IntroductionChapter ObjectivesAfter studying this chapter, you will be able to:Though you may approach a course in anatomy and physiology strictly as a requirement for your field of study, the knowledge you gain in this course will serve you well in many aspects of your life. An understanding of anatomy and
physiology is not only fundamental to any career in the health professions, but it can also benefit your own health. Familiarity with the human body can help you make healthful choices and prompt you to take appropriate action when signs of illness arise. Your knowledge in this field will help you understand news about nutrition, medications, medical devices, and procedures and help you understand genetic or infectious diseases. At some point, everyone will have a problem with some aspect of his or her body and your knowledge can help you to be a better parent, spouse, partner, friend, colleague, or caregiver.
This chapter begins with an overview of anatomy and physiology and a preview of the body regions and functions. It then covers the characteristics of life and how the body works to maintain stable conditions. It introduces a set of standard terms for body structures and for planes and positions in the body that will serve as a foundation for more comprehensive information covered later in the text. It ends with examples of medical imaging used to see inside the living body.
1.1 Overview of Anatomy and PhysiologyBy the end of this section, you will be able to:
Human anatomyis the scientific study of the body’s structures. Some of these structures are very small and can only be observed and analyzed with the assistance of a microscope. Other larger structures can readily be seen, manipulated, measured, and weighed. The word “anatomy” comes from a Greek root that means “to cut apart.” Human anatomy was first studied by observing the exterior of the body and observing the wounds of soldiers and other injuries. Later, physicians were allowed to dissect bodies of the dead to augment their knowledge. When a body is dissected, its structures are cut apart in order to observe their physical attributes and their relationships to one another. Dissection is still used in medical schools, anatomy courses, and in pathology labs. In order to observe structures in living people, however, a number of imaging techniques have been developed. These techniques allow clinicians to visualize structures inside the living body such as a cancerous tumor or a fractured bone.
Like most scientific disciplines, anatomy has areas of specialization. Gross anatomyis the study of the larger structures of the body, those visible without the aid of magnification (Figure 1.2a ). Macro- means “large,” thus, gross anatomy is also referred to as macroscopic anatomy. In contrast, micro- means “small,” and microscopic anatomyis the study of structures that can be observed only with the use of a microscope or other magnification devices (Figure 1.2b ). Microscopic anatomy includes cytology, the study of cells and histology, the study of tissues. As the technology of microscopes has advanced, anatomists have been able to observe smaller and smaller structures of the body, from slices of large structures like the heart, to the three-dimensional structures of large molecules in the body.
Anatomists take two general approaches to the study of the body’s structures: regional and systemic. Regional anatomyis the study of the interrelationships of all of the structures in a specific body region, such as the abdomen. Studying regional
anatomy helps us appreciate the interrelationships of body structures, such as how muscles, nerves, blood vessels, and other structures work together to serve a particular body region. In contrast, systemic anatomyis the study of the structures that make up a discrete body system—that is, a group of structures that work together to perform a unique body function. For example, a systemic anatomical study of the muscular system would consider all of the skeletal muscles of the body.
Whereas anatomy is about structure, physiology is about function. Human physiologyis the scientific study of the chemistry and physics of the structures of the body and the ways in which they work together to support the functions of life. Much of the study of physiology centers on the body’s tendency toward homeostasis. Homeostasisis the state of steady internal conditions maintained by living things. The study of physiology certainly includes observation, both with the naked eye and with microscopes, as well as manipulations and measurements. However, current advances in physiology usually depend on carefully designed laboratory experiments that reveal the functions of the many structures and chemical compounds that make up the human body.
Like anatomists, physiologists typically specialize in a particular branch of physiology. For example, neurophysiology is the study of the brain, spinal cord, and nerves and how these work together to perform functions as complex and diverse as vision, movement, and thinking. Physiologists may work from the organ level (exploring, for example, what different parts of the brain do) to the molecular level (such as exploring how an electrochemical signal travels along nerves).
Form is closely related to function in all living things. For example, the thin flap of your eyelid can snap down to clear away dust particles and almost instantaneously slide back up to allow you to see again. At the microscopic level, the arrangement and function of the nerves and muscles that serve the eyelid allow for its quick action and retreat. At a smaller level of analysis, the function of these nerves and muscles likewise relies on the interactions of specific molecules and ions. Even the three-dimensional structure of certain molecules is essential to their function.
Your study of anatomy and physiology will make more sense if you continually relate the form of the structures you are studying to their function. In fact, it can be somewhat frustrating to attempt to study anatomy without an understanding of the physiology that a body structure supports. Imagine, for example, trying to appreciate the unique arrangement of the bones of the human hand if you had no conception of the function of the hand. Fortunately, your understanding of how the human hand manipulates tools—from pens to cell phones—helps you appreciate the unique alignment of the thumb in opposition to the four fingers, making your hand a structure that allows you to pinch and grasp objects and type text messages.
1.2 Structural Organization of the Human BodyBy the end of this section, you will be able to:
Before you begin to study the different structures and functions of the human body, it is helpful to consider its basic architecture; that is, how its smallest parts are assembled into larger structures. It is convenient to consider the structures of the body in terms of fundamental levels of organization that increase in complexity: subatomic particles, atoms, molecules, organelles, cells, tissues, organs, organ systems, organisms and biosphere (Figure 1.3 ).
