You are on page 1of 20

000200010270575674_R1_CH01_p0001-0022.

qxd 10/2/2011 06:06 AM Page 1

1
An Overview of Anatomy
and Physiology (pp. 2–3)

The Human
Topics of Anatomy (p. 2)

Topics of Physiology (pp. 2–3)

Complementarity of Structure
and Function (p. 3)

Levels of Structural
Organization (pp. 3–4)

Maintaining Life (pp. 4–8)


Body: An
Necessary Life Functions (pp. 4–8)

Survival Needs (p. 8)

Homeostasis (pp. 8–11)


Orientation
Homeostatic Control (pp. 9–11)

W
elcome to the study of one of the most fascinating subjects
Homeostatic Imbalance (p. 11)
possible—your own body. Such a study is not only highly
The Language of Anatomy (pp. 11–20) personal, but timely as well. We get news of some medical
advance almost daily. To appreciate emerging discoveries in genetic
Anatomical Position and Directional
Terms (p. 13)
engineering, to understand new techniques for detecting and treating
disease, and to make use of published facts on how to stay healthy, you’ll
Regional Terms (p. 14) find it helpful to learn about the workings of your body. If you are
Anatomical Variability (p. 14) preparing for a career in the health sciences, the study of anatomy and
Body Planes and Sections (p. 14)
physiology has added rewards because it provides the foundation
needed to support your clinical experiences.
Body Cavities and Membranes (pp. 14–20)

1
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 2

2 U NI T 1 Organization of the Body

In this chapter we define and contrast anatomy and physiol- Another subdivision of gross anatomy is surface anatomy,
ogy and discuss how the human body is organized. Then we re- the study of internal structures as they relate to the overlying
view needs and functional processes common to all living skin surface. You use surface anatomy when you identify the
organisms. Three essential concepts—the complementarity of bulging muscles beneath a bodybuilder’s skin, and clinicians use
structure and function, the hierarchy of structural organization, it to locate appropriate blood vessels in which to feel pulses and
and homeostasis—will unify and form the bedrock for your draw blood.
study of the human body. The final section of the chapter deals Microscopic anatomy deals with structures too small to be
with the language of anatomy—terminology that anatomists seen with the naked eye. For most such studies, exceedingly
use to describe the body or its parts. thin slices of body tissues are stained and mounted on glass
1 slides to be examined under the microscope. Subdivisions of
microscopic anatomy include cytology (si-tol⬘o-je), which con-
An Overview of Anatomy siders the cells of the body, and histology (his-tol⬘o-je), the
study of tissues.
and Physiology Developmental anatomy traces structural changes that oc-
䉴 Define anatomy and physiology and describe their cur in the body throughout the life span. Embryology (em⬙bre-
subdivisions. ol⬘o-je), a subdivision of developmental anatomy, concerns
䉴 Explain the principle of complementarity. developmental changes that occur before birth.
Some highly specialized branches of anatomy are used pri-
Two complementary branches of science—anatomy and marily for medical diagnosis and scientific research. For exam-
physiology—provide the concepts that help us to understand ple, pathological anatomy studies structural changes caused by
the human body. Anatomy studies the structure of body parts disease. Radiographic anatomy studies internal structures as
and their relationships to one another. Anatomy has a certain visualized by X-ray images or specialized scanning procedures.
appeal because it is concrete. Body structures can be seen, felt, Subjects of interest to anatomists range from easily seen
and examined closely. You don’t need to imagine what they structures down to the smallest molecule. In molecular biol-
look like. ogy, for example, the structure of biological molecules
Physiology concerns the function of the body, in other words, (chemical substances) is investigated. Molecular biology is
how the body parts work and carry out their life-sustaining actually a separate branch of biology, but it falls under the
activities. When all is said and done, physiology is explainable anatomy umbrella when we push anatomical studies to the
only in terms of the underlying anatomy. subcellular level.
To simplify the study of the body, when we refer to body One essential tool for studying anatomy is a mastery of
structures and/or physiological values (body temperature, heart anatomical terminology. Others are observation, manipulation,
rate, and the like), we will assume that we are talking about a and, in a living person, palpation (feeling organs with your
healthy young (22-year-old) male weighing about 155 lb (the hands) and auscultation (listening to organ sounds with a
reference man) or a healthy young female weighing about 125 lb stethoscope). A simple example illustrates how some of these
(the reference woman). tools work together in an anatomical study.
Let’s assume that your topic is freely movable joints of the
body. In the laboratory, you will be able to observe an animal
Topics of Anatomy joint, noting how its parts fit together. You can work the joint
Anatomy is a broad field with many subdivisions, each provid- (manipulate it) to determine its range of motion. Using
ing enough information to be a course in itself. Gross, or anatomical terminology, you can name its parts and describe
macroscopic, anatomy is the study of large body structures how they are related so that other students (and your instruc-
visible to the naked eye, such as the heart, lungs, and kidneys. tor) will have no trouble understanding you. The list of word
Indeed, the term anatomy (derived from the Greek words roots (at the back of the book) and the glossary will help you
meaning “to cut apart”) relates most closely to gross anatomy with this special vocabulary.
because in such studies preserved animals or their organs are Although you will make most of your observations with the
dissected (cut up) to be examined. naked eye or with the help of a microscope, medical technology
Gross anatomy can be approached in different ways. In has developed a number of sophisticated tools that can peer
regional anatomy, all the structures (muscles, bones, blood ves- into the body without disrupting it. Read about these exciting
sels, nerves, etc.) in a particular region of the body, such as the medical imaging techniques in A Closer Look on pp. 18–19.
abdomen or leg, are examined at the same time.
In systemic anatomy (sis-tem⬘ik),* body structure is studied Topics of Physiology
system by system. For example, when studying the cardiovascu-
lar system, you would examine the heart and the blood vessels Like anatomy, physiology has many subdivisions. Most of
of the entire body. them consider the operation of specific organ systems. For ex-
ample, renal physiology concerns kidney function and urine
*For the pronunciation guide rules, see the Preface to the Student.
production. Neurophysiology explains the workings of the
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 3

