ANATOMY AND PHYSIOLOGY

1.1 Overview of 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 Figure 1.2 Gross and Microscopic
analyzed with the assistance of a microscope. Anatomy (a) Gross anatomy considers large
Other larger structures can readily be seen, structures such as the brain. (b) Microscopic
manipulated, measured, and weighed. The word anatomy can deal with the same structures,
“anatomy” comes from a Greek root that means though at a different scale. This is a micrograph
“to cut apart.” Human anatomy was first studied of nerve cells from the brain. LM × 1600. (credit
by observing the exterior of the body and a: “WriterHound”/Wikimedia Commons; credit b:
observing the wounds of soldiers and other Micrograph provided by the Regents of
injuries. Later, physicians were allowed to University of Michigan Medical School © 2012)
dissect bodies of the dead to augment their
knowledge. When a body is dissected, its Anatomists take two general approaches to the
structures are cut apart in order to observe their study of the body’s structures: regional and
physical attributes and their relationships to one systemic. Regional anatomy is the study of the
another. Dissection is still used in medical interrelationships of all of the structures in a
schools, anatomy courses, and in pathology specific body region, such as the abdomen.
labs. In order to observe structures in living Studying regional anatomy helps us appreciate
people, however, a number of imaging the interrelationships of body structures, such as
techniques have been developed. These how muscles, nerves, blood vessels, and other
techniques allow clinicians to visualize structures structures work together to serve a particular
inside the living body such as a cancerous tumor body region. In contrast, systemic anatomy is
or a fractured bone. the study of the structures that make up a
discrete body system—that is, a group of
Like most scientific disciplines, anatomy has structures that work together to perform a unique
areas of specialization. Gross anatomy is the body function. For example, a systemic
study of the larger structures of the body, those anatomical study of the muscular system would
visible without the aid of magnification (Figure consider all of the skeletal muscles of the body.
1.2 a). Macro- means “large,” thus, gross
anatomy is also referred to as macroscopic Whereas anatomy is about structure, physiology
anatomy. In contrast, micro- means “small,” is about function. Human physiology is the
and microscopic anatomy is the study of scientific study of the chemistry and physics of
structures that can be observed only with the the structures of the body and the ways in which
use of a microscope or other magnification they work together to support the functions of
devices (Figure 1.2 b). Microscopic anatomy life. Much of the study of physiology centers on
includes cytology, the study of cells and the body’s tendency toward
histology, the study of tissues. As the technology homeostasis. Homeostasis is the state of
of microscopes has advanced, anatomists have steady internal conditions maintained by living
been able to observe smaller and smaller things. The study of physiology certainly
structures of the body, from slices of large includes observation, both with the naked eye
structures like the heart, to the three- and with microscopes, as well as manipulations
dimensional structures of large molecules in the and measurements. However, current advances
body. 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 organelles, cells, tissues, organs, organ
specialize in a particular branch of physiology. systems, organisms and biosphere (Figure
For example, neurophysiology is the study of the 1.3).
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.
Figure 1.3 Levels of Structural
Your study of anatomy and physiology will make Organization of the Human Body The
more sense if you continually relate the form of organization of the body often is discussed
the structures you are studying to their function. in terms of six distinct levels of increasing
In fact, it can be somewhat frustrating to attempt complexity, from the smallest chemical
to study anatomy without an understanding of building blocks to a unique human
the physiology that a body structure supports. organism.
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 Levels of Organization
the hand. Fortunately, your understanding of
how the human hand manipulates tools—from
To study the chemical level of organization,
pens to cell phones—helps you appreciate the
scientists consider the simplest building blocks
unique alignment of the thumb in opposition to
of matter: subatomic particles, atoms and
the four fingers, making your hand a structure
molecules. All matter in the universe is
that allows you to pinch and grasp objects and
composed of one or more unique pure
type text messages.
substances called elements, familiar examples
of which are hydrogen, oxygen, carbon,
1.2 Structural Organization nitrogen, calcium, and iron. The smallest unit of
any of these pure substances (elements) is an
of the Human Body atom. Atoms are made up of subatomic particles
Before you begin to study the different such as the proton, electron and neutron. Two or
structures and functions of the human more atoms
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,
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.

Figure 1.4 Organ Systems of the Human

Body Organs that work together are
grouped into organ systems.
 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.

