Anatomy & Physiology Diploma Module 2essentiallyholistic-onlinetraining.com/wp-content/... · To...

© 2012 Essentially Holistic Not for reproduction in any form without prior permission of Essentially Holistic

Anatomy & Physiology Diploma

Module 2


2

Contents

Contents ....................................................................................................... 2

Course Outline ............................................................................................. 4

Aims & Objectives of the Course: .............................................................. 4

Course Literature ......................................................................................... 4

Structure of the Course: .............................................................................. 5

Section 1 - The Integumentary System ...................................................... 7

a. The Parts and Functions of the Integumentary System........................ 8

b. Structure of the Skin ............................................................................. 10

The Epidermis ............................................................................................ 10

The Dermis ................................................................................................. 12

The Subcutaneous Layer or Subcutis ...................................................... 12

Blood supply to the skin ........................................................................... 12

Lymphatic supply of the skin ................................................................... 13

Nerve supply to the skin ........................................................................... 13

c. Appendages of the skin ........................................................................ 13

d. How the skin ages ................................................................................. 15

e. Common disorders of the skin ............................................................. 16

Section 2 - The Skeletal System (bones) ................................................. 17

a. The Functions of the Skeletal System .................................................. 18

b. The Structure of Bones ......................................................................... 19

1. Types of bones ...................................................................................... 19

2. Bone cells ............................................................................................... 19


3

3. Bone surface markings ......................................................................... 20

4. The structure of long bones.................................................................. 20

c. The Skeleton .......................................................................................... 21

1. The axial & appendicular skeleton ....................................................... 21

2. The facial bones ..................................................................................... 22

d. The spinal column ................................................................................. 24

The curves of the spine ............................................................................. 25

e. How age affects the bones .................................................................... 26

Section 2.1 - The Skeletal System (joints) ............................................... 26

a. Structure and Function of Joints .......................................................... 27

b. Synovial joints ....................................................................................... 27

c. Types of joints ....................................................................................... 28

d. Common disorders and diseases of the skeletal system. .................. 29

Section 3 - The Muscular System ............................................................. 31

a. The structure and functions of the muscle types: .............................. 31

b. How the muscles work .......................................................................... 34

c. Recognising the muscles of the body .................................................. 36

d. Common disorders and diseases of the muscular system. ............... 37

Further Reading ......................................................................................... 38


Anatomy & Physiology course

Course Outline The Human Body is an amazing and very complex machine which we all take for granted! To be a successful therapist it is crucial that you understand how the body functions normally and what happens when it becomes out of balance and diseased. Throughout this course you will be introduced to each body function, given information on how it works, what happens when it doesn’t work and common problems and diseases that can affect it. To ensure you are assimilating the knowledge there will be regular tests. These can take the format of multiple choice questions, short answer questions, longer questions and diagrams to label.

Aims & Objectives of the course: By the end of the course you will be able:

To provide an introduction to the workings of the human body

To provide an understanding of the anatomical terms associated with describing the human body

To develop an awareness of the chemistry underlying the functioning of the human body

To develop an understanding of the organisation of the human body from cells to systems

To provide a thorough understanding of the normal physiology of the human body

To develop an awareness of what constitutes a deviation from normal functioning

To describe symptoms and signs of these deviations

To develop an awareness of how the human body responds to stress

To provide an understanding of the mechanisms by which repair may be affected

Course literature In order to complete the course you will need a copy of:

Ross and Wilson Anatomy & Physiology in Health and Illness (11th Edition) by Anne Waugh & Alison Grant ISBN: 978-0-7020-3227-1

We will use this for reference purposes during the modules and you may wish to use it to read more about topics that interest you. I will refer to the book at the end of each section if there is any further reading required. There is a list of books that you may want to use for further reading at the end of each module.


5

Structure of the Course: The course is presented in five modules:

Module 1 Aims & Objectives of the course Introduction to the Human Body The Chemistry of Life Cells Tissues

Module 2 The Integumentary System The Skeletal System The Muscular System

Module 3 The Nervous System The Endocrine System The Cardiovascular System

Module 4 The Lymphatic System The Immune System The Respiratory System

Module 5 The Digestive System The Urinary System The Reproductive System The Effects of Stress on the System


6

Throughout the course notes you will find the following images: Image This gives details of a diagram, image or chart in the Ross & Wilson book that you need to look at. Additional Work This gives details of extra reading you need to undertake in order to complete the tests and assignments

Media This gives information about films, slideshows or images you may find useful

Additional Work This gives ideas of work to supplement your studies

Have some fun! This gives details of things you may find fun but will help with your learning.


Module 2 - The Integumentary System

The Skeletal System

The Muscular System

Section 1 - The Integumentary System

By the end of this section you will be able to: 1. Name the constituent parts of the integumentary system and briefly describe its functions:

Temperature regulation

Absorption & excretion

Protection

Synthesis of vitamin D

Sensory perception

Immunity 2. Label correctly a diagram of the skin, to identify the following:

Epidermis: Stratum corneum Stratum lucidum Stratum granulosum Stratum spinosum Stratum basale (germinativum)

Dermis: Papillary region Reticular region

Subcutaneous layer e.g. blood vessels, nerve ending 3. Describe the location, structure and functions of the appendages of the skin:

Sebaceous glands

Ceruminous glands

Sweat glands

Hair and nails

4. Explain the functions of keratin and melanin 5. Explain the process of absorption through the skin 6. Define the term erythema 7. Explain how ageing affects the skin 8. Describe the process of pigmentation and how the effects of excessive

exposure to sunlight may affect the skin


8

9. Name & briefly describe common disorders/diseases of the skin including:

Infections: Bacterial: Acne, impetigo Fungal: Tineas (e.g. athlete’s foot) Viral: Herpes simplex, Herpes zoster Papillomas (e.g. warts) Decubitus ulcers

Pediculosis (lice) Rubella, varicella, hives Scabies

Allergies and reactions: General allergies Dermatitis Photosensitivity Burns

Chronic skin conditions: Eczema Psoriasis Scleraderma Skin Cancers Chronic ulcers

a. The parts and functions of the integumentary system The integumentary system helps maintain the homeostasis of the body by providing protection and temperature regulation to the body. It allows the body to sense stimuli provided by the external environment i.e. pleasure, pain and temperature

The Integumentary system consists of:

Skin

Hair

Nails

Sweat and oil glands

Sensory receptors

Its functions are: 1. Protection – the skin carries out the following functions in order to protect the body:

a. To protect the underlying structure of the body from damage by minor trauma and friction.

b. To protect the body from attack by micro-organisms. c. To protect the body where possible from chemicals and gases. d. To protect the body from radiation where possible and also from the

effects of ultra-violet radiation e. To prevent dehydration.


