Lab Practical Prep / Lab # 2

Billy Staggs Cahill

Nursing Student – RN

Fall 2017

Instructor: Dr. Vera Mcilvain PhD 

Anatomy & Physiology


Nurses notes / fractures and dressings: 




This patient’s open fracture has been stabilized c external fixation and the wound has been partially closed c antibiotic beads. . . 
Antibiotic Beads:



The skeletal system includes:

Bone (hardest connective tissue) 

  • cells, collagen fibers, dense mineralized ground substance 



Ligaments connect bone – to – bone

Tendons connect skeleton muscle to bone

Other connective tissues

Blood supply and nerves run through the bone




structural support – site for attachment of tissues and organs

storage of minerals and lipids – calcium salts, yellow bone marrow 

blood cell production – red, white platelets produced in red bone marrow

protection – heart, lungs, brain, spinal cord, reproductive organs 

leverage / movement (together w / skeletal muscle)

bone marrow

Notes and study guide 


tib fib 3

Intercondylar eminence, Lateral condyle, Medial malleolus of tibia, Anterior border, Tibial tuberosity, Lateral malleolus, Head of fibula

  • Do not get tuberosity and tubercle confused! Tubercle is the ribs NOT THE FIB – TIB!
  • A and P view — head of fibula same name / fibula head is head of fibula posterior / anterior — SAME!
  • fibula is the smaller bone, TIBIA IS THE LARGER BONE


tib fib4

tib fib5


Recall: Sisters — TIB – FIB. “Mrs. Tib and Miss Fib

foot 1

D ⇒ M ⇒ P

  • Distal / Middle / Proximal

    Phalanges – x – X – x

    foot 2

  • I, II, III, IV, V — x – x – x – x – x
  • Toe is I

3 circ


Cuneiform — cUnee – form

  1. Medial cuneiform
  2. Intermediate cuneiform
  3. Lateral cuneiform

THEY ARE SIDE – SIDE – SIDE @ top foot, starting below toe. 


M I L 

medial — INTERMEDIATE — lateral 

In feet — Metatarsal, in hand / fingers — Metacarpal 



L and R scapula / both birds peaking out (A, B , F, G) and lower curves inward (D)  > < 













a to b


Repetitive patterns, mapping, points and memorization OF the skeletal system


Recall notes:

Femur – upper leg next to gluteal, below gluteal, has sockets, longish neck and ONE bone. 

Greater and lesser trochanter / curvature / angular neck / 

  • fovea capitis above head / head / neck / 

  • @ bottom → ” the condyles” – lateral/ medial

  • → epicondyle and condyle

  • EPI →  UPPER, condyle is just condyle below epicondyle

  • “wrap” →  patellar surface Anterior / Posterior→  intercondyler fossa, which is where a socket / “dip” is.

  •  A → patellar surface / P → “socket in back” → intercondylar fossa. INTER → “enter bone” place for bone to join.

  • Intercondylar Fossa!

  • medial → “middle” Lateral /   \ Lateral condyle, epicondyle

  • ———— ↑ (line above) intercondylar fossa is LINEA ASPERA, ASPERA! LINEA ASPERA! LINEA ASPERA! 

  • gluteal tuberosity ↑ linea aspera

  • GREATER and lesser trochanter! G and L TROCHANTER



Tibia and Fibula – bottom leg before feet / malleolus! NOT condyle! MALLEOLUS! Lateral & Medial

  • head of fibula bot A and S / tibial tuberosity is ANTERIOR always front q x no matter what! TIBIAL TUBEROSITY!

  • ^^ ← Intercondylar eminence / two @ top →→ Intercondylar eminence /

  • lateral malleolus is the bottom of fibula / point outwardly / medial malleolus is middle and bottom tibia! Medial MALLEOLUS is the tibia and Lateral MALLEOLUS is the fibula 

  • ANTERIOR BORDER is the tibia ↑ medial malleolus


tib and fib 1

tib and fib 2



Sacrum → APEX – top of coccyx

Body @ top / posterior — sacral promontory @ top / anterior

MEDIAN SACRAL CREST / NOT medial, but median!