Figure 1.5 Organ Systems of the Human The body’s largest organ system is the
Body (continued) Organs that work together integumentary system, which includes the skin
are grouped into organ systems. and its associated structures, such as hair and
nails. The surface tissue of skin is a barrier that
protects internal structures and fluids from
The organism level is the highest level of potentially harmful microorganisms and other
organization. An organism is a living being that toxins.
has a cellular structure and that can
independently perform all physiologic functions
necessary for life. In multicellular organisms, Metabolism
including humans, all cells, tissues, organs, and
organ systems of the body work together to The first law of thermodynamics holds that
maintain the life and health of the organism. energy can neither be created nor destroyed—it
can only change form. Your basic function as an
organism is to consume (ingest) energy and
1.3 Functions of Human Life molecules in the foods you eat, convert some of
it into fuel for movement, sustain your body
The different organ systems each have different functions, and build and maintain your body
functions and therefore unique roles to perform
structures. There are two types of reactions that synthesis (anabolism) of ATP, then moves
accomplish this: anabolism and catabolism. the ATP molecules to the location where
energy is needed to fuel cellular activities.
 Anabolism is the process whereby Then the ATP is broken down (catabolism)
smaller, simpler molecules are and a controlled amount of energy is
combined into larger, more complex released, which is used by the cell to
substances. Your body can assemble, perform a particular job.
by utilizing energy, the complex
chemicals it needs by combining small
molecules derived from the foods you
eat Responsiveness
 Catabolism is the process by which
larger more complex substances are Responsiveness is the ability of an organism to
broken down into smaller simpler adjust to changes in its internal and external
molecules. Catabolism releases energy. environments. An example of responsiveness to
The complex molecules found in foods external stimuli could include moving toward
are broken down so the body can use sources of food and water and away from
their parts to assemble the structures perceived dangers. Changes in an organism’s
and substances needed for life. internal environment, such as increased body
temperature, can cause the responses of
Taken together, these two processes are called sweating and the dilation of blood vessels in the
metabolism. Metabolism is the sum of all skin in order to decrease body temperature, as
anabolic and catabolic reactions that take place shown by the runners in Figure 1.7.
in the body (Figure 1.6). Both anabolism and
catabolism occur simultaneously and Movement
continuously to keep you alive.
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
Figure 1.6 Metabolism Anabolic reactions of your daily life.
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
 Figure 1.7 Marathon Runners Runners Oxygen
demonstrate two characteristics of living
humans—responsiveness and movement. Atmospheric air is only about 20 percent oxygen,
Anatomic structures and physiological but that oxygen is a key component of the
processes allow runners to coordinate the chemical reactions that keep the body alive,
action of muscle groups and sweat in including the reactions that produce ATP. Brain
response to rising internal body cells are especially sensitive to lack of oxygen
temperature. (credit: Phil Roeder/flickr) 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.
Development, growth and reproduction
Nutrients
Development is all of the changes the body
goes through in life. Development includes the A nutrient is a substance in foods and
process of differentiation, in which beverages that is essential to human survival.
unspecialized cells become specialized in The three basic classes of nutrients are water,
structure and function to perform certain tasks in the energy-yielding and body-building nutrients,
the body. Development also includes the and the micronutrients (vitamins and minerals).
processes of growth and repair, both of which
involve cell differentiation. The most critical nutrient is water. Depending on
the environmental temperature and our state of
Growth is the increase in body size. Humans, health, we may be able to survive for only a few
like all multicellular organisms, grow by days without water. The body’s functional
increasing the number of existing cells, chemicals are dissolved and transported in
increasing the amount of non-cellular material water, and the chemical reactions of life take
around cells (such as mineral deposits in bone), place in water. Moreover, water is the largest
and, within very narrow limits, increasing the component of cells, blood, and the fluid between
size of existing cells. cells, and water makes up about 70 percent of
an adult’s body mass. Water also helps regulate
Reproduction is the formation of a new our internal temperature and cushions, protects,
organism from parent organisms. In humans, and lubricates joints and many other body
reproduction is carried out by the male and structures.
female reproductive systems. Because death will
come to all complex organisms, without The energy-yielding nutrients are primarily
reproduction, the line of organisms would end. carbohydrates and lipids, while proteins mainly
supply the amino acids that are the building
blocks of the body itself. You ingest these in
1.4 Requirements for Human plant and animal foods and beverages, and the
Life digestive system breaks them down into
molecules small enough to be absorbed. The
Humans have been acclimating to life on breakdown products of carbohydrates and lipids
Earth for at least the past 200,000 years. can then be used in the metabolic processes
Earth and its atmosphere have provided us that convert them to ATP. Although you might
with air to breathe, water to drink, and food feel as if you are starving after missing a single
to eat, but these are not the only meal, you can survive without consuming the
requirements for survival. Although you may energy-yielding nutrients for at least several
rarely think about it, you also cannot live weeks.
outside of a certain range of temperature and
pressure that the surface of our planet and Water and the energy-yielding nutrients are also
its atmosphere provides. The next sections referred to as macronutrients because the body
explore these four requirements of life. needs them in large amounts. In contrast,
micronutrients are vitamins and minerals. These
elements and compounds participate in many
essential chemical reactions and processes, cold by reducing blood circulation to the
such as nerve impulses, and some, such as extremities, the hands and feet, in order to
calcium, also contribute to the body’s structure. prevent blood from cooling there and so that the
Your body can store some of the micronutrients body’s core can stay warm. Even when core
in its tissues, and draw on those reserves if you body temperature remains stable, however,
fail to consume them in your diet for a few days tissues exposed to severe cold, especially the
or weeks. Some others micronutrients, such as fingers and toes, can develop frostbite when
vitamin C and most of the B vitamins, are water- blood flow to the extremities has been much
soluble and cannot be stored, so you need to reduced. This form of tissue damage can be
consume them every day or two. permanent and lead to gangrene, requiring
amputation of the affected region.
Narrow Range of Temperature
Narrow Range of Atmospheric Pressure
You have probably seen news stories about
athletes who died of heat stroke, or hikers who Pressure is a force exerted by a substance that
died of exposure to cold. Such deaths occur is in contact with another substance.
because the chemical reactions upon which the Atmospheric pressure is pressure exerted by the
body depends can only take place within a mixture of gases (primarily nitrogen and oxygen)
narrow range of body temperature, from just in the Earth’s atmosphere. Although you may not
below to just above 37°C (98.6°F). When body perceive it, atmospheric pressure is constantly
temperature rises well above or drops well below pressing down on your body. This pressure
normal, certain proteins (enzymes) that facilitate keeps gases within your body, such as the
chemical reactions lose their normal structure gaseous nitrogen in body fluids, dissolved. If you
and their ability to function and the chemical were suddenly ejected from a space ship above
reactions of metabolism cannot proceed. Earth’s atmosphere, you would go from a
situation of normal pressure to one of very low
That said, the body can respond effectively to pressure. The pressure of the nitrogen gas in
short-term exposure to heat (Figure 1.8) or cold. your blood would be much higher than the
One of the body’s responses to heat is, of pressure of nitrogen in the space surrounding
course, sweating. As sweat evaporates from your body. As a result, the nitrogen gas in your
skin, it removes some thermal energy from the blood would expand, forming bubbles that could
body, cooling it. Adequate water (from the block blood vessels and even cause cells to
extracellular fluid in the body) is necessary to break apart.
produce sweat, so adequate fluid intake is
essential to balance that loss during the sweat Atmospheric pressure does more than just keep
response. Not surprisingly, the sweat response blood gases dissolved. Your ability to breathe—
is much less effective in a humid environment that is, to take in oxygen and release carbon
because the air is already saturated with water. dioxide—also depends upon a precise
Thus, the sweat on the skin’s surface is not able atmospheric pressure. Altitude sickness occurs
to evaporate, and internal body temperature can in part because the atmosphere at high altitudes
get dangerously high. exerts less pressure, reducing the exchange of
these gases, and causing shortness of breath,
The body can also respond effectively to short- confusion, headache, lethargy, and nausea.
term exposure to cold. One response to cold is Mountain climbers carry oxygen to reduce the
shivering, which is random muscle movement effects of both low oxygen levels and low
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
barometric pressure at higher altitudes (Figure
1.9).
Figure 1.10 Negative Feedback Loop In a

