Jun 18, 2019  
2018 - 2019 Catalog 
    
2018 - 2019 Catalog [ARCHIVED CATALOG]

[Add to Portfolio]

BIO 140W - Essentials Of Human Anatomy & Physiology

Credits: 5


Introduces the basic principles and concepts of chemistry, biochemistry and cell biology, as well as human anatomy and physiology for students entering certain allied health curricula. Includes structures and functions of the human body and related terminology.

Prerequisite(s): READING LEVEL 3, WRITING LEVEL 3 and MATH LEVEL 3
Corequisite(s): None
Lecture Hours: 75 Lab Hours: 45
Meets MTA Requirement: Natural Science Lab
Pass/NoCredit: Yes

Outcomes and Objectives 1.   Demonstrate understanding of basic biochemistry as it relates to the study of A&P.   

     A.          Use appropriate metric units.

                  1.    Name the base units for length, volume and mass.

                  2.    Arrange metric prefixes in order from greatest to smallest (kilo, hecto, deka, deci, centi, milli).

                  3.    Explain the relative difference in size between metric units.

                  4.    Use appropriate units for measurements related to anatomy.

     B.           Demonstrate understanding of basic chemistry as it relates to the study of anatomy and physiology.

                  1.    Differentiate between matter and energy and between potential energy and kinetic energy.

                  2.    Describe an atom and an element.

                  3.    List the subatomic particles; describe their relative masses, charges, and positions in the atom.

                  4.    Define atomic number, isotope, and radioisotope.

                  5.    Explain the role of valence electrons in chemical bonding.

                  6.    Distinguish between an atom, an ion, an isotope and a molecule.

                  7.    Differentiate between ionic, covalent, and hydrogen attractions/bonds.

                  8.    Define polar and non-polar compounds.

                  9.    Use chemical notation to symbolize chemical reactions.

                 10.   Distinguish among the major types of chemical reactions that are important for studying physiology (dehydration synthesis,
                         decomposition/hydrolysis).

                  11.   Describe the functions of water and inorganic acids, bases, salts, and buffers.

                  12.  Define pH and describe the pH scale.

                  13.  State the homeostatic pH range of blood.

                  14.  Define physiological acidosis and physiological alkalosis.

                  15.  Explain how the body attempts to keep pH within the limits of homeostasis.

                  16.  Distinguish between organic and inorganic compounds.

                  17.  Describe and compare the building blocks, general structures, and biological functions of carbohydrates, lipids, proteins and nucleic
                         acids.

                  18.  Describe the connection between protein structure and function.

                  19.  Describe the effects of temperature and pH change on protein function.

                  20.  Describe the general mechanism of enzyme activity u sing the following terms: active site, substrate, enzyme-substrate complex,
                         product, specificity and denaturation.

     C.          Discuss the structure and significance of nucleic acids.

                  1.    Define:  nucleus, gene, chromosome, complementary base pairing, DNA, RNA, DNA replication, nucleic acid, nucleotide, template

                  2.    Compare and contrast DNA and RNA, including which nucleotides are found in each type of molecule.

                  3.    Predict the complementary strand of DNA when given a segment of DNA.

                  4.    Explain how errors in DNA replication can alter the functionality of a protein.

2.    Describe the structural anatomy and function of components of the cell.

     A.          Describe cell membrane composition and relate it to function.

                  1.    Define:  diffusion, equilibrium, intracellular fluid, extracellular fluid, interstitial fluid, plasma, solute, solvent, solution, concentration
                         gradient, passive transport processes, active transport, vesicles, facilitated diffusion, osmosis, osmotic pressure, isotonic solution,
                         hypotonic solution, hemolysis, hypertonic solution, crenation, sodium-potassium pump, endocytosis, exocytosis, phagocytosis.

                  2.    Describe the structure of the plasma membrane and identify the structures involved in active and passive transport including protein
                         channels and protein pumps.

                  3.    Differentiate between active and passive transport processes relative to energy source, substances transported, direction and
                         mechanism.

