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MENTAL ILLNESS CRITERIA & DEFINITIONS • Statistical Model: “Normality’’ is that which a majority (e.g., 68%) of the population exhibits, based upon a statistical normal curve. • Societal Expectations: ‘‘Normality” is conformity to sociological roles. • Consensus of Opinions of Experts: Experts (viz., psychologists and psychiatrists) stipulate what is normal. • Subjective Discomfort: The person admits to a problem. • Social or Vocational Incapacity: The inability to function in societal or work-defined roles. • Misinterpretation of Reality: The person is out of touch with or distorting perceived “reality.’’ • Immaturity: Maturity level is below the degree of what is expected at specified age or social milieu. Note: No single criterion for mental illness can describe all types of abnormalities. Defining mental illness relative to social norms or maladaptive behaviors invariably commits one to making a normative (i.e., value) judgment that one’s societal norms are “correct.” Hence, all definitions of mental illness invariably become theory-laden.

THOMAS SZASZ’S OBJECTION The concept of mental illness is a socially construced myth for the purpose of advancing certain social and political agenda. Clinical psychology is an instrument of repression to enforce conformity and stigmatize nonconformist and ‘‘deviant’’ people with the label “mentally ill.’’

REZNEK’S DEFINITION OF MENTAL ILLNESS Something is a mental illness if, and only if, it is an abnormal and involuntary process that does mental harm and should best be treated by medical means. Note: “Abnormality” is used in the constructivist (i.e., normative) sense and not in the statistical or idealistic sense, inasmuch as society determines what is acceptable “normal” behavior.

MEDICAL MODEL METHODOLOGY 1. Describe Symptoms 2. Diagnose (identify specific pathology) 3. Etiology (probable cause of disease) 4. Prescribe Treatment 5. Prognosis (expected course of disease)

CAUSAL FACTORS • Primary Cause: The agent believed to have initially caused the disease. In the medical model, the primary cause is assumed to be a virus, bacteria, chemical toxin such as lead poisoning, genetic inheritance, chemical disorder, or structural brain pathology. • Predisposing Cause: Organism is predisposed to disease under some circumstances (e.g., alcoholism). • Precipitating Cause: A specific event or factor triggers onset of the disease (e.g., it is suspected that Alzheimer’s disease has an environmental precipitating cause). • Reinforcing Cause: Factor that maintains the disease (e.g., severe stress may reinforce the need for narcotic opiates); environmental chemicals may also reinforce the disease.

WORLD’S #1 ACADEMIC OUTLINE

BASIC TERMINOLOGY • • • •

Symptom: The behaviorally manifest signs of a disorder. Syndrome: A collection of symptoms that identifies a disease. Acute: A disorder that has a sudden onset but is short-lived. Chronic: A persistent, long-lasting disorder.

CAUSE OF DISORDERS • Chemical: Usually, an imbalance of certain brain chemicals (e.g., it is suspected that an imbalance in the neurotransmitter serotonin plays a causal role in the onset of schizophrenia). • Infection by micro-organisms (e.g., syphilitic paresis is thought to be caused by the bacteria that initially infected the subject with syphilis, resulting in the subsequent dementia). • Genetic: Genetic mutations and/or predispositions may play a causal role in the onset of a disorder (e.g., manicdepressive illness is thought to have a genetic predisposing factor). • Constitutional Weakness: The organism may have an enduring biological defect that pre-disposes it to some illness. • Physical Deprivation, such as lack of sleep, malnutrition, etc. may play a causal role in the onset of disease. • Brain Pathology: Physical brain disorder, either congenital or traumatic (e.g., head injury), as the cause of mental illness.

CLASSIFICATION & DIAGNOSIS The process of classifying and identifying a disease by reference to symptoms and behavior deviating from “normal.” The major categorizing reference for the classification of mental disorders is the DSM (viz., Diagnostic and Statistical of Disorders in the DSM are sometimes classified unreliably and are invalid for diagnostic agreement among psychiatrists; with the exception of the diagnosis of “manic depressive illness,” the inter-observer diagnostic reliability of DSM is poor). People labelled by DSM classifications are often stigmatized for life.

ASSESSMENT TECHNIQUES The process of identifying the nature and severity of the condition, formulating treatment goals, and evaluating the effect of the treatment. • Medical evaluation • Personality and environmental variables • Interviews with patient • Psychological tests and rating scales • Direct observation of behavior

TREATMENTS • Psychosurgery: Partial or total frontal lobotomy, or other procedure, wherein brain tissue is severed or excised. • Electroconvulsive Shock Therapy (ECS): Administering electrical current of various intensity to the brain to alleviate symptoms of severe chronic depression. • Psychoactive Drugs: Alter mood or behavior by affecting metabolic processes that affect the brain. They are administered to stabilize moods (e.g., lithium for manic-depression), alleviate depressed states (e.g., Prozac), or to induce/subdue certain emotional states.

ADVANTAGES OF MEDICAL MODEL Promotes a more human understanding of patients, aids in the understanding of some organic mental disorders and further initiates research in brain functioning.

DISADVANTAGES OF MEDICAL MODEL Enviromental variables are unduly minimized or neglected; diagnostic and treatment methods are questionable, thus fostering an “institutionalization syndrome.” This approach removes responsibility from the person to want to be cured; it promotes dependence upon hospitals and chemicals.

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PSYCHOLOGICAL PERSPECTIVE As humans attempt to adapt to their environment, maladaptive behavior causes abnormal behavior. The psychological perspective assumes that both normal and abnormal adaptive patterns are learned, not inherited. Thus, treatment consists of substituting healthy adaptive behaviors for maladaptive behaviors. The goal of this approach is to explain abnormality in terms of inefficient and ineffective coping mechanisms. A psychological treatment works only if the patients actively participate in their treatment; the approach is usually ineffective in the case of involuntary institutionalization. • Neo-Freudians: Concentrate on the power of the ego, instead of the id. Emphasized social interactions in the formation of personality, deemphasized instincts and biological factors. In psychotherapy, they emphasize the present, not the past, and tend to advocate shorter periods of treatment. Specific problems that could be readily treated are focused upon.

GENERAL CAUSES OF ABNORMALITY These merely predispose persons to abnormal behavior: • Maternal Deprivation: Especially, orphans who are institutionalized and/or are abandoned by their natural parents. • Pathological Family Patterns: Maladaptive family behavior (e.g., faulty role model) which the child imitates and internalizes; faulty relationship between parent and child (e.g., over-protective, domineering, alcoholic and/or emotionally abusive parents, etc.) • Psychic Trauma (Especially in the psychoanalytic view): An early-repressed childhood traumatic experience is repressed (e.g., abandonment, death or divorce, sexual abuse, etc.) and then resurfaces later as a disorder. • Pathological Interpersonal Relationships: Stressful, anxiety-causing, maladaptive personal relationships (e.g., co-dependent, narcissistic, or control-obsessive), or no relationships at all. • Severe Stress: Extreme pressure on the coping mechanisms which take a destructive toll on psychological processes (e.g., post-traumatic stress disorder resulting from combat, captivity, torture, natural disasters, being kidnapped or terrorized, etc.)

OVERVIEW OF PSYCHOLOGICAL SCHOOLS OF THOUGHT • Psychoanalytic: Early development molds the personality and adaptation; the determinants of behavior are largely subconscious processes. • Neo-Freudian: Focus is on pathological social and interpersonal relationships. • Behavioristic: Faulty learning and conditioning processes produce abnormality; the determinants of behavior can usually be understood only by investigating overt observable behavior. • Humanism: Focus is on how blocked personal growth and value conflicts lead to abnormality.

PSYCHOANALYTIC PERSPECTIVE • Objective Anxiety: Fear and detectable anxiety. • Neurotic Anxiety: (i.e., “free-floating” anxiety): Fear of the actualization of repressed sexually destructive drives. Fear that the individuals will lose control and act out their drives. In such situations, the ego may create various defense mechanisms. • Superego Anxiety: A guilty conscience. • Treatment Methodology: Does not give direct advice, but attempts to assist patients to gain insight into the conditions of their illnesses. • Defense Mechanisms: Function to keep the drives repressed, and prevent the individual from acting them out. The defense mechanism is itself subconscious, because if the person were aware of it, then the patient would be aware of the drives the mechanism is defending against.

Psychological Perspective (continued)

The most productive defense mechanism is sublimation. Sublimation is the re-direction of sexual energy into productive, socially approved areas. The major function and advantages of defense mechanisms are to prevent the ego from being overwhelmed by anxiety. • Disadvantages of Employing Defense Mechanisms: Emotional rigidity and avoidance of problems instead of solving them, resulting in less authenticity and spontaneity; less-efficient ego due to wasting energy.

A COMPENDIUM: DEFENSE MECHANISMS • Reaction Formation: Manifesting behaviors or proclaiming intentions the very opposite of one’s actual unacceptable intentions; e.g., adulterous spouses frequently pronounce their fidelity. • Projection Formation: Accusing another of the very tendencies that one finds anxiety-provoking and unacceptable in oneself; e.g., persons who have been unfaithful (or are considering the same) make frequent jealous accusations against their spouses. • Denial: Denying the existence of an anxiety-provoking situation; e.g., the spouse confronted with evidence of infidelity by his/her partner simply dismisses the evidence as irrelevant because his/her partner would ‘‘never do such a thing.’’ • Repression: Excluding stressful thoughts, impulses, and memories from conscious awareness; e.g., a witness to a ghastly accident may be unable to recall any details of the event. Forgetting certain events, physical debilitation, and emotional stolidity are some manifestations of repression. • Displacement: Substituting a less-threatening object for one causing anxiety and directing reactive impulses toward the substitute; e.g., a boy who is constantly belittled and teased by older classmates may go home and torment his younger sibling. • Regression: Manifesting behaviors which are clearly infantile or immature relative to a person’s chronological age; e.g., a young woman married to an older man may refer to him as ‘‘daddy” and act as a child when confronted with severe stress. • Rationalization: Explaining away, in a seemingly logical manner, unacceptable situations, events, feelings, thoughts, or intentions. There are two basic kinds of rationalization: a. Sour-Grapes Rationalization: A desirable object/ result is devalued when the individual fails to achieve it; e.g., a man whose marriage proposal is rejected may comment that “she was too pretty anyway, and would have caused me nothing but worry and insecurity.” This keeps him from feeling the full extent of his sadness from being rejected. b. Sweet-Lemons Rationalization: A less-than-desirable object/result that is gained is overvalued; thus, the amount of dissatisfaction the person feels is minimized; e.g., a woman who is married to a dull, unattractive, unsuccessful man may comment “but he is always faithful and he is my guy.”

THE BEHAVIORAL MODEL Reaction to the unscientific, and unobservable, nature of psychoanalysis and introspective psychology. This approach emphasizes the scientific method in dealing with abnormality, and only observable phenomenon are taken into consideration. Behaviorism ordinarily presupposes that all behaviors are learned through conditioning. Cognitive behaviorism recognizes non-observable phenomenom that also affect behavior, such as thoughts and ideas (it is argued that these can be considered observable phenomena as long as we allow that the observation can be made by “an audience of one,’’ namely, the person having the thought or idea). Behaviorism is totally deterministic and denies the existence of free will; its treatment methods are most applicable to specific disorders (e.g., phobias).

PARADIGM OF BEHAVIORAL THERAPY Behavior therapy includes any technique based upon conditioning principles/theory. Theory does not appeal to any cognitive causes to explain behavior unless reference to cognitive causes can be translated away operationally or “anchored’’ to overt observable behavior. “Exemplars’’ are frequently utilized as models of research strategy (e.g., Waton’s “Little Albert experiment’’; Pavlov’s classical conditioning of dogs; Skinner’s operant conditioning of pigeons, etc.)

LEXICON OF BEHAVIORISTIC TERMINOLOGY • Reinforcer: Event, object, or stimulus that increases the frequency of the behavior it follows. • Stimulus: Typically, an enviromental event that elicits a behavioral response from an organism. • Response: A physiological and/or behavioral reaction to some environmental stimulus. • Unconditioned Response: A seemingly previously unlearned—i.e., unconditioned—response to a stimulus; e.g., some operant conditioning learning theorists hypothesize that the only unconditioned response the human organism is born with is anxiety as a response to unexpected loud noises or sudden loss of support. It is thought that all other responses are learned through stimulus generalization, reinforcement, chaining, or shaping. • Conditioned Response: Any response that is followed by a reinforcer will have the probability of its reoccurrence increased. A conditioned response occurs only when a reinforcer is present. • Orientation: The propensity of an organism to attend to a novel stimulus—e.g., one notices and becomes alert when one hears an unfamiliar sound in the middle of the night. • Habituation: The tendency of an organism to become less responsive and become desensitized upon repeated exposure to the same stimulus—e.g., persons living near an airport may not be bothered by the loud sound of over-flying aircraft because they have become habituated to the noise. • Stimulus Generalization: The propensity of an organism to exhibit the same response to a different but similar stimulus—e.g., in Watson’s ‘‘Little Albert’’ experiment, the infant was initially conditioned to respond with fear to a white rabbit. However, he soon generalized this response to any white furry object. • Extinction: The process of disconnecting the contingency between a behavior and its consequences—e.g., in treating phobias with “systematic desensitization,’’ the fear-provoking stimulus is gradually paired with a calm response, thus eliciting an extinction of the phobic response.

TREATMENT METHODOLOGY Behavior therapy is increasingly cognitivistic in its approaches as a response to the tacit recognition that appeals to some mentalistic variables which seem necessary to successfully address some disorders. Thus, systematic desensitization employs techniques of mental imagery; rational emotive therapy studies the maladaptive affect of irrational ideas. Still, these techniques seem best suited for behaviors which can be narrowly operationally specified phobias, sexual dysfunctions, etc.

DIAGNOSTIC CLASSIFICATION OF MENTAL ILLNESS PROPOSED BIOLOGICAL CAUSES: Compelling evidence suggests that schizophrenia may have an organic cause which may be hereditary. If this is true, the medical model would afford the best course of treatment. Causes may be: • Brain abnormalities, such as imbalances in certain neurotransmitters (e.g., serotonin). • Neurophysiological abnormalities, such as faulty neuron circuitry. The question is: Is brain pathology the cause or the effect of a disorder?

CAUSAL ATTRIBUTIONS Proposed causal explanations for neuroses include the following: • Behaviorist: Stress is a stimulus for anxiety. The neurotic behavior functions as a negative reinforcer for the amelioration of stress; thus, the resultant reduction in anxiety prompts further avoidance responses which further reinforce the neurotic behavior, thus initiating a vicious cycle. • Psychoanalytic: An unacceptable id impulse triggers anxiety, eliciting the utilization of a defense mechanism as an avoidance mechanism for the anxiety, once again instigating a vicious cycle. Freud claims phobic reactions occurred when anxiety was displaced from an unacceptable object to a neutral object; whereas, behaviorists argue that phobia is caused by classical conditioning. Behavior modification is the most effective treatment for phobias. • General Proposed Eclectic Causes: Faulty personality development due to parental dysfunction or toxic social conditions. Negative self-concept feedback from primary group in early development. Faulty learning and conditioning of maladaptive behavior patterns. Interpersonal theorists argue that a conflict between peer-group norms and parental norms can also cause neurotic behaviors.

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• Psychological and Personal Factors: Characteristics in the subject produce the neurosis. Specific problems that could be readily treated were focused upon. Subject may view the world as threatening, dangerous, and overwhelming. As a response, he/she may build “a wall” around himself/herself to block out the perceived threat of the world, at the same time isolating himself/herself. • Biological Organic Defect: No conclusive evidence exists for an organic cause of neuroses.

TREATMENT METHODOLOGY Various treatment strategies have been developed and proposed for neuroses, including: • Anti-Anxiety Drugs: Sometimes thought to only “mask” the symptoms and not treat the actual disorder. • Behavior Modification: Views the symptoms as the problem, and changes environmental factors that allegedly maintain the disorder. • Cognitive Behavior Therapy: i.e., rational emotive therapy proposes changing deficient thought patterns of the neurotic, which may change behavior. This presupposes that cognition causes behavior and ignores the possibility that the cause of neurotic behavior may not be manifest to conscious awareness.

WARNING: The following summary of mental illness categories is provided only for general information purposes and/or to facilitate study in advanced courses in abnormal psychology. Any attempt to use this guide as a means of diagnosing, labeling, or categorizing any person as “mentally ill” is entirely unwarranted and inappropriate. Such diagnoses should only be attempted with the aid of a mental-health professional with credentials.

DSM-IV CLASSIFICATIONS The DSM-IV utilizes a multi-axial system of assessment on several axes. The five axes included in this multi-axial classification are: Axis I: Clinical Disorders Other Conditions That May Be a Focus of Clinical Attention Axis II: Personality Disorders and Mental Retardation Axis III: General Medical Conditions Axis IV: Psychosocial and Environmental Problems Axis V: Global Assessment of Functioning DISORDERS USUALLY FIRST DIAGNOSED IN INFANCY, CHILDHOOD, OR ADOLESCENCE • Mental Retardation: Characterized by significantly below-average intellectual functioning accompanied by significant impairment in adaptive abilities in at least two of the following cases: self-care, home living, social skills, use of community resources, self-direction, academic skills, work, leisure, health, and safety. • Motor Skills Disorder: Characterized by marked impairment in motor coordination. Diagnosis only applies if the impairment significantly restricts academic or daily living activities; the condition is not due to any known medical condition, and criteria are not met for pervasive developmental disorder. • Communications Disorders: Essential feature includes significantly substandard performance on standardized measures of expressive language development on measures of both nonverbal, intellectual ability and receptive language development. • Pervasive Developmental Disorders: Characterized by severe, pervasive developmental impairment, including areas: reciprocal social interaction skills, communication, skills, or the presence of stereotyped behavior, interests, and activities. The qualitative defining impairments are distinctively deviant relative to the individual’s mental age or developmental level. • Attention-Deficit and Disruptive Behavior Disorders: Notable feature is the presence of hyperactivity/impulsivity and inattention at levels in excess of and prevalence more frequent than is observed in individuals of comparable stages of development. • Feeding or Eating Disorders of Infancy or Early Childhood: Essential feature is the presence of persistent feeding and eating disturbances; includes pica, rumination disorder, and feeding disorder of infancy or early childhood. • Tic Disorders: Characterized by a sudden, rapid, recurrent, non-rhythmic, stereotyped vocalization or motor movement; includes Tourette’s disorder, chronic motor or vocal tic disorder, transient tic disorder, and tic disorder NOS (Not Otherwise Specified). • Elimination Disorders: Two subcategories include encopresis and enuresis. The condition is usually involuntary, and primary physiological causes should be ruled out. Encopresis involves defecation in inap-

DSM-IV CLASSIFICATIONS (continued)

propriate places or occasions. Enuresis involves urination in inappropriate places or occasions. To qualify for diagnosis, the condition needs to be present for prolonged periods with frequently repeated incidents.

OTHER DISORDERS OF INFANCY, CHILDHOOD, OR ADOLESCENCE •Separation Anxiety Disorder: Essential feature is the onset of excessive anxiety upon separation from home or close personal attachments. Anxiety manifest is greater than what is expected of individuals at a similar maturational level. • Selective Mutism: Characterized by a persistent failure to speak in specific social situations where speaking is expected, yet speaking in other situations. Must interfere with social, educational, or vocational achievement. Diagnosis is not warranted when condition can be explained by feelings of social or cultural awkwardness, or if disturbance can be accounted for by embarrassment related to some form of pervasive developmental disorder or psychotic disorder. • Reactive Attachment Disorder of Infancy or Early Childhood: Usually associated with pathological care, the disturbance is characterized by disturbed and developmentally inappropriate social relatedness in most contexts. Onset of the disorder is generally before age five. Condition is not accounted for by only developmental delay or pervasive developmental disorder. • Stereotypic Movement Disorder: Characterized by repetitive, seemingly driven, nonfunctional motor behavior. Behavior interferes with normal activities or has the propensity to cause self-inflicted injury. Behavior is not better accounted for by compulsion, a nervous tic, or a stereotype that is part of pervasive developmental disorder. Physiological effects of a substance or a general medical condition also need to be ruled out. • Disorders of Infancy, Childhood, or Adolescence NOS (Not Otherwise Specified): A residual category for disorders, with onset in infancy, childhood, or adolescence, that cannot accurately be included in other classification.

DELIRIUM, DEMENTIA, AMNESTIC & OTHER COGNITIVE DISORDERS • Delirium: Essential feature of condition is a disturbance of consciousness and an alteration in cognition that develops over a short interval. Subtypes include: delirium due to general medical condition, substance-induced delirium, delirium due to multiple etiologies, and delirium NOS. • Dementia: Essential features include multiple cognitive deficits that include memory impairment. The dementias are also categorized according to presumed etiology; for example, Alzheimer’s type, substance-induced, etc. • Amnestic Disorder: These are disorders that include memory impairment in the absence of significant cognitive impairments. Also listed according to presumed etiology; for example, substance-induced, due to general medical condition, etc.

MENTAL DISORDERS DUE TO A GENERAL MEDICAL CONDITION NOT ELSEWHERE CLASSIFIED • Catatonic Disorder Due to a General Medical Condition: Characterized by the presence of catatonia attributed to the direct physiological effects of a general medical condition. Catatonia is manifested by such symptoms as motoric immobility, excessive motor activity, extreme negativism, mutism, peculiar voluntary movement, echolalia, or echopraxia. • Personality Change Due to a General Medical Condition: Indicated by the presence of a persistent personality disturbance, attributed to the direct physiological effects of a general medical condition. The personality disturbance must manifest a significant change from the individual’s previous characteristic personality pattern. • Mental Disorder NOS Due to a General Medical Condition: A residual category applicable to cases wherein it is established that a disturbance is due to the direct physiological effects of a general medical condition, but the criteria for any other specific mental disorders due to a general medical condition are not met.

SUBSTANCE-RELATED DISORDERS This broad classification encompasses any disorder related to the ingestion or exposure to a drug of abuse, the side effects of medications, or to a toxin. A wide range of substances can play a causal role in such disorders. For example, alcohol, cannabis, cocaine, hallucinogens, etc., as well as idiosyncratic reactions to various medications. Lastly, many toxins can instigate these disorders, including carbon monoxide, heavy metals, carbon dioxide, etc.

SCHIZOPHRENIA & OTHER PSYCHOTIC DISORDERS • Schizophrenia: Characterized by grossly disorganized affect, behavior, and conditions. Condition lasts at least six months and includes at least one month of active phase symptoms of at least two of the following: hallucinations, delusions, disorganized speech, grossly disorganized or catatonic behavior.

Furthermore, several subcategories of this disturbance are identified, including paranoid, disorganized, catatonic, undifferentiated and residual. • Schizophreniform Disorder: Symptomatology equivalent to schizophrenia but disturbance is of less duration (one to six months) and is not accompanied by a decline in functioning. • Schizoaffective Disorder: Condition characterized by a mood disorder episode wherein active-phase symptoms of schizophrenia occur with and are preceded or followed by at least two weeks of delusions and hallucinations in the absence of prominent mood symptoms. • Delusional Disorder: Essential features include at least one month of non-bizarre delusions in the absence of other active phase symptoms of schizophrenia. • Brief Psychotic Disorder: A psychotic disturbance with a duration of one to 30 days. • Shared Psychotic Disorder: Disturbance developing in an individual influenced by someone else manifesting delusions with a similar content. • Psychotic Disorder Due to General Medical Condition: Disturbance such that the psychotic symptoms are attributed to the direct physiological effect of a general medical condition. • Substance-Induced Psychotic Disorder: Psychotic symptoms are attributed to the direct physiological effect of a drug, medication, or toxin. • Psychotic Disorder NOS: Residual category for classifying psychotic disorders that do not meet the criteria for any specific psychotic disorder or manifest psychotic symptomatology about which there is inadequate or contradictory data.

MOOD DISORDERS Depressive disorders are subcategorized as follows: • Major Depressive Disorder: Characterized by at least two weeks of depressed mood or loss of interest, accompanied by at least four additional symptoms of depression. • Dysthymic Disorder: Indicated by at least 2 years of depressed mood for more days than not, accompanied by additional depressive symptoms that do not meet the criteria for major depressive episode. • Depressive Disorder NOS: Encompasses disorders with depressive features that do not meet the criteria for other specific depressive mood disorders. Bipolar disorders are subcategorized as follows: • Bipolar I Disorder: Indicated by at least one manic or mixed episode, with intermittent major depressive episodes. • Bipolar II Disorder: Characterized by at least one major depressive episode accompanied by at least one hypomanic episode. • Cyclothymic Disorder: Is evidenced by at least two years of numerous periods of hypomanic symptoms that do not meet the criteria for manic episode and numerous periods of depressive symptoms that do not meet the criteria for major depressive episode. • Bipolar Disorder NOS: Includes disorders with bipolar features that nonetheless cannot be categorized in any of the specific bipolar disorders. Other mood disorders are subcategorized as follows: • Mood Disorder Due to General Medical Condition: Indicated by a prominent and persistent disturbance in mood attributed to the direct physiological effect of a general medical condition. • Substance-Induced Mood Disorder: Indicated by a significant and persistent disturbance in mood best attributed to the direct physiological effect of a drug of abuse, a medication, another somatic treatment for depression, or exposure to a toxin. • Mood Disorder NOS: A residual disorder for classifying disorders with mood symptoms that cannot be categorized as any specific mood-disorder, and are difficult to categorize as depressive disorder NOS or bipolar disorder NOS.

ANXIETY DISORDERS These disorders are frequently characterized by “panic attacks,” discrete periods wherein the individual experiences fear, even terror, oftentimes concurrently with feelings of doom. Physiological correlates may include symptoms such as palpitation, shortness of breath, sweating, chest pain, feelings of suffocation, and a feeling of “losing control” and fear of “going crazy.” Furthermore, such disorders oftentimes include elements of “agoraphobia,” avoidance of, and anxiety about, places or situations, from which escape might be difficult or embarrassing. • Panic Disorder Without Agoraphobia: Manifested by recurrent unexpected panic attacks, about which there is persistent concern. Panic disorder with agoraphobia would include agoraphobia as an additional element. • Agoraphobia Without History of Panic Disorder: Indicated by the occurrence of agoraphobia and panic-like symptoms without a history of unexpected panic attacks. • Specific Phobia: Essential feature includes clinically significant anxiety elicited by the presence of a feared object or situation, often accompanied by avoidance behavior. • Social Phobia: Characterized by clinically significant anxiety provoked by exposure to certain types of social or performance situations, often leading to avoidance behavior. • Obsessive-Compulsive Disorder: Manifested by obsessions (causing marked anxiety and distress) and/or by compulsions (which serve to neutralize anxiety). The obsessions are frequently specific recurring thoughts, whereas compulsions are repetitious ritualistic behavior, which are performed. • Post-Traumatic Stress Disorder: Manifested by the re-

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experiencing of an extremely traumatic event accompanied by symptoms of increased arousal and by avoidance of stimuli associated with trauma. • Acute Stress Disorder: Indicted by symptoms similar to post-traumatic stress disorder, occurring in the immediate aftermath of an extremely traumatic event. • Generalized Anxiety Disorder: Characterized by at least six months of persistent and excessive anxiety and worry. Anxiety disorders due to a general medical condition, substance-induced, or NOS have similar characterizations as in previous sections.

SOMATOFORM DISORDERS This category encompasses disorders characterized by the presence of observable physical symptoms that are indicative of a general medical condition, yet are not fully explained by a general medical condition, by the direct effects of a substance, or by another mental disorder. The symptoms must cause clinically significant distress or impairment in social, vocational, or other areas of functioning. Furthermore, the symptoms must be unintentional (not under voluntary control). Some subcategories include the following: • Conversion Disorder: Indicated by unexplained symptoms or deficits affecting voluntary motor or sensory functions that suggest a neurological or other general medical condition. Psychological factors are believed to be involved with the symptoms or deficits. • Pain Disorder: Characterized by pain as the predominant focus of clinical attention. Psychological factors are judged to play an important role in the onset, severity, exacerbation or maintenance of the pain. • Hypochondriasis: The preoccupation with the fear of having, or the idea that one is afflicted with, a serious disease based upon the individual’s misinterpretation of bodily symptoms or functions. • Body Dysmorphic Disorder: The preoccupation with an exaggerated or imagined effect in physical appearance.

FACTITIOUS DISORDERS These disorders are characterized by physical or psychological symptoms that are intentionally produced or feigned in order to pretend to be ill. The conclusion that a particular symptom is intentionally produced is made by reference to direct evidence (for example, the individual is found to be in possession of drugs that can produce the symptoms) or by a process of elimination whereby alternative causes are ruled-out.

DISSOCIATIVE DISORDERS The essential feature of these disorders is a disruption in the integration of consciousness as this relates to memory, identity, or perception of the environment. Such disturbances may be gradual, transient and chronic. The following categories have been identified: • Dissociative Amnesia: The inability to recall important personal information, usually of a traumatic or stressful nature, that cannot be explained with ordinary forgetfulness. • Dissociative Fugue: Characterized by episodes of sudden, unexpected travel away from home or one’s ordinary place of work, accompanied by an inability to recall one’s past and confusion about personal identity or the assumption of a new identity. • Dissociative Identity Disorder (Formerly Multiple Personality Disorder): Essential features include the presence of two or more distinct personality states or identities that recurrently assume control of the individual’s behavior, accompanied with the inability to recall important personal information that is too extensive to be accounted for by ordinary forgetfulness. • Depersonalization Disorder: Characterized by a persistent and recurring feeling of being estranged from one’s self, of being a spectator of one’s own life, and of being detached from one’s mental processes or body that is accompanied by intact reality testing (that is, the individual is aware that this is only a feeling of self-alienation and not reality as such).

SEXUAL & GENDER IDENTITY DISORDERS • Sexual dysfunctions are indicated by disturbances in sexual desire and in the psychophysiological changes that characterize the sexual response cycle, and cause marked distress and interpersonal difficulty. Furthermore, disturbance is not better accounted for by another Axis I disorder (except another sexual dysfunction) and is not due exclusively to the direct physiological affects of a substance or a general medical condition. • Paraphilias are characterized by recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. • Gender identity disorders are manifested by strong, persistent cross-gender identification accompanied with persistent discomfort with one’s sex.

SEXUAL DYSFUNCTIONS Sexual Desire Disorders • Hypoactive Sexual Desire Disorder: Indicated by a deficiency or absence of sexual fantasies and desire for sexual activity.

DSM-IV CLASSIFICATIONS (continued)

• Sexual Aversion Disorder: Characterized by the aversion to and active avoidance of genital sexual contact with a sexual partner. Sexual Arousal Disorders • Female Sexual Arousal Disorder: Indicated by the persistent, recurrent inability to attain, or maintain until completion of the sexual activity, an adequate lubricationswelling response of sexual excitement. • Male Erectile Disorder: Indicated by the persistent, recurrent inability to attain, or maintain until the completion of the sexual activity, an adequate erection. Orgasmic Disorders • Female Orgasmic Disorders (Formerly Inhibited Female Orgasm): Characterized by persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Since women manifest wide variability in their orgasmic response, this diagnosis should be made with care; such factors as age, sexual experience, general health, and the degree of sexual stimulation applied should all be weighed carefully. • Male Orgasmic Disorder (Formerly Inhibited Male Orgasm): Characterized by a persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Again, factors involving age, experience, general health, and focus and intensity of stimulation received should be carefully considered. Most commonly, this disturbance may cause the male to be unable to reach orgasm in intercourse, though orgasm can be achieved via other means (for example, autoerotically, or by a partner’s manual or oral stimulation). Sexual Pain Disorders • Dyspareunia (Not Due to a General Medical Condition): Indicated by genital pain experienced with sexual intercourse; although most commonly present during intercourse, the pain may also be present before or after intercourse. Both males and females can be effected. • Vaginismus (Not Due to a General Medical Condition): Essential features include the persistent or recurrent involuntary contraction of the perineal muscles surrounding the outer third of the vagina when vaginal penetration is attempted with a penis, finger, tampon, or speculum. Sexual Dysfunction Due To A General Medical Condition: Indicated by the presence of a clinically significant sexual dysfunction best attributed exclusively to the direct physiological effects of a general medical condition. Disturbances may involve pain during intercourse, hypoactive sexual desire, male erectile dysfunction, etc. Paraphilias • Exhibitionism: Involves deriving sexual pleasure or excitement from exposing one’s genitals to a stranger. Occasionally, the individual masturbates while exposing himself/herself. There is usually no attempt to initiate sexual activity with the stranger. • Fetishism: Involves the utilization of non-living objects (the “fetish”) for purposes of deriving sexual pleasure or producing sexual excitement. The absence of the fetish may be accompanied by erectile dysfunction in males. • Pedophilia: Involves sexual activity with a prepubescent child (usually younger than 13 years of age); the pedophile must be at least 16 years of age and at least five years older than the child. Both sexual maturity of the child and the age difference must be taken into account. • Sexual Masochism: Involves acts (real, not simulated) in which the individual derives sexual excitement from being humiliated, beaten, bound, or otherwise made to suffer. • Sexual Sadism: Involves acts (real, not simulated) in which the individual derives sexual excitement from the physical or psychological suffering (including humiliation) of the victim. • Transvestic Fetishism: Involves cross-dressing for the purpose of deriving sexual pleasure or excitement. Typically, a male masturbates while he is cross-dressed, imagining himself to be both the male subject and female object of a sexual fantasy. This disorder is only described for heterosexual males and is not indicated when the crossdressing occurs as an element of gender identity disorder. • Voyeurism: Involves the surreptitious observation of unsuspecting individuals, usually strangers, who are naked, in the process of disrobing, or engaging in sexual activity. The act of looking is to achieve sexual excitement and possibly orgasm if masturbation is engaged in concurrently with the act of voyeurism. Generally, no sexual activity is sought with the individual observed. • Paraphilia NOS: Residual category to include coding paraphilias that do not meet the criteria of the specific categories. Examples include, but are not limited to, necrophilia (corpses), partialism (exclusive focus on part of the body), zoophilia (non-human animals), coprophilia (feces), klismaphilia (enemas), urophilia (urine), and telephone scatologia (obscene phone calls).

GENDER IDENTITY DISORDERS Two criteria must be satisfied for this diagnosis to apply: • There must be a strong and persistent cross-gender identification that is not due merely to a desire to attain the perceived cultural or social advantages of being the other sex. • There must also be present a persistent discomfort with one’s sex or a sense of inappropriateness in the gender role of that sex.

EATING DISORDERS • Anorexia Nervosa: Characterized by the individual’s refusal to maintain a minimally normal body weight, intense fear of gaining weight, and significantly distorted perception of the shape and size of one’s body. • Bulimia Nervosa: Characterized by binge eating and inappropriate compensatory methods to prevent weight gain (for example, induced vomiting, misuse of laxatives and diuretics, etc.) Furthermore, self-evaluation is excessively influenced by body shape and weight.

•

SLEEP DISORDERS Primary Sleep Disorders: Are sleep disorders wherein the causal role of another mental disorder, a general medical condition, or a substance, have been ruled out. Two subcategories include: • Dyssomnias: Abnormalities in the amount, quality, or timing of sleep. Hence, such disturbances as primary insomnia, primary hypersomnia, and narcolepsy would be included. • Parasomnias: Indicated by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-wake transitions. Hence, such disturbances as nightmares, sleep terror, and sleepwalking would be included.

•

•

IMPULSE-CONTROL DISORDERS NOT ELSEWHERE CLASSIFIED The essential feature of these disorders is the failure to resist an impulse, drive, or temptation to perform an act that is harmful to self or others. Typically, the individual experiences increased tension or arousal before committing the act, followed by relief, pleasure, or gratification after completion of the act. Ensuing feelings of guilt, regret, or self-recrimination may or may not be present. • Intermittent Explosive Disorder: Characterized by discrete episodes of failure to restrain aggressive impulses, resulting in serious assaults or destruction of property. The degree of aggressiveness displayed is grossly disproportionate to the objective physical or psychological provocation. • Kleptomania: Indicated by the repeated failure to resist impulses to steal objects not needed for personal use or monetary value. The theft is not due to vengeance, need for survival, nor is it due to hallucinations. • Pyromania: Essential feature is the ignition of fires for pleasure, gratification and relief of tension. There is a fascination with, curiosity about, and attraction to situational contexts with fire, witnessing its effects, or participating in its aftermath. • Pathological Gambling: Indicated by persistent and recurrent maladaptive gambling behavior that disrupts personal, family, or vocational pursuits. • Trichotillomania: Essential feature is the recurrent pulling out of one’s hair for pleasure, gratification, or relief of tension that results in noticeable hair loss.

•

•

•

ADJUSTMENT DISORDERS Characterized by the development of clinically significant emotional or behavioral symptoms in response to an identifiable psychosocial stressor or stressors. Such stressors may include a romantic break-up, business or financial difficulties, or marital discord, etc.

PERSONALITY DISORDERS Enduring patterns of inner experience and behavior that significantly deviates from the expectations of the individual’s culture, is pervasive and inflexible, originates in adolescence or early adulthood, is stable over time, and leads to clinically significant distress or impairment in one or more important areas of functioning (e.g., social, academic, or occupational). • Paranoid Personality Disorder: Indicated by a pattern of pervasive distrust and suspiciousness of others, such that their motives are interpreted as malevolent. Events and the actions of others are interpreted in the most negative light possible, and convictions of others’ hostility are based on little or no objective evidence. • Schizoid Personality Disorder: Essential features include a pervasive pattern of detachment from social relationships and a restricted range of emotions in interpersonal settings. The individual typically will avoid social interaction, prefers solitary activities and interests, and seems to derive little or no pleasure from sensory, bodily, or interpersonal relationships. Affect is usually “flat” and expressionless, and there is a preference for abstract intellectual interests, such as mechanical, mathematical, or computer-related pursuits. • Schizotypal Personality Disorder: Characterized by a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior. Individuals will frequently have incorrect interpretations of casual incidents and external events as being especially meaningful. These beliefs are not held, however, with delusional conviction. The individual may nonetheless be superstitious or preoccupied with the paranormal to a degree inordinate for his/her specific cultural milieu. “Magical” and superstitious fallacious thinking is also common. • Antisocial Personality Disorder (also referred to as Psychopathy, Sociopathy, or Dyssocial Personality Disorder): Essential features include a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into 4

•

adulthood. Deceit, manipulation, and exploitation are central characteristics of this personality disorder. A pattern of impulsivity may also be present, such that decisions are made capriciously, with little or no forethought or planning. Borderline Personality Disorder: Indicated by a pervasive pattern of instability in interpersonal relationships, of self-image and affects, accompanied by marked impulsivity with an onset in early adulthood and present in a variety of contexts. Individual will often be intensely concerned with abandonment and will go to great lengths to avoid real or imagined abandonment. The perception of impending loss, rejection, separation, or abandonment or the loss of external stability and structure can produce profound alterations in self-image, affect, cognition and behavior. Histrionic Personality Disorder: Characterized by pervasive and excessive emotionality and attention-seeking behavior, originating in early adulthood and manifesting in a variety of contexts. Individual feels uncomfortable and unappreciated if he/she is not the center of attention. Individuals with this disorder will often behave in a melodramatic, histrionic, and flirtatious manner. Narcissistic Personality Disorder: Characterized by a pervasive pattern of grandiosity, need for admiration, and lack of empathy, with an onset in early adulthood and manifest in a variety of contexts. The individual has an exaggerated sense of self-importance, often displaying a conceited, boastful demeanor while overestimating his/her abilities and accomplishments. Avoidant Personality Disorder: Characterized by an inordinate preoccupation with being disapproved of, socially rejected, or criticized. Individual suffers from chronic feelings of inadequacy and is hypersensitive to the possible negative evaluations of others. Typically, significant interpersonal or social involvement is avoided, due to fear of being exposed, ridiculed, or embarrassed. Due to constant need for reassurance, security, and certainty of acceptance, individual often leads a rather isolated or restricted social existence. Dependent Personality Disorder: Indicated by an inordinate and chronic need to be taken care of, resulting in submissive clinging behavior and a fear of separation, abandonment, or rejection. Due to a self-perception of being unable to function without the help of others, the individual displays a variety of submissive and dependent behaviors so as to elicit care giving and nurturing behavior from others. Individual tends to be indecisive about even everyday matters, and requires much advice and reassurance from others due to his/her extremely passive nature. Obsessive-Compulsive Personality Disorder: Essential features include an extreme preoccupation with order, systematization, and organization. Many repetitive rituals are engaged in to ensure a sense of control and stability, and individual abhors any unpredictability, chaos, or spontaneity in his/her lives. Rules, orderliness, perfectionism, fastidiousness, and priggish morality often characterize behavior associated with this disorder. The punctiliousness and excessive attention to detail not only stifle any creativity, spontaneity or flexibility in the individual’s life, but ultimately prove selfdefeating in that the major point of the activity is defeated in as much as the inordinate time spent “perfecting” a project. Personality Disorder NOS: Residual category for classifying disorders which, while manifesting some of the criteria of the various specific personality disorders, nonetheless do not meet all the criteria for any one of them.

OTHER CONDITIONS THAT MAY BE A FOCUS OF CLINICAL ATTENTION This broad category encompasses conditions or problems that may be a focus of clinical attention in that they are coded on Axis I and related to the previously described mental disorders in the following manners: • Although the individual has no mental disorder, the problem is the focus of diagnosis or treatment. • The individual suffers from a mental disorder unrelated to the problem, which is the focus of the initial diagnosis or treatment. • The individual suffers from a mental disorder that is related to the problem, and the problem is sufficiently severe to warrant independent clinical attention. NOTE TO STUDENT: This QUICK STUDY ® guide is an outline of the major topics taught in Abnormal Psychology courses. Due to its condensed format, use it as a Abnormal Psychology guide, but not as a replacement for assigned class work. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ®2001, 2006 BarCharts Inc. 0108

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OVER 1,000 ANATOMICAL IDENTIFICATIONS - COVERS ALL MAJOR SYSTEMS

THE MOST COMPREHENSIVE ALL-IN-ONE ANATOMY CHART Frontal SKELETAL Zygomatic Mandible Manubrium Clavicle Lesser tubercle Greater tubercle Bicipital groove Sternum Ribs Xiphoid process

Maxilla Temporal Cervical vertebrae Coracoid process Acromion Scapula Costal cartilage Humerus Lumbar vertebrae Trochlea

Occipital

Ilium Acetabulum (socket)

Sacrum

Ischium Pubic symphysis

Sternum Ribs

Olecranon

Radius

Medial condyle of tibia Fibula

Tibia

Cuneiforms (I, II, III) Metatarsals Phalanges

Metacarpals

Cervical vertebrae (I-VII)

Obturator foramen Phalanges Ischium (see below) Femur Metacarpals Patella Lateral condyle Medial condyle Tibia Fibula Calcaneus Tibia Metatarsals Cuneiforms CARPALS (I, II, III) 1. Scaphoid 5. Trapezium 6. Trapezoid 2. Lunate Phalanges 3. Triquetal 7. Capitate 8. Hamate 4. Pisiform

Fibula

Cuboid Metatarsals

Vertebrae prominens (VII) Thoracic vertebrae (I-XII)

Transverse costal facet Costal facet Transverse process Superior and inferior articulating processes

Lumbar vertebrae (I-V)

Spinous processes Intervertebral foramen

Inner layer Periosteum Interstitial lamellae Concentric lamellae

Osteon (haversian system) Lacunae containing osteocytes Canaliculi

Endosteum

Vein Nutrient foramen Yellow marrow Femur

Circumferential lamellae

Medullary cavity

Disc

Occipital

Mastoid process Acoustic (or external auditory) meatus Styloid process Zygomatic arch

Compact bone

Ventral root (motor)

Head of femur

Neck of femur

Spinous process Superior articular process Pedicle Transverse process

Proximal secondary epiphysis Great trochanter

Epiphyseal lines

BONE STRUCTURE

Gray and white rami communicans Fovea capitis

Proximal epiphysis

Inferior articular process and facet Sympathetic trunk

1

Wing of sphenoid Ethmoid Lacrimal Temporal Nasal Nasal conchae Zygomatic Infraorbital foramen Mastoid process Vomer Maxilla Mandible Mental foramen

Temporal

Dorsal root (sensory)

Parietal

Squamous suture

Frontal

Parietal

all nonarticulating surfaces)

Promontory

Coccyx (3-5 Var.) (coccygeal vertebrae)

Coronal suture

Sensory ganglion Cancellous bone

Auricular surface (for ilium)

Lambdoid suture

Periosteum (covers

Diaphysis

Body

Phalanges POSTERIOR VIEW SKULL Supraorbital foramen

Blood vessels within haversian or central canal

Blood vessels within Volkmann’s or perforating canal

Trabeculae Pedicle

Sacrum (I-V fused)

Lateral condyle Nutrient a.

Outer layer

Phalanges ** = cut a. = artery a.a. = arteries ex. = extensor fl. = flexor L. = Left (l.i.) = large intestine l. = ligament l.l. = ligaments m. = muscle m.m. = muscles n. = nerve n.n. = nerves R. = Right (s.i.) = small intestine v. = vein v.v. = veins

(behind hamate)

LATERAL VIEW

Perforating or Sharpey’s fibers Distal epiphysis

Atlas vertebrae Axis vertebrae

5678

Distal carpals

Calcaneus

ANTERIOR VIEW VERTEBRAL COLUMN Lateral epicondyle Patellar groove

Ulna

Pubic tubercle

Navicular

Navicular

Ilium Radius

(see below)

Talus

Talus Cuboid

Posterior, superior iliac spine Posterior, inferior iliac spine

Decending ramus of pubis

Medial malleolus Lateral malleolus

Humerus

Coccyx (3-5) Anterior superior Carpals 1 2 3 4 iliac spine

Lateral epicondyle of femur

Patella

Scapula

Lumbar vertebrae (I-V) Sacroiliac joint Sacrum (5 fused)

Ilium

Lateral condyle of tibia

Femur

Clavicle

Thoracic vertebrae (I-XII)

Humerus

Sacrum Coccyx Ischial Metacarpals spine Phalanges Lesser Greater trochanter sciatic notch Lesser trochanter Femur Medial epicondyle of femur

Pubis

Italics are bone features

Acromion Spine of scapula

Clavicle

Radius Ulna Carpals

Head

Neck

Cervical vertebrae (I-VII)

Hyoid

Scapula

Parietal Occipital

Mandible

Ulna Lateral epicondyle of humerus Posterior superior iliac spine Coronoid process Medial sacral crest Tuberosity

Iliac crest

SYSTEM

Maxilla Cervical vertebrae (I-VII)

Medial epicondyle of humerus

Capitulum

Frontal Temporal

Parietal

Frontal

Spinous process White matter (sensory) Lamina Superior articular Synapse facet Superior articular Gray matter Mamillary process process White matter (motor) Transverse Accessory Pia mater Process process Motor n. fibers Arachnoid matter Pedicle Nerve fibers Dura mater Vertebral body Body (centrum) Sympathetic ganglion Intervertebral disc

Superior vertebral notch Vertebral foramen

VERTEBRAE & NERVE STRUCTURE

NERVOUS SYSTEM R. lymphatic duct

Cerebrum (brain)

Parotid lymph nodes Cervical lymph nodes

Cerebellum Cervical plexus

Brachiocephalic v.

Brachial plexus L. thoracic duct

Intercostal n.n. Axillary n.

Intercostal nodes

Axillary lymph nodes

Radial n.

Spinal cord

Lymphatic vessels Radial n. Cubital lymph node Intestinal nodes

Cauda equina {

Subcostal n.n.

Median n.

Common iliac nodes

Lumbar plexus

Cisterna chyli Para-aortic nodes Inguinal lymph nodes

Sacral plexus Nasal cavity Auditory (eustachian) tube Oral cavity Tongue Larynx Trachea Secondary bronchi

Superior, middle & inferior conchae

Pharynx Glottis Vocal fold (cord) Primary bronchi R. lung

Palmar plexus

Popliteal lymph nodes Superficial lymph vessels

Ulnar n.

Femoral n.

Cardiac notch

Iliohypogastric n. Ilioinguinal n.

Saphenous n.

Gluteal n.n. Pudendal n. Sciatic n. Tibial branch of sciatic n. Peroneal branch of sciatic n.

Bronchiole & lobule

Pleura

Plantar vessels Digital n.n. Diaphragm

LYMPHATIC NETWORK Thyroid (ventral) Parathyroids (dorsal) Adrenal (suprarenal)

RESPIRATORY SYSTEM Pituitary (hypophysis) Pineal Thymus (in child)

Parotid gland Tongue Pharynx

Gallbladder Duodenum (s.i.)

ENDOCRINE SYSTEM

Ovaries (female) Testes (male)

Ascending colon (l.i.) Jejunum (s.i.) Cecum Ileum (s.i.)

Anus

COLON

Transverse colon ** (below)

L. colic (splenic) flexure

Ascending colon

Adrenal gland (endocrine system)

Haustra

Esophagus Stomach Spleen (lymphatic system)

Free tenia (tenia libera)

Pancreas (behind stomach)

Ureter

Sigmoid colon

Cecum Vermiform appendix Rectosigmoid junction Rectum Anus Exterior anal sphincter m.

