1. Chapter 9: the healthy human body

2. 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

3. 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)

4. 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)

5. 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

6. 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

7. 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

8. 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

9. 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)

10. 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

11. 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

12. 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

13. 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.

14. 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

15. 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.