9

2. Sensation – The nerve endings that are present in the dermis of the skin transmit information such as: -

a. Heat & cold b. Touch c. Pain

These give information to the body about its surrounding environment, which is acted on at reflex and conscious levels. The fingertips and lips contain an increased number of receptors. Hair on the skin is also sensitive to touch.

3. Temperature regulation – In order for the body to function correctly it must achieve a constant core temperature of 36.8C. This function is a major one carried out by the skin under the control of the hypothalamus. The skin regulates the body temperature by means of convection, conduction, evaporation and radiation of heat on the skin’s surface, depending on the environment that the body is present within.

4. Absorption – Skin has the ability despite being considered waterproof to absorb certain substances – these include fat-soluble vitamins and oestrogens. Essential oils can also be absorbed through the skin and into the bloodstream. Medication is now prescribed using skin patches, which have the action of slow release into the bloodstream.

5. Synthesis of Vitamin D – In conjunction with ultraviolet light the skin converts a fatty substance contained within it called 7-dehydro-cholesterol to vitamin D.

6. Excretion – When there is a slight increase in the temperature, sweat

glands are activated as a means of cooling the body. This is a means of controlling heat in the body. The skin can also excrete sodium chloride and urea in a minor function of the body.

7. Fluid reserve – In times of emergency, fluid can be drawn from the cutis, the layer of fat beneath the dermis.

8. Energy reserve – In times of starvation the body can utilise the subcutaneous layer as an energy reserve.

9. Wound healing – Minor cuts and scrapes experienced by the skin are healed by a series of processes that result in the formation of a scab. Epithelial tissue grows upwards in layers until the skins original thickness has been restored.

Additional Work Further Reading relating to functions of the skin can be found in Ross & Wilson pages 357 - 359


10

b. Structure of the skin

The skin is made up of the following structure:

It has three main layers:

The epidermis – this is the most superficial, outer covering of the skin.

The dermis – this is often referred to as “true skin” and lies below the epidermis supporting it. The dermis supports all other structures of the skin.

The sub-cutaneous layer – this is the layer of fatty tissue found below the dermis.

The Epidermis

This is the superficial layer composed of many layers of cells, which are constantly renewing themselves. The thickness of the epidermis layer varies from one body site to another, but never exceeds 1mm thick. It is thinnest on the eyelids and thickest on the soles of the feet. The epidermis consists of five layers called stratums:

Stratum Germinativum or Basal layer This is the deepest layer of the epidermis and it receives its nourishment from the blood vessels in the dermis where it is attached. Cell division occurs

Opening of

sweat duct

Hair Shaft

Epidermis

Dermis

Meissners

corpuscle

Blood Vessels

Pacinian

Corpuscle

Sweat Gland

Sub-cutaneous

layer

Hair follicle

and root

Sebaceous

gland

Arrector

pili muscle


11

which is called mistosis. As new cells are formed these displace older cells towards the surface. Pigment forming cells are also found in this layer, they are called melanocytes and produce melanin.

Melanin is the skin’s natural pigment that provides colour and offers protection against the harmful effects of ultra-violet light. The action of ultra-violet light on the skin darkens existing melanin and promotes its secretion.

Stratum Spinosum or Prickle cell layer This layer is next above the germinativum. The cells in this layer are connected to each other by fine threads, hence the term “prickle cell” layer. The cells are also living in this layer and capable of dividing by mitosis. Towards the upper part of this layer chemical changes take place and the Keratinisation process commences.

Both these layers contain living cells

Stratum Granulosum or Granular layer This layer is comprised of cells that contain a number of granules, which are involved in the process of Keratinisation. This is the process where living cells become dead, flat, scaly cells. In the process they lose their nuclei and fluid and become filled with the tough protein keratin.

Stratum Lucidum or Clear layer This layer consists of several layers of small, tightly packed, dead, transparent cells, which permit light to pass through. The Lucidum layer is thought to be the barrier zone controlling the transmission of water through the skin. It is more evident in thicker skin, such as the soles of the feet and palms of the hands.

Stratum Corneum or Horny layer This layer is the most superficial and is composed of layers of dead, flat, horny cells tightly packed together. As they contain the protein keratin, they are very tough and provide a protective outer coating for the body. These cells are constantly being shed, a process known as desquamation or exfoliation.

These layers contain cells that are changing from living to dead

Cell Renewal This is the process of living cells being formed in the basal layer which are pushed up through the epidermal layers to reach the corneum layer at the surface. As the cells rise up through the epidermis they lose their nucleus and fluid and become filled with keratin. The result is a dead, flat, horny cell, which is then desquamated from the surface. This is a continuous process.


12

The Dermis

This lies below the epidermis, supporting and nourishing it. It is composed of dense connective tissue containing:

Collagen – a protein which provides support and gives skin its strength and resilience

Elastin – a protein, which gives skin its elasticity i.e., allows it to stretch but quickly regain its shape.

Fibroblasts – these are cells which manufacture collagen and to a lesser degree elastin

Blood and lymph vessels

Nerve endings

Hair follicles

Sweat glands and sebaceous glands

Arrector pili muscles

The dermis can be described in two parts:

a. The Papillary Layer This is the most superficial layer of the dermis, which is irregular in shape and connects to the underside of the epidermis by projection called dermal papillae. The dermal papilla contains blood and lymph capillaries and nerve endings.

b. The Reticular Layer This is the deepest layer and contains the main components of the skin.

The Subcutaneous Layer or subcutis This layer lies below the dermis and is an area where fat is stored. It is comprised of:

Adipose tissue – containing fat cells

Aerolar tissue – containing elastic fibres that make this layer elastic and flexible.

The subcutis provides insulation as fat is a poor conductor of heat and protection as it supports the more delicate structures, such as blood vessels and nerves. It also provides a source of energy when required. It is this layer that separates the skin from the underlying muscle.

Blood supply to the skin

The dermis is highly vascular, unlike the epidermis. Small arteries, called terioles enter the dermis and branch into networks of fine capillaries, which supply active structures. Capillary networks also supply the Stratum Germinativum with essential nutrients. These capillary networks drain into small veins, called venules, which carry blood away from the skin.


13

Lymphatic supply of the skin

Lymphatic vessels form a network throughout the dermis and deeper layers of the epidermis.

