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AnatomyModule

1INTRO

&

TERMSCELLEPITHELIUMCONNECTIVE

TISSUEMUSCLENERVOUS

SYSTEMAXIAL

SKELETONAPPENDICULAR

SKELETONMUSCLESEMBRYOLOGY1才智在線淘寶PARAMEDICAL

ANATOMYThe

topics

start

with

general

ideas

about

body

systems,terms

used

in

describing

the

structures

of

the

body

-

wherethey

are,

how

they

lie,

their

subdivisions,

their

blood

andnerve

supply,

etc;

the

tissues

and

cell

types

making

uporgans;

&

the

structure

and

workings

of

cells.Then,

we

look

at

individual

systems

of

the

body,

e.g.,

muscurespiratory,

etc.There

is

another

way

of

looking

at

the

body,

namely

to

take

aREGION

and

describe

what

structures

are

present

there

andclosely

connected

in

a

physical

sense,

although

they

belongto

several

systems.

Thus,

the

chest

wall

is

musculo-skeletaand

covered

with

skin.

Inside

the

chest

are

parts

ofrespiratory,

cardiovascular,

and

digestive

SYSTEMS

-

lungs&

trachea,

heart

and

vessels,

esophagusW

Beresford2Without

thinking

much

about

it,you

will

acquire

bothunderstandings

of

the

bod才y智-在s線y淘s寶temic

and

regionalANATOMY:

What

is

the

point?Anatomy

is

just

one

way

of

looking

at

the

living

person

usedby

all

members

of

the

medical

team.

What

they

want

to

knowis

what

went

wrong

in

this

patient,

what

is

still

working

weland

how

to

correct

the

problem

without

doing

more

damage.Humans

are

complex

large

mammals

with

several

systemsfor

getting

their

energy

and

distributing

it,

getting

rid

ofproducts,

moving

around

and

manipulating

things

in

theirsurroundings,

detecting

threats

and

change

and

adapting

tothem,

keeping

the

body

working

at

about

the

same

level

andtemperature,

keeping

nasties

outside

the

body

and

dealingwith

ones

that

have

entered,

and

reproducing

themselves.These

systems

take

the

form

of

connected

structures

packed

itightly

in

one

body.

More

than

one

system

can

be

at

a

particul

place,

and

some

are

spread

out

widely

in

many

places.才智在線淘寶

3ANATOMY

&

SYSTEMSHumans

are

complex

large

mammals

with

several

SYSTEMSfor:things

in

their

surroundingsdetecting

threats

and

changeand

adapting

to

themkeeping

the

body

working

at

aboutthe

same

level

and

temperaturekeeping

nasties

outside

the

bodyAlimentary/digestivegetting

their

energy

and

distributing

Viatscular

Respiratorygetting

rid

of

waste

products

Urinary

Respiratory

Digestimoving

around

and

manipulatingMusculo-skeletalNervous/SensoryNervous

&

EndocrineSkinand

dealing

with

ones

that

have

enteredBlood

&

LymphoidReproductive

4and

reproducing

themselves才.智在線淘寶things

in

their

surroundingsdetecting

threats

and

changeand

adapting

to

themkeeping

the

body

working

at

aboutthe

same

level

and

temperaturekeeping

nasties

outside

the

bodygetting

rid

of

waste

products

Urinary

Respiratory

Digestimoving

around

and

manipulatingMusculo-skeletalNervous/SensoryNervous

&

EndocrineSkinand

dealing

with

ones

that

have

enteredBlood

&

LymphoidANATOMY

&

SYSTEMS:

Book

RefsThe

systems

and

their

organs

are

shown

well

on

pp.

5,6

ofMarieb,

and

Figs

1-5

through

1-12

(pp.

8-10)

of

GuyAlimentary/digestivegetting

their

energy

and

distributingViatscular

RespiratoryReproductive

5and

reproducing

themselve才s智.在線淘寶ANATOMY:

What

is

the

point?When

things

go

wrong

and

the

patient

probably

has

signsand

symptoms,

we

think

of

the

primary

place

&

structuresinvolved

and

the

system

affected,

and

then

the

secondaryeffects.

Physiologists

and

internists

are

more

concerned

wthe

systems

and

repercussions;

anatomists,

pathologists

anradiologists

pay

rather

more

attention

to

the

place

-

what

wthe

normal

structure,

what

has

changed,

how

is

it

causingbad

effects.

