of glands in the reticular dermis. Ducts lead out from the reticular dermis to
aid in secretions.
There are three kinds of glands in the reticular dermis: the holocrine gland, apocrine gland,
and merocrine gland.
The holocrine gland disintegrates an entire cell to release sebum. These glands are also known as
sebaceous gland.
Apocrine glands release secretions form the apex (top) of the cell. These glands release proteins,
lipids, and steroids.
The merocrine glands release watery sweat via exocytosis.
Holocrine glands are found on the face, chest on the back. Apocrine glands are concentrated in
the armpits, groin, and around the nipples.
Apocrine sweat glands release secretions right into the hair follicle, in contrast to the other
glands.
Merocrine glands are concentrated in the palms and soles.
Sebum from the holocrine gland is used to lubricate the skin and to slow bacterial growth.
ORGAN SYSTEMS 98
Apocrine glands do not start to release secretions until puberty starts. These glands are
implicated in emotional sweating.
Merocrine glands are considered the most important, as they hope to cool down during
evaporative cooling, and allow the disposal of salts and nitrogenous wastes. Lysozyme and
antibodies are also released by the merocrine glands.

WHY DOES SWEATING COOL YOU DOWN?

Sweat is mostly composed of water. A rephrasing of the titular question is: why does water
sitting on the surface of the skin cool us down?
When the body temperature rises, the temperature of our epidermis also rises. This epidermis is
in contact with water, therefore heat is transferred from the skin to the water molecules of sweat
sitting on the skin.
When the water of the sweat has enough energy, it evaporates. This cools down the entire
system of water and skin, as only the highest energy molecules of water are those that evaporate.
Therefore, the departure of high energy water molecules decreases the total kinetic energy of the
system, and therefore the temperature.
OVERVIEW OF SENSATION AND MEISSNERS CORPUSCLE
Our skin helps us perceive the environment and plays a role in sensation. Mechanoreceptors
and other receptors generate signals in respond to stimuli to help us perceive the environment.
This sensation takes place via afferent nerve fibers which take a stimulus and create a signal for
processing in our CNS. Efferent nerve fibers are used to communicate from the CNS to muscle
fibers.
A-delta fibers are afferent fibers which perceive pain and temperature. A-beta fibers perceive
everything, and include mechanoreceptors.
The structure of the mechanoreceptor determine the function, and the function will help us
determine the location of the receptor.
The Meissners corpuscle is a type of mechanoreceptor, located in the papillary dermis for
perception of external stimuli. In the corpuscle are layers of disks composed of many nuclei.
These disks are known as epithelial or laminar disks. When a force perturbs a disk, the disks are
nudged past each other. Sodium ions then enter an afferent fiber, causing an action potential and
sensation.
Meissners corpuscle is used to perceive light touch in glaborous skin, or non-hairy skin. For
example, this mechanoreceptor would perceive the feeling of putting on a smooth cotton T-shirt.
ORGAN SYSTEMS 99
In Messiners corpuscle, a constantly changing stimulus is needed to perceive the stimulus.
Therefore, after the cotton T-shirt is on our skin and no longer moving, it will not be felt and
Meissners corpuscle will not be activated.

PACNIANS CORPUSCLE AND MERKELS DISK

Pacnians corpuscle is another mechanoreceptor. It is also known as the onion-layered
corpuscle or the lamellar corpuscular.
When a significant force touches one of the lamella, or one of the concentric rings of the
corpuscle, an action potential in an efferent nerve cell is activated.
This type of corpuscle responds to a deep touch in hairy and non-hairy skin. For example, a poke
or push would activate this corpuscle.
This type of mechanoreceptor also requires a constantly changing stimulus. It is located in the
hypodermis.