                  4.    Identify the compartments associated with cells (ICF and ECF including plasma and interstitial fluid).

                  5.    Explain the role of osmosis and osmotic pressure in controlling movement of water through cell membranes.

     B.          Describe the structural anatomy of a cell and the function of its components.

                  1.    Define:  organelle, cytoplasm, plasma membrane, nucleus, cell, cytosol

                  2.    Describe the functions of: lysosomes, peroxisomes, cilia, flagella, nucleolus, nucleus, nuclear envelope, centrioles, mitochondria,
                         ribosomes, smooth and rough endoplasmic reticulum, Golgi apparatus, vesicles and vacuoles.

                  3.    Discuss the structure and function of mitochondria in energy production.

       C.          Discuss the process and significance of ATP formation during cellular respiration.

                  1.    Define:  glycolysis, TCA Cycle (Kreb's), ETC (electron transport system or oxidative phosphorylation).

                  2.    Identify where in the cell the steps of energy production occur.

                  3.    Explain this equation:  ADP + P <—–> ATP

                  4.    Distinguish between anaerobic and aerobic processes in terms of: where they occur in the cell, energy yield, and end products.

     D.         Develop an understanding of cell growth and reproduction as it relates to the study of anatomy and physiology

                  1.    Describe the stages of the cell life cycle, including mitosis, interphase, and cytokinesis, and explain their significance.

                  2.    Explain the relationship between cell division and cancer.

                  3.    Define and explain the role of stem cells in tissue regeneration.

     E.                Develop an understanding of protein synthesis and mutations as it relates to the study of anatomy and physiology.

                  1.    Define mutation and mutagen. Explain how a mutation may affect the functionality of a protein and result in an altered expression of a
                         trait.

                  2.    Explain how the absence or low levels of correctly formed proteins may contribute to genetic diseases.

                  3.    Explain the relationship between DNA, chromosomes, genes, mutations and proteins.

3.    Demonstrate understanding of systems of the human body

     A.          Explain the role of the integumentary system as a functioning organ of the human body.

                  1.    List the functions of the integumentary system and explain how these functions are accomplished.

                  2.    Provide specific examples to demonstrate how the integumentary system responds to maintain homeostasis in the body.

                  3.    List the two layers of the skin and the functions of each of the two layers.

                  4.    Explain the basis for different skin color.

                  5.    Identify on a model or drawing the epidermis and dermis of the skin and the accessory structures of the skin.

                  6.    List the functions of each of the accessory structures of the skin (sweat glands, sebaceous glands, nails, hair, arrector pili muscle,
                         sensory receptors.

                  7.    Describe the purpose of the stratification of the epidermis and differences between stratum germinativum (basale) and stratum
                         corneum.

                  8.    Compare and contrast the function and location of keratinocytes and melanocytes.

                  9.    Differentiate between first-, second-, and third-degree burns.

     B.          Develop an understanding of the gross anatomy of the skeletal system.

                  1.    Define the two major divisions of the skeletal system (axial and appendicular) and list the bones in each.

                  2.    Describe the principal surface markings on bones and their functions.

                  3.    Identify the regions of the vertebral column.

                  4.    Discuss the importance of intervertebral disks and spinal curvatures.

                  5.    Identify all bones and markings listed on the Biology 140 Anatomy Objective List. Identification of anatomy may be on models,
                         skeletons (both articulated and disarticulated), diagrams, MRI, CT and X-ray images and appropriate dissection specimens.

     C.          Develop an understanding of bone physiology.

                  1.    Describe the functions of the skeletal system.

                  2.    Name the four main types of bones (classified by shape).

                  3.    Describe the gross anatomy of a typical long bone and flat bone.

                  4.    Describe the histological features of bone tissue.

                  5.    Define ossification and compare and contrast intramembranous ossification, endochondral ossification and appositional growth.

                  6.    Differentiate between the functions of osteocytes, osteoclasts, and osteoblasts.

                  7.    Discuss the purpose of fontanels.

                  8.    Explain the role of PTH, calcitonin and human growth hormone (hGH) on bone growth and maintenance.

                  9.    Explain the role of PTH and calcitonin on calcium homeostasis and bone density.

                  10.  Explain the role of exercise and mechanical stress on bone remodeling.

     D.         Develop an understanding of joints, focusing on synovial joints.

                  1.                Name the three major functional categories of joints, compare the amount of movement allowed by each and give an example
                                     of each.

                  2.                Describe the structural characteristics shared by all synovial joints.

                  3.                Name and describe (or perform) the common body movements: flexion, extension, dorsiflexion, plantar flexion, abduction,
                                     adduction, circumduction, supination, pronation, inversion, eversion, protraction, retraction, elevation, depression, and rotation.

