WINTER QUARTER
NEW --Week 10
Did someone accidentally pickup Bekah's RED portfolio folder? If so, please put in Heesoon's mailbox! Thanks!
Nancy's Eval Schedule
Heesoon's Eval Schedule
Jean's Eval Schedule
-----------------------------------------------------------------------------------------------------------------
NEW --Week 9
Creative Project Schedule
Potluck Info
Portfolio checklist (Please note that we added a part for you to indicate if you are staying/leaving the program. This is important since we need to know if you are leaving so we can write your evaluation in the final form. If you have already printed/filled this out, please go back and add this info.
Article link: "Reconceptualizing the biological based mental illness"
-----------------------------------------------------------------------------------------------------------------
NEW --Week 8
Heesoon's
Lecture notes 3-1-07
Theme Question Week 8
Applying Gilligan’s concept of violence, what can be done to understand the defendant/perpetrator of the local rape of a young girl (see link)? You need to directly relate your answer to specific references from the seminar text.
------------------------------------------------------
NEW --Week 7
Seminar Books for Spring
Wednesday Feb 21~Marilyn's Journaling Workshop will be held in Sem II C2107 at 2:00pm. PLEASE NOTE TIME!
Links from Heesoon's Lecture 2/20/07
1. Implicit Association
2. Washington State guidelines for Psychologists
3. American Counseling Association
Astrology and diet handout (from Nancy's lecture)
----------------------------------------------------------------------------
NEW --Week 6
Results of Student Survey
--Day of Absence/Day of Presence: Link to information and schedules.
Theme Question Week 6
What are the downfalls in taking a purely scientific or a purely philosophical point of view?
----------------------------------------------------------------------------FYI: 2 Articles you mihgt be interested in:
The DSM-IV-TR and Culture: Considerations for Counselors (pdf)
Wounds that Time Won't Heal: The Neurobiology of Child Abuse (pdf)
---------------------------------------------------------------------------
NEW --Week 5
Theme Paper Question on Ceremony:
Due on Thursday, February 8th
---------------------------------------------------------------------------
For those interested in the visual impact of the "disappeareds" go to:
http://www.desaparecidos.org/arg/eng.html
------------------------------------------------------------------
Article to help with paper! (pdf)
Article to help with paper! (Word)
------------------------------------------------------------------
NEW -- CHANGE IN SCHEDULE! See syllabus for specifics...
Thursday, February 1st, June O'Brien
will speak on Drug and Alcohol treatment (after Nancy's lecture on
pharmacology of drug use).
Thursday, February 8th, (week 5).
Maxine will be our guest speaker.
------------------------------------------------------------------
NEW -- Genetics
Theme Homework Answers (click on link)
Theme Question Week 3: Genetics-Problem D on worksheet.
For
those who can't get enough, link to more pedigree problems!
Links to DSM-IV-TR
Bipolar Disorder
PTSD
Schizophrenia
Theme Question Week 2: Agreeing that temperment is genetic in orgin-How has it been affected in you by your subsequent environment?
Research Methods in Psychology
Hypothesis
1. Experiments (Nomothetic orientation)
Research Design
Experimental ---Cause and Effect
Correlational--- Only about the relationships
“Tended to be higher”
Independent Variable
Dependent Variable
2. Single –Participant Studies (Idiographic Orientation)
- The case studies---relies on clinical data, such as observations, psychological tests, and historical and biographical information.
Cannot demonstrate cause-and-effect relationships.
- The single-participant experiment (Skinner)
Is different from the case study in that it is actually an experiment in which some aspect of the person’s own behavior is used as a control or baseline for comparison with future behaviors.
3. Analogue Studies
An investigation that attempts to replicate or simulate, under
controlled
conditions, a situation that occurs in real life.
Examples:
- To study the possible effects of anew form of treatment on patients
with anxiety disorders, the researcher may use students who have high test anxiety rather than patients with anxiety disorders.
- To test the hypothesis that human depression is caused by continual
encounters with events that one cannot control, the researcher exposes rats to uncontrollable aversive stimuli and examines the increase of depressivelike behaviors such as lack of motivation, inability to learn, and general apathy.
4. Field Studies
Behaviors and events are observed and recorded in their
natural
environment. Sometimes employ data collection technique such as
- questionnaires
- interviews
- analysis of existing records but primary technique is observation. Observers need to be trained have enough self-discipline to avoid disrupting or modifying the behavior processes they are observing and recording.
One needs to understand that
1) Limit to Generalization
2) Sample vs. Population
Primary research
Secondary research
News and Class Information
|
Centering. Syllabus, Covenant, Seminar Group, etc. -Psychopathology -Defense mechanisms (in-depth analysis)
|
Seminar Centering Student introductions.
Readings for SeminarThe Diary of Vaslav Nijinsky. |
AM: Centering. Genetic code Genetics of mental illness
PM: Seminar & Movement Readings for SeminarThe Cosmic Serpent P. 1-80 [Part 1 & plus (will be posted on your faculty's office door) DUE: WEEKLY THEME PAPER |
For Week Two
Wednesday-Molecules of Emotion (p. 9-149)
Thursday- American Vulgar (Part 1).
For Winter Classroom Schedules go to: http://www.evergreen.edu/classschedules/
(great idea David Z)
FALL QUARTER
Copy and paste this form to a blank word document. You can fit three of these on one page.
Creative Project Feedback
Your Name (please print) ________________________
Medium (music, poem, drawing, three-dimensional, performance, etc.
______________
________________________________________________________________________________
________________________________________________________________________________
What caught your interest? (be specific) ______________________________________________________
______________________________________________________________________________
______________________________________________________________________________
CREATIVE PROJECT PRESENTATION SCHEDULE
Tuesday
Thursday
Longhouse
SEM II D1105
9:00-9:20
Centering/announcements
Centering/announcements
9:20-9:30 Miss Kate
Mickey Kelly
9:30-9:40 Madison Bailey
Maeve Dempsey
9:40-9:50 Wendy Aporta
Cheri Knighton
9:50-10:00
Jeanne
Kleiwer
10:00-10:10 Dan Downey
Aaron
Ping
10:10-10:20 Claudia Goeman
Kelly
Pratt
10:20-10:30 Faridah
............Emma Bailey
10:30-10:45 BREAK
BREAK
10:45-10:55 Kazuko Rosen
Dianne Kerwin
10:55-11:05 David Zielinski Koska
Mikaela
Murphy
11:05-11:15 Allyson
......Diva Springmeyer
11:15-11:25 Bonnie
Sandra
Vernon
11:25-11:35 Deborah
Trisha
Johnson
11:40-11:50 Thomas Clark
Angie,
Grace Lund,JackieBoatmant
11:50-12:00 Ethan
Emily
Cox
12:00-12:10 Dan
Cinkovich
Ed Brender
12:10-12:20 Amanda
H.
King
12:30-12:45 LUNCH
POTLUCK
CAB 108 (1:45-2:45
PM)
SEM II D1105
1:45-1:55 Hukee
Meredith
McCord
1:55-2:05 Laura
Allen
Emily Cates
2:05-2:15 Kim Briggs
Eric Buechel
2:15-2:25 Jennie Hudson
Lauren
Tague
2:25-2:35
Jens Lund
2:35-2:45 Bekah J.
Masha
Lisitsa
2:45-2:55 Judy Nickels
Kendra
Debow
SEM II A1107 (3:00-5:00
PM)
SEM II A1105
3:00-3:10 Jackie, Vicky,
Amanda
Tori, Tanya, Jen
3:10-3:20 Alexander Foster
Celeste
Radelet
3:20-3:30 Izumi Takeda
Alicia Poston
3:40-3:50 Katherine Steward
Kendra
Oborn
3:50-4:00 Jason
Stedman
Racheal Mann
4:00-4:05 Kristy Schrader
Laura Wester
4:05-4:10
........... Melissa Little
4:10-4:15 Charlie
Shealy
JohnO’Hagan
4:15-4:20 Memo, Llewelyn
Phillip
Morina
4:20-4:25
| Ester
Hegel
4:24-4:30
Anna
|
4:30-4:35
Jeannie
Hudson
4:35-4:40 Molly,
Rowan, Chenoa
4:40-4:45 Satya
Curcio
4:45-4:55
Lizzy
Martin
4:55-5:00 Memo
Please show respect to you and your learning community members by being in class for their presentations. Show up only for your project and/or leaving early shows insensitivity for others and this will reflect on your evaluation. You will need to print out 77 feedback froms from our program website.