Chapter 1 The Human Body: An Orientation 3


nervous system. Cardiovascular physiology examines the op- widely in size and shape, reflecting their unique functions in
eration of the heart and blood vessels. While anatomy provides the body.
us with a static image of the body’s architecture, physiology re- The simplest living creatures are single cells, but in complex
veals the body’s dynamic and animated workings. organisms such as human beings, the hierarchy continues on to
Physiology often focuses on events at the cellular or mo- the tissue level. Tissues are groups of similar cells that have a
lecular level. This is because the body’s abilities depend on common function. The four basic tissue types in the human
those of its individual cells, and cells’ abilities ultimately de- body are epithelium, muscle, connective tissue, and nervous
pend on the chemical reactions that go on within them. tissue.
Physiology also rests on principles of physics, which help to Each tissue type has a characteristic role in the body, which
explain electrical currents, blood pressure, and the way mus- we explore in Chapter 4. Briefly, epithelium covers the body sur- 1
cles use bones to cause body movements, among other face and lines its cavities. Muscle provides movement. Connec-
things. We present basic chemical and physical principles in tive tissue supports and protects body organs. Nervous tissue
Chapter 2 and throughout the book as needed to explain provides a means of rapid internal communication by transmit-
physiological topics. ting electrical impulses.
An organ is a discrete structure composed of at least two tis-
sue types (four is more common) that performs a specific
Complementarity of Structure and Function function for the body. The liver, the brain, and a blood vessel
Although it is possible to study anatomy and physiology indi- are very different from the stomach, but each is an organ. You
vidually, they are really inseparable because function always re- can think of each organ of the body as a specialized functional
flects structure. That is, what a structure can do depends on its center responsible for a necessary activity that no other organ
specific form. This key concept is called the principle of com- can perform.
plementarity of structure and function. At the organ level, extremely complex functions become
For example, bones can support and protect body organs be- possible. Let’s take the stomach for an example. Its lining is an
cause they contain hard mineral deposits. Blood flows in one di- epithelium that produces digestive juices. The bulk of its wall is
rection through the heart because the heart has valves that muscle, which churns and mixes stomach contents (food). Its
prevent backflow. Throughout this book, we accompany a de- connective tissue reinforces the soft muscular walls. Its nerve
scription of a structure’s anatomy with an explanation of its fibers increase digestive activity by stimulating the muscle to
function, and we emphasize structural characteristics con- contract more vigorously and the glands to secrete more diges-
tributing to that function. tive juices.
The next level of organization is the organ system level.
C H E C K Y O U R U N D E R S TA N D I N G Organs that work together to accomplish a common purpose
1. In what way does physiology depend on anatomy?
make up an organ system. For example, the heart and blood
2. Would you be studying anatomy or physiology if you investi-
vessels of the cardiovascular system circulate blood continu-
gated how muscles shorten? If you explored the location of
ously to carry oxygen and nutrients to all body cells. Besides
the lungs in the body?
the cardiovascular system, the other organ systems of the
body are the integumentary, skeletal, muscular, nervous, en-
For answers, see Appendix G. docrine, lymphatic, respiratory, digestive, urinary, and
reproductive systems. (Note that the immune system is
closely associated with the lymphatic system.) Look ahead to
Figure 1.3 on pp. 6 and 7 for an overview of the 11 organ sys-
Levels of Structural Organization tems, which we discuss in the next section and study in more
䉴 Name the different levels of structural organization that detail in Units 2–5.
make up the human body, and explain their relationships. The highest level of organization is the organism, the living
human being. The organismal level represents the sum total of
䉴 List the 11 organ systems of the body, identify their
all structural levels working together to keep us alive.
components, and briefly explain the major function(s) of
each system.
C H E C K Y O U R U N D E R S TA N D I N G

The human body has many levels of structural organization 3. What level of structural organization is typical of a cytolo-
(Figure 1.1). The simplest level of the structural hierarchy is gist’s field of study?
the chemical level, which we study in Chapter 2. At this level, 4. What is the correct structural order for the following terms:
atoms, tiny building blocks of matter, combine to form tissue, organism, organ, cell?
molecules such as water and proteins. Molecules, in turn, asso- 5. Which organ system includes the bones and cartilages?
ciate in specific ways to form organelles, basic components of Which includes the nasal cavity, lungs, and trachea?
the microscopic cells. Cells are the smallest units of living For answers, see Appendix G.
things. We examine the cellular level in Chapter 3. All cells
have some common functions, but individual cells vary
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 4

4 U NI T 1 Organization of the Body

Organelle
Atoms Molecule
Smooth muscle cell

1 Chemical level 2 Cellular level


Atoms combine to form molecules. Cells are made up of molecules.
1
Smooth muscle tissue

Cardiovascular 3 Tissue level


system
Tissues consist of similar types of cells.

Heart

Blood
vessels Blood vessel (organ)

Smooth muscle tissue

Connective tissue

Epithelial
tissue

4 Organ level
Organs are made up of different types of tissues.

6 Organismal level 5 Organ system level


The human organism is made up of many Organ systems consist of different
organ systems. organs that work together closely.

Figure 1.1 Levels of structural organization. Components of the cardiovascular system are
used to illustrate the levels of structural organization in a human being.

Maintaining Life Like all complex animals, humans maintain their bound-
aries, move, respond to environmental changes, take in and
䉴 List the functional characteristics necessary to maintain life digest nutrients, carry out metabolism, dispose of wastes, repro-
in humans. duce themselves, and grow. We will introduce these necessary
䉴 List the survival needs of the body. life functions here and discuss them in more detail in later
chapters.
We cannot emphasize too strongly that all body cells are in-
Necessary Life Functions terdependent. This interdependence is due to the fact that
Now that you know the structural levels of the human body, the humans are multicellular organisms and our vital body func-
question that naturally follows is: What does this highly orga- tions are parceled out among different organ systems. Organ
nized human body do?
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 5

Chapter 1 The Human Body: An Orientation 5


systems, in turn, work cooperatively to promote the well-being Digestive system Respiratory system
Takes in nutrients, breaks them Takes in oxygen and
of the entire body. This theme is repeated throughout the book. down, and eliminates unabsorbed eliminates carbon dioxide
Figure 1.2 identifies some of the organ systems making major matter (feces)
contributions to necessary life functions. Also, as you read this Food O2 CO2
section, check Figure 1.3 for more detailed descriptions of the
body’s organ systems.
Cardiovascular system
Via the blood, distributes oxygen
Maintaining Boundaries and nutrients to all body cells and
delivers wastes and carbon
Every living organism must maintain its boundaries so that its dioxide to disposal organs
internal environment (its inside) remains distinct from the ex- 1
ternal environment surrounding it (its outside). In single-celled Blood
organisms, the external boundary is a limiting membrane that CO2
encloses its contents and lets in needed substances while re- O2
stricting entry of potentially damaging or unnecessary sub-
stances. Similarly, all the cells of our body are surrounded by a
selectively permeable membrane. Heart
Urinary system
Additionally, the body as a whole is enclosed and protected Nutrients Eliminates
by the integumentary system, or skin (Figure 1.3a). This system nitrogenous
protects our internal organs from drying out (a fatal change), wastes and
Interstitial fluid excess ions
bacteria, and the damaging effects of heat, sunlight, and an un-
believable number of chemicals in the external environment.

Movement
Movement includes the activities promoted by the muscular
system, such as propelling ourselves from one place to another
by running or swimming, and manipulating the external envi- Nutrients and wastes pass
ronment with our nimble fingers (Figure 1.3c). The skeletal sys- between blood and cells
tem provides the bony framework that the muscles pull on as via the interstitial fluid
they work (Figure 1.3b). Movement also occurs when sub-
stances such as blood, foodstuffs, and urine are propelled Integumentary system
through internal organs of the cardiovascular, digestive, and Feces Protects the body as a whole Urine
urinary systems, respectively. On the cellular level, the muscle from the external environment
cell’s ability to move by shortening is more precisely called
contractility. Figure 1.2 Examples of interrelationships among body organ
systems.