                  4.                List the different types of synovial joints, link structural features to joint functions and identify an example of each of these
                                     joints.

                  5.                List the bones involved in the following joints (wrist, knee, shoulder, hip, ankle, elbow, jaw).

     E.          Develop an understanding of the role of muscles and muscle tissue in the human body.

                  1.    Define:  fascia, epimysium, perimysium, endomysium, tendons, aponeuroses, tetanus, isotonic contraction, isometric contraction,
                         muscle tone, muscle fatigue, oxygen debt, motor unit, muscle twitch.

                  2.    Explain the factors that contribute to muscle fatigue.

                  3.    Explain the sliding filament mechanism of skeletal muscle contraction.

                  4.    Explain how muscle fibers are stimulated to contract.

                  5.    Interpret a myogram of a muscle twitch and describe the events occurring during the three phases (latent, contraction, relaxation).

                  6.    Explain the muscle response to changes in stimulation frequency, including summation and tetanus.

                  7.    Explain the muscle response to increasing stimulus strength, including recruitment.

                  8.    Differentiate between isometric and isotonic contractions. 

                  9.    List the sources of energy stored in a typical muscle fiber.

                  10.   Describe three ways in which ATP is regenerated in skeletal muscle (creatine phosphate, aerobic respiration, anaerobic respiration).

                  11.   Distinguish between aerobic and anaerobic endurance, and explain their implications for muscular performance.

     F.          Become proficient with specific skeletal muscle names and their relative functions.

                  1.    Define: origin, insertion, prime mover.

                  2.    Identify all structures listed on the Biology 140 Anatomy Objective List.  Identification of anatomy may be on models, skeletons (both
                         articulated and disarticulated), diagrams, MRI, CT and X-ray images and appropriate dissection specimens

                  3.    Identify the function of the major muscles listed in the anatomy objectives with respect to the following body movements: flexion,
                         extension, dorsiflexion, plantar flexion, abduction, adduction, circumduction, supination, pronation, inversion, eversion, protraction,
                         retraction, elevation, depression, and rotation.

     G.         Develop an understanding of the fundamentals of the nervous system and nervous tissue.

                  1.    List the basic functions of the nervous system.

                  2.    Define the terms central nervous system and peripheral nervous system and list the major parts of each.

                  3.    Describe the relationship between neurons, nerves, and neuroglia.

                  4.    Compare and contrast the structural and anatomical differences between gray matter and white matter.

                  5.    Define neuron, describe its important structural components, and relate each to a functional role.

                  6.    Differentiate between a nerve and a tract, and between a nucleus and a ganglion.

                  7.    Explain the importance of the myelin sheath and identify the cells involved in its formation in the PNS.

                  8.    Describe the function of sensory, motor, and interneurons (association neurons).

                  9.    Define resting membrane potential and describe how the sodium-potassium exchange pump maintains this potential.

                  10.  Contrast relative concentrations of sodium, potassium, chloride and protein ions inside and outside of a resting neuron.

                  11.  Explain how action potentials are generated and propagated along neurons (threshold, depolarization, repolarization,
                         hyperpolarization).

                  12.  Compare and contrast saltatory and continuous conduction (propagation) based on the following criteria:  signal speed and presence
                         or absence of myelination.

                  13.  Explain the events of synaptic transmission.

                  14.  Describe the general functions of neurotransmitters.

                  15.  Define absolute and relative refractory periods.

                  16.  Make predictions about the outcome when drugs which mimic, inhibit, or destroy neurotransmitters, neurotransmitter receptors or
                         degrading enzymes (e.g. AchE) are introduced into the synapse.

     H.         Develop an understanding of the structures and functions of the nervous system.

                  1.    Name the major parts of the brain (as listed on the Anatomy Objectives) and explain

                  2.    Describe how the meninges, cerebrospinal fluid and the blood-brain barrier protect the CNS.

                  3.    Identify all structures listed on the Biology 140 Anatomy Objective List.  Identification of anatomy may be on models, diagrams, MRI,
                         CT and X-ray images and appropriate dissection specimens.

                  4.    Describe the function, location, and formation of cerebrospinal fluid and how it flows in one continuous loop, including the pathway of
                         CSF flow within the brain.

