1.0 Introduction

Chapter Objectives

After studying this chapter, you will be able to:

• Compare and contrast the study of anatomy and physiology
• Describe the structure of the body, from simplest to most complex
• 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 imaging techniques in terms of their function and use in studying the human body

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, procedures and help you understand genetic or infectious diseases. At some point, everyone will have a problem with some aspect of his or her body and your knowledge can help you 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 human body.

1.1 How Structure Determines Function

Learning Objectives

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

• Compare and contrast the study of anatomy and physiology
• Discuss the fundamental structure-function 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, while other, larger structures can readily be seen, manipulated, measured, and weighed. The word “anatomy” comes from the Greek root “ana” which means “to cut apart” and “tomia” which means “to cut.” Human anatomy was first studied by observing the exterior of the body, 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 (image below, Figure 1.1.1a). Gross and macro both mean “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 (image below, Figure 1.1.1b). 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.

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. 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 does) 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.

Chapter Review

Human anatomy is the scientific study of the body’s structures. In the past, anatomy has primarily been studied via observing injuries, and later by the dissection of anatomical structures of cadavers, but in the past century, computer-assisted imaging techniques have allowed clinicians to look inside the living body. Human physiology is the scientific study of the chemistry and physics of the structures of the body. Physiology explains how the structures of the body work together to maintain life. It is difficult to study structure (anatomy) without knowledge of function (physiology) and vice versa. The two disciplines are typically studied together because form and function are closely related in all living things.

1.2 Structural Organization of the Human Body

Learning Objectives

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

• Describe the structure of the body, from simplest to most complex
• Describe the interrelationships between the organ systems

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, such as (from smallest to largest): chemicals, cells, tissues, organs, organ systems, and an organism.

The organization of the body often is discussed in terms of the 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. Examples of these elements 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. Single celled organisms, like bacteria, are extremely small, independently-living organisms with a cellular structure. Humans are multicellular organisms with independent cells working in concert together. 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, 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 1.2.2). 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.

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 multi-cellular organisms, including humans, all cells, tissues, organs, and organ systems of the body work together to maintain the life and health of the organism.

Chapter Review

Life processes of the human body are maintained at several levels of structural organization. These include the chemical, cellular, tissue, organ, organ system, and the organism level. Higher levels of organization are built from lower levels. Therefore, molecules combine to form cells, cells combine to form tissues, tissues combine to form organs, organs combine to form organ systems, and organ systems combine to form organisms.

1.3 Homeostasis

Learning Objectives

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

• List the components of a homeostatically controlled system
• Discuss the role of homeostasis in the human body
• Contrast negative and positive feedback, giving one physiologic example of each mechanism

Maintaining a stable system requires the body to continuously monitor its internal conditions. Though certain physiological systems operate within frequently larger ranges, certain body parameters are tightly controlled homeostatically. For example, body temperature and blood pressure are controlled within a very narrow range. A set point is the physiological value around which the normal range fluctuates. For example, the set point for typical human body temperature is approximately 37°C (98.6°F). Physiological parameters, such as body temperature and blood pressure, tend to fluctuate within a range of a few degrees above and below that point. Receptors located in the body’s key places detect changes from this set point and relay information to the control centers located in the brain. The control centers monitor and send information to effector organs to control the body’s response. If these effectors reverse the original condition, the system is said to be regulated through negative feedback.

Control centers in the brain and other parts of the body monitor and react to deviations from this set point using negative feedback. Negative feedback is a mechanism that reverses a deviation from the set point, and in turn, 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: a sensor, control center and an effector. (Figure 1.3.2a). A sensor, also referred to a receptor, monitors a physiological value, which is then reported to the control center. The control center 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 causes a change to reverse the situation and return the value to the normal range.

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 1.3.2b). 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, 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.

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 the mother’s body are required to expel the baby at the end of pregnancy. The events of childbirth, once begun, must progress rapidly to a conclusion or the life of the mother and the baby are at risk. The extreme muscular work of labor and delivery are the result of a positive feedback system (Figure 1.3.3).

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.

Chapter Review

Homeostasis is the activity of cells throughout the body to maintain the physiological state within a narrow range that is compatible with life. Homeostasis is regulated by negative feedback loops and, much less frequently, by positive feedback loops. Both have the same components of a stimulus, sensor, control center, and effector; however, negative feedback loops work to prevent an excessive response to the stimulus, whereas positive feedback loops intensify the response until an end point is reached.

1.4 Anatomical Terminology

Learning Objectives

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

• Use appropriate anatomical terminology to identify key body structures, body regions, and directions in the body
• 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 major body cavities

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. For example, you might say a scar “on the anterior antebrachium 3 inches proximal to the carpus”. Anatomical terms are derived from ancient Greek and Latin words. Because these languages are no longer used in everyday conversation, the meaning of their words do 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 1.4.1. 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.

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 1.4.1). 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 1.4.2). 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.

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, 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 1.4.3.

• The sagittal plane 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 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 (or horizontal) plane divides the body or organ horizontally into upper and lower portions. Transverse planes produce images referred to as cross sections.

Body Cavities

The body maintains its internal organization by means of membranes, sheaths, and other structures that separate compartments. The main cavities of the body include the cranial, thoracic and abdominopelvic (also known as the peritoneal) cavities. The cranial bones create the cranial cavity where the brain sits. The thoracic cavity is enclosed by the rib cage and 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/peritoneal cavity. The abdominopelvic/peritoneal 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 1.4.4).

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).

Chapter Review

Ancient Greek and Latin words are used to build anatomical terms. A standard reference position for mapping the body’s structures is the normal anatomical position. Regions of the body are identified using terms such as “occipital” that are more precise than common words and phrases such as “the back of the head.” Directional terms such as anterior and posterior are essential for accurately describing the relative locations of body structures. Images of the body’s interior commonly align along one of three planes: the sagittal, frontal, or transverse.

1.5 Medical Imaging

Learning Objectives

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

• Compare and contrast medical imaging techniques in terms of their function and use in studying the human body

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; 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 1.5.1). 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.

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 the 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 1.5.2a). 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.”

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.

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 1.5.2b), 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, abnormalities, and diseases.

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 1.5.2c) 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.

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 1.5.2d). 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.

Microscopy

Microscopy is not an imaging technique, but rather a way to view a small sample of tissue removed from the human body. When there is a problem in a specific body tissue, a physician can remove a sample of the tissue from the body and prepare it as a microscope slide. The physician can then view structures not visible with the naked eye. Commonly used microscope techniques include light microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Tissue samples used in light microscopy are typically stained using colorful dyes to enhance contrast as various parts of the cells take up dye differently. Light microscopes typically magnify approximately 10x to 1000x. In contrast, SEM can magnify up to 500,000x and TEM can magnify up to 10,000,000x. Both SEM and TEM use electron waves rather than light to magnify a sample. SEM provides a 3D image of the sample surface, whereas TEM provides a high resolution image from an ultra-thin sample.

Chapter Review

Detailed anatomical drawings of the human body first became available in the fifteenth and sixteenth centuries; however, it was not until the end of the nineteenth century, and the discovery of X-rays, that anatomists and physicians discovered non-surgical methods to look inside a living body. Since then, many other techniques, including CT scans, MRI scans, PET scans, ultrasonography, and advanced microscopy techniques have been developed, providing more accurate and detailed views of the human body’s form and function.