Responsiveness
Responsiveness, or irritability, is the ability to sense changes
(which serve as stimuli) in the environment and then respond amoeba, the cell itself is the “digestion factory,” but in the multi-
to them. For example, if you cut your hand on broken glass, a cellular human body, the digestive system performs this func-
withdrawal reflex occurs—you involuntarily pull your hand tion for the entire body (Figure 1.3i).
away from the painful stimulus (the broken glass). You don’t
have to think about it—it just happens! Likewise, when carbon Metabolism
dioxide in your blood rises to dangerously high levels, chemical Metabolism (mĕ-tab⬘o-lizm; “a state of change”) is a broad
sensors respond by sending messages to brain centers control- term that includes all chemical reactions that occur within body
ling respiration, and you breathe more rapidly. cells. It includes breaking down substances into their simpler
Because nerve cells are highly irritable and communicate building blocks (more specifically, the process of catabolism),
rapidly with each other via electrical impulses, the nervous synthesizing more complex cellular structures from simpler
system is most involved with responsiveness (Figure 1.3d). substances (anabolism), and using nutrients and oxygen to pro-
However, all body cells are irritable to some extent. duce (via cellular respiration) ATP, the energy-rich molecules
that power cellular activities. Metabolism depends on the diges-
Digestion tive and respiratory systems to make nutrients and oxygen avail-
Digestion is the breaking down of ingested foodstuffs to simple able to the blood and on the cardiovascular system to distribute
molecules that can be absorbed into the blood. The nutrient- them throughout the body (Figure 1.3i, h, and f, respectively).
rich blood is then distributed to all body cells by the cardiovas- Metabolism is regulated largely by hormones secreted by en-
cular system. In a simple, one-celled organism such as an docrine system glands (Figure 1.3e).
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 6

6 U NI T 1 Organization of the Body

Hair Skeletal
muscles

Skin Nails

Bones
1

Joint

(a) Integumentary System (b) Skeletal System (c) Muscular System


Forms the external body covering, and Protects and supports body organs, and Allows manipulation of the environment,
protects deeper tissues from injury. provides a framework the muscles use locomotion, and facial expression. Main-
Synthesizes vitamin D, and houses to cause movement. Blood cells are tains posture, and produces heat.
cutaneous (pain, pressure, etc.) receptors formed within bones. Bones store minerals.
and sweat and oil glands.

Pineal gland
Brain
Pituitary
Thyroid gland
gland Heart
Thymus

Adrenal
gland
Pancreas

Testis

Nerves Ovary Blood


Spinal vessels
cord

(d) Nervous System (e) Endocrine System (f) Cardiovascular System


As the fast-acting control system of the Glands secrete hormones that regulate Blood vessels transport blood, which
body, it responds to internal and external processes such as growth, reproduction, carries oxygen, carbon dioxide,
changes by activating appropriate and nutrient use (metabolism) by body nutrients, wastes, etc. The heart pumps
muscles and glands. cells. blood.

Figure 1.3 The body’s organ systems and their major functions.

Excretion Several organ systems participate in excretion. For example,


Excretion is the process of removing wastes, or excreta the digestive system rids the body of indigestible food residues
(ek-skre⬘tah), from the body. If the body is to operate as we in feces, and the urinary system disposes of nitrogen-containing
expect it to, it must get rid of nonuseful substances produced metabolic wastes, such as urea, in urine (Figure 1.3i and j). Car-
during digestion and metabolism. bon dioxide, a by-product of cellular respiration, is carried in
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 7

Chapter 1 The Human Body: An Orientation 7

Nasal Oral cavity


Red bone
cavity
marrow
Thymus Pharynx Esophagus

Larynx Bronchus
Lymphatic
vessels Trachea
Thoracic
duct Lung Liver
Stomach
Small 1
Spleen intestine

Large
intestine
Lymph nodes Rectum
Anus

(g) Lymphatic System/Immunity (h) Respiratory System (i) Digestive System


Picks up fluid leaked from blood vessels Keeps blood constantly supplied with Breaks down food into absorbable units
and returns it to blood. Disposes oxygen and removes carbon dioxide. that enter the blood for distribution to
of debris in the lymphatic stream. The gaseous exchanges occur through body cells. Indigestible foodstuffs are
Houses white blood cells (lymphocytes) the walls of the air sacs of the lungs. eliminated as feces.
involved in immunity. The immune
response mounts the attack against
foreign substances within the body.

Mammary
glands (in
breasts)
Kidney

Ureter Prostate
gland

Ovary
Penis
Urinary
bladder Testis Ductus
deferens Uterine
Urethra Scrotum Uterus
tube
Vagina

(j) Urinary System (k) Male Reproductive System (l) Female Reproductive System
Eliminates nitrogenous wastes from the Overall function is production of offspring. Testes produce sperm and male sex hormone,
body. Regulates water, electrolyte and and male ducts and glands aid in delivery of sperm to the female reproductive tract. Ovaries
acid-base balance of the blood. produce eggs and female sex hormones. The remaining female structures serve as sites for
fertilization and development of the fetus. Mammary glands of female breasts produce
milk to nourish the newborn.

the blood to the lungs, where it leaves the body in exhaled air identical daughter cells that may then be used for body growth
(Figure 1.3h). or repair. Reproduction of the human organism, or making a
whole new person, is the major task of the reproductive system.
Reproduction When a sperm unites with an egg, a fertilized egg forms and de-
velops into a baby within the mother’s body. The reproductive
Reproduction occurs at the cellular and the organismal level. In
system is directly responsible for producing offspring, but its
cellular reproduction, the original cell divides, producing two
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 8

8 U NI T 1 Organization of the Body

function is exquisitely regulated by hormones of the endocrine Normal Body Temperature


system (Figure 1.3e). If chemical reactions are to continue at life-sustaining rates,
Because males produce sperm and females produce eggs normal body temperature must be maintained. As body
(ova), there is a division of labor in reproduction, and the repro- temperature drops below 37°C (98.6°F), metabolic reactions
ductive organs of males and females are different (Figure 1.3k, l). become slower and slower, and finally stop. When body tem-
Additionally, the female’s reproductive structures provide the perature is too high, chemical reactions occur at a frantic pace
site for fertilization of eggs by sperm, and then protect and nur- and body proteins lose their characteristic shape and stop func-
ture the developing fetus until birth. tioning. At either extreme, death occurs. The activity of the
muscular system generates most body heat.
1 Growth
Growth is an increase in size of a body part or the organism. It Appropriate Atmospheric Pressure
is usually accomplished by increasing the number of cells. How- Atmospheric pressure is the force that air exerts on the surface
ever, individual cells also increase in size when not dividing. For of the body. Breathing and gas exchange in the lungs depend on
true growth to occur, constructive activities must occur at a appropriate atmospheric pressure. At high altitudes, where at-
faster rate than destructive ones. mospheric pressure is lower and the air is thin, gas exchange
may be inadequate to support cellular metabolism.
Survival Needs
The mere presence of these survival factors is not sufficient to
The ultimate goal of all body systems is to maintain life. How- sustain life. They must be present in appropriate amounts. Excesses
ever, life is extraordinarily fragile and requires several factors. and deficits may be equally harmful. For example, oxygen is essen-
These factors, which we will call survival needs, include nutri- tial, but excessive amounts are toxic to body cells. Similarly, the
ents (food), oxygen, water, and appropriate temperature and at- food we eat must be of high quality and in proper amounts.
mospheric pressure. Otherwise, nutritional disease, obesity, or starvation is likely. Also,
while the needs listed above are the most crucial, they do not even
Nutrients begin to encompass all of the body’s needs. For example, we can
Nutrients, taken in via the diet, contain the chemical substances live without gravity if we must, but the quality of life suffers.
used for energy and cell building. Most plant-derived foods are
rich in carbohydrates, vitamins, and minerals, whereas most an- C H E C K Y O U R U N D E R S TA N D I N G
imal foods are richer in proteins and fats. 6. What separates living beings from nonliving objects?
Carbohydrates are the major energy fuel for body cells. 7. What name is given to all chemical reactions that occur
Proteins, and to a lesser extent fats, are essential for building cell within body cells?
structures. Fats also provide a reserve of energy-rich fuel. 8. Why is it necessary to be in a pressurized cabin when flying
Selected minerals and vitamins are required for the chemical at 30,000 feet?
reactions that go on in cells and for oxygen transport in the
blood. The mineral calcium helps to make bones hard and is For answers, see Appendix G.
required for blood clotting.

