Organs and Body Systems: Heart, Lungs, Kidneys, Liver and…

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Organs and Body Systems: Heart, Lungs, Kidneys, Liver and Pituitary Gland

An organ is a collection of specialised tissues arranged to perform one or more coordinated functions. Organs do not work in isolation: the heart delivers blood, the lungs exchange gases, the kidneys regulate the internal environment, the liver processes nutrients and chemicals, and the pituitary coordinates endocrine activity. For physiotherapy students, this anatomy is the foundation for safe assessment, exercise prescription, mobilisation, respiratory care and patient education.

Why an organ-systems approach matters in physiotherapy

A patient’s movement problem may be influenced by circulation, oxygenation, fluid balance, metabolism or hormones. For example, breathlessness limits exercise tolerance; heart failure may cause fatigue and oedema; renal disease changes fluid and electrolyte handling; liver disease can cause weakness and bleeding risk; pituitary disorders can alter growth, muscle strength and bone health. Understanding normal structure and function helps the physiotherapist recognise abnormal responses, choose appropriate precautions and refer promptly.

Learning outcomes

By the end of this lesson, the learner should be able to:

Define an organ and relate organs to tissues, organ systems and homeostasis.
Identify the location, major parts, blood supply and principal functions of the heart, lungs, kidneys, liver and pituitary gland.
Trace the movement of blood through the heart and lungs and explain how the kidneys, liver and pituitary contribute to internal balance.
Relate organ structure to physiotherapy assessment, exercise tolerance, positioning, monitoring and referral.
Recognise important red flags without attempting to diagnose beyond the physiotherapist’s scope.
Use anatomical terminology accurately in documentation and examination answers.

1. Organs, systems and homeostasis

The body is organised from cells to tissues, organs, organ systems and the complete organism. A tissue is a group of similar cells performing a common function. An organ contains at least two tissue types arranged into a recognisable structure. An organ system is a group of organs working together.

Level	Meaning	Example
Cell	Smallest living structural and functional unit.	Cardiac muscle cell, nephron epithelial cell or hepatocyte.
Tissue	Similar cells and extracellular material with a shared role.	Cardiac muscle, nervous tissue, epithelial tissue or connective tissue.
Organ	Several tissues arranged to perform specialised functions.	Heart, lung, kidney, liver or pituitary gland.
Organ system	Organs that cooperate for a major body function.	Cardiovascular, respiratory, urinary, digestive or endocrine system.
Organism	The integrated living human being.	A patient whose systems adapt together during walking or exercise.

Major organ systems and physiotherapy links

System	Main organs/structures	Importance to physiotherapy
Integumentary	Skin, hair, nails, glands	Pressure injury prevention, wound care, thermoregulation and sensation.
Musculoskeletal	Bones, joints, skeletal muscles, tendons and ligaments	Posture, movement, strength, mobility and function.
Nervous	Brain, spinal cord, peripheral nerves	Motor control, sensation, balance, pain and coordination.
Cardiovascular	Heart, blood and blood vessels	Oxygen delivery, exercise response, circulation and vital-sign monitoring.
Respiratory	Airways, lungs, pleura and respiratory muscles	Ventilation, airway clearance, breathing control and exercise tolerance.
Urinary	Kidneys, ureters, bladder and urethra	Fluid/electrolyte balance, blood pressure, fatigue and precautions in renal disease.
Digestive	Gastrointestinal tract, liver, gallbladder, pancreas	Nutrient availability, energy, medication handling and abdominal conditions.
Endocrine	Pituitary, thyroid, adrenals, pancreas, gonads and others	Growth, metabolism, stress response, bone health and tissue repair.
Lymphatic/immune	Lymph vessels, nodes, spleen, thymus and immune cells	Oedema management, infection precautions and cancer rehabilitation.
Reproductive	Ovaries/uterus or testes and associated structures	Pregnancy, pelvic rehabilitation and reproductive health.