                  5.    Contrast the location of gray and white matter in the brain and spinal cord.

                  6.    Identify the components of a reflex arc.

                  7.    Explain the function of ascending pathways and where they terminate.

                  8.    Explain the function of descending pathways and where they originate.

                  9.    Define peripheral nervous system and list its components.

                  10.  Define plexus and identify the body areas innervated by the following plexuses: cervical, brachial, lumbar and sacral.

                  11.   List the 12 pairs of cranial nerves by name and number and the function of each.

     I.          Develop a basic understanding of the autonomic nervous system.

                  1.    Define autonomic nervous system and explain its role within the PNS.

                  2.    Compare the somatic and autonomic nervous systems relative to effectors, efferent pathways, and neurotransmitters released.

                  3.    Define cholinergic and adrenergic receptors and where each is used in the ANS.

                  4.    Compare and contrast the functions of the parasympathetic and sympathetic divisions on the following (cardiovascular system,
                         respiratory system, digestive system, sweat glands, and pupils).

                  5.    Make predictions about the effects of drugs that mimic or inhibit adrenergic or cholinergic effects.

     J.          Develop an understanding of the function and anatomy of the endocrine system.

                  1.    List the components of the endocrine system.

                  2.    Describe the major functions of the endocrine system.

                  3.    Define target cells and describe the role of hormone receptors.

                  4.    Explain the three methods for controlling hormone secretion, and provide examples for each.

                  5.    Describe the locations of and relationship between the hypothalamus and the pituitary gland.

                  6.    Describe the functions of each hormone secreted by the pituitary gland (growth hormone, thyroid-stimulating hormone, luteinizing
                         hormone, follicle stimulating hormone, prolactin, adrenocorticotropic hormone, oxytocin, antidiuretic hormone).

                  7.    Describe the location, hormones and functions of the thyroid gland, parathyroid glands, pancreatic islets, adrenal (suprarenal) glands,
                         ovaries, testes, and pineal gland.

                  8.    Use the hormones listed (grouped by organs) to name the target tissue or cells for each hormone and describe the effect(s) of each
                         hormone on the target tissue or cells: Thyroid gland (thyroxine (T4), triiodothyronine (T3), calcitonin), Parathyroid gland (parathyroid
                         hormone), Adrenal gland (glucocorticoids (cortisol), mineralocorticoids (aldosterone), gonadocorticoids, epinephrine, norepinephrine), 
                         Testis (testosterone), Ovary (estrogen, progesterone), Pancreas (insulin, glucagon), Adipose tissue (leptin).

                  9.    Compare and contrast the roles of the nervous and endocrine systems with respect to signal speed and duration of response by the
                         body.

                  10.  Identify all structures listed on the Biology 140 Anatomy Objective List.  Identification of anatomy may be on models, diagrams, MRI,
                         CT and X-ray images and appropriate  dissection specimens.

     K.          Develop an understanding of the composition and functions of blood.

                  1.    Define the principal components of blood and their functions in the body.

                  2.    Discuss the formation (hematopoiesis), components and functions of whole blood.

                  3.    Describe the phases of hemostasis (vascular spasm, platelet plug formation, coagulation, clot retraction and repair, fibrinolysis).

                  4.    Describe the ABO and Rh blood groups.

                  5.    Describe the structure of erythrocytes and their function in the transport of O2 and CO2.

                  6.    Define erythropoiesis and describe the role of EPO in triggering the process.

     L.          Develop an understanding of the anatomy and function of the cardiovascular system.

                  1.    Describe the location of the heart and the structure and functions of the pericardium.

                  2.    Identify all heart structures listed on the Biology 140 Anatomy Objective List. Identification of anatomy may be on models, diagrams,
                         MRI, CT and X-ray images and appropriate dissection specimens.

                  3.    Discuss the functions of all heart structures listed in the Anatomy Objective list.

                  4.    Trace the pathway of blood through the heart.

                  5.    Describe the clinical importance of coronary circulation.

                  6.    Define: systole, diastole, stroke volume, and cardiac cycle, heart sounds, murmur,

                         blood pressure, pulse.

                  7.    Name the components of the intrinsic conduction system of the heart and how each heartbeat is initiated and maintained.