Oxygen
Homeostasis
All the nutrients in the world are useless unless oxygen is also
available. Because the chemical reactions that release energy 䉴 Define homeostasis and explain its significance.
from foods are oxidative reactions that require oxygen, human 䉴 Describe how negative and positive feedback maintain
cells can survive for only a few minutes without oxygen. Ap- body homeostasis.
proximately 20% of the air we breathe is oxygen. The cooper- 䉴 Describe the relationship between homeostatic imbalance
ative efforts of the respiratory and cardiovascular systems and disease.
make oxygen available to the blood and body cells.
When you think about the fact that your body contains trillions
Water of cells in nearly constant activity, and that remarkably little usu-
Water accounts for 60–80% of our body weight and is the sin- ally goes wrong with it, you begin to appreciate what a marvelous
gle most abundant chemical substance in the body. It provides machine your body is. Walter Cannon, an American physiologist
the watery environment necessary for chemical reactions and of the early twentieth century, spoke of the “wisdom of the
the fluid base for body secretions and excretions. We obtain body,” and he coined the word homeostasis (ho⬙me-o-sta⬘sis) to
water chiefly from ingested foods or liquids. We lose it from describe its ability to maintain relatively stable internal condi-
the body by evaporation from the lungs and skin and in body tions even though the outside world changes continuously.
excretions. Although the literal translation of homeostasis is “unchang-
ing,” the term does not really mean a static, or unchanging, state.
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 9

Chapter 1 The Human Body: An Orientation 9

3 Input: Information 4 Output: Information


sent along afferent Control sent along efferent
pathway to control Center pathway to effector.
center.
Afferent Efferent
pathway pathway
Receptor Effector
2 Receptor
detects change. 5 Response
of effector feeds
IMB back to reduce
AL the effect of
1 Stimulus AN
CE stimulus and
produces 1
returns variable
change in
variable. BALANCE to homeostatic
level.

IMB
AL
AN
CE

Figure 1.4 Interaction among the elements of a homeostatic control system.

Rather, it indicates a dynamic state of equilibrium, or a balance, The control center determines the set point, which is the level
in which internal conditions vary, but always within relatively or range at which a variable is to be maintained. It also analyzes
narrow limits. In general, the body is in homeostasis when its the input it receives and determines the appropriate response or
needs are adequately met and it is functioning smoothly. course of action. Information (output) then flows from the
Maintaining homeostasis is more complicated than it control center to the third component, the effector, along the
appears at first glance. Virtually every organ system plays a efferent pathway. (To help you remember the difference between
role in maintaining the constancy of the internal environ- “afferent” and “efferent,” you might note that information trav-
ment. Adequate blood levels of vital nutrients must be con- eling along the afferent pathway approaches the control center
tinuously present, and heart activity and blood pressure and efferent information exits from the control center.)
must be constantly monitored and adjusted so that the blood The effector provides the means for the control center’s
is propelled to all body tissues. Also, wastes must not be response (output) to the stimulus. The results of the response
allowed to accumulate, and body temperature must be pre- then feed back to influence the effect of the stimulus, either re-
cisely controlled. A wide variety of chemical, thermal, and ducing it (in negative feedback) so that the whole control
neural factors act and interact in complex ways—sometimes process is shut off, or enhancing it (in positive feedback) so that
helping and sometimes hindering the body as it works to the whole process continues at an even faster rate.
maintain its “steady rudder.”
Negative Feedback Mechanisms
Homeostatic Control Most homeostatic control mechanisms are negative feedback
Communication within the body is essential for homeostasis. mechanisms. In these systems, the output shuts off the original
Communication is accomplished chiefly by the nervous and effect of the stimulus or reduces its intensity. These mechanisms
endocrine systems, which use neural electrical impulses or cause the variable to change in a direction opposite to that of the
bloodborne hormones, respectively, as information carriers. We initial change, returning it to its “ideal” value; thus the name
cover the details of how these two great regulating systems op- “negative” feedback mechanisms.
erate in later chapters, but here we explain the basic characteris- Let’s start with an example of a nonbiological negative feed-
tics of control systems that promote homeostasis. back system: a home heating system connected to a temperature-
Regardless of the factor or event being regulated—the sensing thermostat. The thermostat houses both the receptor
variable—all homeostatic control mechanisms are processes (thermometer) and the control center. If the thermostat is set at
involving at least three components that work together 20°C (68°F), the heating system (effector) is triggered ON when
(Figure 1.4). The first component, the receptor, is some type of
the house temperature drops below that setting. As the furnace
sensor that monitors the environment and responds to changes, produces heat and warms the air, the temperature rises, and
called stimuli, by sending information (input) to the second when it reaches 20°C or slightly higher, the thermostat triggers
component, the control center. Input flows from the receptor to the furnace OFF. This process results in a cycling of “furnace-
the control center along the so-called afferent pathway. ON” and “furnace-OFF” so that the temperature in the house
stays very near the desired temperature of 20°C.
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 10

10 U N I T 1 Organization of the Body

Control Center
(thermoregulatory
Information sent center in brain) Information sent
along the afferent along the efferent
pathway to control pathway to
center effectors
Afferent Efferent
pathway pathway

Receptors
Temperature-sensitive Effectors
cells in skin and brain Sweat glands
1
Sweat glands activated

IMB Response
AL Evaporation of sweat
AN
CE Body temperature falls;
Stimulus stimulus ends
Body temperature
rises BALANCE

Stimulus
Response Body temperature falls
Body temperature rises; IMB
AL
stimulus ends AN
CE

Effectors Receptors
Skeletal muscles Temperature-sensitive
cells in skin and brain

Efferent Afferent
Shivering begins pathway pathway
Information sent Information sent
along the efferent along the afferent
pathway to effectors pathway to control
center
Control Center
(thermoregulatory
center in brain)

Figure 1.5 Regulation of body temperature by a negative feedback mechanism.

Your body “thermostat,” located in a part of your brain called The body’s ability to regulate its internal environment is
the hypothalamus, operates in a similar fashion (Figure 1.5). fundamental. All negative feedback mechanisms have the same
Regulation of body temperature is only one of the many ways goal: preventing sudden severe changes within the body. Body
the nervous system maintains the constancy of the internal temperature and blood volume are only two of the variables
environment. Another type of neural control mechanism is seen that need to be regulated. There are hundreds! Other negative
in the withdrawal reflex mentioned earlier, in which the hand is feedback mechanisms regulate heart rate, blood pressure, the
jerked away from a painful stimulus such as broken glass. rate and depth of breathing, and blood levels of oxygen, carbon
The endocrine system is equally important in maintaining dioxide, and minerals. Now, let’s take a look at the other type of
homeostasis. A good example of a hormonal negative feedback feedback control mechanism—positive feedback.
mechanism is the control of blood volume by antidiuretic hor-
mone (ADH). As blood volume drops, receptors in the body Positive Feedback Mechanisms
sense this change, and the hypothalamus of the brain (the con-
In positive feedback mechanisms, the result or response en-
trol center) stimulates the release of ADH to the blood. This
hances the original stimulus so that the response is accelerated.
change in turn prompts the kidneys to reabsorb more water and
This feedback mechanism is “positive” because the change that
return it to the bloodstream. The rising blood volume then ends
results proceeds in the same direction as the initial change, caus-
the stimulus for ADH release.
ing the variable to deviate further and further from its original
value or range.
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 11