POTLUCK SIGN UP
Paper plates: Claudia
Cups: Jennie
Napkins & silverwares: Claudia
Main
Dish or Side
Dish
Beverages
Desserts
Artichoke
Dip/bread-Cheri
Juice-Diva
Cake-Charlie
Couscous-kazuko
juice-Kendra
Emma-cookies
David
Pop-Jackie
Wendy-pumpkin bread
Jeanne-Mac &
Cheese
Water/koolaid-Ian peppermint
brownies-Trisha
John-Chicken
Juice-Maeve
Cookies-Holly
Melissa-Rice
Phillip
Cookies-Laura
Alex-Vegetable
platter
Megan Soda
Estar-yakimordo
Eric-juice
Sandra-sugar free jello salad
John-Sushi
Ethan
Soda
Ed-brownies
Masha-pasta
salad
Madison-cake
Celeste
Allyson-something yummy
Alicia
Brownies-Bonnie
Emily-something
good
Izumi-Pie
Aaron
Lizzi-butter bars
Angie-chips
Judy-Lemmon Bfread
Grace-Sushi
Tanya-cheesecake
Pickled asparagas-Jackie
& broccoli salad
Salsa-Lu
Chicken and rice-memo
Molly-chips/salsa
Lauren
Mikaela-hummus
Mickey-carrot salad
Jen
Lauren
Hukee-rice pesto pasta
dDianne-quinoa
Bekah-roasted veggies
Kelly-falafel patties
Satya
April
Chenoa
Kristy
Katherine-baked beans
Human Health and Development
Project Guidelines for Creativity Project Presentations
In the last week of the quarter you have an opportunity to present a Creative Response to the material covered during the quarter. Following are Guidelines for your preparation.
- You may choose to work individually or with a small group of program co-learners. Whichever way suits you, remember that the project is to be ORIGINAL WORK and it is to REFLECT, INTEGRATE, and SYNTHESIZE PROGRAM MATERIAL.
- Whichever you choose, it is necessary that you bring your idea(s) to your Learning Summary Group as soon as you begin to formulate a plan. In the LS group, each of you will talk about your idea and get feedback from group members. For example, the group will ask questions about the proposed work; help you clarify your plan; let you know if you are on track with Program material or going off on a tangent.
- Mode of Presentation
. movement
. poetry
. visual art (with explanation)
. lecture/presentation which could include video or film footage
- Time allowance for individual presentation: up 10 minutes; for Group: depending on the number of people in the group, up to 20 minutes.
- Deadlines:
Week 9, Monday Submit the following (put under your
seminar group attendance
sheet) the following:
. title or subject matter and brief description of the project
. your name and, if you are part of a group, the names of the others
. any anticipated equipment use for the Program Aide and the three
faculty
. a list of the works, lectures, films or other program influences on
your work
Creative Project Conference
Schedule for Heesoon’s Seminar Group
Tuesday
Thursday
1:45-1:55 Tori Needer
1:55-2:05 Wendy Aporta
2:05-2:15 Llewelyn
Johnson
2:15-2:25 Jackie Boatman
2:25-2:35 Alicia
Poston
Charlie Shealy
2:35-2:45
Ethan
Bonnie
2:45-2:55
David
Chenoa
3:00-3:10 Rowan
S.
Emma Bailey
3:10-3:20 Kendra Debow
3:20-3:30 H.King
3:30-3:40 Cheri Knighton
3:40-3:50 Kazuko Rosen
3:50-4:00 Diva
Springmeyer
Mickey Kelly
4:10-4:20 Izumi Takeda
4:20-4:30 Dan Downey
4:30-4:40 Aaron Ping
4:40-4:50 Estar Hegel
4:50-5:00 Jennifer
Hutchinson
Schedule for Gene Sine
Tuesday
Thursday
1:45-1:55 Hukee
Trisha
1:55-2:05 Madison
Kelly
2:05-2:15 Bird
Jeanne
2:15-2:25 Dan
Judy
2:25-2:35 Angela
Katherine
2:35-2:45 Dianne
Rachel
2:45-2:55 John
Mikaela
2:55-3:05 Alexander
Foster
Sandra V.
3:05-3:15 Tanya
Lauren
Allen
3:15-3:25 Jason Stedman
KristySchrader
3:25-3:35 EmilyCates
4:43 Kim
Briggs
Schedule for Jean Cavendish
Tuesday
Thursday
1:45-1:55 Kendra
Oborn
Staya
Curcio
1:55-2:05 Memo
Ed Breudler
2:05-2:15 Vicky
Lauren
Tague
2:15-2:25 April
John
Schlichting
2:25-2:35 Debie
Emily
Cox
2:35-2:45 Grace Lund
Phillip Merino
2:45-2:55 Deborah Hayes
Jennie Hudson
3:00-3:10
Melissa
3:10-3:20 Masha
Lisitsa
Allyson
3:20-3:30 Amanda
Holderman
Lizi Martin
3:30-3:40 JensLund
Miss
Kate Benak
3:40-3:50 Maeve Dempsey
LauraWestel
3:50-4:00 Rebecca
Jag
Anna
Lisa
4:10-4:20
Ian Clements
4:20-4:30
4:30-4:40
4:40-4:50 Faridha Mon
4:50-5:00 Megan Edwards
Information on Islamic presentation:
You can go to: www.islam-guide.com
Islamic research foundation: www.irf.net
Winter Quarter Book List
Acocella J. (2006). (Ed.). The diary of Vaslav
Nijinsky. University of Illinois Press.
ISBN: 0252073622. 384 pages.
Bland, J. S. (1999). Genetic nutritioneering. Keats Publishing. ISBN:
087983921X.
Gilligan, J. (1997). Reflections on a national epidemic violence. NY: Random
House, Inc. ISBN: 0679779124
Greenberg, J. (1964). I never promised you a rose
garden. Signet. ISBN: 0451160312
Grudin, R. (2006). American vulgar: The politics of manipulation versus
the culture of
awareness. NY: Shoemaker Hoard. ISBN: 1-59376-102-3.
Narby, J. (1998). The cosmic serpent: DNA and the origins of knowledge.
NY:
Tarcher/Putnam. ISBN 0-87477-964-2.
Pert, C. B. (2003). Molecucles of Emotion. NY: Scribner. ISBN:
0684846349
Silko, L. M. (1988). Ceremony. NY: Penguin Group. ISBN: 0140086838, 262 pages.
Thornton, L. (1991). Imagining Argentina. NY: Bantam
Books. ISNN 0-553-34579-6.
Bodies Exhibit
If you are not going to attend the exhibit the following questions need to be answered and turned into your learning summary instructor.
1. Write in depth the reasons for not going into the body exhibit. Be specific. e.g. "I don not feel comfortable"...elaborate this from your inner experience.
2. What did you learn about the neurological factors affecting emotions?
800 Pike Street
Seattle WA 98101
Post-Secondary
Teacher’s Guide
Post-Secondary
BODIES…THE EXHIBITION
800 Pike
Seattle, Washington 89109
Across from the Convention Center
For school group reservations call
800.840.1157
2
CREDITS
Medical Director
Dr. Roy Glover, Professor Emeritus, Anatomy and Cell Biology
University of Michigan
Editors
Cheryl Muré, Director of Education, Premier Exhibitions, Inc.
Terrie Nolinske, Ph.D., Vice President of Education, MOSI
Writers: Exhibition Catalog
Judith B. Geller, Editor, Premier Exhibitions, Inc.
John Zaller, Researcher, Premier Exhibitions, Inc.
Writers: Student Learning Activities
Anthonette Carregal, Director of Academic and Family Programs, MOSI
Anthony Pelaez, Manager of Adult and Family Programs, MOSI
Sonya Rose, Director of Group and Outreach Programs, MOSI
Layout and Design
Cheryl Muré, Director of Education, Premier Exhibitions, Inc.
Lucy Ward, Graphic Design, Premier Exhibitions, Inc.
3
Table of Contents
Introduction
………………………………………………..……….…….4
The Polymer Preservation Process
……………………………………..…….4
Preparing to Visit the Exhibition
………………………………..….………5
Teacher’s Guide to Student Learning – Applied Learning Exercises
Skeletal System
………………………………………………………..........