                  8.    Describe the purpose and diagnostic value of an electrocardiogram.

                  9.    Correlate an ECG tracing with the electrical events of the heart.

                  10.  Describe the phases of the cardiac cycle.

                  11.  Define cardiac output, calculate it, and describe how it is regulated.

                  12.  Describe the effect of the following on cardiovascular function (CO and BP): stimulation by the vagus nerve, exercise, epinephrine,
                         ADH or renin-angiotensin.

                  13.  On diagrams and/or models, identify the body’s major arteries and veins as listed on the Bio 140 Anatomy Objectives list.

                  14.  Compare and contrast the structure and function of arteries, veins, and capillaries.

                  15.  Describe how substances enter and leave the blood in capillaries.

                  16.  Explain how venous blood returns to the heart.

                  17.  Define blood pressure and describe how it varies throughout the systemic circulation.

                  18.  Define vascular resistance and identify the factors that affect vascular resistance and blood pressure.

                  19.  Describe how blood pressure and blood flow are regulated.

                  20.  Compare and contrast pulmonary circulation with systemic circulation.

                  21.  Explain the function and importance of the hepatic-portal system.

                  22.  Name the fetal vascular modifications or “fetal shunts”.

     M.         Develop an understanding of the lymphatic and immune system and resistance to disease.

                  1.    Define immunity and identify the properties of immunity.

                  2.    Identify the major components of the lymphatic system and explain their functions.

                  3.    Describe the importance of lymphocytes and describe where they are found in the body.

                  4.    Describe the types of nonspecific resistance to disease.

                  5.    Distinguish between cell-mediated and antibody-mediated (humoral) immunity.

                  6.    Differentiate between T-cells and B-cells and describe the role each plays in the immune response.

                  7.    Describe the structure and function of antibody molecules, and explain how they function.

                  8.    Describe the primary and secondary immune responses to antigen exposure.

                  9.    Differentiate between the different types of immunity.

                  10.  Explain how lymph is transported to the heart.

     N.         Develop an understanding of the anatomy and function of the respiratory system.

                  1. Identify all structures listed on the Biology 140 Anatomy Objective List.  Identification of anatomy may be on models, diagrams, MRI, CT                 and X-ray images and appropriate dissection specimens.

                  2. Describe the functions of all structures listed in the Anatomy Objective list.

                  3.  Explain how inhalation and exhalation take place and the major muscles used for each.

                  4.    Define the various lung volumes and capacities.

                  5.    Describe the exchange of oxygen and carbon dioxide between alveolar air and blood (external respiration) and between blood and
                         body cells (internal respiration).

                  6.    Describe how the blood transports oxygen and carbon dioxide.

                  7.    Explain how the nervous system controls breathing and list the factors that can alter the rate and depth of breathing.

                  8.    Identify the type of tissue lining the respiratory tract.

                  9.    List, in order, the respiratory structures that air passes through during inspiration.

     O.         Develop an understanding of the anatomy and function of the digestive system.

                  1.    Identify all structures listed on the Biology 140 Anatomy Objective List.  Identification of anatomy may be on models, diagrams, MRI,
                         CT and X-ray images and appropriate dissection specimens.

                  2.    List, in order, the structures that food passes through during digestion.

                  3.    Discuss the functions and relative locations of all structures listed in the Anatomy Objective list.

                  4.    Explain the function of peristalsis and segmentation in digestion.

                  5.    Describe the characteristics of the small intestines that increase surface area for

                  6.    Identify the type of tissue lining the digestive tract.

                  7.    Describe the role the following enzymes and fluids play in digestion (salivary amylase, pepsin, pancreatic enzymes, bile) with respect
                         to their location of secretion, the substances they break down, and the products of breakdown.

                  8.    Describe the location of the visceral and parietal peritoneum.

                  9.    Identify the branch of the nervous system that stimulates digestive function and the cranial nerve involved.

     P.          Develop an understanding of the anatomy and function of the urinary system.

                  1.    Discuss the general functions of the urinary system.

                  2.    Identify all structures listed on the Biology 140 Anatomy Objective List.  Identification of anatomy may be on models, diagrams, MRI,
                         CT and X-ray images and appropriate dissection specimens.

                  3.    Discuss the functions of all structures listed in the Anatomy Objective list.

                  4.    Describe the external structures of the kidney, including its retroperitoneal location, support structures, and covering.