2. Anatomical language for organ study

Superior/inferior: nearer the head/farther from the head; the heart is superior to the diaphragm.
Anterior/posterior: toward the front/back; the sternum is anterior to the heart.
Medial/lateral: nearer the midline/farther from it; the heart is medial to the lungs.
Proximal/distal: nearer/farther from the point of attachment; useful for limbs, not usually for the whole organ.
Superficial/deep: nearer the surface/farther inside; the ribs are superficial to the lungs.
Parietal/visceral: relating to a cavity wall/covering an organ; the pleura has parietal and visceral layers.

Organ-system study aid

Group organs by what they help the body do: pump (heart), exchange (lungs), filter and regulate (kidneys), process and store (liver), and coordinate hormones (pituitary). Then link each organ to its system and clinical function.

3. The heart

The heart is a muscular, hollow organ that acts as two coordinated pumps. The right side sends deoxygenated blood to the lungs; the left side sends oxygenated blood to the systemic circulation. It lies in the middle mediastinum between the lungs, behind the sternum and slightly left of the midline. The apex points downwards, forwards and to the left.

3.1 Coverings and external features

Pericardium: a protective sac with a tough fibrous layer and a serous layer. A small amount of fluid reduces friction as the heart beats.
Base: broad posterior aspect, mainly associated with the atria and great vessels.
Apex: formed mainly by the left ventricle; the apical impulse is normally felt near the left fifth intercostal space in the mid-clavicular region.
Grooves/sulci: coronary and interventricular grooves contain coronary vessels and fat.
Coronary arteries: right and left coronary arteries arise from the ascending aorta and supply the myocardium; venous blood returns through cardiac veins to the coronary sinus and right atrium.

3.2 Chambers, septa and valves

Structure	Receives or pumps	Key features
Right atrium	Receives systemic venous blood from the superior and inferior venae cavae and coronary sinus.	Passes blood through the tricuspid valve to the right ventricle.
Right ventricle	Pumps deoxygenated blood to the pulmonary trunk.	Thinner wall than the left ventricle because pulmonary resistance is lower; has trabeculae carneae and papillary muscles.
Left atrium	Receives oxygenated blood from four pulmonary veins.	Passes blood through the mitral/bicuspid valve to the left ventricle.
Left ventricle	Pumps oxygenated blood into the aorta.	Thickest myocardium because it generates systemic arterial pressure.
Interatrial/interventricular septa	Separate right and left sides.	Prevent mixing of oxygenated and deoxygenated blood after birth; defects may create abnormal shunts.

The four valves maintain one-way flow. The tricuspid and mitral valves are atrioventricular valves; the pulmonary and aortic valves are semilunar valves. Chordae tendineae and papillary muscles prevent the atrioventricular leaflets from prolapsing during ventricular contraction. Valves open and close because of pressure differences, not because muscles pull them open.

3.3 Blood pathway through the heart

Superior/inferior vena cava → right atrium.
Right atrium → tricuspid valve → right ventricle.
Right ventricle → pulmonary valve → pulmonary trunk and pulmonary arteries.
Pulmonary arteries → lung capillaries, where carbon dioxide leaves and oxygen enters the blood.
Pulmonary veins → left atrium.
Left atrium → mitral valve → left ventricle.
Left ventricle → aortic valve → aorta → systemic arteries and tissues.

3.4 Electrical conduction and the cardiac cycle

Sinoatrial (SA) node: the usual pacemaker in the right atrium; initiates atrial depolarisation.
Atrioventricular (AV) node: briefly delays the impulse so the ventricles can fill.
AV bundle (bundle of His), right and left bundle branches: conduct the signal through the interventricular septum.
Purkinje fibres: distribute the impulse through ventricular myocardium for coordinated contraction.

The cardiac cycle includes ventricular filling (diastole), isovolumetric contraction, ventricular ejection (systole) and isovolumetric relaxation. Cardiac output = heart rate × stroke volume. Stroke volume is influenced by preload, contractility and afterload. During graded exercise, sympathetic activity usually raises heart rate and contractility, while venous return and cardiac output increase to meet muscle demand.

