CHAPTER OBJECTIVES

After studying this chapter, you will be able to:

●​ Distinguish between anatomy and physiology, and identify several branches

of each
●​ Describe the structure of the body, from simplest to most complex, in terms of
the six levels of organization
●​ Identify the functional characteristics of human life
●​ Identify the four requirements for human survival
●​ Define homeostasis and explain its importance to normal human functioning
●​ Use appropriate anatomical terminology to identify key body structures, body
regions, and directions in the body
●​ Compare and contrast at least four medical imaging techniques in terms of
their function and use in medicine

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 their
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 ANATOMYA AND PHYSIOLOGY

By the end of this section, you will be able to:

●​ Compare and contrast anatomy and physiology, including their specializations

and methods of study
●​ Discuss the fundamental relationship between anatomy and physiology
Human anatomy is 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 anatomy
is the study of the larger structures of the body, those visible without the aid of
magnification (Figure 1.2 a). Macro- means “large,” thus, gross anatomy is also
referred to as macroscopic anatomy. In contrast, micro- means “small,” and
microscopic anatomy is the study of structures that can be observed only with the
use of a microscope or other magnification devices (Figure 1.2 b). 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.

Figure 1.2 Gross and Microscopic Anatomy (a) Gross anatomy considers large
structures such as the brain. (b) Microscopic anatomy can deal with the same
structures, though at a different scale. This is a micrograph of nerve cells from the
brain. LM × 1600. (credit a: University of Wisconsin and Michigan State Comparative
Mammalian Brain Collections/BrainMuseum.org; credit b: Micrograph provided by
the Regents of University of Michigan Medical School © 2012)

Anatomists take two general approaches to the study of the body’s structures:
regional and systemic. Regional anatomy is 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 anatomy is 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

physiology is 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.Homeostasis is 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
BODY

By the end of this section, you will be able to:

●​ Describe the structure of the human body in terms of six levels of organization
●​ List the eleven organ systems of the human body and identify at least one
organ and one major function of each

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).
Figure 1.3 Levels of Structural Organization of the Human Body The
organization of the body often is discussed in terms of six distinct levels of increasing
complexity, from the smallest chemical building blocks to a unique human organism.

The Levels of Organization

To 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 cell is 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
tissue is a group of many similar cells (though sometimes composed of a few
related types) that work together to perform a specific function. An organ is 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 system
is 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.

In this book and throughout your studies of biological sciences, you will often read
descriptions related to similarities and differences among biological structures,
processes, and health related to a person's biological sex. People often use the
words "female" and "male" to describe two different concepts: our sense of gender
identity, and our biological sex as determined by our chromosomes, hormones,
organs, and other physical characteristics. For some people, gender identity is
different from biological sex or their sex assigned at birth. Throughout this book,
"female" and "male" refer to sex only, and the typical anatomy and physiology of XX
and XY individuals is discussed.
Figure 1.4 Organ Systems of the Human Body Organs that work together are
grouped into organ systems.
Figure 1.5 Organ Systems of the Human Body (continued) Organs that work
together are grouped into organ systems.

The organism level is the highest level of organization. An organism is 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 LIFE

By the end of this section, you will be able to:

●​ Explain the importance of organization to the function of the human organism

●​ Distinguish between metabolism, anabolism, and catabolism
●​ Provide at least two examples of human responsiveness and human
movement
●​ Compare and contrast growth, differentiation, and reproduction

The different organ systems each have different functions and therefore unique roles
to perform in physiology. These many functions can be summarized in terms of a few
that we might consider definitive of human life: organization, metabolism,
responsiveness, movement, development, and reproduction.

Organization
A human body consists of trillions of cells organized in a way that maintains distinct
internal compartments. These compartments keep body cells separated from
external environmental threats and keep the cells moist and nourished. They also
separate internal body fluids from the countless microorganisms that grow on body
surfaces, including the lining of certain passageways that connect to the outer
surface of the body. The intestinal tract, for example, is home to more bacterial cells
than the total of all human cells in the body, yet these bacteria are outside the body
and cannot be allowed to circulate freely inside the body.