7
Muscular System
…………..…………………………..………………..…….
8
Nervous System
…………………………..…………………………........…11
Circulatory System
……………………………………….………..…….......…13
Respiratory System
…………………………………….………………………...15
Digestive System
………………………………………….…...…………...…17
Endocrine System
……………………………………………………………….20
Urinary System
……………………………………………………….……..
23
Male Reproductive System
……………………………………………………27
Female Reproductive System
………………………………………………
30
Organization of Exhibition
…………………………………………………......33
Floor Plan of the Exhibition
………………………………………………………34
Teacher’s Guide to Exhibition Galleries
Skeletal Gallery
…………………………
……………………...…..…….…35
Muscular Gallery
…………..………………………………………………..…40
Nervous System Gallery
………………………….………………...……..…43
Circulatory System Gallery
……………………………………………46
Respiratory System Gallery
…………………………………...……...48
Digestive System Gallery
……………………………….………………….....51
Reproductive and Urinary System
Gallery………………………..………55
Optional: Fetal Gallery
………………………………………………………60
Treated Body Gallery
………………………………………………………62
Glossary of Terms
…………………………………………...……….………..…67
4
INTRODUCTION
In BODIES…THE EXHIBITION, you will see 21 bodies dissected to show
various
systems throughout nine galleries. You will also see over 250
individual organs or
parts - some healthy, some diseased. You will see the effect that
disease and unhealthy
life choices have on the body – what happens to the lungs, for example,
when people
smoke. You will also see how positively amazing the body is – how the
pulleys,
fulcrums and levers we know as muscles, joints and bones let us function
continuously without even thinking about it.
BODIES…THE EXHIBITION celebrates the human body and its inter-related
systems
and functions. By understanding how the body works, we believe you can
better care
for your body and keep it healthy. By studying the systems of the body,
you will come
away with a new appreciation for life.
BODIES…THE EXHIBITION provides an unprecedented opportunity for learning
human anatomy, physiology, and chemistry. BODIES …THE EXHIBITION
enables you
and your students to speak with ease about the body, dispelling some
preconceived
ideas and fears.
This Teacher’s Guide is divided into two sections and applies to
academic content
across the curriculum. First, you will find the Guide to Student
Learning with Applied
Learning Exercises. Next is the Guide to Exhibition Galleries, a road
map to follow
when you visit the exhibition with your students.
THE POLYMER PRESERVATION PROCESS
To help you see what a body really looks like on the inside, this
exhibition uses real
human bodies that have been preserved so they do not decay.
A human specimen is first preserved according to standard mortuary
science. The
specimen is then dissected to show whatever it is that someone wants to
show. Once
dissected, the specimen is immersed in acetone, which eliminates all
body water. The
specimen is then placed in a large bath of silicone, or polymer, and
sealed in a vacuum
chamber. Under vacuum, acetone leaves the body in the form of gas and
the polymer
replaces it, entering each cell and body tissue. A catalyst is then
applied to the
specimen, hardening it and completing the process.
This method of preservation creates a specimen that will not decay.
This offers
thousands of unique teaching possibilities for educators at all levels,
including medical
professionals, archeologists and other scientists.
5
PREPARING TO VISIT THE EXHIBITION
The setting of this exhibition lends itself to a quiet, respectful
viewing of specimens.
There are nine galleries – skeletal system, muscle system, nervous
system, circulatory
system, digestive system, reproductive system, an optional fetal
gallery, and a gallery
that shows how prosthetic joints and surgical tools are used to restore
our health. The
ninth gallery invites guests to write comments about their exhibition
visit and to
thumb through age appropriate books on anatomy.
This amazing exhibition features 21 preserved whole human specimens and
over 250
organs and partial body specimens. In this exhibition all organs and
body systems are
on display. BODIES…THE EXHIBITION teaches you about your body from the
inside
out. Students see diseased and healthy organs and learn about healthy
lifestyle
choices.
BODIES…THE EXHIBITION allows students to learn about their own bodies
and how
to take better care of their health. The exhibition enables students to
see and
understand medical conditions friends and family members face in a
whole new way
by highlighting pressing health concerns including smoking, cancer,
cirrhosis, arthritis
and fractures.
Please prepare your students by discussing what they will be seeing -
real, preserved
specimens of the human body. The specimens have been dissected to
specifically
illustrate each body system and function. Male and female reproductive
organs are
visible in most of the full body specimens. The fetal room is entirely
optional. All
embryos or fetuses died of natural causes in utero.
The specimens are preserved through a process called Polymer
Preservation. This
process is a revolutionary technique in which human tissue is
permanently preserved
using liquid silicone rubber. This prevents the natural process of
decay, making the
specimens available for study for an indefinite period of time. Polymer
Preservation
provides a closer look at the skeletal, muscular, nervous, respiratory,
digestive, urinary,
reproductive, endocrine and circulatory systems, unveiling the
mysteries of the human
anatomy. Human specimens are used instead of models to study individual
variations
and uniqueness.
The exhibition offers a special children’s audio tour, comprehensive
Teacher’s Guides
for Grades K-2, 3-5, 6-8 and 9-12 plus a Post-Secondary Guide for
advanced students.
6
APPLIED LEARNING EXERCISES
By the time students reach the post-secondary level it is expected that
they will be
familiar with the basic structure and function of the human body. The
following
Applied Learning Exercises are designed to expand their knowledge of
the body and
help them apply what they have learned through the use of practical
examples.
For each body system, a selected topic - or topics - will form the
focal point for the
exercises. Each topic will introduce students to relevant issues or
problems that they
themselves might have personally encountered or that they might have
heard or read
about.
Each exercise begins with a series of Questions. The information
requested may or
may not be familiar based on a students previous course work. It is
assumed that
some information will have to be found by consulting reference
textbooks. After
answering these questions, students should have most of the information
necessary to
complete the Putting-It-All-Together section. Again, some additional
reading and
reasoning may be needed to complete this section. Students should be
encouraged to
share their answers with one another explaining the reasoning they used
in their
development. A final Take Home Message is intended to highlight the
significance of
each exercise.
The specific structures discussed in these exercises will be referenced
to the bodies
and specimens displayed in each of the galleries in BODIES...THE
EXHIBITION. This
will allow students who visit the exhibition to see and understand them
from a more
educated point of view.
Spinal cord exposed
7
THE SKELETAL SYSTEM
Bone Health
QUESTIONS
Q1 Describe the different types of bone tissue cells.
Q2 Describe how the organic and inorganic components of bone are formed
and
organized
Q3 What is the relationship between the processes of ossification and
calcification?
Q4 List as many factors as you can that influence these two processes.
PUTTING IT ALL-TOGETHER
A 14 year-old girl lives in an apartment in the city. She does not seem
to like outdoor
activities. When she is not at school she spends most of her time
watching TV,
playing video games, drinking soft drinks, eating junk food and talking
with her friends
on the phone. One afternoon she stumbles, falls and breaks her leg.
Although she
appears healthy, her doctor - after taking her medical history - tells
her that it might
take longer for her broken leg to heal than one might normally expect
for a young
person her age. He also advises her that it is important for her to
change her eating
habits and, after her leg heals, to get more exercise and definitely
spend more time
outdoors. Why do you think the doctor felt it necessary to give her
this rather unusual
prescription and what might be the cause of this longer healing time?
This girl most likely had a low level of calcium in her blood as a
result of her lack of
vitamin D. Her depressed calcium level will naturally slow the bone
healing process
because mineralization of new bone lags behind the formation of osteoid
by
osteoblasts. Vitamin D is required to stimulate the absorption and
transport of
calcium from the gastrointestinal tract into the blood. The source of
vitamin D is either
diet or synthesis in the skin upon exposure to UV radiation. The girl’s
nutrition was
poor and she tended to remain indoors away from normal amounts of UV
light making
lack of vitamin D likely in her case.
TAKE HOME MESSAGE
It is important to take good care of your bones. Good bone health
depends on a
number of different factors. One of the most important factors
necessary for good
bone health is an adequate diet containing the normal daily requirement
of calcium.
UV light is also important because of the effect it has on the skin. So
don’t be a couch
potato! Eat right, spend time out of doors and get adequate amounts of
exercise.
Your bones will be stronger because of it.
BODIES….THE EXHIBITION
Skeletal Gallery
Cases 1 - 10
8
THE MUSCULAR SYSTEM
The Achilles Tendon
QUESTIONS
Q1 What type of tissue is a tendon made of?
