Chapter 1

Major Themes of Anatomy & Physiology

Form and Function
Origins of Biomedical
Science
Scientific Method
Human Origins and
Adaptations
Human Structure
Human Function
Language of Medicine

Anatomy - The Study of Form

Observation of surface structure
Cadaver dissection is cutting & separation of
organs to study their relationships
Comparative anatomy is the study of more than
one species to analyze evolutionary trends
Physical examination
palpation, auscultation, percussion

Gross anatomy is what is visible with naked eye

Histology is examination of cells/tissues with
microscope

Gross Anatomy
Human Cadaver
Intermediate
dissection of the
abdomen.

Histology
Four Primary Tissue Types: CMEN

Connective
Muscular
Epithelial
Nervous

Epithelial Tissue

Connective Tissue

Muscular Tissue

Nervous Tissue

Histology: Kidney

Histology: Skin

Physiology - The Study of Function

Study of bodily functions by use of methods of
experimental science
Comparative physiology involves the study of
different species
Basis for the development of new drugs and
medical procedures

Beginnings of Medicine
Physicians in Mesopotamia & Egypt 3000 years
ago used herbal drugs, salts & physical therapy
A lot of good it did this guy!
His penis was overlooked until
1996earning the title of
Princess.
The "princess" was probably a 5' 9"
tall temple priest who was
approximately 40 years old when
he died.

Beginnings of Medicine
Greek physician Hippocrates established a code of ethics
& urged physicians to seek causes of disease
Aristotle called causes for disease physiologi & said that
complex structures are built from simpler parts
Galen, physician to the Roman gladiators, saw science as a
method of discovery.
did animal dissections since use of cadavers banned
wrote book advising followers to trust their own observation

Four Humors (4 Secretions): Illness resulted from an

over production or under production of humors
400 BC 1800 AD
Phlematic

Choleric

Water
Brain/Lungs
Cold/Moist
Winter/Water
calm, unemotional

Yellow Bile
Gall Bladder
Warm/Dry
Summer/Fire
easily angered, bad
tempered

Sanguine

Melancholic

Blood
Liver
Warm/Moist
Spring/Air
courageous,
hopeful, amorous

Black Bile
Spleen
Cold/Dry
Autumn/Earth
despondent,
sleepless, irritable

Birth of Modern Medicine

Little advancement during the Middle
ages since medicine was taught as
dogma with no new ideas
Avicenna from Muslim world
supported free inquiry over authority
wrote The Canon of Medicine, used in
medical schools until 16th century

Vesalius published accurate gross

anatomy atlas (1543)
Harvey realized blood flows out
from heart & back to it in 1628

Birth of Modern Medicine

Leeuwenhoek invented microscope to look at
fabrics (1632-1723)
Hooke (1665) and Zeiss (1860) developed &
improved compound microscope (described plant
cell walls in 1665)
Schleiden & Schwann thought that all
organisms were composed of cells -- cell theory
of 1839

Birth of Modern Medicine

Clinical practice was in dismal state
bleeding patients to remove toxins, operate with dirty
hands, no anesthesia for amputations
Ignaz Philipp Semmelweis (1818 1865)
Hungarian physician described as the "savior
of mothers", who discovered by 1847 that
the incidence of puerperal fever could be
drastically cut by the use of hand
disinfection (by means of hand washing with
chlorinated lime solution) in obstetrical
clinics. (Vienna General Hospital)
http://en.wikipedia.org/wiki/Ignaz_Semmelweis

Blood Letting:
1860
It was popular to do it in the
spring to prevent disease.
In 1835, a French physician
used medical statistics to
prove that the technique
didnt work
Few listened

Smolan, R., Moffitt, P., Medicines Great Journey, One Hundred Years of Healing, Little, Brown and Co, 1992, p 40.

Living in a Revolution
Pioneers in 19th & 20th centuries
established scientific way of thinking
replaced superstition (four humors) with natural laws
momentous discoveries
germ theory of disease
heredity & structure of DNA

Now at threshold of modern biomedical science

technology enhanced diagnostic ability & life-support strategies
genetic revolution --library of the molecular structure of every
human gene is finished

Gene therapy being used to treat disease

Human Structure
Hierarchy of complexity
organism is composed of
organ systems
organ systems composed
of organs
organs composed of tissues
tissues composed of cells
organelles composed of
molecules
molecules composed of
atoms

Anatomical Variation
No 2 humans are exactly alike
Missing organs
palmaris longus or plantaris muscles

More or less organs than normal

2 spleens, single kidney, 6 or 4 lumbar vertebrae

Variation in organ locations (situs inversus,

dextrocardia, situs perversus)