3.5 Heart functions and physiotherapy relevance

Maintains tissue perfusion and oxygen delivery.
Transports hormones, nutrients, immune cells and metabolic waste through the circulation.
Contributes to blood pressure regulation through cardiac output and interaction with the kidneys and vessels.
Releases natriuretic peptides when cardiac chambers stretch, influencing fluid and sodium excretion.
Determines exercise tolerance together with the lungs, blood, muscles and nervous system.

Clinical application: monitoring exercise

Before and during activity, relate symptoms to heart rate, blood pressure, respiratory rate, oxygen saturation, perceived exertion and recovery time. Stop and escalate according to local protocol when there is new chest pressure, syncope, severe breathlessness, cyanosis, sustained palpitations or an abnormal haemodynamic response. A physiotherapist records what was observed and refers rather than making an unqualified cardiac diagnosis.

4. The lungs

The lungs are paired respiratory organs in the thoracic cavity. They bring air close to pulmonary capillaries for gas exchange and help regulate acid–base balance through carbon dioxide removal. The right lung has three lobes; the left has two lobes and a cardiac notch to accommodate the heart.

4.1 External anatomy and coverings

Apex: extends above the first rib into the root of the neck.
Base: rests on the diaphragm; the right dome is usually higher because of the liver.
Costal surface: faces the ribs and intercostal spaces.
Mediastinal surface and hilum: medial area where the main bronchus, pulmonary vessels, nerves and lymphatics enter or leave.
Visceral pleura: covers the lung surface. Parietal pleura: lines the thoracic wall, diaphragm and mediastinum. The pleural cavity contains a thin lubricating film and normally negative pressure that helps keep the lungs expanded.

Right lung	Left lung
Superior, middle and inferior lobes	Superior and inferior lobes
Horizontal and oblique fissures	Oblique fissure and cardiac notch
Usually broader and slightly shorter	Narrower because the heart projects to the left

4.2 Conducting and respiratory zones

Nose/mouth → pharynx → larynx.
Trachea → right and left main bronchi.
Lobar (secondary) bronchi → segmental (tertiary) bronchi.
Bronchioles → terminal bronchioles (conducting zone).
Respiratory bronchioles → alveolar ducts → alveolar sacs and alveoli (respiratory zone).

Cartilage supports the trachea and bronchi; smooth muscle and mucosa regulate airway calibre and trap particles. Cilia move mucus toward the pharynx, where it can be swallowed or expectorated. Alveoli have thin walls, a large surface area and close contact with capillaries. Type I pneumocytes form most of the gas-exchange surface; type II pneumocytes produce surfactant, which reduces surface tension and helps prevent alveolar collapse.

4.3 Pulmonary circulation and gas exchange

Deoxygenated blood leaves the right ventricle through the pulmonary arteries, passes through capillaries around alveoli and returns oxygenated through pulmonary veins to the left atrium. Oxygen moves down a partial-pressure gradient into blood; carbon dioxide moves out. Effective gas exchange requires ventilation, perfusion, a thin alveolar–capillary membrane and adequate haemoglobin.

Ventilation is movement of air; perfusion is blood flow. A mismatch between them reduces oxygenation. The diaphragm is the principal muscle of quiet inspiration; external intercostals assist expansion. Quiet expiration is mainly passive, whereas forced breathing recruits abdominal and internal intercostal muscles.

4.4 Respiratory mechanics and physiotherapy

Concept	Explanation	Physiotherapy link
Tidal volume	Air moved in a normal quiet breath.	Changes with activity, pain, posture and respiratory disease.
Inspiratory reserve volume	Extra air that can be inhaled after a normal inspiration.	Reduced chest expansion may limit exercise and airway clearance.
Expiratory reserve volume	Extra air that can be exhaled after a normal expiration.	Dynamic hyperinflation can make expiration difficult in obstructive disease.
Residual volume	Air remaining after maximal expiration.	Cannot be expelled by voluntary breathing; increases may occur with air trapping.
Vital capacity	Maximum air exhaled after maximum inspiration.	Useful concept for restrictive patterns and respiratory assessment.
Minute ventilation	Respiratory rate × tidal volume.	May rise during exercise; observe whether the work of breathing is excessive.