Q2 Describe the nature of the blood supply to a tendon.
Q3 With what muscle is the Achilles tendon associated?
Q4 To which bone does the Achilles tendon attach?
Q5 What is the function of the Achilles tendon?
PUTTING IT ALL-TOGETHER
A young football player arrives in your office with a suspected torn
Achilles tendon.
What difficulty would the patient experience that would confirm to you
that this
diagnosis is correct? Assuming that surgery is necessary to repair the
torn tendon,
describe to the patient the circumstances surrounding the surgery and
his expected
time of recovery based on what you know about the Achilles tendon and
its function.
What advice might you give this player that could potentially minimize
future damage
to this important tendon?
1. During surgery the foot is plantar flexed (the function of the
gastrocnemius muscle)
in order to bring the ends of the torn tendon together. The leg and
foot are cast to
stabilize the repair.
2. The healing process will take approximately 8-10 weeks. Tendons have
a very poor
blood supply and therefore heal very slowly.
3. Because of the nature of the injury and the length of time it will
take to heal, the
patient will not be able to put any weight on the foot during the
healing process; thus
requiring the use of crutches.
4. After the cast is removed, the foot will be in the plantar flexed
position (the result of
immobilization of the foot without the ability to contract the
gastrocnemius muscle).
Returning the foot to its normal walking position will take some time.
This is usually
done by asking the patient to wear a boot-like appliance in which the
inside surface of
the boot is built up in layers to conform to the plantar flexed
position of the foot. Then
week-by-week, one layer at a time is removed from the inside surface of
the boot until
the patient’s foot again rests flat on the floor.
TAKE HOME MESSAGE
Protect your Achilles tendon - and all of your other muscle tendons -
through regular
exercise preceded by a warm-up stretching routine. The slow, controlled
stretching of
muscle tendons before rigorous exercise is an important way to protect
them from
tearing. Stretching exercises are important for everyone but
particularly for those
people who do not engage in regular exercise or for older individuals
since tendons
become more susceptible to injury under both circumstances.
9
The Rotator Cuff
QUESTIONS
Q1 Describe the anatomy of a typical movable joint.
Q2 Describe the anatomy of the shoulder joint.
Q3 What movements are permitted at the shoulder joint?
Q4 What structures serve to stabilize the shoulder joint during its
different
movements?
Q5 What is a bursa? Explain how they aid in movement at a joint like
the shoulder.
PUTTING IT ALL-TOGETHER
A 40-year-old amateur tennis player has begun to complain that her
right shoulder
hurts. The pain is particularly intense when she attempts to serve and
has gotten
progressively worse over the past 5 or 6 years. It now bothers her so
much that it often
keeps her from sleeping at night. She goes to see a physician about the
problem who
discovers that she has some serious muscle weakness in her right
shoulder and that
the motion in her right arm is more limited than that in her left arm.
After examining
her, the physician tells her that he believes she has a partial tear of
the rotator cuff and
that the primary damage is not due to damage to the muscles themselves
but is the
result of damage to the rotator cuff tendons.
What exactly is the rotator cuff and what does it do? What do you think
caused the
rotator cuff damage in this particular instance? Why does a rotator
cuff injury most
commonly affect muscle tendons and why does it seem to occur more
frequently as a
person ages? Why are the infraspinatus and the teres minor muscles more
commonly
involved in rotator cuff injuries? What types of rehabilitation
exercises would you
prescribe for a patient to strengthen their rotator cuff muscles?
1. The rotator cuff consists of four muscles and their tendons that
surround (cuff) the
shoulder joint and attach the humerus (arm bone) to the scapula. These
muscles help
raise and rotate the arm. Also, as the arm is raised, they keep the
humerus tight in the
socket of the scapula.
2. This injury was probably the result of the patient’s repetitive
overhead tennis serving
motion.
3. Rotator cuff injuries most often involve structures with a reduced
blood supply.
Tendons, being composed almost entirely of non-living collagen fibers,
have this type
of blood supply. Tendons undergo progressive degeneration as a person
ages thus
they are more likely to be damaged in an older person.
4. The infraspinatus and teres minor muscles are more commonly involved
in rotator
cuff injuries because they function to help slow down arm motion at the
completion of
a particular movement like a tennis serve or the pitching of a baseball.
10
The Rotator Cuff cont’d
5. Rotator cuff strengthening exercises are done with hand weights – 15
pounds is the
absolute maximum. They are done repetitively until fatigue sets in.
Exercises include:
A) arm curls done with the palm forward and with the palm facing
backward B) front
lifts of the arm done with both the palm up and the palm down and C)
lateral lifts of
the arm done in both the upright and in the bent at the waist position
TAKE HOME MESSAGE
The shoulder joint is both elegant and complex. Its design allows us to
reach and use
our hands in many different positions. While the shoulder joint has
great range of
motion, it is very stable. This makes the shoulder vulnerable to
problems if any parts
aren’t in good working order. The rotator cuff tendons are the key to
the healthy
functioning of the shoulder. They are subject to a lot of wear and
tear, or degeneration,
as we use our arms. Tearing of the rotator cuff tendons is an
especially painful injury.
A torn rotator cuff creates a very weak shoulder. Most of the time
patients with torn
rotator cuffs are in the 40’s or 50’s but these tears can happen at any
age.
BODIES….THE EXHIBITION
Muscular Gallery
Cases 11 - 18
11
THE NERVOUS SYSTEM
Sciatica
QUESTIONS
Q1 Describe the basic structure of a peripheral nerve.
Q2 What are spinal nerves and what is their function?
Q3 Describe the origin of the sciatic nerve from the spinal cord and
the course that the
nerve takes to enter the lower limb.
Q4 What is the relationship between the sciatic nerve and the common
peroneal and
tibial nerves?
Q5 Describe the peripheral distribution of these two nerves.
Many people see a physician because they have pain in their lower back
or in their
lower limbs. In most instances, this pain is the result of some
involvement of the
sciatic nerve. Injury to the sciatic nerve produces a condition known
as sciatica.
Sciatica can result from a variety of different causes. Precise
localization of the cause
of a person’s sciatica is important because only then can an
appropriate treatment
regime be devised and implemented to deal with the condition.
PUTTING IT ALL-TOGETHER
Knowing what you do about the sciatic nerve, list some of the sites
where this nerve
can be damaged resulting in the symptoms associated with sciatica. How
can you tell
where the problem in a particular individual might be considering that
there are a
number of different places where the sciatic nerve might be involved?
Why is
knowledge of the sciatic nerve important to someone giving
intramuscular injections?
Why are these injections almost always given when the patient is lying
down?
1. A herniated intervertebral disc might impinge on the nerve branches
that form the
sciatic nerve. The sciatic nerve itself might be compressed where it
passes deep to the
gluteus and piriformis muscles of the buttocks. Damage can also occur
to the
common peroneal and tibial branches of the nerve. Damage caused by a
tumor can
occur at any point along the sciatic nerve or its terminal branches.
Damage may also
occur as the result of disease in an area adjacent to the nerve; such
as the sacroiliac
joint.
2. The onset of sciatica that results from a herniated disc is acute
(sudden) and often
occurs following a stressful physical movement. The pain from such a
problem affects
the specific nerve roots compressed by the disc, resulting in pain from
the buttocks to
the hip, posterior thigh, leg, ankle and foot. It could also result in
a generalized
weakness of many of the muscles whose fibers run in the sciatic nerve.
The pain and
muscle weakness that results from some involvement of either the
sciatic nerve itself
or one of its branches tends to be more chronic (less sudden onset). In
each case, the
12
Sciatica cont’d
pain and muscle weakness typically involve only the body areas and the
muscles to
which each nerve distributes.
3. Involvement of the sciatic nerve itself typically results in pain
radiating over the
entire area to which the nerve distributes; that is, from the buttocks
to the hip,
posterior thigh, leg, ankle and foot. Involvement of the common
peroneal nerve
usually results in pain that is localized down the front and side of
the leg and the
upper surface of the foot, excluding the little toe. Involvement of the
tibial nerve
usually results in pain almost exclusively localized to the sole of the
foot.
4. The sciatic nerve might be injured if an injection is not given in
the proper location.
For a person lying down, the safest area is the upper lateral quadrant
of the buttocks.