Ovary Uterus Endometrium Myometrium Cervical canal Urinary bladder Pubic bone Clitoris

Rectum Fat Prostate gland Anus Bulbourethral gland (Cowper’s) Epididymus Testicular tubules Scrotum

Labia minora Vaginal opening

MALE REPRODUCTIVE SYSTEM

Labia majora 2

Descending colon Free tenia (tenia libera)

R. ureter

L. ureter Urethra

Urinary bladder

Sigmoid colon Prostate (male)

URINARY SYSTEM Descending colon Sacrum

Fimbria

Seminal vesicle

Testis

R. kidney

Ileum

Uterine tube

Sacrum

Navicular fossa

Mesocolic Omental tenia tenia Semilunar folds

L. kidney

Transverse colon (l.i.) Descending colon (l.i.) Appendix Sigmoid colon Rectum

DIGESTIVE SYSTEM & VISCERA

Urinary bladder Vas deferens Pubis Ejaculatory duct Urethra Corpus cavernosum Corpus spongiosum Prepuce

Glans penis and external urethal meatus

R. colic (hepatic) flexure

Trachea Submandibular salivary gland Liver

Pancreas

Oral cavity Sublingual salivary gland

Cervix Sigmoid colon Vagina Coccyx Rectum Urethra Tendon levator ani Anus Muscles of pelvic bowl

FEMALE REPRODUCTIVE SYSTEM

CIRCULATORY SYSTEM

Cereberal a. Superficial temporal a. & v.

Circle of Willis (see below) Sinus sagittalis sup.

Internal jugular v.

L. middle cerebral a. Confluens sinum

External jugular v. Facial a. & v.

Brachiocephalic a.

VEINS

Jugular v. L. external carotid a. Common carotid a.

Brachial v. Superior vena cava Inferior vena cava

Subclavian a. Axillary a.

(Blood flows toward heart)

Superior vena cava

Pulmonary a. L. pulmonary v.v.

Hepatic portal v. Capillaries of liver Inferior vena cava v. Portal circulation

Ulnar a.

Palmar venous network

Renal v.v. Kidneys

External iliac a. Internal iliac a.

Internal iliac v.

Deep femoral v.

Femoral a. Popliteal a. Genicular a.a. Recurrent tibial a. Anterior tibial a. Circle of Willis

Great saphenous v. Genicular v.v.

Anterior communicating a. Middle cerebral a. Lenticulostriate a.

Precentral a.

Great saphenous v. Middle temporal a.

Posterior communicating a.

Internal carotid a. Posterior cerebral a. Superior cerebellar a.

Dorsalis pedis a. R. common carotid R. external jugular v. R. subclavian a. L. common carotid R. brachiocephalic v. Superior vena cava Ascending aorta R. atrium R. coronary a. R. ventricle Inferior vena cava

Anterior inferior cerebral a.

Arch of aorta

L. auricle L. superior pulmonary v.

R. pulmonary a.

Great cardiac v.

Superior vena cava

Circumflex branch of left coronary a.

R. superior pulmonary v.

L. atrium Posterior branch of left coronary a.

R. inferior pulmonary v.

Coronary sinus

Sulcus terminalis

Posterior v. of left ventricle

R. atrium Inferior vena cava R. coronary a.

Apex Middle cardiac v.

Plantar a. anastomosis Inferior thyroid v.

Posterior descending a.

Common carotid a. Sinoatrial (SA) a.

Subclavian a. and v. L. brachiocephalic v. Sinoatrial (SA) node Arch of aorta Ligamentum arteriosum Middle internodal L. pulmonary a. tract Pulmonary trunk Posterior L. pulmonary internodal v.v. tract L. atrium Mitral valve Marginal branches Aortic valve Atrioventricular L. ventricle (AV) node L. posterior R. bundle branch papillary m. Atrioventricular Muscular interventricular (AV) a. septum Purkinje fibers Apex Posterior interventricular Abdominal aorta branch

L.brachioBrachiocephalic trunk cephalic v. R. brachiocephalic v. L. subclavian a. Aortic arch L. pulmonary a.a. Superior vena cava L. pulmonary R. pulmonary a. v.v. R. pulmonary v.v. L. atrium Great cardiac v. Pulmonary valve L. anterior descending R. atrium (or anterior intraventricular) coronary a. Tricuspid valve L. ventricle R. ventricle Apex Fat Descending aorta Inferior vena cava

ANTERIOR HEART

L. pulmonary a.

L. ventricle

Internal jugular v. L. external External jugular v. jugular v.

Inferior thyroid v.

POSTERIOR HEART

Vertebral a.

Basilar a. Internal acoustic (labyrinthine) a.

Internal iliac a. Femoral a. Internal iliac

Capillaries of legs & feet

Anterior cerebral a.

Ascending frontal a.

Plantar venous network

Capillaries of pelvis

L. inferior pulmonary v.

Ophthalmic a.

Anterior tibial v.

Capillaries of colons

Femoral v.

Palmar a. anastomoses L. lateral circumflex a.

Femoral v.

L. atrium Decending thoracic aorta L. ventricle Celiac a. Gastric a. Splenic a. Hepatic a. Stomach Gastric aorta Spleen Descending abdominal aorta Renal a.a. Superior mesenteric a. Inferior mesenteric a.

R. atrium R. ventricle

Celiac trunk Abdominal aorta Renal v. Renal a. Gonadal a. Radial a.

Cephalic v.

Pulmonary capillaries R. pulmonary a.

Arch of Aorta

Brachial a.

External iliac v. Internal iliac v.

L. pulmonary a.

R. pulmonary v.v.

Aortic arch Pulmonary a.

Hepatic portal v. Superior mesenteric v. Superior mesenteric a. Basilic v. Median v.

Capillaries ARTERIES of arms (Blood flows away from heart) & hands Arteries of head, arms & hands Aortic arch

Capillaries of head

L. internal carotid a.

Vertebral a.

Subclavian v. Cephalic v.

BLOOD CIRCUITS

CIRCULATION 3

Inferior thyroid v.

Main right coronary a.

Aortic valve: R. cusp L. cusp Posterior cusp Bachmann’s bundle Main L. coronary a. Circumflex branch Anterior internodal tract Anterior interventricular branch (L. anterior descending)

Common AV bundle (of His) L. bundle branch Perforating branches to interventricular septum Purkinje fibers

NERVES & ARTERIES

MUSCLES Auricularis superior Corrugator fibers Auricularis anterior Risorius Orbicularis oris Platysma Pectoralis major Serratus anterior Rectus sheath

Frontalis Temporalis Orbicularis oculi Masseter Omohyoid Sternohyoid Trapezius Sternomastoid Deltoid Linea alba

Temporalis Occipitalis

Linea semilunaris

Deltoid Brachialis Triceps brachii Ex. carpi radialis longus

Biceps brachii

Bicepital aponeurosis

Bicepital aponeurosis** Pronator teres Brachioradialis Obliquus externus Fl. carpi radialis

Rectus abdominis

Fl. carpi ulnaris Palmarus longus Gluteus medius Palmar aponeurosis

Ex. carpi radialis brevis

Cremaster** Pyramidalis Sartorius Adductor magnus Gracilis Fasciae lata (Band of Richer) Tendons of quadriceps ex. Lateral patellar retinaculum Fat pads

Tensor fasciae latae Iliopsoas Pectineus Adductor brevis Adductor longus Outer Rectus femoris Vastus lateralis

Medial patellar retinaculum Patellar tendon Tibialis anterior Ex. digitorum longus Superior ex. retinaculum Inferior ex. retinaculum Ex. digitorum longus tendons Ex. hallucis longus tendon

Vastus medialis Gastrocnemius Peroneus longus

Ex. hallucis longus Peroneus tertius Ex. hallucis brevis

Sartorius

Vastus lateralis

Masseter** Depressor labii inferioris** Depressor anguli oris** Incisivus labii inferioris Levator scapulae Sternohyoid Omohyoid Subclavius Sternomastoid** Serratus anterior Biceps brachii short head** Subscapularis Biceps brachii long head** Latissimus dorsi Pectoralis minor Coracobrachialis Deltoid** Internal intercostal Serratus anterior External intercostal Linea alba Brachialis Pronator teres** Fl. carpi radialis** Palmaris longus** Fl. digitorum superficialis** Biceps brachii** Fl. carpi ulnaris** Fl. digitorum superficials** Arcuate Obliquus externus** line Obliquus internus** Inguinal l. Transversus abdominis Gluteus Fl. digitorum minimus profundis Iliopsoas Pectineous Gracilis** Abductor Fl. pollicis digiti longus minimi Adductor brevis Adductor pollicis Lumbricales Adductor longus SemitenAdductor magnus dinosus**

ANTERIOR VIEW

Biceps femoris Gastrocnemius

Popliteal fosa

Peroneus longus

Tibialis anterior

Soleus

Fl. hallucis longus Ex. digitorum brevus Peroneus tertius tendon

Ex. digitorum longus Peroneus brevis Peroneus tertius Peroneal retinaculum

Soleus

Inner hamstring tendons

Fl. digitorum longus

Peroneus longus tendon Calcaneal Peroneus brevis tendon (Achilles) tendon Fl. retinaculum Abductor digiti minimi

LATERAL VIEW Corrugator Levator palpabreum

Superior tarsus

Splenius capitis** Semispinalis capitis

Medial ptergoid Stylohyoid Mentalis** Levator scapulae Digastric Omohyoid Rhomboid minor Rhomboid major Supraspinatus Infraspinatus Teres minor** Triceps brachii longhead** Triceps brachii lateral head** Teres major Deltoid** Serratus anterior Triceps brachii medial head Erector spinae External intercostals Serratus posterior inferior Obliquus externus** Obliquus internus Ex. carpi radialis brevis** Supinator Fl. digitorum profundis Pronator teres Abductor pollicis Gluteus longus medius Ex. pollicis longus Piriformis Ex. pollicis Superior brevis gemellus Ex. indiObturator cis internus Gemellus inferior Sacrotuberous 1st Dorsal l. interosseous Quadratus 2nd D.I.O. inferior 3rd D.I.O. Adductor brevis Biceps femoris** Abductor 4th D.I.O. Adductor magnus digiti minimi

Frontalis

Fl. digitorum brevis

Galea aponeurotica Frontalis Temporalis Orbicularis oculi

Occipitalis

Orbicularis oculi Nasalis Procerus Zygomaticus minor Levator labii superiorus Levator labii alaeque nasi Orbicularis Masseter oris Buccinator Mentalis Depressor anguli oris Depressor labii Mentalis inferioris Orbicularis oris Trapezius Acromion (scapula) Supraspinatus Infraspinatus Greater tubercle Teres minor Teres major

Zygomaticus major Masseter Buccinator Depressor anguli oris

Sternomastoid Sternohyoid Omohyoid Clavicle Coracoid process Pectoralis minor Pectoralis major Serratus anterior Rectus abdominis Tendinous inscription

Humerus Obliquus externus Latissimus dorsi Iliac crest

DEEP MUSCLES POSTERIOR VIEW LATERAL VIEW 4

Abductor hallucis

POSTERIOR VIEW MUSCLES OF THE HEAD Temporalis

Levator labii aleque nasi**

Semimembranosus

Gluteus maximus

Semimembranosus

Levator anguli oris Incisivus labii superioris Muscular node

Gluteus medius

Semitendinosus

Gastrocnemius

Nasalis Buccinator

Ex. retinaculum

Vastus lateralis Gracilis

hamstring tendon

Levator labii superioris**

Triceps brachii

Adductor magnus Rectus femoris

Biceps femoris

Zygomatic minor** Zygomatic major**

Teres minor

Fl. carpi ulnaris

Tendon of ex. pollicis longus

Ex. digitorum brevis

ANTERIOR VIEW DEEP MUSCLES Lateral palpebral l.

Infraspinatus

Ex. carpi Brachioradialis ulnaris

Iliotibial band

Ex. digitorum longus

Splenius capitis Deltoid

Ex. carpi radialis brevis

Obliquus externus

Ex. digitorum communis Adductor Hypopollicis thenar longus m.m. Adductor Ex. pollicis pollicis brevis Lumbricales Gluteus Synovial fl. tendon sheaths maximus Fl. synovium Fl. retinaculum Thenar m.m. Ulnar bursa

Linea alba Fl. carpal l.

Occipitalis

Splenius capitis Semispinalis capitis Levator scapulae Scalenus medius Trapezius Sternocleido mastoid Rhoboideus major Omohyoid Teres major Scalenus anterior Latissimus Pectoralis dorsi major Anconeus Serratus anterior Ex. carpi radialis longus Biceps brachii Ex. digitorum communis Rectus abdominis

Splenius capitis Levator scapulae Trapezius

Tendinous inscriptions

Semispinalis capitis

Frontalis

Umbilicus

Supraparietal lobule Precentral Superior SURFACE BRAIN gyrus frontal sulcus Central sulcus (of Middle frontal gyrus Rolando) Inferior frontal sulcus Postcentral sulcus Lateral ventricle(s) Postcentral gyrus Inferior (first & second) frontal gyrus: Inferior parietal Cingulate sulcus Opercular part lobule Triangular part Interthalamic adhesion Supramarginal Orbital part gyrus Anterior commissure Frontal pole Angular Paraterminal gyrus Olfactory bulb gyrus Temporal pole Thalamus (3rd ventricle) ParietoSuperior temporal gyrus occipital Hypothalamus sulcus Temporal lobe Superior temporal sulcus Optic chiasm Transverse Middle temporal gyrus Mamillary body cerebellar Pons fissure Inferior temporal sulcus Hypophysis Pons Cerebral peduncle Inferior temporal gyrus Cerebellum (Pituitary gland) Medulla oblongata Horizontal fissure of cerebellum Medulla oblongata

BRAIN (SAGITTAL SECTION) Sulcus of corpus callosum Corpus callosum Parietal lobe Parieto-occipital sulcus

Occipital lobe Pineal body Posterior commissure Corpus quadral gemminal Cerebral aqueduct Cerebellar peduncles Superior medullary vellum Cerebellum Fourth ventricle

Arbor vitae

Cerebellar cortex

Spinal cord

C1 C2 C3 C4 C5 C6 C7 C8 T1 T2 T3 T4

Cervical plexus C1 - C4 Cervical n.n. C1 - C8 Brachial plexus C5 - T1

Thoracic n.n. T1 - T12

Precentral sulcus Cingulate gyrus Fornix Frontal lobe

Central sulcus

1st Cervicle vertebrae (transverse process**) Supraclavicular n.

BRACHIAL PLEXUS Trace of the mandible

T5 T6

Axillary n.

T7

L2 L3 L4 L5 S1 S2 S3 S4 S5

Sacral n.n. S1 - S5

Superior gluteal n. Inferior gluteal n. Posterior femoral cutaneous n. Pudendal n. Sciatic n. Inferior rectal n. Dorsal nerve of penis (clitoris)

Coccygeal n.

Ulnar n. Filum dora mater

Cutaneous nerve of forearm

T10

HIP LIGAMENTS Inguinal l. Pubofemoral l.

Pubic tubercle

Ex. insertions

Lateral bands

Joint capsule Collateral l.l. Distal phalanx Distal interphalangeal (DIP) joint Middle phalanx Proximal interphalangeal (PIP) joint Proximal phalanx Metacarpophalangeal (MP) joint Articular cartilage th 5 metacarpal Tendon of ex. indicis Tendons of ex. digitorum

Slips of long ex. tendons to lateral bands

Capsular l.

Pubocapsular l.

Dorsal expansion (hood)

Surface 2nd Metacarpal bone

Great trochanter

1st Dorsal interosseous m. 1st Palmar interosseous m.

Transverse acetabular l. Ishiocapsular l. Lesser trochanter

KNEE LIGAMENTS BACK Popliteal surface Adductor tubercle Medial condyle of the femur (articular surface) Medial epicondyle Intercondyler fossa Posterior cruciate l. Medial meniscus Medial condyle of the tibia Tibial (medial) collateral l.

HIP & SCIATIC NERVE

COMPONENTS OF THE FINGER Iliofemoral l. (Y l. of Bigelow)

Joint l.

Obturator membrane

Perineal n. Femur

Intertendinous bands

Tibia

12th Thoracic vertebrae (pedicle**) 1st Lumbar vertebrae (pedicle**) 5th Lumbar vertebrae (pedicle**) Sacrum, is made up of 5 fused vertebrae (pedicles**) Iliohypogastric n. Ilioinguinal n. Genitofemoral n. Lateral femoral cutaneous n. Trace of the pelvis Femoral n.

L1

Sacral plexus L5 - S4

Median n.

T9

Symphysis pubis

Lumbar plexus T12 - L4 Lumbar n.n. L1 - L5

Radial n.

T8

SACRAL PLEXUS

T11 T12

7th Cervicle vertebrae Upper trunk (pedicle and transverse process**) Middle trunk 1st Thoracic vertebrae Inferior trunk (pedicle**) Trace of the scapula Lateral cord Posterior cord Medial cord Humerus Musculocutaneous n.

Thoracic n.n. T1 - T12

Trapezoid

Intertrochanteric line & capsule attachment

Trapezium

Schaphoid

Pisiform Hamate Triquetrum Styloid process Ulna Capitate Radius

Articular capsule

Supraspinous l.

Posterior superior iliac spine Latissimus dorsi

Articular capsule Ilium

Iliac crest

Dorsal sacral foramina Sacroiliac joint Posterior inferior iliac spine Greater sciatic notch Acetabulum Head of femur

Piriformis

Ishiofemoral l.

Great trochanter Neck of femur

Patella Lateral epicondyle

Intercondyler line Lateral condyle of the femur (articular surface) Anterior cruciate l. Lateral epicondyle Anterior meniscofemoral l.

Lateral condyle of the femur Lateral meniscus Fibular (lateral) collateral l.

Posterior meniscofemoral l. Lateral meniscus Fibular (lateral) collateral l.

Lateral condyle of the tibia Patellar l. Head of the fibula

Lateral condyle of the tibia Posterior l.l. of the fibular head

Anterior l.l. of the fibular head Fibula

Head of the fibula 5

Obturator internus

Sacral hiatus

Sciatic n. Ischial tuberosity

Femur

Lumbar vertebrae 3, 4, & 5 Thoracolumbar fasciae

Superior & inferior articulating facets

Coccyx Pubis Spine of ischium Obturator membrane

Lesser trochanter Obturator foramen Ramus of ischium

Ischial bursa

Trochanteric bursa

Sciatic n. Sacrospinal l.

Sacrotuberous l. Trochanteric bursa

KNEE LIGAMENTS FRONT Femur Adductor tubercle Medial epicondyle Medial condyle of the femur Medial meniscus Medial condyle of the tibia Tibial (medial) collateral l. Tibial tuberosity Tibia

HEAD: EYE, EAR, NOSE & MOUTH Central sulcus Parietal lobe Occipital lobe

Cerebellum Inner ear (cochlea) (semicircular canals) Tympanic membrane (eardrum) Temperomandibular joint & capsule Head of the mandible Spinal cord Nuchal l. Cervical n.n. Esophagus

7th cervical vertebrae Hair shaft Pore of sweat gland Merkel’s discs Epidermis (touch) Erector pili m.

Dermis (temperature) Sebaceous glands

Frontal lobe Conjunctiva Lateral rectus m. Temporal lobe Greater arterial circle of iris Sclera Olfactory bulb Choroid (nasal sensory n.n.) Sinus venosus of sclera (Schlemm’s canal) Frontal sinus Retina Optic n. Trabecular network Nasal bone Inferior temporal a. & v. Cornea L. medial nasal concha Posterior Sphenoid chamber Fovea sinus centralis Anterior Pharyngeal in macula lutea chamber tonsil L Cortex L. inferior Lamina cribosa nasal concha ne Capsule of retina Inferior nasal s Nucleus meatus Optic n. (II) Schwalbe’s Hard palate line Iris Auditory tube Fibers of ciliary (eustachian) zonule (suspensory Central a. & v. of Soft palate (uvula) ligament of lens) retina Ciliary process Tongue Inferior nasal a. & v. Orbicularis Anterior oris m. ciliary v. Palatine tonsil fibers Medial rectus m. Ciliary m. Circular Meridional fibers Mandible Ora serrata EYE Genioglossus m. Hyoid bone Geniohyoid m. Auricular cartilage Temporal m. Temporal bone Semicircular canals (external acoustic Epiglottis Mylohyoid m. meatus cartilage) Auditory ossicles Vestibular n. Thyroid cartilage Malleus Incus Stapes Vocal cord Cochlear n. Larynx Cricoid cartilage Facial n. (VII) ** Free n. endings Auricle Stratum corneum Cochlea Stratum lucidum (auditory n.) Stratum granulosum Stratum spinosum Tensor tympani Stratum basale m. (continues through Dermal papillae Epitympanic bone to malleus) Papillary layer recess Stapedius Meissner’s corpuscle (touch) Round m. (cochlear) Reticular layer External Tympanic Sensory n. window acoustic Cuticle membrane meatus Huxley’s layer Auditory Henle’s layer Hair Tympanic cavity Levator veli External sheath (eustachian) follicle (middle ear) palatini m. Glassy membrane tube Connective tissue layer Corpuscle of Krause (cold)

Hypodermis

Sensory n.

Sweat gland

Sweat gland Motor n. (autonomic) Connective tissue Fat lobule Vater-Pacini (pacinian) v. corpuscle (heavy pressure)

Hair matrix Papilla of hair follicle Hair cuticle

External sheath Glassy membrane Corpuscle of Ruffini (heat)

ANATOMY OF THE HAND (PALMAR SURFACE)

a. Motor n. (autonomic)

SKIN

EAR EAR (INTERIOR)

Cochlear duct Tectorial membrane Scali tympani

Deep transverse metacarpal l.l.

Malleus (hammer)

Opponens digiti minimi m. Adductor pollicis m.

Fl. digiti minimi brevis Abductor digiti minimi

Abductor pollicis brevis m. Opponens pollicis m.

Fl. retinaculum

Tendon fl. pollicis longus m.

FOOT

Ulnar n.

Superior extensor retinaculum Tibia bone Tibialis anterior tendon

Tendon fl. digitorum superficialis m.

Inferior extensor retinaculum Talus bone Navicular bone Dorsal cuneonavicular l.l.

Ulna

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Articular capsule Distal phalanx Proximal phalanx

6

Peroneus longus tendon Peroneus brevis Fibula bone Tibialis posterior Soleus Fl. hallucis longus Fl. digitorum longus Calcaneal (Achilles) tendon Calcaneus bone

1st Metatarsal bone Collateral l.l.

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Trochlea

Cuneiform bone Tarsometatarsal l.l. Ex. hallucis longus

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Ex. digitorum longus Ex. hallucis longus

Fl. carpi ulnaris m.

Tendon fl. digitorum profundis m. Radius

Saccule Cochlear duct Stapes (stirrup) in oval (vestibular) Spiral ganglion window Ductus reuniens Round (cochlear) window (closed by secondary tympanic membrane)

Tibialis anterior

Pisiform bone

Tendon adductor pollicis longus m. Tendon ex. pollicis brevis m.

Tendon ex. carpi radialis longus m.

Eardrum (tympanic membrane)

Common synovial sheath

Median n. Tendon fl. carpi radialis m.

Scali vestibuli

Incus (anvil)

Lumbrical muscles I-IV

Facial n. (VII) **

Vestibular membrane

Tensor tympani m.

Synovial sheath

Vestibular n.

Cochlear n.

Stapedius m.

Tendon fl. digitorum superficialis m.

Fl. pollicis brevis m.

Vestibular ganglion

Endolymphatic sac

Distal phalanges

Tendon fl. digitorum profundis m. Digital fibrous sheath

Ampullae Endolymphatic duct

Common crus Semicircular canals & ducts Anterior (superior) Posterior Lateral

Phalanges 2-5

Fl. retinaculum Quadratus plantae m. Tibialis posterior tendon Peroneus Fl. digitorum tendon longus Fl. hallucis longus tendon Lumbricales Fl. hallucis brevis Sesamoid bone Fl. hallucis longus tendon

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WORLD’S #1 ACADEMIC OUTLINE

TOOL MAKING

Archaeology A branch of anthropology focusing on the analysis of human material remains in an attempt to reconstruct past cultures

0.0-0.01 Million years ago

Upper Paleolithic / Later Stone Age

SOME COMMON METHODS Excavation: Uncovering buried materials from the past so that they may be recorded and analyzed Survey: Locating artifacts and potential sites through methods such as ground walking, soil analysis and various remote sensing techniques Grid system: A technique used in excavation allowing better recording of the location of artifacts; a grid is mapped out over the excavation area, which is then excavated one layer at a time and mapped according to the grid system

Engraver

Borer

0.05 Middle Paleolithic / Middle Stone Age

Mousterian point

Toothed blade

0.25 Lower Paleolithic / Early Stone Age Acheulean

DATING TYPES Relative dating: The temporal location of artifacts is described in reference to other artifacts to determine a relative age Absolute dating: Also known as chronometric dating; determines the actual age of an artifact in terms of years, centuries, or other units of time • Radiocarbon (C-14) dating: Absolute dating method measuring the half-life and decay rate of C-14 to nitrogen in organic materials • Amino acid racemization: A chronometric dating technique used on organic material; utilizes changes in proteins when an organism dies to calculate the age at death • Potassium-argon (K-Ar) dating: Chronometric dating method measuring the decay of potassium (K-40) to argon (Ar-40) in volcanic deposits • Argon-argon (40Ar-39Ar) dating: Absolute dating technique used in conjunction with potassium-argon dating that estimates relative quantities of argon-39 to argon-40 gases in volcanic deposits • Obsidian hydration dating: Chronometric dating of obsidian artifacts by measuring the water absorbed on worked surfaces of the artifact • Thermoluminescence dating: Absolute dating technique used to determine the age of ceramics, tiles, bricks and any other fired clay artifacts • Dendrochrononlogy: Also known as tree-ring dating, this absolute dating technique compares a tree sample that is relevant archaeologically to an established tree-ring chronology for the area to determine the year the wood was first utilized by humans • Electron spin resonance: Chronometric dating method that measures trapped electrons in shell and bone

POTTERY • All fired clay artifacts made by humans • Hundreds of types: Food storage vessels, cooking pots, ladles, burial chambers, and pipes, etc. • Widespread use is one of the most compelling indications of sedentism at a site • Pottery decoration used in classifying and tracking change in pottery styles Aztec pottery

1.7

Pick

Hand ax Oldowan

2.5

Chopper

Flake scraper

TRANSITIONAL PERIODS Paleoindians in the New World • Literally, "Old Indians"; first group of humans to come to the New World • Most researchers agree Paleoindians came to the New World sometime before 12,000 years ago, during the Paleolithic ("Old Stone Age") • Hunted mostly big game animals; known for distinctive fluted arrowhead points Mesolithic • Literally, "Middle Stone Age," an archaeological period of time beginning around 12,000 B.C. • Humans became more sedentary and began to subsist on more stationary food resources • Natufian: A cultural tradition beginning in Southwest Asia during the Mesolithic period - Comprised of the first people who occupied permanent settlements and began domestication in this area • Archaic: Term applied to Mesolithic cultures in the New World - Characterized by enormous cultural diversity as populations adapted to different environments - Caused an array of cultures with unique life-ways and technology Neolithic • Literally, "New Stone Age"; established plant and animal domestication beginning about 11,000 years ago in the Middle East • Domestication of plants and animals: Evolutionary process where humans (intentionally or unintentionally) modify plant and animal genetics to better control their exploitation • Early sites - Near East • Levant: The Natufians began the domestication of wheat, barley and lentils (about 10,000 B.P.) 1

Tool Traditions • Oldowan tool tradition: - The earliest identifiable tool-making tradition, associated with Homo habilis, the Oldowan begins the Paleolithic (Old Stone) Age, 2.5 million years ago - Tools were made by striking a stone core, producing flakes which were used as blades and choppers and the cores were used as hammerstones - Primary tool produced was the pebble chopper • Acheulian tool tradition: Tool-making tradition after the Oldowan period, dating from about 1.5 million years ago, associated with Homo erectus - Made the same way as above, but much larger and adhering to more standardized shapes - Primary tool produced was the Acheulian hand axe, a pear-shaped tool • Mousterian tool tradition: Tool-making tradition of the Neandertals from 100,000 - 400,000 years ago in Europe, Southwest Asia, Northern Africa - Tools generally much smaller, more varied and much more skillfully worked than those previous - Tool makers utilized pressure-flaking techniques in contrast to the earlier percussion-flaking techniques Tool techniques • Levallois: Found often in the Mousterian tool tradition; flake tools of standard sizes were made by striking a shaped core • Blade technique: Blade produced by striking a core of stones • Pressure-flaking: Bone, antler or wood tools used to press small flakes off a flint core - Allows for more control over the finished flakes

• Europe-Greece: Cereal and animal domestication as early as 8000 B.P. • Africa - Nile River Valley: Sheep and goat domestication from 6000 B.P. • China - Southern and northern: Early rice cultivation, about 7000 B.P. • Southern Mexico - Tehuacan Valley: Early evidence of maize, about 7000 B.P. • South America - Peru - Highland Peru: Early evidence of beans and maize, about 5500 B.P. - Coastal Peru: Early evidence for gourds, squash and peppers, about 5000 B.P. • North America: Southeast U.S.: Domestication of Inca ruins gourds, 7000 B.P.

CIVILIZATIONS Once used to refer to the pinnacle of the evolutionary line of social development, refers today to urbanized, class-segregated, state-level societies Early sites Mesopotamia: • "The land between two rivers"; between Iran and Arabia and Syria, along the Tigris and Euphrates rivers, where first civilizations flourished from 5600 B.P. • The early Mesopotamian civilization of Sumer witnessed growth of cities into a unified state system • Cuneiform: Early form of writing used to record economic transactions; later used to record stories

Civilizations continued... • The Sumerians are widely known for the flood story in the Epic of Gilgamesh, paralleling the story of Noah and the flood in the Judeo-Christian Bible • Ziggurats: Large, stepped platform temples; a major feature of this religiously oriented civilization Egypt: • One of the first great civi- did you know... lizations Pharaohs commissioned • First unified by the ruler, many architectural tribNarmer-Menes, about 5000 utes: some are still B.P. standing (including the • State was based on god- pyramids) like status of the pharaohs • Scribes used hieroglyphs (a combined pictographic and phonographic form of writing) to record the complex transactions of collection and redistribution processed by the elite ruling class • Late Period (1070-332 B.C.); Pharaonic power declined and was replaced by the Ptolemaic line, instituted by Alexander the Great in 332 B.C. Roman occupation in 30 B.C. officially ended the great Egyptian civilization Indus River Valley: • Harappan Civilization: - Around 4700 B.P.; began along the Indus River in South Asia - Known for massive citadel walls (made from fired clay bricks) engineered to prevent flooding - City streets were well planned; lined with brick faced houses, sometimes 3 stories, many with plumbing - Suddenly declined for unknown reasons, approx. 4000 B.P. China: • Circa 4000 BP, several rulers gained power and prominence • Lived in walled towns - in constant competition and war • Unification of region brought by the Shang civilization of the Yellow Valley at 3700 BP; became most dominant state throughout northern China - Famous for bronze work Crete, Greece, and Rome: • Minoa: Flourished around 4000 B.P by constantly increasing their trade network - The eruption of the volcano Thera at 3473 B.P. accelerated demise • Mycenae: 3600 B.P.; took over trading routes of the Minoans - Rulers acquired much prestige for trading of tin, copper, etc. - Linear B: Writing system made up of 89 characters established Mesoamerica: • Maya: - Beginning about 4000 BP - Complex societies, diverse agricultural techniques (slash and burn in lowlands, terracing and raised fields in highlands); comMayan temple plex belief system - Built great cities with pyramids and central plazas such as Teotihuacan, which housed 12,000 people and extended 8 square miles • Aztec: - Circa 1100 AD. - Developed a great civilization in Mexico - Capital city, Tenochtitlan had rich central precincts, large residential areas, spectacular markets and gardens - Conquered by the Spanish in 1519 South America: • The Inca Empire: - Rule unified majority of South America - Primarily based in Peru - Control extended throughout the Andes mountains; extraordinary bureaucratic and military organization; collapsed in confrontation with the Spanish at 1534

THEORIES FOR THE EVOLUTION OF CIVILIZATIONS • Irrigation systems - Karl Wittfogel’s Hydraulic Theory: Civilization arose because development of irrigation networks called for establishment of organizational management specialists (who eventually became the first ruling class) • Trade networks: Civilization arose because redistribution centers necessitated a centralized management authority; eventually became a centralized government • Environmental and social circumscription; Robert Carniero’s Circumscription Theory: - Civilization develops where populations are contained in an area limited by environmental features, such as mountains, bodies of water, or other groups of people - As circumscribed populations grow and competition for limited resources intensifies, social stratification develops as elite class controls resources - Warfare and conquest of neighboring populations are necessary outcomes, as access to resources is sought - To be successful, such campaigns must be led by a centralized authority, eventually becoming a centralized government • Religion - Indirect role in the development of civi- did you know... In many early civilizations, lization - Religious systems inte- rulers themselves were gral in the formation of considered semi-divine early states - Many monumental architectural structures in early states have religious functions - Often rituals for the maintenance of the social, economic, and political orders were publicly performed by priests on behalf of rulers

LANGUAGE The complete set of sounds and words a culture uses to convey meaning; languages must conform to rules of grammar and syntax in order to convey the intended meaning • Linguistics: Scientific study of language • Structural linguistics: Analysis of a language’s structure. • Phonetics: Study of the way speech sounds are produced, transmitted and received • Phonemes: Smallest units of sound that can affect the meaning of spoken language • Morphemes: Smallest units of sound which carry meaning (e.g., words, suffixes, etc.) • Morphology: Study of the way sounds are organized to create units of meaning • Syntax: Rules followed in phrase and sentence making • Grammar: Formal structure dictating syntax and the subtleties of morphemes • Paralinguistics: Study of the sounds, noises and parts of speech that work together with language to comprise communication; for example, pitch, speed, tone, etc. • Sapir-Whorf Hypothesis: Proposed by Edward Sapir (1929) and elaborated on by Benjamin Whorf in subsequent years; argues languages predispose their native speakers to perceive the world dictated by the language structure • Ethnolinguistics: Study of the interrelationship of language and culture • Sociolinguistics: Study of the use of language in its social context • Glottochronology: Method of dating the historical divergence of related languages by comparing and measuring change in their basic vocabularies

Cultural Anthropology The study of contemporary human societies

CULTURE The shared, learned, symbolic, integrated, adaptive set of behaviors, beliefs, attitudes, values and ideals common to a particular group • Classic Tylor (1871) definition: Culture is "that complex whole which includes knowledge, belief, art, law, morals, custom and any other capabilities and habit acquired by man as a member of society." • Contemporary definition: Learned behaviors and beliefs (values, habits, ideals, etc.) shared by members of a society • Characteristics: - Shared: Cultural knowledge is shared by the group; not an individual phenomenon - Learned: Culture is constantly learned from other members of the culture - Symbolic: Shared through symbolic means, such as language and art - Integrated: The whole of culture is comprised of the interrelation of disparate parts - Adaptive: Constantly changing; as old traits become maladaptive, they are modified or traded for new ones that more efficiently address old problems • Fieldwork: Research method used to learn about human beings through firsthand observations in their natural cultural environments • Participant observation: A field research technique where an anthropologist lives with, works among and participates with the people of a culture for an extended period of time, usually at least a year • Ethnocentrism: Believing one’s own cultural values are supreme over all others • Cultural relativism: Cultural values are thought to be arbitrary standards that should not be used to evaluate cultural behavior; rather, behaviors should be understood within their own cultural context 2

ENCULTURATION The process of an individual learning their society’s culture • Personality: The set of thoughts, feelings and actions that define an individual • Dependence training: Child-rearing practices promoting dependence and compliance in assigned tasks • Independence training: Child-rearing practices fostering independence, self-reliance and a need for personal achievement • Group personality: Studies undertaken in the 1930s and 40s; attempting to determine the dominant psychological patterns of various cultural groups - Modal personality: Personality type most frequently present in a group. - National character: Dominant psychological orientation found among the people of a nation - Core values: The values of central significance to a specific culture

SUBSISTENCE The way a group gets its food • Adaptation: Process by which organisms are modified based on interactions with their environment; allows more efficient interaction • Foraging: Also known as hunting and gathering; subsistence on plants and animals naturally occurring in an environment • Pastoralism: Subsistence based on raising livestock (cattle, sheep, goats, etc.) • Horticulture: Small-scale cultivation using relatively simple techniques and tools as well as "slash-and-burn" • Agriculture: Larger-scale cultivation using more complex techniques and tools; relies on permanently cultivated fields, tools such as plows and draft animals, and other technologies, such as irrigation

FAMILY AND KINSHIP

MARRIAGE

Kin group that resides together comprised of at least one parent and one child Nuclear family: Family organization comprised of a husband, a wife, and their dependent children living in one household Extended family: Group of blood-related nuclear families living in one household Residence types or patterns: • Ambilocal residence: Also known as bilocal residence; a married couple living with either of the husband’s or the wife’s relatives • Avunculocal residence: Married couple residing with the husband’s mother’s brother • Matrilocal residence: Married couple living with or near the wife’s relatives • Neolocal residence: Husband and wife establish their residence anywhere, regardless of the location of their relatives • Patrilocal residence: Married couple living with or near the husband’s relatives Kinship: Relationship between members of a social group related by either blood or marriage • Unilineal descent: Also known as unilateral descent; dictates descent exclusively through either the father’s or mother’s line • Ambilineal descent: Traced equally through either the mother’s or the father’s line • Bilateral descent: Traced through both the mother’s and the father’s lines • Matrilineal descent: Traced through the mother’s line only • Patrilineal descent: Traced through the father’s line only • Lineage: A set of kin genetically linked to a common ancestor tracing their descent by known links through either male or female lines • Clan: Also called a sib; a set of kin who believe they are genetically linked but can’t trace their descent through known links; often made up of several lineages • Phratry: A unlineal descent group made up of at least two clans believing themselves to be of common ancestry • Moiety: A unilineal, exogamus descent group found in a dual organization society

Socially accepted sexual and economic union Cultural Marriage Combinations between individuals in a society • Gender: Differences between males and Social group Social females based on cultural expectations and group experiences; categorizes an individual as masculine or feminine Exogamy Monogamy Endogamy • Incest taboo: Prohibition of sexual relations between related individuals. + + + • Affine: Relative acquired through marriage or + • Consanguine: Biological, or "blood" relative • Endogamy: Marriage within one’s social group (such as one’s kin group, caste, etc.) Polygamy Polygyny Polyandry • Exogamy: Marriage outside of one’s social group • Monogamy: Two individuals join together and do not have other spouses; serial monogamy occurs when monogamy is the norm, but divorce and remarriage are common • Polygamy: Males or females may take more than one spouse • Polygyny: Male is allowed to have more than one wife • Polyandry: Female is allowed to have more than one husband; the most common form is fraternal polyandry, in which a woman marries a set of brothers • Exchange: Formalization of marriage by an economic exchange - Dowry: Marriage exchange in which the bride’s kin gives goods to the groom or his kin Bridewealth/Bride price: Marriage exchange in which the groom’s kin gives goods to the bride or her kin

Kinship terminological systems • Eskimo system: Also known as a lineal system; specific terms are assigned to the members of the nuclear family, with all other relatives subsumed under the category of either "aunt," "uncle," or "cousin" • Hawaiian system: Relatives of the same sex and generation are referred to by the same term • Iroquois system: One’s father and father’s brother are referred to by a single term, as are one’s mother and mother’s sister, but one’s father’s sister and one’s mother’s brother are given separate terms; parallel cousins are classified with brothers and sisters, while cross cousins are classified separately, but (unlike Crow and Omaha kinships) not equated with relatives of some other generation • Crow system: Usually associated with matrilineal descent in which father’s sister and father’s sister’s daughter are called by the same term, mother and mother’s sister are merged under another, while father and father’s brother are merged under a third; parallel cousins are equated with brothers and sisters • Omaha system: The patrilineal equivalent of the Crow system; the line of mother’s patrilineal kin is equated across generations • Sudanese or Descriptive system: One’s father, father’s brother, and mother’s brother are distinguished from one another, as are mother, mother’s sister, and father’s sister; cross and parallel cousins are distinguished as well as from siblings

ECONOMICS The study of systems of production, distribution and exchange Production: Development or creation of goods or services Distribution: Process of changing produced goods for consumption; according to economist Karl Polanyi, distribution occurs according to one of three types of systems: • Reciprocity: Items of roughly equal value are exchanged without the use of money; there are three types: - Generalized reciprocity: Neither the value of a good nor the schedule for repayment are specified - Balanced reciprocity: Both the value of the exchanged goods and the schedules of payment are specified

- Negative reciprocity: Giver of the goods attempts to gain the advantage in the exchange • Redistribution: Exchange process where goods are directed to an economic center to be organized, counted and redistributed • Market exchange: Value of a good or service is determined by supply and demand, and the medium of exchange is something symbolic (such as money) Exchange: Buying and selling, or trade, of goods or services Formalist: School of thought that argues economic theory is valid cross-culturally Substantivist: School of thought that argues for understanding economic activity in its specific cultural contexts Leveling mechanisms: Customs that keep wealth somewhat equally distributed

ART

POLITICAL ORGANIZATION

Expression of human creative abilities in verbal, ornamental, musical or pictorial forms • Folklore: Set of ballads, myths, folktales, legends, proverbs, riddles and superstitions of a cultural group • Myth: Sacred story attempting to explain nature and creation • Legend: Larger-than-life narrative told as if it were true • Tales: Story created or embellished for entertainment • Ethnomusicology: Analysis of music did you know... as an aspect of Music is an important aspect culture of many cultures

The way a society is organized around issues of power and economics • Band: A relatively small group of people with a division of labor based on age and sex, with social relations based on egalitarianism; typically found among foraging people • Tribe: A variety of somewhat independent groups united by a common language and culture; generally larger than bands; there may be a chief who speaks for the group, but social relations are still egalitarian, with labor divided along age and sex lines; typically found among farmers and herders • Chiefdom: Several individual communities are hierarchically subsumed under the rule of a centralized chief • State: Centralized political system found in large, complex societies; has the power to coerce its members into maintenance of the hierarchy imposed by the elite ruling class by means of law and physical enforcements • Controls: Customs and practices that regulate societal behavior - Internal controls: Members of the society are personally responsible for their actions, i.e. individuals act according to a culture’s conceptions of what is proper, right, and correct; often rely on belief in supernatural forces that may inflict punishment for improper actions - External controls: Also known as sanctions; social institutions enforcing social norms and order; such as courts, police and councils of elders • Law: Formal rules or sanctions providing the basis for determining guilt, as well as the means or type of punishments

NON-KIN GROUPS Groups or associations of individuals not based on family relations • Sex association: Category of people based on sex • Age grade: Category of people based on age; typically, groups of similar age are organized into age sets, which move through a series of age grades together through life • Common-interest associations: Result when those with common interests group together; sometimes membership is required by law, such as the draft or a labor union • Class: Social category whose members are judged as relatively equal based on the predominating system of evaluation • Caste: Group in which membership is determined by birth and marriage and dictated by endogamy (marriage within the group) 3

RELIGION

CULTURE CHANGE

Belief system that posits a human relationship to the supernatural • Animism: Belief that nature is animated by spirit beings • Animatism: Belief in the existence of impersonal supernatural forces • Priest or priestess: Member of a culture serving as a full-time religious specialist • Shaman: Member of a culture who serves as a (usually) part-time religious specialist; believed to have the ability to communicate directly with supernatural beings and powers • Ritual: Patterned acts performed in an attempt to manipulate the spiritual world - Rites of passage: Performed at specific stages in the life cycle to mark important status changes, e.g., birth, marriage, and death - Rites of intensification: Performed to return cohesiveness to the group before or during a crisis or before a potential crisis - Rite of reversal: Allows for a reversal of ordinary roles and obligations of individuals • Magic: Practiced by individuals believed to have the power to psychically manipulate the supernatural and natural world • Witchcraft: Practiced by individuals believed to have a psychic power, often unconscious, that can harm others or cause sickness; sorcery is associated with a conscious attempt to adversely affect an individual or group • Revitalization movement: Social movement, often religious, organized to restore a culture to its former, supposedly more desirable, state

All cultures experience change over time, depending on their particular circumstances; changes in the environment, foreign contact, and even internally imposed cultural modifications can lead to culture change • Innovation: Utilizing existing cultural elements in a novel manner • Invention: New tool, practice or principle that offers a fresh solution to either an old or new problem • Diffusion: Spread of cultural traits through trade, migration and borrowing; often leads to culture change as old traits are replaced by newly diffused ones • Culture loss: New innovations often lead to the loss of older ones; this can affect a loss of the entire culture as interdependent institutions are modified or thrown away • Acculturation: Forced adaptation resulting from continual contact with other cultures • Modernization: Cultural change experienced by societies that transition to a more Westernized, industrial lifestyle

Biological Anthropology The study of the biological aspect of humans and our ancestors, including molecular biology and genetics, primatology, paleoanthropology and human biology

MENDELIAN GENETICS Gregor Mendel • Father of Genetics • Silesian monk, educated at University of Vienna • Experimented on heredity in pea plants • Experiments conducted 1856-1863 • Defined the unit of inheritance (gene) as being discrete • Work published in 1866, but not recognized until 1900

Gregor Mendel

The Theory • Describes traits expressed through a single gene, a section of DNA that codes for a particular trait • A gene may have several different forms or alleles • Observable traits and characters represent the phenotype of the organism • The genotype is the genetic makeup; those genes that are expressed and unexpressed - Homozygous: Having the same alleles for a particular trait - Heterozygous: Having different alleles for a particular trait • A gene can be dominant or recessive - Dominant genes are are always expressed when present - Recessive genes are expressed only when paired with another recessive gene Principles of Mendelian Genetics. • Principle of Segregation: In the formation of gametes, homologous chromosomes separate so each gamete is equally likely to contain either member of the original pair • Principle of Assortment: Random distribution of the members of any pair of alleles is independent of the distribution of other pairs in the formation of gametes Complex Traits • Most complex traits are affected by multiple genetic and environmental factors • Polygenic trait: Depends on the action of more than one gene Mutation • Any heritable change in a gene • The basic mechanism of evolution

MOLECULAR BIOLOGY AND GENETICS DNA - The Genetic Code • 1869: DNA discovered • 1920s: DNA shown to be in chromosomes • 1944: First evidence that DNA is the genetic material of an organism • 1953: James Watson and Francis Crick discovered the three dimensional structure of DNA • DNA, deoxyribonucleic acid, controls heredity - Molecular structure of DNA is a double helix consisting of a linear sequence of paired nucleotide bases - Nucleotides of DNA are adenine, thymine, guanine and cytosine - Pairing between nucleotides of DNA is complementaryadenine pairs with thymine, cytosine pairs with guanine

A

H H H G H C H H T H

O -O

P

O

O

O CH2

T

-O

O -O P O O CH2

CH2 O O-

O H H

A O P O O CH2

P

O

C

H H H

G

CH2 O P OO CH2 O

Protein synthesis O P OO H • DNA codes for RNA (ribonucleic acid) = transcription G C H H • RNA codes for proteins = translation CH2 O O -O P O Transcription O P OO O - The production of a strand of messenger RNA (mRNA); H CH2 G C H complementary in base sequence to a DNA strand H CH2 O O - Base pairing in DNA and RNA -O P O O P OO - Complementary base pairing specifies the linear O CH2 H A sequence of RNA H T - RNA differs from DNA by having a ribose sugar instead 5' 3' of a deoxyribose sugar DNA - Genetic code - RNA contains the base uracil in place of thymine - Adenine pairs with uracil; thymine pairs with adenine; guanine pairs with cytosine and cytosine pairs with guanine Translation - The genetic code is read as a codon, or series, of three bases from the mRNA strand; each codon codes for a single amino acid - Each transfer RNA (tRNA) contains a complementary codon to a codon sequence in mRNA; tRNA’s position amino acids during translation - Amino acids are strung together to form a polypeptide chain; the order of the chain determined by the sequence of codons contained in the mRNA - Occurs on ribosomes, which contain several types of ribosomal RNA (rRNA) MITOSIS

MEIOSIS

• Process where a single, diploid parent cell gives rise to two diploid daughter cells genetically identical to each other and to the original parent cell • Multi-phase process in which sister chromatids comprising the replicated chromosome separate and are deposited into the cells being formed

• A single, diploid parent cell gives rise to four haploid daughter cells genetically distinct from each other and the original parent cell • Produces gametes • Multi-phase process includes the possible swapping of genetic material between homologous chromosomes in the process of crossing-over

4

PRIMATOLOGY Characteristics • Vision: Primates place a greater emphasis on vision than they do olfaction • Forward facing eyes - Binocular vision: Overlapping field of vision for each eye - Stereoscopic vision: Depth perception due to integration of visual information in the brain - See in color • Large brain relative to body size • Female usually produces small litters of one or two offspring • Increased parental investment in offspring • Increased period of development, including gestational and postnatal development • Show a variety of locomotor modes: - Arboreal quadrupedalism: Moving on all four limbs in the trees - Terrestrial quadrupedalism (knuckle-walking): Moving on all four limbs on the ground - Vertical clinging and leaping: Moving or jumping between vertical substrates, such as tree trunks - Brachiation (suspension; semi-brachiation): Moving underneath a substrate by using the arms - Bipedalism: Moving on top of a substrate with just the hindlimbs • Locomotion tends to be hindlimb dominated • Unspecialized molars • A maximum of two incisors, one canine, three premolars, and three molars on each half of the jaw • Grasping big toe and thumb • Nails on all digits instead of claws, and tactile pads on the hands and feet • Generally limited to tropical regions CLASSIFICATION OF PRIMATES Order: Primates • Suborder: Strepsirhini - Superfamily: Lemuroidea (Lemurs) - Superfamily: Lorisoidea (Lorises and Galagos) • Suborder: Haplorhini - Hyporder: Tarsiiformes (Tarsiers) - Hyporder: Anthropoidea • Infraorder: Platyrrhini (New World Monkeys) • Infraorder: Catarrhini (Old World Monkeys, Apes and Humans) - Superfamily: Cercopithecoidea (Old World Monkeys) - Superfamily: Hominoidea • Family- Proconsulidae • Family- Hylobatidae • Family- Hominidae - Subfamily- Ponginae (Pongo) - Subfamily- Homininae • Tribe- Gorillini • Tribe- Hominini (Homo sapiens) - Subfamily- Homininae, incertae sedis Strepsirhines vs. haplorhines • Features of strepsirhines - Shortest developmental period - Moist rhinarium (nose pad) - Split upper lip (philtrum) - Postorbital bar, no postorbital closure - Tapetum lucidum (reflective layer Strepsirhine (lemur) behind the retina) - Most species are nocturnal (active at night) - Unfused frontal bone and mandible - Tooth comb - Grooming claw on second digit of foot Haplorhine • Features of haplorhines (chimpanzee) - Extended development; humans have the longest pre- and postnatal periods

- Fused frontal bone and mandibular symphysis - Postorbital closure - Upright incisors - Larger brain relative to body size - Most species are diurnal - More complex social behaviors Behavior and Ecology Primate Diets • Types of diets based on primary food source - Frugivore: Fruits Leaves, did you know... - Folivory: stems Primates are omni- Insectivory: Insects vores, but most - Gumnivory: Gums species have certain and saps adaptations in their - Gramnivory: Seeds, gut and teeth herbs and grains designed for special• Primates aggressively ization of diet control a specific territory encompassing several feeding areas; a territory may be part of an entire home range of a species - Home range: Area within which an animal normally lives, or the total territory occupied by a group in the course of one year - Primates aggressively defend territories Primate Social Groups • Variables used to define social groups: - Mating type - Residence group composition - Foraging group coherence - Philopatry type (permanent residence in natal groups) Why do primates live in social groups? • Resource defense model: Social groups enhance access to resources • Predation model: Primates live in social groups to reduce vulnerability to predators Social organization by mating type • Solitary (one adult): A single female and her offspring whose range is overlapped by a single male; the male may have a home range that overlaps those of several different females; males and females generally interact only for mating (ex. orangutans and galagos) • Monogamy (one male - one female): One adult male and one female along with any immature offspring; mating is exclusive within the pairbond (ex. gibbons, titi monkey) • Polyandry (one female - multimale): One reproductively active female and two or more reproductively active males plus offspring; there may be other mature, related females; however, the single reproducing female actively suppresses their reproduction; males help rear offspring • Polygyny (one male - multifemale): Seen in species where females leave their natal group; lots of female transfer; strong sexual dimorphism (ex. howlers, langurs, gelada baboons, gorillas) • Polygyny (multimale - multifemale): Either sex transfers to a different group when mature; most are female-bonded groups (ex. macaques, baboons, vervets, squirrel monkeys, capuchins, some colobines); complicated system not easily applied (e.g., in chimps, males form a cohesive group whose home range overlaps that of several females) Social Interactions • Those behaviors assumed to affect the fitness of one or more individuals • Usually reduce interactions to the least common denominator - the actor and recipient • Social Interactions: - Selfish: Benefits the actor but not the recipient - Mutualistic: Benefits the actor and the recipient - Altruistic: Benefits the recipient but not the actor - Spiteful: Benefits neither the recipient nor the actor 5

PALEOANTHROPOLOGY Early Evolutionary Theory Pre-Darwinian Theory • Georges Comte de Buffon (1707-1788) - Proposed the idea of organic change; species could change, but not give rise to new species • Erasmus Darwin (1731-1802) - Grandfather of Charles Darwin - Believed species could change through competition and sexual selection • Jean-Baptiste Lamarck (1744-1829) - Provided first persuasive theory of organic evolution - Principle of Use and Disuse: The more frequently an organ is used, the more prominent it becomes; those less frequently used are likely to diminish altogether in succeeding generations • Inheritance of Acquired Characteristics: - Features enhanced or lost through principles of "use and disuse" pass to all offspring, provided the acquired modifications are common in both sexes, or at least to individuals which produce young; (ex. Giraffe predecessors were constantly stretching upward to reach foliage, causing their necks to grow longer; these longer necks are inherited; over the course of generations the necks of all giraffes get longer) • Georges Cuvier (1769-1832) - Proposed that species could become extinct - Proponent of Catastrophism: Features of the Earth are the result of periodic geologic revolutions • Charles Lyell (1797-1875) - Proponent of James Hutton’s principle of Uniformitarianism, which suggested that geologic features are the result of continuous, gradual change Darwinian Theory • Charles R. Darwin (1809-1882) - Proposed the theory of evolution through natural selection, which can be broken down into three separate inferences: • Struggle for exisCharles R. Darwin tence among individuals - Potential exponential increase of populations - Populations tend to remain stable in size - Limitation of resources • Differential survival (natural selection) - Struggle for existence - Variation in physical and behavioral characters - Heritability of individual variation • Evolution through action of natural selection over many generations • Alfred Russel Wallace (1823-1913) - Proposed a hypothesis of evolution through natural selection at the same time, but independently, from Darwin Mechanisms of Evolution • Natural selection: Differential reproduction or survival of replicating organisms caused by agencies not directed by humans • Genetic drift: A random change in the frequency of alleles in a population - Founder effect: Occurs when a small population colonizes a new habitat and subsequently increases in number - Bottleneck: A severe but temporary reduction in population size that reduces the amount of genetic variation • Migration (gene flow): Transfer of genes from one population into another by interbreeding • Mutation: Change in the composition of a gene or the genetic make-up of the organism

Paleoanthropology continued...