Positioning can improve ventilation–perfusion matching and reduce work of breathing; choose a position according to the patient’s condition and tolerance.
Breathing control, thoracic expansion, supported coughing and airway-clearance techniques require assessment, consent and monitoring.
Record respiratory rate, pattern, accessory-muscle use, cough, sputum, chest movement, oxygen saturation and response to activity.

Clinical scenario: breathlessness during mobilisation

A patient recovering from pneumonia becomes very breathless after standing. Sit the patient safely, assess responsiveness and airway, observe breathing and oxygen saturation, and follow the facility’s escalation and oxygen policy. Do not push through severe distress. Compare pre-activity and recovery observations, document the intervention and communicate a change to the clinical team.

5. The kidneys

The kidneys are paired retroperitoneal organs that filter plasma, form urine and maintain the chemical stability of the internal environment. They lie on the posterior abdominal wall; the right kidney is usually slightly lower because of the liver. The renal hilum faces medially and transmits the renal artery, renal vein, nerves, lymphatics and ureter.

5.1 Gross anatomy and protection

Renal capsule: tough fibrous covering closely attached to the kidney.
Perirenal fat and renal fascia: cushion and help hold the kidney in position.
Cortex: outer region containing renal corpuscles and convoluted tubules.
Medulla: inner region containing renal pyramids and collecting ducts.
Renal columns: cortical tissue extending between pyramids.
Renal papillae → minor calyces → major calyces → renal pelvis → ureter: the drainage pathway for urine.

5.2 The nephron

The nephron is the functional unit. Each nephron contains a renal corpuscle—glomerulus within Bowman’s capsule—and a tubular system.

Afferent arteriole → glomerular capillaries: pressure filters water and small solutes into Bowman’s space; cells and most plasma proteins remain in the blood.
Proximal convoluted tubule: reabsorbs most filtered water, sodium, glucose, amino acids and bicarbonate; also secretes selected substances.
Loop of Henle: establishes a medullary concentration gradient; the descending limb is more water-permeable and the ascending limb actively moves salts but is relatively impermeable to water.
Distal convoluted tubule: fine-tunes electrolytes and acid–base balance under hormonal influence.
Collecting duct: adjusts final water reabsorption in response to antidiuretic hormone and delivers urine toward the papilla.
Efferent arteriole/peritubular capillaries and vasa recta: receive reabsorbed substances and support exchange around the tubules.

5.3 Kidney functions

Function	How it is achieved	Physiotherapy relevance
Excretion	Removes urea, creatinine, drug metabolites and excess ions in urine.	Renal impairment may alter fatigue, medication handling and exercise tolerance.
Fluid balance	Adjusts water excretion and concentration of urine.	Monitor prescribed fluid limits, oedema and postural symptoms.
Electrolyte balance	Regulates sodium, potassium, calcium, phosphate and other ions.	Abnormal potassium can affect muscle and cardiac function; confirm precautions with the team.
Acid–base balance	Excretes hydrogen ions and reabsorbs/produces bicarbonate.	Metabolic acidosis may contribute to weakness and rapid breathing.
Blood-pressure control	Renin–angiotensin–aldosterone system, sodium handling and volume control.	Check blood pressure and dizziness during transfers or exercise.
Endocrine functions	Produces erythropoietin and activates vitamin D (calcitriol).	Chronic kidney disease can cause anaemia, bone-mineral problems and reduced exercise capacity.
Gluconeogenesis	Contributes to glucose production during fasting.	Consider overall energy status in a medically complex patient.