                  5.    Describe the microscopic structure of the kidneys.

                  6.    List the major processes in urine formation and where each occurs in the nephron and collecting system.

                  7.    List, in order, the structures that filtrate passes through in the nephron and what occurs in each structure.

                  8.    List, in order, the urinary structures that urine passes through once it leaves the nephron until it leaves the body.

                  9.    Compare and contrast the male and female urethra.

                  10.  List substances that are normal and abnormal urinary components.

                  11.  Define diuretic and describe how they affect kidney function.

                  12.  Explain how the following hormones affect kidney function: renin-angiotensin II system, EPO, calcitriol (Vitamin D).

     Q.         Develop an understanding of the anatomy and function of the female and male reproductive system and prenatal development.

                  1.    Identify all structures listed on the Biology 140 Anatomy Objective List.  Identification of anatomy may be on models, diagrams, MRI,
                         CT and X-ray images and appropriate dissection specimens.

                  2.    Discuss the functions of all structures listed in the Anatomy Objective list.

                  3.    Describe how sperm cells are produced (spermatogenesis).

                  4.    Explain the roles of hormones in regulating male reproductive functions (testosterone, FSH, LH).

                  5.    Describe how oocytes are produced (oogenesis).

                  6.    Describe the major events of the ovarian and uterine cycles.

                  7.    Explain the major developmental events that occur during the embryonic period.

                  8.    Define the fetal period.

                  9.    Explain the roles of hormones in regulating female reproductive functions (estrogen, progesterone, follicle stimulating hormone,
                         luteinizing hormone, oxytocin, prolactin, human chorionic gonadotropin).

                  10.  Trace the path of a sperm from the location of production until it leaves the body.

                  11.   Trace the path of an oocyte from the location of production until it leaves the body.

     R.          Develop an understanding of the major tissue types in the human body.

                  1.    Name the four major types of tissue found in the human body.

                  2.    Discuss the general characteristics of epithelial tissue that make it well suited as a tissue that lines and covers surfaces and cavities.

                  3.    List the general functions of epithelial tissue.

                  4.    Name and describe the three “layering” arrangements (simple, pseudostratified, stratified) of epithelial tissue.

                  5.    Name and describe the three “shape” categories (squamous, cuboidal, columnar) of epithelial tissue.

                  6.    Name the major types of epithelium and identify an organ in which each is found.

                  7.    Discuss the components of connective tissue that account for its varied functions and locations in the human body.

                  8.    Describe the types of connective tissue found in the body and indicate the general functions for each type.

                  9.    Discuss the general characteristics of muscle tissue that allow it to be used in propulsion of the skeleton and hollow organs.

                  10.  List the three types of muscle tissue.

                  11.  Compare and contrast the three types of muscle tissue based on the following criteria:  location, control (voluntary or involuntary), cell
                         shape, presence or absence of striations, number of nuclei.

                  12.  List the two cell types found in nervous tissue and discuss the characteristics and functions of each.

                  13.  Name the specific serous membranes and their common function.

  4.    Demonstrate an understanding of the relationship between anatomy and physiology in the human body.

     A.          Define anatomy and physiology.

     B.          Name (in order of increasing complexity) the different levels of structural organization that make up the human body, and explain their
                   relationships.

  5.    Demonstrate an understanding of homeostasis and system integration.

     A.          Define homeostasis.

     B.          Define positive feedback.

     C.          Define negative feedback and describe its role in maintaining body homeostasis.

     D.          Describe examples of when positive and negative feedback are used in the human body.

     E.          Explain the significance of homeostasis for living systems.

     F.          Provide an example of how homeostatic imbalance results in disease

6.    Use communication skills to convey ideas of anatomy and physiology.

     A.          Write effectively for a specific audience and purpose.

     B.          Demonstrate the learning of concepts through writing.

     C.          Perform writing tasks to promote learning.

     D.          Speak effectively and accurately in the language of anatomy and physiology.

                   1.    Describe the anatomical position.

                   2.    Use correct anatomical terminology to describe body planes, body sections, body

                          regions, body directions and surface anatomy.

                  3.     Locate and name the major body cavities and their subdivisions.

                  4.    Name the four quadrants of the abdominopelvic cavity and know major organs in

                         those areas (liver, stomach, spleen, small intestine, large intestine, appendix, urinary

                         bladder).



[Add to Portfolio]