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)

1.5 Homeostasis

Maintaining homeostasis requires that the body

continuously monitor its internal conditions. negative feedback loop, a stimulus—a deviation
From body temperature to blood pressure to from a set point—is resisted through a
levels of certain nutrients, each physiological physiological process that returns the body to
condition has a particular set point. A set homeostasis. (a) A negative feedback loop has
point is the physiological value around which four basic parts. (b) Body temperature is
the normal range fluctuates. A normal range is regulated by negative feedback.
the restricted set of values that is optimally
healthful and stable. For example, the set point
In order to set the system in motion, a stimulus
for normal human body temperature is
must drive a physiological parameter beyond its
approximately 37°C (98.6°F) Physiological
normal range (that is, beyond homeostasis).
parameters, such as body temperature and
This stimulus is “heard” by a specific sensor. For
blood pressure, tend to fluctuate within a normal
example, in the control of blood glucose, specific
range a few degrees above and below that point.
endocrine cells in the pancreas detect excess
Control centers in the brain and other parts of
glucose (the stimulus) in the bloodstream. These
the body monitor and react to deviations from
pancreatic beta cells respond to the increased
homeostasis using negative feedback. Negative
level of blood glucose by releasing the hormone
feedback is a mechanism that reverses a
insulin into the bloodstream. The insulin signals
deviation from the set point. Therefore, negative
skeletal muscle fibers, fat cells (adipocytes), and
feedback maintains body parameters within their
liver cells to take up the excess glucose,
normal range. The maintenance of homeostasis
removing it from the bloodstream. As glucose
by negative feedback goes on throughout the
concentration in the bloodstream drops, the
body at all times, and an understanding of
decrease in concentration—the actual negative
negative feedback is thus fundamental to an
feedback—is detected by pancreatic alpha cells,
understanding of human physiology.
and insulin release stops. This prevents blood
sugar levels from continuing to drop below the
Negative Feedback normal range.