Cells, for example, have a cell membrane (also referred to as the plasma
membrane) that keeps the intracellular environment—the fluids and
organelles—separate from the extracellular environment. Blood vessels keep blood
inside a closed circulatory system, and nerves and muscles are wrapped in
connective tissue sheaths that separate them from surrounding structures. In the
chest and abdomen, a variety of internal membranes keep major organs such as the
lungs, heart, and kidneys separate from others.

The body’s largest organ system is the integumentary system, which includes the
skin and its associated structures, such as hair and nails. The surface tissue of skin
is a barrier that protects internal structures and fluids from potentially harmful
microorganisms and other toxins.
Metabolism
The first law of thermodynamics holds that energy can neither be created nor
destroyed—it can only change form. Your basic function as an organism is to
consume (ingest) energy and molecules in the foods you eat, convert some of it into
fuel for movement, sustain your body functions, and build and maintain your body
structures. There are two types of reactions that accomplish this: anabolism and
catabolism.

●​ Anabolism is the process whereby smaller, simpler molecules are combined

into larger, more complex substances. Your body can assemble, by utilizing
energy, the complex chemicals it needs by combining small molecules derived
from the foods you eat
●​ Catabolism is the process by which larger more complex substances are
broken down into smaller simpler molecules. Catabolism releases energy. The
complex molecules found in foods are broken down so the body can use their
parts to assemble the structures and substances needed for life.

Taken together, these two processes are called metabolism. Metabolism is 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.

Figure 1.6 Metabolism Anabolic reactions are building reactions, and they consume
energy. Catabolic reactions break materials down and release energy. Metabolism
includes both anabolic and catabolic reactions.

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.
INTERACTIVE LINK
View this video to learn more about metabolic processes. Which organs of the body
likely carry out anabolic processes? What about catabolic processes?

Responsiveness
Responsiveness is 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.

Movement
Human 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.
Figure 1.7 Marathon Runners Runners demonstrate two characteristics of living
humans—responsiveness and movement. Anatomic structures and physiological
processes allow runners to coordinate the action of muscle groups and sweat in
response to rising internal body temperature. (credit: Phil Roeder/flickr)

Development, growth and reproduction

Development is 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.

Growth is 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.

Reproduction is 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 LIFE

Learning Objectives
By the end of this section, you will be able to:

●​ Discuss the role of oxygen and nutrients in maintaining human survival

●​ Explain why extreme heat and extreme cold threaten human survival
●​ Explain how the pressure exerted by gases and fluids influences human
survival

Humans have been acclimating 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.
Oxygen
Atmospheric 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.

Nutrients
A nutrient is 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 Temperature

You 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.

Figure 1.8 Extreme Heat Humans acclimate to some degree to repeated exposure
to high temperatures. (credit: McKay Savage/flickr)

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

Pressure is 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).

Figure 1.9 Harsh Conditions Climbers on Mount Everest must accommodate

extreme cold, low oxygen levels, and low barometric pressure in an environment
hostile to human life. (credit: Melanie Ko/flickr)

HOMEOSTATIC IMBALANCES
Decompression Sickness

Decompression 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 HOMEOSTASIS

Learning Objectives
By the end of this section, you will be able to:

●​ Discuss the role of homeostasis in healthy functioning

●​ Contrast negative and positive feedback, giving one physiologic example of
each mechanism

Maintaining homeostasis requires that the body continuously monitor its internal
conditions. From body temperature to blood pressure to levels of certain nutrients,
each physiological condition has a particular set point. A set point is the
physiological value around which the normal range fluctuates. A normal range is the
restricted set of values that is optimally healthful and stable. For example, the set
point for normal human body temperature is approximately 37°C (98.6°F)
Physiological parameters, such as body temperature and blood pressure, tend to
fluctuate within a normal range a few degrees above and below that point. Control
centers in the brain and other parts of the body monitor and react to deviations from
homeostasis using negative feedback. Negative feedbackis a mechanism that
reverses a deviation from the set point. Therefore, negative feedback maintains body
parameters within their normal range. The maintenance of homeostasis by negative
feedback goes on throughout the body at all times, and an understanding of negative
feedback is thus fundamental to an understanding of human physiology.