Nerve supply to the skin

The skin is an important sensory organ. There are many nerves found throughout the dermis:

Sensory nerves – these send signals to the brain, providing information about the environment. They are sensitive to heat, pain, cold and pressure.

Motor nerves – relay impulses from the brain and are responsible for the dilation or constriction of blood vessels, contraction of the arrector pili muscles and the secretion of perspiration from the sweat glands.

Additional Work Further Reading relating to the structure of the skin can be found in Ross & Wilson pages 354 – 357

Image More diagrams of the skin can be seen on Ross & Wilson, page 354 – 356

c. Appendages of the skin Appendages of the skin are things that are associated with the skin and have a particular role to play in its function.

Hair and Hair Follicles The functions of hair are protection, filter for breathing, heat loss and sensation. Hair grows from a tube- like depression (hair follicle) that extends from the epidermis, down through the dermis and often into the subcutaneous layer. The follicle is actually a down-growth of epidermis cells. At the base of the follicle is a cluster of cells called the hair bulb. The hair is formed by cell division in the bulb. As these cells move up through the follicle they become keratinised, forming a shaft of hair. Hair has a protective function and is found all over the body, except the palms, soles and lips.

The hair is anchored inside the follicle by the inner root sheath, which grows up with the hair. The hair shaft is the part of the hair that grows above the surface of the skin and consists of three layers: the cortex, cuticle and medulla. Hair growth is cyclic. Following a period of active growth, the follicle breaks down and becomes shorter. The old hair is shed, the follicle rests until the time it is ready to produce another hair.


14

Arrector pili muscle This is a small muscle that is attached to the underside of the epidermis and the hair follicle. It is responsible for pulling the hair erect. They contract in response to cold or emotional stimuli. As a result of the contraction air is trapped between the hairs and the skin to insulate the body when it is cold although this is a rather vestigial structure now. This reaction produces goose bumps.

Sebaceous glands These are small sac-like glands that are usually attached to a hair follicle. They can occur independently where they open directly onto the surface of the skin. Sebaceous glands occur all over the surface of the skin, most numerous on the scalp, face and back. They secrete the skin’s natural oil called sebum. Sebum coats the surface of the skin and hair and keeps it supple and prevents water evaporation from the skin’s surface. Sebum has anti-fungal properties and is slightly acid.

The sebaceous glands are affected by the endocrine system and during puberty can become overactive. The male hormone testosterone causes the gland to enlarge while the female hormone oestrogen causes the gland to decrease. This explains why so many teenagers are troubled by seborrhoea (excessive oiliness) which can lead to the formation of acne.

Ceruminous (Sweat) Glands There are two types of sweat glands in the skin 1. Eccrine or Sudoriferous glands – these are often referred to as “true” sweat glands. They are present all over the body but are most numerous on the palms and soles. They lie in the dermis, consisting of a coiled secretory portion with a duct that opens in a pore on the surface of the skin. They secrete sweat which is a clear liquid containing 98% water and sodium chloride (salt) and traces of other substances, such as urea and uric acid. The secretion of sweat is controlled by the nervous and hormonal system and is particularly active during exercise, heat and emotional stress. The function of sweat is to control body temperature through its evaporation from the surface of the skin, which in turn removes heat.

2. Apocrine glands – These occur in connection with hair follicles in the axillary and pubic areas. Similar in structure to the eccrine glands but much larger, they develop during puberty and secrete a thicker, milky fluid containing water, salt and fatty particles. When this type of sweat reacts with the air and is broken down by bacteria it can lead to body odour. The apocrine glands are controlled by the nervous and hormonal system.

a. Excretion Sweat is eliminated from the sweat glands. Waste materials such as urea, uric acid, ammonia and lactic acid are contained within the sweat. Excretion


15

is a minor function of the skin with the main excretory organs being the kidneys.

b. Secretion Sweat is produced by the sebaceous glands. Sebum is a lubricant and keeps the hair and skin moist, pliable and waterproofed. It also contributes to the acid mantle.

Nails The nail has a number of uses from being useful tools to providing protection for the tips of the fingers and toes. Nails are an extension of the 2nd layer of the epidermis (stratum lucidum). The nail which is visible is made from dead flattened cells which have been keratinised. Beneath the skin the nail is alive and this is where active growth takes place.

Image An image of the nail structure can be found in Ross & Wilson page 357

Additional Work Further information on the appendages of the skin can by found in Ross & Wilson pages 356 & 357

Additional Work Research the structure and function of the nail using textbooks and the internet

Media This video clip views the skin through a microscope down through the visible layers

http://www.dailymotion.com/video/x4mt1u_zoom-into-human-skin_tech

d. How the skin ages Signs of aging do not normally become visible until the late forties. Most of the changes related to the aging process occur in the proteins found in the dermis. The collagen fibres start to decrease in number, stiffen, break and take on a disorganised state. The elastic fibres lose some of their elasticity, causing them to thicken into clumps and fray. This effect is accelerated in smokers. Fibroblasts that are responsible for the production of collagen start to decline in number resulting in decreased collagen levels. As a result of these changes the skin develops furrows and creases (wrinkles).

http://www.dailymotion.com/video/x4mt1u_zoom-into-human-skin_tech


16

As the aging process continues the skin immune response is depleted with the reduction of Langerhans cells and reduced efficiency of the macrophages. The size of the sebaceous glands also decreases meaning that the skin is drier and breaks more easily allowing infection to enter through these openings. Sweat production declines with age, commonly causing higher instances of heatstroke in the elderly. Hair also suffers a decline in melanocytes leading to grey hair, hair loss and thinning. Age spots occur as a result of the increase in size of some melanocytes. Aging skin is much thinner than its younger version, adipose tissue is lost and the blood vessels become thicker and less permeable. Older skin takes much longer to heal becoming susceptible to skin cancer and pressure sores. Growth of both nails and hair diminishes in the 40s often resulting in dry brittle nails that split and break easily.