A negative feedback system has three basic Humans have a similar temperature regulation
components (Figure 1.10a). A sensor, also feedback system that works by promoting either
referred to a receptor, is a component of a heat loss or heat gain (Figure 1.10b). When the
feedback system that monitors a physiological brain’s temperature regulation center receives
value. This value is reported to the control data from the sensors indicating that the body’s
center. The control center is the component in temperature exceeds its normal range, it
a feedback system that compares the value to stimulates a cluster of brain cells referred to as
the normal range. If the value deviates too much the “heat-loss center.” This stimulation has three
from the set point, then the control center major effects:
activates an effector. An effector is the
component in a feedback system that causes a
 Blood vessels in the skin begin to dilate
change to reverse the situation and return the
allowing more blood from the body core
value to the normal range.
 to flow to the surface of the skin allowing labor and delivery are the result of a positive
the heat to radiate into the environment. feedback system (Figure 1.11).
 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 Figure 1.11 Positive Feedback Loop Normal
in cells throughout the body. The brain also childbirth is driven by a positive feedback loop. A
signals the adrenal glands to release positive feedback loop results in a change in the
epinephrine (adrenaline), a hormone that causes body’s status, rather than a return to
the breakdown of glycogen into glucose, which homeostasis.
can be used as an energy source. The
breakdown of glycogen into glucose also results The first contractions of labor (the stimulus) push
in increased metabolism and heat production. the baby toward the cervix (the lowest part of the
uterus). The cervix contains stretch-sensitive
Positive Feedback nerve cells that monitor the degree of stretching
(the sensors). These nerve cells send messages
Positive feedback intensifies a change in the to the brain, which in turn causes the pituitary
body’s physiological condition rather than gland at the base of the brain to release the
reversing it. A deviation from the normal range hormone oxytocin into the bloodstream.
results in more change, and the system moves Oxytocin causes stronger contractions of the
farther away from the normal range. Positive smooth muscles in of the uterus (the effectors),
feedback in the body is normal only when there pushing the baby further down the birth canal.
is a definite end point. Childbirth and the body’s This causes even greater stretching of the
response to blood loss are two examples of cervix. The cycle of stretching, oxytocin release,
positive feedback loops that are normal but are and increasingly more forceful contractions
activated only when needed. stops only when the baby is born. At this point,
the stretching of the cervix halts, stopping the
release of oxytocin.
Childbirth at full term is an example of a situation
in which the maintenance of the existing body
state is not desired. Enormous changes in the A second example of positive feedback centers
mother’s body are required to expel the baby at on reversing extreme damage to the body.
the end of pregnancy. And the events of Following a penetrating wound, the most
childbirth, once begun, must progress rapidly to immediate threat is excessive blood loss. Less
a conclusion or the life of the mother and the blood circulating means reduced blood pressure
baby are at risk. The extreme muscular work of 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

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, a scar in the “anterior (front) carpal
For example, is a scar “above the wrist” located
(wrist) region” would be present on the palm side
on the forearm two or three inches away from
of the wrist. The term “anterior” would be used
the hand? Or is it at the base of the hand? Is it
even if the hand were palm down on a table.
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
Figure 1.12 Regions of the Human Body The
longer used in everyday conversation, the
meaning of their words does not change. human body is shown in anatomical position in
an (a) anterior view and a (b) posterior view. The
Anatomical terms are made up of roots, prefixes, regions of the body are labeled in boldface.
and suffixes. The root of a term often refers to
an organ, tissue, or condition, whereas the prefix A body that is lying down is described as either
or suffix often describes the root. For example, prone or supine. Prone describes a face-down
in the disorder hypertension, the prefix “hyper-” orientation, and supine describes a face up
means “high” or “over,” and the root word orientation. These terms are sometimes used in
“tension” refers to pressure, so the word describing the position of the body during
“hypertension” refers to abnormally high blood specific physical examinations or surgical
pressure. procedures.