HUMAN EVOLUTION Trends • Alteration of skeletal features - Bipedalism - Reduction of face (less prognathic) - Reduction in molar tooth size - Thick enamel on molars - Loss of C/P3 complex - Well developed second cusp on the lower premolars - Change in dental eruption patterns - Ape- M1, I1, I2, M2, P3, P4, C, M3 - Human- M1, I1, I2, P3, C, P4, M2, M3 • Efficient exploitation of terrestrial habitat • Increasing brain size and complexity • Tool use Early Hominins • Late Miocene hominins - Sahelanthropus tchadensis • Dated between 6-7 million years ago (mya) • Found in the Sahel region of Chad • Very primitive, may not be a hominin - Orrorin tugenensis • 5.6 - 6.2 million years old from Kenya • May be earliest biped - Ardipithecus ramidus • 4.39 - 5.8 million years old from Ethiopia • "Gracile" Pliocene hominins - All possess primitive, ape-like features, including a chimpanzee-sized brain (~400ml) - Australopithecus anamensis: 3.9 to 4.2 mya from Kenya - Australopithecus afarensis • 2.8 to 4.0 mya from Ethiopia and Tanzania • The famed Lucy skeleton is a member of this species - Australopithecus africanus: 2.5 to 3.0 mya from South Africa - Australopithecus bahrelghazali: 3.0 to 3.5 mya from Chad - Australopithecus garhi: 2.5 mya from Ethiopia - Kenyanthropus platyops: 3.2 to 3.5 mya from Kenya • "Robust" Pliocene hominins - All are characterized by large molars and dishshaped faces - Paranthropus aethiopicus: 2.5 to 2.8 mya from Kenya and Ethiopia - Paranthropus boisei: 1.0 to 2.5 mya from Ethiopia, Kenya and Tanzania - Paranthropus robustus: 2.0 mya from South Africa

Hominoids Lemurs, New world Old world monkeys Orangutans Gorilla Chimp Bonobo Human lorises Tarsiers monkeys Present Pleistocene 1.7 Pliocene 5 Sivapithecus

Morotopithecus 24 Oligocene

Aegyptopithecus

36 Eocene

Paleocene 65

Eosimiidae

?

Adapidae

55

Omomyidae

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Late Cretaceous Period Primate stock

Primate evolution

• Evolution of Old World monkeys - Propliopithecid family may be ancestral to Old World monkeys, apes, and humans; or possibly just apes - From late Eocene - early Oligocene of Egypt and Oman - Propliopithecus, Aegyptopithecus, Catopithecus • Evolution of apes - Evolved approximately 20 million years ago - Proconsul: Earliest apes - Sivapithecus: Early great apes; relatives of modern orangutans

Early Homo • Less primitive than the australopithecines • Homo habilis - 1.5 to 2.4 mya from did you know... Kenya, Tanzania and Early homo habilis South Africa made the earliest discovered stone tools - Brain size 660 ml - Less primitive than the known as the Oldowan industry australopithecines • Homo rudolfensis - 1.8 to 2.4 mya from Kenya and Malawi - The cranial capacity is approximately 775cc - Associated with the Oldowan industry • Homo erectus - Dates between 400,000 and 1.8 mya - Complex of derived and primitive features, but more like modern humans than earlier species - Associated with the Acheulian stone tool industry - First hominin species to be found outside Africa - Evolved first in Africa, spread to other areas including Europe and Indonesia - Cranial capacity on average, was 946cc (727-1225 ml) - Shows the earliest and best evidence for the development of complex language - First hominin to utilize fire • Homo georgicus - Dated at 1.81 to 0.05 mya from Dmanisi (Georgia) - Little is known about this species • Homo heidelbergensis - Formerly Archaic Homo sapiens - Existed in Africa, Asia and Europe from 800,000 to 100,000 years ago - More robust than modern humans - Cranial capacity averaged 1,283 ml (1,100-1,450 ml) - Used Acheulian tools; may have used later Mousterian tools • Homo neanderthalensis - Lived between 32,000 and 300,000 years ago - Range restricted to Europe and the Middle East - Possessed many typical archaic features- sloping forehead, low skull, no chin, large brow ridges - Bodies were adapted for life in a cold climate - Largest average brain size of any known hominin; averaging1400 ml (1,125-1,750 ml) - Associated with the Mousterian tool industry; small-flake tools with evidence of retouching 6

Kenyapithecus

Miocene Million years ago

Primate Evolution • Cenozoic Era - Epochs Paleocene (65-55 mya), Eocene (55-36 mya), Oligocene (36-23.5 mya), Miocene (23.5-5.3 mya), Pliocene (5.3-1.6 mya), Pleistocene (1.6 mya - Present) • Primate Origins - Early Paleocene (65 mya) - Early primates (ex. Plesiadapis) lack the complete suite of features generally associated with extant primates; for this reason some researchers separate out this early group - True primates (strepsirhines) appear in the fossil record around the early Eocene (55 mya) • Hypotheses for primate origins - Arboreal hypothesis • Primates evolved by adapting to life in trees, which required enhanced vision, grasping hands and feet - Visual predation hypothesis • Early primates first adapted to life in the bushy forest undergrowth and low tree branches • Foraging for insects necessitated evolution of enhanced vision, grasping hands and feet, nails for capturing prey • True Primates - Appear in the early Eocene - Adapids of North America, Europe and Asia - During the Oligocene (35-23.5 m.y.a.), haplorhines were the most numerous primates • Origin of New World monkeys - The parapithecid family may be ancestral to the New World monkeys as exemplified by Apidium and Qatrania - Rafting Theory of NW Origins: Suggests primates made it to the New World by rafting from Africa approximately 25 million years ago

- Appear to have been nomadic, living in different shelters at different times of the year - Practice many types of ritualistic behavior, including funeral rituals • Homo sapiens - First appear in the fossil record between 200,000 and 160,000 years ago - Produced delicate stone tools - First evidence of art was the use of red ocher about 70,000 years ago - First cave paintings- 32,000 years ago - Modern humans expanded into areas not inhabited before by other hominins - Australia: 50,000 years ago - North America: 25,000 to 15,000 years ago

THEORIES OF MODERN HUMAN ORIGINS • Multiregionalism/Coninuity model - Suggests modern humans evolved from regional H. erectus populations that exchanged genes • Out-of-Africa/Replacement Model - Suggests modern humans originated from a single population in Africa - After evolving in Africa, spread to other parts of the world, replacing other hominid species either through competition or assimilation

PRICE: U.S. $5.95 CAN. $8.95 Authors: Michael S. Harris, PH.D Douglas Broadfield, PH.D ISBN-13: 978-142320387-2 ISBN-10: 142320387-9

Note to Student: Due to its condensed format, use this QuickStudy ® guide as a reference, but not as a replacement for assigned class work. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2004 BarCharts, Inc. 0707

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Aromatherapy

Soothe your body & mind, and improve your health naturally using these powerful oils & techniques!

Oils Used in Aromatherapy

Essential Oils Volatile and fragrant liquid or semiliquid substances extracted from plants by distillation or cold-pressing ■ Powerful healing agents that contain the highly concentrated vital energy of plants ■ All-natural, complete, free of additives ■

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What Is Aromatherapy

A holistic approach to wellness • Traces its origins to ancient times when our ancestors recognized the effect of aromatic plants on the human body, mind and spirit ■ Utilizes natural essential oils extracted from a wide variety of plants to promote health and vitality and to instill a sense of harmony with the natural world ■ A safe and effective alternative for dealing with many routine, day-to-day challenges to good health and well-being ■

Using Essential Oils Essential oils should only be unless used externally, otherwise directed by a qualified health-care professional Do not use for self-treatment of serious medical problems without appropriate professional advice Always dilute prior to use on the body Know the specific therapeutic properties and safety precautions for each oil you use Use only in very small amounts

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■

■ ■

■

Massage Best for body aches, skin care, stress and other emotional states tial oil (or ■ Add 4 to 8 drops of a single essen a blend of essential oils) to 4 teaspoons of ■

carrier oil Massage into the body, avoiding the eyes and other delicate or sensitive areas

Bath Best for body aches, colds, skin care, stress and other emotional states ■ Add 2 drops of a single essential oil (or up to 4 drops of a blend of essential oils) to a tablespoon of honey or whole milk • Stir into a warm bath, being careful not to get bath water in the eyes • Soak for 10 to 20 minutes

Carrier Oils Fatty, nonvolatile oils extracted from seeds, nuts or fruits ■ Moisturize and nourish the skin ■ Used to dilute essential oils for application to the body ■

Examples Sweet almond oil, grapeseed oil and olive oil

Inhalation Best for colds, flu and sinusitis ■ Add 2 to 4 drops of a single essential oil (or a blend of essential oils) to a pot of steaming (not boiling) water that has been removed from the heat source ■ Keeping your face about 10 inches from the pot, with eyes closed, lean over the pot and inhale WARNING: Do not use this method if you have asthma

Diffusion Best for colds, emotional states, and sanitizing the air to help preve nt colds/flu ■ Many devices for diffusin g essen tial oils into the air are available commercially and come with instructions for use oil ■ Or, add 4 to 8 drops of any essential of bowl a to oils) tial essen of (or blend steaming water that has been removed from its heat source; set in a secure place where pets and children cannot drink it not ■ Light bulb ring diffus ers are recommended because they can ruin your oils (they give off too much heat)

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Warning

Safety Precautions

Keep essential oils away from babies, children and pets ■ Every essential oil is different; for safe and effective use, be sure you are familiar with the specific actions and precautions for each oil (many oils have special precautions) ■ Always follow recommended dilutions and application procedures; do not exceed recommended amounts ■ Never use the essential oil of a plant to which you are allergic ■ Do not allow essential oils to get in or near the eyes, and do not apply them onto the genital region, inside the nose or mouth, or onto seriously damaged skin ■ Do not massage someone who has an infectious illness (such as the flu or measles) or cancer; do not massage over varicose veins, infected areas, broken bones or injuries ■ Do not take essential oils internally except under the supervision of a qualified health-care professional ■ If essential oils accidentally get into the eyes, flush immediately with whole milk or cream (these fats will dissolve and remove the essential oils) ■ In case of accidental ingestion of essential oils, obtain immediate medical assistance Allergy Test Perform 2 skin patch tests on small areas of the arm on successive days before using the oil on larger areas ■

Purchasing Essential Oils Appropriate oils are usually labeled aromatherapy grade or therapeutic grade ■ Look for essential oils labeled “100% pure” (rose and jasmine are often available diluted in carrier oil, since the price of the pure oils is prohibitively expensive for many people) away from anything labeled ■ Stay fragrance or nature identical oils; these are synthetic, have no therapeutic properties, and should never be used in aromatherapy ■

Tip In order to be effective, essential oils must be of the highest quality

Storing Essential Oils ■ ■ ■ ■ ■

Use of essential oils with babies and children requires different procedures than those covered in this guide 1

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Store in tightly closed, dark or opaque glass jars Keep away from heat, moisture and direct light Open bottles only for use and close again as soon as possible Do not refrigerate The shelf life of most essential oils is about 12 to 18 months (when properly stored) Citrus oils and juniper oil generally have a shelf life of about 6 months (when properly stored)

Essential Oils Frankicense

Bergamot

7

Botanical Name Citrus bergamia Actions analgesic, antiseptic, antispasmodic, calmative, carminative, diuretic, stomachic, uplifting Uses acne, anxiety, colds/flu, cold sores, cystitis, depression, flatulence, stomachache, stress Cautions/Comments phototoxic*

1

Botanical Name Boswellia carteri Actions analgesic, antidepressant, anti-inflammatory, astringent, calmative, cicatrizant, cytophylactic, diuretic, emmenagogue, expectorant, strengthening, tonic, uterine, vulnerary Uses anxiety, bronchitis, colds/flu, coughs, depression, dysmenorrhea, laryngitis, mature skin, meditation aid, menorrhagia, nervous exhaustion, scars, slack skin, stress

Cedarwood, Atlas Botanical Name Cedrus atlantica Actions antifungal, antiseptic, aphrodisiac, astringent, calmative, diuretic (mild), expectorant, mucolytic, tonic Uses acne, arthritis, bronchitis, cystitis, depression, fungal infections, oily skin, rheumatism, stress Cautions/Comments avoid during pregnancy

2

Geranium Botanical Name Pelargonium graveolens Actions analgesic, antidepressant, anti-inflammatory, astringent, cicatrizant, cytophylactic, diuretic, hemostatic, lymphatic stimulant, tonic, vasoconstrictor, vulnerary Uses acne, bruises, depression (mild), fluid retention, menopause, nervous tension, neuralgia, PMS, scars, skin care (all types), sore throat, stress Cautions/Comments may cause wakefulness if used at night

8

Chamomile, Roman

3

Botanical Name Anthemis nobilis Actions analgesic, antidepressant, anti-inflammatory, antineuralgic, antiseptic, calmative, carminative, digestive, diuretic, emmenagogue, febrifuge, hepatic, muscle relaxant, nervine, tonic, vulnerary Uses anxiety, arthritis, dry skin, flatulence, headaches, immune system, indigestion, insomnia, menstrual cramps, muscle pain, neuralgia, PMS, rheumatism, sprains, stress Cautions/Comments may cause drowsiness; can cause dermatitis in allergic individuals

Grapefruit

9

Juniper

Clary Sage

5

6

10

Botanical Name Salvia sclarea Actions antidepressant, anti-inflammatory, antispasmodic, aphrodisiac, astringent, calmative, diuretic, emmenagogue, hypotensive, nervine, regenerative, tonic, uterine Uses anxiety, depression, frigidity/impotence, insomnia, menopause, mental exhaustion, muscle spasms, stomach cramps, stress, wrinkles Cautions/Comments avoid during pregnancy; do not use while drinking alcohol; may cause intense dreams; larger amounts may cause headache; may impair concentration and cause drowsiness

4

Botanical Name Citrus paradisi Actions antidepressant, antiseptic, astringent, depurative, diuretic, lymphatic stimulant, tonic Uses acne, colds/flu, depression, fluid retention, muscle stiffness, nervous exhaustion, slack skin Cautions/Comments phototoxic *; short shelf life

Botanical Name Juniperus communis Actions antirheumatic, antiseptic, astringent, calmative, depurative, diuretic, emmenagogue, lymphatic stimulant, nervine, rubefacient, sudorific, tonic Uses acne, amenorrhea, anxiety, colds/flu, cystitis, detoxification, dysmenorrhea, fluid retention, gout, lower back pain, rheumatism, stress Cautions/Comments avoid during pregnancy and in cases of kidney disease; it is slightly irritating, so use in low concentrations; short shelf life

Lavender

11

Cypress

Botanical Name Lavandula angustifolia Actions analgesic, antidepressant, antifungal, antiinflammatory, antirheumatic, antiseptic, antispasmodic, calmative, cholagogue, choleretic, cicatrizant, cytophylactic, deodorant, diuretic, emmenagogue, hypotensive, nervine, tonic, vulnerary Uses acne, burns (mild), coughs, cuts (minor), dermatitis, dysmenorrhea, flu, fungal infections, headaches, insomnia, irritability, muscle aches and spasms, nausea, nervous tension, rheumatism, sciatica, sore throat, sprains, stomach cramps, stress Cautions/Comments may cause drowsiness; it’s one of the most versatile and widely used essential oils

Botanical Name Cupressus sempervirens Actions antirheumatic, antiseptic, antispasmodic, astringent, calmative, deodorant, diuretic, insect repellent, tonic, vasoconstrictor Uses body aches, coughs, dysmenorrhea, edema, foot odor, mature skin, menopause, menorrhagia, oily skin, rheumatism, stress/tension Cautions/Comments avoid during pregnancy

Eucalyptus Botanical Name Eucalyptus globulus Actions analgesic, antifungal, antineuralgic, antirheumatic, antiseptic, antispasmodic, decongestant, depurative, expectorant, febrifuge, immune tonic, insect repellent, rubefacient, stimulant, vulnerary Uses arthritis, burns (mild), colds/flu, concentration, cuts, disinfectant, insect repellent, muscle aches, nervous exhaustion, neuralgia, rheumatism, sinus congestion Cautions/Comments avoid in cases of high blood pressure or epilepsy; avoid when taking homeopathic remedies; avoid excessive use; may cause wakefulness if used at night

Lemon

12

2

Botanical Name Citrus limonum Actions anti-inflammatory, antirheumatic, antisclerotic, antiseptic, astringent, carminative, cicatrizant, depurative, diuretic, febrifuge, immunostimulant, rubefacient Uses acne, arthritis, cellulite, colds/flu, coughs, dyspepsia, gout, herpes, oily skin, rheumatism Cautions/Comments short shelf life; phototoxic*; mild skin irritant, so use in low concentrations; may cause sensitization

Petitgrain

Marjoram, Sweet Botanical Name Origanum marjorana Actions analgesic, antiseptic, antispasmodic, calmative, carminative, cephalic, diuretic, emmenagogue, expectorant, hypotensive, nervine, stomachic, tonic, vasodilator Uses anxiety, arthritis, bruises, colds, coughs, exhaustion, flatulence, headache, insomnia, menstrual cramps, muscle aches and strains, nervous tension, rheumatism, sprains, stomach cramps, stress Cautions/Comments avoid during pregnancy; may cause drowsiness; avoid excessive use

13

14

Botanical Name Citrus aurantium var. amara Actions antidepressant, antiseptic, calmative, digestive, nervine, tonic Uses acne, anxiety (mild), dyspepsia, insomnia, nervous exhaustion, stress

19

Rosemary Botanical Name Rosmarinus officinalis Actions analgesic, anticatarrhal, antineuralgic, antirheumatic, antiseptic, antispasmodic, astringent, carminative, cephalic, cholagogue, choleretic, cytophylactic, diuretic, emmenagogue, expectorant, hepatic, hypertensive, nervine, restorative, rubefacient, stimulant, stomachic, sudorific, tonic, vulnerary Uses acne, alopecia, arthritis, colds/flu, coughs, dysmenorrhea, dyspepsia, fluid retention, gout, greasy hair, muscle pain, neuralgia, rheumatism, sciatica Cautions/Comments avoid during pregnancy and in cases of asthma, hypertension and epilepsy; may cause insomnia and restlessness; use in moderation; avoid during pregnancy

20

Myrrh Botanical Name Commiphora myrrha Actions anticatarrhal, antifungal, anti-inflammatory, antiseptic, astringent, balsamic, calmative, carminative, cicatrizant, emmenagogue, expectorant, tonic, vulnerary Uses arthritis, athlete’s foot, chapped or cracked skin, colds/flu, coughs, diarrhea, dyspepsia, laryngitis, mature skin, sore throat

Orange, Sweet

15

16

Botanical Name Citrus sinensis Actions antidepressant, antiseptic, antispasmodic, calmative, carminative, cholagogue, choleretic, stomachic, tonic Uses constipation, depression, dyspepsia, insomnia, nervous tension, stress

Rosewood Botanical Name Aniba rosaeodora Actions analgesic, antiseptic, aphrodisiac, cephalic, deodorant, regenerative, tonic Uses acne, colds/flu, exhaustion, frigidity, headaches, nervous tension, scars, skin care (all types), wrinkles Cautions/Comments its production contributes to deforestation in the rainforest

21

Palmarosa Botanical Name Cymbopogon martinii var. martinii Actions anti-inflammatory, antiseptic, calmative, cicatrizant, hydrating, nervine, regenerative, tonic Uses acne, anxiety, insomnia, nervous exhaustion, restlessness, scars, skin care (all types), stress

Sandalwood Botanical Name Santalum album Actions antidepressant, anti-inflammatory, antiseptic, antispasmodic, aphrodisiac, astringent, calmative, carminative, diuretic, emollient, expectorant, tonic Uses acne, coughs, cystitis, depression, dry/cracked skin, frigidity/impotence, insomnia, laryngitis, nervous exhaustion, sore throat, stress

22

Patchouli Botanical Name Pogostemon cablin Actions antidepressant, antifungal, anti-inflammatory, antiseptic, aphrodisiac, cicatrizant, cytophylactic, diuretic, insect repellent, nervine, tonic Uses acne, cracked skin, depression, frigidity, fungal infections, mature skin, nervous exhaustion, slack skin, stress Cautions/Comments although small amounts of patchouli generally have a calming effect, too much may be stimulating

17

Tea Tree

23

Peppermint

18

*

Botanical Name Mentha piperita Actions analgesic, antifungal, anti-inflammatory, antiseptic, antispasmodic, carminative, cephalic, cholagogue, expectorant, febrifuge, nervine, stomachic, vasoconstrictor Uses colds/flu, coughs, dyspepsia, flatulence, headaches, mental fatigue, muscular aches and pains, nausea, neuralgia, ringworm, stomach cramps Cautions/Comments avoid when taking homeopathic remedies; may cause restlessness or insomnia if used at night or to excess; use in moderation; may cause sensitization

Botanical Name Melaleuca alternifolia Actions analgesic, antifungal, anti-inflammatory, antiseptic, balsamic, cicatrizant, expectorant, immune stimulant, sudorific, vulnerary Uses acne, arthritis, athlete’s foot, blisters, burns (minor), colds/flu, cold sores, coughs, cuts, insect bites, ringworm, warts Cautions/Comments may cause sensitization; tea tree put into a hot bath may cause itching

Ylang Ylang

24

Remember

Botanical Name Cananga odorata Actions antidepressant, antifungal, antiseptic, antispasmodic, aphrodisiac, calmative, hypotensive, nervine, tonic Uses acne, alopecia, anger, anxiety, depression, frigidity, insomnia, irritability, nervousness, skin care (all types), stress Cautions/Comments use in moderation—too much can cause headache; may cause sensitization

Always perform skin patch tests when using an oil for the first time [see Safety Precautions, page 1] * Do not apply / use for 12 hours prior to sun /sunlamp exposure

3

Glossary alopecia Hair loss amenorrhea Absence or suppression of menstrual bleeding analgesic Reduces or relieves pain anaphrodisiac Reduces sexual desire anticatarrhal Aids removal of excessive mucus or phlegm in the sinuses or other body areas antifungal Helps prevent and heal fungus infections antineuralgic Reduces or relieves nerve pain antirheumatic Helps prevent and relieve symptoms of rheumatism antisclerotic Helps prevent hardening of tissues; aids sclerosis of the arteries antiseptic Cleanses tissues of germs and microorganisms antispasmodic Reduces or relieves spasms aphrodisiac Increases sexual desire astringent Produces contraction of tissue balsamic Having a sweet aroma and soothing qualities calmative Produces soothing/calming effect carminative Soothing to the digestive system; relieves gas and stomach cramps cephalic Benefits the head or brain; helps to clear the head and improve thinking cholagogue Stimulates contraction of the gallbladder, aiding in the evacuation of bile choleretic Stimulates the liver to excrete bile cicatrizant Stimulates the formation of scar tissue

Therapeutic Index of Traditional Use acne atlas cedarwood, bergamot, geranium, grapefruit, juniper, lavender, lemon, palmarosa, patchouli, petitgrain, rosemary, rosewood, sandalwood, tea tree, ylang ylang anxiety bergamot, chamomile (roman), clary sage, frankincense, juniper, lavender, marjoram, palmarosa, petitgrain, ylang ylang arthritis atlas cedarwood, chamomile (German and Roman), eucalyptus, juniper, lemon, marjoram, myrrh, rosemary, tea tree athlete’s foot lavender, myrrh, patchouli, tea tree bites/stings chamomile (German and Roman), geranium, lavender, tea tree bruises chamomile (German), lavender, marjoram, rosemary burns (mild) chamomile (German), lavender, tea tree colds and flu atlas cedarwood, eucalyptus, frankincense, lavender, peppermint, rosemary, tea tree coughs atlas cedarwood, eucalyptus, frankincense, lavender, marjoram, rosemary, sandalwood, tea tree DISCLAIMER: This guide is intended for informational purposes only. It is not intended for the diagnosis, treatment or cure of any medical condition or illness, and should not be used as a substitute for professional medical care. BarCharts, Inc., its writers and editors are not responsible or liable for the use or misuse of the information contained in this guide. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. © 2005 BarCharts Inc. 0608

cystitis Inflammation of the bladder cytophylactic Increases the activity of leukocytes (white blood cells); stimulates regeneration of cells depurative Purifies and detoxifies the blood dermatitis Inflammation of the skin digestive Benefits the digestive system and the process of digestion diuretic Increases the production and elimination of urine; stimulates removal of fluid from tissues dysmenorrhea Painful menstruation dyspepsia Indigestion; abdominal pain and/or gas, heartburn, and sometimes nausea edema Abnormally large amounts of fluid in intercellular tissue spaces; swelling emmenagogue Stimulates menstruation emollient Softens tissue and soothes inflammation expectorant Promotes discharge of mucus and phlegm from the respiratory system febrifuge Reduces fever flatulence Intestinal gas hemostatic Reduces or stops bleeding hepatic Pertaining to the liver hypertensive Raises blood pressure; helps to counteract low blood pressure hypoglycemiant Lowers blood sugar hypotensive Lowers blood pressure; helps to counteract high blood pressure immunostimulant Stimulates the immune system lymphatic Pertaining to or acting on the lymphatic system

menorrhagia Excessive menstrual bleeding mucolytic Dissolves and breaks down mucus nervine Tones and strengthens nerves/ nervous system; relaxes and soothes mind and body neuralgia Recurring pain along the pathway of a nerve phototoxic Increases skin’s sensitivity to ultraviolet light, possibly resulting in severe sunburn regenerative Heals; renews tissue; benefits the skin restorative Helps to strengthen the body and restore health rheumatism A chronic disorder that causes pain and aching in muscles or joints rubefacient A substance producing an increase in blood flow where applied to the skin, causing redness sensitization An immune reaction where repeated exposure to a substance results in sensitivity to it; similar to allergic response stomachic Improves appetite and aids digestion; strengthens and tones the stomach styptic Reduces external bleeding sudorific Induces sweating tonic Strengthens the body, helps preserve and restore health uterine Acts on and benefits the uterus vasoconstrictor Reduces blood flow vasodilator Increases blood flow vulnerary Aids in the healing of wounds and sores

cuts/scrapes (minor) chamomile (German), eucalyptus, lavender, myrrh, tea tree depression (temporary, mild) bergamot, geranium, grapefruit dry skin atlas cedarwood, chamomile (Roman), frankincense, geranium, lavender, palmarosa, patchouli, sandalwood fatigue/nervous exhaustion clary sage, eucalyptus, frankincense, geranium, grapefruit, lavender, ylang ylang headache chamomile (Roman), lavender, peppermint indigestion bergamot, chamomile (Roman), marjoram, peppermint, rosemary insect bites chamomile (German), lavender, tea tree jet lag bergamot, eucalyptus, frankincense, lavender, ylang ylang laryngitis eucalyptus, frankincense, lavender, sandalwood mature skin clary sage, cypress, frankincense, geranium, lavender, myrrh, rosewood, sandalwood, ylang ylang menstrual cramps chamomile (Roman), lavender, marjoram muscle pain and spasm chamomile (German and Roman), eucalyptus, lavender, marjoram, peppermint, rosemary

nervousness/stress bergamot, chamomile (Roman), clary sage, frankincense, geranium, lavender, sandalwood, sweet orange, ylang ylang oily skin atlas cedarwood, bergamot, cypress, geranium, juniper, lavender, petitgrain, tea tree premenstrual syndrome (PMS) chamomile (Roman), frankincense, geranium, grapefruit, juniper, lavender, sandalwood rheumatism atlas cedarwood, chamomile (German and Roman), cypress, eucalyptus, juniper, lavender, marjoram, rosemary ringworm [see athlete’s foot] sleeplessness chamomile (Roman), clary sage, lavender, marjoram, petitgrain, sandalwood sprains chamomile (German and Roman), eucalyptus, lavender, marjoram, rosemary (soak sprains or apply compresses; do not massage) sunburn (mild) chamomile (Roman), eucalyptus, lavender wrinkles frankincense, geranium, lavender, palmarosa, patchouli, sandalwood

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PHYSICAL CHANGES

SCOPE OF THE PROBLEM A. Incidence & Prevalence 1. Asthma is a common disorder that affects 15 to 17 million people in the United States 2. Thought to occur in 6.2% of the US population 3. Most common chronic disease of childhood, affecting an estimated 4.8 million children 4. Causes approximately 100 million days of restricted activities each year. 5. Asthma precipitates more than 2 million adult emergency department visits each year 6. 500,000 hospitalizations occur annually due to exacerbation of asthma symptoms; ranks as the 6th leading cause of hospital admissions 7. More than 5,000 deaths due to asthma occur each year in the United States – most are preventable B. Costs: Total economic impact of asthma is $6.2 billion – including hospitalizations, emergency department visits, outpatient visits and lost school and workdays C. The Asthma Trend 1. Self-reported asthma has increased by 75% from 1980 to 1994 2. Asthma among children is a growing problem with a 72% increase between 1982 and 1994 3. Death and disability related to asthma has increased dramatically over the past 20 years D. The History of Asthma Management 1. Many patients and their physicians underestimate asthma's severity 2. For more than 35 years, asthma was considered to be an episodic, reversible airway constriction 3. Advances in medical research have shown that asthma should be considered a chronic airway inflammatory disease characterized by at least partially reversible airway constriction 4. The severity of symptoms do not often correlate with the objective physical findings 5. Despite the availability of effective anti-asthmatic medications, many people have asthma that is not well controlled 6. Inadequate treatment and inappropriate therapy are the major contributors to asthma illness and death 7. The National Heart, Lung, and Blood Institute published new guidelines in 1997 as a means to improve the detection and treatment of asthma 8. The four key components for asthma control in the NHLBI guidelines are: a. Assessment and monitoring (how to detect and watch the trend of asthma) b. Pharmacological therapy (medications used to maintain long-term control of asthma symptoms) c. Control of factors contributing to asthma severity (identifying and removing triggers for asthma) d. Individual education for a partnership in asthma care (developing an individualized care plan written by the patient and physician to help the asthmatic person take control of their disease)

A. What happens when you breathe? RESPIRATORY SYSTEM 1. When you breathe in, air travels through your nose and/or mouth through a tube called the trachea (also known as the “windpipe”) Trachea 2. Air enters a series of smaller tubes that Primary branch off from the trachea; these bronchi branched smaller tubes are the bronchi, and they divide further into Secondary smaller tubes called the bronchioles bronchi 3. It is in the bronchi and the bronchioles that asthma has its main effects; there are three components that result in Bronchiole difficulty breathing: & lobule a. When the airways come into contact with an asthma trigger, the tissue inside the bronchi and bronchioles become inflamed (inflammation) b. At the same time, the muscles on the outside of the airways tighten (constriction or bronchospasm), causing the airways to narrow c. A thick fluid (mucus) enters the airways, which become swollen and may be partially or completely plugged by the mucus B. Inflammation 1. Inflammation occurs when an exposure to an asthma trigger causes cells within the airways of the lung to release strong substances that result in airway tissue swelling 2. Swelling of the airway wall causes it to become more rigid and interferes with airflow 3. This inflammation results in a complex interaction within the lung’s airways, resulting in bronchospasm 4. Inflammation of the airways is an early and persistent component of asthma 5. Persistent, inadequately treated inflammation may lead to permanent changes in the airway structure C. Bronchospasm 1. Bronchospasm is an exaggerated tightening of the BRONCHOSPASM airways resulting in a smaller sized opening for air to pass in and out of the lungs during breathing Bronchiole 2. Bronchospasm is also referred to as airway hyperresponsiveness 3. The propensity for airways to narrow too easily and to “mush” is a major feature of asthma 4. Bronchospasm may result from exposure to an asthma trigger 5. The level of airway narrowing usually correlates with the severity of the asthma attack D. Mucus Production 1. Increased mucus production results when glands within the airways release an excess of thick mucus during an attack 2. Although this is meant to protect the lung from a trigger, this thick, abundant mucus results in further narrowing of the airways, even to the point that the mucus actually clogs a small airway completely

WHAT IS ASTHMA? 2. The most common triggers include: a. Strong emotional expression (laughing or crying hard) b. Aspirin and other medications c. Smoke (tobacco, wood) d. Changes in weather NORMAL GAS EXCHANGE e. Pollen Bronchiole f. Dust g. Animal fur and Alveoli dander CARBON h. Feathers DIOXIDE i. Molds Alveolus OXYGEN j. Grass k. Viruses Capillaries l. Cold air m. Exercise

A. Asthma is a life-long disorder of the lungs and airways B. It is characterized by airway inflammation or swelling combined with excessive airway tightness, resulting in a restriction of airflow into and out of the lungs C. Asthma has a recurring pattern of periodic episodes of difficult breathing alternating with periods of relief D. Asthma involves many cells and cellular elements within the body that play a role in its long-term effects E. During an asthma episode, you may feel like you cannot catch your breath and you may cough, wheeze or feel chest tightness F. Symptoms occur more frequently at night or in the early morning G. Characterized by sudden periodic episodes of difficulty 1. Often referred to as “attacks,” they are usually related to exposure to a trigger (a certain substance that a person’s airways are sensitive to) 1

INDICATIONS

4. Some other conditions may also result in wheezing: a. Foreign body aspiration b. Cystic fibrosis c. Croup, or other viral infections of the upper airway d. Inflammation of the epiglottis e. Tuberculosis f. Habitual cough g. Congestive heart failure h. Chronic obstructive lung disease i. Allergic reaction to an inhaled substance D. Goals of Asthma Therapy: 1. Prevent chronic and troublesome symptoms 2. Maintain near normal or normal lung function 3. Maintain normal activity levels 4. Prevent recurrent exacerbations of asthma and minimize the need for emergency department visits or hospitalizations 5. Provide optimal medication management with few or no side effects 6. Meet the patient’s and family’s expectations of asthma care E. Periodic Assessment and Monitoring: 1. Once your physician has determined that you have asthma and its severity, it is important that you are monitored in an ongoing manner 2. Ongoing monitoring will determine whether the goals of therapy are being met

(Correlates to Measurement and Monitoring of the NHLBI 1997 Recommendations) A. Initial Assessment: When your physician is considering the possibility you may have asthma, he will most likely take the following steps: 1. Obtain a detailed medical history from you, looking for the following indicators: a. Wheezing: High-pitched whistling sounds when breathing out. b. A recurrent history of cough (that is worse at night), difficulty breathing and chest tightness c. Symptoms that occur or worsen in the presence of any of the triggers listed on previous page d. Family history: The doctor may ask if any of your family members have problems with asthma or allergies e. Your physician may ask you many questions about your home, including how old it is, how it is heated and cooled, whether you have carpet or concrete and if you have any pets f. He/she will also ask if anyone smokes in your home or around you g. Your doctor will ask you about your job or school to determine if there are exposures outside the home that may trigger asthma 2. Perform a physical examination a. Physical examination focuses on the upper respiratory tract, chest and skin b. The physician will look for over-expansion of the chest with the appearance of hunched shoulders and chest deformity c. Assessment of the number of chest, neck and abdominal muscles used to breath in and out d. He/she will listen for the sounds of wheezing and for prolonged time spent breathing out (exhalation) e. An asthmatic person may have increased nasal secretions and swelling of the mucous membranes of the nose and mouth f. The physician will also look for any signs of an allergic skin condition, such as dermatitis or eczema 3. Diagnostic Testing a. Spirometry Measurements 1) A painless breathing test that measures your lung power 2) You may be asked to repeat this breathing test after inhaling some medication; this helps determine whether there is airflow obstruction and whether it is reversible 3) Generally used in adults and children over age 4 4) Typically measures Forced Vital Capacity or FVC, the maximal volume of air forcibly exhaled from the peak of inhalation 5) Also measures Forced Expiratory Volume in 1 second or FEV1, the volume of air exhaled during the first second of the FVC b. These additional studies are not routine, but may be considered: 1) Further pulmonary function studies: An expansion of the painless breathing test 2) Chest x-ray: A radiographic image of your chest 3) Allergy testing: Skin testing to determine what you are allergic to c. The presence of multiple key indicators along with the spirometry measurements are needed to determine the likelihood of asthma B. Determining the Severity of Asthma: Once your physician has determined that you have asthma, it may be classified into one of the following categories, based upon how asthma is affecting you; this will determine which treatment is best suited for you 1. Mild intermittent asthma: a. Symptoms 2 or fewer times a week b. No symptoms between episodes c. Episodes usually brief 2. Mild persistent asthma: a. Symptoms more than twice a week, but less than once a day b. Episodes may affect physical activity 3. Moderate persistent asthma: a. Daily symptoms b. Asthma episodes 2 or more times a week (some may last days) c. Episodes interfering with physical activity 4. Severe persistent asthma: a. Symptoms most of the time b. Physical activity limited c. Frequent asthma episodes C. All that Wheezes is Not Asthma 1. Although wheezing is a key symptom of asthma, there are other things that must be considered before labeling a person as an asthmatic, or an episode of breathlessness as an asthma attack 2. For instance, if a child in respiratory distress with an audible wheeze is automatically labeled asthmatic, you could miss the presence of a foreign body that has become lodged in the upper airway with detrimental or deadly consequences 3. It is important to consider the history, current symptoms and health examination findings as a whole, not assuming anything without putting these all together

TAKING CONTROL Asthma doesn’t have to put major limits on your life. There are many things that you can do to take control of your asthma and minimize its impact. A. Know Your Asthma Symptoms: Any one of these symptoms may mean you have asthma, or may be having an attack; you can have one or more of these symptoms or even different ones 1. Wheezing 2. Difficulty catching your breath 3. Coughing 4. Tightness in the chest 5. Feeling tired 6. Trouble exhaling 7. Waking up often in the middle of the night 8. Heavy breathing B. Track Your Triggers: Each case of asthma is unique; learn what can trigger an asthma episode for you; go over the list of common asthma triggers and check off the ones that set off your asthma episode or make them worse ❒ Air pollution – smoke or fumes ❒ Aspirin or other medications ❒ Breathing cold air, air conditioning ❒ Changes in the weather ❒ Cockroaches, their feces and dried body parts ❒ Colds, other respiratory infections ❒ Dust or dust mites ❒ Exercise, playing hard or using stairs ❒ High humidity ❒ Mold, mildew ❒ Perfume, body deodorants ❒ Pet fur or dander ❒ Pollen ❒ Stress ❒ Strong chemical smells – paint, cleaning fumes ❒ Strong emotional responses – laughing or crying ❒ Tobacco smoke ❒ Other If you are not sure what triggers your asthma, it will help to keep a log of your asthma attacks such as the one below: DATE & TIME OF ATTACK

12/2/2003 2 PM

WHERE WERE YOU?

IN THE BASEMENT AT HOME

WHAT YOU WERE DOING?