Negative Feedback
A negative feedback system has three basic components (Figure 1.10a). A sensor,
also referred to a receptor, is a component of a feedback system that monitors a
physiological value. This value is reported to the control center. The control center
is the component in a feedback system that compares the value to the normal range.
If the value deviates too much from the set point, then the control center activates an
effector. An effector is the component in a feedback system that causes a change to
reverse the situation and return the value to the normal range.

Figure 1.10 Negative Feedback System In a negative feedback system, a

stimulus—a deviation from a set point—is resisted through a physiological process
that returns the body to homeostasis. (a) A negative feedback system has five basic
parts. (b) Body temperature is regulated by negative feedback.
In order to set the system in motion, a stimulus must drive a physiological parameter
beyond its normal range (that is, beyond homeostasis). This stimulus is “heard” by a
specific sensor. For example, in the control of blood glucose, specific endocrine cells
in the pancreas detect excess glucose (the stimulus) in the bloodstream. These
pancreatic beta cells respond to the increased level of blood glucose by releasing
the hormone insulin into the bloodstream. The insulin signals skeletal muscle fibers,
fat cells (adipocytes), and liver cells to take up the excess glucose, removing it from
the bloodstream. As glucose concentration in the bloodstream drops, the decrease in
concentration—the actual negative feedback—is detected by pancreatic alpha cells,
and insulin release stops. This prevents blood sugar levels from continuing to drop
below the normal range.

Humans have a similar temperature regulation feedback system that works by

promoting either heat loss or heat gain (Figure 1.10b). When the brain’s temperature
regulation center receives data from the sensors indicating that the body’s
temperature exceeds its normal range, it stimulates a cluster of brain cells referred to
as the “heat-loss center.” This stimulation has three major effects:

●​ Blood vessels in the skin begin to dilate allowing more blood from the body
core to flow to the surface of the skin allowing the heat to radiate into the
environment.
●​ As blood flow to the skin increases, sweat glands are activated to increase
their output. As the sweat evaporates from the skin surface into the
surrounding air, it takes heat with it.
●​ The depth of respiration increases, and a person may breathe through an
open mouth instead of through the nasal passageways. This further increases
heat loss from the lungs.

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.
INTERACTIVE LINK
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 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 feedback intensifies 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 a person’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 a person giving birth
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).

Figure 1.11 Positive Feedback Loop Normal childbirth is driven by a positive

feedback loop. A positive feedback loop results in a change in the body’s status,
rather than a return to homeostasis.

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 TERMINOLOGY

Learning Objectives
By the end of this section, you will be able to:

●​ Demonstrate the anatomical position

●​ Describe the human body using directional and regional terms
●​ Identify three planes most commonly used in the study of anatomy
●​ Distinguish between the posterior (dorsal) and the anterior (ventral) body
cavities, identifying their subdivisions and representative organs found in each
●​ Describe serous membrane and explain its function

Anatomists and health care providers use terminology that can be bewildering to the
uninitiated. However, the purpose of this language is not to confuse, but rather to
increase precision and reduce medical errors. For example, is a scar “above the
wrist” located on the forearm two or three inches away from the hand? Or is it at the
base of the hand? Is it on the palm-side or back-side? By using precise anatomical
terminology, we eliminate ambiguity. Anatomical terms derive from ancient Greek
and Latin words. Because these languages are no longer used in everyday
conversation, the meaning of their words does not change.