Additional Work Research more about how the aging process affects the skin using textbooks and the internet

e. Common disorders of the skin The skin is one of the most vulnerable organs of the body. The majority of skin conditions are not life threatening but they can cause major discomfort, leading to disabling conditions. As the skin is so visible it can lead to cases of stress and anxiety. Skin disorders can be treated successfully with aromatherapy and complimentary therapies but some require the care of healthcare professionals. Common skin disorders include:

Infections: Bacterial: Acne, impetigo, erythema Fungal: Tineas (e.g. athlete’s foot) Viral: Herpes simplex, Herpes zoster Papillomas (e.g. warts) Decubitus ulcers

Pediculosis (lice) Rubella, varicella, hives Scabies

Allergies and reactions: General allergies Dermatitis Photosensitivity Burns


17

Chronic skin conditions: Eczema Psoriasis Scleraderma Skin Cancers Chronic ulcers

Additional Work Further information on common disorders of the skin can be found in Ross & Wilson pages 362 – 364

Additional Work Research more about common disorders of the skin using textbooks and the internet

Section 2 - The Skeletal System (Bones)

By the end of this section you will be able to:

1. Describe the main functions of the skeletal system:

Support

Protection

Movement

Mineral storage

Production of blood cells

2. Classify bones according to location, shape and function

3. Describe the structure and development of bone cells

4. Recognise prominent bony points by surface marking

5. Describe the structure of a typical long bone and label a simple diagram

6. Name the components and describe the functions of the axial and appendicular skeletons

7. Recognise and name the main facial and cranial bones and sinuses:

Cranial bones: Frontal Parietal Temporal Occipital Sphenoid Ethmoid

Sinuses: Ethmoidal sinus Frontal sinus


18

Sphenoidal sinus Maxillary sinus

Facial bones: Nasal Maxilla & mandible 8. Describe the arrangement of the vertebrae in the spinal column:

9. Describe the normal curvatures of the spine and recognise disorders

10. Name and locate the major bones of the body of on a simple diagram

11. Describe the effects of ageing on bone

a. The functions of the skeletal system The functions of the skeleton are: - a. Protection – In certain areas of the body a casing of bones protects

delicate organs. An example of this is the skull.

b. Support – The structure of the skeleton maintains the shape of the body despite activity by the muscles. It forms a means of suspension for some of the vital organs and also prevents them from crushing each other.

c. Locomotion – At the meeting point of two bones a joint is formed, which is moved, by muscle. There are various types of joint, which provide different types and degrees of locomotion.

d. Muscle attachment - It is necessary for bones to be attached to limb bones at one end in order to produce movement. They must also have a rigid attachment at the other end so that only one part of the limb moves during muscle contraction.

e. To create boundaries for the body cavities – This is in order to protect the organs within

f. Accessory function – Within the facial and some of the cranial bones cavities are present which contain air and give resonance to the voice. These nasal bones also create a bridge to allow for the free flow of air.

g. Bone function – The bones function to produce red and some white blood cells. Bones also produce reserves of phosphate and calcium.


19

Media You may find this video useful to watch http://www.youtube.com/watch?v=TnY6l9hMOew&feature=related

b. The structure of bones

1. Types of Bones The different types of bones are:

Long Bones – these are the body’s levers, they allow movement, particularly in the limbs.

Examples are - tibia, fibula, clavicle, humerus, radial and ulna

Short Bones – these are strong, compact bones that are usually grouped in parts of the body where little movement is required

Examples are – tarsal and carpals

Flat Bones – these are protective bones with broad flat surfaces for muscle attachment

Examples are – occipital, scapula and sternum

Irregular Bones – these are bones that do not fit into the other categories and have different characteristics

Examples are – vertebrae, maxilla and mandible

Sesamoid Bones – these are bones within tendons. There are only 2 sesamoid bones in the body.

Examples are – patella and hyoid

2. Bone cells Bones are living tissue which is formed from cells known as oestoblasts. The tissue varies in density and compactness. The closer to the surface it is the more compact the bone is. Many bones have a central cavity that contains marrow; this is the source of most of the cells of the blood and is also a storage site of fats. There are two types of bone tissue:

Cancellous – this type of bone looks like a sponge. It is found at the end of long bones and in irregular, flat and sesamoid bones. Bone marrow only exists in cancellous bone

Compact – to the naked eye this looks like a solid structure. If examined under a microscope it looks like a honeycomb. Compact bone is found on the outside of most bones and in the shaft of long bones

http://www.youtube.com/watch?v=TnY6l9hMOew&feature=related


20

Additional Work Further information about the structure and development of bone cells can be found in Ross & Wilson pages 381 - 384

3. Bone Surface Markings

All bones are required to carry out specific functions, as a result of this their structure and surface markings are developed to meet these needs. The majority of these are not present at birth but develop as required in the skeleton. These developments tend to be in response to tension on the surface of the bone from tendons, ligaments. New bone is deposited on the required surfaces resulting in the formation of raised and roughened areas. Where compression occurs on the bone surface a depression is formed. There are two main types of surface markings:

Depressions and openings – these allow for the passage of soft tissues or form joints.

I.e. fissures, fossa and foramen

Processes, projections or outgrowths – these help form joints or form points of attachment for connective tissue

I.e. condyle, crest and tuberosity

Additional Work Further information about bone markings can be found in Ross & Wilson pages 384 - 385

Additional Work Research more about the types of bone markings in the body using the internet or textbooks

4. The Structure of Long Bones

A long bone is composed of:

A diaphysis or shaft This is constructed of compact bone with a central medullary canal containing yellow bone marrow (fatty).

Two epiphyses or extremities These are composed of cancellous bone with an outer covering of compact bone.

The diaphysis and epiphyses are separated by epiphyseal cartilages. These ossify when growth is complete.


21

Long bones are almost completely covered with periosteum, a vascular membrane with two layers which covers the whole of the bone except the joint cavities. This allows for the attachment of tendons. Hyaline cartilage replaces the periosteum on the surfaces that form the joints. The outer layer is fibrous and tough, protecting the bone underneath. The inner layer consists of osteoclasts and oestoblasts which are responsible for the breakdown, repair, remodelling and production of bone. Blood supply to the shaft is from nutrient arteries whilst the epiphyses have their own blood supply. In mature bones these two supplies are heavily interconnected

Image A diagram showing the structure of a long bone can be found in Ross & Wilson page 380

Additional Work Research more about the structure of long bones using the internet or textbooks

c. The skeleton The skeleton is the bony framework of the body. It forms the cavities which protect some of the body’s structures and organs, forms joints, and gives attachment to muscles, which in turn allow for movement of the body. Bone marrow is also used in the production of blood cells.

1. The Axial & Appendicular Skeleton The skeleton is described in two parts: -

The Axial skeleton (axis of the body) and consists of:

Skull

Vertebral column

Sternum (breast bone)

Ribs It consists of 80 bones in total.

The Appendicular skeleton (appendages attached to the body) consists of:

The bones of the upper limbs, the two clavicles and the two scapulae

The bones of the lower limbs and the two innominate bones of the pelvis. It consists of 126 bones in total.