GETTING OUT THE DUSTY, DAMP AND COLD HOLIDAY DECORATIONS

C. Limit Exposure to Asthma Triggers: 1. Pets a. Keep pets away from the bedroom b. Keep pets away from carpets or upholstery c. Have pets bathed weekly d. Keep pets outside e. Find new homes for pets 2

SPECIAL DETAILS

2. Cockroaches a. Do not leave food out b. Empty the garbage every night c. Exterminate your home with poison baits or traps rather than chemical agents 3. Mold and Mildew a. Reduce indoor humidity by installing a dehumidifier b. Clean tubs, sinks and showers regularly with a bleach containing cleanser c. Avoid damp places, such as basements d. Clean heating and air conditioning ducts regularly e. Replace worn carpet 4. Dust Mites a. Encase your bed mattress and pillows in an allergen-impermeable cover b. Wash sheets and blankets weekly in hot water c. Avoid feather pillows and down comforters d. Reduce indoor humidity e. Remove carpet from the bedrooms f. Avoid lying down on a carpeted floor or upholstered couch g. Ask someone to vacuum for you or use a dust mask while vacuuming h. Dust with a damp cloth weekly i. Clean curtains and shades often j. For children, minimize the number of stuffed toys and wash the toys weekly in hot water 5. For Pollen a. Limit time spent outdoors during the season in which you have the greatest problem with allergies b. Use air conditioning rather than opening windows c. Stay inside during the midday and afternoon when the pollen count is highest d. Avoid hanging laundry outside to dry 6. For Allergies a. Consider allergy testing b. Ask your physician about special treatment for allergies 7. For Infections a. Ask your physician about an annual flu shot b. Treat cold symptoms and respiratory infections promptly 8. For Cold Air a. Breathe through your nose while outdoors so air is warmed b. Wear a scarf around your face on extremely cold days 9. For Smoke and other Irritants a. Avoid tobacco smoke! b. Limit use of wood-burning stoves and fireplaces c. Avoid strong-smelling products and perfumes 10. Exercise a. If possible, avoid exertion outside when levels of air pollution or pollen counts are high b. Speak to your physician about pre-medication prior to exercise or exertion 11. Aspirin Sensitivity a. Use safe alternative medications in place of aspirin b. Speak to your physician about what over-the-counter medications should be avoided 12. Occupational Exposure a. Be aware of the possibility you may be exposed to asthma triggers in your workplace b. Discuss avoidance, ventilation, respiratory protection and tobacco smoke-free environment with on-site health care providers or managers

4. Metered-Dose Inhalers (MDI’s) METERED-DOSE a. Metered-dose inhalers are a primary means INHALER of delivering asthma medications b. Metered-dose inhalers are devices designed to release a premeasured amount of medication into the air c. They are not all alike, but in general they have a chamber that holds the medication and a propellant that turns the medication into a fine mist d. When properly used, the MDI gets the medication into the airways where it is needed quickly, but when used incorrectly, symptoms may persist and worsen, leading to a severe asthma attack e. Using a spacer attached to the MDI results in better delivery of the medication to airways; the spacer holds the discharged, premeasured cloud of medication mist in a chamber until the patient breathes in. f. How Do I Use a Metered-Dose Inhaler? 1) Before using any MDI, review the product instructions and ask your physician, nurse or pharmacist for help, if needed 2) Remove the cap and look inside to see that nothing is blocking the mouthpiece 3) Hold the inhaler upright with the mouthpiece at the bottom and shake it 4) Attach to the spacer chamber (if you are using one) 5) Tilt your head back slightly and breathe out fully 6) Place the inhaler or chamber mouthpiece between your lips and seal it around the opening 7) Press down on the inhaler to release the medication as you start to breathe in 8) Breathe in slowly and steadily; take 3 - 5 seconds for each breath 9) Hold your breath for 10 seconds to allow the medication to settle in the lungs 10) Breathe out slowly 11) Repeat puffs as prescribed by your physician 12) If a steroid inhaler is used, rinse your mouth after use g. The Future of MDI’s 1) Most MDI’s deliver premeasured doses of medicine to the lungs using the propellant chlorofluorocarbons, or CFCs 2) Too many CFCs can damage the ozone layer around the earth, so the Environmental Protection Agency has given manufacturers several years to develop alternative ways to deliver medications 3) Several innovations are under way: 4) Hydrofluoroalkane (HFA) propellant is environmentally safe; this form of MDI tastes less bitter and comes in a smaller canister size than the CFC MDI’s 5) Dry-powder inhalers (DPI) deliver medication without a propellant • This device releases a fine cloud of dry powder when the patient closes his lips around the mouthpiece and breathes in h. Other Guidelines for Using MDI’s: 1) Using an MDI requires some practice initially 2) Over time, you may find your MDI use less precise • It is recommended that you practice the steps as outlined above every few months to ensure that you are using this device correctly • If you feel the inhaler spray land on your tongue or on the back of your throat, the medication is not reaching your lungs • You may want to practice the steps to improve your timing or demonstrate your technique for your physician 3) A 200-puff canister should last 30 days 4) If you use more than one type of MDI, clearly label each so that you use them as indicated; for example, label inhaled corticosteroid MDI’s as daily and bronchodilators as quick relief treatment 5) Clean spacers often 6) If you have trouble using an MDI, ask your physician for a spacer device 5. Using a Nebulizer a. A nebulizer machine turns medication into a mist, so the mist can be breathed in through a face mask or mouthpiece b. There are many different kinds of nebulizers available, so ask your healthcare provider to show you how your nebulizer works c. Read and follow manufacturer’s instructions d. Add medication to the nebulizer cup as directed NEBULIZER by your physician e. Attach the mouthpiece or mask to the cup with the medicine in it f. Take deep, slow breaths g. Continue until all the medication in the cup is used up h. Rinse or wash the equipment according to manufacturer’s recommendations

MEDICATIONS A. Long-term or maintenance medication prevent asthma attacks 1. Used daily as prescribed even if you feel no symptoms 2. Not used for rescue therapy during an asthma attack 3. Does not help reverse an asthma attack, but can prevent one 4. Inhaled steroids are the mainstay of maintenance care or prevention 5. May also use the following medications for maintenance: a. Long-acting bronchodilators – smooth muscle relaxation b. Most cell stabilizers c. Leukotriene modifiers – pills used to prevent airway inflammation d. Methylxanthines – pill or injection through a vein to counteract bronchospasm and inflammation e. Allergy medications - as a pill or injection B. Short-term or Rescue Therapy 1. Used to treat acute episodes/attacks 2. Work by relaxing the muscle around the airways that tighten during an asthma attack, allowing the air tubes to open 3. Short-acting bronchodilators (3 types) a. Beta2 agonists 1) Preferred rescue therapy 2) Inhaled agent (MDI [see below]or nebulizer treatment) 3) Side effects include rapid heartbeat, anxiety, and tremors b. Anticholinergic agents c. Combination drugs 3

PARTNERING WITH YOUR PHYSICIAN

HELPING A CHILD MANAGE ASTHMA

A. Make an asthma diary (See Taking Control, Page 2) B. Monitor Your Asthma with a Peak Flow Meter 1. A peak flow meter measures how well your PEAK FLOW lungs are able to expel air METER 2. Using one on a regular basis is an effective means of monitoring your asthma 3. Peak flow meters come in many shapes and sizes, but they all work the same way a. Each device consists of a plastic tube, a mouthpiece and a small pointer along a scale b. When you seal your lips around the mouthpiece and exhale, the scale shows the amount of force of the air blown out of the lungs c. This force is measured in liters per minute and is called the Peak Expiratory Flow, abbreviated PEF 4. During an asthma attack, the airways become narrowed, causing symptoms discussed earlier under Physical Changes, Page 1 a. This narrowing does not occur suddenly, but builds up gradually. Your airways may have begun to narrow before you feel any symptoms of asthma b. Monitoring your peak expiratory flow (PEF) can indicate airway narrowing even before you actually feel any symptoms c. The trend of your PEF numbers can indicate an impending problem, allowing you to adjust your asthma medications accordingly to avoid a severe episode 5. A peak flow meter can help both you and your doctor by: a. Showing what makes your asthma worse b. Helping to determine whether a particular treatment plan is working well c. Signaling a need for more or different types of medications to add to your treatment plan d. Setting a peak flow level that indicates emergency care is imperative. 6. Peak flow meters can be used by anyone, including children ages 5 and older; to use your peak flow meter: a. Slide the pointer all the way down to the bottom of the scale b. Stand up and take a deep breath c. Place your lips over the mouthpiece, taking care not to allow any gaps. Do not put your tongue inside the mouthpiece hole d. Blow as quickly and as forcefully as you can in a single blow; the idea is not to see how long you can blow, but rather how fast and hard you can push the air out of your lungs e. Take the meter out of your mouth and record the number next to the pointer f. Repeat steps 1 through 6 for two more blows, recording the highest of the three measurements; record this number in your asthma diary 7. Charting Your Asthma a. When you first start using a peak flow meter, you should take PEF readings at least twice per day at various times and record these numbers b. After 2-3 weeks, look over the numbers and pick out the highest reading c. This number is your personal best peak flow reading and indicates good asthma control d. Once you have found your personal best, your physician can help you set up three “zones;" these zones are based on percentages of your personal best number and can be used as guidelines for managing your asthma 1) Green Zone: More than 80% of your personal best number; this signals good asthma control and that you should take your asthma medications as usual 2) Yellow Zone: 50% - 80% of your personal best; this indicates caution; some airway narrowing is present, so you should take your short-acting quick-relief medication right away to prevent asthma symptoms; ask your doctor if you need to change or increase your daily medications and be especially careful to avoid your asthma triggers 3) Red Zone: Less than 50% of personal best and indicates a medical alert; significant airway narrowing is present, and you must take your quick-relief medication right away and call your physician, or go directly to a local emergency room 4) Remember these are general guidelines; talk to your doctor

A. The key to a normal childhood with asthma is to keep asthma under control. Be aware that you child may feel: 1. Different from other children 2. Embarrassed 3. Depressed 4. Fearful that an asthma episode may get out of control 5. Frustrated 6. Angry B. Help your child feel confident in his ability to keep asthma under control: 1. Help your child prepare for the doctor’s appointment 2. Help your child use the MDI’s, nebulizer, and peak flow meter 3. Watch for changes in your child’s breathing 4. Inform teachers and other responsible adults 5. Make sure medications are available 6. Ask that other children learn about asthma 7. Make an action plan for people who care for your child based upon the 3 asthma zones 8. Help your child develop an exercise plan by encouraging exercise, taking MDI medications in advance, warming up to exercise and breathing through their nose as much as possible 9. Consider sending your child to asthma summer camp 10. Offer praise and love often

80

0

70 0

60 0

50

0

55 0

45 0

30

0

35

20 0

10

75 0

65

0

40 0

0

25 0

0

10 0

50

ZONE

STATUS

Green zone: all clear. Peak flow is from ____ 80% to 100% of (your personal best peak flow reading) to ____ (multiply your personal best times .80)

Doing well: Your asthma is under control

Yellow zone: caution. Peak flow is at 50% - 80%. the peak flow range is from ____ (your personal best multiplied by .80 to ____ (your personal best times .50)

Increase in symptoms: Airways are beginning to narrow; treatment plan may not be working

Red zone: Medical alert. Peak flow is less than 50%. Peak flow is less than ____ (your personal best times .50)

Danger: No improvement or increasing symptoms

THE CONNECTION BETWEEN ASTHMA AND ALLERGIES A. Long regarded as trivial, people are beginning to realize that allergies are serious disorders that may trigger sneezing, wheezing, coughing and itching B. Allergies may also be linked to serious chronic respiratory illnesses, including asthma C. Allergies reflect an overreaction of the immune system to substances D. However, like asthma, allergies can be managed to minimize the effect on your life E. When asthma is diagnosed, it may be important to determine if you also have allergies F. Treating asthma without treating underlying allergies may not result in optimal health

FYI:

SOME VALUABLE SOURCES OF INFORMATION AND SUPPORT:

3. Asthma and Allergy Foundation of America 1233 20th St.NW, Suite 402 Washington, DC 20036 1-800-7-ASTHMA (1-800-727-8462) 2. American Lung Association http://www.aafa.org 1-800-LUNG-USA E-mail address: [email protected] (1-800-586-4872) http://www.lungusa.org

1. National Asthma Education and Prevention Program NHLBI Information1 Center P.O.Box 30105 Bethesda, MD 20824-0105 http://www.nhlbi.nih.gov

U.S.$4.95 / CAN.$7.50

ACTION

CREDITS Author: : Jody J. Grahn, MSN, APRN, BS Layout: Jim Ashley

Avoid asthma triggers Continue on currently prescribed therapy

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Remember that these are general guidelines, so talk to your doctor. Together you can work as a team to keep your asthma under control

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Adjust your therapy and activities as indicated in personal asthma management plan; take action promptly before a severe attack occurs Call your doctor or go to the nearest emergency room. If you have difficulty walking & talking due to shortness of breath or if your lips or fingernails are blue, call 911 immediately

DISCLAIMER: Always consult your doctor or therapist with any concerns or problems with your condition. This guide is intended only for informational purposes and helpful hints. In no way is this chart meant to be a substitute for professional medical care. Neither BarCharts®, nor its writers, designers or editing staff, are in any way responsible or liable for the use or misuse of the information contained in this guide. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2003 BarCharts Inc. Boca Raton, FL. 0608

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WORLD’S #1 ACADEMIC OUTLINE

BIOCHEMICAL PERIODIC TABLE 1

Key Elements in the Body

H

1. 3. 6. 7. 8. 9. 11. 12. 13. 14.

Hydrogen

3

Li Lithium

11

12

Na

Mg

Sodium

Magnesium

19

20

Hydrogen Lithium Carbon Nitrogen Oxygen Fluorine Sodium Magnesium Aluminum Silicon

22

15. 16. 17. 19. 20. 22. 25. 26. 27. 28.

Phosphorus Sulphur Chlorine Potassium Calcium Titanium Manganese Iron Cobalt Nickel

25

26

29. 30. 32. 33. 34. 35. 50. 53.

Copper Zinc Germanium Arsenic Selenium Bromine Tin Iodine

27

28

6

13

29

7

8

9

C

N

O

F

Carbon

Nitrogen

Oxygen

Fluorine

14

15

16

17

Al

Si

P

S

Cl

Aluminum

Silicon

Phosphorus

Sulfur

Chlorine

30

32

33

34

K

Ca

Ti

Mn

Fe

Co

Ni

Cu

Zn

Ge

As

Se

Potassium

Calcium

Titanium

Manganese

Iron

Cobalt

Nickel

Copper

Zinc

Germanium

Arsenic

Selenium

50

GLUCOSE

35

Br Bromine

53

Sn

I

Tin

Iodine

BROADER CHEMICAL PRINCIPLES 2. Hydrophilic = Lipophobic: Affinity for polar Energy = 1 q1.q2 group; soluble in water, repelled by nonpolar 1. Electrostatic: Strong ε r12 Examples: alcohol, amine, carboxylic acid interaction between ions; for 3. Amphipatic: Polar and nonpolar functionality; charges q1 and q2; separated by r12, Polarizability common for most biochemical molecules: fatty R and solvent dielectric constant, ε ; δacids, amino acids and nucleotides C O water has large ε; stabilizes C. Behavior of Solutions R zwitterion formation 1. Miscible: 2 or more substances form 1 phase; α: Measures 2. Polarizability, R-Oδoccurs for polar + polar or non-polar + non-polar distortion of electron cloud by other H 2. Immiscible: 2 liquids form aqueous and organic R nuclei and electrons layers; compounds are partitioned between the δN R 3. Dipole moment, µ : Asymmetric layers based on chemical properties (acid/base, R electron distribution gives partial polar, nonpolar, ionic) charge to atoms 3. Physical principles: Dipole 4. London forces (dispersion): Interaction a.Colligative properties depend on solvent identity and concentration of solute; a solution has a higher Attraction due to induced dipole + - + boiling point, lower freezing point and lower vapor moments; force increases with µ pressure than the pure solvent 5. Dipole-dipole interaction: The stable b.Biochemical example: Osmotic pressure - Water positive end of one dipole is attracted diffuses through a semi-permeable membrane from a + - - + to the negative end of another dipole; hypotonic to a hypertonic region; the flow produces strength increases with µ less stable a force, the osmotic pressure, on the hypertonic side 6. Hydrogen bonding: Enhanced Osmotic Pressure dipole interaction Hydrogen Bonding Π = iMRT between bonded H and Π: Osmotic pressure (in atm) δN the lone-pair of i: Van’t Hoff factor = # of ions per solute molecule Hδ+ H H neighboring O, N or S; M: Solution molarity (moles/L) Ammonia R: Gas constant = 0.082 L atm mol–1 K–1 gives “structure” to T: Absolute temperature (in Kelvin) liquid water; solubilizes δR O alcohols, fatty acids, 4. Solutions of gases Hδ+ Oδ- ... Hδ+ amines, sugars, and Water a.Henry’s Law: The amount of gas dissolved in a Hδ+ Alcohol liquid is proportional to the partial pressure of the gas amino acids

A.Intermolecular Forces H O

H C

H

C

DNA

TRIGLYCERIDE H H C H H H

H

C H

H H C

H C C H H H

C

C

H C

H H

H

H C

H C C

H C H

H

H

C

H

H

C

H

C

H

H

H

H

H C

H

H

H

H C

C H

H C H C H

H

C

H H H

C H H O C H H C H H C C H O H C C H C O C H C H H H H H C H H H C H O C C H C H H C C C O H H H O H C

H

H

H

C

H

H

B. Types of Chemical Groups

δN R

R

R

1. Hydrophobic = Amine Lipophilic: Repelled by polar group; insoluble in water; affinity for non-polar Examples: alkane, arene, alkene

b.Carbon dioxide dissolves in water to form carbonic acid c.Oxygen is carried by hemoglobin in the blood d.Pollutants and toxins dissolve in bodily fluids; react with tissue and interfere with reactions Examples: Sulfur oxides and nitrogen oxides yield acids; ozone oxidizes lung tissue; hydrogen cyanide disables the oxidation of glucose

BONDS & STRUCTURE IN ORGANIC COMPOUNDS

REACTIONS, ENERGY & EQUILIBRIUM A.Mechanisms Resonance

1. Most bonds are polar covalent; the more O O electronegative atom is the “–” end of the bond C C <=> Example: For >C=O, O is negative, C is positive N N+ 2. Simplest Model: Lewis Structure: Assign valence electrons as bonding electrons and nonbonding lone-pairs; more accurate bonding models include valencebonds, molecular orbitals and molecular modeling 3. Resonance: The average of several Lewis structures describes the bonding Example: The peptide bond has some >C=N< character

B. Molecular Structure Typical Behavior of C, N & O Atom C4

e–

4 bonds

N 5 e – 3 bonds, 1 lone pair O6

e–

2 bonds, 2 lone pairs

sp3

sp2

sp

-C-C-

>C=C<

-C≡C-

>N-

R=N-

-C≡N

-O-

>R=O

R

C

R

a.Isomers: same formula, different bonds H OH C b.Stereoisomers: same formula and bonds, H OH C different spatial arrangement c.Chiral = optically active: Produces + or – H rotation of plane-polarized light d.D: Denotes dextrorotary based on clockwise D(+) - Glyceraldehyde rotation for glyceraldehyde e.L: Denotes levorotary based on counter-clockwise O H rotation for glyceraldehyde; insert (–) or (+) to C denote actual polarimeter results HO H C f. D/L denotes structural similarity with D or L glyceraldehyde H OH C g.Chiral: Not identical with mirror image h.Achiral: Has a plane of symmetry H i. Racemic: 50/50 mixture of stereoisomers is L(–) - Glyceraldehyde optically inactive; + and – effects cancel j. R/S notation: The four groups attached to the chiral atom are ranked a,b,c,d by CH3 CH3 molar mass Br H Br H C •The lowest (d) is directed away from = the viewer and the sequence of a-b-c C Br produces clockwise (R) or counter- H Br H clockwise (S) configurations CH 3 CH3 •This notation is less ambiguous than ThreeFischer D/L; works for molecules with >1 dimensional projection chiral centers k.Nomenclature: Use D/L (or R/S) and +/– in the compound name: Example: D (–) lactic acid l. Fisher-projection: Diagram for chiral compound m.Molecular conformation: All Alkene molecules exhibit structural variation H H H Me due to free rotation about C-C single C C C C bond; depict using a NewmanH Me Me Me diagram Cis Trans n.Alkene: cis and trans isomers; >C=C< does not rotate; common in Chain Positions fatty acid side chains C δ

C γ

C β

R C α

C

C

C

1. Saturated: Maximum # of Hs (all C-C) γ β δ 2. Unsaturated: At least one >C=C< 3. Nucleophile: Lewis base; attracted to the + charge of a nucleus or cation 4. Electrophile: Lewis acid; attracted to the electrons in a bond or lone pair Carbon-chain Prefixes

1 2 3 4 5 6

methethpropbutpenthex-

7 8 9 10 11 12

heptoctnondecundecdodec-

13 14 15 16 17 18

tridectetradecpentadechexadecheptadecoctadec-

19 20 22 24 26 28

P ∆H

O

H

nonadeceicosdocostetracoshexacosoctacos-

Exothermic

Endothermic

Ea

1. Geometries of valence electron hybrids: sp2 - planar, sp3 - tetrahedral, sp - linear 2. Isomers and structure

C. Common Organic Terminology

1. Biochemical reactions involve a number of simple steps that together form a mechanism 2. Some steps may establish equilibria, since reactions can go forward, as well as backward; the slowest step in the mechanism, the rate-determining step, limits the overall reaction rate and product formation 3. Each step passes through an energy barrier, the free energy of activation (Ea), characterized by an unstable configuration termed the transition state (TS); Ea has an enthalpy and entropy component Potential energy

A.Bonding Principles

of

1. ∆G = Σ prod ∆G0f – Σ react ∆G0f 2. For coupled reactions: Hess’s Law: 3. Combine reactions, add ∆G, ∆H, ∆S 4. An exergonic step can overcome an endergonic step Example: ATP/ADT/AMP reactions are exothermic and exergonic; these provide the energy and driving force to complete less spontaneous biochemical reactions; Example: ATP + H2O => ADP + energy 1. LeChatlier’s Principle

Ea R

Reactants Reaction progress Products

D. Standard-Free Energy Formation, ∆G0f :

E. Equilibrium

Transition state

∆H

∆G > 0 endergonic not spontaneous small Keq ∆G = –RT ln(Keq) – connection with equilibrium

P P

B. Key Thermodynamic Variables 1. Standard conditions: 25ºC, 1 atm, solutions = 1 M 2. Enthalpy (H): ∆H = heat-absorbed or produced ∆H < 0 exothermic ∆H > 0 endothermic

C. Standard Enthalpy of Formation, ∆H0f 0 0 1. ∆H = Σ prod ∆Hf – Σ react ∆Hf 2. Entropy (S): ∆S = change in disorder 3. Standard Entropy, S0: ∆S = Σ prod S0 – Σ react S0 4. Gibbs-Free Energy (G):

∆G = ∆H – T∆S; the capacity to complete a reaction ∆G = 0 at equilibrium Keq = 1 steady state ∆G < 0 exergonic large Keq spontaneous

a.Equilibrium shifts to relieve the stress due to changes in reaction conditions b.Keq increases: Shift equilibrium to the product side c.Keq decreases: Shift equilibrium to the reactant side

2. Equilibrium changes

and

temperature

a.For an exothermic process, heat is a product; a decrease in temperature increases Keq b.For an endothermic process, heat is a reactant; an increase in temperature increases Keq

3. Entropy and Enthalpy factors ∆G = ∆H – T∆S a.∆H < 0 promotes spontaneity b.∆S > 0 promotes spontaneity c.If ∆S > 0, increasing T promotes spontaneity d.If ∆S < 0, decreasing T lessens spontaneity Note: T is always in Kelvin; K = ºC + 273.15

KINETICS: RATES OF REACTIONS A.Determination of Rate For a generic reaction, A + B => C: 1. Reaction rate: The rate of producing C (or consuming A or B) 2. Rate-law: The mathematical dependence of the rate on [A], [B] and [C] 3. Multiple-step reaction: Focus on rate-determining step - the slowest step in the mechanism controls the overall rate

B. Simple Kinetics 1. First-order: Rate = k1[A] Examples: SN1, E1, aldose rearrangements 2. Second order: Rate = k2[A]2 or k2[A][B] Examples: SN2, E2, acid-base, hydrolysis, condensation

C. Enzyme Kinetics 1. An enzyme catalyzes the reaction of a substrate to a product by forming a 2

stabilized complex; the enzyme reaction may be 103-1015 times faster than the uncatalyzed process 2. Mechanism: Step 1. E + S = k1 => ES Step 2. ES = k2 => E + S Step 3. ES = k3 => products + E [E] = total enzyme concentration, [S] = total substrate concentration, [ES] = enzyme-substrate complex concentration, k 1 - rate ES formation, k2 - reverse of step 1, k3 - rate of product formation

3. Data analysis: Michaelis-Menten Examine steady Equation: state of [ES]; rate Vmax [S] of ES formation v = K + [S] m equal rate of disappearance Km = (k2 + k3)/k1 (Michaelis constant) v – reaction speed = k3[ES] Vmax = k3 [E]

4. Practical solution: Lineweaver-Burk approach:

1 v 1

Vmax 1/v=Km/Vmax(1/[S])+1/Vmax The plot “1/v vs. 1/[S]” is 1 Km linear slope = V Km max Slope = Km /Vmax , 1 [s] y - intercept = 1/Vmax Lineweaver-Burke x - intercept = –1/Km Calculate Km from the data

D. Changing Rate Constant (k) 1. Temperature increases the rate constant: Arrhenius Law: k = Ae–Ea/RT • Determining Ea: Graph “ln(k) vs. 1/T”; calculate Ea from the slope

2. Catalyst: Lowers the activation energy; reaction occurs at a lower temperature 3. Enzymes a. Natural protein catalysts; form substrate-enzyme complex that creates a lower energy path to the product b.In addition, the enzyme decreases the Free Energy of Activation, allowing the product to more easily form c.Enzyme mechanism is very specific and selective; the ES complex is viewed as an “induced fit” lock-key model since the formation of the complex modifies each component Enzyme + Substrate

Enzyme/Substrate complex

Enzyme + Product

ORGANIC ACIDS & BASES Arrhenius

E+S

Base

aqueous H3O+

aqueous OH–

proton donor

Brønsted-Lowry

E/S complex

Enzyme E+P

E. Energetic Features of Cellular Processes 1. Metabolism: The cellular processes that use nutrients to produce energy and chemicals needed by the organism a. Catabolism: Reactions which break molecules apart; these processes tend to be exergonic and oxidative b.Anabolism: Reactions which assemble larger molecules; biosynthesis; these processes tend to be endergonic and reductive

2. Anabolism is coupled with catabolism by ATP, NADPH and related high-energy chemicals 3. Limitations on biochemical reactions a.All required chemicals must either be in the diet or be made by the body from chemicals in the diet; harmful waste products must be detoxified or excreted b.Cyclic processes are common, since all reagents must be made from chemicals in the body c.Temperature is fixed; activation energy and enthalpy changes cannot be too large; enzyme catalysts play key roles

MAJOR TYPES OF BIOCHEMICAL REACTIONS

D. Buffers

1. A substance that can react as an acid or a base 2. The molecule has acid and base functional groups; Example: amino acids 3. This characteristic also allows amphoteric compounds to function as OH single-component buffers for O P OH biological studies

B. Acids

OH

1. Ka= [A–][H+]/[HA] Phosphoric acid pKa = –log10(Ka) 2. Strong acid: Full dissociation: HCl, H2SO4 and HNO3: Phosphoric acid 3. Weak acid: Ka << 1, large pKa 4. Key organic acid: RCOOH Examples: Fatty acid: R group is a long hydrocarbon chain; Vitamin C is abscorbic acid; nucleic acids contain acid phosphate groups Acid Acetic

pKa 4.75

Acid Formic

pKa 3.75

Carbonic

6.35

Bicarbonate

10.33

H2PO4–

7.21

HPO42–

12.32

H3PO4

2.16

NH4+

9.25

C. Organic Bases

H C 4

N3 HC

2 1

Common Buffers Buffer composition

approx. pH 4.8

ammonia + ammonium salt

9.3

carbonate + bicarbonate

6.3

diacid phosphate + monoacid phosphate

7.2 COOH

E. Amino Acids

1. Amino acids have amine (base) H2N C H and carboxylic acid functionality; R the varied chemistry arises from the chemical nature of the R- group L Amino acid • Essential amino acids: Must be provided to mammals in the diet

2. Polymers of amino acids form proteins and peptides

COO +

• Natural amino acids adopt the L H3N configuration

3. Zwitterion; self-ionization; the “acid” donates a proton to the “base”

ethane C2H6, methyl (Me) -CH3, ethyl (Et) -C2H5

Addition Nucleophilic: Electrophilic:

Add to a >C=C< Nucleophile attacks >C=O

Hydrogenate Hydrate Hydroxylate

Alkene

>C=C<

ethene C2H4, unsaturated fatty acids

Aromatic ring

-C6H5

benzene - C6H6, phenylalanine

Substitution Nucleophilic:

Replace a group on alkane (OH, NH2) SN1 or SN2

Amination of R-OH deamination

Alcohol

R-OH

methanol Me-OH, diol = glycol (2 -OH), glycerol ( 3 -OH)

Ether

R”-O-R’

ethoxyethane Et-O-Et, or diethyl ether

Elimination: E1 and E2

Reverse of addition, produce >C=C<

Dehydrogenate Dehydrate

Aldehyde

O R-C-H

methanal H2CO or formaldehyde, aldose sugars

Isomerization

Change in bond connectivity

aldose => pyranose

Ketone

O R-C-R’

Me-CO-Me 2-propanone or acetone ketose sugars

Oxidationloss of eReductiongain of eCoupled Processes

Biochemical: Oxidize: ROH to >C=O Add O or remove H Hydrogenate Reduce: Reverse of fatty acid oxidize Metals: Change valence

Carboxylic acid

O RC-OH

Me-COOH ethanoic acid or acetic acid Me-COO- Acetate ion

Ester

O RC-OR’

Me-CO-OEth, ethyl acetate, Lactone: cyclic ester, Triglycerides

Amine

N-RR’R”

H3C-NH2, methyl amine, R-NH2 (1º) - primary, RR'NH (2º) - secondary, RR'R"N (3º) - tertiary

Hydrolysis

Water breaks a bond, add -H and -OH to form new molecules

Hydrolyze peptide, sucrose triglyceride

Amide

O R-C-NRR'

H3C-CO-NH2, acetamide Peptide bonds

R-NH or R-OH combine via bridging O or N

Form peptide or amylose

Condensation

Cyclic Ethers: O

O

Pyran

Furan

3

H

R

• Isoelectric point, pI: pH that produces balanced charges in the Zwitterion

Examples C

C

Zwitterion

TYPES OF ORGANIC COMPOUNDS

C

CH

Pyrimidine

acetic acid + acetate salt

H

Alkane

6

N

Henderson Hasselbalch Equation: pH = pKa + log (salt/acid)

C 1. Kb=[OH–][B+]/[BOH] N 7 N1 6 5 C pKb = –log10(Kb) 8 CH 2. Strong base: Full HC 2 3 4 C 9 N dissociation: NaOH, KOH N H 3. Weak base: Kb << 1, Purine large pKb 4. Organic: Amines & derivatives Examples: NH3 (pKb = 4.74), hydroxylamine (pKb =7.97) and pyridine (pKb = 5.25) 5. Purine: Nucleic acid component: adenine (6-aminopurine) & guanine (2-amino-6-hydroxypurine)

Type of Compound

5 CH

1. A combination of a weak acid and salt of a weak acid; equilibrium between an acid and a base that can shift to consume excess acid or base 2. Buffer can also be made from a weak base and salt of weak base 3. The pH of a buffer is roughly equal to the pKa of the acid, or pKb of the base, for comparable amounts of acid/salt or base/salt 4. Buffer pH is approximated by the Henderson Hasselbalch equation Note: This is for an acid/salt buffer

A.Amphoteric

Common Acids & pKa Enzyme

6. Pyrimidine: Nucleic acid component: cytosine (4-amino2-hydroxypyrimidine), uracil (2,4-dihydroxypyrimidine) & thymine (5-methyluracil)

proton acceptor

electron-pr acceptor electron-pr donor electrophile nucleophile

Lewis

Active site

Enzyme

Acid

BIOCHEMICAL COMPOUNDS e.Disaccharides Disaccharide M-OH + M-OH → M-O-M Common • 2 units • Lactose (β-galactose + β-glucose) β (1,4) link Name •Sucrose (α-glucose + β-fructose) α, β (1,2) link Acetic acid • Maltose (α-glucose + α-glucose) α (1,4) link

A.Carbohydrates: Polymers of Monosaccharides 1. Carbohydrates have the general formula (CH2O)n 2. Monosaccharides: Simple sugars; building blocks for polysaccharides Common Sugars

CH2OH

Triose

3 carbon

glyceraldehyde

Pentose

5 carbon

ribose, deoxyribose

Hexose

6 carbon

glucose, galactose, fructose

H

HO

a.Aldose: Aldehyde CHO CH2OH type structure: H C OH C O H-CO-R HO C H HO C H b.Ketose: Ketone type H C OH H C OH structure: R-CO-R H C OH H C OH c.Ribose and CH2OH CH2OH deoxyribose: Aldose Ketose Key component in D Glucose D Fructose nucleic acids and ATP CH2OH

CH2OH

O

O H

H

H

H

H

OH

OH

H

OH

Ribose

H

H

OH

H

OH

Deoxyribose

d.Monosaccharides cyclize to ring structures in water • 5-member ring: Furanose (ala furan) •6-member ring: Pyranose (ala pyran) • The ring closing creates two possible structures: α and β forms •The carbonyl carbon becomes another chiral center (termed anomeric) •α: -OH on #1 below the ring; β: OH on #1 above the ring •Haworth figures and Fischer projections are used to depict these structures (see figure for glucose below) Haworth Figure

Fischer Projection H

C

OH

H

C

OH

HO

C

H

H

C

OH

H

C

6 CH OH 2 5

H O

O H

H

1

4

HO

OH 3

H

H

OH

2

OH

CH2OH

α-D-Glucopyronose

2.Polysaccharides a.Glucose and fructose form polysaccharides b.Monosaccharides in the pyranose and furanose forms are linked to from polysaccharides; dehydration reaction creates a bridging oxygen c.Free anomeric carbon reacts with -OH on opposite side of the ring d.Notation specifies form of monosaccharide and the location of the linkage; termed a glycosidic bond

CH2OH O

O H

H

H OH

H

H

OH

O

H

H OH

H

H

OH

OH

Maltose - Linked α D Glucopyronose

f. Oligosaccharides • 2-10 units • May be linked to proteins (glycoproteins) or fats (glycolipids) •Examples of functions: cellular structure, enzymes, hormones g.Polysaccharides • >10 units Examples: - Starch: Produced by plans for storage

Common Fatty Acids Systematic

Formula

ethanoic

CH3COOH

Butyric

butanoic

C3H7COOH

Valeric

pentanoic

C4H9COOH

Myristic

tetradecanoic

C13H27COOH

Palmitic

hexadecanoic

C15H31COOH

Stearic

octadecanoic

C17H35COOH

Oleic

cis-9-octadecenoic

C17H33COOH

Linoleic

cis, cis-9, 12 octadecadienoic

C17H31COOH

Linolenic

9, 12, 15octadecatrienoic (all cis)

C17H29COOH

Arachidonic 5, 8, 11, 14C19H31COOH eicosatetranoic (all trans) OH

O

OH

O

C

C

- Amylose: Unbranched polymer of α (1,4) linked glucose; forms compact helices - Amylpectin: Branched α (1,6) linkage

amylose

using

- Glycogen: Used by animals for storage; highly branched polymer of α (1,4) linked glucose; branches use α (1,6) linkage - Cellulose: Structural role in plant cell wall; polymer of β (1,4) linked glucose - Chitin: Structural role in animals; polymer of β (1,4) linked N-acetylglucoamine

3. Carbohydrate Reactions a.Form polysaccharide via condensation b.Form glycoside: Pyranose or furanose + alcohol c.Hydrolysis of polysaccharide d.Linear forms are reducing agents; the aldehyde can be oxidized e.Terminal -CH2-OH can be oxidized to carboxylic acid (uronic acid) f. Cyclize acidic sugar to a lactone (cyclic ester) g.Phosphorylation: Phosphate ester of ribose in nucleotides h.Amination: Amino replaces hydroxyl to form amino sugars i. Replace hydroxyl with hydrogen to form deoxy sugars (deoxyribose)

Saturated Stearic Acid

4. Common fatty acid compounds a.Triglyceride or triacylglycerol: Three fatty acids bond via ester linkage to glycerol A b.Phospholipids: phosphate group bonds to one of three positions R-PO4 or HPO4 group

1. Lipid: Non-polar compound, R insoluble in water C O Examples: steroids, fatty acids, HO triglycerides 2. Fatty acid: R-COOH Essential fatty acids cannot be synthesized by the body: linoleic, linolenic and arachidonic 3. Properties and structure of fatty acids: a.Saturated: Side chain is an alkane b.Unsaturated: Side chain has at least one >C=C<; the name must include the position # and denote cis or trans isomer c.Solubility in water: <6 C soluble, >7 insoluble; form micelles d.Melting points: Saturated fats have higher melting points; cis- unsaturated have lower melting points 4

R1

CO

O

CH2

R2

CO

O

CH

CO

O

CH2

R3

Triglyceride

of fatty acid/glycerol;

5. Examples of other lipids a.Steroids: Cholesterol and hormones Examples: testosterone, estrogen R''

R = Nearly always methyl R' = Usually methyl R'' = Various groups 1

11

R H

8

5 4

H

17

13

16

14

15

9

10

3

R

12

2

Fatty Acid

B. Fats and Lipids

Unsaturated Oleic Acid

H

H

7 6

Generic Steroid

b.Fat-soluble vitamins: • Vitamin A: polyunsaturated hydrocarbon, all trans • Vitamins D, E, K

6. Lipid reactions

3 Fatty Acids + Glycerol

HO CH2 a.Tr i g ly c e r i d e : R1 CO OH T h r e e - s t e p R2 CO OH HO CH p r o c e s s : R3 CO OH HO CH2 dehydration reaction of fatty acid and glycerol b.The reverse of this reaction is hydrolysis of the triglyceride c.Phosphorylation: Fatty acid + acid phosphate produces phospholipid d.Lipase (enzyme) breaks the ester linkage of triglyceride

BIOCHEMICAL COMPOUNDS continued

C. Proteins and Peptides - Amino Acid Polymers R2 O

d.Quaternary structure: The conformation of protein subunits in an oligomer

H

6. Chemical reactions of proteins:

1. Pe p t i d e s a r e N C H C OH formed by H COOH linking amino H2N C H + R1 acids; all 2 Amino acids natural peptides contain L-amino acids

a.Synthesis of proteins by DNA and RNA b.Peptides are dismantled by a hydrolysis reaction breaking the peptide bond c.Denaturation: The protein structure is disrupted, destroying the unique chemical features of the material d.Agents of denaturation: Temperature, acid, base, chemical reaction, physical disturbance

a.Dipeptide: Two linked amino acids b.Polypeptide: Numerous linked amino acids c.The peptide bond is R2 H the linkage that O N C H connects a pair of C amino acids using a COOH dehydration reaction; H2N C H the N-H of one amino R1 Dipeptide acid reacting with the OH of another => -N- bridge d.The dehydration reaction links the two units; each amino acid retains a reactive site

7. Enzymes a.Enzymes are proteins that function as biological catalysts b.Nomenclature: Substrate + - ase Example: The enzyme that acts on phosphoryl groups (R-PO4) is called phosphatase

8. Enzymes are highly selective for specific reactions and substrates

2. The nature of the peptide varies with amino acids since each R- group has a distinct chemical character a.R- groups end up on alternating sides of the polymer chain b.Of the 20 common amino acids: 15 have neutral side chains (7 polar, 8 hydrophobic), 2 acidic and 3 basic; the variation in R- explains the diversity of peptide chemistry (see table, pg. 6)

3. Proteins are polypeptides made up of hundreds of amino acids a.Each serves a specific function in the organism b.The structure is determined by the interactions of various amino acids with water, other molecules in the cell and other amino acids in the protein

4. Types of proteins: a.Fibrous: Composed of regular, repeating helices or sheets; typically serve a structural function Examples: keratin, collagen, silk b.Globular: Tend to be compact, roughly spherical; participates in a specific process: Examples: enzyme, globin c.Oligomer: Protein containing several subunit proteins Examples fibrinogen hemoglobin

Common Mol Wt 450,000 68,000

insulin ribonuclease trypsin

5,500 13,700 23,800

Protein Function Physical structures Binds O2 Glucose metabolism Hydrolysis of RNA Protein digestion

5. Peptide Structure: a.Primary structure: Primary Structure Ala-Ala-Cys-Leu The linear sequence of amino acids connected by peptide bonds • Ala-Ala-Cys-Leu or A-A-C-L denotes a peptide formed from 2 alanines, a cysteine and 1 leucine •The order is important since this denotes the connectivity of the amino acids in the protein b.Secondary structure: Describes how the polymer takes shape Example: Helix or pleated sheet •Factors: H-bonding, hydrophobic interactions, disulfide bridges (cysteine), ionic interactions c.Tertiary structure: The overall 3-dimensional conformation

1.

2. 3. 4. 5. 6.

Six Classes of Enzymes (Enzyme Commission) Type Reaction Oxidoreductase Oxidation-reduction Examples: oxidize CH-OH, >C=O or CH-CH; Oxygen acceptors: NAD, NADP Tranferase Functional group transfer Examples: transfer methyl, acyl- or amine group Hydrolase Hydrolysis reaction Examples: cleave carboxylic or phosphoric ester Lysase Addition reaction Examples: add to >C=C<, >C=O, aldehyde Isomerase Isomerization Example: modify carbohydrate, cis-trans fat Ligase Bond formation, via ATP Examples: form C-O, C-S or C-C

9. An enzyme may require a cofactor Examples: Metal cations (Mg 2+, Zn 2+ or Cu 2+); vitamins (called coenzymes) 10. Inhibition: An interference with the enzyme structure or ES formation will inhibit or block the reaction 11. Holoenzyme: Fully functional enzyme plus the cofactors 12. Apoenzyme: The polypeptide component

D. Nucleic Acids: Polymers of Nucleotides 1. Nucleotide: A phosphate group and organic base (pyrimidine or purine) attached to a sugar (ribose or deoxyribose) • Name derived from the base name •Example: Adenylic acid = adenosine-5’monophosphate = 5’ AMP or AMP

2. Nucleoside: The base attached to the sugar •Nomenclature: Base name + idine (pyrimidine) or + osine (purine) •Example: adenine riboside = adenosine; adenine deoxyriboside = deoxyadenosine Nucleic Acid Components

3. Cyclic nucleotides: The Phosphate phosphate group attached to Sugar Base the 3’ position bonds to the Nucleotide 5’ carbon 3’, 5’ cyclic AMP = cAMP and cGMP 4. Additional Phosphates a.A nucleotide can bond to 1 or 2 additional phosphate groups b.AMP + P => ADP - Adenosine diphosphate ADP + P => ATP - Adenosine triphosphate c.ADP and ATP function as key biochemical energy-storage compounds

5. Glycosidic bond: Linkage between the sugar and base involve the anomeric carbon (carbon #1) >C-OH (sugar) + >NH (base) => linked sugar - base 6. Linking Nucleotides: The B polymer forms as each S phosphate links two sugars; #5 P position of first sugar and #3 S B position of neighboring sugar P 7. Types of nucleic acids: S Double - stranded D NA B (deoxyribonucleic acid) and Linking R NA Nucleotides single - stranded (ribonucleic acid) 8. Components of a nucleotide: sugar, base and phosphate a.Sugar: ribose (RNA) or deoxyribose (DNA) b.Bases: purine (adenine and guanine) and pyrimidine (cytosine, uracil (RNA) and thymine (DNA))

9. In DNA, the polymer strands pair to form a double helix; this process is tied to base pairing 10. Chargaff’s Rule for DNA: a.Adenine pairs with thymine P (A: T) and guanine pairs with cytosine (C: G) b.Hydrogen bonds connect the base pairs and supports the helix c.The sequence of base pairs along the DNA strands serves as genetic

information

for

P S-T...A-S P P S-C...G-S P P S-G...C-S P P Chargaff’s Rule

reproduction and cellular control

11. DNA vs RNA: DNA uses deoxyribose, RNA uses ribose; DNA uses the pyrimidine thymine, RNA uses uracil 12. Role of DNA & RNA in protein synthesis a.DNA remains in the nucleus b.Messenger-RNA (m-RNA): Enters the nucleus and copies a three-base sequence from DNA, termed a codon. m-RNA then passes from the nucleus into the cell and directs the synthesis of a required protein on a ribosome c.Transfer-RNA (t-RNA): Carries a specific

Base

Nucleoside

Nucleotide

adenine

Adenosine Deoxyadenosine

Adenylic acid, AMP dAMP

guanine

Guanasine Deoxyguanisine

Guanylic acid, GMP dGMP

cytosine

Cytidine Deoxycytidine

Cytidylic acid, CMP dCMP

uracil

Uridine

Uridylic acid, UMP

RNA, oriented by m-RNA and r-RNA, then

thymine

Thymidine

Thymidylic acid, dTMP

chemically connected by enzymes

5

amino acid to the ribosomal-RNA (r-RNA) and aligns with the m-RNA codon d.Each codon specifies an amino acid, STOP or START; a protein is synthesized as different amino-acids are delivered to the ribosome by t-

COMMON AMINO ACIDS hydrophobic = yellow, basic = blue, acidic = red, polar = green Amino acid MW essential - e

pKa pKb

pI R-pKa

-R

Alanine 89.09

Ala A

2.33 9.71

6.00

hydrophobic

Arginine e 174.20

Arg R

2.03 9.00

10.76 12.10

basic

Asn N 2.16 8.73

5.41

NH CH2 CH2 CH2

polar

O H2N

Aspartate 133.10

Asp D 1.95 9.66

Cysteine 121.16

Cys C

Glutamate 147.13

Glu E

Glutamine 146.15

Gln Q

2.77 3.71

acidic

1.91 5.07 10.28 8.14

polar

2.16 9.58

3.22 4.15

acidic

2.18 9.00

5.65

polar

Histidine e 155.16 Isoleucine e 131.18

Gly G His H

Ile I

2.34 9.58 1.70 9.09 2.26 9.60

5.97 7.59 6.04 6.02

C

HOOC

HOOC

CH2 CH2

Leu L

2.32 9.58

Lysine e 146.19

Lys K

2.15 9.16

Methionine e 149.21

Met M 2.16 9.08

5.98

CH2

CH2

CH2 NH

N

hydrophobic

CH3

CH2

CH2 CH2

HC CH3

hydrophobic

CH2

CH3 S

Phenylalanine Phe F e 165.19

2.18 9.09

Proline 115.13

1.95 6.30 10.47

Pro P

hydrophobic CH3

5.74

5.48

CH2

CH2

CH2

CH2

hydrophobic CH2

CH2

H C

CH2

Ser S

2.13 9.05

5.68

polar

Threonine e 119.12

Thr T

2.20 8.96

5.60

polar

N H

COOH

HO

CH2

CH3

CH OH

Tryptophan e 204.23

Trp W 2.38 9.34

Tyrosine 181.19

Tyr Y

Valine - e 117.15

Val V

5.89

hydrophobic

CH2 N H

2.24 9.04

5.66 10.10

polar

2.27 9.52

5.96

hydrophobic

M

adenine - purine base

HO

• Leu UUA UUG CUU CUC CUA CUG • Ala GCU GCC GCA GCG

C6H6

CH2

CH3 HC CH3

m

milli (10-3)

ADP

adenosine diphosphate

Man

mannose sugar

AMP adenosine monophosphate Met

aa methionine

Arg

aa arginine

mL

milliliter

Asn

aa asparagine

mm

millimeter

Asp

aa aspartate

N

atm

atmosphere

Avogadro’s number

(pressure unit)

elemental nitrogen

• Met START AUG • STOP UAA UAG UGA

adenosine triphosphate

n

nano (10-9)

C

aa cysteine

O

orotidine

cytosine - pyrimidine

elemental oxygen P

aa proline

calorie

phosphate group

Cys

aa cysteine

elemental phosphorous

D

aa aspartate

DNA deoxyribonucleic acid dRib

2-deoxyribose sugar

E

aa glutamate

F

aa phenylalanine

Fru

fructose sugar

G

aa glycine

• Val GUU GUC GUA GUG

Gal

galactose sugar

Glc

glucose sugar

Glu

aa glutamate

• His CAU CAC

H

aa histidine

h

hour

aa histidine

I

aa isoleucine

pico (10-12)

Phe

aa phenylalanine

Pro

aa proline

Q

R

aa glutamine

aa arginine gas constant

Rib

ribose sugar

RNA ribonucleic acid S

aa serine Svedberg unit

Planck’s constant His

p

coenzyme Q, ubiquinone

guanine - purine base

• Arg CGU CGC CGA CGG AGA AGG

aa asparagine

ATP

Dalton

• Cys UGU UGC

aa methionine Molar (moles/L)

aa alanine

cal

• Tyr UAU UAC

aa lysine

Ala

elemental carbon

• Ile AUU AUC AUA

• Trp UGG CH2

hydrophobic

Serine 105.09

aa alanine

• Glu GAA GAG

-H

CH2

A

• Thr ACU ACC ACA ACG

CH2

basic

H2N

Lys

CH2

polar

basic

amino acid

• Asp GAU GAC

O

9.74 10.67

aa

CH2

HC CH3

Leucine e 131.18

• Phe UUU UUC

HS

H2N C

Glycine 75.07

ABBREVIATIONS USED IN BIOLOGY & BIOCHEMISTRY

• Lys AAA AAG

NH

H2N C

Asparagine 132.12

H3C-

AMINO ACID RNA CODONS

s

second (unit)

Ser

aa serine

T

aa threonine thymine - pyrimidine absolute temperature

Thr

aa threonine

Trp

aa tryptophan

Tyr

aa tyrosine

U

uracil - pyrimidine

V

aa valine

inosine

• Ser UCU UCC UCA UCG

elemental iodine

• Gln CAA CAG

Ile

aa isoleucine

J

Joule (energy unit)

K

• Ser AGU AGC

aa lysine

volt (electrical potential)

Kelvin - absolute T

• Pro CCU CCC CCA CCG

elemental potassium (103)

Val

aa valine

W

aa tryptophan

k

kilo

• Asn AAU AAC

L

aa leucine liter (volume)

X

xanthine

• Gly GGU GGC GGA GGG

Lac

lactose sugar

Y

aa tyrosine

Leu

aa leucine

yr

year

elemental tungsten

Note: Source - CRC Handbook of Chemistry & Physics

free downloads &

U.S. $5.95 CAN. $8.95

hundreds of titles at

Author: Mark Jackson, PhD.

quickstudy.com

Note: Due to the condensed nature of this chart, use as a quick reference guide, not as a replacement for assigned course work. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2004 BarCharts, Inc. 0607

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ISBN-13: 978-142320390-2 ISBN-10: 142320390-9

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• Study of the Plant Kingdom... Our Essential Partners in Life • ALTERNATION OF GENERATIONS

INTRODUCTION What’s so special about plants? • They are photosynthetic, using the ultimate energy source, the sun, to make their own food. For this reason they are called autotrophs. Plants power most ecosystems and are thus essential to life on Earth.

Have you thanked a plant today?

GAMETE EVOLUTION Plants have developed different strategies for gamete production and fusion. • Isogamy – Gametes are equally motile and of similar size. • Anisogamy – One gamete Female(+) Male(-) is large and less motile, with nutrient reserves, while the other is smaller and more motile, with few nutrient reserves. • Oogamy – One gamete is non-motile and large, with large nutrient reserves (egg), while the other is smaller and motile (sperm) and must locate the larger gamete.

Isogamy

A unique evolutionary strategy for reproduction where a single plant organism has two phases to its life history. • Gametophyte – Haploid, multicelled individual produces gametes via mitosis. Dominant form in lower plants. • Sporophyte – Diploid, multicelled individual from gamete fusion (zygote); produce haploid spores via meiosis for dispersal; spores germinate via mitosis to produce gametophytes. Dominant form in higher plants. • Isomorphic A/G – Gametophyte and sporophyte individuals are morphologically indistinguishable. • Heteromorphic A/G – Gametophyte and sporophyte individuals are morphologically distinct.

PLANT CLASSIFICATION SEEDS, VASCULAR Angiosperms

Oogamy Gymnosperms

PLANT EVOLUTION

• New problems on land: Plants must adapt to living in the air, a non-aquatic, dry medium. This presents some problems: - Obtaining water and preventing water loss. - Transporting water and nutrients. - Gas exchange (requires moisture) - Gravity - Reproduction when gametes swimming in water is limited. - Temperature flux of air is more rapid than in water. Plant adaptations/solutions • Chlorophyll A & B, to capture sunlight – similar to green algae chlorophyll. • Starch storage, for prolonged inactive periods during seasonal variations. • Gametes protected and kept moist inside plant tissues. • Stomata (leaf openings) to regulate gas exchange. • Wax surfaces to prevent excess water loss. • Root system to pull in water and nutrients from soil. • Conduction tissues to transport water, nutrients and food. • Support tissues to battle gravity for vertical growth. • All of these adaptations have greatly enhanced the success of plants on land today.

Spore n n

n

Antheridium

Archegonium Sperm

Egg

n Spores

Syngamy

Meiosis

2n

2n Spore mother cell

Zygote 2n

Embryo

Sporangia

Diploid

Sporophyte (2n)

NONVASCULAR PLANTS 1st Plants on Land • Lack vascular tissues • Gametophyte is dominant, sporophyte nutritionally dependent on gametophyte. • Small; live in moist environments; gametes released into water. a. Division Hepatophyta (Liverworts) b. Division Anthocerophyta (Hornworts) c. Division Bryophyta (Mosses)

Anisogamy

Plant evolution: Land colonization occurred about 400 mya, likely from aquatic, green algae ancestor.

Haploid Gametophyte (n)

(a)

(b)

SEEDLESS, VASCULAR Ferns

Club Mosses Sporophyte Gametophyte

Horsetails

Growing region Foot of sporophyte

Whisk Ferns

(c) Capsule

NONVASCULAR

Sporophyte Mosses

Seta Foot

Liverworts

Hornworts

GREEN ALGAL ANCESTOR 1

Gametophyte

SEEDLESS VASCULAR PLANTS

SEED “Ferns”

Microphyll Evolution Stem

Microphyll

Vascular tissue Vascular Projection supply to projection

Unbranched stem

Leaf with one vein

Extinct fossil forms that may show transition from seedless vascular plants (e.g., ferns) to vascular seed plants (e.g., gymnosperms and angiosperms).