An injection given here may still accidentally pierce a nerve if the
patient is standing
up.
TAKE HOME MESSAGE
The pain that results from involvement of the sciatic nerve can have
many different
causes. It can occur because of something as simple as a misplaced
intramuscular
injection or because of the pressure placed on the nerve by tense
muscles or a
tightened spine. On the other hand, it can also occur because of
something much
more serious such as cancer, a diseased joint, or a herniated disc.
Accurate diagnosis
of the cause of sciatica is imperative since it is the key to the
development of a proper
regimen of treatment.
This is the central nervous system; the brain and the spinal cord.
BODIES….THE EXHIBITION
Nervous System Gallery
Cases 19 - 31
13
THE CIRCULATORY SYSTEM
Fetal Circulation
QUESTIONS
Q1 What is the function of the placenta?
Q2 How is the placenta functionally connected with the fetus?
Q3 What type of blood, oxygenated or un-oxygenated, is found within the
umbilical
arteries and vein? What other blood vessels show a comparable
oxygenation pattern?
Q4 What is meant by the term “blue baby”?
Blood flow through the body is described in terms of several different
circulatory
routes. One of these routes exists only in the fetus and is known as
the fetal
circulation. Immediately after a baby is born, the fetal circulatory
route is adjusted and
two new routes are the formed; the pulmonary circulation route and the
systemic
circulation route. These adjustments insure that the newborn baby’s
blood is properly
oxygenated and effectively distributed to all of the newborn’s cells,
tissues and organs.
PUTTING IT ALL-TOGETHER
The fetal circulation route contains two important right-left shunts
that are necessary
to insure that oxygenated blood reaches all of the developing fetal
cells, tissue and
organs. Name these important shunts, locate them and describe why each
is
important for the normal development of the developing fetus. When do
each of these
shunts close? Why is their closure necessary to the health of the
newborn?
1. The foramen ovale is an opening in the interatrial septum of the
fetal heart, an
opening that allows oxygenated blood returning to the right atrium from
the placenta
to pass directly into the left atrium. Since the lungs are not
functional before birth, the
foramen ovale allows blood to bypass the future pulmonary side of the
heart (right
side) and directly enter the systemic side of the heart (left side)
from where it can be
directed to the cells, tissues and organs of the fetus. The ductus
arteriosus is a small
duct that connects the pulmonary trunk with the aorta. It also allows
oxygenated blood
to pass directly from the pulmonary trunk into the aorta. This allows
the small amount
of blood leaving the right ventricle to bypass the lungs since they do
not begin to
function until immediately after birth.
2. The foramen ovale closes immediately after birth while the ductus
arteriosus usually
closes during the first three weeks of life. When both of these
structures close, the
normal adult pattern of blood circulation through the heart, the
pulmonary and the
systemic circulation routes is established. A small depression seen in
the interatrial
septum of the adult heart, the fossa ovalis indicates the location of
what once was the
foramen ovale. Similarly, a small fibrous cord seen connecting the
pulmonary trunk
(the ligamentum arteriosum) is all that remains of the fetal ductus
arteriosus.
14
Fetal Circulation cont’d
3. The ductus arteriosus, though small, is very important to the normal
development
of the heart. Since the heart is made up of cardiac muscle which must
contract in
order to develop properly, it is necessary for the wall of the
developing right ventricle
to pump blood even though the lungs to which it normally sends its
blood are not
functioning. It can do this by pumping blood into the pulmonary trunk
from where it is
shunted to the aorta thus bypassing the lungs. This allows the right
ventricle to
develop normally and be ready to function immediately after the baby is
born. If the
ductus weren’t present, the right ventricle would be underdeveloped at
birth and not
be able to effectively pump blood in its normal fashion. This is why
the ductus
arteriosus is sometimes called the “exercise channel of the right
ventricle.”
It is not uncommon for the foramen ovale to not close completely at the
time of birth.
When this happens, unoxygenated blood returning to the right atrium is
shunted
directly into the left atrium. This is a problem once the lungs, and
not the placenta,
assume the responsibility for oxygenating the blood. The consequence of
a patent
foramen ovale is that a great deal of unoxygenated blood is delivered
to the body via
the aorta. Since blood rich in carbon dioxide is blue, and not red, it
gives a somewhat
bluish color to the skin surface. Thus the name “blue baby” is often
given to infants
that experience this condition. Fortunately this problem is easily
repaired surgically.
When this is done, the normal pattern of adult circulation is
established.
TAKE HOME MESSAGE
After birth, the physician’s job is to determine the health of the
newborn infant. Visual
examination is an important way to assess several different internal
developmental
problems. The bluish appearance of the skin often indicates a
circulatory problem,
most often an interatrial heart defect. Such a defect can be life
threatening and needs
to be surgically repaired. A group of chemicals known as prostaglandins
seem to play
an important role in maintaining a patent ductus arteriosus during
fetal life. This
finding has important clinical consequences. It has been shown that an
injection of
prostaglandins can be used to insure that the ductus arteriosus doesn’t
close
prematurely or to insure that it remains patent to compensate for some
other severe
heart anomaly, i.e. coartation (narrowing) of the aorta. Likewise,
giving prostaglandin
inhibitors to a premature baby born can insure that the ductus closes
properly which
helps establish the normal newborn circulation routes.
BODIES….THE EXHIBITION
Circulatory System Gallery
Cases 32 - 49
Veins and arteries of the heart
15
THE RESPIRATORY SYSTEM
Cystic Fibrosis
QUESTIONS
Q1 List, in correct order, the respiratory passageways that carry
outside air to the lung
alveoli.
Q2 Describe the processes by which inspired air is filtered, humidified
and warmed.
Q3 Describe how integral membrane proteins, facilitated diffusion, and
osmotic
gradients influence the movement of materials across the cell membrane.
Q4 What is the function of the exocrine portion of the pancreas?
Q5 What is an autosomal recessive trait?
PUTTING IT ALL-TOGETHER
Since Cystic fibrosis is a genetic condition that involves glands found
throughout the
body, it is a disease that can affect many different organs. Cystic
fibrosis is inherited as
an autosomal recessive trait. What does this say about the genetic
makeup of the
parents of an affected individual? What chance does a child born to
parents that
possess the gene for cystic fibrosis have to be born with the disease?
To be born as a
carrier of the disease? To be born as a non-carrier of the disease?
This disease affects
secretions within the lung airways and within the ducts of the
pancreas. Describe the
process responsible for altered function in both of these organs. How
does this
disease affect the ability of the pancreas and lung to function
normally? Describe what
can be done in each instance to help restore normal function.
1. An abnormal gene on one of the autosomal chromosomes (one of the
first 22 "nonsex"
chromosomes) from each parent is required to cause the disease. People
with
only one abnormal gene in the gene pair are called carriers but, since
the gene is
recessive, they do not exhibit the disease. In other words, the normal
gene of the pair
can supply the function of the gene so that the abnormal gene is
described as acting in
a recessive manner. Both parents must be carriers in order for a child
to have
symptoms of the disease. A child who inherits the gene from one parent
will be a
carrier.
2. The First Law of Mendelian Inheritance is known as the Principle of
Segregation. It
states that two members of a gene pair (alleles) segregate (separate)
from each other
in the formation of gametes. Half the gametes carry one allele and the
other half
carries the other allele. In the case that both parents are carriers of
the disease but
neither are affected, there is a 25% chance that a child will be born
with the disease, a
50% chance that a child will be a carrier of the disease and a 25%
chance that a child
will be born a non-carrier of the disease.
3. Cystic fibrosis affects chloride transport across cells membranes.
People with the
disease cannot effectively secrete chloride. This disrupts the
essential balance of salt
and water that is needed to maintain a normal thin coating of fluid and
mucus inside
16
Cystic Fibrosis cont’d
of the lungs, pancreas, and passageways in other organs. The mucus
becomes thick,
sticky, and hard to move. Normally, mucus in the lungs traps germs
which are then
cleared out of the lungs. But in cystic fibrosis, the thick, sticky
mucus and the germs it
traps remain in the lungs and the lungs become infected. In the
pancreas, the same
process obstructs the pancreatic ducts and leads to a backup of enzymes
that can
ultimately destroy the pancreas itself.