But

the

two

kinds

of

knowledge

interact.Thus,

the

internal-medicine

doc

knows

the

cell

behavior

andbiochemistry

of

how

blood

clots,

and

why

this

is

more

likelysome

people;

while

the

anatomist

can

partly

explain

why

clotform

in

the

veins

of

resting

legs,

and

why

any

clot

dislodgedin

the

leg

is

likely

to

block

vessels

in

the

lung

-

a

pulmonarembolism.

The

nurse

needs

to

have

an

idea

of

both

aspects,and

what

to

recommend

to

the

bed-ridden

patient

or

the

long-haul

traveller.才智在線淘寶

6ANATOMY

AS

STRUCTURESThese

systems

take

the

form

of

connected

structures

packed

itightly

in

one

body.

More

than

one

system

can

be

at

a

particu

place,

and

some

are

spread

out

widely

in

many

places.Skin,

for

example:

helps

maintain

body

temperature;

protectagainst

microorganisms

and

water

loss;

provides

touch,

andsensory

feedback

to

control

movement;

in

places,

skin

actsas

a

tight

jacket

to

enclose

soft

tissues,

such

as

muscle.So

while

we

describe

what

the

structures

are

at

particularplace,

we’ll

keep

in

mind

a

few

aspects

of

how

thestructures

are

participating

in

the

various

systems.And

while

we

describe

what

the

structures

are

of

a

particulasystem,

we’ll

keep

in

mind

aspects

of

other

structures

atthose

sites

in

the

body.才智在線淘寶

7ANATOMICAL

NAMES

IDescriptions

in

anatomy

aim

at

a

distinctive

name

for

eachstructure,

and

one

that

is

precise

so

that

everyone

agrees

owhich

thing

is

under

discussion,

e.g.,

to

be

treatedSome

names

seem

to

be

straightforward

-

just

one

word(often

derived

from

the

Latin

or

Greek),

e.g.,

patella

for

tkneecap.

But

hold

on!

There

are

two,

so

that

we

need

anadjective

specifying

right

or

left.In

practice,

the

adjectives

tend

to

pile

up

for

a

precise

namFor

example,

the

left,

posterior,

tibial

arteryNo

different

from

a

full

address

to

get

your

mail

to

arrive

ayour

door:

Apt

4,

326

Marquis

Ave,

TRENTON,

NJ

16235Also,

we

need

to

retain

the

layman’s

name

to

help

inexplaining

to

the

patient

or

a

relative.才智在線淘寶8ANATOMICAL

NAMES

IISome

names

seem

to

be

straightforward

-

just

one

word

(oftenderived

from

the

Latin

or

Greek),

e.g.,

patella

for

the

kneecap.

Buhold

on!

There

are

two,

so

that

we

need

an

adjective

specifyingright

or

left.In

practice,

the

adjectives

tend

to

pile

up

for

a

precise

name.

Forexample,

the

left,

posterior,

tibial

arteryAnother

form

of

anatomical

name

is

to

say‘The

something

of

somewhere’,

as

for

humannames,

such

as

Rufus

of

EphesusExamples

are

the

muscles

Biceps

brachii

(ofthe

arm)

versus

Biceps

femoris

(of

the

femurbone

in

the

thigh&

further

specified

as

Right

or

Left才智在線淘寶9THE

ANATOMICAL

POSITIONThe

dead

(dissecting-table)

anatomicalposition

has

the

person

lying

flat

on

herback,

arms

by

the

sides,

palms

facingThe

adjectives

in

many

names

fix

thestructure

or

part

of

a

structure

inrelation

to

an

agreed

standardorientation

of

the

body,

extending

to

anorgan’s

relation

to

adjacent

structuresAnatomicalposition

-aliveupwards

-

think

‘taking

the

rays’

-

whicalso

has

the

thumbs

sticking

outwardsAnatomical

position

-

deadWe’ll

now

apply

anatomi智ca線l

t寶erms

and

(layman’sMEDIAL

&

LATERALThumb

pointsLaterally

(Outwards)Little

finger

liesMedially

(Towards

the

midline)MEDIAN11(Midlin才e)智在線淘寶MEDIAN(Midline)MEDIAL

againMEDIAN

can

be

used

for

the

middle

lineof

other

structures

than

the

whole

bodyThus,

theMEDIAN

NERVEruns

along

inthe

middle

ofthe

forearm才智在線淘寶12ARMS

&

LEGS:

BewareThe

layman’s

term

is

sometimes

given

aspecial,

more

restricted

meaningThus,

the

ARM

is

only

thesection

above

the

elbowFrom

elbow

to

wrist

is

theFOREARMThe

section

of

the

leg

above

theknee

is

the

THIGHFrom

knee

to

ankle

is

theLEG才智在線淘寶13JOINTS

BETWEEN

BONESHIPThe

large

ones

often

use

the

layman’sterm,

but

all

joints

can

be

named

in

termsof

the

two

or

more

bones

involvedSHOULDERELBOWKNEE才智在線淘寶14WRISTANKLEThus,

the

shoulder

is

alsothe

gleno-humeral

joint,from

the

glenoid

fossa(depression)

of

thescapula

and

the

humerusbone

of

the

armAt

the

elbow,

there

is

morethan

one

joint

because

thehumerus

meets

with

ulna

andradius

bones

of

the

forearmPERINEALSURFACE

REGIONS

ASSOCIATED

WITH

JOINTSHipThe

adjectives

are

applieto

underlying

structuresShoulder(Groin)INGUINAL(Behind-the-knee)POPLITEALElbowCUBITAL(Front

side

of

elbow(Armpit)AXILLARY15Knee(Crotch才)智在線淘寶SPELLING

IN

ANATOMY

MATTERSEven

if

we

have

not

drawn

your

attention

tit,

try

yourself

to

note

possible

confusiAXILLARY

is

not

auxillaryPERINEAL

is

not

thesame

as

peronealThe

ILEUM

is

a

part

of

thegut;

the

ILIUM

is

a

boneAs

a

bedtime

exercise,

go

over

the

labelediagrams

and

say

the

names

to

yourself,noting

oddities

of

the

spelling.

You

wilhave

to

come

up

with

the

names

out

of

your

head

in

the

laboratory

exams

&

to16label

fig才gu智r在e線s淘寶PRONUNCIATION

IN

ANATOMY

MATTERS

LESSAmerican

and

British

orthopedic

surgeons

haveoperated

together

for

more

than

50

yearsdespite

several

differences,

e.g.,

cervical(neck),

which

has

a

long

‘i’

in

BritishEnglish.You

can

hear

the

terms

spoken

in

standardAmerican

at

this

site:

http://www.An

ordinary

dictionary

gives

the

pronunciat

of

most

terms.

A

medical

dictionary

will

fil

the

rest.For

now,

relax

about

pronunciation:

justvocalize

the

term

to

yourself

in

your

ownway

that

indicates

to

you

the

exact

spelling.The

‘correct’

form

will

come

with

time.才智在線淘寶17VENTRAL

&

DORSAL(Back)(Front)DORSAL/

POSTERIORVENTRAL/

ANTERIORAlthough

there

is

a

choice

of

terms,convention

has

usually

has

settled

on

aparticular

pair;

and,

if

‘dorsal’

is

usfor

one

side

of

a

structure,

then

‘ventrashould

be

applied

to

the

other

(ditto

foranterior/posterior)Only

showsAnterior

aspects才智在線淘寶18RIGHT

&

LEFTMEDIANLEFTRIGHTLEFT

arm,

RIGHT

kidney,RIGHT

common

carotid

artery‘common’

because

it

will

shortlybranch

into

internal

&

externalcarotiarteries19(Midline才)智在線淘寶RightVENTRICLELeftVENTRICLESVCA

O

RPT

LeftATRIUMRightATRIUMTwo

LEFT

chambers

of

the

heartANTERIOR/FRONT

VIEW

OF

THE

HEARTThe

differences

between

left

andright

or

laterality

are

interest才a智s在i線s淘t寶he

usage

of

the

terms20RIGHT

&

LEFTLEFTRIGHTAlthough

the

heart

has

left

and

rightsides,

the

best

position

for

the

heartturns

out

to

be

tipped

and

rotated

inthe

chest

cavity,

so

that

the

rightchambers

face

forward/

anteriorly,and

are

more

visible

from

the

frontRightVENTRICLELe

f

tVEN

T

R

I

C

L

EAO

P

T

Lef

tR

A

T

R

I

U

MS

V

CR

i

g

h

t

A

T

R

I

U

MWithin

the

chest,

the

heart

encroachesmore

on

the

left

lung,

so

that

the

leftlung

is

not

an

exact

mirror-image

of

theright

lung

-

smaller,

fewer

lobes,

etcMEDIAN(Midline)才智在線淘寶21RIGHT

&

LEFTLEFTRIGHTHaving

dual

structures

gives

addedpower,

and

security

in

case

one

is

lost,damaged,

or

diseased,

e.g.,

kidneys,lungs,

eyes,

ovariesFor

other

structures,

having

twowould

complicate

matters.