Megaphyll Evolution

FLOWERS

Main axis of stem

Dichotomously branching stems

Side branch

Overtopping (one branch becomes main axis of stem) Megaphylls

Leaves with many veins Webbing of side branch systems

• Most plants are angiosperms and thus produce flowers with both male and female reproductive structures. • Flower anatomy - Sepals, petals - Stamen (Male Portion): Anther, filament - Pistil (Carpel, Female Portion): Stigma, style, ovary, ovule

{

The pistil contains the female organs

Stigma Style Ovary Ovule

Petal

{

Seedless Vascular plants • Possess xylem & phloem for transport of materials. • Sporophyte is dominant. • Evolution of leaf for efficient light capture. - Microphylls, megaphylls (In botany, the prefixes "micro" and "mega" generally refer to similar structures in male and female parts of the plant, respectively). • Division Lycophyta (Club Mosses) - Roots present. - Leaves present (microphylls). • Division Psilophyta (Whisk Ferns) No roots or leaves • Division Sphenophyta ( Horsetails) - Roots present. - Stems contain silica. - Leaves present (microphylls). - Division Pterophyta (Ferns) - Roots present. - Leaves (= fronds) - Fronds present (megaphylls). - Fern life history (see fig. below) - Sporophyte, sori, sporangia, spores, gametophyte (= prothallus), archegonium with eggs and antheridium with sperm • The Plant Scene (300 mya): Many seedless vascular plants and some nonvascular plants exhibited lush, dense growth covering large expanses in Earth’s history. • Much of today’s oil, coal and gas deposits were formed by these plants. Evolution of the "seed" plants • Terrestrial adaptations of seed plants. - Gametophytes protected in moist sporophytic, reproductive tissues. - Pollination replaced swimming for sperm delivery to egg. - The seed evolved - a dormant embryo with surrounding nutrients protected from environmental conditions. Seeds replaced spores as dispersal agents, using wind, water or animals. • The seed - a fertilized egg - Inside an ovule. - Integument, megasporangium ➔ megaspore ‘gametophyte ➔ egg sperm

Anthers (microsporangia)

The stamen contains the male organs

OVULE TO SEED Megasporangium (2n)

Seed coat (2n) (derived from integument)

Integument (2n) Spore case (n)

Female gametophyte (n)

Pollen tube (n)

Egg nucleus (n)

Micropyle

Food supply (derived from female gametophyte tissue)

Discharged sperm nucleus (n) Embryo (2n) (new sporophyte) Megaspore (n)

(b) Fertilized ovule

(a) Ovule

Filament

Sepal

Receptacle

(c) Seed

FERN LIFE HISTORY The sporophyte (still attached to the gametophyte) grows, develops

rhizome

zygote

sorus

Diploid Stage fertilization Archegonium egg

egg producing structure

sperm

sperm producing structure

meiosis

Haploid Stage

Sporangia The spores are released from a spore chamber

Spores develop Prothallus mature gametophyte (underside)

A spore germinates and grows into a gametophyte

Antheridium

TRENDS IN ALTERNATION OF GENERATIONS Gametophyte (n)

Sporophyte (2n) Gametophyte (n)

Sporophyte (2n) Sporophyte (2n)

• Sporophyte dependent on gametophyte (e.g., bryophytes)

Gametophyte (n)

• Large sporophyte and small, independent gametophyte (e.g., ferns) • Reduced gametophyte dependent on sporophyte (seed plants) 2

• Angiosperms have dominated the plant scene since the demise of dinosaurs and many gymnosperms (Cenozoic era, 65 mya to present). • Seed in a protective container or cotyledon • Angiosperm life cycle: - Microspore mother cell ➔ microspores ➔ pollen grain (male gametophyte)which includes tube cell and generative cell (sperm) - Megaspore mother cell ➔ megaspore ➔ embryo sac with 7 cells and 8 nuclei (female gametophyte) ➔ egg - Two sperm move through the pollen tube and engage in a double fertilization (where one sperm fuses with the egg to form a zygote/embryo, and the other sperm fuses with a large, central cell to form endosperm/nutrient reserve for the embryo) until it can produce its first leaves and begin photosynthesis. - Pollination and fertilization occur within hours to days, making angiosperms quick reproducers, compared to gymnosperms. • Flowers ensure pollination by insects, birds and mammals. - Flowers and pollinators co-evolved. • Seed dispersal - Important because plants may drop seeds close by, but new individuals will possibly compete with parent plants. - Wind, water and animals are common dispersal agents. - Fruits can entice animals to aid in dispersal. • Fruits – ripened ovary (see fig.) • Monocots and Dicots - two major groups of angiosperms (see fig. for differences) - Monocots include grasses, corn, sugar cane, palm trees, lilies and orchids. - Dicots include most trees, vines, shrubs and cacti.

THE GYMNOSPERMS - “naked seed” plants • Dominant plant when dinosuars ruled (Mesozoic era, 220 - 65 mya). • Do not produce flowers. • Ovules/seeds exposed. • Division Cycadophyta - Slow-growing palm-like trees found primarily in tropics and sub-tropics. • Division Ginkgophyta - Only one living member. - Ginkgo biloba (common diet supplement) • Division Gnetophyta - Closest living relatives of angiosperms - Ephedra - Drug ephedrine originally derived from this plant. - Cells resemble xylem vessel cells of angiosperms. - Cone clusters resemble flowers. • Division Coniferophyta (Conifers, Evergreens) - Oldest, tallest, most massive plants (e.g., 380 ft. tall Redwood tree). - Leaves form needles, which slow desiccation and are resistant to grazing by herbivores. - Important economically as wood/paper source, resin, turpentine and Christmas trees • Pine life cycle: - Ovulate cone = megastrobilus with megasporophylls (scales) - Micropyle, where pollen lands on ovulate cone. - Pollen cone = microstrobilus with microsporphylls - The process from pollination to fertilization can take over a year, which proved slow once the angiosperms evolved.

GYMNOSPERM LIFE CYCLE Megaspore(n) Scale of female cone Female cone

HAPLOID Gametophyte generation Megasporangium Ovule

Male cones

Pollen chamber

Note that the same plant has both pollen-producing male cones and egg-producing female cones

Micropyle Female

MEIOSIS gametophyte(n)

Egg Microspores(n) Microspore Reduced mother cells(2n) archegonium

Germinating pollen produces pollen tubes to reach the egg. Male gametophyte (germinating pollen grain)

Pollen grain

FERTILIZATION Scale of male cone

Sporophyte(2n)

The gametophytes are tiny

DIPLOID Sporophyte generation

Female gametophyte(n)

Seed coat Suspensors Seed Female gametophyte

Zygotes(2n) Winged seed

Embryo Female cone Developing embryo

Wing

The seed protects the embryo

Scale of female cone

THE ANGIOSPERMS - “enclosed seed” plants FRUIT DEVELOPMENT Endosperm

ANGIOSPERM LIFE CYCLE

Primary endosperm cell

Pollen grains (n) Generative cell

Anther

Fruit flesh

Ovary

Meiosis Integument

Seed coat Tube cell Fruit

Microspores (n) Anther

Pollen mother cells (2n)

Stigma

Functional megaspore (n) Megaspore mother cell (2n)

Pollen tube

8-nucleate embryo sac (megagametophyte) (n)

Zygote

Embryo

MONOCOTS VS DICOTS MONOCOTS

DICOTS

Sperm cells

Florals parts in multiples of 4 of 5

Floral parts in multiples of three

Meiosis

Ovary Adult sporophyte (2n) with flowers Germination

LEAVES

Ovule Seed (2n) Endosperm (3n)

Double fertilization

Formation of pollen tube (n)

Long tapering blades with parallel venation

Broad to narrow leaves with netted venation

STEMS

Seed coat Egg Vascular bundles are scattered

Vascular bundles arranged in a circle

SEEDS

Endosperm (3n) Embryo (2n)

Contain 1 cotyledon

3

Flower

Contain 2 cotyledons

PLANT ARCHITECTURE

STEM STRUCTURE

• Plant needs and solutions: - Leaves - Collection and conversion of solar energy - Stems - Positioning and support of leaves - Roots - Anchorage and absorption - Vascular system - Transport Axillary bud

• • • •

Cellulose-based cell walls for support and growth toward sunlight Epidermis Dicots with cortex and pith separated by ring of vascular bundles. Monocots with ground tissue with scattered vascular bundles.

Shoot tip (terminal bud)

Vessels Meristematic cell in xylem (brick-shaped cells)

Epidermis Vascular bundle

Young leaf

Cortex

Pith

Flower

Node Internode

Epidermis

Node

Transverse section of a stem, with enlargement of a vascular bundle shown to the right

Leaf Ring of vascular bundles divides ground tissue into cortex and pith

Vascular tissues

Sieve-tube members and companion cells in phloem

Seeds (inside fruit)

Air space Vessel in xylem

Epidermis

Thick-walled sclerenchyma cells forming a sheath around the mature vascular bundle

Ground tissue

Ground tissues

Vascular bundle

Withered cotyledon

Fibers in phloem

Shoot system Root system

Root hairs Primary root

Root tip Root cap

Lateral root

Groundvascular bundles distributed through ground tissue

Transverse section of a stem, with enlargement of a vascular bundle shown to the right

ROOT STRUCTURE

LEAF STRUCTURE • • • • • •

Sieve-tube member Companion cell in phloem in phloem

Epidermis Cuticle with wax to resist desiccation (produced by epidermis). Guard cells with stomata to regulate gas exchange. Mesophyll - Photosynthetic layer. Dicots with palisade and spongy layers; monocots with one layer. Vein - Vascular bundle for transport of materials.

Epidermis Endodermis

Root section Palisade mesophyll

Cortex Casparian strip

Vein vascular bundle

Endodermis Upper epidermis

Casparian strip

Cuticle

• • • • •

Bundle sheath Xylem Stoma Lower epidermis

Stoma

Guard cells

Spongy mesophyll

4

Movement of water through the endodermis to the center of the root

Epidermis - Has root hairs for increased absorption area for water/minerals. Cortex Endodermis - With casparian wax strips Stele - Central cylinder with vascular tissues inside Apoplastic pathway vs. symplastic pathway: Water enters through root epidermis and passes in the spaces "between" cortex cells apoplastically unti reaching the endodermis. Casparian strips prevent water from passing between endodermal cells. Thus, water is forced through the cell membranes symplastically where it is filtered before reaching the vascular tissues within the stele. In this way, potentially harmful substances might be removed by the selectively-permeable membranes of the endodermal cells.

PLANT DEVELOPMENT

VASCULAR TISSUES • Xylem, used for water/mineral transport. - Tracheids - Thin, hollow, dead cells with perforated, tapered ends. - Vessel members (element) - Thick, hollow, dead cells with large holes on end. • Phloem used for sugar/food transport. - Sieve tube members (element), hollow, living cells with perforated ends. - Companion cells, living cells that help keep sieve tube member cells alive.

Pits in wall

Sieve plate One vessel member

no cytoplasm (cells are dead at maturity)

MERISTEMATIC TISSUES • Growth after germination • Upward growth - Epicotyl or Coleoptile - Phototropism - Plant growth and movement in response to light. • Downward growth - Radicle or hypocotyl - Gravitropism - Plant growth response to gravity via statolith sensors. • Meristematic tissues form all tissues of adult plant (similar to germ tissues of animals). • Apical meristems - Responsible for increase in plant height. • Lateral meristem - Responsible for increase in plant diameter (girth). • Three primary meristems: - Protoderm - Epidermis - Ground meristem Cortex and ground tissues - Procambium - Vascular bundles with xylem and phloem.

sievetube member (alive) companion cell (alive) Portion of one vessel

Portions of tracheids

Portion of one sieve tube

IMPORTANT SYMBIOSES WITH PLANTS • Root nodules & bacteria - Bacteria fix nitrogen and are housed in root nodules to supply "fertilizer," thus allowing the plant to thrive, even in soils that are nutrient poor. • Mycorrhizae - Most plants today have an association between their roots and fungi in the soil. This association, or mycorrhizae, is critical in aiding water/mineral uptake by the plant.

VEGETATIVE (asexual) REPRODUCTION Plants typically produce new parts/structures without sexual reproduction, thus allowing the quick spread of the plant into the immediate habitat.

Fleshy leaves Stem

Stem

Corm

Bulb

Apical Meristem

Protoderm Ground meristem Procambium Three Primary Meristems:

Vascular bundle Vascular cambium

Stem of primary plant body

Cork cambium

Lateral Meristems (their location in stems showing secondary growth)

SEEDLING DEVELOPMENT Foliage leaves

New plant

Cotyledon

Stolon (runner)

Epicotyl Rhizome Cotyledon

Root

Cotyledon

Hypocotyl

Hypocotyl

Asexual Reproductive Modes of Flowering Plants Mechanism

Representative

Characteristics Radicle

Vegetative reproduction on modified stems Runner (stolon)

Strawberry

Rhizome Corm

Bermuda grass Gladiolus

Tuber

Potato

Bulb

Onion lily

Parthenogenesis

Orange tree, rose

Vegetative propagation

Jade plant, African violet

Tissue culture propagation

Orchids, lily, tulip, wheat, rice, corn

New plants arise at nodes on an above ground horizontal stem New plants arise at nodes of underground horizontal stem New plant arises from axillary bud on short, thick, vertical underground stem

Seed coat

Bean

Foliage leaves Epicotyl

Hypocotyl

Cotyledon

New shoots arise from axillary buds on tubers (enlarged tips of slender underground rhizomes)

Hypocotyl Radicle

New bulb arises from axillary bud on short underground stem Embryo develops without nuclear or cellular fusion (e.g., from unfertilized haploid egg; or develops adventitiously, from tissue surrounding embryo sac) New plant develops from tissue or organ (e.g., a leaf) that drops or is separated from plant New plant induced to arise from cell of a parent plant that is not irreversibly differentiated

Pea Coleoptile

Radicle

Corn 5

Foliage leaves

Plant development continued: • Vascular cambium - Produces xylem inward and phloem outward • Cork cambium - Cork • Wood is produced from xylem: - Annual rings (see fig.) - Heartwood vs. sapwood (see fig.) - Heartwood - Clogged xylem, little water transport - Sapwood - Newer xylem, free flowing water transport • Bark is produced from phloem, cork cambium, cork - Lenticels are cracks in the bark to facilitate gas exchange. - "Girdling plants" or cutting a horizontal band around the circumference of the plant, can be deadly because the vascular cambium, in which nutrients and water travel vertically, can be damaged. Lawn equipment (especially weed whackers) is a potential source of this kind of plant damage. • Exchange and Transport - Plants obtain gases, nutrients, minerals and water via internal fluids. - Gas exchange- stomata, roots, lenticels - Internal transport- xylem and phloem - Fluids move in xylem via adhesion, cohesion, evaporation and osmosis. • Theories of upward movement: - Capillary action - Some water moves up small vascular cells naturally. - Root pressure - Solutes inside the root tissues draw some water up. - Transpiration pull (cohesion-adhesion-tension)- The main motive force for transporting water up to the top of a plant (sometimes several hundred feet). - Essentially, as water evaporates from the leaf surface, the cohesive and adhesive properties of water pull water molecules from below, establishing a water tension/pressure. One drawback is it requires loss of water from the plant. In dry conditions or arid environments, this water loss for vertical transport can be critical to plants – thus, a replenishing water supply in the roots is vital. • Fluid movement in phloem (see fig.) - Sugars produced by the leaves via photosynthesis must be distributed to the rest of the plant. Gravity can assist this basically downward movement. However, getting the sugars into the cells of the phloem requires energy (i.e. active transport). Sometimes large quantities of sugars/starch are stored in special vegetative structures (e.g., tubers).

SECONDARY GROWTH Xylem Heartwood Cork (with cambium)

"Bark"

Vascular cambium

ANNUAL RINGS 1993

1992 Annual ring 1991

1990 250 um

INTERNAL TRANSPORT IN PHLOEM Xylem

Phloem

Companion cell

This QUICKSTUDY ® guide is an outline of the basic topics taught in Botany courses. Due to its condensed format, use it as a Botany guide but not as a replacement for assigned class work.

Leaf (source of sucrose)

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Sieve Companion cell

Water Sucrose 6

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BRAIN IN PLACE Parietal lobe Inferior parietal lobule

LATERAL VIEW

Precentral gyrus

Frontal lobe Temporal lobe

Central fissure

Olfactory bulb (nasal sensory n.n.)

Central fissure (of Rolando)

Superior frontal sulcus

Supraparietal lobule

Lateral fissure

Middle frontal gyrus Inferior frontal sulcus

Postcentral gyrus

Supramarginal gyrus

Optic n.

Angular gyrus

Frontal sinus

Occipital lobe

Sphenoid sinus

Parieto-occipital sulcus

Nasal bone

Transverse cerebral fissure

Inferior frontal gyrus:

Postcentral sulcus Inferior parietal lobule

Opercular part Triangular part

Supramarginal gyrus

Orbital part

L. medial nasal concha

Cerebellum

L. inferior nasal concha Hard palate Orbicularis oris m.

Superior temporal gyrus Parietooccipital sulcus Angular gyrus

Temporal pole Superior temporal sulcus

Mandible

Cervical n.n. Spinal cord

Tongue

Auditory (eustachian) tube Soft palate (uvula)

MEDIAL VIEW

Genioglossus m.

Precentral sulcus Central sulcus

Posterior commisure Pineal body

Olfactory bulb

Inferior nasal meatus

Head of the mandible

Corpus callosum

Frontal pole

Pharyngeal tonsil

Inner ear (cochlea) (semicircular canals) Nuchal l. Tympanic membrane (eardrum) Temperomandibular joint & capsule

Parietal lobe

a. a.a. L. l. m. n. n.n.

= = = = = = =

artery arteries Left ligament muscle nerve nerves

Anterior communicating a. Anterior cerebral a.

Fornix

Lateral ventricle(s) (1st & 2nd) Anterior commisure Paraterminal gyrus

Corpora quadrigemina

Medulla oblongata

ARTERIES Middle infraorbital a.

Medial striate a. Internal carotid a. Lateral orbitofrontal a. Ascending frontal a.

Occipital lobe

Cerebral aqueduct

Posterior cerebral a.

Pontine a.a. Internal acoustic (labyrinthine) a.

Middle cerebral a. & branches Frontal lobe Cingulate sulcus Thalamus (3rd ventricle) Hypothalamus

Middle & lateral lenticulostriate a.a.

Anterior inferior cerebellar a.

Anterior choroidial a.

Optic chiasm

Cerebellar peduncles

Hypophysis (pituitary gland)

Superior medullary vellum

Posterior communicating a. Anterior spinal a. Superior cerebellar a.

Temporal lobe

Cerebellum

Arbor vitae Spinal cord

Pons

Horizontal fissure of cerebellum

Inferior temporal sulcus Inferior temporal gyrus

Interthalamic adhesion

Parietooccipital sulcus

Cerebellar cortex

Cerebellum

Sulcus of corpus callosum Cingulate gyrus

Middle temporal gyrus

Transverse cerebellar fissure

Mamillary body Pons 4th ventricle Medulla oblongata

Basilar a.

Vertebral a.

Cerebral peduncle Posterior spinal a.

Posterior inferior cerebellar a.

FRONTAL SECTION

Optic chasm Olfactory bulb I

Medial thalamic nucleus Insular gyrus

Claustrum Mamillary body nucleus

Optic tract

Lateral sulcus

Trochlear n. IV

Temporal lobe

Trigeminal n. V Interpeduncular fossa

Hippocampus

Abducens n. VI

Pons Longitudinal fasciculus of pons Flocculus

Cerebral penduncle Middle cerebellar peduncle

Choroid plexus of ventricle IV

Intermedius & vestibulocochlear n.

Facial n. VII

Pyramidal decussation Spinal cord

Intermedial n. Vestibulocochlear n. VIII Glossopharyngeal n. IV

Flocculus Medulla oblongata Cerebellum

Foramen caecum Medulla oblongata

Facial n.

Vagus n. rootlets

Mamillary body Oculomotor n. III Cerebral penducle

Optic n. II

Lateral sulcus

Choroid plexus of lateral ventricle, inferior horn

Glossopharyngeal n. rootlets

Hypophysis (pituitary)

Olfactory tract

3rd ventricle

External capsule

Frontal lobe

Frontal pole

Head of caudate nucleus

Globus pallidis

ANTERIOR VIEW

Longitudinal cerebral fissure

Longitudinal cerebral fissure Corpus callosum trunk Septum pellucidum Columns of fornix

Choroid plexus of lateral ventricle Internal capsule Putamen lentiform nucleus

Vagus n. X Hypoglossal n. XII Accessory n. XI

VENTRICLES

1st cervical n. 2nd cervical n.

Interthalamic adhesion

Lateral ventricle central part

Inferior olive

Spinal cord 3rd ventricle

Interventricular foramen of Monroe

Anterior horn

Posterior horn

Anterior commisure Optic recess

Cerebral aqueduct

Optic chiasm

HORIZONTAL SECTION Genu of corpus callosum Anterior horn of lateral ventricle

Septum pellucidum

Columns of fornix

Inferior horn of lateral ventricle

Infundibular recess 4th ventricle Olfactory bulb I Lateral recess of Olfactory tract 4th ventricle

Median aperture

Optic chiasm II

Central canal

Longitudinal cerebral fissure Frontal pole of cerebrum Head of caudate nucleus Straight gyrus Anterior part of internal capsule Olfactory sulcus Orbital sulci Orbital gyri Internal capsule Temporal pole Claustrum External capsule

Lateral sulcus

Putamen Subthalamic nucleus

Globus pallidis

Red nucleus

Posterior part of internal capsule

3rd ventricle

Thalamus Tail of caudate nucleus

Superior colliculus

Inferior horn of lateral ventricle

Choroid plexus Optic radiation

Vermis of cerebellum

INFERIOR VIEW

Anterior perforate substance Lateral sulcus Tuber cinereum Uncus Rhinal sulcus Inferior temporal sulcus Inferior temporal gyrus Cerebral peduncle Posterior perforated substance Red nucleus Substantia nigra Cerebral aqueduct Lateral occipitotemporal gyrus Medial occipitotemporal gyrus Collateral sulcus Parahippocampal gyrus Lingual gyrus Calcerine sulcus Isthmus of cingulate gyrus

Pineal body

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Occipital pole of cerebrum

Optic n. II Hypophysis (pituitary gland) Optic tract Mamillary body Oculomotor n. III Trochlear n. IV Pons Ophthalmic n. TriMaxillary n. geminal Mandibular n. n. V Abducens n. VI Facial n. VII Intermedial n. Vestibulocochlear n. VIII Choroid plexus Glossopharyngeal n. IX Hypoglossal n. XII Vagus n. X Accessory n. XI Medulla oblongata Lobus simplex

Cerebellum 1st cervical n. Spinal cord Superior semilunar Vermis lobule Longitudinal cerebral fissure

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VENOUS SYSTEM Pulmonary valve Tricuspid valve R. atrium R. brachial v.v. R. basilic v. R. cephalic v. Hepatic v.v. Inferior vena cava R. median cubital v. R. radial v. R. common iliac v. R. cephalic v. R. basilic v. R. ulnar v. R. superficial palmar venous arch

L. facial v. L. inferior labial v. L. internal jugular v. L. external jugular v. L. subclavian v. Brachiocephalic v. L. pulmonary a. Superior vena cava Pulmonary trunk R. ventricle L. renal v. L. internal iliac v. L. external iliac v. L. profunda femoris

Accessory R. proper palmar saphenous v. digital v.v. R. superficial femoral v. R. great saphenous v. R. genicular v.v.

R. peroneal v. R. anterior tibial v. R. dorsal venous network of foot

SCHEMA: HEAD & NECK Superior sagittal sinus Inferior sagittal sinus Straight sinus Frontal v. Transverse sinus Angular v. Transverse v. Maxillary v. Retromandibular v. Superior labial v. Facial v. Inferior labial v. Vertebral v. Mastoid emissary v. Internal jugular v. External jugular v. Deep cervical v. Middle thyroid v. R. subclavian v. Brachiocephalic v.

L. pulmonary v.v. L. axillary a. L. circumflex a. L. atrium L. ventricle Deep brachial a. L. brachial a. Superior ulnar collateral a. Inferior mesenteric a. L. radial a. Anterior interosseous a. L. external iliac a. L. internal iliac a. L. ulnar a. L. lateral circumflex a. Deep palmar arch Superficial palmar arch Radialis indicis a. Muscular branches Proper palmar digital a. Descending branch of lateral circumflex a. L. popliteal a. Genicular a.a. L. tibial recurrent a.

CIRCULATORY SYSTEM

L. lateral External circumflex jugular v. femoral v.v. Brachiocephalic a. Subclavian v. Cephalic v. Brachial v. Superior vena cava Pulmonary valve R. atrium Tricuspid valve R. ventricle Inferior vena cava Hepatic portal v. Superior mesenteric v. Superior mesenteric a. Basilic v. Median v. Cephalic v.

Superficial temporal a. & v. Facial a. & v. Deep femoral a. Vertebral a. R. superficial Common femoral a. carotid a. Subclavian a. Aortic arch Axillary a. Pulmonary a. L. atrium Mitral valve L. ventricle Brachial a. Celiac trunk Abdominal aorta Renal v. Renal a. Testicular a. Radial a. Ulnar a. External iliac a. Internal iliac a. Deep femoral v.

R. dorsal venous arch of foot R. dorsal digital v.v.

ARTERIAL SYSTEM

Superficial temporal a. Angularis Facial a. Mental a. R. common carotid a. R. vertebral a. R. subclavian a. Aortic arch Ascending aorta Aortic valve Mitral valve Descending thoracic aorta Splenic a. Common hepatic a. Superior mesenteric a. R. renal a. Abdominal aorta R. testicular (ovarian) a. R. common iliac a. Femoral a.

Internal jugular v.

R. intercapitular v.v.

a. = artery a.a. = arteries L. = left R. = right v. = vein v.v. = veins

Supratrochlear v. L. superficial temporal v. L. superior labial v.

External iliac v. Internal Palmar iliac v. venous network Femoral v. Great Frontal a. saphenous v. Anterior Genicular cerebral a. Circle of Willis v.v. Anterior Superficial tibial v. parietal a. Middle cerebral a. Posterior cerebral a. Superficial temporal a. Transverse facial a. Maxillary a. Great saphenous v. Basilar a. Angular a. Plantar Superior labial a. venous Inferior labial a. network Facial a. Internal carotid a. Dorsalis pedis a. External carotid a. Vertebral a. Common carotid a. Superior thyroid a. Thyrocervical trunk Brachiocephalic trunk Arch of aorta L. subclavian a.

L. anterior tibial a. Peroneal a. Lateral malleous a. Dorsalis pedis a. Lateral tarsal a. Arcuate a. Dorsal digital a.

Palmar a. anastomoses

L. lateral circumflex a.

Femoral a.

BLOOD CIRCUITS

Veins (Blood flows toward heart) Arteries (Blood flows away from heart)

Capillaries of head

Popliteal a. Genicular a.a. L. pulmonary v.v. R. pulmonary a. Superior vena cava R. pulmonary v.v. Recurrent tibial a.

Pulmonary a. R. atrium Anterior tibial a. R. ventricle Hepatic portal v. Hepatic a. Capillaries of liver Inferior vena cava Portal circulation Plantar a. anastomosis Renal v.v. Kidneys Internal iliac v. Femoral v. Capillaries of pelvis Capillaries of legs & feet

Capillaries of arms & hands Head, arm & hand a.a. Aortic arch L. pulmonary a.

Arch of aorta

Pulmonary capillaries L. atrium Descending thoracic aorta L. ventricle Celiac a. Gastric a. Stomach Splenic a. Spleen Gastric aorta Descending abdominal aorta Renal a.a. Superior mesenteric a. Inferior mesenteric a. Capillaries of colons Internal iliac a. Internal iliac a. Femoral a.

BRAIN & NECK Lateral orbitofrontal a. Ascending frontal a. Precentral a. Central a. Anterior parietal a. Posterior parietal a. Posterior pericallosal a. Angular a. Parieto-occipital a. Posterior temporal a.

CIRCLE OF WILLIS

Medial Frontal Branches: Posterior Middle Anterior Callosomarginal a. Frontopolar a. Pericallosal a. Anterior communicating a.

Anterior cerebral a.

Lenticulostriate a.

Temporal branch of the posterior cerebral a.

Lumen

Tunica adventitia Valve

Tunica adventitia Terminal arteriole Meta-arteriole

Postcapillary venule

Precapillary sphincters

Intercellular cleft

Basal lamina** Fenestrations

Tight junction Endothelial cell** Cell nucleus

Capillary bed Red blood cell

Blood flow

CORONARY ARTERIES & CARDIAC VEINS

L. coronary a.

Aortic valve

Branch to sinoatrial node

Oblique v. of L. atrium Great cardiac v. Circumflex branch of L. coronary a.

Anterior R. atrial branch of R. coronary a. Anterior cardiac v.v. R. coronary a. R. marginal branch of R. coronary a.

Vertebral a. External carotid a.

Anterior inferior cerebral a.

Transverse facial a. Internal carotid a. Facial a.

HEPATIC PORTAL VEINS

Tunica media

Tunica media

Occipitalis a. Posterior auricular a. Ascending pharyngeal a.

Vein

Subendothelial layer

Subendothelial layer Internal elastic lamina

Supratrochlear a.

Angular a.

Vertebral a.

Tunica intima: Endothelium

Tunica intima: Endothelium

Supraorbital a.

Maxillary a.

Superior cerebellar a.

BLOOD VESSELS Artery

Basilar a. Internal acoustic (labyrinthine) a.

Posterior cerebral a.

External carotid a. Common carotid a. Subclavian a. Vertebral a.

Deep temporal a.

Parietal branch of superficial temporal a. Frontal branch of Middle superficial temporal a. temporal a.

Infraorbital a.

Internal carotid a.

Internal carotid a.

Basilar a. L. middle cerebral a. Posterior cerebral a.

SKULL & ARTERIES

Precentral a.

Posterior communicating a.

Posterior communicating a.

Anterior temporal a.

Ascending frontal a.

Middle temporal a.

Central a. of retina Ophthalmic a. Anterior cerebral a.

Posterior temporal a.

Ophthalmic a.

Middle cerebral a.

Supraorbital a. Posterior ciliary a.

Middle temporal a.

Anterior communicating a.

Inferior vena cava R. gastric v. R. branch Liver (transparent) Portal v. Cystic v. Gallbladder Pancreaticoduodenal v.v. Pancreas R. colic flexure Duodenum Middle colic v. Superior mesenteric v. Inferior vena cava R. colic v. Ascending colon Ileocolic v.v. Cecal vv. Cecum Ileum Appendix Appendicular v. Common iliac v.v.

ARTERIES OF BRAIN Anterior cerebral a.

Descending palatine a. Superior labial a. Inferior labial a. Mentalis a. Inferior alveolar a. Submentalis a. Deep lingual a. Lingual a. Superior thyroid a. Hepatic v.v. Esophagus L. gastric v. L. branch Stomach (transparent) Spleen Splenic v. L. gastroepiploic v. Inferior mesenteric v. L. colic v.v. Inferior mesenteric v. Jejunal & ileal v. Descending colon Sigmoid v.v. Sigmoid colon Superior rectal v. Rectum Middle infraorbital a. Anterior communicating a.

Recurrent a. (of Heubner) Internal carotid a.

Lateral orbitofrontal a. Ascending frontal a.

Posterior communicating a.

Middle cerebral a. & branches

Anterior interventricular branch (L. anterior descending) of L. coronary a.

Middle & lateral lenticulostriate a.a.

Coronary sinus

Anterior choroidal a.

Internal acoustic (labyrinthine) a.

Superior cerebellar a.

Anterior inferior cerebellar a.

Posterior cerebral a. Pontine a.a.

Small cardiac v. Opening of coronary sinus

Posterior L. ventricular branch

Middle cardiac v. Posterior interventricular branch of R. coronary a. (posterior descending a.)

Edge of the transparent heart

NOTE TO STUDENT Use this comprehensive study guide in the classroom, in the gym, at home or anywhere you need complete anatomical information. This guide is not designed to take the place of classroom attendance. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2004 BarCharts Inc. 0108

Customer Hotline: 1-800-230-9522

Posterior v. of L. ventricle

Basilar a. Anterior spinal a.

Vertebral a. Posterior spinal a.

Posterior inferior cerebellar a.

(Inferior view)

ISBN-13: 978-142320719-1 ISBN-10: 142320719-X

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WORLD’S #1 ACADEMIC OUTLINE

PERMANENT TEETH

** = cut Stria of Retzius a. = artery Fissure l.l. = ligaments Cusp Lateral incisor Tuft m. = muscle Enamel Cuspid (canine) n. = nerve n.n. = nerves Crown 1st bicuspid v. = vein (premolar) Contact area

Labial surface Central incisor

Cingulum Gum Distal surface

1st molar

Triangular ridge

2nd

Enamel prism Pulp horn Contour line of Owen Interdental papilla

Dentin Pulp

2nd bicuspid (premolar)

Interproximal surface

Pulpal vessels & n.n. Dentogingival fibers

Pulp chamber Neck

molar

Circular fibers Trans-septal fibers

Gingiva

Cusp

3rd molar

Dentinal tubules

Contingent surface

Cementum

Root

Oblique fibers of periodontium Root canal**

Interradicular septum

Buccal surface

3rd molar

Compact bone

2nd molar

Gingival margin

Mandible**

1st molar

Pulpal sensory n.

Cancellous bone

Apical foramen

2nd bicuspid

Mesial surface Gingival papilla Lingual surface Incisal edge

DECIDUOUS ARCH Labial surface Cingulum Dental tubercle

1st bicuspid MOUTH Cuspid Superior labial frenulum Lateral incisor Superior lip Central incisor Hard palate Gingiva Palatine raphe Palatopharyngeal arch Soft palate Central incisor Lateral incisor Cuspid 1st

Gum Interproximal surface Cusp

Apical fibers Alveolar n., a. & v.

MARGINAL GINGIVA

Palatoglossal arch

Enamel spindle

Stria of Retzius

molar

Gingival sulcus Oral sulcular epithelium Oral epithelium

Junctional epithelium

2nd molar

Collagen fibers in cross section

Neutrophilic granulocyte

Vessels of the gingival plexus

Lymphocyte Distal surface

Posterior wall of oropharynx

Buccal surface Gingival margin

Dentinal tubules Palatine tonsil Uvula

2nd molar

Mesial surface Lingual surface Incisal edge Central incisor

1st molar Cuspid Lateral incisor

TOOTH

Enamel spindle

Collagen fibers in long section

Periodontal l.l.

Marginal alveolar bone

Acellular cementum

Sharpey’s fibers

Tongue Gingiva Inferior labial frenulum

Vestibule Inferior lip

Facial View

Tomes granular layer Lingual View

Cusp of Carabelli

3rd molars

2nd molars

1st 2nd Cuspids 1st bicuspid bicuspid molars (premolars) (premolars) (canine)

Lateral incisors

Central incisors

Lateral incisors

PERMANENT TEETH

1st 2nd Cuspids 1st (canine) bicuspid bicuspid molars (premolars) (premolars)

2nd molars

3rd molars

TRIGEMINAL NERVE Middle superior alveolar n. Posterior superior alveolar n. Zygomatic n. Long & short ciliary n.n. Ciliary ganglion Pterygopalatine branches Nasociliary n. Lacrimal n. Frontal n. Tentorial branch Ophthalmic n. (V1)

PRE-ERUPTION

Infraorbital foramen

Permanent teeth:

Communicating branch

3rd molar (wisdom tooth) (not illustrated) 17-25 yr.

Zygomaticotemporal n.

2nd molar 12-13 yr. 1st molar 6-7 yr. 2nd bicuspid (premolar) 12-13 yr. 1st bicuspid (premolar) 11 yr. Cuspid (canine) 11 yr. Lateral incisor 8 yr. Central incisor 7 yr.

Zygomaticofacial n. Anterior superior alveolar n. Infraorbital n. Infraorbital foramen Dental branches

Maxillary n. (V2) Pons Trigeminal n. (V) Trigeminal (semilunar) ganglion Mandibular n. (V3) Foramen ovale Posterior division Medulla oblongata Auriculotemporal n. Anterior division Posterior deep temporal n. Lateral pterygoid n. Chorda tympani n. Buccal n. Anterior deep temporal n. Lingual n. Inferior alveolar n. Mylohyoid n. Mandibular foramen

Gingival branches Labial branches Mental branches

Mental foramen

1st molar 10-15 mo. Canine (eyetooth) 16-20 mo. Lateral incisor 8-10 mo. Central incisor 6-8 mo.

Mental n.

Inferior alveolar n. Inferior dental branches Inferior dental plexus Middle temporal a.

Inferior gingival branches Buccinator m.** Parotid gland Palatine glands

Parietal branch of superficial temporal a. Tongue

Frontal branch of superficial temporal a. Deep temporal a. Posterior superior alveolar a.

Posterior auricular a. Parotid duct

Uvula**

Deciduous teeth: 2nd molar 2 yr.

Infraorbital a.

Occipitalis a.

Supraorbital a.

Parotid gland

Supratrochlear a. Descending palatine a. Angular a.

Parotid duct

Anterior superior alveolar a.

Sublingual caruncle with opening of submandibular duct

Saliva

Infraorbital a. Maxillary a. Superior labial a.

Transverse facial a.

Dental branches Sublingual ducts Buccinator m.** Masseter m.** Anterior lingual glands

Sublingual gland

Inferior labial a.

Vertebral a.

Mentalis a. Inferior alveolar a.

Internal carotid a.

Deep lingual a.

Mylohyoid m.**

Salivary pool Submandibular duct

Ascending pharyngeal a.

Submandibular glands

External carotid a. Facial a.

Lingual a. Superior thyroid a. Mylohyoid branch

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NOTE TO STUDENT: Use this comprehensive QuickStudy ® study guide in the classroom, at home or anywhere you need complete information about the digestive system. This guide is not designed to take the place of classroom attendance. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2004 BarCharts Inc. 0308

Submentalis a.

SKULL & ARTERIES ISBN-13: 978-142320721-4 ISBN-10: 142320721-1

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EMERGENCY NUMBERS EMERGENCY RESCUE - 911 or ______________________________ DOCTOR ________________________ POISON CONTROL_______________ POLICE_________________________ FIRE____________________________

HOW TO CALL FOR HELP Stay calm. Getting hysterical often panics the victim, hinders communication with emergency medical personnel and causes even more harm and delay

When calling for help, give: • Precise location, address and telephone number from where you are calling; if the address is unknown, look around for landmarks, businesses or cross streets • The nature of the emergency or injury • The number of people involved • Your name • Ages and gender of victims involved

WORLD’S #1 QUICK REFERENCE GUIDE

COMMON AILMENTS Foreign Matter in Eye Symptoms:

• Irritation, redness, pain • Unable to open eye • Visual problems Treatment:

• Flush eye with water or use eye wash kit • Examine eye to see if matter is removable • CAREFULLY remove with corner of a folded tissue; if unable to remove, seek medical advice • If irritation persists or eye is encrusted with yellow drainage, seek medical advice • If severe pain, inability to open eye, or visual problems exist, go to E.R.

Black Eye • Apply a cold compress to reduce swelling and pain • If pain persists, or visual problems develop, go to E.R.

Nosebleeds • Sit upright, leaning slightly forward • Pinch nostrils for 5 to 10 minutes • Do NOT blow your nose • If bleeding continues, apply ice pack to bridge of nose or back of neck, or apply pressure to upper lip

Earache • Hold a hot water bottle or heating pad on ear • Control pain with over-the-counter medication • Consult physician if pain persists, is severe or accompanied by fever

Toothache • Rinse mouth with warm salt water to remove any food debris • Take over-the-counter medication for pain • Apply ice pack to face • Do not place aspirin directly on the tooth • A topical anesthetic may be applied for temporary relief • See the dentist as soon as possible

Loss of Permanent Tooth • Rinse tooth gently, do NOT hold by root end • Try to reinsert the tooth into socket • If you cannot reinsert the tooth, place in a container of milk • See dentist or E.R. WITHIN ONE HOUR

LYME DISEASE BROKEN/ DISLOCATED BONES & FRACTURES Treatment:

• Seek medical attention • If victim must be moved, immobilize the injured area first • If an arm or leg is involved, splint the part in the position in which it was found before moving the victim; do not attempt to straighten the limb • Use folded blankets or towels around the area to aid immobilization • If it is an open fracture (one where the bone breaks through the skin), control bleeding (see “Bleeding Wounds,” page 2)

Symptoms (caused by the bite from a deer tick): • Red, bull’s-eye-shaped rash that increases in diameter daily around bite • Chills • Dizziness • Fatigue

• Fever • Muscle and joint pain • Nausea • Severe headache • Stiff neck Treatment:

• If suspected, seek medical attention; there is no effective home remedy

QUICK TIPS • Substitute a bag of frozen vegetables for an ice pack • Put ice in a resealable bag and wrap in paper towel or cloth • Do not use cotton on an open wound • Always have hydrogen peroxide on 1

hand for minor cuts and scrapes • If wound is really dirty, pour or dab on hydrogen peroxide; avoid squirting directly into wound • Keep ipecac syrup to induce vomiting if recommended by poison control

WOUNDS

SHOCK

Cut, Puncture, Scrape, Abrasion Treatment:

• Stop bleeding by applying pressure • Clean area thoroughly with antiseptic or warm, soapy water • Apply antibiotic ointment and bandage • With a puncture wound, or wound inflicted by a rusty/dirty item, seek medical care within 24 hrs., as antibiotics/tetanus shot may be required • If the cut is on an extremity, hold above heart level to stop bleeding • If there are signs of infection, redness, swelling, yellow discharge, increased pain or fever, see your physician • If wound is deep, long, or gapes open, see your physician or go to E.R.

Bleeding Wounds When dealing with a severely bleeding wound or amputation, if you have to leave the victim to seek help, first get the bleeding under control • Call rescue - if blood is bright red, there may be an artery involved; be sure to tell the operator • Have victim lie down, preferably with head slightly lowered to prevent fainting • If wound is on an extremity, raise above heart level • Cut away clothing and apply pressure with a clean, absorbent cloth

If unavailable, apply pressure with hand • Maintain pressure for 10 minutes, do NOT remove original bandage; if it becomes blood-soaked, apply another bandage over it • If bleeding cannot be controlled, apply pressure to a point above the wound • If internal organs are exposed, apply wet, clean cloth with gentle pressure • Attempt to control bleeding with pressure until medical personnel arrive • A tourniquet is not recommended

Penetrating Objects • Call rescue • Do NOT remove any penetrating or foreign objects • Apply sufficient bandages to immobilize the object and support its position in the wound

SPRAINS & STRAINS Symptoms:

• Severe pain • Bruising, swelling and heat • Unable to move injured part Treatment:

• Rest affected limb • Ice on and off for 48 hrs. • Compress with elastic bandage • Elevate affected limb

Shock due to Injury Symptoms:

• Weakness and cold, clammy skin with pale or bluish tinge • Rapid, shallow breathing • Faint and/or rapid pulse • Restlessness, confusion or agitation • Nausea and sweating Treatment:

• Call for medical assistance • Lay victim down, tilt head to one side • Loosen clothing; keep victim warm • Control any bleeding • Keep victim calm and quiet • Do not administer liquid; moisten lips if necessary • Elevate legs if there are no suspected hip, leg, head, neck or back injuries

Allergic Reaction & Anaphylactic Shock Symptoms:

• Sudden appearance of hives that are widespread and itching • Swelling of the lips, tongue and mouth (may feel itchy) • Wheezing or difficulty breathing • Nausea, vomiting or cramps • Lightheadedness Treatment:

• Call rescue to determine severity of reaction • If available, take recommended dose of oral antihistamine • If food-related, brush teeth to prevent ingesting more allergen

BURNS & SCALDS Note: Any burn to the face, hands, feet, mouth or groin needs immediate medical attention.

First-degree burn: A minor burn, affecting only the top layers of skin Symptoms:

• Redness and pain Treatment:

• Run under cold water or apply a cold, wet cloth off and on for 24 hrs. • Do not rub or apply butter or petroleum-based products • Keep clean to prevent infection

Second-degree burn: Affects the underlying layers of skin as well as outer layers Symptoms: • Redness, pain, swelling and blisters

Treatment:

Treatment:

• Immediately immerse affected area in cold water or apply cold, wet compresses • Cover the area loosely with clean gauze or cloth • Do not apply butter or petroleum-based products or sprays • Do NOT break blisters; if blisters open, keep dressing on area • If a large area is affected, or if burn starts draining, seek medical attention

Third-degree burn: Destroys all the layers of skin and nerves Symptoms: • Skin may be white or black in appearance • Can be extremely painful, or completely painless if there is nerve damage • Underlying tissue and/or muscle may be exposed 2

• Call rescue • Lightly cover area with a sheet or sterile gauze (do not secure with tape) • If breathing has stopped, begin CPR

Fire If clothing is on fire, smother flames with a blanket, coat, etc; do not remove clothing stuck to skin

Sunburn • Take cool baths or apply wet, cool compresses • Apply aloe or lotion to sooth skin • Take over-the-counter pain medication for fever, chills or pain • Do NOT use butter or petroleumbased products • Do NOT break blisters • For severe sunburn, with severe pain, swelling or large blistered area, go to E.R.