Clinical application: renal precautions

Ask about dialysis schedule, vascular access, fluid restrictions, fatigue, dizziness and recent laboratory concerns. Protect a fistula or graft from compression and blood-pressure cuffs unless the renal team directs otherwise. Adapt intensity, allow rest, monitor symptoms and coordinate timing around dialysis according to local policy.

6. The liver

The liver is the largest internal gland and a major metabolic organ. It occupies the right upper abdomen beneath the diaphragm, with a smaller left lobe extending across the midline. Its surfaces are related to the diaphragm, stomach, duodenum, right kidney, colon and gallbladder.

6.1 Gross anatomy and blood supply

Diaphragmatic surface: smooth and moulded to the diaphragm; the falciform ligament marks the external division between right and left anatomical lobes.
Visceral surface: related to abdominal organs and contains the porta hepatis.
Porta hepatis/portal triad: the hepatic portal vein, hepatic artery and bile duct travel together in the hepatoduodenal ligament with lymphatics and nerves.
Dual inflow: the portal vein supplies most blood and brings absorbed nutrients from the gut; the hepatic artery supplies oxygen-rich blood. Blood leaves through hepatic veins to the inferior vena cava.
Functional segments: the liver is divided into vascular and biliary segments used in clinical imaging and surgery; do not confuse these with the external anatomical lobes.

6.2 Microscopic organisation

Hepatocytes are arranged in plates around central veins. Blood flows through sinusoids from branches of the portal vein and hepatic artery toward the central vein. Bile flows in the opposite general direction through canaliculi to bile ducts. Kupffer cells remove particles and old cells; hepatic stellate cells store vitamin A and can contribute to fibrosis when chronically activated.

6.3 Major functions

Function	Examples	Clinical/physiotherapy link
Carbohydrate metabolism	Stores glycogen, releases glucose and performs gluconeogenesis.	Energy availability and glucose stability influence activity tolerance.
Lipid metabolism	Processes fatty acids, cholesterol and lipoproteins.	Metabolic disease may coexist with cardiovascular risk and deconditioning.
Protein synthesis	Produces albumin and many clotting factors.	Low albumin contributes to oedema; impaired clotting increases bleeding risk.
Detoxification/biotransformation	Modifies medicines, alcohol, hormones and toxins for elimination.	Medication effects and sedation may be prolonged in liver dysfunction; check with the prescriber.
Bile production	Produces bile salts that assist fat digestion and excretion of bilirubin.	Jaundice, pruritus and poor nutrition may affect participation and skin care.
Bilirubin handling	Conjugates bilirubin and excretes it into bile.	Observe and report jaundice or dark urine according to clinical protocol.
Storage	Stores glycogen, iron, copper and vitamins A, D, E, K and B12.	Deficiencies can affect muscle, bone, nerve and tissue health.
Immune and filtering role	Sinusoidal cells remove microbes and debris from portal blood.	Advanced disease may increase infection risk and systemic complications.

6.4 Liver and movement rehabilitation

Chronic liver disease may cause sarcopenia, weakness, fatigue and reduced balance; progress exercise gradually.
Ascites can restrict diaphragm movement and make supine positioning uncomfortable; use supported positioning and monitor breathing.
Oedema, fragile skin and altered clotting require careful handling, pressure protection and communication with the medical team.
Encephalopathy can impair attention, balance and safety awareness; supervise transfers and avoid assuming poor participation is simply lack of motivation.

Clinical scenario: a patient with jaundice and fatigue

During a mobility session, a patient appears unusually drowsy and has increasing abdominal swelling. Pause demanding activity, assess safety and vital signs, ask about new symptoms, and report the change promptly. Position comfortably, protect the skin and document objective observations. The physiotherapist should not attribute the change to “normal tiredness” or alter medication independently.

7. The pituitary gland

The pituitary gland (hypophysis) is a small endocrine gland at the base of the brain. It lies in the sella turcica of the sphenoid bone and connects to the hypothalamus through the infundibulum. Although small, it releases hormones that regulate growth, thyroid activity, adrenal function, reproduction, lactation and water balance.