Image An image of the skeleton showing the axial and appendicular bones can be found in Ross & Wilson page 387


22

Additional Work Information about the axial and appendicular skeleton can be found in Ross & Wilson pages 385 – 401

You may also find this website article useful: http://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeleton

Have some fun! This may help you remember the names of the bones! http://www.youtube.com/watch?v=vya4wpS2fgk&feature=related

2. The Facial Bones The facial contours are determined by the relative sizes and positions of the facial bones together with the muscles and fatty tissues, which lie over them. The skull consists of the cranium and the face.

The skull and facial bones are comprised of:

Cranial Bones This consists of 8 bones in total. They are flat bones and articulate at interlocking joints called sutures. They surround the brain and provide a strong, bony protective cage. The bones are as follows:

Frontal (1) – this bone forms the frontal and upper wall of the orbits (eye sockets).

Parietal (2) – these two bones form the sides and roof of the cranium.

http://en.wikipedia.org/wiki/List_of_bones_of_the_human_skeleton

http://www.youtube.com/watch?v=vya4wpS2fgk&feature=related


23

Temporal (2) – these two bones form the lower part of the sides of the cranium. Each temporal bone has a projection behind the ear called the mastoid process

Occipital (1) - This bone forms the back and base of the cranium. It contains a large hole – the foramen magnum, through which the spinal cord, blood vessels and nerves pass. On each side of the foramen are the occipital condyles, which articulate with the first vertebrae.

Sphenoid (1) - This is located in front of the temporal bone and serves as a bridge between the cranium and the facial bones. It articulates with the frontal, temporal, occipital and ethmoid bones.

Ethmoid (1) – This bone forms part of the wall of the orbit, the roof of the nasal cavity and part of the nasal septum.

Sinuses The sinuses or “paranasal sinuses” are air-filled cavities in the bones of the skull. The paranasal sinuses communicate with the nasal air cavities and are lined with mucous membrane. There are a set of four cavities located in the following bones near to the nose:

Ethmoid sinus – behind and below the frontal sinuses

Frontal sinus - located in the frontal bone or forehead

Sphenoidal sinus – at the back of the nasal passageways

Maxillary sinus - in the upper cheek area

Facial Bones This consists of 14 bones in total. They are mainly irregular in shape and similarly to the cranium they are fused together, with the exception of the mandible, which is the only moveable bone of the skull. The bones are as follows:

Nasal - The two maxillae unite to form the upper jaw and carry the upper teeth. They articulate with all the other bones of the face except the mandible. They also form part of the floor of the orbits and nasal cavities.

Maxilla – This is a fusion of two bones along the palatal fissure that form the upper jaw. This is similar to the mandible

Mandible - This is the only moveable bone in the skull. It forms the lower jaw and chin. The mandible carries the lower teeth.

http://en.wikipedia.org/wiki/Palate

http://en.wikipedia.org/wiki/Jaw

http://en.wikipedia.org/wiki/Mandible


24

Additional Work Further information about the bones of the face and skull can be found in Ross & Wilson pages 386 – 391 Image Images of the bones of the face and skull can be found in Ross & Wilson pages 386 – 391

d. The Spinal Column The spinal (backbone) or vertebral column consists of 33 vertebrae, the sacrum and coccyx separated by vertebral discs. It houses the spina column within the spinal canal. It is constructed in the following way:

Cervical Spine – 7 vertebrae (C1 – 7) C1 is known as the ‘atlas’ and supports the head C2 is known as the axis C7 is known as the ‘vertebra prominens’ All of these vertebrae are small bodied. Only cervical vertebrae have transverse foramen

Thoracic Spine – 12 vertebrae (T1 – T12) The vertebrae have costal facets which articulate with the heads of the ribs They are intermediate size – between the cervical and lumbar

Lumbar vertebrae (L1 – L5) These have a large body and do not contain either facets or transverse foramen

Coccygeal vertebrae – 4 These are fused and form the tailbone


25

The Curves of the spine The spine presents several curves when it is viewed laterally. These curves are situated in the following areas:

Cervical - this is a convex, forward curve. It begins at the apex of the odontoid process, ending in the middle of the second thoracic vertebrae. It is the least prominent of the curves

Thoracic – this is a concave forward curve It begins at the middle of the 2nd thoracic vertebrae and ends at the middle of the 12th thoracic vertebrae. Its most prominent point is at the point of the 7th thoracic vertebrae

Lumbar – this is more prominent in women than men. It is a anteriorly convex curve and is described as a lordotic curve

It begins in the middle of the last thoracic vertebrae and ends at the sacrovertebral angle.

Pelvic – this is a concave curve which points down and forward It begins at the sacrovertebral articulation, ending at the point of the coccyx.

The pelvic and thoracic curves are known as primary curves due to the fact they are present during fetal life. The secondary or compensatory curves in the cervical and lumbar spine are developed after birth. The cervical curve develops when a child is able to hold up its head and sit upright. The lumbar curve develops when the child starts to crawl and walk. Curvature Disorders

Kyphosis

An exaggerated outward curvature of the spine

Scoliosis

A sideways curvature of the spine

Lordosis

An exaggerated inward curvature of the spine

Kyphosis Scoliosis Lordosis

Additional Work More information about the spinal column can be found in Ross & Wilson pages 391 – 396


26

e. How age affects the Bones From birth through adolescence more bone tissue is produced than is lost. This then levels out to a roughly equal level through early adulthood. As the body enters middle age and the production of hormones diminishes (this is more prevalent in women) a decrease in bone mass occurs. In old age the production of bone tissue is far outweighed by the loss of bone. As female bones tend to be smaller than their male counterparts the change in bone structure had a greater adverse effect accounting for the higher instance of osteoporosis in women.

Additional Work You may wish to research how age affects the bone tissue in textbooks or on the internet.