The Levels of OrganizationTo study the chemical level of organization, scientists consider the simplest building blocks of matter: subatomic particles, atoms and molecules. All matter in the universe is composed of one or more unique pure substances called elements, familiar examples of which are hydrogen, oxygen, carbon, nitrogen, calcium, and iron. The smallest unit of any of these pure substances (elements) is an atom. Atoms are made up of subatomic particles such as the proton, electron and neutron. Two or more atoms combine to form a molecule, such as the water molecules, proteins, and sugars found in living things. Molecules are the chemical building blocks of all body structures.
A cellis the smallest independently functioning unit of a living organism. Even bacteria, which are extremely small, independently-living organisms, have a cellular structure. Each bacterium is a single cell. All living structures of human anatomy contain cells, and almost all functions of human physiology are performed in cells or are initiated by cells.
A human cell typically consists of flexible membranes that enclose cytoplasm, a water-based cellular fluid together with a variety of tiny functioning units called organelles. In humans, as in all organisms, cells perform all functions of life. A tissueis a group of many similar cells (though sometimes composed of a few related types) that work together to perform a specific function. An organis an anatomically distinct structure of the body composed of two or more tissue types. Each organ performs one or more specific physiological functions. An organ systemis a group of organs that work together to perform major functions or meet physiological needs of the body.
This book covers eleven distinct organ systems in the human body (Figure 1.4 )and (Figure 1.5 ). Assigning organs to organ systems can be imprecise since organs that “belong” to one system can also have functions integral to another system. In fact, most organs contribute to more than one system.
The organism level is the highest level of organization. An organismis a living being that has a cellular structure and that can independently perform all physiologic functions necessary for life. In multicellular organisms, including humans, all cells, tissues, organs, and organ systems of the body work together to maintain the life and health of the organism.
1.3 Functions of Human LifeBy the end of this section, you will be able to:
Taken together, these two processes are called metabolism. Metabolismis the sum of all anabolic and catabolic reactions that take place in the body (Figure 1.6 ). Both anabolism and catabolism occur simultaneously and continuously to keep you alive.
Every cell in your body makes use of a chemical compound, adenosine triphosphate (ATP), to store and release energy. The cell stores energy in the synthesis (anabolism) of ATP, then moves the ATP molecules to the location where energy is needed to fuel cellular activities. Then the ATP is broken down (catabolism) and a controlled amount of energy is released, which is used by the cell to perform a particular job.
Click and ExploreView this animation (http://openstaxcollege.org/l/metabolic)to learn more about metabolic processes. What kind of catabolism occurs in the heart?
Responsiveness Responsivenessis the ability of an organism to adjust to changes in its internal and external environments. An example of responsiveness to external stimuli could include moving toward sources of food and water and away from perceived dangers. Changes in an organism’s internal environment, such as increased body temperature, can cause the responses of sweating and the dilation of blood vessels in the skin in order to decrease body temperature, as shown by the runners in (Figure 1.7 ).
MovementHuman movement includes not only actions at the joints of the body, but also the motion of individual organs and even individual cells. As you read these words, red and white blood cells are moving throughout your body, muscle cells are contracting and relaxing to maintain your posture and to focus your vision, and glands are secreting chemicals to regulate body functions. Your body is coordinating the action of entire muscle groups to enable you to move air into and out of your lungs, to push blood throughout your body, and to propel the food you have eaten through your digestive tract. Consciously,
of course, you contract your skeletal muscles to move the bones of your skeleton to get from one place to another (as the runners are doing in (Figure 1.7 ), and to carry out all of the activities of your daily life.
Development, growth and reproduction Developmentis all of the changes the body goes through in life. Development includes the process of differentiation, in which unspecialized cells become specialized in structure and function to perform certain tasks in the body. Development also includes the processes of growth and repair, both of which involve cell differentiation.
Growthis the increase in body size. Humans, like all multicellular organisms, grow by increasing the number of existing cells, increasing the amount of non-cellular material around cells (such as mineral deposits in bone), and, within very narrow limits, increasing the size of existing cells.
Reproductionis the formation of a new organism from parent organisms. In humans, reproduction is carried out by the male and female reproductive systems. Because death will come to all complex organisms, without reproduction, the line of organisms would end.
1.4 Requirements for Human LifeBy the end of this section, you will be able to:
Humans have been adapting to life on Earth for at least the past 200,000 years. Earth and its atmosphere have provided us with air to breathe, water to drink, and food to eat, but these are not the only requirements for survival. Although you may rarely think about it, you also cannot live outside of a certain range of temperature and pressure that the surface of our planet and its atmosphere provides. The next sections explore these four requirements of life.
OxygenAtmospheric air is only about 20 percent oxygen, but that oxygen is a key component of the chemical reactions that keep the body alive, including the reactions that produce ATP. Brain cells are especially sensitive to lack of oxygen because of their requirement for a high-and-steady production of ATP. Brain damage is likely within five minutes without oxygen, and death is likely within ten minutes.
NutrientsA nutrientis a substance in foods and beverages that is essential to human survival. The three basic classes of nutrients are water, the energy-yielding and body-building nutrients, and the micronutrients (vitamins and minerals).
The most critical nutrient is water. Depending on the environmental temperature and our state of health, we may be able to survive for only a few days without water. The body’s functional chemicals are dissolved and transported in water, and the chemical reactions of life take place in water. Moreover, water is the largest component of cells, blood, and the fluid between cells, and water makes up about 70 percent of an adult’s body mass. Water also helps regulate our internal temperature and cushions, protects, and lubricates joints and many other body structures.