Human Function
Characteristics of life

organization
cellular composition
excretion
metabolism
responsiveness and movement
homeostasis
development (growth or differentiation)
reproduction
evolution

Clinical death is no brain waves for 24 hours

Physiological Variation
Differs with sex, age, diet, weight, degree of
physical activity
Typical human values
reference man
22 years old, 154 lbs, light physical activity
2800 kcal/day

reference woman
same as man except 128 lbs and 2000 kcal/day

METABOLIC and HORMONAL DIFFERENCES:

Example Human Chorionic Gonadotropin in Urine Samples

Homeostasis
Hippocrates noted that body normally returns
to a state of equilibrium by itself
needs to detect the change & oppose it

Walter Cannon (1871-1945) coined the term

homeostasis indicating stable internal
environment

Internal environment described as dynamic

equilibrium
fluctuates within a range around a certain set

point

Loss of homeostatic control causes illness or

death

Hippocrates
Father of Medicine
460 370 BC

Homeostasis
Mechanism:
Receptor
Integrator
Effector

Terms:
Set Point
Negative Feedback
Positive Feedback

Negative Feedback Loops

Mechanism to keep a variable close to its set
point
Body senses a change & activates mechanisms
to reverse it

Set at 68

Negative Feedback, Set Point

Room temperature does not stay at set point of 68

degrees -- it only averages 68 degrees

Human Thermoregulation

Blood temperature sensing nerve cells in base of brain

control shivering, sweating & vasomotor activity
vasodilation with heat & vasoconstriction with cold

Evaporation of water & heat radiation occur

Control of Blood Pressure

Rise in blood pressure detected
stretch receptors in wall of heart and major
arteriesRECEPTOR
Nerve signals travel to cardiac center in
brainstemINTEGRATOR CONTROL CENTER
Nerve signals slow heart (and vasodialate blood
vessels) and lower blood pressureEFFECTOR

Homeostasis: Blood Pressure

Negative Feedback
Mechanisms

Receptor

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Control Center

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Structures Needed for Feedback Loop

Receptor = structure that senses change
stretch receptors (Baroreceptor) in heart & large blood
vessels send information of an elevated BP to
integrator

Integrator = control center

cardiac center in brainstem (medulla oblongata) that
signals heart to slow

Effector = structures that carry out commands of

the control center
heart slows and BP decreases
sweating begins and evaporation cools the body

Positive Feedback Loops

Physiological change that leads to an even greater change in
the same direction (self-amplifying)
Normal way of producing rapid changes
birth, blood clotting, protein digestion, generation of nerve signals

Hyperthermia
Life-Threatening Fever

If temperature rises above 108 degrees due to

bacterial infection
metabolic rate
increases causing
body to produce
heat faster still

Temperature
increases &
cycle repeats
Fatal at 113
degrees

Review of Major Themes

Unifying principles behind all aspects of human
anatomy and physiology
cell theory: all structure & function result from the
activity of cells. Cells are the basic unit of structure in
every living thing.
homeostasis: maintaining stable conditions within the
body. Important in adjusting to environmental insults
and changes.
hierarchy of structure: levels of complexity
unity of form and function: physiology can not be
separated from anatomy

Medical Imaging
Radiography
x-rays discovered (William Roentgen) in 1885
penetrate soft tissues & darken photographic
film on other side of the body
dense tissue (bone, teeth and tumors) are not
penetrated so photographic film remains white
radiopaque substances can be either injected
(angiography) or swallowed for examination
of the gastrointestinal tract

Sonography
high-frequency ultrasound waves echoes back
from internal organs
obstetrics uses to locate placenta, evaluate fetal
age, position and development

Radiograph: AP Chest

Radiograph: AP Chest

Medical Imaging
Computed Tomography (CT scan)
low-intensity X rays applied to the body
computer analysis produces an image of a slice
of the body about as thin as a coin
tumors, aneurysms, hemorrhages, kidney
stones, etc (http://online.wsj.com/article/SB126082398582691047.html)

Magnetic Resonance Imaging (MRI)

magnetic field aligns hydrogen atoms; radio
waves realign the atoms; when radio is turned
off the atoms give off energy depending on tissue
type
computer analysis produces a slice type image
better for soft tissue analysis than CT

Medical Imaging
Positron Emission Tomography (PET scan)
assesses the metabolic state of a tissue
injection of radioactively labeled glucose emits
positrons (a positive particle of equal mass of an
electron).
colliding positrons & electrons
give off gamma rays that are
analyzed by computer
color image of glucose usage at
that moment
extent of damaged heart tissue
activity of brain of neurology patients