Merkels disk is a single disk. It is a specialized keratinocyte which holds many vesicles. These
vesicles hold many neuropeptides, and the disk is attached to a receptor.
When the disk is stimulated, the peptides are released and stimulate a receptor, causing sodium
to enter the disk.
This stimulates an afferent neuron. It is located in the stratum basale or the papillary dermis.
It responds to light touch that is sustained. The stimulus does not need to change for us to notice
it.
RUFFINIS ENDING AND HAIR FOLLICLE RECEPTOR
Ruffinis ending is another corpuscle. It is called Ruffinis ending or Ruffinis corpuscle. This
mechanoreceptor has no disks or rings, but rather a afferent nerve fiber. It is a A-beta fiber which
branches into the corpuscle.
There are many afferent branch receptors in the corpuscle, as well as collagen, a structural fiber.
When the skin is stretched, a force is generated which hits the Ruffini corpuscle. This causes the
collagen to be perturbed. Because this collagen shifts, ion channels within the A-beta fiber opens
causing an action potential to be generated.
This type of mechanoreceptor responds to sustained touch and is located deep within the skin in
the dermis, specifically the reticular dermis.
ORGAN SYSTEMS 100
The last mechanoreceptor discussed is the hair follicle receptor. When a stimulus touches a
hair, there is a nerve fiber that surrounds the follicle.
The impetus for this action potential is due to the deflection of the hair (a light touch on hairy
skin). This type of receptor is located in the reticular dermis. A constantly changing stimulus is
needed, else collagen will fill in the receptor.
PAIN AND TEMPERATURE
The perception of pain is called nociception while the perception of heat is called
thermoception. We sense pain and temperature using a specialized receptor.
To sense temperature, we rely on the TrpV1 receptor, which is also sensitive to pain. TrpV1 is a
receptor located in the cell membrane. When there is a change in temperature, a conformational
change occurs in this protein.
When heat or pain are applied, this conformational change occurs. Each cell with TrpV1 receptor
has nerve fibers which send signals to the brain.
Pain, such as poking, causes cells to break up and release molecules, which bind to TrpV1
receptors, causing the same conformational change a change in temperature causes, sending a
signal to the brain.
There are three types of nerve fibers: fast, medium, and slow. Fast nerve fibers are fat and
contain a lot of myelin, allowing the signal to travel quickly. The large diameter of the nerve
fiber also causes less resistance. These types of fibers are also known as A-beta fibers.
Medium nerve fibers are smaller in diameter and have less myelin, causing a slower signal.
These are known as A-delta fibers.
Slow nerve fibers are very small in diameter and are unmyelinated. Signals through these fibers
are sent to the brain slowly. They are also known as c fibers.
When we touch a stove, all fibers would act. A-beta fibers will act fast causing us to recoil our
hand, A-delta fibers will carry the sensation of pain, and c-fibers will cause a lingering sense of
pain hours after we have touched the stove.
Similarly, when we eat spicy foods containing capsaicin, the capsaicin binds to nerve fibers,
causing the signaling pathway as a change in temperature.
THERMOREGULATION BY MUSCLES
We shiver and use our muscles to maintain our body temperature, a process called
thermoregulation. When we perceive it is hot, our brain senses it is hot in the hypothalamus.
The hypothalamus is split into the anterior and posterior hypothalamus, each of which
responding to different temperature.
When it is hot, we use the front (anterior) hypothalamus (mnemonic think Front=Fire). If it is
cold, we use the posterior part of our hypothalamus.
Smooth muscle lines our arterioles, while skeletal muscle works on our biceps, etc.
When blood cells move around in arterioles, they carry energy. When it is hot, we aim to
dissipate this energy/heat. Vasodilation therefore occurs when it is hot to dilate the arterioles of
the skin. This allows more blood flow to flow near the skin, allowing us to cool off by diverting
blood flow to our skin.
Skeletal muscles do nothing when it is hot.
Vasoconstriction occurs when it is cold, causing arterioles near the skin to become narrower to
retain more heat carried by the blood. Skeletal muscle contract when it is cold and take ATP to
make ADP and energy. This is an exothermic reaction, which can be used to heat up in cold
environments (shivering).

Reproductive System:
ORGAN SYSTEMS 101

A secondary spermatocyte is formed after completion of meiosis I; it has 46 chromatids and 23

chromosomes.

Reproductive System:
Ejaculatory duct is not one of the first structure to conduct sperm during ejaculation
Vas Deferens is not one of the first structure to conduct sperm during ejaculation
Ampulla of vas deferens is the expansion of the vas deferens closer to ejaculatory duct.
Epididymis, vas deferens, ampulla of vas deferens, ejaculatory duct, urethra is the correct order.
Prostatic cancer may lead to inhibition of secretions of prostate that are essential for sperm activation
Bulbourethral glands produce pre ejaculatory fluid that aids in lubrication, thus its obstruction does not interfer
with sperm production, maturation or activation (acronym: think of an imaginary BULBO lubricant brand)
During spermiogenesis, maturation of the sperm, unnecessary cytoplasm is shed off.
The pliable tissues are not responsible for secretion of seminal fluid
Corpus spongiosum remains pliable during an erection.
During an erection the corpus spongiosum remains pliable, corpora cavernosa becomes firm, and the pliable
tissues maintain the urethra open.
Clitoris is very distant from cervix
Fimbriae is connected with ovaries, thus distant from cervix
Fornix is immediately adjacent to cervical canal, thus likely to be infected.

Oxytocin is responsible for labor contractions and kept at low levels during pregnancy
Levels of estrogen are kept high during pregnancy
Progesterone secretion has to be kept high during pregnancy. Progesterone is initially secreted by
corpus luteum, so early degeneration of corpus luteum may lead to misscarriage.

The ovaries hold the corpus luteum that secrete estrogen earlier in the pregnancy and the placenta
is responsible for estrogen production later in the pregnancy
Low estrogen/progesterone = menses

Estrogen levels peak twice during the uterine cycle, and changes do not consistently correlate with changes in the
endometrium.
Luteinizing hormone levels peak prior to thickening of the endometrium.
Follicle-stimulating hormone levels peak prior to thickening of the endometrium.
Progesterone is a progestational hormone whose peak is correlated with thickening of the endometrium.

Estrogen levels must rise before ovulation

Follicle stimulating hormone levels must rise before ovulation
Luteinizing hormone levels must rise before ovulation.
Progesterone levels rise after ovulation already occurred.

Order of Sperm Leaving: straight tubules, rete testis, efferent ductules, epididymis ductus, vas
deferens, ejaculatory duct, prostatic urethra, membranous urethra
ORGAN SYSTEMS 102

Second polar body is haploid

Hint #2
Secondary oocyte is halpoid
Hint #3
Spermatid is haploid
Hint #4
Primary spermatocyte, primary oocyte, and zygote are examples of diploid cells

Sertoli cells' tight junction create the blood testis barrier prevent antibodies from binding to sperm
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Stratified layers of epithelial cells line tissues and glands that require layers of protection.
Simple, single layer epithelia allow for the passage of small particles.
Simple cuboidal epithelial cells line secretory ducts.
The lining of lymphatic vessels is composed of simple squamous epithelium.
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