The energy-yielding nutrients are primarily carbohydrates and lipids, while proteins mainly supply the amino acids that are the building blocks of the body itself. You ingest these in plant and animal foods and beverages, and the digestive system breaks them down into molecules small enough to be absorbed. The breakdown products of carbohydrates and lipids can then be used in the metabolic processes that convert them to ATP. Although you might feel as if you are starving after missing a single meal, you can survive without consuming the energy-yielding nutrients for at least several weeks.
Water and the energy-yielding nutrients are also referred to as macronutrients because the body needs them in large amounts. In contrast, micronutrients are vitamins and minerals. These elements and compounds participate in many essential chemical reactions and processes, such as nerve impulses, and some, such as calcium, also contribute to the body’s structure. Your body can store some of the micronutrients in its tissues, and draw on those reserves if you fail to consume them in your diet for a few days or weeks. Some others micronutrients, such as vitamin C and most of the B vitamins, are water-soluble and cannot be stored, so you need to consume them every day or two.
Narrow Range of TemperatureYou have probably seen news stories about athletes who died of heat stroke, or hikers who died of exposure to cold. Such deaths occur because the chemical reactions upon which the body depends can only take place within a narrow range of body temperature, from just below to just above 37°C (98.6°F). When body temperature rises well above or drops well below normal, certain proteins (enzymes) that facilitate chemical reactions lose their normal structure and their ability to function and the chemical reactions of metabolism cannot proceed.
That said, the body can respond effectively to short-term exposure to heat (Figure 1.8 ) or cold. One of the body’s responses to heat is, of course, sweating. As sweat evaporates from skin, it removes some thermal energy from the body, cooling it. Adequate water (from the extracellular fluid in the body) is necessary to produce sweat, so adequate fluid intake is essential to balance that loss during the sweat response. Not surprisingly, the sweat response is much less effective in a humid environment because the air is already saturated with water. Thus, the sweat on the skin’s surface is not able to evaporate, and internal body temperature can get dangerously high.
The body can also respond effectively to short-term exposure to cold. One response to cold is shivering, which is random muscle movement that generates heat. Another response is increased breakdown of stored energy to generate heat. When that energy reserve is depleted, however, and the core temperature begins to drop significantly, red blood cells will lose their ability to give up oxygen, denying the brain of this critical component of ATP production. This lack of oxygen can cause confusion, lethargy, and eventually loss of consciousness and death. The body responds to cold by reducing blood circulation to the extremities, the hands and feet, in order to prevent blood from cooling there and so that the body’s core can stay warm. Even when core body temperature remains stable, however, tissues exposed to severe cold, especially the fingers and toes, can develop frostbite when blood flow to the extremities has been much reduced. This form of tissue damage can be permanent and lead to gangrene, requiring amputation of the affected region.
Everyday CONNECTION
Controlled Hypothermia
As you have learned, the body continuously engages in coordinated physiological processes to maintain a stable temperature. In some cases, however, overriding this system can be useful, or even life-saving. Hypothermia is the clinical term for an abnormally low body temperature (hypo- = “below” or “under”). Controlled hypothermia is clinically induced hypothermia performed in order to reduce the metabolic rate of an organ or of a person’s entire body.
Controlled hypothermia often is used, for example, during open-heart surgery because it decreases the metabolic needs of the brain, heart, and other organs, reducing the risk of damage to them. When controlled hypothermia is used clinically, the patient is given medication to prevent shivering. The body is then cooled to 25–32°C (79–89°F). The heart is stopped and an external heart-lung pump maintains circulation to the patient’s body. The heart is cooled further and is maintained at a temperature below 15°C (60°F) for the duration of the surgery. This very cold temperature helps the heart muscle to tolerate its lack of blood supply during the surgery.
Some emergency department physicians use controlled hypothermia to reduce damage to the heart in patients who have suffered a cardiac arrest. In the emergency department, the physician induces coma and lowers the patient’s body temperature to approximately 91 degrees. This condition, which is maintained for 24 hours, slows the patient’s metabolic rate. Because the patient’s organs require less blood to function, the heart’s workload is reduced.
Narrow Range of Atmospheric Pressure Pressureis a force exerted by a substance that is in contact with another substance. Atmospheric pressure is pressure exerted by the mixture of gases (primarily nitrogen and oxygen) in the Earth’s atmosphere. Although you may not perceive it, atmospheric pressure is constantly pressing down on your body. This pressure keeps gases within your body, such as the gaseous nitrogen in body fluids, dissolved. If you were suddenly ejected from a space ship above Earth’s atmosphere, you would go from a situation of normal pressure to one of very low pressure. The pressure of the nitrogen gas in your blood would be much higher than the pressure of nitrogen in the space surrounding your body. As a result, the nitrogen gas in your blood would expand, forming bubbles that could block blood vessels and even cause cells to break apart.
Atmospheric pressure does more than just keep blood gases dissolved. Your ability to breathe—that is, to take in oxygen and release carbon dioxide—also depends upon a precise atmospheric pressure. Altitude sickness occurs in part because the atmosphere at high altitudes exerts less pressure, reducing the exchange of these gases, and causing shortness of breath, confusion, headache, lethargy, and nausea. Mountain climbers carry oxygen to reduce the effects of both low oxygen levels and low barometric pressure at higher altitudes (Figure 1.9 ).