7.1 Parts and relationships

Anterior pituitary (adenohypophysis): glandular tissue controlled largely by hypothalamic releasing and inhibiting hormones through the hypothalamic–hypophyseal portal circulation.
Posterior pituitary (neurohypophysis): neural tissue that stores and releases hormones made in hypothalamic nuclei.
Optic chiasm: lies superior to the gland; an enlarging pituitary mass can affect the optic pathways and produce visual-field changes.
Cavernous sinuses: lie laterally and contain important vessels and cranial nerves; invasive lesions can cause ophthalmoplegia or facial sensory symptoms.

7.2 Pituitary hormones and target effects

Hormone	Source	Main target/effect	Physiotherapy relevance
Growth hormone (GH)	Anterior pituitary	Stimulates growth through IGF-1 and influences protein, fat and glucose metabolism.	Excess or deficiency may alter stature, muscle mass, fatigue and joint loading.
Thyroid-stimulating hormone (TSH)	Anterior pituitary	Stimulates thyroid hormone production.	Thyroid dysfunction can cause weakness, tremor, fatigue, heat/cold intolerance and altered exercise response.
Adrenocorticotropic hormone (ACTH)	Anterior pituitary	Stimulates adrenal cortex cortisol production.	Cortisol excess or deficiency affects muscle, bone, blood pressure, energy and recovery.
Follicle-stimulating hormone (FSH)	Anterior pituitary	Supports ovarian follicle development and spermatogenesis.	Relevant to reproductive health, bone density and life-stage changes.
Luteinising hormone (LH)	Anterior pituitary	Triggers ovulation and supports sex-hormone production.	Sex-hormone deficiency may contribute to low bone density and fatigue.
Prolactin	Anterior pituitary	Promotes breast development and milk production.	Consider postpartum status and communicate endocrine symptoms appropriately.
Antidiuretic hormone (ADH/vasopressin)	Made in hypothalamus; released posteriorly	Increases renal water reabsorption and contributes to vascular tone.	Abnormal water balance can cause dehydration, headache, confusion or excessive urination.
Oxytocin	Made in hypothalamus; released posteriorly	Uterine contraction and milk ejection.	Relevant in pregnancy and postpartum rehabilitation, with appropriate scope and referral.

7.3 Hypothalamic–pituitary target-gland axes

The hypothalamus releases regulatory hormones; the pituitary releases trophic hormones; target glands produce peripheral hormones. Negative feedback usually reduces hypothalamic and pituitary stimulation when the peripheral hormone level is adequate. Important axes include:

HPT axis: hypothalamus → TRH → TSH → thyroid → T3/T4.
HPA axis: hypothalamus → CRH → ACTH → adrenal cortex → cortisol.
HPG axis: hypothalamus → GnRH → FSH/LH → ovaries or testes → sex hormones and gametes.
Growth axis: hypothalamic signals → GH → liver/tissues → IGF-1 and growth effects.

7.4 Clinical links for physiotherapy

Acromegaly/gigantism: excess GH after or before epiphyseal closure respectively; may cause enlarged hands/feet, joint pain, weakness, sleep apnoea and cardiovascular risk.
Growth-hormone deficiency: may affect growth, body composition and muscle performance.
Hypopituitarism: reduced target-gland stimulation can cause fatigue, weakness, low blood pressure and poor tolerance of activity.
Diabetes insipidus: inadequate ADH effect causes excessive dilute urine and thirst; dehydration can compromise exercise safety.
Pituitary mass effect: headache or visual-field changes need medical review; do not ignore new visual complaints during rehabilitation.
Steroid dependence: a patient receiving long-term glucocorticoids may have muscle weakness, fragile skin and altered stress responses; follow medical precautions.