Section 2.1 - The Skeletal System (Joints) By the end of this section you will be able to: 1. Describe the classification of joints by structure and function

2. Describe a typical synovial joint and explain the functions of its constituent parts

3. Recognise each type of synovial joint and give examples of each: I.e. hinge, ball & socket, condyloid, saddle, pivot

4. Describe the type of movement at each type of joint

5. Explain “range of movement” and describe the factors which limit movement at joints

6. Describe the effects of ageing on synovial joints

7. Name & briefly describe common disorders/diseases of the skeletal system including:

Arthritic conditions: Osteoarthritis Rheumatoid arthritis Ankylosing spondylitis Reactive arthropothies Infective arthropothies Joint replacements

Soft tissue conditions: Bursitis Tendonitis Sprains & Strains Synovitis


27

General: Gout Non-specific back pain Postural defects, including lordosis, scoliosis and kyphosis Subluxation (dislocation) Contractures Osteoporosis

a. Structure and Function of Joints A joint or articulation is where two bones meet. Their structure or the way in which they move classifies joints. Most joints in the body are synovial joints. These are versatile, lubricated joints such as the knee, in which the surfaces in contact slide over each other easily. Articular cartilage covers the bone ends, ligaments provide stability, and a fibrous capsule encloses the joint. Surrounding muscles produce movement. The types of joints can be classified as follows: -

1. Fixed or semi-movable joints Not all joints are freely movable, after growth is complete; the bones of the skull become fixed together by fibrous tissue, forming immovable suture joints. In the lower leg, the tibia and fibula are stabilised by ligaments that allow only a small amount of movement.

2. Synovial joints In a synovial joint, the shape of articular cartilage surfaces and the way they fit together determine the range and direction of the joint’s movement.

Media You may like this video clip http://www.youtube.com/watch?v=BXoMa2bVC18

b. Synovial Joints Synovial joints are the most common moveable joint found in the human body. The movement is created at the point of contact of articulating bones. Synovial joints can be distinguished from cartilaginous joints and fibrous joints by their structure and function. The major difference is that the articulating surfaces are surrounded by a capsule of synovial fluid which provides lubrication. A synovial joint has the following structure:

Articular capsule This fibrous capsule is a continuation of the periosteum of the bone. It is highly innervated but lacks blood and lymph vessels (avascular)

Articular cartilage This lines the epiphyses on the joint end of the bone. Its mechanism is designed to be resistant to load and shock

http://www.youtube.com/watch?v=BXoMa2bVC18


28

Synovial Membrane This forms the inner layer of the fibrous articular cartilage. It is present where there is no articular cartilage

Image A diagram of a synovial joint can be found in Ross & Wilson page 402 fig. 16.45 Additional Work More information about the joints can be found in Ross & Wilson pages 401 – 409

c. Types of Joints

Pivot Joint A projection from one bone turns within a ring-shaped socket of another bone or the ring turns around the bony projection. A pivot joint formed by the top two cervical vertebrae allows the head to turn from side to side.

Hinge Joint In this the simplest of joints, the convex surface of one bone fits into the concave surface of another. This allows for movement like a hinged door in only one plane. Both the elbow and the knee are modified hinge joints. They bend up and down in one plane quite easily but are also capable of very limited rotation.

Ellipsoidal Joint An ovoid or egg shaped, bone end is held within an elliptical cavity. The radius bone of the forearm and the scaphoid bone of the hand meet in an ellipsoidal joint. This type of joint can be flexed and moved from side to side but rotation is limited.

Ball and Socket Joint The rounded end of one bone fits into the cup like cavity of another bone. Of all joint structures, a ball and socket type allows for the greatest range of movement. The shoulder and the hip are both ball and socket joints.

Saddle Joint The joint surface of each bone has both concave and convex areas so that the bone can rock back and forth and from side to side but have


29

limited rotation. The only saddle joints in the body are at the base of the thumbs.

Gliding Joint The two surfaces of bones that meet in a gliding joint are almost flat, and slide over one another. Movement is limited, however, by strong encasing ligaments. Some joints in the foot and wrist move in this way.

Range of Movement Range of movement is a term which defines the ‘normal range’ of distance and direction in which a joint can move. This range is different for each joint.

Limitations in the normal range can be as a result of mechanical problems with a specific joint or it may affect many joints if it is caused by a disease such as arthritis. Pain, swelling and stiffness are all factors that can affect range of movement in a joint leading to impaired function and limited range/ Physical therapy and specific exercises can help to improve the range of motion.

The effect of aging on Synovial Joints As the body ages there is a decrease in the production of synovial fluid within the joints. In addition to this the ligaments shorten, losing some flexibility and the articular cartilage thins. The effect of aging on the joint has many determining factors including genetics, diet and lifestyle. The process may begin as early as 20 but by the age of 80 almost everyone is showing signs of degeneration in the hips, shoulders and knees. It is also common for the vertebrae to be affected in older age, resulting in the posture becoming hunched.

Additional Work More information about the joints can be found in Ross & Wilson pages 404 - 409

d. Common disorders and diseases of the skeletal system. People of any age can be affected by disorders and diseases of the skeletal system. They can be painful, debilitating and life changing. They respond well to holistic therapies. It is a good idea to familiarise yourself with the most common conditions listed below:

Arthritic conditions: Osteoarthritis Rheumatoid arthritis Ankylosing spondylitis Reactive arthropothies Infective arthropothies Joint replacements


30

Soft tissue conditions: Bursitis Tendonitis Sprains & Strains Synovitis

General: Gout Non-specific back pain Postural defects, including lordosis, scoliosis and kyphosis Subluxation (dislocation) Contractures Osteoporosis

Additional Work Further information about the disorders and diseases of the skeletal system can be found in Ross & Wilson pages 421 – 425

Additional Work You may wish to research more about the disorders and diseases of the skeletal system using the internet and text books


Section 3 - The Muscular System

By the end of this section you will be able to: 1. Describe the structure & functions of the three types of muscle tissue:

skeletal (striated)

smooth (non-striated)

cardiac

2. Describe the gross and microscopic structure of skeletal muscle

3. Describe the mechanism of the process of muscle contraction

4. Define muscle tone, isotonic and isometric contraction, agonist, and antagonist

5. Indicate on a model or diagram the principal superficial muscles of the body

6. List the points of origin & insertion of the major muscles and their actions

7. Describe the direction of fibres

8. Explain the process of muscle fatigue

9. Explain the structure and functions of tendons and ligaments

10. Name & briefly describe common disorders/diseases of the muscular system including:

Local: Fibrositis Fibromyalgia Repetitive strain injury

Carpel tunnel syndrome Ganglion cysts Dupuytren’s contracture

General: Muscle wasting diseases e.g. Myasthenia gravis, Muscular dystrophy

Chronic fatigue syndrome (ME) Peripheral neuropathies e.g. diabetes, drug induced

a. The structure and functions of the muscle types: Functions of the Muscular system The main job of the muscular system is to provide movement for the body. There are more than 650 muscles in the body which are attached to the skeleton with tendons. The actions of muscles are:

Create movement

Assist in the support of joints and maintain posture

Produce heat and help maintain body temperature


32

There are two types of muscles:

Voluntary muscles – these can be controlled and changed according to need i.e. picking up a cup

Involuntary muscles – there is little or no control over the action of these muscles i.e. the heart beating.