Anatomical Position Regional Terms

To further increase precision, anatomists The human body’s numerous regions have
standardize the way in which they view the body. specific terms to help increase precision
Just as maps are normally oriented with north at (see Figure 1.12). Notice that the term
the top, the standard body “map,” or anatomical “brachium” or “arm” is reserved for the “upper
position, is that of the body standing upright, arm” and “antebrachium” or “forearm” is used
with the feet at shoulder width and parallel, toes rather than “lower arm.” Similarly, “femur” or
forward. The upper limbs are held out to each “thigh” is correct, and “leg” or “crus” is reserved
side, and the palms of the hands face forward as for the portion of the lower limb between the
illustrated in Figure 1.12. Using this standard knee and the ankle. You will be able to describe
position reduces confusion. It does not matter the body’s regions using the terms from the
how the body being described is oriented, the figure.
terms are used as if it is in anatomical position.
Directional Terms Figure 1.13 Directional Terms Applied to the

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. Human Body Paired directional terms are
 Superior (or cranial) describes a
shown as applied to the human body.
position above or higher than another
part of the body proper. The orbits are Body Planes
superior to the oris.
 Inferior (or caudal) describes a position
A section is a two-dimensional surface of a
below or lower than another part of the
three-dimensional structure that has been cut.
body proper; near or toward the tail (in
Modern medical imaging devices enable
humans, the coccyx, or lowest part of
clinicians to obtain “virtual sections” of living
the spinal column). The pelvis is inferior
bodies. We call these scans. Body sections and
to the abdomen.
scans can be correctly interpreted, however,
 Lateral describes the side or direction only if the viewer understands the plane along
toward the side of the body. The thumb which the section was made. A plane is an
(pollex) is lateral to the digits. imaginary two-dimensional surface that passes
 Medial describes the middle or direction through the body. There are three planes
toward the middle of the body. The commonly referred to in anatomy and medicine,
hallux is the medial toe. as illustrated in Figure 1.14.
 Proximal describes a position in a limb
that is nearer to the point of attachment
 The sagittal plane is the plane that
or the trunk of the body. The brachium is
divides the body or an organ vertically
proximal to the antebrachium.
into right and left sides. If this vertical
 Distal describes a position in a limb that
plane runs directly down the middle of
is farther from the point of attachment or
the body, it is called the midsagittal or
the trunk of the body. The crus is distal
median plane. If it divides the body into
to the femur.
unequal right and left sides, it is called a
 Superficial describes a position closer parasagittal plane or less commonly a
to the surface of the body. The skin is longitudinal section.
superficial to the bones.
 The frontal plane is the plane that
 Deep describes a position farther from divides the body or an organ into an
the surface of the body. The brain is anterior (front) portion and a posterior
deep to the skull. (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 expand and contract without distorting other
divides the body or organ horizontally tissues or disrupting the activity of nearby
into upper and lower portions. organs.
Transverse planes produce images
referred to as cross sections.

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
Figure 1.14 Planes of the Body The three vertebral column and by cerebrospinal fluid, a
planes most commonly used in anatomical and colorless fluid produced by the brain, which
cushions the brain and spinal cord within the
medical imaging are the sagittal, frontal (or
posterior (dorsal) cavity.
coronal), and transverse plane.

Body Cavities and Serous Membranes The anterior (ventral) cavity has two main
subdivisions: the thoracic cavity and the
The body maintains its internal organization by abdominopelvic cavity (see Figure 1.15).
means of membranes, sheaths, and other The thoracic cavity is the more superior
structures that separate compartments. subdivision of the anterior cavity, and it is
The dorsal (posterior) cavity and the ventral enclosed by the rib cage. The thoracic cavity
(anterior) cavity are the largest body contains the lungs and the heart, which is
compartments (Figure 1.15). These cavities located in the mediastinum. The diaphragm
contain and protect delicate internal organs, and forms the floor of the thoracic cavity and
the ventral cavity allows for significant changes separates it from the more inferior
in the size and shape of the organs as they abdominopelvic cavity. The abdominopelvic
perform their functions. The lungs, heart, cavity is the largest cavity in the body. Although
stomach, and intestines, for example, can 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 layers is a very thin, fluid-filled serous space, or
regions or four quadrants (Figure 1.16). 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
Figure 1.16 Regions and Quadrants of the several organs in the abdominopelvic cavity. The
Peritoneal Cavity There are (a) nine abdominal serous membranes form fluid-filled sacs, or
regions and (b) four abdominal quadrants in the cavities, that are meant to cushion and reduce
peritoneal cavity. 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
The more detailed regional approach subdivides
thin, slippery serous fluid located within the
the cavity with one horizontal line immediately
serous cavities. The pleural cavity reduces
inferior to the ribs and one immediately superior
friction between the lungs and the body wall.
to the pelvis, and two vertical lines drawn as if
Likewise, the pericardial cavity reduces friction
dropped from the midpoint of each clavicle
between the heart and the wall of the
(collarbone). There are nine resulting regions.
pericardium. The peritoneal cavity reduces
The simpler quadrants approach, which is more
friction between the abdominal and pelvic
commonly used in medicine, subdivides the
organs and the body wall. Therefore, serous
cavity with one horizontal and one vertical line
membranes provide additional protection to the
that intersect at the patient’s umbilicus (navel).
viscera they enclose by reducing friction that
could lead to inflammation of the organs.
Membranes of the Anterior (Ventral) Body
Cavity 1.7 Medical Imaging