Imaginetwo

mouths,

or

two

anuses,

or

twopenises.Not

all

single

structures

are

on

themidline,

for

example,

the

spleen

&liverMEDIAN(Midline)才智在線淘寶22RIGHT

&

LEFT(Midline)LEFTRIGHTNot

all

single

structures

are

on

themidline,

for

example,

the

spleen

&

livSPLEENLIVER23才智在線淘寶SURFACE

ANATOMYA

very

useful

amount

of

anatomy

isavailable

from

the

surface

examinatiocombined

with

touch

(palpation)But

it

requires

knowing

theunderlying

deep

regional

anatomyFor

example,

the

liver

is

normallyprotected

up

under

the

right

rib-cage.it

is

enlarged

by

disease,

it

can

be

felprotruding

down

into

the

right

upperquadrant

of

the

abdomen24Enlargement,Protrusion,Displacement

aretypical

terms

in

de才sc智cr在i線b淘in寶g

such

changesRIGHT

&

LEFT(Midline)LEFTRIGHTLIVERNot

all

single

structures

are

on

themidline,

for

example,

the

spleen

&

livSPLEENThis

lopsidedness

affects

thestomach

and

gut

which

alsoshare

the

abdominal

cavity.25才智在線淘寶RIGHT

&

LEFT

IN

CROSS-SECTIONSLEFTRIGHTMEDIAN(Midline)LEFTRIGHTBeware,

thepatient’s

LEFT,although

on

yourBecause

the

conrviegnhtion

is

that

youinterpret

the

X-Ray,

CT

or

MR

imageas

looking

at

the

source

patient

inthe

anatomical

position

from

thefeet

upwards26才智在線淘寶CROSS-SECTIONAL

IMAGESCross-sectional

(transverse)

imagesinterpreted

as

the

source

patient

being

in

theanatomical

position

viewed

from

the

feet

upwardsLEFTRIGHT27才智在線淘寶Cross-sectional

(transverse)

imagesinterpreted

as

the

source

patientbeing

in

the

anatomical

positionviewed

from

the

feet

upwardsLEFTRIGHTCROSS-SECTIONAL

IMAGES:

Horizontal

/Transverse‘Horizontal’

means

the

same

astransverse,

but

is

counterintuitive

in

the

MRRIIGHT

machineLEFTMEDIAN(Midli28ne)才智在線淘寶para-SAGITTALmid-SAGITTALOTHER

PLANES

FOR

IMAGINGCORONALThis

is

the

planeused

for

the

commonfrontal

chest

X-ray才智在線淘寶29Images

are

from:

X-rays,Computed

Tomography

(CT)computed

from

many

X-rays,Magnetic

Resonance

Imaging(MRI),

&

Ultrasound

(US)para-SAGITTALmid-SAGITTALIMAGINGActual

slices/cross-sectionsand

other‘preparations’

are

made

from

deadpeople

who

have

given

permission.These

are

used

to

check

the

reliability

othe

images

from

the

living.才智在線淘寶30ANATOMY

OF

CROSS-SECTIONS:

WristCarpal-tunnel

syndrome

&compromised

median

nerveCross-sections

ofstructures

than

thehead

&

trunk

helpshow

&

explaindisordersUlnar

nerveUlnar

arteryTendons

to

flexMedian

nerveTendons

to

extendoutside

tunnel,

ondorsal

side

of

wristFlexor

retinaculum

-

sheet

of

fibrous

limbs

&

othertissue

roofing

in

the

tunnelCARPAL

BONES才智在線淘寶31BODY

WALL

&

CAVITIES:

Casing

&

ContentsThe

body

wall

is

musculo-skeletal

andcovered

with

skinThe

cavities

house

soft

organs:

sometubular

or

bag-like

with

a

space(s)inside

(the

lumen),

others

are

moresolid,

e.g.,

the

spleen,

kidneys,

anliver.

These

all

are

the

VISCERA.‘SOMATIC’

is

applied

to

the

limbsand

body

wall,

‘VISCERAL’

to

theviscera才智在線淘寶32BODY

CAVITIES

I

VentralDIAPHRAGM

-

a

moving

muscular

sheetfor

separation

&

breathingABDOMINAL

(Belly)PELVICTHORACIC

(Chest)Further

subdivided

into

PLEURAL

CAVITIES(lungs)

&

PERICARDIAL

CAVITY

(for

theheart)Belly

button

=

Umbil3l3icus才智在線淘寶BODY

CAVITIES

II

DorsalThe

bones

of

the

skull

areorganized

to

form

the

face

anda

cranial

cavity

for

the

brainThe

vertebrae

making

up

the

spinehave

many

surfaces

for

muscle

toattach

and

stabilize

and

move

thespine.

But

also,

they

each

have

ahole.

