Chapter 9: the healthy human body

Learning Objectives Describe the body systems and define key anatomical terms Integumentary system Musculoskeletal system Nervous system Circulatory system Respiratory system Urinary system Gastrointestinal system Endocrine system Reproductive system Lymphatic and immune systems

Body systems and key anatomical terms Homeostasis Metabolism Cells Tissues Organs Anterior/ventral Posterior/dorsal Superior Inferior Medial Lateral Proximal Distal Homeostasis is the condition in which all of the body’s systems are working at their best. Illness is a disruption in the body’s homeostasis. Metabolism is the physical and chemical processes by which substances are produced or broken down into energy or products for use by the body. Simply stated, metabolism is how the body uses energy. Cells are the basic building block of all living things. Cells divide, develop, and die, renewing tissues and organs. Tissues are groups of cells that perform similar tasks. Organs are groups of tissues that perform specific functions. Organs in a group to perform a specific functions are called organ systems. We will discuss each of these organ systems in more detail later in this presentation: Integumentary Musculoskeletal Nervous Circulatory Respiratory Urinary Gastrointestinal Endocrine Reproductive Immune and Lymphatic Remember: Signs are what the NA actually sees, hears, feels, or smells. Symptoms are not directly seen by the NA, but reported by the resident. It is important for NAs to know these anatomical terms of location: Anterior or ventral (front of the body or body part) Posterior or dorsal (back of the body or body part) Superior (toward the head) Inferior (away from the head) Medial (toward the midline of the body) Lateral (to the side away from the midline of the body) Proximal (closer to the torso) Distal (farther away from the torso)

Integumentary system Integument Important points about the integumentary system Normal aging to the integumentary system Signs and symptoms to report related to the integumentary system The integumentary system is the skin. Integument means a natural protective covering. NAs should know these important points about the integumentary system: Body’s largest organ and system Natural protective covering Prevents excessive loss of water and injury to internal organs Skin made of tissue and glands Skin is a sense organ. Regulates body temperature The following are normal changes of aging in the integumentary system: Thinner, drier, more fragile skin Less elastic skin Thinning fatty tissue can cause person to feel colder Thinner, gray hair Wrinkles and brown spots Nails harder and more brittle Dry, itchy skin due to lack of oil from sebaceous glands NAs should report these signs and symptoms related to the integumentary system: Pale, white, reddened, or purple areas Blisters or bruises Complaints of tingling, warmth, or burning Dry or flaking skin Itching or scratching Rashes or discoloration Swelling Cuts, boils, sores, wounds, abrasions Fluid or blood draining from skin Broken skin Changes in moistness/dryness Changes in wound or ulcer Redness or broken skin between toes or around toenails Scalp or hair changes Skin that appears different from normal In darker complexions, look for change in the feel of the tissue or appearance of the skin (e.g., “orange peel” look)

Musculoskeletal system Bones Joint Muscles Atrophy Contracture Important points about the musculoskeletal system Normal changes to the musculoskeletal system Signs and symptoms related to the musculoskeletal system that should be reported The musculoskeletal system is made of bones, joints, and muscles. Bones are rigid connective tissues that make up the skeleton, protect organs, and allow the body to move. Joints are the places at which two bones meet. Muscles are groups of tissues that provide movement of body parts, protection of organs, and creation of body heat. Muscles can atrophy causing contractures. Atrophy is the wasting away, decreasing in size, and weakening of the muscles from lack of use. Contracture is the permanent and often painful shortening of a muscle, usually due to lack of activity. NAs should know these important points about the musculoskeletal system: Human body has 206 bones. Two bones meet at joint (for movement). Joints make movement possible in either all directions or in one direction only. Muscles provide movement and produce body heat. Physical activity/exercise increases circulation, increasing blood flow to organs and tissues. Inactivity can cause depression, pneumonia, constipation, UTIs, loss of self-esteem, and blood clots. Muscles develop atrophy or contractures from inactivity. ROM exercises help prevent atrophy or contractures. The following are normal changes of aging in the musculoskeletal system: Muscles weaken and lose tone. Body movement slows. Bones lose density and become more brittle. Joints can stiffen/become painful. Height is gradually lost. NAs should report these signs and symptoms related to the musculoskeletal system: Changes in movement and activity Changes in ability to do ROMs Pain during movement New or increased swelling of joints White, shiny, red, or warm areas over joints Bruising Aches and pains reported by resident