4. The primary treatment of cystic fibrosis involves agents that break
up the thick
mucous in the lungs. This includes postural drainage, also called chest
physical
therapy [CPT]), a procedure that requires vigorous percussion (by using
cupped
hands) on the back and chest to dislodge the thick mucus from the
lungs. Antibiotics
are also used to treat lung infections. Cystic fibrosis also can affect
the digestive
system interfering with the ability of the body to absorb adequate
nutrients. To address
this problem, people are encouraged to eat an enriched diet and to take
both
replacement vitamins and pancreatic enzymes.
TAKE HOME MESSAGE
The Cystic Fibrosis Foundation was established in 1955 to raise money
for research to
find a cure for cystic fibrosis and to improve the quality of life for
the 30,000 children
and young adults who suffer from the disease. Today there is still no
cure for cystic
fibrosis but, because of ongoing research, great strides are being
made. Whereas 30
years ago, not many people with cystic fibrosis lived past childhood,
nowadays many
can live well into their 30's.
Bronchial tree in the lung
BODIES….THE EXHIBITION
Respiratory Gallery
Cases 50 - 61
17
THE DIGESTIVE SYSTEM
JAUNDICE
QUESTIONS
Q1 What is bile?
Q2 List some of the important functions of bile.
Q3 What does the formation of bile have to do with hemoglobin?
Q4 Describe the path that bile takes as it flows through the liver to
the gallbladder.
Q5 What stimulates the release of bile from the gallbladder? How does
it eventually
reach the duodenum?
PUTTING IT ALL-TOGETHER
A baby is born 2 month prematurely. After being examined by his
pediatrician, he is
pronounced well enough to go home and does so the following day.
Several days later,
his mother notices that the white part of his eyes (the sclera) and his
skin look yellow.
In a panic she calls her pediatrician to ask for advice. Her
pediatrician tells her that she
believes her son has a case of neonatal jaundice and that there is no
need to worry
unless his skin color begins to get darker. She explains that under
most circumstances
the yellowish color will begin to disappear in a few weeks. She
suggests that one way
to help speed the process is through the use of phototherapy; placing
her baby under
artificial ultraviolet light while at the same time protecting his
eyes. The mother follows
this advice and after three weeks time is pleased to see that her
baby’s skin and eye
color have again returned to normal.
What is jaundice and what causes the yellow skin and eye color
associated with it?
What does jaundice have to do with the liver? Why are babies,
especially those born
prematurely, so susceptible to developing jaundice? How does the use of
artificial light
help clear up the problem? What are some of the symptoms of jaundice?
What are its
major causes?
1. Jaundice, also known as icterus, is not a disease but rather a sign
that can occur in many
different diseases. Both the yellow skin and the sclera result from
high blood levels of the
chemical, bilirubin. Bilirubin comes from red blood cells. When red
blood cells get old, they
are destroyed. Hemoglobin, the iron-containing chemical in red blood
cells that carries oxygen,
is released from the destroyed red blood cells after the iron it
contains is removed. The
chemical that remains in the blood after the iron is removed becomes
bilirubin.
2. The liver has many functions. One is to produce and secrete bile
into the intestines to help
digest dietary fat. Another is to remove toxic chemicals or waste
products from the blood.
Bilirubin is a waste product. After the bilirubin has entered the liver
cells, the cells attach other
chemicals to the bilirubin and then secrete it into bile. The complex
that is secreted in bile is
called conjugated bilirubin. The conjugated bilirubin is eliminated in
the feces. Bilirubin is
what gives feces its brown color. The color of the skin and sclera vary
depending on the level of
bilirubin. When the bilirubin level is mildly elevated, they are
yellowish. When the bilirubin level
is high, they tend to be brown.
18
Jaundice cont’d
3. Neonatal jaundice is associated with increased levels of bilirubin
in the baby’s blood. In fact,
bilirubin levels in the blood become elevated in almost all infants
during the first few days
following birth and jaundice occurs in more than half. For all but a
few infants, elevated
bilirubin levels, and the jaundice that results from it, represent a
normal physiological
phenomenon and do not cause problems. The cause of normal,
physiological jaundice is well
understood. During life in the uterus, the red blood cells of the fetus
contain a type of
hemoglobin that is different than the hemoglobin that is present after
birth. When an infant is
born, the infant’s body begins to rapidly destroy the red blood cells
containing the fetal-type
hemoglobin and replaces them with red blood cells containing the
adult-type hemoglobin. This
process floods the liver with bilirubin derived from the fetal
hemoglobin. The liver in a
newborn infant is not mature and its ability to process and eliminate
bilirubin is limited. As a
result of both the influx of large amounts of bilirubin and the
immaturity of the liver, bilirubin
accumulates in the blood. Within two or three weeks, the destruction of
red blood cells ends.
The liver matures and the bilirubin levels return to normal. Artificial
light helps break down
bilirubin in the skin, changing it into a form that can be eliminated
by the baby’s kidneys.
Newborns with jaundice typically receive phototherapy for several days.
4. Jaundice and cholestasis (the abnormal flow of bile from the liver
into
the intestine), by themselves, causes few problems except in the
newborn. Jaundice can turn the skin and sclera yellow. In addition,
stool
can become light in color, even clay-colored, because of the absence of
bilirubin. The urine may turn dark or brownish in color. This occurs
when the bilirubin that is building up in the blood begins to be
excreted
from the body in the urine. Just as in feces, the bilirubin turns the
urine
brown. Besides the cosmetic issues of looking yellow and having dark
urine and light stools, the symptom that is most frequently associated
with jaundice and cholestasis is itching; medically known as pruritus.
Pruritus can sometimes be so severe that it causes patients to scratch
their skin “raw,” to have trouble sleeping, and, rarely, even to commit
suicide.
5. It is the disease causing the jaundice that causes most problems.
There are three different
classes of causes for jaundice: Prehepatic, Hepatic and Posthepatic.
Prehepatic jaundice
occurs when too much bilirubin is being produced for the liver to
remove from the blood. For
example, patients with hemolytic anemia have an abnormally rapid rate
of destruction of their
red blood cells. This releases large amounts of bilirubin into the
blood. Hepatic jaundice
occurs when there is a defect in the liver that prevents bilirubin from
being removed from the
blood, converted to bilirubin/glucuronic acid (conjugated) or secreted
in bile. This can occur
in patients with acute and chronic inflammation of the liver caused by
hepatitis, cirrhosis
caused by poor diet and excessive alcohol consumption, and cancer of
the liver (mostly
metastatic). Jaundice commonly seen in a newborn baby is another
example of hepatic
jaundice. Drugs can also cause hepatic jaundice by interfering directly
with the chemical
processes within the cells of the liver and bile ducts that are
responsible for the formation and
secretion of bile to the intestine. As a result, the constituents of
bile, including bilirubin, are
retained in the body. The best example of a drug that causes this
latter type of cholestasis and
jaundice is estrogen. 3) Posthepatic jaundice occurs when there is a
blockage of the bile ducts
that decreases the flow of bile and bilirubin from the liver into the
intestines. For example, the
bile ducts can be blocked by cancers, gallstones, or inflammation of
the bile ducts. The
decreased conjugation, secretion, or flow of bile that can result in
jaundice is referred to as
cholestasis: however, cholestasis does not always result in jaundice.
Healthy Liver
19
TAKE HOME MESSAGE
10 Ways to Love Your Liver
1) Street drugs can cause serious damage and scar me permanently.
2) Don't drown me in beer, liquor or wine. (If you drink alcohol, have
two or fewer
drinks per day)
3) Since everything you eat must pass through me, eat a well- balanced,
nutritionally
adequate diet. If you enjoy foods from each of the four food groups,
you will probably
obtain the nutrients you need.
4) Cut down on the amount of deep-fried and fatty foods you consume.
Doctors
believe that the risk of gallbladder disorders; including gallstones, a
liver-related
disease, can be reduced by avoiding high fat and cholesterol foods.
5) Increase your intake of high-fiber foods; such as fresh fruits and
vegetables, whole
grain breads, rice and cereals. A high-fiber diet is especially helpful
in keeping me
healthy.
6) If you are dieting to lose weight, make sure that you are still
getting all the vitamins
and minerals your body - and I - need to function properly.
7) A regular exercise routine, two or three days a week, will help keep
me healthy, too.
8) I have to detoxify what you breathe in, so when you paint a room, or
go on a
cleaning binge, make sure the room is well ventilated or wear a mask.
9) Teach children what a syringe looks like and tell them to leave it
alone. Never, ever,
touch a discarded syringe or needle.