DRUG OVERDOSE Symptoms:

• Abnormal pupil size or pupils nonreactive (they do not contract when a light is shined on them) •Agitation • Confusion/hallucinations • Difficulty breathing • Drowsiness • Nausea • Paranoia • Staggering • Sweating • Unconsciousness • Violent behavior • Vomiting

Treatment:

Treatment:

• Take victim to E.R. or call rescue • Do not try to reason with the victim • Do not try to restrain the victim if you are going to jeopardize your own safety; call police • If breathing has stopped, begin CPR

Alcohol Poisoning Symptoms: • Seizures • Slurred speech • Stumbling, staggering • Unconsciousness • Violent behavior • Vomiting

FOOD POISONING

CONVULSIONS

Symptoms:

Symptoms:

• Severe stomach cramps • Nausea and vomiting • Weakness • Diarrhea within a few hours of eating • Stomach flu-like symptoms, fever Treatment:

• Identify the source of the poisoning if possible; if it is from mushrooms or canned food, seek medical assistance immediately • For minor food poisoning, the symptoms will eventually subside; vomiting can provide relief • Call rescue if there are signs of paralysis, difficulty breathing, difficulty speaking or swallowing, if pain is severe, if there is blood in the vomit or stool, or the stomach is distended

INTERNAL BLEEDING Symptoms: Not always apparent, but any number of the following symptoms may be present:

• Tender, swollen, bruised areas • Vomiting/coughing up blood • Bleeding from the rectum or vagina •Light-headedness, shallow breathing •Dilated pupils •Abdominal swelling or hardness •Cold, clammy skin • Color blue or pale Treatment: Have victim lie quietly; keep him/her warm and seek medical attention immediately

• Blackout, fainting or confused behavior • Drooling • Twitching and thrashing • Loss of bladder control • Vigorous muscle spasms Treatment:

• Call rescue • Do not restrain the victim • Do not put anything in the victim’s mouth • Do not move the victim; unless necessary • If a child is convulsing from high fever, cool body slowly with cool, wet compresses; DO NOT immerse the child in the tub Until help arrives, note whether: • The victim is having multiple seizures or they last longer than 2 minutes • Victim can be awakened between seizures • The victim has health problems such as diabetes, high blood pressure or alcoholism

• Call rescue While waiting: • Stay with the victim • Try to put the victim to bed; prop victim on side in case vomiting occurs; this will prevent aspiration of the vomit (vomit gets into lungs, causing suffocation) • Check on the victim frequently • If person is violent, call police • If coherent, try to give sports drinks to increase electrolyte levels • Watch for seizures

HEART ATTACK Symptoms:

• Pain in middle of chest, behind breastbone • Pain in the arm, shoulder and/or back • Feeling of severe indigestion • Tightness/crushing feeling in chest • Short, fast or noisy breathing • Tightening or pain in jaw • Sweating/nausea • Victim pale or bluish in color Treatment:

• Call rescue - don’t wait for symptoms to pass • Keep victim as calm as possible • Do not leave the victim alone • Do not take anything by mouth, unless it’s a prescribed heart medication • If breathing stops, begin CPR

LOSS OF A BODY PART

STROKE

Treatment:

Symptoms:

• Call rescue • Victim and extremity must get to hospital immediately • Apply pressure to wound with a clean cloth to control bleeding (see “Bleeding Wounds,” page 2) • Elevate area above heart level, if possible • Lay victim flat and keep warm to prevent shock • Wrap severed body part in clean cloth and place in plastic bag; immerse in ice water; if not available, keep as cool as possible • Do not put extremity directly on ice 3

• Sudden numbness or weakness in face, arm or leg, especially on one side of the body confusion, trouble • Sudden speaking or understanding • Blurred vision or trouble seeing • Dizziness, loss of balance or coordination • Sudden trouble walking • Severe headache with no known cause Treatment:

• Call rescue immediately and monitor condition until help arrives

THE ELEMENTS Heat exhaustion Symptoms:

If symptoms are severe, call for medical attention immediately • Dizziness, weakness, nausea, headache and vomiting • Cool, moist, pale or flushed skin • Profuse sweating • Feeling thirsty and hot • Muscle cramps Treatment:

• Drink plenty of fluids, especially sports drinks • Move to a cool area

Heat stroke Symptoms:

• Sweating has stopped • Body temperature rises rapidly • Not aware of thirst or heat • Confused, delirious, irrational behavior • May lose consciousness or have convulsions • Red, hot, dry skin • Muscle cramps

• Dilated pupils • Shallow breathing • Rapid, weak pulse Treatment:

• Seek medical attention immediately • Get to a cool place • Cool skin with cold, wet cloths or cold water • Apply to armpit, neck and groin areas • Elevate feet • Give sips of water or sports drinks

Frost Bite Symptoms:

• Numbness or insensitivity in the suspected area • Discolored skin • Waxy appearance to the skin • Pain or discomfort • Skin is cold to the touch Treatment:

• Soak in warm water, approximately 100-105 degrees – NO warmer • Do not let the body part touch the container holding the water

POISONING Swallowed Household chemicals, medications and pesticides Symptoms:

• Soak until the area is red and feels warm • Bandage the area with a soft cloth or gauze; gently put cotton inbetween fingers and toes • Seek medical help

Hypothermia (exposure to the cold) Symptoms:

• Decreased levels of consciousness • Glassy stare • Numbness • Rigid muscles • Shivering • Slow, erratic pulse • Slurred speech Treatment:

• Call for medical assistance immediately • Remove wet clothing; warm victim • Have victim lie down • Give warm drinks - not with alcohol or caffeine • DO NOT immerse the victim in water • Handle the victim very gently

CARBON MONOXIDE POISONING

Inhaled • Call rescue • Move victim to fresh air • If not breathing, start CPR; take precautions to avoid poisoning from residue on the victim’s lips or face; use a pocket mask for additional protection, if available

• Burns on mouth and lips or unusual breath odor • Unexplained stains and odor on clothing Common poisonous household • Nausea and vomiting chemicals – keep where chil• Difficulty breathing or coughing dren cannot get to them! • Disoriented behavior • Air conditioning refrigerant • Acetaminophen • Drooling • All medications and drugs • Abdominal pain • Ammonia and window cleaner • Excessive sleeplessness • Anti-freeze • Dizziness or double vision • Bleach • Heart palpitations • Drain opener • Weakness • Fabric softener Treatment: • Fertilizer • Furniture polish • Locate the source of poisoning • Call poison control center and res- • Gasoline • Hair treatments cue immediately • Laundry and dish detergents • Keep victim calm • Keep a supply of ipecac syrup on • Lighter fluid • Moth balls hand, especially with children, if • Paint thinner instructed to induce vomiting • Plant food • Read the poison source label, if • Rubbing alcohol available, for further instructions • Turpentine • Remove soiled clothing • Vitamins 4

Carbon monoxide is an odorless, colorless, potentially deadly gas that may be present: • When a car is left running in a poorly ventilated room • When a car’s exhaust system is blocked • As a byproduct of manufacturing or industry • In or around burning buildings • When a gas-powered heating unit malfunctions Symptoms: • Severe headache • Lethargy • Disorientation • Agitation • Coma • Unconsciousness Treatment: Be sure area is well-ventilated before rescue; it may only take moments to be overcome if sufficient fumes remain • Call rescue • Get the victim into open, fresh air immediately • Check for pulse and breathing; administer CPR if necessary • If there is a pulse, but the victim is not breathing, start mouth-tomouth resuscitation

INSECTS, SNAKES, SPIDERS & SEA CREATURES Bee & Wasp Stings

Spider Bites

Difficulty breathing, headache or coughing, could be signs of allergic reaction; seek medical attention immediately (see “Anaphylactic Shock,” page 2) Symptoms: • Red, swollen, painful area with a small point of entry in the center Treatment: • Remove the stinger by scraping skin with a credit card or cardboard edge; do not use tweezers; they can inject more venom into the skin • Wash area with soap and water • Apply ice pack • Apply calamine lotion or use a paste of baking soda and water, or over-thecounter 1% hydrocortisone cream

Snake Bites Take a good look at the snake, if possible - you may need to provide a description Symptoms: • Sharp pain • Swelling • Weakness • Shortness of breath • Vomiting • Dizziness Scarlet King Snake • Blurred vision Treatment:

• Call rescue • Have the victim lie quietly, keeping the bitten area below heart level to slow the blood flow to the heart • Clean the area - wipe AWAY from the bite to prevent more venom from entering the wound • Do NOT cut the bite or try to suck out the venom • Do not apply ice

• Spiders are found in dark areas, such as under furniture, woodpiles, in shoes, barns, basements, etc. • If possible, bring the spider or the remains of the spider with you to the physician for identification Both the black widow and brown recluse spider bites need to be attended to immediately by a medical professional

Treatment:

• Gently pick off any tentacles, using gloves or edge of credit card • Rinse the area with salt or fresh water or soak with vinegar • 1% hydrocortisone cream may be used on affected area • If rash or pain persists, seek medical advice

Animal Bite

Black Widow Symptoms:

•A b d o m i n a l pain • Pain in muscles • Pain in soles of feet • Swollen eyelids • Excessive sweating • Bite looks like a small pin prick • Dull, numbing pain • Headache • Shortness of breath • Tightness in chest Brown Recluse Spider Symptoms: • Bite appears as an ulcer circled by a red ring • Stinging sensation • Weakness • Fever • Joint Pain • Nausea • Shock Treatment: • Wash area with soap and water • Apply a cold compress

Man-o-war (Jellyfish) Sting Symptoms:

• Sudden severe stinging sensation when swimming in ocean water • Tentacles stuck to the skin

• Wash carefully with soap and water • Apply an antiseptic, such as hydrogen peroxide • Apply antibiotic cream and bandage • Rabies is always a concern with any animal bite; be sure to notify animal control so the animal may be captured (if necessary), tested for rabies, and quarantined • Seek medical attention immediately • If bite is severe, try to stop the bleeding (see “Bleeding Wounds,” page 2) and call rescue

Fire Ants (only in southern states): Symptoms:

• Itchy, stinging rash • Blisters Treatment:

• Apply ice pack to bites to relieve pain and swelling • 1% hydrocortisone cream can be applied to relieve itching • If an allergic reaction occurs, or if large areas are bitten, seek medical attention

PLANTS - POISON IVY, OAK & SUMAC • Rash in the pattern of streaks or patches • Pimples or blisters Treatment:

Poison Ivy

Poison Oak

Poison Sumac

Symptoms:

• Redness of skin and extreme itching

• Wash exposed skin immediately with soap and water • Clean under fingernails to prevent spreading • Remove and wash clothes and clean shoes of victim to prevent spreading 5

• Apply cool compresses • Apply anti-itch medication (calamine lotion/1% hydrocortisone cream) • Consult physician if rash persists, itching can’t be controlled, rash is on face, eyes or genitals, and/or rash has pus or odor • Seek medical help if there is swelling or difficulty breathing

HYPERVENTILATION

HEAD, NECK & BACK INJURY If injury is suspected, DO NOT move victim unless absolutely necessary Symptoms: • Head, neck or back are in an odd position • Paralysis • Unable to move fingers and/or toes • Numbness in any part of the body Treatment: • Call rescue • If there is head injury, assume there is neck injury • Keep victim as still as possible

• Immobilize the head and neck carefully with rolled towels or clothing tucked around the sides of the neck and head • If CPR needs to be performed, do not move the head or neck; instead, pull the lower jaw forward • If the victim must be moved to avoid further injury, hold the head, neck and shoulders absolutely still when moving; several people should assist if available; use a board, door or other rigid, flat object to transport the victim to safety

CHOKING MANEUVER For Conscious Child or Adult Symptoms:

• If airway is completely blocked, victim may not be able to breathe, cough or speak; ask him/her if he/she is choking, a nod or “yes” gesture will confirm

• Use quick presses of the fist in 5 upward thrusts • Repeat until obstruction is coughed up, or victim begins breathing

For Unconscious Child or Adult • Have someone call rescue • Straddle prone victim, as shown • Place heels of hands against victim’s abdomen, below rib cage, just above the navel • Use quick presses of the hand in 5 upward thrusts; repeat if necessary • If object is visible in mouth, sweep object out with hooked finger

Treatment:

• Stand behind victim with arms wrapped around waist, as shown • Lock hands into a fist • Place the thumb side of fist against victim’s abdomen, below rib cage, just above the navel

Treatment:

• Call rescue

• Deep, rapid, irregular breathing • The feeling of loss of control of breathing Treatment:

• Calm the person; ask him/her to concentrate on taking slow, deep breaths • If this is not effective, call rescue

CONCUSSION Symptoms (caused by a blow to the head): • Severe headache • Dizziness • Sudden urge to sleep • Vomiting • Increased size of one pupil • Restless, agitation, irritability Treatment:

• Monitor levels of consciousness • Do not allow victim to fall asleep • Call rescue or bring victim to E.R.

FAINTING Symptoms that fainting is about to occur: • Sensation of dizziness, weakness, cold sweats, rapid pulse To prevent onset: • Have victim sit down and place head between knees or lie down If victim faints: • Raise feet 12 to 15 inches • Apply wet, cool, cloth to forehead • If consciousness does not return within 8 minutes, call rescue US $5.95

ELECTROCUTION • NEVER touch a victim of electric shock until the source of electricity has been separated from victim, turned off, or proper precautions have been taken • Shut off fuse box or unplug the source of electricity

Symptoms:

• If victim is not breathing, administer CPR until medical help arrives • With lightening strikes, begin CPR immediately, if necessary (electricity has already passed through the body) • When breathing has started, elevate victim’s feet and keep him/her warm to avoid shock

ISBN-13: 978-142320726-9 ISBN-10: 142320726-2

All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2002, 2003 BarCharts, Inc. 0508

This guide was compiled, written and edited by a consortium consisting of 2 EMT's, a nurse practitioner and a certified first aid instructor.

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WORLD’S #1 ACADEMIC OUTLINE

Basic Concepts A. Organismal Reproduction 1. One of the most important requisites of all life, from the earliest life forms to present-day organisms, is reproduction 2. Characteristics or traits of organisms must be passed on during reproduction B. Cellular Reproduction 1. Life as we know it is based on the cell, the basic unit of life 2. Cell theory states all organisms are made up of cells and come from cells C. DNA 1. DNA (deoxyribonucleic acid) is the molecule of inheritance in ALL cellular forms of life D. Chromosomes 1. Eukaryotic cells possess nuclear DNA with structural and enzymatic proteins, forming chromatin, which is visible as chromosomes during parts of the cell cycle 2. Prokaryotic cells possess simpler DNA 3. Sexually reproducing organisms typically have pairs of homologous chromosomes (look-alike chromosomes) E. RNA 1. RNA (ribonucleic acid) is found in several forms, most of which are used in protein synthesis 2. RNA is the molecule of inheritance in some viruses, which are not cell-based life forms F. Genes 1. Functional unit of inheritance and basis for most traits 2. Located at loci, or specific positions, on DNA; to be preserved and transmitted 3. Control biological processes through production of proteins and RNA

4. Genotype refers to the genetic composition of the organism 5. Phenotype refers to the observable inherited traits (e.g., physical, behavioral, physiological characteristics); based on the inherited genotype

Genes Form Basis of Inheritance Nucleus B A T

A

G

C

A

C

D

T

T

A

C

G

Gene

G. Ploidy 1. Homologous chromosome pairs have the same loci, thus genes 2. When both chromosomes are present, for each gene there are two representatives; this is represented by the symbol 2n or diploid condition 3. When only half of each homologous chromosome pair is present, such as in gametes, this is represented by the symbol n or haploid H. Alleles 1. Alternate forms of the same gene that could occupy the same locus (e.g., brown versus blue eye color)

chromosomes possess two 2. Homologous representatives of each gene (i.e., 2n) 3. Homozygous refers to the diploid condition where both alleles of the genotype are identical (e.g., AA, aa) 4. Heterozygous refers to the diploid condition where both alleles of the genotype are different (i.e., Aa) 5. Dominant alleles form a phenotypic expression regardless of the other allele on the matched chromosome of the homologue (e.g., “AA” or “Aa” genotypes will both express the phenotype designated by the “A” allele) 6. Recessive alleles fail to form a phenotypic expression unless the other allele on the matched chromosome is also recessive (e.g., “aa” genotype is the only way for the phenotype designated by the “a” allele to be expressed, assuming no other gene pairs influence inheritance [see epistasis discussion in Gene Action Categories, page 2]) 7. Additional types of allelic interactions will be discussed in subsequent sections 8. Determining gamete types: Assuming there are no mutations, alleles present in gametes are determined by the diploid genotypes of parents a. For homozygous genotypes, haploid gametes will be identical for the given traits (i.e., AA individual would produce “A” gametes only; AAbb individual would produce “Ab” gametes only) b. For heterozygous genotypes, haploid gametes will be different for the given traits (i.e., Aa individual would produce “A” & “a” gametes; AaBb individual would produce “AB, Ab, aB, ab” gametes— assuming two traits are unlinked [see Independent Assortment & Dihybrid Crosses, page 2])

Mendelian Genetics A. Gregor Mendel (1822–1884) 1. An Austrian monk who, through his love and interest in nature, developed the basic ideas of genetics long before chromosomes and genes (i.e., molecular biology) were discovered a. He developed his ideas by studying plants; in particular, his most famous work involved crosses with pea plant varieties 2. His results and interpretations contrasted with a prevailing (at that time) theme of inheritance called “blending”—the concept that inherited traits mixed to create a in composite characteristic offspring B. Mendel’s Genetics Laws 1. Segregation of Alternate Factors & Monohybrid Crosses a. Specifically, Mendel discovered that with certain traits, there were individual plants which, if only crossed with other plants just like them, would almost always produce the exact same phenotype

b.

c.

d.

e.

f. g. h.

i. j. k.

i. These individuals were called true-breeders ii. We now call this condition homozygous He also found that some individuals with similar appearance, when crossed, would not have all offspring of the same kind i. We now call this condition heterozygous Mendel decided to systematically do single-trait crosses to determine the causes for the previously stated observations Specifically, a parental generation (P) initiated these experimental crosses by using two truebreeding pea plants for opposite phenotypes (e.g., purple versus white flowers) Offspring from this cross (F1) all showed only one of the traits (e.g., purple flowers), and this trait was called the dominant trait Traits from the P generation “did not blend” in these F1 individuals F1 individuals, the hybrids, were cross-pollinated— the monohybrid cross—to produce F2 individuals 3/4 of the F2 individuals expressed the dominant trait, while 1/4 expressed the trait of the other P parent (e.g., white) that had not been expressed in the F1 generation—this latter trait was the recessive form The expected phenotypic ratio of the F2 individuals in monohybrid crosses would be 3:1 The expected genotypic ratio of the F2 individuals in monohybrid crosses would be 2:1:1 The diagram at right, called a Punnett square, summarizes results of a single-trait cross similar to those done by Mendel on pea plants and other organisms: 1

Mendel’s 1st Law: Segregation of Alternate Factors Normal male (gg)

Gray female (GG) P generation Gametes produced by P generation F1 generation

g

G

All Gg Dominant G masks recessive g Gametes produced G g by F1 generation G

All Gg g

GG

Gg

Gg

gg

F2 G e n e r a t i o n

l. Mendel concluded there had to be some physical entities or “factors” passed on by each parent of a cross i. We now know these to be genes ii. He also concluded that these factors came in pairs, which then became unpaired (in the production of gametes, which occurs during meiosis) and recombined during fertilization iii. The two P generation individuals had the factors in alternate forms called alleles (e.g., purple versus white flowers)

Mendelian Genetics (continued )

iv. Each of these true-breeding parent plants had a pair of identical factors, but their gametes had only one v. Thus, F1 individuals were hybrids genotypically, but only expressed the dominant phenotype m. Monohybrid Cross: Once Mendel realized the F1 individuals were genotypic “hybrids,” he predicted the recessive trait that “disappeared” would reappear if: i. F1 hybrid individuals were crossed to produce F2 offspring ii. The results summarized in “h” above confirmed his predictions 2. Independent Assortment & Dihybrid Crosses a. Mendel continued his crossing experiments by looking at multiple traits simultaneously b. P generation, consisting of two true-breeding parents of different forms (phenotypes) for two traits, were crossed, producing F1 individuals c. The F1 genotypic hybrids for both traits were crossed—the dihybrid cross—producing F2 individuals d. 9/16 of the F2 individuals expressed both dominant traits; 3/16 expressed 1 dominant trait, and 1 recessive trait; 3/16 expressed the opposite dominant trait, and the opposite recessive trait; 1/16 expressed both recessive traits e. The expected phenotypic ratio of the F2 individuals in dihybrid crosses would be 9:3:3:1 f. The expected genotypic ratio of the F2 individuals in dihybrid crosses would be 1:1:1:1:2:2:2:2:4—a total of 9 genotypes g. The following Punnett square summarizes results of two-trait crosses, similar to those done by Mendel:

Mendel’s 2nd Law: Independent Assortment Gray, short-haired P generation

Normal, long-haired Parents ggss

GGSS Gametes produced by P generation

GS

F1 generation

gs

All GgSs Gametes form by segregation of alleles & individual assortment gs gS Gs GS

All GgSs

GS

GG SS Gray, short

GG Ss Gray, short

Gs

GG Ss Gray, short

GG ss Gray, long

Gg SS Gray, short Gg Ss Gray, short

Gg Ss Gray, short Gg ss Gray, long

gS gs

Gg SS Gray, short

Gg Ss Gray, short

Gg Ss Gray, short

Gg ss Gray, long

F2

G e n e r gg SS gg Ss a Normal, Normal, t short short i o gg Ss gg ss n Normal, Normal, short long

F2 phenotypes 9

Gray, short-haired

Gray, long-haired

3

Normal, short-haired

Normal, long-haired

h. Mendel concluded statistically that these results occurred because the alleles for one trait did not affect the inheritance of alleles for the other trait, which is independent assortment i. Special note: Mendel did not observe independent assortment for all traits studied [see Mendel’s Ratios & Beyond, “C” on this page, for more about gene linkage] 3. Trihybrid Crosses & Beyond

a. Tracking three or more traits simultaneously is possible; the following summarizes such crosses: P = AABBCC x aabbcc (true breeders crossed) F1 = AaBbCc x AaBbCc (trihybrid individuals crossed) F2 = 27:9:9:9:3:3:3:1 (phenotypic ratio) b. The following Punnett square summarizes results of Mendel’s three-trait crosses—specifically, the F2 individuals produced from the F1 trihybrid individuals: Trihybrid Cross ABC

ABc

AbC

Abc

aBC

aBc

abC

abc

ABC AABBCC

AABBCc

AABbCC

AABbCc

AaBBCC

AaBBCc

AaBbCC

AaBbCc

ABc

AABBCc

AABBcc

AABbCc

AABbcc

AaBBCc

AaBBcc

AaBbCc

AaBbcc

AbC

AABbCC

AABbCc

AAbbCC

AAbbCc

AaBbCC

AaBbCc

AabbCC

AabbCc

Abc

AABbCc

AABbcc

AAbbCc

AAbbcc

AaBbCc

AaBbcc

AabbCc

Aabbcc

aBC

AaBBCC

AaBBCc

AaBbCC

AaBbCc

aaBBCC

aaBBCc

aaBbCC

aaBbCc

aBc

AaBBCc

AaBBcc

AaBbCc

AaBbcc

aaBBCc

aaBBcc

aaBbCc

aaBbcc

abC

AaBbCC

AaBbCc

AabbCC

AabbCc

aaBbCC

aaBbCc

aabbCC

aabbCc

abc

AaBbCc

AaBbcc

AabbCc

Aabbcc

aaBbCc

aaBbcc

aabbCc

aabbcc

3. The following diagram summarizes many types of gene c. Probability rules can be used to calculate actions, each of which will be discussed in greater detail in genotypes and phenotypes, in place of the sections that follow using Punnett squares (especially useful in multiple-trait crosses) i. Addition Rule: The occurrence of Gene Actions Parental Dominance mutually exclusive events equals the Genotypes I Incomplete Dominance sum of their individual probabilities; Parental Codominance that is, calculate probabilities n Phenotypes Pleiotropy associated with the dominant and h Paired gene (factor) Multiple Alleles e alleles are segregated & recessive alleles as demonstrated in a Monogenic vs. r independently sorted monohybrid cross: Polygenic Inheritance 1 1 1 i during meiosis, • AA = /4 , Aa = /2 , aa = /4 Epistasis t producing gametes that • For example, in a monohybrid Sex Determination combine to form a cross, the chance of a dominant Linked vs. Unlinked Genes Progeny offspring phenotype is equal to 1/4 (AA) + n Sex-Linked Traits Phenotypes 1/ 2 (Aa) = 3/ 4 c Autosomal Linkage Sex-Influenced Traits e Progeny ii. Multiplication Rule: The probability Sex-Limited Traits of independent events occurring Genotypes Environmental Interactions simultaneously is equal to the product of their individual probabilities • For example, the probability of being D. Gene Action Categories a. Dominance: One allele dominates or masks the effects AABbcc = (1/4) x (1/2) x (1/4) = 1/32 of the other allele(s) OR 2/64 [see Punnett square above] b. Incomplete Dominance: Neither allele is expressed fully; in such cases, phenotypes are “blended” d. Branch (Fork) Diagrams are alternatives to c. Codominance: Both alleles are expressed fully (NOTE: Punnett squares; multiplication rule used to It is frequently difficult to distinguish this pattern from calculate genotypic and phenotypic ratios incomplete dominance) e. Additional mathematical relationships d. Pleiotropy: One gene affects several phenotypes associated with multiple-trait crosses e. Multiple Alleles: Three or more alleles for a gene are i. n = number of heterozygous gene pairs present within a population (although diploid individuals ii. 2n = number of different gametes formed can only have two at a time) iii. 3n =number of different genotypes f. Monogenic versus Polygenic Inheritance: Traits based formed on a single gene versus traits based on multiple genes iv. 2n =number of different phenotypes g. Epistasis: One gene alters the effect of another gene formed h. Sex Determination: For many organisms, special 4. Back Cross: A cross of an F1 individual (Aa) chromosomes have genes that determine gender; in with either of the two P generation individuals some, such as sea turtles and alligators, environmental (AA or aa) factors, such as the temperature at which eggs develop, 5. Test Cross: A cross of an individual having a determine gender dominant phenotype (but unknown genotype— i. Linked versus Unlinked Genes: Genes on the same e.g., AA or Aa) with an individual that is chromosome are linked; genes on different homozygous recessive (aa) chromosomes are unlinked and assort independently a. If the recessive phenotype shows up in i. Gene Mapping: Recombinant progeny (involving approximately half of the offspring, the crosses) can be used in some organisms to map gene unknown genotype is determined to be a loci; molecular techniques are used for many species, heterozygote including humans (e.g., Human Genome Project C. Mendel’s Ratios & Beyond [also see structural genomics discussion in 1. Mendel’s work paved the way for the most Molecular Genetics, page 5]) basic understanding of inheritance; however, j. Sex Linkage: In humans, genes found on the X or Y future discoveries revealed that many traits chromosomes (e.g., color blindness) are inherited in ways much more complex k. Autosomal Linkage: Multiple genes found on non-sex than those demonstrated in the basic chromosomes monohybrid and dihybrid crosses l. Sex-Influenced Traits: Same genotype expressed 2. Thus, 3:1 and 9:3:3:1 phenotypic ratios are differently in males versus females (e.g., baldness in uncommon in nature humans) 2

m. Sex-Limited Traits: Same genotype expressed only in one sex; suppressed in the opposite sex (e.g., beard development and breast development in humans) n. Chromosomal Non-Disjunctions: During meiosis, chromatids and/or homologous chromosomes may fail to separate, triggering alterations in phenotypic expressions of genotypes i. Aneuploidy: Abnormal number (too few/too many; missing pieces/extra pieces) of chromosomes o. Polyploidy: Presence of more than two sets of chromosomes (e.g., 3n = triploid) p. Environmental Effects: Phenotypes that are affected by non-genetic, environmental factors (e.g., differential pigment development in Siamese cats) based on temperature; cooler body areas have heavier melanin deposition [see sex determination, item “h” in this list] E. Human Genetics 1. We know more about the genetics of many organisms than that of humans, mostly because there are fewer ethical issues and shorter generation times for non-human organisms 2. The Human Genome Project has helped in the discovery of genes and their functions through molecular studies [see Molecular Genetics section, page 5] 3. The inheritance patterns of some human traits have been worked out (using mostly Mendelian Genetics) and are summarized in the table that follows: Human Traits & Known Inheritance Patterns Name of Trait

Phenotypes

Mode of Inheritance

ABO Blood Groups

Type A, B, AB, O

Autosomal Codominant – Multiple Alleles: Type A = AA or IAIA; AO or IAi Type B = BB or IB IB; BO or IBi Type AB = AB or IA IB Type O = OO or ii

Achondroplasia

Dwarfism

Autosomal Dominant: Aa = dwarf, aa = normal (AA is lethal)

Albinism

Lack of pigmentation in eyes, hair, Autosomal Recessive: A_ = normal, aa = albino skin

Color Blindness

Cystic Fibrosis

Cannot distinguish red or green

Hypersecretion of mucus in lungs

Sex-Linked Recessive: XC XC or XC Xc = normal-vision female XC Y = normal-vision male XcXc = color-blind female Xc Y = color-blind male Autosomal Recessive: C_ = normal, cc = disease

4. Human Pedigree: Studying inheritance patterns of humans is complex both biologically and ethically; thus, much of what we know is based on looking at family histories or trees (pedigree analysis) a. Specifically, phenotypes of all known family members from as many generations as possible are assembled; this is especially important when attempting to trace the sources/causes of genetic disorders i. Proband refers to the first person for whom a particular genetic condition has been diagnosed: If this is a male, he is called the propositus; if this is a female, she is called the proposita ii. The diagnosis and identification of the proband individual serves as the basis for determining the genetic basis of the condition through the use of standardized diagrams iii. Following is a chart illustrating some standard symbols used in pedigrees and a sample pedigree:

Human Pedigree Symbols Normal male Normal female Sex unknown, normal Male with phenotype of interest

Female with phenotype of interest

Dimples

Dimple(s) in cheek(s)

Autosomal Dominant: D_ = dimples, dd = no dimples

Ear Lobes

Free vs. attached

Autosomal Dominant: D_= free lobes, dd = attached lobes

Sex unknown with phenotype of interest

Blue → dark brown

Autosomal Incomplete Dominant: BB = dk. brown, Bb = lt. brown, bb = blue, model with 3 Genes? Recent studies suggest “NO” specific eye color genes exist

Male heterozygous for recessive allele

Freckles

Freckles vs. no freckles

Autosomal Dominant: F_ = freckles, ff = no freckles

Stillbirth or spontaneous abortion

Hairy Ears

Hair on ear edge (pinna)

Y-Linked Dominant: XYH = hairy-eared male, XYh = normal male

Mating

Hairline Shape

Widow’s peak vs. straight

Autosomal Dominant: W_ = widow’s peak, ww = straight line

Mating between relatives

Height

Variable height

Polygenic: aabbccddeeff = shortest, AABBCCDDEEFF = tallest

Blood clotting impairment

Sex-Linked Recessive: XHXH or XHXh = normal female XhXh = hemophiliac female XHY = normal male XhY = hemophiliac male

Eye Color

Hemophilia

Proband or

Huntington’s Disease Mental decay

Autosomal Dominant: H_ = disease, hh = normal

Muscular Dystrophy “Duchenne”

Muscle weakening & loss of coordination

Sex-Linked Recessive: XDXD or XDXd = normal female XdXd = dystrophic female XDY = normal male XdY = dystrophic male

Pattern Baldness

Receding hairline

Sex-Influenced: BB = bald male, thin-hair female Bb = bald male, full-hair female bb = full hair in both sexes

Phenylketonuria (PKU)

Missing enzyme for phenylalanine metabolism

Autosomal Recessive: P_ = normal (results in mental impairment), pp = PKU

Polydactyly

Extra toes & fingers

Autosomal Dominant, Incomplete Penetrance: P_ = extra toes or fingers (but may be normal) pp = normal # of toes & fingers

Rh Blood Groups

Rh factor on red blood cells (RBC) Autosomal Dominant: R_= Rh-positive, r = Rh-negative

Sickle-Cell Anemia

Female heterozygous for recessive allele

Deceased

Roman numerals represent generation II

I

First born

One-egg Monozygotic twin

Defective RBC blood disorder

Autosomal Incomplete Dominant: SS = anemia, Ss = carrier, ss = normal

Skin Pigmentation

Dark to light

Polygenic: aabbcc = lightest → AABBCC = darkest

Tay-Sachs Disease

Nervous degeneration

Autosomal Recessive: T_ = normal, Tt = carrier, tt = disease

Tongue Folding

Fold vs. not fold

Autosomal Dominant: F_ = fold, ff = unable to fold tongue

Tongue Rolling

Roll vs. not roll

Autosomal Dominant: R_= roll, rr = unable to roll tongue

3

Siblings

Last born

Two-egg Monozygotic twin

Sample Pedigree

Sample Genetics Problems Please refer to the Human Traits & Known Inheritance Patterns table [see page 3] for assistance with problems involving human traits; attempt to work out the problems on a blank sheet of paper before viewing the solutions to each problem, which are shown in the next section [see Solutions to Sample Genetics Problems, pages 4–5]; in crosses tracking more than one trait simultaneously, assume multiple traits are unlinked unless stated otherwise 1. Orange and black fur in domestic cats are sex-linked, with the gene locus on the X chromosome; cats have similar sex determination patterns as humans; the two fur-color alleles display codominance, with heterozygous cats displaying a calico pattern (i.e., separate patches of black and orange fur; a calico female is mated to a black male): a. What is the probability that a female kitten will be a calico? b. What is the probability a male kitten will be a calico? 2. There is a gene that affects peapod color and has two alleles: G = yellow and g = green; there is another gene that affects peapod shape and has two alleles: W = round and w = wrinkled: a. Mendel’s original crosses (P generation) would have consisted of which two genotypes? b. List the possible types of gametes produced by these original parent plants c. If gametes from question “b” are joined in fertilization, determine the genotype(s) of the offspring d. If the individuals of question “c” are crossed with each other, how many genotypes will be possible in the offspring? e. Determine the phenotypic ratios of the offspring produced in question “d” 3. A certain hypothetical species called an EWOK has a gene that controls “fur” color—a dominant allele causes blue fur, and a recessive allele causes red fur; another gene controls “ear” length—a dominant allele causes long ears, and a recessive allele causes short ears; these two genes are linked, and a cross is performed between an individual homozygous for both dominant traits and an individual homozygous recessive for both traits: a. Determine the phenotypes(s) of all possible offspring b. How many types of gametes can be produced by the offspring listed in question “a”? c. What would be the possible phenotypes of the offspring in a test cross involving the offspring of question “a”? (Do a test cross on the offspring listed in question “a”); ASSUME NO CROSSING OVER d. Do the same thing here as you did in question “c,” but now give the possible phenotypes ASSUMING CROSSING HAS OCCURRED 4. Jenna has type A blood and does not exhibit symptoms of diabetes; her husband, Stephan, has type B blood and is diabetic; Stephan and Jenna have a male child, Oscar, who has type O blood and, like his father, has diabetes; based on the information given, answer the following questions: a. Name the genotypes of both parents and Oscar b. What is the probability that their next child will have the same genotype and phenotype as Oscar’s?

5. A genetics marriage counselor has a couple, Carly and Cedric, both with no hemophilia symptoms, seeking professional advice; Carly says that both her parents are normal, but she has a brother with hemophilia; Cedric, the man she will marry, is normal but knows one of his cousins has hemophilia: a. What is the probability of disease in children they might have? 6. In cattle, when red and white cattle are mated, the offspring are roan (a mixture of red and white fur); for another trait in cattle, hornless is dominant to possessing horns; white hornless cattle and red horned cattle are crossed: a. F1 individuals would have what genotype(s)? b. If F1 individuals are crossed, how many would be expected to be roan and hornless? c. If F1 individuals are crossed, how many would be expected to be white and horned? 7. Three siblings, a brother and two sisters, are examined for color-blindness; the examiner discovers that the boy and one sister are color-blind, while the other sister has normal color vision: a. Determine the genotype and phenotype of each parent 8. Diabetes, a recessive trait in humans, occurs in 10% of a certain population; a normal female and a normal male in this population have a child who is diabetic: a. What is the probability that their next child will be a diabetic? 9. A “hypothetical” recessive allele in humans causes feet to grow backward, while the normal dominant allele causes feet to grow forward; another gene controls foot length, and its alleles display incomplete dominance, so when a person is heterozygous for foot-length alleles, he/she will have normalsized feet, but when homozygous for either of the two foot-length alleles, the person will be either big-footed or small-footed; a cross occurs between a backward-pointing, large-footed male and a homozygous forward-pointing, normal-size-footed female: a. The female can produce how many types of gametes as far as these traits are concerned? b. Determine all possible phenotypes of the offspring c. In the original cross, if the male parent had backward-pointing feet of normal size, how many different phenotypes in the offspring would be possible? d. In the original cross, if the female parent had normal-size feet but was backward-pointing, how many different phenotypes in the offspring would be possible? e. In the cross with the female in question, “d,” will any offspring have forward-pointing feet? 10.Sheri has type A blood and normal color vision capabilities; her mother was type O and also had normal color vision, while her father was type AB and color-blind; Sheri recently married Randy, who had identical phenotypes for both traits as those of her father: a. Determine the possible phenotypes of children they might have

Solutions to Sample Genetics Problems 1. This problem involves a trait that exhibits codominance, and the gene is located on the X chromosome in cats; to solve this problem, assume sex determination in cats is the same as for humans Genetics Key: XB = black, XO = orange, Y = no allele for this trait XB XB = black female XB XO = calico female XB XO XOXO = orange female XB XBXB XBXO XB Y = black male Y XBY XOY XO Y = orange male The Cross: male = XB Y x female = XB XO Answers: a. 50% of the female kittens will be calico b. 0% of the male kittens will be calico (the two codominant alleles must both be present to produce a calico phenotype; males can only have one allele, as they only have one X chromosome) 2. This problem is a basic two-trait, progeny-testing cross as originally described by Mendel Answers: a. P generation: either GGWW, ggww OR GGww, ggWW b. Gametes: either GW, gw OR Gw, gW c. F1 individuals: GgWw

d. F1 x F1 cross yields nine genotypes in the F2 individuals e. F1 x F1 cross yields a phenotypic ratio of 9:3:3:1 3. Both fur color and ear length display complete dominance; however, both genes are linked, and thus, when calculating gamete possibilities, be aware that the two genes will NOT assort independently Genetics Key: Fur Color: B = blue, b = red BB = blue Bb = blue bb = red Ear Length: L = long, l = short LL = long Ll = long ll = short The Cross: BBLL x bbll → BbLl Answers: a. One phenotype produced: Blue fur, long ears b. 2 (BL, bl; because the dominant and recessive alleles are on separate chromosomes, respectively) c. The test cross of BbLl x BL bl bbll without crossing over bl BbLl bbll yields the following results: Two phenotypes produced: (1) Blue fur, long ears; (2) Red fur, short ears 4

d. The test cross of BbLl x bbll with crossing over yields the following results*: BL Bl bL bl bl

BbLl

Bbll

bbLl

bbll

Four phenotypes produced: (1) Blue fur, long ears; (2) Blue fur, short ears; (3) Red fur, long ears; (4) Red fur, short ears [* NOTE: It is possible crossing over would not recombine the dominant and recessive alleles; in such case, only two phenotypes (“c” above) would be produced; however, because crossing over might produce recombinant progeny, the answer reflects the possible gametes and progeny] 4. This problem involves two separate inheritance patterns: ABO blood group and diabetes [see Genetics Key in solution to question #6] The Cross: Stephan = BOdd x Jenna = AODd; Oscar = OOdd (to produce this child’s genotype and phenotype, both parents must have “O” alleles for blood type and “d” alleles for diabetes) AD

Ad

OD

Od

Bd

ABDd

ABdd

BODd

BOdd

Od

AODd

AOdd

OODd

OOdd

Solutions to Sample Genetics Problems (continued )

Answers: a. & b. 1/8 offspring will have type O blood and be diabetic (genotype = OOdd) 5. Carly, Cedric and both sets of parents have normal phenotypes (otherwise, they would have stated they have the disease); for Cedric and Carly’s father, the genotype/phenotype are: XHY = normal male (it does not matter that Cedric’s cousin has the disease); however, Carly’s genotype/phenotype can be: XHXH or XHXh = normal female; but because Carly has a brother with hemophilia (genotype/phenotype: XhY = hemophiliac), their mother would have to contribute a gamete with the hemophilia allele; thus, the mother’s genotype is XHXh, which is a normal phenotype but carrier genotype; following is a Punnett square with the cross of Carly’s parents: The results show that Carly can XH Xh be either XHXH or XHXh: That H H H H h represents a 50% chance of being X X X X X a carrier; if she is a carrier, the Y XHY XhY Punnett square directly above would also represent the cross between Cedric and her; by applying the Multiplication Probability Rules [see section 3, c, ii, page 2], probabilities of conditions in the offspring can be calculated Answer: a. Carly’s genotype cannot be definitively determined Carly’s probability of being XHXh = 50% (0.5) Probability of a daughter with the disease = 0% (0.0) 0.5 Carly is a carrier x 0.0 Daughter is diseased 0.0 0% overall probability of daughters with the disease Probability of a son with the disease = 50% (0.5) 0.5 Carly is a carrier x 0.5 Son is diseased 0.25 25% overall probability of sons with the disease 6. This problem involves two separate inheritance patterns: Cattle fur color, which exhibits incomplete dominance; and horn development, which exhibits complete dominance Genetics Key: Fur Color: W = white, w = red WW = white Ww = roan ww = red Horn Development: H = hornless h = horns present HH = hornless Hh = hornless hh = horns present The Cross: The use of the symbol “F1” traditionally indicates progeny testing, as originally employed by Mendel in his pea plant crosses; this requires that the original parents be pure breeders or homozygous, and that the hornless genotype must be HH, not Hh; thus, the P generation crosses could be either: WWHH x wwhh OR WWhh x wwHH Answers: a. F1 genotype: WwHh F1 x F1 cross: WH

WH WWHH

Wh WWHh

wH WwHH

wh WwHh

Wh

WWHh

WWhh

WwHh

Wwhh

Answer: a. Male parent: XcY = color-blind male Female parent: XCXc = normal-vision female 8. This problem involves a trait involving complete dominance; in this case, the normal or “good” allele is dominant, and the defective allele that causes diabetes is recessive: Genetics Key: D = normal, d = diabetes DD = normal, Dd = normal, dd = diabetic The Cross: Both parents must be heterozygotes: Dd x Dd = dd child Answer: a. 25% probability for all subsequent offspring to have the same genotype/phenotype as the first child 9. To solve this problem, and others that are unfamiliar, first create a key for symbols and the type of genetic inheritance pattern; foot growth direction displays complete dominance, while foot size displays incomplete dominance: Genetics Key: Foot Growth Direction: B = forward, b = backward BB = forward Bb = forward bb = backward Foot Size: L = large or big, l = small or little LL = large feet Ll = normal feet (incomplete dominance) ll = small feet The Cross: Male = bbLL x Female = BBLl Answers: BL Bl a. The female can produce two gamete types (BL, Bl) bL BbLL BbLl b. Two phenotypes produced: (1) forwardpointing, big feet; (2) forward-pointing, normal-sized feet BL Bl c. Changing the original cross to male = bbLl x bL BbLL BbLl female = BBLl yields the bl BbLl Bbll results shown: The cross shown yields three phenotypes (forward/big, forward/normal, forward/small) d. Changing the original cross bL bl to male = bbLL x female = bbLl yields the results bL bbLL bbLl shown: e. Changing the original cross to male = bbLL x female = bbLl would yield no offspring with forward-pointing feet 10. This problem involves two separate inheritance patterns in humans: ABO blood group and colorblindness The Cross: Randy = AB XcYx; Sheri = AO XCXc (this must be her genotype, as her mother contributed an “O” allele for blood type, and her father contributed an “Xc” allele for colorblindness) AXc

AY

BXc

BY

AAXCXc

AAXCY

ABXCXc

ABXCY

wH

WwHH

WwHh

wwHH

wwHh

AXC

wh

WwHh

Wwhh

wwHh

wwhh

AXc AAXcXc

AAXcY ABXcXc ABXcY

AOXCXc

AOXCY BOXCXc BOXCY

OXc AOXcXc

AOXcY BOXcXc BOXcY

b. 6 out of 16 (38%) would be roan & hornless, with genotypes of either WwHH or WwHh c. 1 out of 16 (6%) would be white & horned, with a genotype of WWhh 7. The key to solving this problem is that the sister is colorblind, which is the genotype/phenotype: XcXc = color-blind female; this means that both parents contributed the “Xc” allele; the other sister was normal, which would make her genotype/phenotype: XCXc = normal-vision female; thus, the mother must have contributed the “XC” or normal allele

OXC

Answer: a. Male and female offspring would have every combination of blood type A, B & AB with every combination of vision (i.e., normal vs. color-blindness); based on the known genetics patterns, however, type O blood would not be present in any offspring, regardless of gender 5

Molecular Genetics A. The Central Dogma 1. Soon after the discovery of the structure of DNA, the function of nucleic acids in general was better understood; the following subsection summarizes the major processes involved in molecular biology; when relating these processes to inheritance, this is called molecular genetics: a. DNA Replication: New DNA is copied from existing DNA—a process that uses or conserves half the original DNA, while the other half is new (i.e., semiconservative replication) b. DNA Transcription: Messenger RNA (mRNA) is copied from DNA; intervening sequences (introns) are removed and remaining portions (exons) are ready to be translated c. DNA Translation: Proteins are synthesized from mRNA by ribosomes

The Central Dogma DNA Strand Transcription

Messenger RNA

Transfer RNA

Ribosomal RNA

Translation Proteins Amino Acids

Ribosomes

Protein

2. Retroviruses: Group of RNA viruses possessing a special enzyme, reverse transcriptase, that allows the viral genome to go in the reverse direction of the information flow of the central dogma; this allows the viral RNA to be converted into DNA, thereby altering the host cell’s genome a. DNA ← Viral DNA B. Mutations 1. Any random, permanent change in the DNA molecule; many are harmful, some have no effect, and a few actually benefit the organism; nature selects those mutations that are beneficial or adaptive in organisms to help shape the course of evolution a. Point Mutation: Change in one nucleotide base pair b. Chromosomal Mutation: Change in chromosome number or structure C. Genomics 1. Study of the entire genome of species a. Structural Genomics: Gene mapping and sequencing b. Functional Genomics: Studying how gene sequences operate, including proteomics (study of functioning of proteins coded by genes) c. Comparative Genomics: Analysis of gene sequences of different species

Molecular Genetics (continued ) D. Developmental Genetics 1. Advances in molecular biology have revolutionized the study of developmental biology; for example, studies on the fruit fly Drosophila have illustrated fundamental processes in cellular differentiation a. Homeotic Genes: Sets of genes that control basic body patterns in organisms, including members of the fungal, plant and animal kingdoms b. Homeobox: Specific nucleotide sequences (composed of about 180 base pairs) typically associated with homeotic genes c. Hox Genes: Subset of homeobox genes that are found in many different animals and are highly conserved (i.e., basically the same), indicating that, evolutionarily, they arose very early in the development of life on Earth

Homeobox Hox Genes of Animals Are Highly Conserved Fly homeobox DNA sequence

Frog DNA

Fly homeobox DNA sequence is mixed with Frog DNA

Heat

Strands separate

Cool

Fly homeobox DNA binds to frog DNA, confirming sequence similarity E. Cancer Genetics 1. Cancers frequently involve three types of mutated genes: a. Oncogenes: Stimulate abnormal cell growth and division, which can lead to malignant tumors; originate from normal genes, called proto-oncogenes,

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which regulate the cell cycle; viruses can also transmit oncogenes to host cells b. Tumor-Suppressor Genes: Normally prevent the uncontrolled growth and division of cells and tissues; mutations may deactivate these genes, which can lead to cancers c. Mutator Genes: Can increase the mutation rates of other genes, thereby increasing the chance of cancerous tissues developing F. Non-Mendelian Inheritance 1. Mitochondrial & Chloroplast Genomes a. The Endosymbiotic Hypothesis suggests that mitochondria and chloroplasts are derived evolutionarily from prokaryotes; the strongest evidence for this hypothesis is that both organelles have their own set of DNA: mtDNA in mitochondria and cpDNA in chloroplasts b. Genes on these non-nuclear sources of DNA are called extranuclear genes; they have “non-Mendelian” inheritance patterns, because they do not engage in meiotic segregation and re-assortment processes c. Uniparallel Inheritance: Offspring (male and female) have characteristics of just one parent d. Maternal Inheritance: In most sexually reproducing, eukaryotic organisms, the haploid genome and cytoplasm with organelles from the female gamete are passed to the zygote, while the male gamete essentially contributes only a haploid genome; very little cytoplasm is transferred to the zygote; thus, traits associated with mtDNA are inherited from the maternal parent 2. Infectious Heredity: Symbiotic bacteria and viruses that are transmitted in cytoplasm G. Molecular Evolution 1. Although morphological characteristics (visible phenotypes) have been the traditional focus of evolutionary biology, emergent molecular techniques have allowed the study of the evolution of DNA and protein sequences 2. Molecular Phylogenies: Phylogenetic trees, illustrating evolutionary relatedness of all species, have been revised and updated using modern molecular techniques; one major development was dividing life into three large groups or domains: Bacteria, Archaea and Eukarya

Population & Evolutionary Genetics Genes in populations versus individuals A. Populations evolve just as species do B. Genotype: Genetic composition of an individual C. Gene Pool: Genetic composition of a population of individuals; that is, all alleles for all genes in a population D. Evolution involves changes in gene pools over time; to understand changes in gene pools as populations evolve, an understanding of non-evolving populations is necessary The Hardy-Weinberg Law A. Both allelic frequencies and genotypic ratios (i.e., gene pools) remain constant from generation to generation in sexually reproducing populations, if the following conditions of equilibrium exist: 1. Mutations do not occur 2. No net movement of individuals out of or into a population occurs 3. All offspring produced have the same chances for survival, and mating is random; that is, no natural selection occurs 4. The population is large so that chance would not alter frequencies of alleles B. Algebraic equivalent of the Hardy-Weinberg Law: 1. p2 + 2pq + q2 = 1, where: a. p = frequency of dominant allele b. q = frequency of recessive allele c. p2 = AA genotype d. 2pq = Aa genotype e. q2 = aa genotype C. Example: 1. If, in a group of six individuals, there are nine dominant (A) alleles and three recessive (a) alleles, then p = 9/12 or 0.75 and q = 3/12 or 0.25; a total of 12 gametes will be produced, nine of which will have the dominant allele and three with the recessive allele 2. The algebraic equation above can be used to predict the ratios of the three possible genotypes as a result of fertilizations: a. Frequency of AA genotypes is p2 or (0.75)2 = 0.56 b. Frequency of Aa genotypes is 2pq or 2(0.75)(0.25) = 0.38 c. Frequency of aa genotypes is q2 or (0.25)2 = 0.06 3. The frequencies of dominant and recessive alleles are still the same—the specific alleles have been redistributed Hardy-Weinberg & Natural Populations A. Few (if any) populations are in equilibrium; therefore, changes in allele frequencies and, thus, gene pools do occur in natural populations B. The Hardy-Weinberg Law helps to identify the mechanisms of these evolutionary changes by predicting that one or more of the four conditions required are not met; that is: 1. Mutations occur 2. Individuals leave and enter populations 3. Non-random mating and natural selection occur 4. Small populations exist

Allele Frequency Changes Frequency of allele for gray body is higher

Gray male

Frequency of allele for gray body is lower

Normal female

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Disclaimer: This QuickStudy® guide is intended for informational purposes only. Due to its condensed format, this guide cannot cover every aspect of the subject; rather it is intended for use in conjunction with course work and assigned texts. Neither BarCharts, Inc., its writers, editors nor design staff, are in any way responsible or liable for the use or misuse of the information contained in this guide. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2008 BarCharts, Inc. Boca Raton, FL 0408

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CIRCULATION

WORLD’S #1 ACADEMIC OUTLINE

L. common carotid a.

Inferior thyroid v. L. brachiocephalic v.

Brachiocephalic trunk R. common carotid trunk

Subclavian a. & v.

ANTERIOR HEART

R. common carotid Inferior thyroid v.

Internal jugular v.

L. pulmonary a. Arch of aorta

Internal jugular v. R. external jugular v.

L. external jugular v.

Internal jugular v.

a. = artery a.a. = arteries L. = Left m. = muscle m.m. = muscles R. = Right v. = vein v.v. = veins

L. auricle R. pulmonary a.

R. subclavian a.

External jugular v. R. brachiocephalic v.

Arch of aorta

Superior vena cava

Ligamentum arteriosum L. pulmonary a.

R. pulmonary a. R. pulmonary v.v.

L. pulmonary v.v. Pulmonary trunk L. atrium Mitral valve L. ventricle Aortic valve L. posterior papillary m.

Pulmonary valve R. atrium Tricuspid valve

Muscular interventricular septum

Aortic arch L. pulmonary a.a.

Superior vena cava

Ascending aorta

Aortic valve

L. atrium

L. pulmonary v.v. L. atrium

Ascending aorta R. atrium

L. ventricle

R. coronary a.

L. anterior descending (or anterior intraventricular) coronary a.

Inferior vena cava Fat

Great cardiac v.

Apex

Circumflex branch of L. coronary a.

Anterior cardiac v.v.

Coronary sinus

R. coronary a. L. ventricle

R. superior pulmonary v. R. inferior pulmonary v.

Great cardiac v.

Posterior L. ventricular branch

R. marginal branch of R. coronary a.

Sulcus terminalis

Posterior branch of L. coronary a.

Posterior v. of L. ventricle Apex L. ventricle Coronary sinus

NERVES & ARTERIES

Aortic valve Branch to sinoatrial node L. coronary a. Oblique v. of L. atrium Anterior R. atrial Great branch of R. cardiac v. coronary a.