Decompression SicknessDecompression sickness (DCS) is a condition in which gases dissolved in the blood or in other body tissues are no longer dissolved following a reduction in pressure on the body. This condition affects underwater divers who surface from a deep dive too quickly, and it can affect pilots flying at high altitudes in planes with unpressurized cabins. Divers often call this condition “the bends,” a reference to joint pain that is a symptom of DCS.
In all cases, DCS is brought about by a reduction in barometric pressure. At high altitude, barometric pressure is much less than on Earth’s surface because pressure is produced by the weight of the column of air above the body pressing down on the body. The very great pressures on divers in deep water are likewise from the weight of a column of water pressing down on the body. For divers, DCS occurs at normal barometric pressure (at sea level), but it is brought on by the relatively rapid decrease of pressure as divers rise from the high pressure conditions of deep water to the now low, by comparison, pressure at sea level. Not surprisingly, diving in deep mountain lakes, where barometric pressure at the surface of the lake is less than that at sea level is more likely to result in DCS than diving in water at sea level.
In DCS, gases dissolved in the blood (primarily nitrogen) come rapidly out of solution, forming bubbles in the blood and in other body tissues. This occurs because when pressure of a gas over a liquid is decreased, the amount of gas that can remain dissolved in the liquid also is decreased. It is air pressure that keeps your normal blood gases dissolved in the blood. When pressure is reduced, less gas remains dissolved. You have seen this in effect when you open a carbonated drink. Removing the seal of the bottle reduces the pressure of the gas over the liquid. This in turn causes bubbles as dissolved gases (in this case, carbon dioxide) come out of solution in the liquid.
The most common symptoms of DCS are pain in the joints, with headache and disturbances of vision occurring in 10 percent to 15 percent of cases. Left untreated, very severe DCS can result in death. Immediate treatment is with pure oxygen. The affected person is then moved into a hyperbaric chamber. A hyperbaric chamber is a reinforced, closed chamber that is pressurized to greater than atmospheric pressure. It treats DCS by repressurizing the body so that pressure can then be removed much more gradually. Because the hyperbaric chamber introduces oxygen to the body at high pressure, it increases the concentration of oxygen in the blood. This has the effect of replacing some of the nitrogen in the blood with oxygen, which is easier to tolerate out of solution.
The dynamic pressure of body fluids is also important to human survival. For example, blood pressure, which is the pressure exerted by blood as it flows within blood vessels, must be great enough to enable blood to reach all body tissues, and yet low enough to ensure that the delicate blood vessels can withstand the friction and force of the pulsating flow of pressurized blood.
1.5 HomeostasisBy the end of this section, you will be able to:
In contrast, activation of the brain’s heat-gain center by exposure to cold reduces blood flow to the skin, and blood returning from the limbs is diverted into a network of deep veins. This arrangement traps heat closer to the body core and restricts heat loss. If heat loss is severe, the brain triggers an increase in random signals to skeletal muscles, causing them to contract and producing shivering. The muscle contractions of shivering release heat while using up ATP. The brain triggers the thyroid gland in the endocrine system to release thyroid hormone, which increases metabolic activity and heat production in cells throughout the body. The brain also signals the adrenal glands to release epinephrine (adrenaline), a hormone that causes the breakdown of glycogen into glucose, which can be used as an energy source. The breakdown of glycogen into glucose also results in increased metabolism and heat production.
Click and ExploreWater concentration in the body is critical for proper functioning. A person’s body retains very tight control on water levels without conscious control by the person. Watch this video (http://openstaxcollege.org/l/H2Ocon)to learn more about water concentration in the body. Which organ has primary control over the amount of water in the body?
Positive Feedback Positive feedbackintensifies a change in the body’s physiological condition rather than reversing it. A deviation from the normal range results in more change, and the system moves farther away from the normal range. Positive feedback in the body is normal only when there is a definite end point. Childbirth and the body’s response to blood loss are two examples of positive feedback loops that are normal but are activated only when needed.
Childbirth at full term is an example of a situation in which the maintenance of the existing body state is not desired. Enormous changes in the mother’s body are required to expel the baby at the end of pregnancy. And the events of childbirth, once begun, must progress rapidly to a conclusion or the life of the mother and the baby are at risk. The extreme muscular work of labor and delivery are the result of a positive feedback system (Figure 1.11 ).
The first contractions of labor (the stimulus) push the baby toward the cervix (the lowest part of the uterus). The cervix contains stretch-sensitive nerve cells that monitor the degree of stretching (the sensors). These nerve cells send messages to the brain, which in turn causes the pituitary gland at the base of the brain to release the hormone oxytocin into the bloodstream. Oxytocin causes stronger contractions of the smooth muscles in of the uterus (the effectors), pushing the baby further down the birth canal. This causes even greater stretching of the cervix. The cycle of stretching, oxytocin release, and
increasingly more forceful contractions stops only when the baby is born. At this point, the stretching of the cervix halts, stopping the release of oxytocin.
A second example of positive feedback centers on reversing extreme damage to the body. Following a penetrating wound, the most immediate threat is excessive blood loss. Less blood circulating means reduced blood pressure and reduced perfusion (penetration of blood) to the brain and other vital organs. If perfusion is severely reduced, vital organs will shut down and the person will die. The body responds to this potential catastrophe by releasing substances in the injured blood vessel wall that begin the process of blood clotting. As each step of clotting occurs, it stimulates the release of more clotting substances. This accelerates the processes of clotting and sealing off the damaged area. Clotting is contained in a local area based on the tightly controlled availability of clotting proteins. This is an adaptive, life-saving cascade of events.