Radius and Ulna








E  head of radius  D → neck of radius C → radial tuberosity  F → olecronon G → trochlear notch H → coronoid process I → proximal radioulnar joint K → interosseous membrane B → radius J → ulna A → radial styloid process N → distal radioulnar JOINT! (DO NOT THINK NOTCH! IT IS A JOINT) M → ulnar styloid process L → head of ulna

radius and ulna

  • 1 → distal radioulnar joint

  • 2  → ulnar styloid process

  • 3 → olecronon

  • 4 → trochlear notch

  • 5 → coronoid process (notice the triangular top)

  • 6 → radial styloid process

  • 7 → radial tuberosity

  • 8 → head of radius (think of nail head for identification in lab)

  • 9 → radial notch of the ulna / proximal radioulnar JOINT

  • 10 → lateral epicondyle

  • 11 → olecronon fossa

  • 12 → coronoid fossa 


Radius: Thumb Side, Ulna: Little Finger Side.

radius frac

FEMUR (the condyle and trochanter bone)


1 → head of femur

2 → lesser trochanter

3 → medial epicondyle

4 → linea aspera

5  →  lateral epicondyle

6 → greater trochanter

7 → lateral condyle

8  → medial condyle

9 → patellar surface

10  → neck of femur 




  1. Recall:
  2. FEMUR — condyle and epicondyle , lateral & medial
  3. TIBIA AND FIBIA — malleolus, medial and lateral
  4. FEMUR — lesser and greater trochanter
  5. RADIUS AND ULNA — styloid process, radial and ulnar, also distal and proximal radioulnar joints
  6. FEET — cuneiforms, medial, intermediate and lateral + calcaneus, cuboid, talus, navicular
  7. HAND — “ates”, hamate, lunate, capitate + triquetrum, pisiform, trapezium, trapezoid, scaphoid

FEET — tarsals

HANDS — carpals 

w / feet — recall cuboid:


  • the sides and top, etc look like a cuboid, not exact, but close

cuboid 2

CUBOID is aligned w/ the cuneiforms (medial —  intermediate — lateral) → CUBOID

navicular and calcaneus are below and appear bigger / longer (to me anyway)



R and L hints:

  1. Humerus – hold the bone so that the capitulum and trochlea face YOU (anterior)

-if the head faces left – it is a left humerus

  1. Ulna – face the trochlear notch away from you (U-shaped process) and look at the olecranon

-ask yourself – on what side is the radial notch?
-if it is on the right – it is a right ulna

3. Radius – orient the bone with the round head UP and the distal end DOWN
-look at “bumps” at the distal end
-look for the styloid process at the distal end
-if it is on the right side – it is a right radius

4. Scapula – hold the bone with the spine facing YOU and the apex facing DOWN
-if the acromion faces left – it is a left scapula
-NOTE: the corocoid process is spelled with a “c” and so is “scapula”

5. Femur – the head must face IN and the lesser trochanter must be on the BACK side of the bone
-so hold the bone so that the head is on top and the trochanters are on the BACK surface of the bone
-if the head faces left – it is a left femur

6. Tibia – hold the bone so that the intercondylar eminence is towards the top and you are looking at the tibial tuberosity
-if the medial malleolus on the distal end is on the left side – it is a left tibia

7. Clavicle – a. point the flat sternal end toward the midline
b. the clavicle bulges OUT then IN
c. the conoid tubercle must point DOWN


  1. Cervical – three holes, forked spinous process
  2. Thoracic – one hole, long, thin spinous process
  3. Lumbar – one hole, processes are thick and large
  4. Atlas – looks very different, almost like a circle
  5. Axis – look for the “dens” near the body