Chapter 1 The Human Body: An Orientation 11


In contrast to negative feedback controls, which maintain 1 Break or tear
some physiological function or keep blood chemicals within occurs in blood
narrow ranges, positive feedback mechanisms usually control vessel wall.
infrequent events that do not require continuous adjustments.
Typically, they set off a series of events that may be self-
perpetuating and that, once initiated, have an amplifying or
waterfall effect. Because of these characteristics, positive feed- Positive feedback
cycle is initiated.
back mechanisms are often referred to as cascades (from the
Italian word meaning “to fall”).
Positive feedback mechanisms are likely to race out of con- 1
trol, so they are rarely used to promote the moment-to-moment 3 Released 2 Platelets
well-being of the body. However, two familiar examples of their chemicals adhere to site
use as homeostatic mechanisms are the enhancement of labor attract more Positive and release
platelets. feedback chemicals.
contractions during birth and blood clotting. loop
Chapter 28 describes the positive feedback mechanism in
which oxytocin, a hypothalamic hormone, intensifies labor
contractions during the birth of a baby (see Figure 28.17). Oxy-
tocin causes the contractions to become both more frequent
and more powerful. The increased contractions cause more
Feedback cycle ends
oxytocin to be released, which causes more contractions, and when plug is formed.
so on until the baby is finally born. The birth ends the stimu-
lus for oxytocin release and shuts off the positive feedback
mechanism. 4 Platelet plug
Blood clotting is a normal response to a break in the wall of forms.
a blood vessel and is an excellent example of an important body
function controlled by positive feedback. Basically, once a vessel
has been damaged, blood elements called platelets immediately
begin to cling to the injured site and release chemicals that at- Figure 1.6 Summary of the positive feedback mechanism
tract more platelets. This rapidly growing pileup of platelets regulating formation of a platelet plug.
temporarily “plugs” the tear and initiates the sequence of events
that finally forms a clot (Figure 1.6).

Homeostatic Imbalance
Homeostasis is so important that most disease can be regarded 11. Why is the control mechanism shown in Figure 1.6 called a
as a result of its disturbance, a condition called homeostatic positive feedback system? What event ends it?
imbalance. As we age, our body’s control systems become less
efficient, and our internal environment becomes less and less For answers, see Appendix G.
stable. These events increase our risk for illness and produce the
changes we associate with aging.
Another important source of homeostatic imbalance occurs
when the usual negative feedback mechanisms are over- The Language of Anatomy
whelmed and destructive positive feedback mechanisms take 䉴 Describe the anatomical position.
over. Some instances of heart failure reflect this phenomenon.
䉴 Use correct anatomical terms to describe body directions,
Examples of homeostatic imbalance appear throughout this
regions, and body planes or sections.
book to enhance your understanding of normal physiological
mechanisms. This symbol introduces the homeostatic
Most of us are naturally curious about our bodies, but our in-
imbalance sections and alerts you to the fact that we are describ-
terest sometimes dwindles when we are confronted with the ter-
ing an abnormal condition.
minology of anatomy and physiology. Let’s face it—you can’t
just pick up an anatomy and physiology book and read it as
C H E C K Y O U R U N D E R S TA N D I N G
though it were a novel.
9. What process allows us to adjust to either extreme heat or Unfortunately, confusion is likely without precise, special-
extreme cold? ized terminology. To prevent misunderstanding, anatomists use
10. When we begin to get dehydrated, we usually get thirsty, universally accepted terms to identify body structures precisely
which causes us to drink fluids. Is thirst part of a negative or and with a minimum of words. We present and explain the lan-
a positive feedback control system? Defend your choice. guage of anatomy next.
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 12

12 U N I T 1 Organization of the Body

TABLE 1.1 Orientation and Directional Terms


TERM DEFINITION EXAMPLE

Superior (cranial) Toward the head end or The head is superior to the abdomen.
upper part of a structure or
the body; above

1
Inferior (caudal) Away from the head end or The navel is inferior to the chin.
toward the lower part of a
structure or the body; below

Ventral (anterior)* Toward or at the front of The breastbone is anterior to the


the body; in front of spine.

Dorsal (posterior)* Toward or at the back of The heart is posterior to the breast-
the body; behind bone.

Medial Toward or at the midline The heart is medial to the arm.


of the body; on the inner
side of

Lateral Away from the midline The arms are lateral to the chest.
of the body; on the outer
side of

Intermediate Between a more medial The collarbone is intermediate between


and a more lateral structure the breastbone and shoulder.

Proximal Closer to the origin of the The elbow is proximal to the wrist.
body part or the point of
attachment of a limb to
the body trunk

Distal Farther from the origin of a The knee is distal to the thigh.
body part or the point of
attachment of a limb to
the body trunk

Superficial (external) Toward or at the body The skin is superficial to the skeletal
surface muscles.

Deep (internal) Away from the body The lungs are deep to the skin.
surface; more internal

*The terms ventral and anterior are synonymous in humans, but this is not the case in four-legged animals. Anterior refers to the leading portion of the body
(abdominal surface in humans, head in a cat), but ventral specifically refers to the “belly” of a vertebrate animal, so it is the inferior surface of four-legged animals.
Likewise, although the dorsal and posterior surfaces are the same in humans, the term dorsal specifically refers to an animal’s back. Thus, the dorsal surface of
four-legged animals is their superior surface.
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 13

Chapter 1 The Human Body: An Orientation 13


Cephalic Cephalic
Frontal Otic
Orbital Occipital (back
Nasal of head)
Oral Upper limb
Mental Acromial Cervical
Cervical Brachial (arm)
Thoracic Antecubital
Sternal Olecranal
Back (dorsal)
Axillary Antebrachial Scapular
(forearm) 1
Mammary
Carpal (wrist)
Vertebral
Abdominal
Umbilical Lumbar
Manus (hand)
Pelvic Pollex Sacral
Inguinal Metacarpal
(groin) Palmar Gluteal
Digital
Perineal (between
Lower limb anus and external
Coxal (hip) genitalia)
Pubic (genital) Femoral (thigh)
Patellar
Popliteal
Crural (leg)
Sural (calf)
Fibular or peroneal

Pedal (foot)
Thorax
Tarsal (ankle)
Abdomen Calcaneal
Back (Dorsum) Metatarsal
Digital
Plantar
Hallux

(a) Anterior/Ventral (b) Posterior/Dorsal

Figure 1.7 Regional terms used to designate specific body areas. (a) The anatomical
position. (b) The heels are raised to show the plantar surface of the foot, which is actually on
the inferior surface of the body.

Anatomical Position and Directional Terms refer to those sides of the person or the cadaver (body of a de-
ceased person) being viewed—not those of the observer.
To describe body parts and position accurately, we need an initial
Directional terms allow us to explain where one body
reference point, and we must indicate direction. The anatomical
structure is in relation to another. For example, we could de-
reference point is a standard body position called the anatomical
scribe the relationship between the ears and the nose infor-
position. In the anatomical position, the body is erect with feet
mally by stating, “The ears are located on each side of the head
slightly apart. This position is easy to remember because it resem-
to the right and left of the nose.” Using anatomical terminol-
bles “standing at attention,” except that the palms face forward
ogy, we can condense this to “The ears are lateral to the nose.”
and the thumbs point away from the body. You can see the
Using anatomical terms saves words and is less ambiguous.
anatomical position in Table 1.1 (top) and Figure 1.7a.
Commonly used orientation and directional terms are
It is essential to understand the anatomical position because
defined and illustrated in Table 1.1. Many of these terms are also
most of the directional terms used in this book refer to the
used in everyday conversation, but keep in mind as you study
body as if it were in this position, regardless of its actual position.
them that their anatomical meanings are very precise.
Another point to remember is that the terms “right” and “left”
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 14