1.6 Anatomical TerminologyBy the end of this section, you will be able to:
Body Cavities and Serous MembranesThe body maintains its internal organization by means of membranes, sheaths, and other structures that separate compartments. The dorsal (posterior) cavityand the ventral (anterior) cavityare the largest body compartments (Figure 1.15 ). These cavities contain and protect delicate internal organs, and the ventral cavity allows for significant changes in the size and shape of the organs as they perform their functions. The lungs, heart, stomach, and intestines, for example, can expand and contract without distorting other tissues or disrupting the activity of nearby organs.
Subdivisions of the Posterior (Dorsal) and Anterior (Ventral) CavitiesThe posterior (dorsal) and anterior (ventral) cavities are each subdivided into smaller cavities. In the posterior (dorsal) cavity, the cranial cavityhouses the brain, and the spinal cavity(or vertebral cavity) encloses the spinal cord. Just as the brain and spinal cord make up a continuous, uninterrupted structure, the cranial and spinal cavities that house them are also continuous. The brain and spinal cord are protected by the bones of the skull and vertebral column and by cerebrospinal fluid, a colorless fluid produced by the brain, which cushions the brain and spinal cord within the posterior (dorsal) cavity.
The anterior (ventral) cavity has two main subdivisions: the thoracic cavity and the abdominopelvic cavity (see (Figure 1.15 ). The thoracic cavityis the more superior subdivision of the anterior cavity, and it is enclosed by the rib cage. The thoracic cavity contains the lungs and the heart, which is located in the mediastinum. The diaphragm forms the floor of the thoracic cavity and separates it from the more inferior abdominopelvic cavity. The abdominopelvic cavityis the largest cavity in the body. Although no membrane physically divides the abdominopelvic cavity, it can be useful to distinguish between the abdominal cavity, the division that houses the digestive organs, and the pelvic cavity, the division that houses the organs of reproduction.
Abdominal Regions and QuadrantsTo promote clear communication, for instance about the location of a patient’s abdominal pain or a suspicious mass, health care providers typically divide up the cavity into either nine regions or four quadrants (Figure 1.16 ).
The more detailed regional approach subdivides the cavity with one horizontal line immediately inferior to the ribs and one immediately superior to the pelvis, and two vertical lines drawn as if dropped from the midpoint of each clavicle (collarbone). There are nine resulting regions. The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersect at the patient’s umbilicus (navel).
Membranes of the Anterior (Ventral) Body CavityA serous membrane(also referred to a serosa) is one of the thin membranes that cover the walls and organs in the thoracic and abdominopelvic cavities. The parietal layers of the membranes line the walls of the body cavity (pariet- refers to a cavity wall). The visceral layer of the membrane covers the organs (the viscera). Between the parietal and visceral layers is a very thin, fluid-filled serous space, or cavity (Figure 1.17 ).
There are three serous cavities and their associated membranes. The pleurais the serous membrane that surrounds the lungs in the pleural cavity; the pericardiumis the serous membrane that surrounds the heart in the pericardial cavity; and the peritoneumis the serous membrane that surrounds several organs in the abdominopelvic cavity.The serous membranes form fluid-filled sacs, or cavities, that are meant to cushion and reduce friction on internal organs when they move, such as when the lungs inflate or the heart beats. Both the parietal and visceral serosa secrete the thin, slippery serous fluid located within the serous cavities. The pleural cavity reduces friction between the lungs and the body wall. Likewise, the pericardial cavity reduces friction between the heart and the wall of the pericardium. The peritoneal cavity reduces friction between the
abdominal and pelvic organs and the body wall. Therefore, serous membranes provide additional protection to the viscera they enclose by reducing friction that could lead to inflammation of the organs.
1.7 Medical ImagingBy the end of this section, you will be able to:
For thousands of years, fear of the dead and legal sanctions limited the ability of anatomists and physicians to study the internal structures of the human body. An inability to control bleeding, infection, and pain made surgeries infrequent, and those that were performed—such as wound suturing, amputations, tooth and tumor removals, skull drilling, and cesarean births—did not greatly advance knowledge about internal anatomy. Theories about the function of the body and about disease were therefore largely based on external observations and imagination. During the fourteenth and fifteenth centuries, however, the detailed anatomical drawings of Italian artist and anatomist Leonardo da Vinci and Flemish anatomist Andreas Vesalius were published, and interest in human anatomy began to increase. Medical schools began to teach anatomy using human dissection; although some resorted to grave robbing to obtain corpses. Laws were eventually passed that enabled students to dissect the corpses of criminals and those who donated their bodies for research. Still, it was not until the late nineteenth century that medical researchers discovered non-surgical methods to look inside the living body.
X-RaysGerman physicist Wilhelm Röntgen (1845–1923) was experimenting with electrical current when he discovered that a mysterious and invisible “ray” would pass through his flesh but leave an outline of his bones on a screen coated with a metal compound. In 1895, Röntgen made the first durable record of the internal parts of a living human: an “X-ray” image (as it came to be called) of his wife’s hand. Scientists around the world quickly began their own experiments with X-rays, and by 1900, X-rays were widely used to detect a variety of injuries and diseases. In 1901, Röntgen was awarded the first Nobel Prize for physics for his work in this field.