8. How the five organs work together

Physiological task	Heart	Lungs	Kidneys	Liver	Pituitary
Oxygen delivery	Pumps blood	Loads oxygen and removes carbon dioxide	Supports erythropoietin production	Processes nutrients used for energy	Influences metabolism through endocrine axes
Fluid and pressure control	Cardiac output	Responds to pulmonary pressures	Controls water, sodium and renin	Synthesises plasma proteins	ADH release regulates water retention
Exercise response	Raises output	Raises ventilation and gas exchange	Maintains acid–base/electrolytes over time	Provides glucose and metabolises substances	Coordinates growth, thyroid, adrenal and reproductive responses
Clinical risk when impaired	Low perfusion, arrhythmia, heart failure	Hypoxaemia, increased work of breathing	Fluid overload, electrolyte disturbance, uraemia	Bleeding, jaundice, encephalopathy, malnutrition	Hormonal deficiency/excess, visual-field effects, water imbalance

9. Physiotherapy assessment and safety checklist

Review: diagnosis, referral, medications, recent investigations, oxygen/fluid orders, dialysis schedule, surgery and precautions.
Baseline: consciousness, pain, respiratory rate/pattern, pulse, blood pressure, oxygen saturation, temperature where relevant, symptoms and functional status.
Observe: colour, sweating, work of breathing, oedema, jaundice, posture, fatigue, exercise technique and ability to communicate.
Plan: choose position, intensity, duration, rest periods and monitoring based on the patient’s condition and goals.
Reassess: compare symptoms and vital signs with baseline and observe recovery after activity.
Escalate: stop activity and seek clinical review for new chest pain, fainting, severe breathlessness, new confusion, cyanosis, severe headache/visual changes or a rapidly deteriorating state.
Document: objective findings, intervention, response, education, communication and plan. Use correct anatomical terms and patient identifiers.

10. Practical learning activities

Draw and label the chambers, valves, great vessels and direction of flow through the heart.
Use a torso model to locate the lungs, pleural space, diaphragm, liver and kidneys; explain why the right lung and kidney are related to the liver.
Trace an oxygen molecule from inspired air to a quadriceps muscle and trace carbon dioxide back to the atmosphere.
Build a nephron flow diagram from glomerulus to collecting duct and annotate filtration, reabsorption and secretion.
Create a table linking each pituitary hormone to its target, effect and a possible rehabilitation implication.
Practise a safe pre-exercise and post-exercise observation chart for a patient with cardiopulmonary disease.

11. Examination points and revision questions

High-yield points

The right heart pumps to the lungs; the left heart pumps to the systemic circulation.
The left ventricle has the thickest wall because it generates systemic pressure.
Gas exchange occurs across the alveolar–capillary membrane; ventilation and perfusion must be matched.
The nephron filters plasma and then selectively reabsorbs and secretes substances to form urine.
The liver has dual blood inflow and performs metabolic, synthetic, storage, detoxification and biliary functions.
The anterior pituitary is glandular and regulated through portal blood; the posterior pituitary releases hypothalamic hormones.
During rehabilitation, organ function is assessed through symptoms, signs, vital observations and response to activity—not by anatomy alone.

Define an organ and distinguish it from a tissue and an organ system.
Describe the position, chambers, valves, coronary supply and electrical conduction system of the heart.
Trace blood flow from the vena cava to the aorta and name the valves crossed.
Compare the right and left lungs and explain the roles of pleura, diaphragm, bronchi and alveoli.
Explain ventilation, perfusion, diffusion and ventilation–perfusion mismatch.
Describe the gross structure of the kidney and the functions of the nephron.
Explain how kidneys regulate fluid, electrolytes, acid–base balance, blood pressure and erythropoiesis.
Discuss the liver’s blood supply and at least eight functions.
Differentiate anterior and posterior pituitary hormones and explain negative feedback.
Give five precautions a physiotherapist should consider before mobilising a patient with heart, lung, renal, liver or pituitary disease.

12. References and further study

Educational note: This page supports anatomy and physiology learning; it does not replace local clinical protocols, medical review or supervised practical training. Apply examination and mobilisation precautions prescribed by the responsible clinical team.