Anatomical terms are made up of roots, prefixes, and suffixes. The root of a term
often refers to an organ, tissue, or condition, whereas the prefix or suffix often
describes the root. For example, in the disorder hypertension, the prefix “hyper-”
means “high” or “over,” and the root word “tension” refers to pressure, so the word
“hypertension” refers to abnormally high blood pressure.

Anatomical Position
To further increase precision, anatomists standardize the way in which they view the
body. Just as maps are normally oriented with north at the top, the standard body
“map,” or anatomical position, is that of the body standing upright, with the feet at
shoulder width and parallel, toes forward. The upper limbs are held out to each side,
and the palms of the hands face forward as illustrated in Figure 1.12. Using this
standard position reduces confusion. It does not matter how the body being
described is oriented, the terms are used as if it is in anatomical position. For
example, a scar in the “anterior (front) carpal (wrist) region” would be present on the
palm side of the wrist. The term “anterior” would be used even if the hand were palm
down on a table.

Figure 1.12 Regions of the Human Body The human body is shown in anatomical
position in an (a) anterior view and a (b) posterior view. The regions of the body are
labeled in boldface.
A body that is lying down is described as either prone or supine. Prone describes a
face-down orientation, and supine describes a face up orientation. These terms are
sometimes used in describing the position of the body during specific physical
examinations or surgical procedures.

Regional Terms
The human body’s numerous regions have specific terms to help increase precision
(see Figure 1.12). Notice that the term “brachium” or “arm” is reserved for the “upper
arm” and “antebrachium” or “forearm” is used rather than “lower arm.” Similarly,
“femur” or “thigh” is correct, and “leg” or “crus” is reserved for the portion of the lower
limb between the knee and the ankle. You will be able to describe the body’s regions
using the terms from the figure.

Directional Terms
Certain directional anatomical terms appear throughout this and any other anatomy
textbook (Figure 1.13). These terms are essential for describing the relative locations
of different body structures. For instance, an anatomist might describe one band of
tissue as “inferior to” another or a physician might describe a tumor as “superficial to”
a deeper body structure. Commit these terms to memory to avoid confusion when
you are studying or describing the locations of particular body parts.

●​ Anterior (or ventral) Describes the front or direction toward the front of the
body. The toes are anterior to the foot.
●​ Posterior (or dorsal) Describes the back or direction toward the back of the
body. The popliteus is posterior to the patella.
●​ Superior (or cranial) describes a position above or higher than another part
of the body proper. The orbits are superior to the oris.
●​ Inferior (or caudal) describes a position below or lower than another part of
the body proper; near or toward the tail (in humans, the coccyx, or lowest part
of the spinal column). The pelvis is inferior to the abdomen.
●​ Lateral describes the side or direction toward the side of the body. The thumb
(pollex) is lateral to the digits.
●​ Medial describes the middle or direction toward the middle of the body. The
hallux is the medial toe.
●​ Proximal describes a position in a limb that is nearer to the point of
attachment or the trunk of the body. The brachium is proximal to the
antebrachium.
●​ Distal describes a position in a limb that is farther from the point of
attachment or the trunk of the body. The crus is distal to the femur.
●​ Superficial describes a position closer to the surface of the body. The skin is
superficial to the bones.
 ●​ Deep describes a position farther from the surface of the body. The brain is
deep to the skull.

Figure 1.13 Directional Terms Applied to the Human Body Paired directional
terms are shown as applied to the human body.

Body Planes
A section is a two-dimensional surface of a three-dimensional structure that has
been cut. Modern medical imaging devices enable clinicians to obtain “virtual
sections” of living bodies. We call these scans. Body sections and scans can be
correctly interpreted, however, only if the viewer understands the plane along which
the section was made. A plane is an imaginary two-dimensional surface that passes
through the body. There are three planes commonly referred to in anatomy and
medicine, as illustrated in Figure 1.14.