The X-rayis a form of high energy electromagnetic radiation with a short wavelength capable of penetrating solids and ionizing gases. As they are used in medicine, X-rays are emitted from an X-ray machine and directed toward a specially treated metallic plate placed behind the patient’s body. The beam of radiation results in darkening of the X-ray plate. X-rays are slightly impeded by soft tissues, which show up as gray on the X-ray plate, whereas hard tissues, such as bone, largely block the rays, producing a light-toned “shadow.” Thus, X-rays are best used to visualize hard body structures such as teeth and bones (Figure 1.18 ). Like many forms of high energy radiation, however, X-rays are capable of damaging cells and initiating changes that can lead to cancer. This danger of excessive exposure to X-rays was not fully appreciated for many years after their widespread use.
Refinements and enhancements of X-ray techniques have continued throughout the twentieth and twenty-first centuries. Although often supplanted by more sophisticated imaging techniques, the X-ray remains a “workhorse” in medical imaging, especially for viewing fractures and for dentistry. The disadvantage of irradiation to the patient and the operator is now attenuated by proper shielding and by limiting exposure.
Modern Medical ImagingX-rays can depict a two-dimensional image of a body region, and only from a single angle. In contrast, more recent medical imaging technologies produce data that is integrated and analyzed by computers to produce three-dimensional images or images that reveal aspects of body functioning.
Computed TomographyTomography refers to imaging by sections. Computed tomography (CT)is a noninvasive imaging technique that uses computers to analyze several cross-sectional X-rays in order to reveal minute details about structures in the body (Figure 1.19a ). The technique was invented in the 1970s and is based on the principle that, as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates 360 degrees around the patient, taking X-ray images. A computer combines these images into a two-dimensional view of the scanned area, or “slice.”
Since 1970, the development of more powerful computers and more sophisticated software has made CT scanning routine for many types of diagnostic evaluations. It is especially useful for soft tissue scanning, such as of the brain and the thoracic and abdominal viscera. Its level of detail is so precise that it can allow physicians to measure the size of a mass down to a millimeter. The main disadvantage of CT scanning is that it exposes patients to a dose of radiation many times higher than that of X-rays. In fact, children who undergo CT scans are at increased risk of developing cancer, as are adults who have multiple CT scans.
Click and ExploreA CT or CAT scan relies on a circling scanner that revolves around the patient’s body. Watch this video (http://openstaxcollege.org/l/CATscan)to learn more about CT and CAT scans. What type of radiation does a CT scanner use?
Magnetic Resonance Imaging Magnetic resonance imaging (MRI)is a noninvasive medical imaging technique based on a phenomenon of nuclear physics discovered in the 1930s, in which matter exposed to magnetic fields and radio waves was found to emit radio signals. In 1970, a physician and researcher named Raymond Damadian noticed that malignant (cancerous) tissue gave off different signals than normal body tissue. He applied for a patent for the first MRI scanning device, which was in use clinically by the early 1980s. The early MRI scanners were crude, but advances in digital computing and electronics led to their advancement over any other technique for precise imaging, especially to discover tumors. MRI also has the major advantage of not exposing patients to radiation.
Drawbacks of MRI scans include their much higher cost, and patient discomfort with the procedure. The MRI scanner subjects the patient to such powerful electromagnets that the scan room must be shielded. The patient must be enclosed in a metal tube-like device for the duration of the scan (see (Figure 1.19b ), sometimes as long as thirty minutes, which can be uncomfortable and impractical for ill patients. The device is also so noisy that, even with earplugs, patients can become anxious or even fearful. These problems have been overcome somewhat with the development of “open” MRI scanning, which does not require the patient to be entirely enclosed in the metal tube. Patients with iron-containing metallic implants (internal sutures, some prosthetic devices, and so on) cannot undergo MRI scanning because it can dislodge these implants.
Functional MRIs (fMRIs), which detect the concentration of blood flow in certain parts of the body, are increasingly being used to study the activity in parts of the brain during various body activities. This has helped scientists learn more about the locations of different brain functions and more about brain abnormalities and diseases.
Click and ExploreA patient undergoing an MRI is surrounded by a tube-shaped scanner. Watch this video (http://openstaxcollege.org/ l/MRI)to learn more about MRIs. What is the function of magnets in an MRI?
Positron Emission Tomography Positron emission tomography (PET)is a medical imaging technique involving the use of so-called radiopharmaceuticals, substances that emit radiation that is short-lived and therefore relatively safe to administer to the body. Although the first PET scanner was introduced in 1961, it took 15 more years before radiopharmaceuticals were combined with the
technique and revolutionized its potential. The main advantage is that PET (see (Figure 1.19c ) can illustrate physiologic activity—including nutrient metabolism and blood flow—of the organ or organs being targeted, whereas CT and MRI scans can only show static images. PET is widely used to diagnose a multitude of conditions, such as heart disease, the spread of cancer, certain forms of infection, brain abnormalities, bone disease, and thyroid disease.
Click and ExplorePET relies on radioactive substances administered several minutes before the scan. Watch this video (http://openstaxcollege.org/l/PET)to learn more about PET. How is PET used in chemotherapy?