Nervous system Central Nervous System (CNS) Peripheral Nervous System (PNS) Important points related to the nervous system Normal changes of aging in the nervous system Signs and symptoms related to the nervous system that should be reported The central nervous system (CNS) is the part of the nervous system that is composed of the brain and spinal cord. The peripheral nervous system (PNS) is the part of the nervous system made up of the nerves that extend throughout the body. NAs should know these important points about the nervous system: Control and message center of body Controls and coordinates all body functions Senses information from outside the body Two main parts: central nervous system (brain) and peripheral nervous system (nerves) The following are normal changes of aging in the nervous system: Slower responses and reflexes Decrease in sensitivity of nerve endings in skin Some memory loss, more often with short-term memory NAs should report these signs and symptoms related to the nervous system: Fatigue or pain with movement Shaking or trembling Inability to move one side of body Difficulty speaking or slurring of speech Numbness or tingling Disturbance or change in vision or hearing Dizziness or loss of balance Changes in eating or fluid intake Difficulty swallowing Bowel or bladder changes Depression or mood changes Memory loss or confusion Violent behavior Unusual or unexplained change in behavior Decreased ability to perform ADLs

Parts of the eyes and ears The eye is a sensory receptor for vision. The sclera is the tough outer coat of the eye. The cornea is the part of the sclera that covers the front of the eye. The iris is the colored portion of the eye. It controls the size of the pupil which determines the amount of light let into and out of the eye. The retina is in the back of the eye and is where the receptors for light can be found. The ear is divided into three parts: the outer ear, middle ear, and inner ear. Outer ear contains the auricle or pinna which is found on the outside of the head. The auditory canal is the tube that carries sound waves into the head. The middle air contains the eardrum which vibrates and transmits the vibrations to the ossicles which are little bones. The ossicles touch the inner ear which is comprised of the cochlea where the receptors of sound can be found and the semicircular canals where the center for balance and equilibrium can be found. The following are normal changes of aging to a person’s senses: Reduced vision and hearing (sense of balance may be affected) Decreased senses of taste, touch, and smell Decreased sensitivity to heat and cold NAs should report these signs and symptoms related to the sense organs: Changes in vision or hearing Signs of infection Dizziness Complaints of pain in eyes or ears

Circulatory system Important points about the circulatory system Changes of aging in the circulatory system Signs and symptoms related to the circulatory system The heart is a four chambered pump and pumps blood away from the heart in arteries and toward the heart in veins. Systole is the phase where the heart is at work, contracting and pushing blood out of the left ventricle. Diastole is the phase when the heart relates or rests. NAs should know these important points about the circulatory system: Made up of heart, blood vessels, and blood Blood carries food, oxygen, and essential substances to cells. Heart has four chambers (two atria/upper chambers and two ventricles/lower chambers). Heart functions in two phases: resting phase—diastole (chambers fill with blood) and contracting phase—systole (ventricles pump blood). Major functions are to: Supply food, oxygen, and hormones to cells Produce and supply antibodies Remove waste products from cells Control body temperature The following are normal changes of aging in the circulatory system: Heart pumps less efficiently Decreased blood flow Narrowed blood vessels NAs should report these signs and symptoms related to the circulatory system: Changes in pulse rate Weakness or fatigue Loss of ability to perform ADLs Swelling of hands and feet Pale or blue hands, feet, or lips Chest pain Weight gain Shortness of breath, changes in breathing patterns, inability to catch breath Severe headache Inactivity, which can lead to circulatory problems

Respiratory system Respiration Inspiration Expiration Sputum Important points about the respiratory system Normal changes of aging in the respiratory system Respiration is the process of breathing air into the lungs and exhaling air our of the lungs. Inspiration is breathing in. Expiration is exhaling air out of the lungs. Sputum is thick mucus coughed up from the lungs. NAs should know these important points about the respiratory system: Inspiration is breathing in and expiration is breathing out by the lungs. Functions are To bring oxygen into body To eliminate carbon dioxide produced by the body The following are normal changes of aging in the respiratory system: Loss of lung strength Decreased lung capacity Decreased oxygen in the blood Weakened voice NAs should report these signs and symptoms related to the respiratory system: Changes in respiratory rate Shallow breathing or breathing through pursed lips Coughing or wheezing Nasal congestion or discharge Sore throat, difficulty swallowing, swollen tonsils Need to sit after mild exertion Pale, bluish, or gray lips or extremities Pain in chest Discolored sputum (yellow, green, gray, or bloody)