●​ The sagittal plane is the plane that divides the body or an organ vertically
into right and left sides. If this vertical plane runs directly down the middle of
the body, it is called the midsagittal or median plane. If it divides the body into
unequal right and left sides, it is called a parasagittal plane or less commonly
a longitudinal section.
 ●​ The frontal plane is the plane that divides the body or an organ into an
anterior (front) portion and a posterior (rear) portion. The frontal plane is often
referred to as a coronal plane. (“Corona” is Latin for “crown.”)
●​ The transverse plane is the plane that divides the body or organ horizontally
into upper and lower portions. Transverse planes produce images referred to
as cross sections.

Figure 1.14 Planes of the Body The three planes most commonly used in
anatomical and medical imaging are the sagittal, frontal (or coronal), and transverse
plane.

Body Cavities and Serous Membranes

The body maintains its internal organization by means of membranes, sheaths, and
other structures that separate compartments. The dorsal (posterior) cavity and the
ventral (anterior) cavity are 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.
Figure 1.15 Dorsal and Ventral Body Cavities The ventral cavity includes the
thoracic and abdominopelvic cavities and their subdivisions. The dorsal cavity
includes the cranial and spinal cavities.

Subdivisions of the Posterior (Dorsal) and Anterior (Ventral)

Cavities

The posterior (dorsal) and anterior (ventral) cavities are each subdivided into smaller
cavities. In the posterior (dorsal) cavity, the cranial cavity houses 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 cavity is 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 cavity is 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 Quadrants

To 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).

Figure 1.16 Regions and Quadrants of the Peritoneal Cavity There are (a) nine
abdominal regions and (b) four abdominal quadrants in the peritoneal cavity.

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 Cavity

A 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).
Figure 1.17 Serous Membrane Serous membrane lines the pericardial cavity and
reflects back to cover the heart—much the same way that an underinflated balloon
would form two layers surrounding a fist.

There are three serous cavities and their associated membranes. The pleura is the
serous membrane that encloses the pleural cavity; the pleural cavity surrounds the
lungs. The pericardium is the serous membrane that encloses the pericardial cavity;
the pericardial cavity surrounds the heart. The peritoneum is the serous membrane
that encloses the peritoneal cavity; the peritoneal cavity 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 IMAGING - ANATOMY AND

PHYSIOLOGY

Learning Objectives
By the end of this section, you will be able to:

●​ Discuss the uses and drawbacks of X-ray imaging

●​ Identify four modern medical imaging techniques and how they are used

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-Rays
German 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-ray is 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.
Figure 1.18 X-Ray of a Hand High energy electromagnetic radiation allows the
internal structures of the body, such as bones, to be seen in X-rays like these.
(credit: Trace Meek/flickr)

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 Imaging

X-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 Tomography

Tomography 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.”
Figure 1.19 Medical Imaging Techniques (a) The results of a CT scan of the head
are shown as successive transverse sections. (b) An MRI machine generates a
magnetic field around a patient. (c) PET scans use radiopharmaceuticals to create
images of active blood flow and physiologic activity of the organ or organs being
targeted. (d) Ultrasound technology is used to monitor pregnancies because it is the
least invasive of imaging techniques and uses no electromagnetic radiation. (credit
a: Akira Ohgaki/flickr; credit b: “Digital Cate”/flickr; credit c: “Raziel”/Wikimedia
Commons; credit d: “Isis”/Wikimedia Commons)

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.
INTERACTIVE LINK
A CT or CAT scan relies on a circling scanner that revolves around the patient’s
body. Watch this video 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.
INTERACTIVE LINK
A patient undergoing an MRI is surrounded by a tube-shaped scanner. Watch this
video 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.
INTERACTIVE LINK
PET relies on radioactive substances administered several minutes before the scan.
Watch this video to learn more about PET. How is PET used in chemotherapy?

Ultrasonography

Ultrasonography is 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.