As

the

holes

line

up,

theycreate

the

spinal

canal

(cavity)

forthe

spinal

cord才智在線淘寶34PROXIMAL

&

DISTALProximal

and

distal

apply

to

long

structu

that

have

a

start

somewhere,

e.g.,

a

limb,

finger,

an

artery,

a

section

of

the

gut(Close)(Far)PROXIMALDISTAL才智在線淘寶35SUPERIOR

&

INFERIOR(Upper)SUPERIORLip(Lower)INFERIORLipSUPERIORINFERIOR才智在線淘寶36ROSTRAL

&

CAUDALRostral

and

Caudal

have

the

samemeanings

as

Superior

and

Inferior.ROSTRALSUPERIOR

INFERIORCAUDALROSTRALCAUDALFrom

Rostrum

-the

snout

or

be才a智k在o線f淘a寶n

animal,and

Cauda

-the

3t7ailSUPERFICIAL

&

DEEP(Outer/surface)SUPERFICIAL(Inner)DEEPDEEPSUPERFICIAL

VeinsThe

ones

used

for

injection38Veins才智在線淘寶left

EXTERNAL

iliac

arteryheaded

for

the

legEXTERNAL

&

INTERNALare

applied

in

much

the

samesense

as

superficial

and

deepleft

common

iliac

arteryleft

INTERNAL

iliac才a智r在t線e淘r寶yfor

pelvic

structures39TRANSVERSEBODYTransverse

colonTransversestructures

run

cross-wisein

thebodyTransverse

process

of

vertebraThis

could

have

beennamed

the

lateral

process,but

was

not才智在線淘寶40Medially,

anteriorly,

superiorly,

etcAs

a

long

structure

travels,

wespeak

of

its

direction

orchanges

in

course,

in

referenceto

the

planes

of

the

bodyThus

an

artery/vein/ureter/bronchus,

etc,

can

travelinferiorly,

superiorly,medially,

laterally,ventrally,

dorsally,

etc才智在線淘寶41Lying

face-down

is

PRONEPRONE

&

SUPINEThe

dead

anatomical

position

has

the

person

lying

flaton

his

back,

arms

by

the

sides,

palms

facing

upwards.This

is

lying

SUPINEThe

distinction

matters

when

you

translate

to

a

mother/father

that

the

baby

sho才u智l在d線淘b寶e

laid

down

supine

to

4s2

leepPRONATION

&

SUPINATION

IThese

are

movements

that

refer

tothe

hand,

wrist,

and

forearm

bonesOne

reaches

for

food,

a

cookie,

say,

with

thefingers

stretched

out

and

the

palm

downHaving

closed

one’s

fingers

over

the

food,one

rotates

the

wrist

and

lower

forearm

tohave

the

food

facing

one’s

mouth.

Then,flexing

the

elbow

joint

brings

the

food

to

thmouth.

Try

it

for

yourself.Turning

the

wrist

so

that

the

palm

facesdownwards

(platewards)

is

PRONATION.The

motion

of

turning

the

wrist

so

that

the

palmfaces

upwards(才m智o在u線th淘hw寶ards)is

SUPINATION.43Followed

byelbow

&

shoulder

flexionPRONATION

&

SUPINATION

IIHaving

closed

one’s

fingers

over

the

food,

one

rotates

twrist

and

lower

forearm

to

have

the

food

facing

one’smouth.

Then,

flexingthe

elbow

&

shoulder

joints

brings

tfood

to

the

mouth.The

motion

of

turning

the

wrist

sothat

the

palm

faces

upwards(mouthwards)

is

SUPINATION.Turning

the

wrist

so

that

thepalm

faces

downwards(platewards)

is

PRONATION.Note

crossing

offorearm

bones44才智在線淘寶You

will

notice

that

this

arrangement

reliesneatly

on

having

a

hinge

-

the

elbow

-

halfwaydown,

with

the

arm

bone

-

the

humerus

-

ofroughly

equal

length

to

the

forearm

radius

&ulna

bonesPRONATION

&

SUPINATION

IIIThen,

flexing

the

elbow

&

shoulderjoints

brings

the

food

to

the

mouth.才智在線淘寶45GROSS

ANATOMYThis

story

of

getting

food

to

the

moutshows

working

anatomy

as

parts

of

thebody,

movements

around

joints,muscle

actions,

and

some

underlyingactions

of

bones

of

the

skeletonOtherstoriesof

how

the

bodyworks

make

sense

onlyinterms

of

much

smaller

unitsseen

with

the

microscope,down

to

the

levelof

cells

andparts

of

cells

-

microscopic

anatomy

or

histology,