A serous membrane (also referred to a serosa) For thousands of years, fear of the dead and legal
is one of the thin membranes that cover the sanctions limited the ability of anatomists and
walls and organs in the thoracic and physicians to study the internal structures of the
abdominopelvic cavities. The parietal layers of human body. An inability to control bleeding, infection,
the membranes line the walls of the body cavity and pain made surgeries infrequent, and those that
(pariet- refers to a cavity wall). The visceral layer were performed—such as wound suturing,
amputations, tooth and tumor removals, skull drilling,
of the membrane covers the organs (the
and cesarean births—did not greatly advance
viscera). Between the parietal and visceral 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 Refinements and enhancements of X-ray techniques
robbing to obtain corpses. Laws were eventually have continued throughout the twentieth and twenty-
passed that enabled students to dissect the corpses first centuries. Although often supplanted by more
of criminals and those who donated their bodies for sophisticated imaging techniques, the X-ray remains a
research. Still, it was not until the late nineteenth “workhorse” in medical imaging, especially for viewing
century that medical researchers discovered non- fractures and for dentistry. The disadvantage of
surgical methods to look inside the living body. irradiation to the patient and the operator is now
attenuated by proper shielding and by limiting
X-Rays exposure.

Modern Medical Imaging

German physicist Wilhelm Röntgen (1845–1923) was
experimenting with electrical current when he
discovered that a mysterious and invisible “ray” would X-rays can depict a two-dimensional image of a body
pass through his flesh but leave an outline of his region, and only from a single angle. In contrast, more
bones on a screen coated with a metal compound. In recent medical imaging technologies produce data
1895, Röntgen made the first durable record of the that is integrated and analyzed by computers to
internal parts of a living human: an “X-ray” image (as produce three-dimensional images or images that
it came to be called) of his wife’s hand. Scientists reveal aspects of body functioning.
around the world quickly began their own experiments
with X-rays, and by 1900, X-rays were widely used to Computed Tomography
detect a variety of injuries and diseases. In 1901,
Röntgen was awarded the first Nobel Prize for physics
for his work in this field. Tomography refers to imaging by
sections. Computed tomography (CT) is a
noninvasive imaging technique that uses computers
The X-ray is a form of high energy electromagnetic to analyze several cross-sectional X-rays in order to
radiation with a short wavelength capable of reveal minute details about structures in the body
penetrating solids and ionizing gases. As they are (Figure 1.19a). The technique was invented in the
used in medicine, X-rays are emitted from an X-ray 1970s and is based on the principle that, as X-rays
machine and directed toward a specially treated pass through the body, they are absorbed or reflected
metallic plate placed behind the patient’s body. The at different levels. In the technique, a patient lies on a
beam of radiation results in darkening of the X-ray motorized platform while a computerized axial
plate. X-rays are slightly impeded by soft tissues, tomography (CAT) scanner rotates 360 degrees
which show up as gray on the X-ray plate, whereas around the patient, taking X-ray images. A computer
hard tissues, such as bone, largely block the rays, combines these images into a two-dimensional view
producing a light-toned “shadow.” Thus, X-rays are of the scanned area, or “slice.”
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
Figure 1.19 Medical Imaging Techniques (a) The
structures of the body, such as bones, to be seen in
results of a CT scan of the head are shown as
X-rays like these. (credit: Trace Meek/flickr)
successive transverse sections. (b) An MRI machine
generates a magnetic field around a patient. (c) PET
scans use radiopharmaceuticals to create images of in parts of the brain during various body activities.
active blood flow and physiologic activity of the organ This has helped scientists learn more about the
or organs being targeted. (d) Ultrasound technology is locations of different brain functions and more about
used to monitor pregnancies because it is the least brain abnormalities and diseases.
invasive of imaging techniques and uses no
electromagnetic radiation INTERACTIVE LINK