14 U N I T 1 Organization of the Body

Regional Terms the new medical imaging devices (A Closer Look, pp. 18–19)
produce sectional images rather than three-dimensional
The two fundamental divisions of our body are its axial and
images.
appendicular (ap⬙en-dik⬘u-lar) parts. The axial part, which
It takes practice to decipher an object’s overall shape from
makes up the main axis of our body, includes the head, neck,
sectioned material. A cross section of a banana, for example,
and trunk. The appendicular part consists of the ap-
looks like a circle and gives no indication of the whole banana’s
pendages, or limbs, which are attached to the body’s axis.
crescent shape. Likewise, sectioning the body or an organ
Regional terms used to designate specific areas within these
along different planes often results in very different views. For
major body divisions are indicated in Figure 1.7. The figure
example, a transverse section of the body trunk at the level of
also gives the common term for each of these body regions
1 the kidneys would show kidney structure in cross section very
(in parentheses).
nicely. A frontal section of the body trunk would show a dif-
ferent view of kidney anatomy, and a midsagittal section
Anatomical Variability would miss the kidneys completely. With experience, you will
Although we use common directional and regional terms to refer gradually learn to relate two-dimensional sections to three-
to all human bodies, you know from observing the faces and body dimensional shapes.
shapes of people around you that humans differ in their external
C H E C K Y O U R U N D E R S TA N D I N G
anatomy. The same kind of variability holds for internal organs as
well. In some bodies, for example, a nerve or blood vessel may be 12. What is the anatomical position? Why is it important that
somewhat out of place, or a small muscle may be missing. you learn this position?
Nonetheless, well over 90% of all structures present in any human 13. The axillary and acromial regions are both in the general area
body match the textbook descriptions. We seldom see extreme of the shoulder. Where specifically is each located?
anatomical variations because they are incompatible with life. 14. What type of cut would separate the brain into anterior and
posterior parts?
Body Planes and Sections For answers, see Appendix G.
For anatomical studies, the body is often cut, or sectioned, along
a flat surface called a plane. The most frequently used body
planes are sagittal, frontal, and transverse planes, which lie at Body Cavities and Membranes
right angles to one another (Figure 1.8). A section is named for
䉴 Locate and name the major body cavities and their sub-
the plane along which it is cut. Thus, a cut along a sagittal plane
divisions and associated membranes, and list the major
produces a sagittal section.
organs contained within them.
A sagittal plane (saj⬘ı̆-tal; “arrow”) is a vertical plane that di-
vides the body into right and left parts. A sagittal plane that lies 䉴 Name the four quadrants or nine regions of the abdom-
exactly in the midline is the median plane, or midsagittal plane inopelvic cavity and list the organs they contain.
(Figure 1.8c). All other sagittal planes, offset from the midline,
are parasagittal planes (para = near). Anatomy and physiology textbooks typically describe two sets
Frontal planes, like sagittal planes, lie vertically. Frontal of internal body cavities called the dorsal and ventral body cav-
planes, however, divide the body into anterior and posterior ities. These cavities are closed to the outside and provide differ-
parts (Figure 1.8a). A frontal plane is also called a coronal plane ent degrees of protection to the organs contained within them.
(kŏ-ro⬘nal; “crown”). Because these two cavities differ in their mode of embryonic de-
A transverse, or horizontal, plane runs horizontally from velopment, and their lining membranes, the dorsal body cavity
right to left, dividing the body into superior and inferior parts is not recognized as such in many anatomical references. How-
(Figure 1.8b). Of course, many different transverse planes exist, ever, the idea of two sets of internal body cavities is a useful
at every possible level from head to foot. A transverse section is learning concept and we use it here.
also called a cross section.
Oblique sections are cuts made diagonally between the Dorsal Body Cavity
horizontal and the vertical planes. Because oblique sections The dorsal body cavity, which protects the fragile nervous sys-
are often confusing and difficult to interpret, they are sel- tem organs, has two subdivisions (Figure 1.9, gold areas). The
dom used. cranial cavity, in the skull, encases the brain. The vertebral, or
At the bottom of Figure 1.8, you can see examples of mag- spinal, cavity, which runs within the bony vertebral column,
netic resonance imaging (MRI) scans that correspond to the encloses the delicate spinal cord. The spinal cord is essentially a
three different sections shown in the figure. In the clinical continuation of the brain, and the cranial and spinal cavities are
sciences, the ability to interpret sections made through the continuous with one another.
body, especially transverse sections, is important. Additionally,
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 15

Chapter 1 The Human Body: An Orientation 15

Frontal plane

Median (midsagittal) plane


1

Transverse plane

(a) Frontal section (through torso) (b) Transverse section (through torso, inferior view) (c) Median section (midsagittal)

Left and Liver Heart Spleen Liver Spinal cord Aorta Pancreas Spleen Rectum Vertebral Intestines
right lungs column
Stomach Arm Subcutaneous fat layer Body wall

Figure 1.8 Planes of the body with corresponding magnetic resonance imaging
(MRI) scans.
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 16

16 U N I T 1 Organization of the Body

Cranial
Cranial cavity cavity
(contains brain)

Vertebral
cavity

Superior
Dorsal body mediastinum
1 cavity Thoracic
cavity Pleural
(contains cavity
heart and
lungs) Pericardial
cavity within
the mediastinum
Vertebral cavity
(contains spinal Diaphragm Ventral body
cord) cavity
(thoracic and
Abdominal cavity abdominopelvic
(contains digestive Abdomino- cavities)
viscera) pelvic
cavity

Pelvic cavity
(contains urinary
Dorsal body cavity bladder, reproductive
Ventral body cavity organs, and rectum)

(a) Lateral view (b) Anterior view

Figure 1.9 Dorsal and ventral body cavities and their subdivisions.

Ventral Body Cavity


H O M E O S TAT I C I M B A L A N C E
The more anterior and larger of the closed body cavities is the When the body is subjected to physical trauma (as in an auto-
ventral body cavity (Figure 1.9, rust-red areas). Like the dorsal mobile accident), the abdominopelvic organs are most vulnera-
cavity, it has two major subdivisions, the thoracic cavity and the ble. Why? This is because the walls of the abdominal cavity are
abdominopelvic cavity. The ventral body cavity houses internal formed only by trunk muscles and are not reinforced by bone.
organs collectively called the viscera (vis⬘er-ah; viscus = an or- The pelvic organs receive a somewhat greater degree of protec-
gan in a body cavity), or visceral organs. tion from the bony pelvis. ■
The superior subdivision, the thoracic cavity (tho-ras⬘ik),
is surrounded by the ribs and muscles of the chest. The tho- Membranes in the Ventral Body Cavity The walls of the ven-
racic cavity is further subdivided into lateral pleural cavities tral body cavity and the outer surfaces of the organs it contains
(ploo⬘ral), each enveloping a lung, and the medial mediastinum are covered by a thin, double-layered membrane, the serosa
(me⬙de-ah-sti⬘num). The mediastinum contains the pericardial (se-ro⬘sah), or serous membrane. The part of the membrane
cavity (per⬙ı̆-kar⬘de-al), which encloses the heart, and it also lining the cavity walls is called the parietal serosa (pah-ri⬘ĕ-tal;
surrounds the remaining thoracic organs (esophagus, trachea, parie = wall). It folds in on itself to form the visceral serosa,
and others). covering the organs in the cavity.
The thoracic cavity is separated from the more inferior You can visualize the relationship between the serosal layers
abdominopelvic cavity (ab-dom⬘ı̆-no-pel⬘-vic) by the di- by pushing your fist into a limp balloon (Figure 1.10a). The part
aphragm, a dome-shaped muscle important in breathing. The of the balloon that clings to your fist can be compared to the vis-
abdominopelvic cavity, as its name suggests, has two parts. ceral serosa clinging to an organ’s external surface. The outer
However, these regions are not physically separated by a muscu- wall of the balloon then represents the parietal serosa that lines
lar or membrane wall. Its superior portion, the abdominal the walls of the cavity. (However, unlike the balloon, the parietal
cavity, contains the stomach, intestines, spleen, liver, and other serosa is never exposed but is always fused to the cavity wall.) In
organs. The inferior part, the pelvic cavity, lies in the bony the body, the serous membranes are separated not by air but by
pelvis and contains the urinary bladder, some reproductive or- a thin layer of lubricating fluid, called serous fluid, which is
gans, and the rectum. The abdominal and pelvic cavities are not
aligned with each other. Instead, the bowl-shaped pelvis tips
away from the perpendicular.
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 17