The muscular system is managed by the nervous system which transmits message through the motor verves to the brain causing the muscle to contract or relax. There are three types of muscle tissue:

1. Skeletal (Striated, striped or voluntary) muscle This muscle is the flesh or lean meat of the body. The ‘stripes’ are bands across the fibres about 1/1000 mm wide produced by regular alternation of the actin and myosin components of actomyosin. Nearly all striated muscle is under conscious control, but also takes part in unconscious reflexes.

2. Smooth (Non-striated, involuntary or visceral muscle) This muscle is found in the wall of the digestive and urinary tracts and other hollow organs, and of the blood vessels. Its fibres, each a single cell, are much shorter than striated fibres. All smooth muscle is controlled unconsciously through the sympathetic and parasympathetic nervous systems, usually together, one stimulating and the other inhibiting.

3. Cardiac muscle – This is the muscle that forms the substance of the heart. It can be regarded as an enormously developed involuntary muscle in the wall of a blood vessel, but it differs from any other muscle. Its fibres are short and thick, and form a dense mesh. They contract rhythmically without any nervous impulse; the nerves only modify the rate of contraction.

Media You may like this video clip http://www.youtube.com/watch?v=PJDrR3sZPZU&feature=related

The gross and microscopic structure of skeletal muscles The muscles are made up of large numbers of muscle fibres. A connective tissue sheath known as the epimysium covers the entire muscle. Inside the muscle the fibres are arrange in separate bundles (fascicles) which are then surrounded by their own connective tissue sheath, the perimysium. The fascicles are constructed of individual muscle cells which are surrounded with a fine connective tissue layer known as endomysium. All of these connective tissue layers run the whole length of the muscle. They bind the fibres together in an organised manner. When they reach the end of the muscle they blend together to form the tendon which secures the muscle to the bone. Tendons tend to have a rope like structure but they can form into broad sheets known

http://www.youtube.com/watch?v=PJDrR3sZPZU&feature=related


33

as an aponeurosis. The connective tissue layers in the muscle in the transmission of contraction force from each individual muscle cell to the points of attachment on the skeleton. The term belly is used to describe the fleshy part of the muscle which bulges and becomes shorter when the muscle contracts.

Image A diagram of the organisation within skeletal muscle can be found in Ross & Wilson page 410 fig. 16.54

When skeletal muscle is viewed under a microscope the cells structure is cylindrical in shape and they lie parallel to each other. They have a banded appearance which has alternating light and dark stripes. These fibres can be up to 35cm long in some muscles. Each cell has several nuclei as a result of their size. These are situated just under the cell membrane (the sarcolemma). The cytoplasm of the muscle cells (sacroplasm) is constructed of tiny filaments which run longitudinally along the length of the muscle (these are the contractile filaments). Many mitochondria are also present as they are required for producing ATP from glucose and oxygen to power the contractile mechanism. Myoglobin, a specialised oxygen binding substance is also present. It is similar to haemoglobin found in the red blood cells and stores oxygen within the muscle. As well as this calcium is stored in large amounts in the intracellularly. This is then released into the sacroplasm when nervous stimulation of the muscle occurs. It is essential for the contractile activity of the microfilaments.

Within the muscle fibre there are two types of contractile myofilament which are known as thick and thin. These appear in repeating units known as sacromeres. The thick filaments are constructed of a protein known as myosin (the dark bands under a microscope). The thin filaments are constructed of a protein known as actin (the light bands).

Each of the sacromeres is bound at each end to a stripe known as the z-line, myosin fibres are attached to this stripe. Actin fibres are present in the middle of each sacromeres, overlapped by myosin.

Media You may like this video clip http://www.youtube.com/watch?v=ren_IQPOhJc

Tendons & Ligaments 1. Ligaments A ligament is a short band of tough, fibrous, dense, regular connective tissue composed mainly of long, stringy collagen fibres. Ligaments connect to other bones to form a joint. They do not connect muscles to bones; that is the

http://www.youtube.com/watch?v=ren_IQPOhJc


34

function of tendons. Some ligaments limit the mobility of certain movements altogether.

Capsular ligaments are part of the articular capsule which surrounds the synovial joints. These act as mechanical reinforcements. The bones are joined together by extra-capsular ligaments which also provide joint stability.

Ligaments are elastic unlike tendons which are inelastic and fixed. Ligaments gradually lengthen when under tension. When a joint is dislocated it should be set as quickly as possible to prevent over lengthening of the ligaments, this leads to a weakening of the joint and thus makes it prone to future dislocations. Sports men/women perform stretching exercises designed to lengthen the ligaments and make the joints supple. When a ligament is torn it can lead to instability in the joint. In severe cases surgery may be required to reattach the ligament and stabilise the joint.

2. Tendons Tendons or sinew connect the muscle to the bone. They are formed from a tough band of fibrous connective tissue. They are able to withstand tension. They are similar in construction to ligaments being constructed of collagen. Tendons work with muscles to exert a pulling force.

b. How the muscles work The process of Muscle contraction Skeletal muscles contract quickly and relax promptly. Each muscle fibre is served by a nerve fibre, which ends in a neuromuscular plate through which the stimulus to contract is passed. Each muscle fibre acts in an "all or nothing" manner, with a brief latent period after relaxation before it is able to contract again. The degree of contraction of the muscle as a whole is proportional to the number of fibres active. This in turn varies with the strength, speed of application and duration of stimulus and with load and temperature.

Normally a few fibres are stimulated, maintaining tone, even when the muscle is at rest. When many fibres are stimulated together, they produce either shortening of the whole muscle and thus movement (isotonic contraction) or increase in tension between the two ends without movement (isometric contraction).

When a muscle contracts actively, the actin filaments slide over the myosin filaments toward the centre of the sarcomere.

During muscular action a number of enzyme controlled chemical reactions take place. During the contractile phase the muscle proteins actin and myosin form actomyosin, which reacts with adenosinetriposphate (ATP) to form adenosinediphosphate-actomyosin (ADP-actomyosin) with liberation of energy. The ATP is ultimately re-synthesised by energy derived from the


35

anaerobic breakdown of glycogen to lactic acid. If oxygen is not available this lactic acid accumulates and interferes with the activity of the enzymes to such an extent that no further energy is made available and the contraction of the muscle ceases. If oxygen is available, one-fifth of the lactic acid is oxidised to carbon dioxide and water, yielding energy for the resynthesis of glycogen from the other four-fifths. If activity continues long enough to use up all the reserves of glycogen in the muscle, no further activity can take place till they have been replenished. The muscle is fatigued and requires rest.