Since 1970, the development of more powerful A patient undergoing an MRI is surrounded by a tube-
computers and more sophisticated software has made shaped scanner. Watch this video to learn more about
CT scanning routine for many types of diagnostic MRIs. What is the function of magnets in an MRI?
evaluations. It is especially useful for soft tissue
scanning, such as of the brain and the thoracic and Positron Emission Tomography
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 Positron emission tomography (PET) is a medical
scanning is that it exposes patients to a dose of imaging technique involving the use of so-called
radiation many times higher than that of X-rays. In radiopharmaceuticals, substances that emit radiation
fact, children who undergo CT scans are at increased that is short-lived and therefore relatively safe to
risk of developing cancer, as are adults who have administer to the body. Although the first PET scanner
multiple CT scans. was introduced in 1961, it took 15 more years before
radiopharmaceuticals were combined with the
technique and revolutionized its potential. The main
Magnetic Resonance Imaging advantage is that PET (see Figure 1.19c) can
illustrate physiologic activity—including nutrient
Magnetic resonance imaging (MRI) is a noninvasive metabolism and blood flow—of the organ or organs
medical imaging technique based on a phenomenon being targeted, whereas CT and MRI scans can only
of nuclear physics discovered in the 1930s, in which show static images. PET is widely used to diagnose a
matter exposed to magnetic fields and radio waves multitude of conditions, such as heart disease, the
was found to emit radio signals. In 1970, a physician spread of cancer, certain forms of infection, brain
and researcher named Raymond Damadian noticed abnormalities, bone disease, and thyroid disease.
that malignant (cancerous) tissue gave off different
signals than normal body tissue. He applied for a INTERACTIVE LINK
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 PET relies on radioactive substances administered
computing and electronics led to their advancement several minutes before the scan. Watch this video to
over any other technique for precise imaging, learn more about PET. How is PET used in
especially to discover tumors. MRI also has the major chemotherapy?
advantage of not exposing patients to radiation.
Ultrasonography
Drawbacks of MRI scans include their much higher
cost, and patient discomfort with the procedure. The Ultrasonography is an imaging technique that uses
MRI scanner subjects the patient to such powerful the transmission of high-frequency sound waves into
electromagnets that the scan room must be shielded. the body to generate an echo signal that is converted
The patient must be enclosed in a metal tube-like by a computer into a real-time image of anatomy and
device for the duration of the scan (see Figure 1.19b), physiology (see Figure 1.19d). Ultrasonography is the
sometimes as long as thirty minutes, which can be least invasive of all imaging techniques, and it is
uncomfortable and impractical for ill patients. The therefore used more freely in sensitive situations such
device is also so noisy that, even with earplugs, as pregnancy. The technology was first developed in
patients can become anxious or even fearful. These the 1940s and 1950s. Ultrasonography is used to
problems have been overcome somewhat with the study heart function, blood flow in the neck or
development of “open” MRI scanning, which does not extremities, certain conditions such as gallbladder
require the patient to be entirely enclosed in the metal disease, and fetal growth and development. The main
tube. Patients with iron-containing metallic implants disadvantages of ultrasonography are that the image
(internal sutures, some prosthetic devices, and so on) quality is heavily operator-dependent and that it is
cannot undergo MRI scanning because it can unable to penetrate bone and gas.
dislodge these implants.
Key Words
Functional MRIs (fMRIs), which detect the
concentration of blood flow in certain parts of the
abdominopelvic cavity
body, are increasingly being used to study the activity
 division of the anterior (ventral) cavity that describes the back or direction toward the
houses the abdominal and pelvic viscera back of the body; also referred to as
anabolism posterior
assembly of more complex molecules from dorsal cavity
simpler molecules posterior body cavity that houses the brain
anatomical position and spinal cord; also referred to the posterior
standard reference position used for body cavity
describing locations and directions on the effector
human body organ that can cause a change in a value
anatomy frontal plane
science that studies the form and two-dimensional, vertical plane that divides
composition of the body’s structures the body or organ into anterior and posterior
anterior portions
describes the front or direction toward the gross anatomy
front of the body; also referred to as ventral study of the larger structures of the body,
anterior cavity typically with the unaided eye; also referred
larger body cavity located anterior to the to macroscopic anatomy
posterior (dorsal) body cavity; includes the growth
serous membrane-lined pleural cavities for process of increasing in size
the lungs, pericardial cavity for the heart, and homeostasis
peritoneal cavity for the abdominal and pelvic steady state of body systems that living
organs; also referred to as ventral cavity organisms maintain
catabolism inferior
breaking down of more complex molecules describes a position below or lower than
into simpler molecules another part of the body proper; near or
caudal toward the tail (in humans, the coccyx, or