Mitral valve

R. atrium

L. superior pulmonary v. L. inferior pulmonary v.

Circumflex branch of L. coronary a.

CORONARY ARTERIES & CARDIAC VEINS

Pulmonary trunk

Pulmonary valve

R. brachiocephalic v.

Descending aorta

Abdominal aorta

INTERIOR HEART

L. subclavian a.

R. ventricle

Apex R. ventricle

Superior vena cava

L. brachiocephalic v.

L. common carotid

Inferior vena cava

POSTERIOR HEART

Sinoatrial (SA) a.

R. atrium Inferior vena cava R. coronary a. Posterior descending a. L. atrium Middle cardiac v. Main R. coronary a. Aortic valve: R. cusp L. cusp Posterior cusp

Sinoatrial (SA) node Middle internodal tract Posterior internodal tract

Bachmann’s bundle Main L. coronary a. Anterior internodal tract Circumflex branch

Marginal branches Atrioventricular (AV) node Common AV bundle (of His)

Tricuspid valve

R. bundle branch

Small cardiac v. Opening of coronary sinus Papillary m.m.

R. ventricle

Muscular interventricular septum Papillary m.m.

Posterior v. of L. ventricle

Middle cardiac v. Posterior interventricular branch of R. coronary a. (posterior descending a.)

Anterior interventricular branch (L. anterior descending) of L. coronary a.

Edge of the transparent heart

Atrioventricular (AV) a. Purkinje fibers Posterior interventricular branch Perforating branches to interventricular septum

Purkinje fibers Anterior interventricular branch (L. anterior descending) of L. coronary a.

L. bundle branch

BEGINNING OF DIASTOLE

END OF DIASTOLE

Sinoatrial (SA) node

Contracting atria

END OF SYSTOLE

SYSTOLE

Atrioventricular (AV) node

Contracting ventricles

HEART IN DIASTOLE

HEART IN SYSTOLE

Anterior semilunar cusp

Pulmonary valve L. semilunar cusp L. anterior descending a.

R. semilunar cusp R. coronary a. Marginal branch

Aortic valve L. coronary a.

Anterior semilunar cusp

Pulmonary valve L. semilunar cusp L. anterior descending a.

R. semilunar cusp R. coronary a. Marginal branch

Aortic valve L. coronary a.

Anterior cusp

Posterior semilunar cusp

Posterior semilunar cusp

Mitral valve

Mitral valve

Anterior cusp

Tricuspid valve

Tricuspid valve Anterior cusp

Anterior cusp Posterior cusp

Posterior cusp

Posterior cusp

Posterior cusp Medial cusp

Medial cusp Posterior v.

Posterior v. Small cardiac v.

Coronary sinus Middle cardiac v.

Coronary sinus

Annulus fibrosis

NOTE TO STUDENT

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All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2000 BarCharts Inc. Boca Raton, FL. 0608

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Small cardiac v. Annulus fibrosis

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INTRODUCTION Urinary incontinence is the inability to control urination; it can range in severity from slight leakage to total loss of bladder control This chart is designed to help you understand the causes of incontinence and give helpful hints on its management; this information is not a substitute for professional medical care; always consult your physician if problems arise It is estimated there are over 13 million incontinent adults in the U.S. today; women are twice as likely to have this condition as men; children may also have bladder control problems; urinary incontinence is treatable and usually does not require surgery; some causes of incontinence include muscle weakness, an enlarged prostrate blocking the urethra, and diseases or injuries involving nerves and muscles; pregnancy, bladder infections and certain medications may temporarily cause incontinence

NORMAL CONTROL OF URINE • Urine control is very complex; the brain, spinal cord and muscles of the bladder, urethral sphincter and pelvic floor must work together • Urine is stored when the brain makes the bladder relax and pelvic muscles contract • When control centers in the brain quiet, the pelvic muscles relax, and the bladder can squeeze and empty BLADDER Medications that can affect bowel or bladder control: Diuretics Anti-hypertensives Sedatives Antihistamines Narcotics Antidepressants

TYPES OF INCONTINENCE Stress Incontinence: • Occurs when the pressure closing the bladder is greater than the pressure in the urethra • Results in loss of urine while coughing, laughing or changing position • Most prevalent in women, especially after childbirth and hysterectomy • Occurs when the muscles and tissues closing or supporting the urethra are weak or damaged, such as with childbirth, weight gain or some types of surgery • May worsen with altered levels of estrogen during the menstrual cycle, or after surgical or natural menopause • Surgery is designed to restore the normal position of the bladder and/or the bladder neck and urethra

WORLD’S #1 ACADEMIC OUTLINE

Urge Incontinence: • An overwhelming urge to urinate, followed by the release of a sometimes large amount of urine • Caused by bladder wall spasms; also described as unstable, spastic or overactive • Can be set off by the sound of running water, walking past a favorite bathroom, returning home, or sudden bladder filling due to alcohol or other diuretics • Common after menopause and in older persons when the bladder muscle is more irritable • Also common when MS, diabetes, stroke or Parkinson’s interrupts control messages from the brain’s higher centers • Irritation sometimes increased by concentrated urine from inadequate fluid intake, or by caffeine, citrus juice, artificial sweeteners, or spicy foods • Usually not related to excess urine in the bladder but rather to an irritated bladder muscle from infection, bladder calculi (stones), polyps or cancer

Overflow Incontinence: • Leakage of typically small amounts of urine when the pressure in an overfull bladder overcomes the pressure in or around the urethra • May cause urine to flow back up into the kidneys, damaging or destroying them • Usually due to either a bladder that contracts weakly or a blockage of the urethra • Common in men with an enlarged prostate, especially when taking cold medications • Nerve damage due to diabetes, spinal injury, MS or a birth defect may prevent bladder wall muscle from contracting or prevent muscles that close the urethra from relaxing • Treatments include medication review, surgery to remove obstruction, clean intermittent catheterization, and as a last resort, indwelling catheterization • Urethral blockage may cause bladder spasms/instability over time that persists after prostate surgery

Functional Incontinence: • Occurs in people with borderline bladder control who are unable to reach the toilet in time because of physical problems like arthritis or muscles affected by a stroke • Also caused by environmental barriers, such as stairs, distance or crowds preventing timely access to bathroom • May occur in those with dementia or severe depression who don’t remember how to get to the bathroom or even care about it • Offering assistance to get to the bathroom every 1—2 hours and a drink of water following use of the toilet may correct this • Having a commode nearby or keeping the route to the bathroom free of obstacles and well lit may also help

Fecal Incontinence (loss of normal bowel control): • There are over 1 million people in the US suffering from fecal incontinence

• Commonly caused by chronic constipation from inadequate fiber and fluids

• May also be caused by a weak anal sphincter • Ignoring the first urge to have a BM causes the stool to dry out, increasing constipation

• When unable to expel hard rectal contents, liquid stool higher in the intestine may move past the obstruction, giving the appearance of diarrhea • A full rectum also may press against the bladder or urethra, and cause urinary problems

EVALUATION OF INCONTINENCE Evaluation of Incontinence: • Focused history and physical examination • Analysis of a urine sample • A toileting diary covering several days, recording toilet use and accidents

• Stress test – observation of leakage with activity • Measurement of urine in bladder after urinating Specialized tests not part of basic evaluation: • Urodynamics: Determination of functional status of urinary bladder and urethra • Cystoscopy: A narrow telescope-like tube is used to help in identifying lesions, pouches, holes and blockages • Imaging: Examines the bladder, ureters and kidneys for lesions and blockages

Summary of information collected to diagnose possible causes of incontinence: • Focused history • A diary, covering several • Physical examination days, recording toilet • Analysis of urine use and accidents sample • Estimate of urine left in bladder after emptying it

CATHETERIZATION Indwelling catheterization Indicated only when urine output must be closely monitored, incontinence hampers healing of a stage 3 or 4 pressure ulcer, in the terminally ill to avoid undue pain or trauma, or as the last resort to avoid institutionalization • Insertion is a sterile procedure to prevent UTI • Use the smallest catheter that drains well (14 or 16 Fr.) • Avoid balloons > 10 ml, unless for hemostasis • Base catheter changes on patient need, not a predetermined interval • Urine may leak around catheter because of bladder spasms, too large a catheter or balloon, catheter blockage or infection Intermittent self-catheterization • Far safer over time than an indwelling catheter • Clean technique and washing catheter with soap and water is recommended • Catheter guides, grasp aids and mirrors may assist females but should be ultra-portable to avoid postponing catheterization

SKIN CARE • Urine and especially feces can seriously damage skin if allowed to remain

• Use absorptive products with polymer gel and change when wet

• Wash skin with incontinence wipe or cleanser but avoid excess friction; avoid soap as it removes natural protective lubricants • Barriers such as the petroleum-based products and zinc oxide protect against breakdown • Skin breakdown or pressure ulcers (bedsores or decubiti) are increased with mobility limitations • Collection devices help when treatment fails; there are many types (disposable & reusable): liners, drip collectors, condoms, pads, guards, undergarments, briefs and bed pads; device should be comfortable and discreet, and keep skin, clothes and furniture dry; overpadding damages skin and reduces leakage awareness

(Also consult BarCharts® Wound Care Guide)

TREATMENT Behavioral Techniques: These decrease the frequency and amount of incontinence in most persons when used by experienced health care providers, have no reported side effects and do not limit future treatment options; clinical practice guidelines typically suggest trying behavioral methods first; listed in order of participation required: • Scheduled toileting: Help offered at fixed or regular intervals • Habit training: Toileting scheduled to match usual voiding habits • Prompted voiding: Person is asked if they are wet or dry, assisted to the bathroom, and praised for appropriate toileting • Pelvic muscle rehabilitation: Exercises making the pelvic floor bulkier, giving better closure and support to the bladder • Urge suppression: Using pelvic muscle contractions, controlled breathing and/or distraction to quiet an irritable bladder • Bladder training: Drinking adequate fluid and gradually prolonging voiding intervals

Other Interventions • Medicine: Over-the-counter and prescription drugs may be beneficial but some have side effects, such as a dry mouth • Pessary: A rubber, silicon or plastic device inserted in the vagina to give additional support • Electrical stimulation: Uses a vaginal or rectal probe to make pelvic muscles tighten • Implanted nerve stimulator: Implanted near the sacral area of the spine to stimulate nerves controlling bladder function • Artificial sphincter: Inflatable ring surgically implanted around the urethra or rectum; patient squeezes bulb to temporarily transfer water from the ring to an internal reservoir, allowing emptying of the bladder or bowels • Other surgery: Goal is to restore the normal position of the bladder and/or urethra, or to relieve urethral or prostatic obstruction

PELVIC FLOOR EXERCISES These exercises strengthen muscles that support the pelvic contents and close off the urethra and anus Guidance of a health care professional is helpful; exercises usually improve control, but only if: • They are done regularly and correctly • Pelvic muscles are completely relaxed before beginning exercises • Abdominal and gluteal muscles are kept relaxed throughout the entire exercise • Breathing is regular, without holding at any time • Exercises are not done to point of exhaustion

How to do Pelvic Floor Muscle Exercises: • Locate correct muscle by pretending you are trying to avoid passing gas; never practice by repeatedly interrupting the urine stream • A lifting and tightening sensation can be felt when done correctly; men will see the base of their penis pull in; women can feel pressure when two fingers are inserted into the vagina • Keep muscles tense as long as comfortable, between 2-5 seconds at first Customer Hotline # 1.800.230.9522 ISBN-13: 978-142320729-0 ISBN-10: 142320729-7

• Relax muscles for the same duration • Repeat a total of 10 times, if possible • Do exercises each time the bladder has been emptied, or at other times, to a total of 50 squeezes daily

• Over a period of weeks, try to build up to 10second holds, with 10-second rests in between

Aids to learning PFM Exercises: Dr. Kegel pioneered pelvic floor muscle exercises in the 1950s as a way to regain bladder control without surgery; he gave his patients a simple pressure sensor to use for biofeedback because he had observed that 40% of them could not learn to exercise properly with just verbal instruction • EMG, surface or internal: Displays on a computer monitor the signals nerves send to the support muscles and external sphincters, making it easier to learn to control and strengthen them; home devices are also available • Vaginal pressure sensor: Worn in vagina while exercising, with a measuring device attached • Vaginal weights: Tampon-shaped devices graduated in weight, worn in the vagina while walking

GLOSSARY anus: Outlet of rectum, FOLEY containing sphincter muscles to close it off; lies in the fold between the buttocks bed & chair pad: STRAIGHT Reusable or disposable; CATHETERS that protects upholstered furniture or mattress commode: A portable toilet biofeedback: Sound or visual display of any normally non-visible bodily function, so as to learn to modify it; often used to gain control of muscles which support and close off urethra and anus bladder: A balloon-like muscular organ that stores and empties urine BPH (Benign Prostatic Hypertrophy): Non-cancerous enlargement of prostate, common in older men; usually controlled by medication; if the passage of urine becomes completely blocked, this is an emergency, and medical help should be sought immediately briefs (reusable): Absorbent adult diaper with elastic (pullup), snaps, or plastic and tape at the hip catheter: A soft tube that is inserted through the urethra to drain the bladder catheter guide: Plastic device that helps a female find her urethra during catheterization condom or external catheter: Worn on the penis (similar to a condom) and connected to a leg bag or bedside drainage bag drip collector: Absorbent pocket that holds the penis and adheres to the undergarment, to collect small amounts of urine enuresis alarm: A sensor used in the crotch of pajamas or in a bed pad, to set off an alarm when wet fecal impaction: Hardened stool or feces in the rectum which prevent normal bowel movements foley catheter: Catheter with a built-in “balloon” inflated after insertion, to hold the catheter in place

DISCLAIMER: Always consult your doctor or nurse specialist with any concerns or problems with your condition. This guide is intended only for informational purposes and helpful hints. In no way is this guide meant to be a substitute for professional medical care. Neither BarCharts®, nor its writers & editors, are in any way responsible or liable for the use or misuse of the information contained in this guide. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2000, 2002 BarCharts, Inc. 0608

It is connected to a drainage bag and used during surgery to monitor outflow during critical conditions, or when no other method to control urine is feasible; causes dependence; may damage bladder and urethra, and allows bacterial invasion; bladder infections are difficult to control while it is being used guard: Incontinence protection that is slightly larger than a pad, with plastic or foam on the outside; holds more than a pad Kegels: Pelvic floor muscle exercises done using biofeedback, pioneered by Arnold Kegel, MD kidneys: Two beanshaped organs that 2000 CC filter waste from the blood and produce urine leg bag: A plastic pouch connected to a catheter, supported by a pocket in a garment or by straps DRAIN BAG fastening it to the leg jelly: lubricating Liquid substance used to lubricate a catheter to make insertion easier nocturia: Excessive (>2) urination during night nocturnal enuresis: Urine leakage during sleep pads: Shaped like a sanitary napkin, but especially designed for urine collection, so less likely to leak penile clamp: Semi-rigid clamp that surrounds the penis to control accidental urine loss pelvic floor muscles: Group of muscles extending from the pubic bone to the tail bone, providing support for the pelvic organs, and opening and closing the urethra and anus bowel prolapse: Descent of uterus, bladder or other organs toward or past womb openings in pelvic floor prostate: A gland in the pubic male pelvis that surrounds bone the urethra just below the bladder protective clothing: Apparel with plastic layers or panels pelvic floor muscles to protect against wetting raised toilet seat: Fits over or attaches to toilet, raising the seat to make it easier to get off toilet retracted penis pouch: Pouch attached with adhesive barrier at base of penis, to divert urine from an inverted or small penis to a drainage bag sphincter: The muscle around the urethra or anus, controlling the emptying of the bladder or rectum undergarment: Similar to a loincloth, with straps attached by buttons or Velcro™; panty liners and pullup types similar to regular underpants are also available ureters: Two thin tubes that carry urine from the kidney to the bladder urethra: Tube from bladder base to the outside, about 8 inches long in men, 1-11/2 inches in women urologist: A doctor who specializes in conditions of the urinary tract in both men and women UTI (Urinary Tract Infection): Symptoms include burning, frequent and painful urination; in the elderly, behavioral changes may be the only sign

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WORLD’S #1 QUICK REFERENCE GUIDE

an introduction to

Health Care definitions

purpose > What are a patient’s rights and responsibilities?

health Dynamic state of balance character-

> What are the different types of health care?

ized by anatomical, physiological, social, psychological and spiritual integrity

> Who provides health care services?

health care Services provided for the pur-

> Where are the services provided?

pose of promoting, maintaining, monitoring or restoring physical or mental health

> How is health care financed?

health care industry Complex array of preventive, remedial and therapeutic services provided by health facilities, practitioners, government and voluntary agencies, noninstitutional care facilities, medical equipment and pharmaceutical manufacturers and health insurance companies

•The health care industry is one of the most complex, regulated, diversified and technologically advanced systems in American society •This guide presents an overview of selected components within the delivery system •The patient receives health care from health professionals in a setting as a result of a particular health insurance plan •Providers are reimbursed by the payer (patient, government, managed care company, private insurance company) according to the contractual terms of the health plan

health care system A structured network of services encompassing personal health care, public health services, teaching and research activities, and health insurance coverage patient / client Recipient of a health service provider A health professional and / or facility / organization /company authorized to provide health care

Health Care preventive care

hierarchy of care

Focus on disease prevention and health maintenance

Range of services within the system

Primary

• Education on good health habits and resources to prevent illness / disease • Focus on disease prevention and health maintenance • Identification of individuals at risk for developing specific health problems • Appropriate interventions to prevent a health problem ¤ Primary Care • Early detection and routine treatment of health problems • Usually the health care system entry point • Provided in an ambulatory facility ¤ Secondary Care • Traditional acute care for: Emergency care Diagnosing and treating an illness • Individuals may enter system at this level • Intermediate level of health care ¤ Tertiary Care • Specialized, highly technical care • Performed in a sophisticated, research / teaching medical center

A c tiv itie s dir e ct e d t owa r d: • Improving general well-being • Involving specific protection for selected diseases Ex. Immunizations, school education programs

Secondary Fo cuses on: • Early diagnosis • Rapid initiation of treatment • Ex. Screening tests

Tertiary • Concern with rehabilitation and return of a patient to maximum usefulness with a minimum risk of recurrence • Want to prevent further deterioration Ex. rehabilitation therapies (physical / occupational therapy)

¤ Preventive Care

■

■

1

• Given by highly trained specialists using advanced technology ¤ Restorative Care • Intermediate follow-up and rehabilitation for convalescing patients • Includes subacute care ¤ Continuing Care • Long term with little expectation of improvement in physical / mental status • Care of the chronically ill • Performed at home or in a medical facility • Includes palliative care (relieves / reduces uncomfortable symptoms, does not cure) and respite care (temporary relief for the primary caregiver)

SETTINGS Sites / locations where one or many health services are provided; some settings fit into multiple categories; Ex. hospitals

¤ Ambulatory Care • Care provided on an outpatient basis — does not require an overnight stay in a health facility • Includes a variety of services — preventive care activities, diagnostic testing, therapies and rehabilitation • Office based medical practice — most predominate setting

Hierarchy Of Care continued

• Additional settings include: Clinics Hospital Health Dept. School Industrial Prison Family Planning Walk-in Volunteer

Centers Surgical Renal Dialysis Community Health Urgent / Emergency Care Birthing MRI Women’s Health Pain Management

Agencies Volunteer Home Health Care

• Clinical laboratories, internet, mobile diagnostic and medical screening services

¤ Hospitals

• Provide a variety of inpatient and outpatient health services • Voluntary accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

• Characteristics: o Licensed o Continuous nursing services o Structured medical staff o Specialized departments (radiology, laboratory, etc.) • Categories: o Ownership: Government / private (investor owned / not for profit) o Scope / type of service: General / specialized o Location: Urban / rural o Length of stay: Short-term / long term

¤ Long Term Care

• Medical, nursing, social, personal care, rehabilitative and palliative care provided on a recurring or continuing basis to individuals with chronic disease, disability or mental disorders • Settings include: o Community based: Adult daycare centers, hospice, home (health care / delivered meals), senior centers, community residential care facilities o Institutions: Skilled nursing facilities, assisted living facilities, continuous care retirement communities, Alzheimer’s facilities

Health Professionals definitions

Licensure by Endorsement Process of evaluating an “out-of-state” professional’s credentials malpractice professional misconduct / negligence • Four criteria for malpractice: ■ Duty: Obligation / responsibility to the patient ■ Breach of duty: Failure to perform responsibility ■ Damages: Injury must have occurred ■ Causation: Injury was caused by breach of duty professional liability Legal obligation of health professionals, or their insurers, to compensate patients for damages caused by acts of omission or commission by practitioners reciprocity Mutual agreement between two states whereby each state recognizes the license from the other state registration Listing of licensed or certified health professionals on an official roster scope of practice Professional practice boundaries (rights, responsibilities, restrictions) standards of care Expected professional conduct in a given situation (reasonably prudent person concept)

accreditation Process whereby an independent, impartial organization / agency formally recognizes a health facility or an educational program as meeting its predetermined standards ex. Commission on Accreditation of Allied Health Education Programs (CAAHEP) certification Permission granted by a nongovernment agency or association to practice a profession after successful completion of preestablished standards code of ethics Set of ethical standards / principles which guide an individual’s behavior / conduct ethics Moral standards / principles governing professional conduct: ethical principles include: • Autonomy Independent decision-making, personal choice • Beneficence Doing good, kindness, charity • Fidelity Observance of promises and duties, promise-keeping • Justice Righteousness, equitableness, fairness • Nonmaleficence Duty to do no harm Good Samaritan laws State laws protecting health professionals from civil liability when providing emergency assistance; assistance cannot be reckless / grossly negligent licensure Permission granted by a government agency to practice a profession after successful completion of preestablished standards; requirements vary by state

CRC CRT CST CT (ASCP)

professional designations ARNP ATR-BC CCT C DA CDT CMA CNMT CO COMT C OT C OTA CP C PhT C PO

Advanced Registered Nurse Practitioner Registered Art Therapist — Board Certified Certified Cardiographic Technician Certified Dental Assistant Certified Dental Technician Certified Medical Assistant Certified Nuclear Medicine Technologist Certified Orthotist Certified Ophthalmic Medical Technologist Certified Ophthalmic Technician Certified Occupational Therapy Assistant Certified Prosthetist Certified Pharmacy Technician Certified Prosthetist & Orthotist

CTRS DC DDS DMD DO DPM DTR EMT EMT-P HT (ASCP)

2

Certified Rehabilitation Counselor Certified Respiratory Therapist Certified Surgical Technologist Cytotechnologist (American Society of Clinical Pathologists) Certified Therapeutic Recreation Specialist Doctor of Chiropractic Doctor of Dental Surgery Doctor of Dental Medicine Doctor of Osteopathy Doctor of Podiatric Medicine Dietetic Technician, Registered Emergency Medical Technician Emergency Medical Technician — Paramedic Histologic Technician (American Society of Clinical Pathologists)

Patient / Client physician/patient

relationship

£ Physician is patient’s advocate: what is in the best interest of the patient • Relationship has evolved from a paternalistic to a collaborative decision making model • Mutual agreement and joint obligations between physician and patient £ Physician/Patient Privilege • Protection of confidential physician/patient communication in a legal proceeding: o Patient consent needed ■ Privilege belongs to the patient; utilized for patient’s benefit ■ Statutory law usually applies; exceptions in many states ■ Relates to confidential disclosures during the course of treatment £ Fiduciary Relationship • An individual has a duty to act for the benefit of another within the confines of the relationship; physician / patient relationship based upon confidentiality, trust, honesty and good faith • Hippocratic Oath states, “What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself holding such things shameful to be spoken about…”

confidentiality

£ Privileged communication between health professional and the patient £ Patient’s right to privacy information cannot be released without the patient’s consent £ Health professionals have a legal / ethical duty not to disclose confidential information £ Legal exceptions vary by state and include: • Abuse (child, elder, spouse) • Court order • Gun / knife wounds • Infectious / communicable diseases

consent

£ Giving approval, permission or agreement £ Basic patient right £ Patient Self-Determination Act, 1990: • An individual has the right to accept or refuse medical or surgical treatment £ Patient signs a general / blanket consent form when admitted into a health care facility £ Special consent forms required for most invasive procedures — research studies, clinical trials, surgery, chemotherapy, and other specialized interventions £ Express Consent • Verbal or written consent • Clearly and directly stated £ Informed Consent • Signed, dated, witnessed agreement must be signed prior to the treatment intervention • Patient authorizes specific intervention • Purpose Patient autonomy, right to make decisions regarding health care • Components: o Informed: ■ Information is provided on the risks, complications, benefits, alternatives, description of the intervention, definition of and probability of success and consequences if intervention is refused o Consent: Agreement /authorization for intervention • Conditions: o Conscious, mentally competent adult (if minor, parent(s) or legal surrogate) o Voluntarily signed o Information on intervention has been given to the patient o All patient’s questions have been answered o All statements are clear, rational and understood by the patient £ Implied Consent Inferred from one’s behavior or silence; Ex. medical emergency, unanticipated situation

medical records

£ A permanent, legal record of a patient’s care: patient’s medical care profile / data base £ Medical records are required by accrediting, certifying and licensing agencies and organizations £ Documentation must be correct, complete, legible, factual and timely £ Each health care facility has its own charting policies and procedures £ Purpose Patient care management, reimbursement, teaching/research, communication, legal and medical review

HTL (ASCP)

PT A RCI S RC S RD RDH RDMS RHIA RN R.Ph. RR T RT (N) RT (R) RT (T) R VS SCT (ASCP)

Histotechnologist (American Society of Clinical Pathologists) LCSW Licensed Clinical Social Worker LMHC Licensed Mental Health Counselor LPN Licensed Practical Nurse LVN Licensed Vocational Nurse MD Doctor of Medicine MLT (ASCP) Medical Laboratory Technician (American Society of Clinical Pathologists) MT (ASCP) Medical Technologist (American Society Of Clinical Pathologists) MT-BC Music Therapist-Board Certified NA Nursing Assistant OD Doctor of Optometry OTR Occupational Therapist, Registered PA-C Physician Assistant-Certified PT Physical Therapist 3

Physical Therapist Assistant Registered Cardiovascular Invasive Specialist Registered Cardiac Sonographer Registered Dietician Registered Dental Hygienist Registered Diagnostic Medical Sonographer Registered Health Information Administrator Registered Nurse Registered Pharmacist Registered Respiratory Therapist Radiologic Technologist (Nuclear Medicine) Radiologic Technologist (Radiographer) Radiologic Technologist (Radiation Therapist) Registered Vascular Specialist Specialized Cytotechnologist (American Society of Clinical Pathologists)

Medical records continued

£ Basic Rule “If it wasn’t recorded, then it wasn’t done.” £ Contents Medical/family history, complaints, observations, progress notes, orders, results from diagnostic tests/procedures, treatments, medications, diagnosis and documents (informed consent forms, advance directives, etc) £ Ownership Physical property of the health care facility or practitioner £ Accessibility Generally, with proper written authorization the patient has accessibility; governed by state law £ Retention Time period determined by state/federal laws £ Health Insurance Portability and Accountability Act 1996 (HIPAA) • First federal privacy standards protecting patients’ medical records and other individually identifiable health information • Addresses the following issues: o Access to medical records: Generally, patients should be able to see and obtain copies of their medical records and request corrections if they identify errors and mistakes o Notice of privacy practices: Covered health plans, doctors and other health care providers must provide a notice to their patients on how their personal medical information will be used and their rights under the privacy regulation o Use of Personal medical information: Sets limits on how individually identifiable health information may be used o Prohibition on marketing: Sets restrictions and limits on the use of patient information for marketing purposes o Stronger state laws: Standards do not affect state laws that provide additional privacy protections for patients • Confidential communication Patients can request their doctors, health plans and other covered entities take reasonable steps to ensure communications are confidential • Complaints: o Consumers may file a formal complaint regarding the privacy practices of a covered health plan or provider o Enforcement by the U.S. Department of Health and Human Services Office for Civil Rights (OCR)—civil and criminal penalties • Law reflects basic principles of: o Consumer control o Public responsibility o Boundaries o Security o Accountability

patients’ rights &

responsibilities

£ Rights • Receive accurate, easily understood information about health plans, professionals, and facilities • Choice of providers and plans that ensure access to appropriate high quality health care • Access to emergency health services when and where needed • Participate in health care decisions • Considerate, respectful care from health professionals at all times and under all circumstances • Communicate with providers in confidence individually identifiable information is protected • Fair and efficient process for resolving differences with health plans, practitioners, and facilities £ Responsibilities • Practice good health habits live a healthy lifestyle • Comply with treatment plan learn about medical condition • Communicate relevant information to health practitioners • Recognize risks and limits of medical science • Know health plan coverage, options, administrative andoperational procedures • Respect other patients and health professionals • Make a good faith effort to meet financial obligations • Report wrongdoing and fraud to the appropriate authorities 4

treatment r ights

£ A patient can: • Accept or reject treatment (informed consent vs. informed refusal) • Leave a hospital against medical advice £ Emergency Medical Treatment and Active Labor Act 1986 (EMTALA) • Patient anti-dumping law • Established criteria for: o Emergency services o Interhospital patient transfer • Hospitals must provide: o Medical screening exam—does an emergency condition exist? o Prior to transfer, stabilizing treatment for an emergency patient and a woman in active labor o Continued treatment until patient’s discharge or transfer • In emergencies, patient has right to treatment, regardless of ability to pay or insurance coverage • Gives guidelines for transfer of a non-stabilized patient • Applies to all hospitals receiving federal funds • Penalties for violation of the law

advance direct i ves

£ Written legal documents whereby an individual indicates treatment preferences /instructions should s(he) become decisional incapacitated • Signed, dated, witnessed documents put in medical record £ Types of and requirements for directives vary by state law £ Patient Self-Determination Act 1990 • Applies to most institutional providers and prepaid plans participating in Medicare or Medicaid • Law requires that providers and prepaid plans: o Document (in the medical record) whether the individual has an advance directive o Educate staff and community about directives o Develop and provide patients written information on their rights to execute an advance directive o Ask each admitting patient if s(he) has an advance directive: patient has the right to prepare one if s(he) so desires o Ensure state law compliance regarding advance directives o Inform patients of the facility’s policies and procedures concerning implementation of an advance directive o Do not discriminate in the provision of care/ treatment on the presence or absence of an advance directive £ Types of Advance Directives: • Instructive o Living Will ■ Written instructions for life prolonging procedures—provide, withhold or withdraw ■ Can include non-specific or specific treatment statements ■ Takes effect when a patient cannot communicate his/her wishes o Do Not Resuscitate (DNR) order ■ Written instructions that the patient does not wish to be resuscitated in the event of cardiopulmonary arrest • Health Care Surrogate/Proxy o Also called Durable Power of Attorney for Health Care o Authorizes another individual (proxy/surrogate) to make health care decisions for the patient o Patient must be decisional incapacitated/incompetent unable to make medical decisions o A surrogate can be given the power to: ■ Refuse or consent to treatment/medication ■ Withdraw life sustaining treatment ■ Access medical records ■ Make anatomical gifts ■ Authorize admission/discharge from a health facility

Financing definitions Ambulatory Patient Classifications (APCs) A prospective payment system for ambulatory care services; APCs are groupings of services and procedures that are clinically similar and use comparable resources Benefits Health services provided according to the health plan contract Consolidated Omnibus Budget Reconciliation Act 1985 (COBRA) Requires employers to permit employees/family members to continue group health coverage at their expense, but at group rates, if they lose coverage due to certain events Co-payment Specified charge for a service, paid by enrollee when service is provided Deductible A specific amount of money the enrollee must pay before insurance benefits begin Diagnosis Related Groups (DRGs) Prospective payment system for inpatient hospital services; classification system based on diagnostic category/code Employee Retirement Income Security Act 1974 (ERISA) Protects individuals enrolled in pension, health and other benefit plans sponsored by private sector employers; Administered by U.S. Department of Labor Enrollee/subscriber Member receiving health services under a particular health plan Home Health Resource Groups (HHRGs) a prospective payment system for home health services: classification based on

the health condition (clinical characteristics) and service needs of the beneficiary Managed care A system combining the functions of health insurance, delivery and administration to promote cost-effective health care Medicare Supplement Policy (Medigap) Health insurance that pays certain costs not covered by Medicare Out-of-pocket expenses Costs not covered by a health insurance plan Pre-existing condition Medical condition that existed prior to the date insurance coverage began Preferred providers Providers who contract to offer health services in a particular health plan Primary Care Provider (PCP) Health professional serving as the initial interface between the enrollees and the health care system; usually a physician, the PCP coordinates the treatment of enrollees Premium Amount paid by a policyholder for insurance coverage Prepayment Advance payment for health services Resource Utilization Groups (RUGs) A prospective payment system for skilled nursing facility care; nursing home residents are classified based on their clinical condition, used services and functional status Self-insurance plan Financial risk for provided health services carried by the sponsoring employer Third party payer Intermediary between patient and provider reimburses provider for patient’s care; Ex. insurance companies and governments (federal /state /local) Utilization Review (UR) A formal utilization assessment for appropriateness and economy of delivered health care services

insurance / reimbursement

£ Health Insurance plan • Financing method for health services • Contractual agreement whereby one party (insurer) agrees to indemnify or reimburse another party for services according to the contract terms • Contains the benefits, exclusions and other coverage requirements • Two categories of health financing: o Private Financing : o Public Financing : ■ Managed Care Plans ■ Medicaid ■ Individual private health insurance ■ Medicare ■ Group insurance ■ Military Health Services (TRICARE) ■ Self-Insurance ■ Department of Veterans Affairs ■ Indian Health Services ■ State Children’s Health Insurance Program (SCHIP) • Health Insurance Portability and Accountability Act 1996 (HIPAA) Eligible individuals guaranteed the right to purchase individual health insurance with no pre-existing condition exclusions, if certain federal requirements are met £ Provider Reimbursement Methods • capitation Flat rate per person for health services during a specified time • fee for service Specific dollar amount for each service performed; some third-party payers use a “discounted fee for service” • per diem rate A per day flat inpatient rate determined by bundling/combining all services provided per patient • Prospective Payment System (PPS) An established predetermined rate for health services based on the setting where the service is provided: o APCs — ambulatory care o HHRGs— home health o DRGs — hospital inpatient o RUGs— skilled nursing facility • Resource-Based Relative Value Scale (RBRVS) Used by Medicare for physician reimbursement; relates payments to resources physicians use o Three categories of resources—physician’s work, practice expenses and malpractice insurance expenses • retrospective payment system Patient day rate determined after 3rd party payers have formulized “allowable costs” • salary Compensation paid for work/services 5

managed care models The listed models are representative: there are many variations within the basic models Health Maintenance Organization (HMO) Healthcare practice providing comprehensive health services to voluntary enrollees for a fixed, prepaid fee; emphasis on prevention and early detection of disease • Different models include: o Staff: HMO salaried physicians, clinic-type arrangement, only HMO members o Group: HMO contracts with a multi-specialty physician group: group provides all medical services o Network: HMO contracts with multiple physician group practices o Independent Practice Association (IPA): HMO contracts with a legally organized association of private practice physicians Preferred Provider Organization (PPO) • Contracted agreement between providers and purchasers of services • Discounted fee for service • Enrollee financially penalized if non-participating provider used • Preauthorization required for selected services Exclusive Provider Organization (EPO) • Similar to PPO in structure and purpose • Enrollee limited to contracted providers Point of Service (POS) • Hybrid of HMO and PPO • Provider chosen when care is needed • Financial incentive to use participating providers Integrated Delivery System/Network (IDS/IDN) Group of organizations providing coordinated, comprehensive and cost effective health services; Ex. Physician—Hospital Organization (PHO)— hospital (or a group of hospitals) and physicians

Selected Gove r nment Programs ¤ Medicare • Title XVIII of the Social Security Act • Established in 1965 • Administered by the Centers for Medicare and Medicaid Services (CMS) — a federal agency • Health insurance program for: o People age 65 or older o People under age 65 with certain disabilities o People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant) • Part A — Hospital Insurance o Helps cover medically necessary: ■ Inpatient hospital stay ■ Skilled nursing facility care ■ Home health care ■ Hospice care ■ Blood — received as an inpatient o Certain conditions must be met o Most people do not have to pay a premium for Part A • Part B — Medical Insurance o Helps cover medically necessary: ■ Medical and other services — doctors’ services, outpatient medical / surgical services and supplies, durable medical equipment, outpatient mental health care, occupational and physical therapy, diagnostic tests, second surgical opinions ■ Clinical laboratory services ■ Home health care ■ Outpatient hospital services ■ Blood — received as an outpatient ■ Preventive Services — selective screening tests and flu, pneumococcal and Hepatitis B shots o Services and supplies must be medically necessary o Most people pay a monthly premium for Part B • Uses a Prospective Payment System (PPS) for provider reimbursement • Quality Improvement Organization (QIO) Program National Network of QIOs, designed to monitor and improve health care utilization and quality for Medicare beneficiaries ¤ Medicaid • Title XIX of the Social Security Act • Established in 1965 • Jointly funded cooperative venture between federal and state governments • Purpose To assist states in providing adequate medical care to “eligible needy persons” • Within federal guidelines, each state: o Establishes its own eligibility standards o Determines the type, amount, duration and scope of services o Sets the payment rate for services o Administers its own program DISCLAIMER Always consult your doctor or therapist with any concerns or problems with your condition. This guide is intended only for informational purposes, and is not meant to be a substitute for professional medical care. Neither BarCharts®, its writers, designers nor editing staff, are in any way responsible or liable for the use or misuse of the information contained in this guide. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. © 2005 BarCharts Inc. 0706

• Largest program providing medical and health related services to low income people • Program varies considerably from state to state • States must provide coverage for the “categorically needy”; may provide coverage for the “medically needy” • Five broad coverage groups for Medicaid: o Children o Pregnant women o Adults in families with dependent children o Individuals with disabilities o Individuals 65 and over • Basic services that must be offered to the “categorically needed” include: o Inpatient / outpatient hospital services o Physician / pediatric and family nurse practitioner services o Laboratory / x-ray services o Nursing facility services for individuals aged 21 or older o Family planning services and supplies o Home health care for persons eligible for skilled nursing services o Rural health clinic / federally qualified health center and ambulatory center services o Prenatal care o Vaccines for children o Midwife services o Early and periodic screening, diagnosis and treatment services for individuals under age 21 ¤ State Children’s Health Insurance Program (SCHIP) • Title XXI of the Social Security Act • Established in 1997 • Federal / state partnership state administered with each state setting its own guidelines on eligibility and services • Purpose Expand health insurance coverage for children • Covers uninsured low-income children who are: o Not eligible for Medicaid o Under the age of 19 yrs o An uninsured low income child resides in a family with an income: ■ Below 200% of the Federal Poverty Level (FPL) OR ■ 50% higher than the state’s Medicaid eligibility threshold • A state can: o Expand Medicaid eligibility o Design a separate children’s health insurance program o Develop a combination of the two options o The federal government must approve each state’s plan • Insurance pays for: o Doctor visits o Hospitalizations o Immunizations o Emergency room visits

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6

WORLD’S #1 ACADEMIC OUTLINE

SPINE

TEMPEROMANDIBULAR & HYOID **=cut a.=artery ex.=extensor fl.=flexor l.=ligament l.l.=ligaments

Lateral (temperomandibular) l.

Hiatus of vertebral a.

Temporal bone

Ligamentum nuchae (nuchal l.)

Anterior atlantooccipital membrane

Capsule of lateral atlantoaxial joint

Atlar l.

Intervertebral discs

Stylohyoid l.

Iliolumbral l.

Sphenomandibular l. Superior costal facet

TEMPEROMANDIBULAR JOINT Articular tubercle Articular disc

Costotransverse joint Interarticular l.

Intertransverse l.

Intervertebral disc

Superior costotransverse l.

Posterior longitudinal l.**

Supraspinous l. Posterior sacral foramina

Greater sciatic foramen Iliofemoral l.

Joint of head of rib (opened)

Posterior sacroiliac l.l.

Great trochanter

Posterior sacrococcygeal l.

Ischiofemoral l.

Nucleus pulposus**

Styloid process

Supraspinous l.**

Mandible

Ligamentum flavum**

LUMBAR SPINE

Nucleus pulposus**

Intervertebral disc** Superior articular process

Anterior longitudinal l.**

Sacrospinous l. Sacrotuberous l.

Lesser trochanter

Vertebral body**

PELVIS (SUPERIOR VIEW)

Interspinous l.** Intertransverse l.

L4

Sacrolumbar l.

Lamina Auricular surface Intertransverse l.

Spinous process

Sacrum

Articular capsule

L4

Transverse process

STERNOCLAVICULAR & SHOULDER Superior Clavicle transverse scapular l. Costoclavicular l.

Anterior sternoclavicular l. Interclavicular l.

1st rib** Costal cartilages**

Posterior sacrococcygeal profundis l.

Coccyx

Ligamentum flavum

Coracoclavicular l.: conoid part Trapezoid part Acromioclavicular l. Acromion Coracoacromial l. Supraspionus tendon** Coracohumeral l.

Greater trochanter Iliofemoral l.

Superior pubic l. Obturator foramen

Intertubular synovial sheath Humerus** Scapula Radiate Glenohumeral l. sternocostal l.

Biceps brachii tendon (long head)**

Superior pubic ramus

Inferior pubic ramus

ELBOW (LATERAL VIEW) Humerus**

Annular l.

Radius** Articular capsule

Femur**

Lesser trochanter

(ANTERIOR VIEW) Humerus**

Biceps brachii tendon**

Articular capsule

Medial epicondyle

Lateral epicondyle Radial collateral l.

Subscapularis tendon**

2nd rib**

Sternal synchondrosis

Inguinal l. Anterior inferior iliac spine Lesser sciatic foramen

Lineaterminalis Pubic symphysis

Bursal openings

Manubrium**

Anterior superior iliac spine

Pubic tubercle

Inferior articular process L5

Iliac crest Arcuate line (pelvic rim)

Sacrospinal l. Anterior sacrococcygeal l. Sacrotuberal l.

Posterior sacrococcygeal superficialis l.

Lateral sacrococcygeal l.

Iliolumbar l.

Greater sciatic foramen Promontory

Articular capsules Posterior longitudinal l.**

Interspinal l.

L5

Anterior longitudinal l.**

Vertebrae (L5)

Intertransverse l.

Obturator membrane Ischial tuberosity

Zona orbicularis

Femur **

Ventral sacroiliac l. Annulus fibrosus

Sternocostal interarticular l.

Ligamentum flavum

Anterior superior iliac spine

Spinous process**

Joint capsule

Articular disc

Articular capsules

Iliac crest

Annulus fibrosus**

Clavicle**

Superior articular facet

Intervertebral disc

Inferior costal facet

Radiate l. of head of rib

Axis (C2)

PELVIS (POSTERIOR VIEW)

Costal facet

Anterior longitudinal l.**

Hyoid bone

Inferior longitudinal fascicles Transverse l. of atlas Superior longitudinal fascicle

{

Transverse costal facet (T1)

Transverse foramen

Ligamentum flavum

Deeper (accessory) portion of tectorial membrane

Stylomandibular l. Mandible (transparent)

Posterior atlanto-occipital membrane

Capsule of lateral atlantoaxial joint

Spinous process (C6)

Transverse process (C7)

Atlas (C1)**

Capsule of atlanto-occipital joint

Articular capsules of zygoapophyseal joints

Atlantoaxial l.

Styloid process

Base of skull**

Posterior atlantooccipital membrane Capsule of atlantooccipital joint

Joint capsule

CRANIOCERVICAL

Tectorial membrane**

Occipital bone

Cruciform l.

BarCharts, Inc. ®

Annular l.

Triceps brachii tendon**

Radial collateral l.

Ulna**

Interosseous membrane**

Ulnar collateral l.

Biceps brachii tendon**

Oblique cord

Radius**

Interosseous membrane**

Ulna**

WRIST & HAND (PALMAR VIEW)

HIP LIGAMENTS

Deep transverse metacarpal l.l.

Sesamoid Joint capsules

Symphysis pubis

HIP LIGAMENTS (OPENED) Epiphysial Acetabular line** labrum (lip) Femoral head cartilage**

Inguinal l.

Pubic tubercle

Pubofemoral l.

Palmar l.l. (palmar plates)

Iliofemoral l. (Y l. of Bigelow)

Collateral l.l.

Cancellous bone

Fat pad**

Joint capsule

Great trochanter

Pubocapsular l.

Palmar carpometacarpal l.l. Hamatometacarpal l.

Fl. retinaculum**

Hamulus of hamate Radiate carpal l. Pisohamate l. Pisometacarpal l. Pisiform

Tubercle of trapezium

Great trochanter

Obturator membrane Transverse acetabular l.

Tubercle of scaphoid

Tuberosity of ischium

Ulnar collateral l. Palmar radiocarpal l.

Distal radioulnar joint capsule

Interosseous membrane** Radius

Ulna

WRIST (DORSAL VIEW)

Dorsal carpometacarpal l.l. Hamate

Metacarpal 1 Trapezoid

Dorsal intercarpal l.l. Scaphoid Radial collateral l.

Medial

epicondyle

Interosseous membrane**

Carpometacarpal articulation & l.l. Metacarpal 4

Intercarpal articulation & l. Radiocarpal Lunate articulation & l. Radius

Collateral l.l. Deep transverse metacarpal l.

Palmar plate l.

Hamate & hamulus

Carpal tunnel Pisiform Fl. retinaculum**

RIGHT FOOT (LATERAL VIEW) Anterior tibiofibular l.

Fibula**

Dorsal talonavicular l.

Superior ex. retinaculum Anterior talofibular l.

Tibial (medial) collateral l.

Fibular (lateral) collateral l.

Posterior cruciate l.

Superior peroneal retinaculum Calcaneal (Achilles) tendon**

Tibia

Lateral condyle of the tibia

Fl. hallucis longus tendon** Collateral l.l. Joint capsules

Deep transverse metatarsal l.

Sesamoids

Plantar l.l. (plates)

Peroneus brevis tendon**

Inferior peroneal retinaculum Long plantar l.

Peroneus longus tendon**

Dorsal calcaneocuboid l.

NOTE TO STUDENT Use this comprehensive study guide in the classroom, in the gym, at home or anywhere you need complete anatomical information. This guide is not designed to take the place of classroom attendance. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2002, 2005 BarCharts Inc. 0608

Customer Hotline # 1.800.230.9522

Dorsal metatarsal l.l. Dorsal cuneocuboid l.l.

Tibial (medial) collateral l. Tibial tuberosity

{

Inferior ex. retinaculum Dorsal talonavicular l.

Posterior talocalcaneal l.

Ex. hallucis longus tendon**

Tibialis anterior Plantar cuneonavicular l.

Dorsal cuneonavicular l.l. Dorsal intercuneifom l. Medial cuneiform Plantar cuboidnavicular l. Dorsal tarsometatarsal l.l. Collateral l.l. Plantar calcaneonavicular l. Ex. hallucis Tibia (medial malleolus) longus tendon** Tibialis posterior tendon** Fl. digitorum longus tendon** Fl. hallucis longus tendon**

Superior peroneal retinaculum

Fl. retinaculum Fl. digitorum brevis**

ISBN-13: 978-142320732-0 ISBN-10: 142320732-7

Tibia

Tibia** Medial taloPosterior tibiotalar l. calcaneal l. Tibiocalcaneal l. Fibula** Inferior longitudinal fascicles Talus Anterior tibiotalar l.

Medial cuneiform

Inferior peroneal retinaculum

Calcaneus

Patellar l.

RIGHT FOOT (MEDIAL VIEW)

Metatarsal 1

Metatarsal 5

Fibula (lateral malleolus)

Calcaneofibular l.

Anterior l.l. of the fibular head

Fibula

Long plantar l. Posterior talocalcaneal l.

Medial condyle of the tibia

Posterior l.l. of the fibular head

Plantar metatarsal l.l. Dorsal cuneonavicular Plantar l.l. tarsometatarsal l.l. Dorsal intercuneiform Cuboid l.l. Peroneus longus Dorsal tarsometatarsal l.l. tendon Peroneus brevis tendon Plantar calcaneocuboid l.

Posterior talofibular l.

Medial meniscus

Head of the fibula

Fl. digitorum brevis tendon**

Bifurcate l. Dorsal cuboidnavicular l.

Medial condyle of the femur

Head of the fibula

RIGHT FOOT (INFERIOR VIEW)

Interosseus talocalcaneal l.

Tibia**

Lateral meniscus Fibular (lateral) collateral l.

Lateral meniscus

Tibialis Posterior Fl. digitorum longus tendon**

Inferior ex. retinaculum

Ex. (hallucis) longus tendon**

Medial epicondyle

Lateral condyle of the tibia

Medial condyle of the tibia

FINGER (MEDIAL VIEW)

Adductor tubercle

Lateral epicondyle

Posterior meniscofemoral l.

Medial meniscus

Femur

Lateral condyle of the femur

Anterior meniscofemoral l.

Intercondyler fossa

Ulna**

Patella

Intercondyler line Lateral condyle of the femur (articular surface) Anterior cruciate l. Lateral epicondyle

Adductor tubercle

Marrow cavity

KNEE LIGAMENTS (FRONT) Femur

Medial condyle of the femur (articular surface)

Capitate

Trapezium

Femur**

Popliteal surface

Pisiform Triquetrum Ulnar collateral l. Distal radioulnar joint capsule

Femur shaft

Lesser trochanter

KNEE LIGAMENTS (BACK)

Metacarpal 5

Dorsal metacarpal l.l.