Chapter 1 The Human Body: An Orientation 17


Outer balloon wall
(comparable to parietal serosa)

Air (comparable to serous cavity)

Inner balloon wall


(comparable to visceral serosa)

(a) A fist thrust into a flaccid balloon demonstrates


the relationship between the parietal and visceral
serous membrane layers.
1
Right upper Left upper
Heart quadrant quadrant
(RUQ) (LUQ)

Parietal
pericardium Right lower Left lower
quadrant quadrant
(RLQ) (LLQ)
Pericardial
space with
serous fluid

Figure 1.11 The four abdominopelvic quadrants. In this


Visceral
pericardium scheme, the abdominopelvic cavity is divided into four quadrants by
two planes.

Abdominopelvic Regions and Quadrants Because the ab-


dominopelvic cavity is large and contains several organs, it
(b) The serosae associated with the heart.
helps to divide it into smaller areas for study. Medical personnel
usually use a simple scheme to locate the abdominopelvic
Figure 1.10 Serous membrane relationships.
cavity organs (Figure 1.11). In this scheme, a transverse and a
median plane pass through the umbilicus at right angles. The
secreted by both membranes. Although there is a potential four resulting quadrants are named according to their positions
space between the two membranes, the barely present, slitlike from the subject’s point of view: the right upper quadrant
cavity is filled with serous fluid. (RUQ), left upper quadrant (LUQ), right lower quadrant
The slippery serous fluid allows the organs to slide without (RLQ), and left lower quadrant (LLQ). (See Figure 1.12 for
friction across the cavity walls and one another as they carry out organs located in different areas of the abdomen.)
their routine functions. This freedom of movement is especially
important for mobile organs such as the pumping heart and the Another division method, used primarily by anatomists, uses
churning stomach. two transverse and two parasagittal planes. These planes, posi-
The serous membranes are named for the specific cavity and tioned like a tic-tac-toe grid on the abdomen, divide the cavity
organs with which they are associated. For example, as shown in into nine regions (Figure 1.12):
Figure 1.10b, the parietal pericardium lines the pericardial cavity ■ The umbilical region is the centermost region deep to and
and folds back as the visceral pericardium, which covers the surrounding the umbilicus (navel).
heart. Likewise, the parietal pleurae (ploo⬘re) line the walls of ■ The epigastric region is located superior to the umbilical re-
the thoracic cavity, and the visceral pleurae cover the lungs. The gion (epi = upon, above; gastri = belly).
parietal peritoneum (per⬙ı̆-to-ne⬘um) is associated with the ■ The hypogastric (pubic) region is located inferior to the
walls of the abdominopelvic cavity, while the visceral peri- umbilical region (hypo = below).
toneum covers most of the organs within that cavity. (The pleural ■ The right and left iliac, or inguinal, regions (ing⬘gwı̆-nal)
and peritoneal serosae are illustrated in Figure 4.11c on p. 139.) are located lateral to the hypogastric region (iliac = superior
part of the hip bone).
H O M E O S TAT I C I M B A L A N C E ■ The right and left lumbar regions lie lateral to the umbilical
When serous membranes are inflamed, their normally smooth region (lumbus = loin).
surfaces become roughened. This roughness causes the organs
■ The right and left hypochondriac regions lie lateral to the
to stick together and drag across one another, leading to excru- epigastric region (chondro = cartilage).
ciating pain, as anyone who has experienced pleurisy (inflam- (Text continues on p. 20.)
mation of the pleurae) or peritonitis (inflammation of the
peritonea) knows. ■
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 18

18 U N I T 1 Organization of the Body

Medical Imaging: Illuminating the Body


Until 50 years ago, the magical but murky
X ray was the only nonsurgical means to
Right Left
extract information from within a living body.
Produced by directing X rays, electromag-
netic waves of very short wavelength, at the
1 body, an X ray or radiograph is essentially
a shadowy negative image of internal struc-
tures. Dense structures absorb the X rays
most and so appear as light areas. Hollow
air-containing organs and fat, which absorb
the X rays less, show up as dark areas.
What X rays do best is visualize hard, bony
structures and locate abnormally dense
structures (tumors, tuberculosis nodules) in
the lungs.
The 1950s saw the advent of nuclear
medicine, which uses radioisotopes to
scan the body, and ultrasound tech-
niques, which use sound waves. The
1970s brought CT, PET, and MRI scans. Pancreas Left kidney Spleen
Liver Vertebra
These technologies not only reveal the
structure of our “insides” but also wring (a) A CT scan through the superior abdomen.
out information about the hidden workings
of their molecules. volumes at normal speed, in slow motion, brain’s biochemical activity in vivid colors.
Computed tomography (CT, for- and at a specific moment. DSR’s greatest PET’s greatest value has been its ability to
merly called computerized axial tomog- value has been to visualize the heart beat- provide insights into brain activity in peo-
raphy, CAT) uses a refined version of ing and blood flowing through blood ves- ple affected by mental illness, stroke,
X-ray equipment. As the patient is slowly sels. This information allows clinicians to Alzheimer’s disease, and epilepsy. One of
moved through the doughnut-shaped CT evaluate heart defects, constricted or its most exciting uses has been to deter-
machine, its X-ray tube rotates around the blocked blood vessels, and the status of mine which areas of the healthy brain are
body and sends beams from all directions coronary bypass grafts. most active during certain tasks (e.g.,
to a specific level of the patient’s body. Another computer-assisted X-ray tech- speaking, listening to music, or figuring
Because at any moment its beam is con- nique, digital subtraction angiography out a mathematical problem), providing
fined to a “slice” of the body about as (DSA) (angiography = vessel pictures), direct evidence of the functions of specific
thick as a dime, CT ends the confusion provides an unobstructed view of small brain regions. Currently PET can reveal
resulting from overlapping structures seen arteries. Conventional radiographs are signs of trouble in those with undiagnosed
in conventional X rays. The device’s com- taken before and after a contrast medium Alzheimer’s disease (AD) because regions
puter translates this information into a de- is injected into an artery. The computer of beta-amyloid accumulation (a defining
tailed, cross-sectional picture of each subtracts the “before” image from the “af- characteristic of AD) show up in brilliant
body region scanned. CT scans are at the ter” image, eliminating all traces of body red and yellow, as in photo (c). PET scans
forefront for evaluating most problems structures that obscure the vessel. DSA is can also help to predict who may develop
that affect the brain and abdomen. Their often used to identify blockages in the ar- AD in the future by identifying areas of
clarity, illustrated in photo (a), has all but teries that supply the heart wall, as in decreased metabolism in crucial memory
eliminated exploratory surgery. photo (b), and in the brain. areas of the brain.
Xenon CT is a CT brain scan enhanced Just as the X ray spawned related Sonography, or ultrasound imag-
with radioactive xenon gas to quickly trace technologies, so too did nuclear medicine ing, has some distinct advantages over
blood flow. Inhaled xenon rapidly enters the in the form of positron emission to- the approaches examined so far. The
bloodstream and distributes to different mography (PET). PET excels in observ- equipment is inexpensive, and the ultra-
body tissues in proportion to their blood ing metabolic processes. The patient is sound used as its energy source seems to
flow. Absence of xenon from part of the given an injection of radioisotopes tagged be safer than the ionizing forms of radia-
brain indicates that a stroke is occurring to biological molecules (such as glucose) tion used in nuclear medicine. The body
there, information that aids treatment. and is then positioned in the PET scanner. is probed with pulses of sound waves
Dynamic spatial reconstruction As the radioisotopes are absorbed by that cause echoes when reflected and
(DSR) uses ultrafast CT scanners to pro- the most active brain cells, high-energy scattered by body tissues. A computer
vide three-dimensional images of body gamma rays are produced. The computer analyzes these echoes to construct
organs from any angle, and scrutinize their analyzes the gamma-ray emission and somewhat blurry outlines of body organs.
movements and changes in their internal produces a live-action picture of the A single easy-to-use handheld device
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 19