describes a position below or lower than lowest part of the spinal column); also
another part of the body proper; near or referred to as caudal
toward the tail (in humans, the coccyx, or lateral
lowest part of the spinal column); also describes the side or direction toward the
referred to as inferior side of the body
cell magnetic resonance imaging (MRI)
smallest independently functioning unit medical imaging technique in which a device
of all organisms; in animals, a cell contains generates a magnetic field to obtain detailed
cytoplasm, composed of fluid and organelles sectional images of the internal structures of
computed tomography (CT) the body
medical imaging technique in which medial
a computer-enhanced cross-sectional X-ray describes the middle or direction toward the
image is obtained middle of the body
control center metabolism
compares values to their normal range; sum of all of the body’s chemical reactions
deviations cause the activation of an effector microscopic anatomy
cranial study of very small structures of the body
describes a position above or higher than using magnification
another part of the body proper; also referred negative feedback
to as superior homeostatic mechanism that tends to
cranial cavity stabilize an upset in the body’s physiological
division of the posterior (dorsal) cavity that condition by preventing an excessive
houses the brain response to a stimulus, typically as the
deep stimulus is removed
describes a position farther from the surface normal range
of the body range of values around the set point that do
development not cause a reaction by the control center
changes an organism goes through during its nutrient
life chemical obtained from foods and beverages
differentiation that is critical to human survival
process by which unspecialized cells organ
become specialized in structure and function functionally distinct structure composed of
distal two or more types of tissues
describes a position farther from the point of organ system
attachment or the trunk of the body group of organs that work together to carry
dorsal out a particular function
organism sensor
living being that has a cellular structure and (also, receptor) reports a monitored
that can independently perform all physiological value to the control center
physiologic functions necessary for life serosa
pericardium membrane that covers organs and reduces
sac that encloses the heart friction; also referred to as serous membrane
peritoneum serous membrane
serous membrane that lines the membrane that covers organs and reduces
abdominopelvic cavity and covers the organs friction; also referred to as serosa
found there set point
physiology ideal value for a physiological parameter; the
science that studies the chemistry, level or small range within which a
biochemistry, and physics of the body’s physiological parameter such as blood
functions pressure is stable and optimally healthful,
plane that is, within its parameters of homeostasis
imaginary two-dimensional surface that spinal cavity
passes through the body division of the dorsal cavity that houses the
pleura spinal cord; also referred to as vertebral
serous membrane that lines the pleural cavity
cavity and covers the lungs superficial
positive feedback describes a position nearer to the surface of
mechanism that intensifies a change in the the body
body’s physiological condition in response to superior
a stimulus describes a position above or higher than
positron emission tomography (PET) another part of the body proper; also referred
medical imaging technique in which to as cranial
radiopharmaceuticals are traced to reveal supine
metabolic and physiological functions in face up
tissues systemic anatomy
posterior study of the structures that contribute to
describes the back or direction toward the specific body systems
back of the body; also referred to as dorsal thoracic cavity
posterior cavity division of the anterior (ventral) cavity that
posterior body cavity that houses the brain houses the heart, lungs, esophagus, and
and spinal cord; also referred to as dorsal trachea
cavity tissue
pressure group of similar or closely related cells that
force exerted by a substance in contact with act together to perform a specific function
another substance transverse plane
prone two-dimensional, horizontal plane that
face down divides the body or organ into superior and
proximal inferior portions
describes a position nearer to the point of ultrasonography
attachment or the trunk of the body application of ultrasonic waves to visualize
regional anatomy subcutaneous body structures such as
study of the structures that contribute to tendons and organs
specific body regions ventral
renewal describes the front or direction toward the
process by which worn-out cells are replaced front of the body; also referred to as anterior
reproduction ventral cavity
process by which new organisms are larger body cavity located anterior to the
generated posterior (dorsal) body cavity; includes the
responsiveness serous membrane-lined pleural cavities for
ability of an organisms or a system to adjust the lungs, pericardial cavity for the heart, and
to changes in conditions peritoneal cavity for the abdominal and pelvic
sagittal plane organs; also referred to as anterior body
two-dimensional, vertical plane that divides cavity
the body or organ into right and left sides X-ray
section form of high energy electromagnetic
in anatomy, a single flat surface of a three- radiation with a short wavelength capable of
dimensional structure that has been cut penetrating solids and ionizing gases; used
through
in medicine as a diagnostic aid to visualize
body structures such as bones