Corocoid – “c” in scapula
Coronoid – “n” in ulna (or mandible)
Conoid – is the clavicle



Microsoft Word - Frontiers Manuscript 061513 Revised Manuscript

Ossification — Bone formation 





It’s all transitory


Origin of bone cells


osteogenic cell develops into an osteoblast:

osteogenic cell →→ osteoblast →→ osteocte

bone cell


OSTEOCLAST is from white blood cell lineage



  • most numerous
  • mature bone cells / non – dividing
  • develop from osteoblasts
  • one osteocyte / lacuna (space)
  • connected by canaliculi 


canaliculi — small canal or tubular passage

can –  a – lick – u lie



x – bone maintenance nutrients / waste exchange

x – turnover of matrix components

x – repair damage

x – “strain sensors”

x – can convert back to osteoblasts or osteoprogentetor if needed






Metabolism / Triglycerides

Notes by: Billy Staggs Cahill

Nursing Student – RN

A&P Instructor: Dr. Vera Mcilvain PhD / Adjunct Professor 

Fall 2017

Onondaga Community College 

tri info




  • Are lipoproteins
  • they consist of 95% triglycerides (core, inside)
  • They transport dietary lipids from the intestines to other parts of the body


Adipose Tissue





Lipid Panel

Checks for different types of cholesterol. There are good and bad kinds of fats.

It is recommended by the American Heart Association, anyone 21 and older get checked frequently / have a lipid panel done every 5 years.

There should be an overnight fast before the lipid panel is given. 

There are hardly any symptoms when triglycerides are high.  “silent but can be deadly” 

lipid panel

Dieting for triglycerides:

  • Target: To decrease triglyceride levels
  • Remember: Eating before a lipid panel is given can influence the results

The patient must be informed of a good diet to help lower triglyceride levels / cholesterol.

There are many different diets, ways, routes to target levels.

Quick Notes:

A good breakfast with milk, fruit and wheat toast is a start, eat a light weight meal q 2 – 4 hrs.

Cut sugars — replace c fruit, this can eliminate the craving for sugars / carbs

Eat fiber

Limit fructose

moderately low – fat diet

omega -3 fatty acids

Exercise regularly


Replace x sugar craving c fruit: if a desire for a piece of cake / replace c  apple or orange (any fruit desired).

x – breakfast → fruit, wheat toast, no more than 1 egg

x lunch →  fruit or vegetable c tuna, wheat bread, chicken or anything healthy that cuts fat. Take vitamin in between meals.

x dinner →  vegetable, replace starch, flour c sweet potatoes, green beans, &c. fish, chicken, wheats, fruit snacks, peanut butter, &c. All good / limit serving / maintain good eating habits c nutrition.

q d / take vit / omega / exercise / eat healthy / watch carb intake along c sugars / glucose &c.

  • Sensible decisions to maintain good triglycerides.
  • Once back to normal, keep practicing good health

tri food




Integument II / nurse notes

Notes and writing by Billy Staggs Cahill 

Nursing – RN 

Fall 2017

Anatomy and Physiology

Instructor: Dr. Vera Mcilvain


Why it’s important for a nurse to know the Integumentary System.

By: Billy Staggs Cahill (Nursing Student)

     Like most anatomy, the epidermis and dermis is very complex and has physiological cycle to it. It’s important for a nurse to know about about skincare, vitamins, nutrients, and learning about the subcutaneous layer — the hypodermis is important, since hypodermic syringes are part of nursing. It’s all relative and accumulative knowledge; the more a nurse knows, the better she / he is on the career front.

     There are many nursing and pre – nursing students who look at anatomy and physiology as a mountain to climb on their way to success. In all that is sacred of science and useful in the medical field — anatomy and physiology should be a main focus at the time it’s studied by the student. It’s very important for a good nurse to know and study anatomy and physiology thoroughly. 