Dorsal radiocarpal l.l. Radius**

Ischiocapsular l.

Intertrochanteric line & capsule attachment

Lesser trochanter

Deltoid l.

Palmar ulnocarpal l.

Bony trabeculi

Interarticular round l.

Capitate

Lunate

Joint capsule

Zona orbicularis

Acetabular cartilage**

Capsular l. Palmar metacarpal l.l.

Hip capsule

Calcaneal (Achilles) tendon** Superior ex. retinaculum Navicular

Phalanges Peroneus longus tendon

Articular capsules

Sesamoid Metatarsal 1 Plantar l.l. (plates) Deep transverse metatarsal l.

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Layout: Dominic Thompson

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U.S.$3.95 CAN.$5.95

Calcaneus Long plantar l.

Plantar calcaneocuboid l. Tibialis anterior tendon**

WORLD’S #1 ACADEMIC OUTLINE

BarCharts, Inc. ®

LYMPHATIC SYSTEM

HEAD & NECK Occipital nodes ** = a. = L. = l. = m. = R. = v. = v.v. =

cut artery Left ligament muscle Right vein veins

R. lymphatic trunk

ARM AXILLA & THORAX Central axillary nodes

Parotid lymph nodes

Retroauricular nodes Superficial parotid nodes Posterior submandibular node Brachiocephalic v.** Buccal node Intercostal nodes

Jugulodigastric nodes

Brachial nodes

Axillary lymph nodes Subscapular nodes

Submental nodes

Upper deep cervical nodes (jugular)

Lymphatic vessels

Submandibular nodes

Lower deep cervical nodes

Interpectoral nodes

Intestinal nodes

Cubital lymph nodes

Paramammary nodes

Cisterna chyli

Suprahyoid node

Transverse cervical nodes

Pathways to opposite breast

R. lymphatic duct Para-aortic nodes

Subclavian chain of nodes

Parasternal nodes

Subclavian nodes

Cervical lymph nodes

L. thoracic duct

Internal jugular nodes

Common iliac nodes

Pathways to subdiaphragmatic nodes

THORACIC DUCT Palmar vessels

Inguinal lymph nodes

NODES & VESSELS Efferent lymphatic vessels**

R. subclavian lymph trunk

Medulla

Superficial lymph Superior vessels vena cava

V. & a. of node** Medullary sinus Hilum Direction of lymph flow

Afferent lymphatic vessels**

R. jugular trunk R. lymphatic duct

Popliteal lymph nodes

Medullary cords

L. jugular trunk

Cortex Intercostal lymph nodes

Germinal center in follicle

Reticulin Capsule Subcapsular sinus

Vascular pattern

Brachiocephalic v.** Accessory hemiazygos v. Intercostal lymph nodes Thoracic duct

Marginal zone

Trabecula

L. subclavian lymph trunk

Azygos v.

Follicle Valve

Thoracic duct

Posterior intercostal v.v.

Direction of lymph flow Tunica adventicia

Hemiazygos v.

Lymph capillary R. lumbar trunk

Capillary bed

Precapillary sphincter

Subcostal v.

Tunica media

Tunica intima

Lateral aortic lymph nodes

Cisterna chyli

Arteriole** Venule** Minivalve (lymphatic fluid entrance port) Filament to connective tissue

Plantar vessels Intestinal trunk

Endothelial cell Retroaortic lymph nodes

Lateral aortic lymph nodes L. lumbar trunk

LARGE INTESTINE

DEEP ABDOMINAL & INGUINAL NODES L. gastric a.

Thoracic duct**

Superior mesenteric nodes Cardiac ring of nodes

Hepatic v.v.**

Thoracic duct**

Cisterna chyli

Celiac nodes

Celiac node Inferior vena cava**

Epicolic nodes

Abdominal aorta

Thoracic duct

L. lumbar trunk

Cisterna chyli

L. lumbar nodes

R. lumbar trunk

Subaortic common iliac nodes

Inferior vena cava**

Common iliac nodes

Lateral common iliac nodes

Paracolic nodes Middle colic nodes

R. colic nodes Paracolic nodes Ileocolic nodes

Inferior mesenteric nodes

Sacral nodes

Intermediate external iliac nodes

Interiliac external iliac node

Highest deep inguinal node (Rosenmuller or Cloquet)

Cecal nodes

L. colic nodes

Internal iliac nodes

Inguinal l.

Superolateral superficial inguinal nodes

Deep inguinal nodes Fascia lata

Inferior superficial inguinal nodes

Cremaster m.**

Cut fascia

Cribiform fascia

Sigmoid colon**

Paracolic nodes Appendicular nodes

Common iliac nodes

Aorta**

Superior rectal nodes

HEART & LUNGS

L. gastric nodes L. superior pancreatic nodes

Thoracic duct**

Preaortic nodes

Great saphenous v.

STOMACH & PANCREAS Esophagus**

Sigmoid nodes

Diaphragm**

Celiac nodes

Splenic nodes

Cisterna chyli

R. tracheal nodes Inferior deep cervical node

L. tracheal nodes Inferior deep cervical node

L. brachiocephalic v.**

Thoracic duct

Subclavian chain of nodes

R. brachiocephalic v.**

R. superior tracheobronchial nodes

Aortic arch node L. superior tracheobronchial nodes

Inferior tracheobronchial nodes

R. superior pancreatic node

Bronchopulmonary (hilar) nodes

Pulmonary nodes

Suprapyloric nodes

Subpleural lymph plexus

Subpleural lymphatic plexus

Bronchopulmonary (hilar) nodes

Interlobular lymph vessels

Pyloris L. gastroepiploic (gastro-omental) node Pancreas (behind stomach)

Infrapyloric nodes

R. gastroepiploic (gastro-omental) nodes

Head of pancreas Stomach (transparent)

Superior mesenteric nodes Duodenum

Superior mesenteric a.** Preaortic nodes

NOTE TO STUDENT

Use this comprehensive study guide in the classroom, in the gym, at home or anywhere you need complete anatomical information. This guide is not designed to take the place of classroom attendance. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher.

©2002, 2005 BarCharts Inc. 0807

ISBN-13: 978-142320734-4 ISBN-10: 142320734-3

Pulmonary nodes

Interlobular lymph vessels

Heart (transparent)

Retrocardiac nodes Anterior mediastinal nodes

CREDITS

Images ® Vincent Perez perezstudio.com Layout: Dominic Thompson

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L. gastric nodes

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Infracardial nodes

BarCharts, Inc.®

FOUNDATION OF MEDICAL WORDS A. Structure Most medical words are composed of two or more terms. To define a medical word: • divide the word into its terms • analyze the terms • define the word Examples: Pericarditis peri = around; card = heart; itis = inflammation Inflammation around the heart Oncology onco = tumor, mass; logy = study of Study of tumors

B. Terms Term + Term (.....+.....) = medical word There are five categories of terms: 1.Prefix - beginning of a word (ex., pre____; post_____) Designated by a “____” after the term. 2.Suffix - ending of a word (ex., _____stomy; _____itis) Designated by a “____” before the term. 3.Root - foundation/base of a word (ex., hepat; gastr) 4.Combining vowel - vowel (usually “o”) added to a root (ex., gastro). Use a combining vowel when joining: a. Root to another root (ex., gastrohepatitis) b. Root to a suffix beginning with a consonant (ex., cardiomegaly)

5.Combining form - root + vowel (ex., hepat/o; gastr/o) Designated by a “/” between the root and the vowel Examples: Hyperleukocytosis hyper (prefix) = excessive leuko (combining form) = white cyt (root) = cell osis (suffix) = condition of Definition: condition of excessive white blood cells (leukocytes) Hematotoxic hemato (combining form) = blood tox (root) = poison ic (suffix) = pertaining to Definition: pertaining to blood poisoning

TIPS: 1.Some terms have more than one definition. To determine the correct definition in a particular medical word, analyze the other terms in the word. Example: Poliomyelitis polio = gray (matter) myel = spinal cord, bone marrow itis = inflammation Definition: Inflammation of the gray matter of the spinal cord. The bone marrow does not have gray matter. 2.Some terms may function as a root/combining form in one word and a suffix in another word. Classification depends upon the specific medical word. Examples: Cytology cyto (combining form) = cell logy (suffix) = study of Definition: Study of cells Erythrocyte erythro (combining form) = red cyte (suffix) = cell Definition: Red blood cell

WORLD’S #1 ACADEMIC OUTLINE

THE HUMAN BODY A. Development Cells - tissues - organs - systems - organism 1.Cells: Major Components a. Cell membrane b. Cytoplasm c. Nucleus

-genesis

2.Tissues: Primary Types a. Connective b. Epithelium c. Muscle d.Nervous

3.Organs a. Composed of two or more different tissues b. Have specific functions

4.Systems: Related organs with common functions 5.Organism: A living person

B. Cavities A space containing organs 1.Dorsal a. Cranial b. Vertebral (spinal)

2.Ventral a. Abdominal b. Pelvic c. Thoracic

C. Planes An imaginary flat surface 1.Frontal – anterior/posterior 2.Sagittal – right/left 3.Transverse – upper/lower

D. Positions A reference point for location or direction. 1.Anterior/Ventral – front of the body Posterior/Dorsal – back of the body 2.Deep – away from the surface Superficial – on the surface 3.Inferior – situated below Superior – situated above 4.Lateral – pertaining to the side 5.Medial – pertaining to the middle 6.Prone – lying face down Supine – lying face up TERMS acu-algia anomal/o anthrop/o

DEFINITIONS needle pain irregular man, human being

antr/o aque/o axi/o bar/o bio-, bi/o blast/o, -blast

antrum water axis weight, pressure life, living early embryonic stage, immature heat cancer down, downward tail chemical, chemistry time, timing deep sleep body cold cell back to lead power, strength pain

calor/i carcin/o catacaud/o chem/o chron/o -coma corpor/o cry/o cyt/o, -cyte dors/o duct/o dynam/o -dynia

equieti/o fil/i, fil/o -form

1

WORDS acupuncture cephalalgia anomaly anthroposomatology antrotomy aqueous axial barotaxis biogenesis blastocyte calorimetry carcinoma catabiotic caudal chemosurgery chronobiology semicoma corporeal cryotherapy cytology dorsoventral conduction dynamogenesis gastrodynia

ger/o, geront/o gymn/o -hexia hist/o hydr/o iatr/o -ician ion/o kary/o kel/o -labile later/o -logist -logy -lucent lumin/o ly/o medi/o medic/o mer/o mesomorph/o nom/o nomennos/o nucle/o nutri/o -oma onc/o organ/o path/o pharmac/o physi/o -plasm -poiesis prote/o psamm/o -puncture pyr/o pyret/o sanit/a scirrh/o somat/o -some spectr/o system/o techn/o temp/o, tempor/o the/o -therapy, therapeut/o therm/o -tumescence, tumesc/o -type, typ/o ventr/o -verse vir/o viscer/o vit/o zyg/o

equality, equal equilibrium cause etiology thread filopressure specified shape, multiform form production, neogenesis formation aged, old age geriatrics naked gymnophobia condition cachexia tissue histoclastic water, hydrogen hydrolysis treatment, physician iatrogenic specialist clinician ion ionogram nucleus karyorrhexis tumor, fibrous keloid growth unstable, perishable frigolabile side bilateral specialist neurologist study of cardiology light-admitting radiolucent light luminescence dissolve, loosen lyophilic middle medial heal, healing medical part meromicrosomia middle mesoderm shape, form dolichomorphic custom, law nomotopic name nomenclature disease nosology nucleus nucleoplasm to nourish nutrition tumor, mass histocytoma tumor, mass oncogenesis organ organomegaly disease pathogenic drugs pharmacology nature physiologist formation, growth neoplasm formation cytopoiesis protein proteolysis sand, sand-like psammoma material to pierce a surface venipuncture fire, fever, heat pyrogen fever pyretogenic health sanitarian hard scirrhoma body somatoscopy body chromosome image, spectrum spectrocolorimeter system systematic art, skill technology time, the temples tempostabile a god treatment

theotherapy therapeutics

heat swelling

thermometer detumescence

class, representative form belly, front of the body turn virus internal organs life union, junction

somatotype ventrolateral transverse virologist visceromegaly vitamin zygogenesis

TERMINOLOGY SETS A. DIRECTIONAL TERMS abaway from adtoward, near ambiaround, on both sides amphiaround, on both sides anaupward, backward antebefore, forward anter/o front antiagainst apoaway, separation catadown, downward circumaround contraagainst, opposite dextr/o right diathrough, apart disapart, to separate ec-, ectooutside, out en-, endoinside, within epiabove, over, upon esowithin exout, away from exooutside of, outward extraoutside forebefore, in front of hyperabove, excessive, beyond hypounder, deficient, below infrabelow, beneath interbetween intrawithin juxtanear later/o side levoleft medi/o middle mesomiddle paraalongside, near, beyond, abnormal perthrough, throughout periaround, surrounding postafter, behind poster/o behind, towards the back prebefore, in front of probefore proxim/o near retrobehind, backward sinistr/o left subunder, beneath superabove, beyond supraabove, beyond tel/e distant, end transacross B. FIVE rrh’s -rrhagia, -rrhage -rrhaphy -rrhea -rrhexis rrhythm/o

excessive flow suture flow, discharge rupture rhythm

C. NUMERICAL VALUES half demihemisemione monounione and a half sesquitwo bidithree trifour tetraquadrifive quinquepentpentasix hexhexasex-

heptaseptseptieight octaoctinine noniten (101) decahundred (102) hectothousand (103) kilomillion (106) megabillion (109) gigatrillion (1012) teraquadrillion (1015) petaquintillion (1018) exaone tenth (10-1) decione hundredth (10-2) centione thousandth (10-3) millione millionth (10-6) microone billionth (10-9) nanoone trillionth (10-12) picoone quadrillionth (10-15) femtoone quintillionth (10-18) attoseven

D. SURGICAL PROCEDURES -centesis surgical puncture of a cavity -desis surgical fixation, fusion -ectomy surgical removal -pexy fixation -plasty surgical correction/repair -rrhaphy suture -sect to cut -stomy surgical opening -tomy surgical incision -tripsy to crush, break E. PATHOGENS acar/o arachn/o bacteri/o -coccus fung/i helminth/o, -helminth hirud/i, hirudin/i ixod/i myc/o parasit/o pedicul/o scolec/o verm/i vir/o

mites spider bacteria berry-shaped bacterium fungus, mushroom worm leech ticks fungus parasite louse worm worm virus

SKELETAL SYSTEM A. Bones 1.Formation – Ossification 2.Types – Long/short/flat/irregular 3.Tissues – Compact/spongy (cancellous) 4.Markings – Depressions/openings/projections 5.Axial skeleton a. Skull b. Vertebral column c. Thoracic cage

6.Appendicular skeleton a. Upper extremities b. Lower extremities c. Pectoral girdle d.Pelvic girdle

B. Joints/articulations 1.Structural classification a. Fibrous b. Cartilaginous c. Synovial

2.Functional classification a. Synarthroses b. Amphiarthroses c. Diathroses 2

TERMS ankyl/o arthr/o articul/o brachi/o burs/o calcane/o carp/o centr/o cephal/o cervic/o chir/o, cheir/o chondr/o cleid/o coccyg/o cost/o cox/o crani/o cubit/o dactyl/o euryfaci/o femor/o fibul/o geni/o gnath/o gnos/o goni/o gyr/o holohumer/o hypsiili/o ischi/o ithykyph/o lamin/o lip/o -listhesis lord/o lox/o lumb/o maxill/o mega-, megalo-megaly mel/o om/o opisth/o oste/o panpatell/o ped/o pelv/i perone/o petr/o phalang/o -physis pod/o -porosis pub/o rachi/o sacr/o scapul/o scoli/o skelet/o spin/o spondyl/o stern/o synov/o tal/o tars/o tibi/o vertebr/o xiph/o

DEFINITIONS WORDS stiff, crooked, bent ankylosis joint arthrodysplasia joint articulation arm brachiocephalic bursa bursolith heel calcaneodynia wrist carpoptosis center centrosclerosis head cephaledema neck, cervix cervicofacial hand chiropodalgia cartilage chondrodystrophy clavicle cleidorrhexis coccyx coccygodynia rib costosternal hip coxarthrosis skull cranioclast elbow, forearm genucubital digit (finger or toe) dactylospasm wide, broad eurycephalic face facioplasty femur ischiofemoral fibula fibulocalcaneal chin genioplasty jaw gnathoschisis knowledge acrognosis angle goniometer circle, spiral gyrospasm entire, complete holoarthritis humerus humeroradial high hypsicephaly ilium iliolumbar ischium ischiodynia erect, straight ithylordosis humpback kyphoscoliosis lamina laminectomy fat lipochondroma slipping spondylolisthesis curvature, bending lordoscoliosis oblique, slanting loxarthron loin lumbodynia maxilla maxillotomy large megalopodia enlargement dactylomegaly limb, limbs melalgia shoulder omodynia backward, behind opisthognathism bone osteochondroma all panarthritis patella patellofemoral foot, child pedal pelvis pelvimeter fibula peroneotibial stone, petrous region petromastoid of temporal bone phalanges phalangitis growth, growing diaphysis foot podiatrist porous, decrease osteoporosis in density pubis pubovesical spine rachioplegia sacrum sacrocoxalgia scapula scapulopexy crooked, twisted scoliorachitic skeleton skeletogenous spinal cord, spine spinocerebellar vertebrae spondylopyosis sternum sternocostal synovia, synovectomy synovial membrane talus talofibular tarsus, edge of eyelid tarsoclasis tibia tibiotarsal vertebra vertebrosternal sword-shaped, xiphocostal xiphoid

NERVOUS SYSTEM A. Cells 1.Neuron – Dendrites, cell body, axon 2.Neuroglia (glial)

B. Central Nervous System (CNS) 1.Brain – Cerebrum, cerebellum, brainstem, diencephalon 2.Spinal cord – Ascending/descending tracts 3.Membranes (meninges) – Dura mater, arachnoid, pia mater 4.Cerebrospinal Fluid (CSF)

C. Peripheral Nervous System (PNS) 1.Cranial nerves (12 pairs) 2.Spinal nerves (31 pairs) 3.Afferent (sensory) division: sensory receptors 4.Efferent (motor) division a. Somatic nervous system (voluntary) b. Autonomic nervous system (involuntary)

i. Sympathetic nervous system ii. Parasympathetic nervous system TERMS -algesia, alges/o astr/o atel/o -bulia, -boulia cerebell/o cerebr/o -crasia drom/o, -drome encephal/o esthesi/o, -esthesia gangli/o, ganglion/o gli/o heli/o hydr/o hypn/o hypothalam/o keraun/o klept/o -lemma -lepsy -lexia log/o, -log, -logue -mania medull/o mening/o ment/o -mnesia myel/o narc/o neur/o noci-noia -paresis phaner/o -phobia, phob/o phren/o picr/o piez/o, pies/i, -piesis -plegia

DEFINITIONS pain sensitivity star, star shaped incomplete, imperfect will cerebellum cerebrum, brain mixture (good or bad), temperament running

WORDS analgesia astrocytoma atelomyelia abulia cerebellospinal cerebroid eucrasia

brain sensation, feeling

encephalomalacia esthesioneurosis

ganglion

gangliocytoma

dromotropic

glue, neuroglia sun water, hydrogen sleep hypothalamus

gliocyte heliophobia hydrocephalocele hypnogenic hypothalamohypophysical lightning keraunoneurosis theft, stealing kleptomania confining membrane epilemma seizure epilepsy speech, word bradylexia word, speech, logorrhea thought madness, obsessive hypomania preoccupation medulla, marrow medulloblast meninges, meningocele membranes mind dementia memory ecmnesia bone marrow, myelocele spinal cord numbness, stupor narcoanesthesia nerve neurotripsy to cause harm, nociceptor injury or pain mind, will paranoia partial paralysis hemiparesis visible, apparent phaneromania fear, aversion phobophobia mind, diaphragm bitter pressure paralysis

tachyphrenia picrotoxin piesesthesia quadriplegia

poli/o -pore -praxia psych/o psychr/o radicul/o rhiz/o schiz/o somn/i, -somnia syring/o tauto-taxia, tax/o tel/o tephr/o thanat/o thec/o vag/o

gray (matter) opening, passageway action, activity mind cold nerve root root split, division sleep tube, fistula identical, same arrangement, coordination end gray (ashen) death sheath vagus nerve

poliomyelitis neuropore parapraxia psychokinesis psychrophobia radiculitis rhizotomy schizophasia insomnia syringomyelocele tautomeral dystaxia telodendron tephromyelitis thanatomania neurothecitis vagolysis

MALE REPRODUCTIVE SYSTEM A. Scrotum Sac containing the testes

B. Testes 1.Seminiferous tubules - spermatozoa 2.Interstitial cells - testosterone

C. Ducts 1.Epididymis 2.Vas deferens/ductus deferens 3.Ejaculatory duct 4.Urethra

D. Penis Erectile tissue

E. Glands 1.Seminal vesicles 2.Prostate gland 3.Bulbourethral (Cowper’s) gland

F. Secretion Semen 1.Sperm 2.Glandular secretions TERMS andr/o balan/o -cele -cide crypt/o epididym/o genit/o gon/o gonad/o olig/o orch/o, orchi/o, orchid/o osche/o phall/o phim/o prostat/o semin/i sperm/o, spermat/o test/o, testicul/o vas/o venere/o vesicul/o zo/o

2.Ureters - Tubes 3.Bladder - Trigone 4.Urethra - Tube

B. Urine 1.Formation - Filtration, reabsorption, secretion 2.Composition - Water, nitrogenous waste, salts, other substances TERMS a-, analbumin/o ammon/o -atresia atretoazot/o calci/o cali/o cupr/o cyan/o cyst/o -ectasis, -ectasia fusc/o glomerul/o keton/o lith/o nephr/o noct/i py/o pyel/o ren/o uric/o ur/o -uresis ureter/o urethr/o -uria urin/o vesic/o

DEFINITIONS without, not albumin ammonium closure, occlusion closed, lacking an opening nitrogen, urea calcium calyx copper blue bladder, cyst dilation, expansion dark brown glomerulus ketones stone, calculus kidney night pus renal pelvis kidney uric acid urine urination ureter urethra urine condition urine urinary bladder

WORDS anuria albuminometer ammonuria urethratresia atretocystia azoturia hypocalciuria pyelocaliectasis cupruresis urocyanosis cystogram nephrectasia urofuscohematin glomerulopathy ketonuria pyelolithotomy nephrotoxic noctalbuminuria pyocalix pyelophlebitis renogastric uricosuria uroerythrin diuresis ureterocolostomy urethrorrhagia pyuria urinalysis vesicoclysis

FEMALE REPRODUCTIVE SYSTEM A. Ovaries

DEFINITIONS male glans penis hernia, swelling killing, agent which kills hidden, concealed epididymis reproduction genitals gonads scanty, few, little testis

WORDS androgen balanoblennorrhea hydrocele spermicide

scrotum penis muzzle prostate gland semen spermatozoa

oscheoplasty phallodynia paraphimosis prostatocystotomy seminiferous spermatogenesis

testis vas deferens, vessel sexual intercourse seminal vesicle animal

testectomy vasovasostomy

cryptorchism epididymectomy genitourinary gonocyte gonadogenesis oligospermia orchidopexy

venereologist vasovesiculitis azoospermia

URINARY SYSTEM A. Organs 1.Kidneys - Cortex, medulla, nephron, collecting duct, renal pelvis 3

1.Oocyte development 2.Ovulation

B. Fallopian tubes/uterine tubes Fertilization

C. Uterus 1.Wall a. Perimetrium b.Myometrium c. Endometrium

2.Parts a. Fundus b. Body c. Cervix

D. Vagina Hymen

E. External genitalia/vulva 1.Labia majora/minora 2.Clitoris 3.Bartholin’s glands

F. Breasts 1.Mammary glands 2.Nipple 3.Areola 4.Lactation

G. Menstrual cycle 1.Phases 2.Hormonal interaction 3.Cessation

TERMS amni/o cervic/o chori/o -clasis, -clast, -clasia colp/o culd/o -cyesis embry/o episi/o fet/o galact/o gravid/o -gravida gynec/o helc/o hymen/o hyster/o lact/o lecith/o -lipsis mamm/o mast/o men/o metr/o nat/o neonullio/o obstetr/o omphal/o oophor/o ov/o, ov/i ovari/o -para, -parous -partum perine/o

DEFINITIONS amnion neck, cervix chorion break, breaking

C. Circulation

G. Pancreas Endocrine/exocrine tissue

1. Pulmonary 2. Systemic

H. Large intestine Parts - cecum, colon, rectum, anus

D. Blood pressure vagina cul-de-sac pregnancy embryo vulva fetus milk pregnancy pregnant woman woman, female ulcer hymen uterus milk yolk, ovum omit, fail breast breast menses, menstruation uterus birth new none egg, ovum midwife navel ovary egg, ovum ovary to bear, bring forth childbirth, labor perineum

phys/o sacchar/o

deformed, maimed air, gas sugar

salping/o terat/o thel/o toc/o, -tocia tub/o uter/o vagin/o viv/i vulv/o

fallopian tube monster nipple childbirth, labor tube uterus vagina life, alive vulva

per/o

WORDS amnioscopy cervicovaginitis chorioadenoma cranioclasis

CARDIOVASCULAR A. Heart 1.Four chambers a. Two upper (atria) b. Two lower (ventricles)

2.Wall a. Endocardium b. Myocardium c. Pericardium

3.Two partitions a. Interatrial septum b. Interventricular septum

4.Four valves a. Atrioventricular

i. Tricuspid ii. Bicuspid (mitral) b. Semilunar

i. Pulmonary ii. Aortic

B. Blood vessels 1. Arteries - arterioles 2. Veins - venules 3. Capillaries

colporrhaphy culdoscopy ovariocyesis embryopathy episiostenosis fetography galactacrasia gravidocardiac unigravida gynecography helcomenia hymenitis panhysterectomy lactorrhea centrolecithal menolipsis mammography mastalgia menorrhagia myometritis neonatology neonatal nulliparity oogenesis obstetrician omphalocele oophorohysterectomy ovicide ovariocentesis septipara postpartum colpoperineoplasty peromelia physometra saccharogalactorrhea salpingocyesis teratogenesis thelorrhagia dystocia tuboplasty uterolith vaginography viviparous vulvopathy

TERMS abdomin/o

1.Systole (contraction) 2.Diastole (relaxation)

E. Pulse Rhythmical expansion and contraction of an artery as a result of the heart contraction

F. Electrical/Conduction system 1.Components - SA node - AV node - bundle of His - bundle branches - Purkinje fibers 2.Measurement - EKG/ECG TERMS aneurysm/o angi/o aort/o arteri/o arteriol/o

DEFINITIONS aneurysm vessel aorta artery arteriole

ather/o

fatty substance, plaque atrium slow heart movement irrigation, washing heart embolus suppress, restrain enlargement less, smaller movement, motion flutter, throbbing

atri/o bradycardi/o cine-clysis coron/o embol/o isch/o -megaly mi/o -motor palpit/o, palpitat/o phleb/o presbyrhe/o

vein aging, elderly flow, current, stream -spasm involuntary contraction sphygm/o pulse -sphyxia pulse -stenosis narrowed, constricted tachyfast tel/e end, distant -tension stretched, strained valv/o, valvul/o valve varic/o varicose veins vas/o vessel, vas deferens vascul/o vessel ven/o vein ventricul/o ventricle of the heart or brain venul/o venule

WORDS aneurysmectomy angioblast aortomalacia arteriolith arteriolosclerosis atheroma atrioseptopexy bradycardia cardioptosis cineangiograph venoclysis coronary embolectomy ischemia atriomegaly miocardia venomotor palpitation phleborrhexis presbycardia rheocardiography vasospasm sphygmoscope asphyxia aortostenosis tachycardia telecardiography hypertension valvulotome varicophlebitis vasohypotonic vasculitis venography ventriculogram venular

GASTROINTESTINAL SYSTEM A. Oral cavity Tongue, teeth, hard/soft palate, gums, salivary glands

B. Pharynx C. Esophagus D. Stomach 1.Sphincters 2.Parts - fundus, body, pylorus

E. Small intestine Parts - duodenum, jejunum, ileum

F. Liver Right and left lobes 4

DEFINITIONS abdomen

WORDS abdominocentesis cholagogue dentagra amylolysis anorectocolonic arsenicophagy ateloglossia

producer, leader severe pain starch anus arsenic incomplete, imperfect bil/i bile biligenesis bucc/o cheek buccal cec/o cecum cecoileostomy celi/o abdomen celiomyositis cheil/o, chil/o lip cheiloschisis -chezia, -chesia defecation dyschezia chol/e gall, bile cholangiostomy choledoch/o common bile duct choledocholithiasis chyl/o chyle chylopoiesis col/o colon proctocolectomy dent/i tooth dentalgia dips/o thirst adipsia duoden/o duodenum duodenohepatic -emesis vomiting hyperemesis enter/o intestines enteroclysis (small intestines) esophag/o esophagus esophagocele gastr/o stomach dextrogastria ge/o earth, soil geophagia gingiv/o gums gingivoplasty gloss/o tongue glossolalia gluc/o glucose, sugar glucokinetic glyc/o glucose, sugar glycosialorrhea hepat/o liver hepatosplenomegaly idi/o individual, distinct, idioglossia unknown ile/o ileum ileoileostomy jejun/o jejunum jejunorrhaphy lapar/o abdomen, laparoscope abdominal wall lingu/o tongue retrolingual loph/o ridge lophodont odont/o tooth anodontia or/o mouth intraoral -orexia appetite hyperorexia orth/o straight, normal, orthodontist correct palat/o palate palatoplegia -pepsia digestion dyspepsia peritone/o peritoneum peritoneoclysis phag/o, eating, ingestion phagodnamomphagia eter -posia drinking polyposia -prandial meal postprandial proct/o rectum, anus proctopexy ptyal/o saliva ptyalogenic pyl/e portal vein pylemphraxis pylor/o pylorus pyloroplasty pyr/o heat, fire, fever pyrosis rect/o rectum rectocele sial/o saliva sialolith sigmoid/o sigmoid colon sigmoidoscope sit/o food sitophobia splanchn/o viscera splanchnoptosis -stalis contraction peristalsis staphyl/o uvula, grapelike staphylorrhaphy clusters stomat/o mouth stomatomalacia -tresia opening, proctotresia perforation typhl/o cecum, blindness typhlectasis uran/o palate uranoschisis zym/o enzyme, ferment zymolysis -agogue -agra amyl/o an/o arsenic/o atel/o

BLOOD A. Composition 1.Plasma (55%) - Pale, yellow fluid 2.Formed elements (cells) - 45% a. Erythrocytes b. Leukocytes

i. Granulocytes (eosinophils, basophils, neutrophils) ii. Agranulocytes (monocytes, lymphocytes) c. Thrombocytes (platelets)

B. Blood Groups 1.ABO Group a. Types - A/B/AB/O b. Determined by antigen(s) on erythrocyte

2.Rh Group a. Rh+ / Rhb. Presence or absence of Rh antigen on erythrocyte

C. Blood Clotting (coagulation) 1.Chemical reactions 2.Clot prevention 3.Clot retraction TERMS agglutin/o anis/o bas/o, basi/o coagul/o -crit -emia eosin/o erythr/o ferr/i, ferr/o gigant/o -globin granul/o hem/o, hemat/o kal/i leuk/o myel/o natr/o neutr/o norm/o -pheresis -phil, -philia -phore -phoresis phosphat/o poikil/o pykn/o, pycn/o rhod/o sangu/i, sanguin/o sapr/o schist/o, -schisis ser/o sider/o spher/o strept/o thromb/o -volemia

DEFINITIONS clumping unequal

WORDS agglutinophilic anisonormocytosis base, foundation basophil coagulation, coagulopathy clotting separate thrombocytocrit blood condition erythremia red, rosy, dawn eosinopenia red erythrocytoschi sis iron ferrometer huge gigantocyte protein hemoglobin granules agranulocytosis blood hemocytozoon potassium white bone marrow, spinal cord sodium neutral normal, usual removal affinity for, tendency towards bearer, processor bearing, transmission phosphate variation, irregular thick, dense red, rosy blood

hyperkalemia leukocytotoxin myelocytosis hypernatremia neutropenia normochromo cyte plateletpheresis hemophilia siderophore electrophoresis phosphatemia poikiloblast pyknocyte rhodocyte sanguiferous

rotten, decay split, cleft

sapremia schistocyte

serum, serous iron round, sphere twisted, curved clot, thrombus

serosanguineous sideropenia spherocytosis streptococcemia thromboelastogram normovolemia

blood volume

ENDOCRINE SYSTEM A. Characteristics 1.Ductless glands called endocrine glands 2.Glands secrete hormones directly into the blood stream 3.Hormones affect growth/development, reproduction, metabolism

B. Endocrine Glands 1.Pituitary a. anterior b. posterior

lepid/o lepr/o onych/o pachypapul/o perspir/o phyt/o

hollow, concave, depressed flakes, scales leprosy nail thick papule, pimple breathe through plant

pil/o prurit/o pseudo-

hair itching false

psor/o py/o rhytid/o seb/o steat/o sud/o trich/o ul/o ungu/o verruc/i xer/o

itching pus wrinkle sebum fat sweat hair scar, scarring nail wart dry

koil/o

2.Thyroid 3.Parathyroid 4.Adrenal a. medulla b. cortex

5.Pancreas 6.Testes 7.Ovaries 8.Pineal 9.Thymus TERMS acr/o aden/o adren/o cortic/o crin/o hirsut/o hormon/o medull/o myx/o pancreat/o

DEFINITIONS extremities gland adrenal glands cortex secrete, separate hairy hormone medulla, marrow mucus pancreas

parathyroid/o phe/o

parathyroid dusky

pineal/o pituitar/o thym/o thyr/o tox/o, toxic/o -trophy, troph/o

pineal gland pituitary gland thymus gland thyroid gland poison nourishment, growth

WORDS acrogeria adenectopia adrenomegaly corticoadrenal crinogenic hirsutism hormonopoiesis medulloadrenal myxedema pancreatolithotomy parathyroidoma pheochromoctoma pinealopathy pituitarism thymotoxin thyrocele thyrotoxicosis hypertrophy

INTEGUMENTARY SYSTEM A. Skin Layers 1.Epidermis 2.Dermis/corium 3.Subcutaneous/hypodermis

koilonychia lepidosis leproma onychomycosis pachydermatocele papulopustular perspiration phytophotodematitis pilomotor pruritogenic pseudochromhidrosis psoriasis pyodermatitis rhytidectomy seborrhea steatocryptosis sudokeratosis hypertrichosis uloid subungual verrucosis xeroderma

RESPIRATORY SYSTEM A. Upper Respiratory Tract 1.Nose - Nasal cavity, paranasal sinuses 2.Pharynx - Nasopharynx, oropharynx, laryngopharynx

B. Lower Respiratory Tract 1.Larynx - Vocal Cords 2.Trachea - C-shaped rings of cartilage 3.Bronchi a. Right/left bronchus b. Bronchioles - alveoli

4.Lungs a. Lobes - right (3) / left (2) b. Pleura

B. Hair 1.Components

C. Pulmonary Ventilation

a. Shaft b. Root c. Bulb

1.Inspiration/expiration 2.Diaphragm

2.Cycle - Growth/resting

C. Glands 1.Sebaceous/oil - sebum 2.Sudoriferous/sweat a. apocrine b. eccrine

D. Nails Components 1.Free edge 2.Nail body 3.Nail root DEFINITIONS thorny, spiny ray, radiation bromine containing compound, odor caus/o, cauter/o burn, burning -chroia skin coloration chrom/o color chrys/o gold cutane/o skin derm/o, skin dermat/o erythem/o flushed, redness eschar/o scab graph/o writing hidr/o sweat ichthy/o fish iod/o iodine kerat/o horny tissue, cornea TERMS acanth/o actin/o brom/o

5

WORDS acanthoma actinodermatitis bromoderma causalgia xanthochroia chromomycosis chrysiasis subcutaneous dermatopathy erythema escharotomy graphesthesia hyperhidrosis ichthyosis iododerm keratolysis

TERMS alveol/o aspir/o, aspirat/o blenn/o brachybronch/o bronchiol/o -capnia, capn/o coni/o epiglott/o lal/o, -lalia lampr/o laryng/o lept/o

DEFINITIONS WORDS alveolus alveolitis inhaling, removal aspiration

mucus short bronchus bronchiole carbon dioxide dust epiglottis speech, babble clear larynx slender, thin, delicate lob/o lobe mediastin/o mediastinum mogidifficult nas/o nose osm/o, sense of smell, -osmia odor, impulse osphresi/o, sense of smell, -osphresia odor ox/o, -oxia oxygen -pagus conjoined twins pector/o chest phas/o, -phasia speech phon/o, -phonia voice, sound phren/o mind, diaphragm pimel/o fat, fatty pleur/o pleura -pnea breathe

blennothorax brachypnea bronchorrhagia bronchiolectasis hypercapnia coniofibrosis epiglottitis laliatry lamprophonia laryngoxerosis leptophonia lobectomy mediastinoscopy mogiphonia nasolabial anosmia osphresiometer hypoxia thoracopagus pectoralgia dysphasia rhinophonia phrenalgia pimelorthopnea pleurocholecystitis hyperpnea

pneum/o pneumon/o -ptosis -ptysis pulmon/o respir/o, respirat/o rhin/o sept/o silic/o sinus/o span/o spir/o steth/o therm/o thorac/o trache/o traumat/o xen/o

lung, air lung, air prolapse, drooping spitting lung breathe, breathing

pneumopexy pneumonomycosis laryngoptosis hemoptysis pulmonologist respirator

nose partition silica, quartz cavity, sinus scanty, scarce breathe chest heat chest trachea trauma, injury, wound strange, foreign

rhinolithiasis septorhinoplasty silicosis sinusotomy spanopnea bronchospirometer stethoscope thermopolypnea thoracoschisis tracheostenosis traumatopnea xenophonia

1.Excitability 2.Contractility 3.Elasticity 4.Extensibility

-pterygium

tenorrhaphy tenontography kinesiotherapy

tone, tension

myatonia

pupill/o retin/o scler/o scot/o son/o staped/o stich/o, -stichia stigmat/o -tropia tympan/o uve/o vitre/o

SPECIAL SENSES: EYE/EAR A. Eye 1.Layers/Tunics a. Fibrous

i. Sclera ii. Cornea b. Vascular

i. Choroid ii. Ciliary body iii. Iris

a. clear, watery fluid b. formed from interstitial fluid

2.Lymphatic Vessels - Valves 3.Lymphatic Organs a. Tonsils

i. palatine ii. pharyngeal iii. lingual b. Lymph Nodes - concentration of nodes

i. inguinal ii. axillary iii. cervical

2.Middle a. Auditory/eustachian tube b. Auditory ossicles - Malleus/incus/stapes

c. Spleen d.Thymus

3.Inner Bony labyrinth-semicircular canals/vestibule/cochlea

2.Smooth a. Involuntary/nonstriated b. Located in walls of hollow organs

3.Cardiac

WORDS myasthenia auxotonic achalasia ergometry fasciodesis fibromyoma flexor ideomuscular kinesioneurosis leiomyoma ligamentopexy myolysis musculoskeletal myorrhexis paleokinetic palikinesia pygalgia rhabdoid rhabdomyolysis rotator myostasis sthenometry myostroma

TERMS acous/o acoust/o ambly/o audi/o, audit/o aur/o, auricul/o blephar/o cochle/o conjunctiv/o cor/o corne/o -cusis cycl/o dacry/o dipl/o hygr/o ir/o, irid/o kerat/o lacrim/o logad/o myring/o ocul/o ophthalm/o ophry/o -opia, -opsia opt/o ot/o palpebr/o phac/o phak/o phot/o platy-

pupillatonia retinotoxic sclerectasia scotopia sonometer stapedectomy polystichia astigmatism anatropia tympanosclerosis uveoplasty vitreocapsulitis

1.Lymph

a. Auricle b. External auditory canal c. Tympanic membrane/eardrum

a. Voluntary/striated b. Movement c. Naming d.Attached to the skeleton

pimelopterygium

A. Lymphatic System

c. Nervous - Retina

1.External

1.Skeletal

abnormality of the conjunctiva pupil retina sclera darkness sound stapes rows mark, point to turn eardrum uvea glassy, vitreous body

LYMPHATIC & IMMUNE SYSTEM

B. Ear

B. Types

ISBN-13: 978-142320291-2 ISBN-10: 142320291-0

syndesmectopia

a. Eyebrows b. Eyelids c. Lacrimal apparatus d.Conjunctiva e. Eyelashes

A. Characteristics

U.S. $5.95/CAN $8.95

ten/o tenont/o -therapy, therapeut/o ton/o

ligament, connective tissue tendon tendon treatment

2.Associated Structures

MUSCULAR SYSTEM

a. Involuntary/striated b. Found in the heart TERMS DEFINITIONS -asthenia, weakness asthen/o aux/o growth, acceleration -chalasia relaxation erg/o work fasci/o fascia fibr/o fiber, fibrous flex/o bend ide/o idea, mental images kinesi/o, movement - kinesia,-kinetic lei/o smooth ligament/o ligament -lysis dissolution, breakdown muscul/o muscle my/o, myos/o muscle pale/o old palin-, palirecurrence, repetition pyg/o buttocks rhabd/o rod rhabdomy/o striated/skeletal muscle rot/o, rotat/o turn, revolve -stasis standing still, standing sthen/o, -sthenia strength -stroma supporting tissue of an organ

syndesm/o

DEFINITIONS hearing hearing, sound dim, dull hearing ear

B. Immune System WORDS acousia acoustics amblyoscope audiometer auriculotemporal

eyelid blepharorrhaphy cochlea cochleitis conjunctiva conjunctivitis pupil corectasia cornea corneosclera hearing presbycusis ciliary body, circular cyclodialysis tear dacryoadenectomy double diploscope moisture hygroblepharic iris iridemia cornea, horny tissue keratomalacia tear, lacrimal duct lacrimotomy whites of the eyes logadectomy eardrum myringomycosis eye oculonasal eye ophthalmodynia eyebrow ophryitis vision heteropsia eye, vision optometer ear otopyorrhea eyelid palpebritis lens phacocele lens phakoma light photophobia broad, flat platycoria

NOTE TO STUDENT This QUICKSTUDY® reference guide is a comprehensive list of medical terminology. This is a powerful study tool that can be quickly and repeatedly referred to during and well beyond your college years. All rights reserved. No part of this publication may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission from the publisher. ©2000, 2002 BarCharts Inc. Boca Raton, FL. 1106

6

1.Non-specific response - skin, inflammation, phagocytosis 2.Specific response a. acquired immunity

i. natural (active/passive) ii. artificial (active/passive) b. antibody-mediated immunity c. cell-mediated immunity TERMS adenoid/o alloautoaxill/o -edema -emphraxis immun/o inguin/o lien/o lymph/o nod/o -penia peri-phylaxis ple/o sarc/o -sepsis splen/o tetan/o thym/o tonsill/o top/o vaccin/o

DEFINITIONS adenoids other, different self armpit swelling stoppage, obstruction protection, immune groin spleen lymph knot deficiency around protection more flesh putrefaction spleen tetanus thymus tonsils particular place or area vaccine

CREDITS Author: Dr. Corinne B. Linton Customer Hotline # 1.800.230.9522

hundreds of titles at

quickstudy.com

WORDS adenoidectomy allotoxin autoantitoxin axillary lymphedema splenemphraxis immunogenic inguinodynia lienomalacia lymphangiophlebitis nodular lymphocytopenia perilymphangitis anaphylaxis pleocytosis lymphosarcoma antisepsis splenectasis tetanophilic thymectomy tonsillolith splenectopy vaccinogenous

BarCharts, Inc. ®

FOUNDATION OF MEDICAL WORDS A. Structure Most medical words are composed of two or more terms. To define a medical word: • divide the word into its terms • analyze the terms • define the word Examples: Pericarditis peri = around; card = heart; itis = inflammation Inflammation around the heart Oncology onco = tumor, mass; logy = study of Study of tumors

B. Terms Term + Term (.....+.....) = medical word There are five categories of terms: 1.Prefix - beginning of a word (ex., pre____; post_____) Designated by a “____” after the term. 2.Suffix - ending of a word (ex., _____stomy; _____itis) Designated by a “____” before the term. 3.Root - foundation/base of a word (ex., hepat; gastr) 4.Combining vowel - vowel (usually “o”) added to a root (ex., gastro). Use a combining vowel when joining: a. Root to another root (ex., gastrohepatitis) b. Root to a suffix beginning with a consonant (ex., cardiomegaly)

5.Combining form - root + vowel (ex., hepat/o; gastr/o) Designated by a “/” between the root and the vowel Examples: Hyperleukocytosis hyper (prefix) = excessive leuko (combining form) = white cyt (root) = cell osis (suffix) = condition of Definition: condition of excessive white blood cells (leukocytes) Hematotoxic hemato (combining form) = blood tox (root) = poison ic (suffix) = pertaining to Definition: pertaining to blood poisoning

TIPS: 1.Some terms have more than one definition. To determine the correct definition in a particular medical word, analyze the other terms in the word. Example: Poliomyelitis polio = gray (matter) myel = spinal cord, bone marrow itis = inflammation Definition: Inflammation of the gray matter of the spinal cord. The bone marrow does not have gray matter. 2.Some terms may function as a root/combining form in one word and a suffix in another word. Classification depends upon the specific medical word. Examples: Cytology cyto (combining form) = cell logy (suffix) = study of Definition: Study of cells Erythrocyte erythro (combining form) = red cyte (suffix) = cell Definition: Red blood cell

WORLD’S #1 ACADEMIC OUTLINE

THE HUMAN BODY A. Development

Cells - tissues - organs - systems - organism 1.Cells: Major Components a. Cell membrane b. Cytoplasm c. Nucleus

2.Tissues: Primary Types a. Connective b. Epithelium c. Muscle d.Nervous

3.Organs a. Composed of two or more different tissues b. Have specific functions

4.Systems: Related organs with common functions 5.Organism: A living person

B. Cavities

A space containing organs 1.Dorsal a. Cranial b. Vertebral (spinal)

2.Ventral a. Abdominal b. Pelvic c. Thoracic

C. Planes

An imaginary flat surface 1.Frontal – anterior/posterior 2.Sagittal – right/left 3.Transverse – upper/lower

D. Positions

A reference point for location or direction. 1.Anterior/Ventral – front of the body Posterior/Dorsal – back of the body 2.Deep – away from the surface Superficial – on the surface 3.Inferior – situated below Superior – situated above 4.Lateral – pertaining to the side 5.Medial – pertaining to the middle 6.Prone – lying face down Supine – lying face up

TERMS acid/o acuacu/o, acut/o adip/o aer/o agit/o -algia ambul/o anomal/o anthrac/o anthrop/o antr/o aphth/o apic/o aque/o atmoaxi/o bar/o bary-basia bathy-, bathobio-, bi/o blast/o, -blast -calculia

DEFINITIONS acid, sour, bitter needle sharp, severe fat air, gas rapidity, restlessness pain to walk irregular coal, carbon, carbuncle man, human being antrum ulcer apex water steam, vapor axis weight, pressure heavy, dull, hard walking deep, depth life, living early embryonic stage, immature to compute 1

WORDS acidity acupuncture subacute adiponecrosis aerophagy agitophasia cephalalgia ambulatory anomaly anthracosis anthropometry antrotomy aphthosis apicotomy aqueous atmometer abaxial barotrauma baryphonia brachybasia bathycardia biogenesis blastocyte dyscalculia

calor/i campt/o capsul/o, caps/o carcin/o cari/o -cataphasia cathar/o, cathart/o -cathisia, -kathisia caud/o cavit/o, cav/o chem/o chron/o clin/o -coimesis -coma consci/o constrict/o contus/o corpor/o critic/o cry/o cyt/o, -cyte dem/o desicc/o dilat/o dolich/o dolor/o dors/o duct/o dynam/o -dynia dysechin/o ectr/o ele/o emmetr/o enanti/o equierethism/o eti/o eu-facient febr/i fil/o, fil/i, filament/o -form frig/o, frigid/o funct/o gel/o gemell/o -gen, gen/o -genesis -genic ger/o, geront/o -grade hapl/o heredo-hexia hist/o homeohydr/o iatr/o -ician ion/o

heat bent capsule, container cancer caries, rottenness affirmation cleansing, purging

calorimetry camptocormia capsulitis carcinolysis cariogenic acataphasia catharsis

sitting

acathisia

tail caudal hollow, cavity cavitation chemical, chemistry chemosurgery time, timing chronobiology to slope, bend clinocephaly sleeping dyscoimesis deep sleep semicoma awareness, aware unconscious narrowing, binding vasoconstriction to bruise contusion body corporeal crisis, dangerous critical cold cryotherapy cell cytocide people epidemic to dry electrodesiccation enlarge,expand vasodilator long dolichofacial pain dolorogenic back dorsoventral to lead conduction power, strength dynamometer pain gastrodynia bad, difficult, painful dysphonia spiny, prickly echinocyte congenital absence ectrogeny oil eleoma the correct measure, emmetropia proportioned opposite, opposed enantiobiosis equality, equal equilibrium irritation erethismic cause etiology good, normal, well eubiotics to cause, make liquefacient happen fever febriphobia thread, threadlike filamentous specified shape, form multiform

cold performance to freeze, congeal twins producing, generating production, formation produced by, forming

frigorism dysfunctional gelosis gemellology pathogen neogenesis carcinogenic geriatrics centigrade haploid heredoimmunity cachexia histoclastic homeodynamics

aged, old age step simple, singl