Ultrasonography Ultrasonographyis an imaging technique that uses the transmission of high-frequency sound waves into the body to generate an echo signal that is converted by a computer into a real-time image of anatomy and physiology (see (Figure 1.19d ). Ultrasonography is the least invasive of all imaging techniques, and it is therefore used more freely in sensitive situations such as pregnancy. The technology was first developed in the 1940s and 1950s. Ultrasonography is used to study heart function, blood flow in the neck or extremities, certain conditions such as gallbladder disease, and fetal growth and development. The main disadvantages of ultrasonography are that the image quality is heavily operator-dependent and that it is unable to penetrate bone and gas.Key TermsCHAPTER REVIEW 1.1 Overview of Anatomy and Physiology
Human anatomy is the scientific study of the body’s structures. In the past, anatomy has primarily been studied via observing injuries, and later by the dissection of anatomical structures of cadavers, but in the past century, computer-assisted imaging techniques have allowed clinicians to look inside the living body. Human physiology is the scientific study of the chemistry and physics of the structures of the body. Physiology explains how the structures of the body work together to maintain life. It is difficult to study structure (anatomy) without knowledge of function (physiology). The two disciplines are typically studied together because form and function are closely related in all living things.
1.2 Structural Organization of the Human Body
Life processes of the human body are maintained at several levels of structural organization. These include the chemical, cellular, tissue, organ, organ system, and the organism level. Higher levels of organization are built from lower levels. Therefore, molecules combine to form cells, cells combine to form tissues, tissues combine to form organs, organs combine to form organ systems, and organ systems combine to form organisms.
1.3 Functions of Human Life
Most processes that occur in the human body are not consciously controlled. They occur continuously to build, maintain, and sustain life. These processes include: organization, in terms of the maintenance of essential body boundaries; metabolism, including energy transfer via anabolic and catabolic reactions; responsiveness; movement; and growth, differentiation, reproduction, and renewal.
1.4 Requirements for Human Life
Humans cannot survive for more than a few minutes without oxygen, for more than several days without water, and for more than several weeks without carbohydrates, lipids, proteins, vitamins, and minerals. Although the body can respond to high temperatures by sweating and to low temperatures by shivering and increased fuel consumption, long-term exposure to extreme heat and cold is not compatible with survival. The body requires a precise atmospheric pressure to maintain its
gases in solution and to facilitate respiration—the intake of oxygen and the release of carbon dioxide. Humans also require blood pressure high enough to ensure that blood reaches all body tissues but low enough to avoid damage to blood vessels.
1.5 Homeostasis
Homeostasis is the activity of cells throughout the body to maintain the physiological state within a narrow range that is compatible with life. Homeostasis is regulated by negative feedback loops and, much less frequently, by positive feedback loops. Both have the same components of a stimulus, sensor, control center, and effector; however, negative feedback loops work to prevent an excessive response to the stimulus, whereas positive feedback loops intensify the response until an end point is reached.
1.6 Anatomical Terminology
Ancient Greek and Latin words are used to build anatomical terms. A standard reference position for mapping the body’s structures is the normal anatomical position. Regions of the body are identified using terms such as “occipital” that are more precise than common words and phrases such as “the back of the head.” Directional terms such as anterior and posterior are essential for accurately describing the relative locations of body structures. Images of the body’s interior commonly align along one of three planes: the sagittal, frontal, or transverse. The body’s organs are organized in one of two main cavities—dorsal (also referred to posterior) and ventral (also referred to anterior)—which are further sub-divided according to the structures present in each area. The serous membranes have two layers—parietal and visceral—surrounding a fluid filled space. Serous membranes cover the lungs (pleural serosa), heart (pericardial serosa), and some abdominopelvic organs (peritoneal serosa).
1.7 Medical Imaging
Detailed anatomical drawings of the human body first became available in the fifteenth and sixteenth centuries; however, it was not until the end of the nineteenth century, and the discovery of X-rays, that anatomists and physicians discovered non-surgical methods to look inside a living body. Since then, many other techniques, including CT scans, MRI scans, PET scans, and ultrasonography, have been developed, providing more accurate and detailed views of the form and function of the human body.
INTERACTIVE LINK QUESTIONSClick and Explore1.View this animation (http://openstaxcollege.org/l/ metabolic)to learn more about metabolic processes. What kind of catabolism occurs in the heart?
Click and Explore2.Water concentration in the body is critical for proper functioning. A person’s body retains very tight control on water levels without conscious control by the person. Watch this video (http://openstaxcollege.org/l/H2Ocon)to learn more about water concentration in the body. Which organ has primary control over the amount of water in the body?
3.A CT or CAT scan relies on a circling scanner that revolves around the patient’s body. Watch this video
Click and Explore(http://openstaxcollege.org/l/CATscan)to learn more about CT and CAT scans. What type of radiation does a CT scanner use?
Click and Explore4.A patient undergoing an MRI is surrounded by a tube- shaped scanner. Watch this video (http://openstaxcollege.org/l/MRI)to learn more about MRIs. What is the function of magnets in an MRI?
Click and Explore5.PET relies on radioactive substances administered several minutes before the scan. Watch this video (http://openstaxcollege.org/l/PET)to learn more about PET. How is PET used in chemotherapy?