Muscle Tone Muscle contraction in the body is under the ruling of ‘all or none’. This determines whether each muscle fibre contracts fully or not at all. The degree of contraction within the whole muscle is dependant on the density of fibres within the muscle that are in a contracted state at any one time and the amount of times they are stimulated. Muscle tone is a sustained partial muscle contraction that maintains the posture without the muscles becoming fatigued. This action is not under voluntary control. Good muscle tone helps to protect the joints and gives muscles firmness and shape even when they are relaxed.

Isotonic and Isometric contractions When a muscle contracts it usually results in it entering into a shortened state. An example of this is when a cup is lifted by the hand. The bicep shortens, generating power in the muscle to lift the weight and maintain constant tension. This type of contraction is known as an isotonic contraction (iso = same, tonic = tension). When a muscle tries to perform an action where it does not have enough strength, the muscles would still work hard to attempt the action but it would result in the muscles remaining the same length with the power generated creating tension in the muscles. This is know as an isometric contraction (iso = same, metric = length).

Agonist and Antagonist Movement often occurs as a result of a group of muscles working together. Most of the muscles in the body are arranged in opposing (antagonistic) pairs at joints i.e. adductors and abductors. These pairs are formed by a leader (agonist) which creates an action when it contracts. The other muscle of the pair known as the antagonist stretches and yields to the effects of the agonist. An example of this is the biceps brachii which is the agonist and the triceps brachii is the antagonist. The two roles can be reversed when carrying out certain movements.

Muscle Fatigue When a muscle works it requires sustained levels of fuel molecules such as glucose along with an adequate supply of oxygen. When these supplies are not adequate to feed the needs of the muscle, fatigue will occur. In response


36

to this the action of the muscle is reduced and will cease altogether if this situation continues. Muscles require chemical energy in the form of ATP which is usually as a result of the breakdown of carbohydrates and fats. Protein can be used to supply this need if the supplies of fat and carbohydrate are inadequate. A constant supply of oxygen is required to ensure that all potential energy is released from the fuel molecules. When insufficient oxygen is available the body uses anaerobic metabolic pathways to produce the energy. These are less efficient and result in the formation of lactic acid. When there is an accumulation of lactic acid in the working muscles, fatigue occurs. Fatigue can also occur when energy stores have been exhausted or as a result of injury.

Additional Work Further information about how the muscles work can be found in Ross & Wilson pages 411 – 412

c. Recognising the muscles of the body There are over 650 muscles in the human body. Although it is not essential to know all of them it is important to know the major superficial muscles that form the human body. It is also preferable for you to understand their actions, origins and insertions.

Below are various resources that you may find valuable in getting to know the muscles of the human body:

Additional Work Further information about how the muscles can be found in Ross & Wilson pages 413 - 420

Internet Resource: Muscles of the body - http://en.wikipedia.org/wiki/List_of_muscles_of_the_human_body

Internet Resource: Origin & Insertion of muscles tables - http://www.ptcentral.com/muscles/

Have some fun! Muscles activity http://www.bbc.co.uk/science/humanbody/body/interactives/3djigsaw_02/index.shtml?muscles

http://en.wikipedia.org/wiki/List_of_muscles_of_the_human_body

http://www.ptcentral.com/muscles/

http://www.bbc.co.uk/science/humanbody/body/interactives/3djigsaw_02/index.shtml?muscles

http://www.bbc.co.uk/science/humanbody/body/interactives/3djigsaw_02/index.shtml?muscles


37

d. Common disorders and diseases of the muscular system. People of any age can be affected by disorders and diseases of the muscular system. They can be painful, debilitating and life changing. They respond well to holistic therapies. It is a good idea to familiarise yourself with the most common conditions listed below:

Local: Fibrositis Fibromyalgia Repetitive strain injury

Carpel tunnel syndrome Ganglion cysts Dupuytren’s contracture

General: Muscle wasting diseases e.g. Myasthenia gravis, Muscular dystrophy

Chronic fatigue syndrome (ME) Peripheral neuropathies e.g. diabetes, drug induced

Additional Work Further information about the disorders and diseases of the muscular system can be found in Ross & Wilson pages 424 - 425

Additional Work You may wish to research more about the disorders and diseases of the skeletal system using the internet and text books


Further Reading

Anderson P D. 2004 Human Anatomy and Physiology Colouring Workbook and Study Guide

Jones and Bartlett Publishers, Inc;

Ball J. 2005 Understanding Disease: A Health Practitioner's Handbook Vermilion

Blandine C G. 2004 Anatomy of Movement Eastland Press

Blakey P. 2008 The Muscle Book Himalayan Institute Press

Bowden B & J. 2002 An Illustrated atlas of the skeletal muscles, Morton publishing, USA

Cash M 1999 The Pocket Atlas of the Moving Body Ebury Press

Cohen BJ. 2008 Memmler's the Human Body in Health and Disease Lippincott, Williams & Wilkins

Crawley J L. 2002 Photographic Atlas for Anatomy and Physiology

Morton publishing, USA

Jarmey C. 2008 The Concise Book of Muscles Lotus Publishing

Kapit W & Elson L. 2001 Anatomy Colouring Book Benjamin Cummings

Kapit W, Macey RI Physiology Colouring Book & Meisami E. 1999 Benjamin Cummings Martin E. 2007 Concise Medical Dictionary OUP Oxford

Parker S & Medi-mation 2007 The Human Body Book: The Ultimate Visual Guide to Anatomy, Systems and

Disorders Dorling Kindersely Thibodeau GA & The Human Body in Health and Disease, Patton KT. 2009 Mosby


39

Tortora GJ & Principles of Anatomy and Physiology Grabowski SR. 2008: with Atlas and Registration Card John Wiley

Waugh A & Grant A. 2006 Ross and Wilson's Anatomy and Physiology Colouring and Workbook

Churchill Livingstone

Werner R. 2009 A massage therapist’s guide to Pathology Lippincott Williams & Wilkins,

DVD’s

Anatomy for Beginners – Dr Gunther von Hagens This was originally shown on Channel 4 television and shows an autopsy taking place. Interesting but not for the squeamish!!

***The Books & DVD’s Highlighted in Red are particularly recommended***

Date post:	02-Jun-2020
Category:	Documents
Upload:	others
View:	2 times
Download:	0 times

Anatomy & Physiology Diploma Module 2essentiallyholistic-onlinetraining.com/wp-content/... · To...

Documents