Chapter 1 The Human Body: An Orientation 19

(continued)

Narrowing
of the artery

Artery
supplying
heart

(b) A DSA image of the arteries that supply the heart. (c) In a PET scan, regions of beta-amyloid accumulation “light up”
(red-yellow) in an Alzheimer’s patient (left) but not in a healthy
person (right).

emits the sound and picks up the echoes, zlingly clear in MRI scans. MRI can also inducing MRI present some thorny prob-
so sections can be scanned from many tune in on metabolic reactions, such as lems. For example, they can “suck” metal
different body planes. processes that generate energy-rich ATP objects, such as implanted pacemakers
Because of its safety, ultrasound is the molecules. and loose tooth fillings, through the body.
imaging technique of choice in obstetrics Until recently, trying to diagnose asthma Moreover, although such strong magnetic
for determining fetal age and position and and other lung problems has been off lim- fields are currently considered safe, there
locating the placenta. However, sound its to MRI scans because the lungs have a is no convincing evidence that they are
waves have low penetrating power and low water content. However, an alternate risk free.
rapidly dissipate in air, so sonography is of tack—filling the lungs with a gas that can Although stunning, medical images
little value for looking at air-filled structures be magnetized (hyperpolarized helium-3 other than straight X rays are abstrac-
(the lungs) or those surrounded by bone or xenon-129)—has yielded spectacular tions assembled within the “mind” of a
(the brain and spinal cord). pictures of the lungs in just the few sec- computer. They are artificially enhanced
Magnetic resonance imaging (MRI) onds it takes the patient to inhale, hold for sharpness and artificially colored to
produces high-contrast images of our soft the breath briefly, and then exhale. This increase contrast (all their colors are
tissues, an area in which X rays and CT technique offers a distinct improvement “phony”). The images are several steps
scans are weak. As initially developed, MRI over the hours required for conventional removed from direct observation.
primarily maps the body’s content of hydro- MRI and it has the additional advantage of As you can see, medical science offers
gen, most of which is in water. The tech- using a magnetic field as little as one- remarkable diagnostic tools. Consider the
nique subjects the body to magnetic fields tenth that of the conventional MRI. M2A Swallowable Imaging Capsule, a tiny
up to 60,000 times stronger than that of Newer variations of MRI include mag- camera that a patient swallows like a pill,
the earth to pry information from the body’s netic resonance spectroscopy (MRS), and then excretes normally 8–72 hours
molecules. The patient lies in a chamber which maps the distribution of elements later. As the M2A travels through the di-
within a huge magnet. Hydrogen molecules other than hydrogen to reveal more about gestive tract, it photographs the small
act like tiny magnets, spinning like tops in how disease changes body chemistry. intestine and beams the color images to a
the magnetic field. Their energy is further Other advances in computer techniques Walkman-sized receiver. A study found
enhanced by radio waves, and when the display MRI scans in three dimensions to the device to be 60% effective at detect-
radio waves are turned off, the energy re- guide laser surgery. ing intestinal problems, compared to a
leased is translated into a visual image. The functional MRI tracks blood 35% success rate with other imaging
MRI distinguishes body tissues based flow into the brain in real time. Matching techniques. At present the M2A can
on their water content, so it can differenti- thoughts, deeds, and disease to brain ac- provide images only of the small intestine
ate between the fatty white matter and tivity has been the sole domain of PET. because the battery gives out before it
the more watery gray matter of the brain. Because functional MRI does not require enters the large intestine.
Because dense structures do not show injections of tracers and can pinpoint New imaging technologies also make
up at all in MRI, it peers easily into the much smaller brain areas than PET, it may long-distance surgery possible. Visual
skull and vertebral column, enabling the provide a desirable alternative. Clinical images of a diseased organ travel via
delicate nerve fibers of the spinal cord to studies are also using functional MRI to fiber-optic cable to surgeons at another
be seen. MRI is also particularly good at determine if a patient in the vegetative location (even a different country), who
detecting tumors and degenerative dis- state has conscious thought. manipulate delicate robotic instruments
ease. Multiple sclerosis plaques do not Despite its advantages, the powerful to remove the organ.
show up well in CT scans, but are daz- magnets of the clanging, claustrophobia-
000200010270575674_R1_CH01_p0001-0022.qxd 10/2/2011 06:06 AM Page 20

20 U N I T 1 Organization of the Body

Liver Diaphragm
Right Left
1 hypochondriac Epigastric hypochondriac
region Gallbladder Stomach
region region

Ascending colon of Transverse colon


Right Left of large intestine
Umbilical large intestine
lumbar lumbar
region region region Small intestine Descending colon
of large intestine
Cecum Initial part of
Right iliac Hypogastric Left iliac
(inguinal) (pubic) (inguinal) sigmoid colon
Appendix
region region region
Urinary bladder

(a) Nine regions delineated by four planes (b) Anterior view of the nine regions showing the superficial organs

Figure 1.12 The nine abdominopelvic regions. In (a) the superior transverse plane is just
inferior to the ribs; the inferior transverse plane is just superior to the hip bones; and the
parasagittal planes lie just medial to the nipples.

Other Body Cavities C H E C K Y O U R U N D E R S TA N D I N G

In addition to the large closed body cavities, there are several 15. Joe went to the emergency room where he complained of
smaller body cavities. Most of these are in the head and most severe pains in the lower right quadrant of his abdomen.
open to the body exterior. Figure 1.7 provides the terms that What might be his problem?
will help you locate all but the last two cavities mentioned here. 16. Of the uterus, small intestine, spinal cord, and heart, which
is/are in the dorsal body cavity?
1. Oral and digestive cavities. The oral cavity, commonly
17. When you rub your cold hands together, the friction be-
called the mouth, contains the teeth and tongue. This
tween them results in heat that warms your hands. Why
cavity is part of and continuous with the cavity of the
doesn’t warming friction result during movements of the
digestive organs, which opens to the exterior at the anus.
heart, lungs, and digestive organs?
2. Nasal cavity. Located within and posterior to the nose, the
nasal cavity is part of the respiratory system passageways. For answers, see Appendix G.
3. Orbital cavities. The orbital cavities (orbits) in the
skull house the eyes and present them in an anterior
position.
4. Middle ear cavities. The middle ear cavities in the skull
lie just medial to the eardrums. These cavities contain
tiny bones that transmit sound vibrations to the hearing
receptors in the inner ears.
5. Synovial cavities. Synovial (sı̆-no⬘ve-al) cavities are joint
cavities. They are enclosed within fibrous capsules that
surround freely movable joints of the body (such as the
elbow and knee joints). Like the serous membranes,
membranes lining synovial cavities secrete a lubricating
fluid that reduces friction as the bones move across one
another.