Review QuestionsQuestion 1.6Which of the following specialties might focus on studying all of the structures of the ankle and foot?microscopic anatomy muscle anatomy regional anatomy systemic anatomyQuestion 1.7A scientist wants to study how the body uses foods and fluids during a marathon run. This scientist is most likely a(n) ________.exercise physiologist microscopic anatomist regional physiologist systemic anatomistQuestion 1.8The smallest independently functioning unit of an organism is a(n) ________.cell molecule organ tissueQuestion 1.9A collection of similar tissues that performs a specific function is an ________.organ organelle organism organ systemQuestion 1.10The body system responsible for structural support and movement is the ________.cardiovascular system endocrine system muscular system skeletal systemQuestion 1.11Metabolism can be defined as the ________.adjustment by an organism to external or internal
changes process whereby all unspecialized cells become
specialized to perform distinct functions process whereby new cells are formed to replace
worn-out cells sum of all chemical reactions in an organismQuestion 1.12Adenosine triphosphate (ATP) is an important molecule because it ________.is the result of catabolism release energy in uncontrolled bursts stores energy for use by body cells All of the aboveQuestion 1.13Cancer cells can be characterized as “generic” cells that perform no specialized body function. Thus cancer cells lack ________.differentiation reproduction responsiveness both reproduction and responsivenessQuestion 1.14Humans have the most urgent need for a continuous supply of ________.food nitrogen oxygen waterQuestion 1.15Which of the following statements about nutrients is true?All classes of nutrients are essential to human survival.
Because the body cannot store any micronutrients, they need to be consumed nearly every day.
Carbohydrates, lipids, and proteins are micronutrients.
Macronutrients are vitamins and minerals.Question 1.16C.J. is stuck in her car during a bitterly cold blizzard. Her body responds to the cold by ________.increasing the blood to her hands and feet becoming lethargic to conserve heat breaking down stored energy significantly increasing blood oxygen levelsQuestion 1.17After you eat lunch, nerve cells in your stomach respond to the distension (the stimulus) resulting from the food. They relay this information to ________.a control center a set point effectors sensorsQuestion 1.18Stimulation of the heat-loss center causes ________.blood vessels in the skin to constrict breathing to become slow and shallow sweat glands to increase their output All of the aboveQuestion 1.19Which of the following is an example of a normal physiologic process that uses a positive feedback loop?blood pressure regulation childbirth regulation of fluid balance temperature regulationQuestion 1.20What is the position of the body when it is in the “normal anatomical position?”The person is prone with upper limbs, including palms, touching sides and lower limbs touching at sides.
The person is standing facing the observer, with upper limbs extended out at a ninety-degree angle from the torso and lower limbs in a wide stance with feet pointing laterally
The person is supine with upper limbs, including palms, touching sides and lower limbs touching at sides.
None of the aboveQuestion 1.21To make a banana split, you halve a banana into two long, thin, right and left sides along the ________.coronal plane longitudinal plane midsagittal plane transverse planeQuestion 1.22The lumbar region is ________. a. inferior to the gluteal region b. inferior to the umbilical region c. superior to the cervical region d. superior to the popliteal regioncranial cavity mediastinum posterior (dorsal) cavity All of the aboveQuestion 1.24In 1901, Wilhelm Röntgen was the first person to win the Nobel Prize for physics. For what discovery did he win?nuclear physics radiopharmaceuticals the link between radiation and cancer
X-raysQuestion 1.25Which of the following imaging techniques would be best to use to study the uptake of nutrients by rapidly multiplying cancer cells?CT MRI PET ultrasonographyQuestion 1.26Which of the following imaging studies can be used most safely during pregnancy?CT scans PET scans
ultrasounds X-raysQuestion 1.27What are two major disadvantages of MRI scans?release of radiation and poor quality images
high cost and the need for shielding from the magnetic signals
can only view metabolically active tissues and inadequate availability of equipment
release of radiation and the need for a patient to be confined to metal tube for up to 30 minutesCRITICAL THINKING QUESTIONS28.Name at least three reasons to study anatomy and physiology.
29.For whom would an appreciation of the structural characteristics of the human heart come more easily: an alien who lands on Earth, abducts a human, and dissects his heart, or an anatomy and physiology student performing a dissection of the heart on her very first day of class? Why?
30.Name the six levels of organization of the human body.
31.The female ovaries and the male testes are a part of which body system? Can these organs be members of more than one organ system? Why or why not?
32.Explain why the smell of smoke when you are sitting at a campfire does not trigger alarm, but the smell of smoke in your residence hall does.
33.Identify three different ways that growth can occur in the human body.
34.When you open a bottle of sparkling water, the carbon dioxide gas in the bottle form bubbles. If the bottle is left open, the water will eventually “go flat.” Explain these phenomena in terms of atmospheric pressure.
35.On his midsummer trek through the desert, Josh ran out of water. Why is this particularly dangerous?
36.Identify the four components of a negative feedback loop and explain what would happen if secretion of a body chemical controlled by a negative feedback system became too great.
37.What regulatory processes would your body use if you were trapped by a blizzard in an unheated, uninsulated cabin in the woods?
38.In which direction would an MRI scanner move to produce sequential images of the body in the frontal plane, and in which direction would an MRI scanner move to produce sequential images of the body in the sagittal plane?
39.If a bullet were to penetrate a lung, which three anterior thoracic body cavities would it enter, and which layer of the serous membrane would it encounter first?
40.Which medical imaging technique is most dangerous to use repeatedly, and why?
41.Explain why ultrasound imaging is the technique of choice for studying fetal growth and development.