“A fine perceptive of the human anatomy is clinically significant to members of the health care team, including nurses. It is important to know the human body and how it functions in its healthy state. By knowing such, it will be easier to learn about pathophysiology, clinical assessment and many other nursing procedures. Those are exact reasons why we, nurses, have this subject as a prerequisite for other nursing subjects.” Nursing Crib — Why You Should Know Your Anatomy is a good online article and source that sums up why it’s important for all the health team should know anatomy, including nurses! Of course — this is relating to your own medical knowledge.

In what ways is it good for a nurse to know about the Integumentary System?

Why should we know about the skin? 


Vitamins and oils?

How about nutrition, and what our skin needs?

 It’s good for nurses to take care of themselves, maintaining a healthy lifestyle and diet. Let’s get one thing straight! There’s no such thing as perfect! However, there is theory and practice. What works best for each individual’s skin may not be for everyone. This doesn’t mean go out and spend all your money on some secret anti – aging cream or drops. It simply means to know the Integumentary System is to know how our skin works — what’s best for our skin and good hygiene. 

Let’s focus on skincare:

skin care1

 People are always looking at ways to help their skin, and sometimes they may ask a nurse. Most likely not, but as nurses ( female or male), we should focus on ways helping ourselves and maintaining a good example of health. It doesn’t take a “skin genius” Dermatologist to maintain good skin. 

According to WebMD, the following are the vitamins and antioxidants to maintain skin health:

  • Vitamin A, also known as retinol, is important for helping to keep skin healthy
  • Vitamin C, also known as ascorbic acid, helps protect cells and tissue and aids wound healing.
  • Vitamin E helps to maintain cell structures and protect cell membranes.
  • Selenium is a mineral that helps prevent damage to cells and tissues.
  • Vitamins C and E, and selenium are antioxidants that may help protect skin from sun damage.

There are numerous products that can be used for different types of skin. Everyone varies when it comes to using skin products. We may use a new lotion or soap that has hit the market, while our mothers’ use Oil of Olay. Some people invent their own skin products by fruits, herbs, lotions and all kinds of x, y, z potions. Whatever you find works best for your integument is what’s best for you — it’s really that simplex. Personally, I find a combination of Vit. E & A to work wonders. Also many different lotions seem to work best for skin. It doesn’t have to be a specific, expensive lotion from Eden. It can be as simplex as baby lotions, coconut oils or Argon. There’s so many different names and varieties, it’s all sample, test and game. 

     Many people, including nurses have a bad habit of biting their nails. There’s ways of stopping and breaking this bad habit! It’s called a clear coat of nail hardener, even men can use this technique to stop biting their nails. It makes you think twice about biting your nails with a chemical layered on top of it. Who wants a nurse with nails like Dr. Jekyl? I certainly wouldn’t! 

     Good hygiene and skincare IMO is a big PLUS for nurses, doctors and anyone who desires to be a good example of health. This is ONLY one reason it’s good to know the Integumentary System and all anatomy of our bodies. It’s not only critical for a health team, but also good measure in taking care of ourselves! 



Side notes (compilation) to the Integumentary System:

Langer’s Lines:

Important for surgeons to know, not so much nurses.

langer's lines

  • In certain areas of the body
  • Collagen fibers in reticular region orient more in one direction than in others
  • Knowledge of lines important for surgeons, however on Integ. Exams for all medical students.



  • Functions:
  • Protects and insulates
  • Guards openings (nose, ears) against particles and insects
  • Is sensitive to very light touch
  • Hair follicle: produce hair
  • Invagination of epidermis into dermis
  • Wrapped with dense Connective Tissue
  • Surrounded by root hair plexus
  • Arrector pili – smooth muscle cells. “goosebumps”
  • Hair color (melanocytes) grey hair: melanocytes produce less melanin


Microscope slides / Melanocytes and other / Epidermis & Dermis












Hypodermic syringes:

hypodermic needle2