10) Use caution and common sense regarding intimate contact. Hepatitis
viruses live
in body fluids, including blood and seminal fluid.
BODIES….THE EXHIBITION
Digestive System Gallery
Cases 62 - 70
Digestion: 1 palate,
2 salivary glands, 3 tongue,
4 epiglottis, 5 esophagus,
6 stomach, 7 liver,
8 gallbladder, 9 pancreas,
10 duodenum, 11 jejunum,
12 ileum (10, 11, and 12
comprise the small intestine),
13 cecum,
14 ascending colon,
15 transverse colon,
16 descending colon,
17 sigmoid flexure,
18 rectum (13-18 comprise the
large intestine),
19 anus, 20 vermiform
appendix
20
THE ENDOCRINE SYSTEM
Goiter
QUESTIONS
Q1 What is the difference between an exocrine gland and an endocrine
gland?
Q2 Locate the thyroid gland and describe its relationship to important
nearby
structures.
Q3 Describe the structure and function of a thyroid follicle.
Q4 What is the functional relationship between the hypothalamus, the
pituitary gland
and the thyroid gland?
Q5 What is meant by negative feedback? Give an example.
PUTTING IT ALL-TOGETHER
A 35-year-old woman visits her physician complaining of difficulty
sleeping at night.
She says she falls asleep only to wake up with a choking sensation. She
has difficulty
sleeping when her neck is flexed to the left; however, with her head
propped up on
pillows and with her neck flexed to the right, she has no problem
sleeping. On
examination, her physician finds that the left side of her neck is
somewhat swollen.
She is diagnosed as having a fairly large goiter.
What is a goiter? Why does the woman have difficulty sleeping when her
neck is flexed
to the left and why is this condition relieved when her neck is flexed
to the right and
supported by a pillow? What are some of the additional signs of a
goiter? Why do
people with a goiter have difficulty breathing? What is the thyroid
gland – pituitary
gland – negative feedback loop? Use it to explain why a deficiency of
iodine in the diet
can cause a goiter. What can be done to treat this condition? What
condition(s), other
than iodine deficiency, can cause a goiter?
1. A goiter is an enlargement of the thyroid gland – it is not cancer.
2. The close relationship between the trachea and the lobes of the
thyroid gland
commonly results in pressure on the trachea in people with pathological
enlargement
of the thyroid gland. The left lobe of this woman’s thyroid is larger
than the right lobe.
When she falls asleep and has a tendency to flex her neck laterally to
the left, this kinks
the trachea over the enlarged left lobe of her thyroid resulting in the
chocking
sensation she describes. Because the right lobe of her thyroid is not
enlarged she finds
that, by flexing her neck to the right and sleeping on a pillow, she is
able to maintain
the patency of the trachea.
21
Goiter cont’d
3. In addition to a swelling in the neck, signs and symptoms of goiter
may include (a)
difficulty breathing, (b) a tight feeling in the throat, (c) coughing,
(d) hoarseness, and
(e) difficulty swallowing. All of these are the result of the close
relationship between
the thyroid gland, the larynx and the trachea.
4. A hypothalamic releasing hormone (known as thyroid stimulating
hormone
releasing factor or TSHRF) stimulates cells of the anterior pituitary
gland to secrete
thyroid-stimulating hormone (TSH). TSH in turn stimulates the thyroid
gland to
secrete thyroid hormone, a hormone that circulates through the
bloodstream to
stimulate its target cells to increase their metabolic activity. At the
same time,
circulating levels of thyroid hormone feed back (negative feedback) to
(1) prevent the
hypothalamus from producing TSHRF and also to (2) prevent the cells of
the anterior
pituitary (negative feedback) from producing TSH.
5. Active thyroid hormone (secreted as either triiodothyronine T3 or
tetraiodothyronine
T4) is necessary to inhibit the production of TSHRF and TSH. When these
two
hormones are inhibited, the thyroid gland is silenced until the level
of active thyroid
hormone in the bloodstream falls. When this occurs, TSHRF and TSH are
no longer
inhibited and both begin to be secreted again in normal amounts by the
hypothalamus
and the anterior pituitary. This insures that increased amounts of
thyroid hormone are
synthesized and released from the thyroid gland. When no iodine is
available, the
thyroid hormone secreted by the thyroid gland lacks this necessary
molecule and is
rendered non-active. It is important to understand that only active
thyroid hormone
has the ability to negatively inhibit the production of TSHRF and TSH.
Thus, in the
presence of non-active thyroid hormone, TRHRF and TSH continue to
stimulate the
thyroid gland. The long-term consequence of excessive TSHRF and TSH
stimulation of
the thyroid is overgrowth of the thyroid follicles and enlargement of
the thyroid itself.
6. Because we salt everything with iodized salt, iodine deficiency is
not a problem in
America. In most instances, thyroid hormone replacement therapy is
prescribed for
iodine deficiency. Hormone replacement inhibits thyroid-stimulating
hormone (TSH)
and allows the thyroid to recover.
7. Under-activity of the thyroid gland (hypothyroidism) typically
causes the thyroid
gland to enlarge. Hypothyroidism is almost always due to disease within
your thyroid
gland that causes a decrease in the production of thyroid hormone. If
your thyroid
begins to fail, and hormone levels fall below normal, your pituitary
gland senses that
there is not enough thyroid hormone in the blood. Thyroid function –
and sometimes
size - increases through the action of thyroid stimulating hormone,
which it releases
into the bloodstream. The most common cause of low thyroid hormone
production is
an autoimmune disease called Hashimoto's thyroiditis in which a
person’s own
lymphocytes make antibodies that slowly and gradually disable the
hormoneproducing
cells in their thyroid gland. Excellent tests designed to detect blood
TSH
level are available to diagnose the condition accurately. Treatment
with oral thyroid
hormone (thyroxine) usually restores normal thyroid function.
22
Goiter cont’d
TAKE HOME MESSAGE
Your thyroid is that little glandular butterfly in your neck that
you're not exactly sure
what it is or why it's there. It wasn't even described in the
scientific literature until 1656
when Thomas Wharton made a distinction between it and the larynx. For
the next 200
years, its function – the regulation of the body's metabolism - was
completely
unknown.
You can take care of your thyroid and prevent a goiter very simply.
Just make sure you
get enough iodine in your diet. One fifth of the world's population, 1
billion people,
have diets that are deficient in iodine. People in these areas commonly
have thyroid
enlargement. In European countries, and many other developed countries,
iodine
intake has only risen to normal levels in recent years. In the past,
particularly in the
Great Lakes region of the United States, many people developed goiters
because of a
lack of iodine in their diet due to the soil used to grow edible crops.
This dietary iodine
deficiency was eliminated early in the last century with the addition
of iodine to salt
(iodized salt) and the presence of iodine in milk and bread products.
BODIES….THE EXHIBITION
The Nervous System Gallery
Case 25
Larynx, Trachea, and Bronchial Tree
23
THE URINARY SYSTEM
Kidney Stones
QUESTIONS
Q1 Where are the kidneys located within the body?
Q2 What are the main functions of the kidneys?
Q3 What path does urine take from the time it enters a minor calyx of
the kidney until
it leaves the body?
Q4 What is visceral pain and what way(s) does it differ from somatic
pain?
Q5 How is visceral pain normally experienced?
PUTTING IT ALL-TOGETHER
A man calls his physician early one morning to report that he was
struck with a very
bad pain on the left side of his back after dinner the night before.
The pain built up in
about 5 minutes to a severity that he had never experienced before. The
pain was so
bad, in fact, that he became nauseous and vomited. After this, he felt
that some of the
pain had gone away. He thought that a bad virus or something he ate had
upset his
stomach. But the pain kept him awake all that night and, in his
opinion, did not seem
to get much better since it first began. After listening to the man’s
symptoms, his
physician tells him that he thinks he is suffering from a kidney stone.
What are kidney stones? Why do kidney stones cause so much discomfort?
How do
kidney stones form? Although the chemical composition of kidney stones
may vary,
what is the most common type of kidney stone? What are some of the
causes of
kidney stones?
What signs and symptoms are commonly used to diagnose a kidney stone?
What is
the key in a consideration of this man’s problem? What are some of the
risk factors for
developing kidney stones? What role, if any, does diet play in the
development of
kidney stones? How are kidney stones treated?