Urinary system Important points about the urinary system Normal changes of aging in the urinary system Signs and symptoms related to the urinary system that should be reported NAs should know these important points about the urinary system: Functions are: To eliminate wastes To maintain water balance The following are normal changes of aging in the urinary system: Reduced ability of kidneys to filter blood Weakened bladder muscle tone Bladder holds less urine causing more frequent urination Bladder may not empty completely, causing more susceptibility to infection NAs should report these signs and symptoms related to the urinary system: Weight loss or gain Swelling in extremities Painful urination or burning during urination Changes in urine (cloudy, odor, color) Change in frequency or amount of urine Swelling in abdominal/bladder area Complaints that bladder feels full or painful Urinary incontinence (the inability to control the bladder, which leads to an involuntary loss of urine) Pain in kidney or back/flank Inadequate fluid intake

Digestive system Important points Normal changes of aging Signs and symptoms to report NAs should know these important points about the gastrointestinal system: Digestion prepares food for absorption into cells. Elimination is expelling solid wastes. The following are normal changes of aging in the gastrointestinal system: Decreased saliva production affects chewing/swallowing. Dulled sense of taste may result in poor appetite. Absorption of vitamins/minerals decreases. Digestion takes longer, is less efficient. Body waste moves more slowly through intestines; constipation is more frequent. NAs should report these signs and symptoms related to the gastrointestinal system: Difficulty swallowing or chewing Fecal incontinence Weight gain or loss Loss of appetite Abdominal pain or cramping Diarrhea Nausea and vomiting (especially coffee grounds type) Constipation Flatulence Hiccups, belching Bloody, black, or hard stools Heartburn Poor nutritional intake

Endocrine system Important points Normal changes Signs and symptoms to report NAs should know these important points about the endocrine system: Glands secrete hormones, which are chemical substances that control numerous body functions Hormones are carried by the blood to organs in order to achieve the following: Maintain homeostasis Influence growth and development Regulate blood sugar levels Regulate calcium levels in bones Regulate body’s ability to reproduce Determine how fast cells burn food for energy The following are normal changes of aging in the endocrine system: Decrease in levels of hormones, such as estrogen and progesterone Less production of insulin Less able to handle stress NAs should report these signs and symptoms related to the endocrine system: Headache Weakness Blurred vision Dizziness Irritability Sweating Change in “normal” behavior Confusion Change in mobility Change in sensation Numbness or tingling in arms or legs Weight gain/loss Loss of appetite/increase in appetite Increased thirst Frequent urination Hunger Dry skin Skin breakdown Sweet or fruity breath Sluggishness or fatigue Hyperactivity

Reproductive system Important points Normal changes Male Reproductive System NAs should know these important points about the reproductive system: Reproductive organs and hormones are different in males (testes, scrotum, testosterone) and females (ovaries, fallopian tubes, estrogen). Reproductive system allows humans to reproduce (to create new human life). The following are normal changes of aging in the integumentary system: Male: Decrease in sperm production Enlargement of the prostate gland Female: Menstruation ends Decrease in estrogen leads to loss of calcium, causing brittle bones Drying and thinning of vaginal walls NAs should report these signs and symptoms related to the reproductive system: Discomfort or difficulty with urination Discharge from penis or vagina Swelling of genitals Blood in urine or stool Breast changes, lumps, or discharge Sores on genitals Reports of impotence Reports of painful intercourse Remember: Residents have the right to sexual freedom and expression. They have the right to privacy and to meet their sexual needs.

Immune and lymphatic systems Important points Normal changes Signs and symptoms to report NAs should know these important points about the immune system: Nonspecific immunity protects the body from disease in general. Specific immunity protects the body against a particular disease invading the body at a given time. NAs should know these important points about the lymphatic system: Functions of system are to remove excess fluids and waste products and to help the immune system fight infections. It is closely related to the circulatory system because lymph fluid, after being purified in the lymph nodes, flows into the bloodstream. It has no pump, but is circulated by muscle activity, massage, and breathing. The following are normal changes of aging in the immune and lymphatic systems: Increased risk of infections due to weaker immune system Takes long to recover from an illness Decreased number and size of lymph nodes Decreased response to vaccines NAs should report these signs and symptoms related to the immune and lymphatic systems: Recurrent infections Swelling of lymph nodes Increased fatigue

Review Body systems and key anatomical terms In this chapter, we have talked broadly, and specifically, about each of the body systems and have defined key anatomical terms. Terms related to each of the body systems were discussed as well as key points related to each. Signs and symptoms related to each body system that the NA should report were outlined, as well.