1. Kidney stones are hardened mineral deposits that tend to form in the
kidneys or
upper urinary tract when your urine becomes too concentrated. This
causes minerals -
and other substances in the urine - to form crystals on the inner
surfaces of your
kidneys. Over time, these crystals may combine to form a small, hard
mass or stone.
2. Small stones can cause some discomfort as they pass out of the body.
Regardless of
size, stones may pass out of the kidney or become lodged either within
the kidney
(within the calyces or renal pelvis) or within the ureters that carry
urine from the kidney
to the bladder. These stones cause severe pain that begins in the lower
back and
radiates to the side or groin. A lodged stone can block the flow of
urine causing
distention and pressure to build in the affected ureter and kidney.
This increased
pressure results in stretching and spasm causing severe pain.
24
Kidney Stones cont’d
3. Kidney stones form when there is either a high level of calcium
(hypercalciuria),
oxalate (hyperoxaluria), or uric acid (hyperuricosuria) in the urine; a
lack of citrate in
the urine; or insufficient water in the kidneys to dissolve waste
products. The kidneys
must maintain an adequate amount of water in the body to remove waste
products. If
dehydration occurs, high levels of substances that do not dissolve
completely (e.g.,
calcium, oxalate, uric acid) may form crystals that slowly build up
into kidney stones.
4. Approximately 75% to 85% of all kidney stones are calcium stones.
These stones are usually a combination of calcium and oxalate, a
compound that occurs naturally in some fruits and vegetables. The
most common cause of calcium stone production is excess calcium in
the urine - a condition known as hypercalciuria. Excess calcium is
normally removed from the blood by the kidneys and excreted in the
urine. In hypercalciuria, excess calcium builds up in the kidneys and
urine where it combines with other waste products to form stones.
Low levels of citrate, high levels of oxalate and uric acid, and
inadequate urinary volume may also cause calcium stone formation.
5. Calcium stones are composed of calcium that is chemically bound
to either oxalate or phosphate. Of these, calcium oxalate is more
common. Calcium phosphate stones typically occur in patients with
metabolic or
hormonal disorders. Increased intestinal absorption of calcium,
excessive hormone
levels (hyperparathyroidism), and renal calcium leak (kidney defect
that causes
excessive calcium to enter the urine) can cause hypercalciuria.
Prolonged inactivity
also increases urinary calcium and may cause stones.
6. You're not likely to have signs and symptoms unless a kidney stone
is either quite
large, is causing a blockage, is associated with an infection or is
being passed. Then
the most common symptom is an intense, colicky pain that may fluctuate
in intensity
over periods of 5 to 15 minutes. The pain usually starts in your back
or your side, just
below the edge of your ribs. As the stone moves down the ureter towards
your bladder,
the pain may radiate to your groin. If the stone stops moving, the pain
may stop too.
Other signs and symptoms may include: the presence of blood in the
urine (dark
urine), nausea and vomiting, a persistent urge to urinate and fever and
chills, if an
infection is present.
7. The key finding is this instance is the abrupt onset of the man’s
excruciating urinary
tract pain. When a part of the collecting system of the upper urinary
tract (this consists
of the calyces, renal pelvis and ureter) becomes distended, the
intensity of visceral
pain that is evoked is primarily a measure of the rate of distention.
Therefore, the
abrupt onset of excruciating pain is suggestive of an acute high rate
of distention of
some part of the upper urinary collecting system.
25
Kidney Stones cont’d
8. Several factors increase the risk for developing kidney stones;
including inadequate
fluid intake and dehydration, reduced urinary flow and volume, certain
chemical levels
in the urine that are too high (e.g., calcium, oxalate, uric acid) or
too low (e.g., citrate),
and several medical conditions. Anything that blocks or reduces the
flow of urine (e.g.,
urinary obstruction, genetic abnormality) also increases the risk.
Medical conditions
such as excessive parathyroid hormone, which causes calcium loss
(hyperparathyroidism), gout (caused by excessive uric acid in the
blood), high blood
pressure (hypertension), inflammation of the colon causing chronic
diarrhea,
dehydration, plus chemical imbalances (colitis) and urinary tract
infections are also
risk factors.
9. Diet plays an important role in the development of kidney stones,
especially in
patients who are predisposed to the condition. A diet that is high in
sodium, fats and
protein (meat, chicken and fish) and low in fiber (fruits, vegetables
and whole grains)
may increase a person’s risk of developing kidney stones. High doses of
vitamin C can
result in high levels of oxalate in the urine (hyperoxaluria) and
increase the risk for
kidney stones. Oxalate is found in berries, vegetables (e.g., green
beans, beets,
spinach, squash, and tomatoes), nuts, chocolate, cranberries and tea.
10. Treatment depends on the size and type of stone, the underlying
cause, the
presence of urinary infection, and whether the condition recurs. Stones
4 mm and
smaller (less than 1/4 inch in diameter) pass without intervention in
90% of cases;
those 5 – 7 mm do so in 50% of cases; and those larger than 7 mm rarely
pass without
intervention. When surgery is necessary, the most commonly used
procedure for
treating kidney stones is called extracorporeal shock wave lithotripsy
(ESWL). It uses
shock waves to break the stones into tiny pieces that are then passed
in your urine. If
possible, the kidney stone is allowed to pass naturally. The patient is
instructed to
strain their urine to obtain the stone(s) for analysis. It is important
to analyze the
chemical composition of kidney stones to determine how to prevent
recurrent stone
formation. Dietary changes may be required and fluid intake should be
increased.
Patients with stones must increase their urinary output. Generally,
2000 cc of urine per
day (slightly more than 1/2 gallon) is recommended and patients should
drink enough
water to produce this amount of urine. Dietary calcium should not be
severely
restricted. Reducing calcium intake often causes problems with other
minerals (e.g.,
oxalate) and may result in a higher risk for calcium stone disease.
26
Kidney Stones cont’d
TAKE HOME MESSAGE
If you've ever passed a kidney stone, you're not likely to forget the
experience — it can
be excruciatingly painful. What's more, kidney stones are increasingly
common. One in
10 Americans will have at least one kidney stone some time in their
life. Not all kidney
stones cause symptoms. They're often discovered when a person has an
X-ray for an
unrelated condition or when they seek medical care for problems such as
blood in
their urine or recurring urinary tract infections. The pain becomes
agonizing only when
a stone breaks loose and begins to work its way down from the kidneys
to the bladder.
Most small kidney stones pass into the bladder without causing any
permanent
damage. Still, it's important to determine the underlying cause in
order to prevent
more stones from forming. In many cases, simply drinking more water and
making a
few dietary changes can prevent kidney stones.
BODIES….THE EXHIBITION
Digestive System Gallery
Case 67
Veins and arteries of the kidney
27
THE MALE REPRODUCTIVE SYSTEM
Benign Prostatic Hypertrophy (BPH)
QUESTIONS
Q1 Where is the prostate gland located within the body?
Q2 What is the relationship between the following: the prostate gland
and the urethra;
the prostate gland and the urinary bladder; and the prostate gland and
the rectum?
Q3 What hormonal relationship exists between the testes and the
prostate?
Q4 What are prostate specific antigens?
Q5 What is the function of the prostate gland?
PUTTING IT ALL-TOGETHER
During his annual physical exam, a 60 year-old man mentions to his
physician that
over the past 6 months he has noticed some pain when attempting to
urinate. He
indicates that he has also had trouble starting and stopping and has
been experiencing
urgency (a sudden desire to urinate), dysuria (difficulty with
urination) and nocturia
(excessive urination at night). After doing a digital rectal exam,
conducting a prostate
specific antigen (PSA) blood test and getting the results of a rectal
ultrasound, his
physician determines that he is suffering from benign enlargement of
the prostate -
more commonly known as benign prostatic hypertrophy or BPH.
Describe the manner in which the prostate grows. What causes the
prostate gland to
enlarge as a person ages? How does an enlarged prostate gland interfere
with
urination? What affect does an enlarged prostate gland have on the
urinary bladder?
What are the primary symptoms of BPH? Why is a prostate specific
antigen (PSA) test
done as part of a man’s prostate health examination? What is the
relationship between
BPH and prostate cancer?
1. As a man matures, the prostate gland goes through two main periods
of growth.
The first occurs early in puberty, when the prostate doubles in size.
At around age 25,
the gland begins to grow again. This second growth phase often results,
years later, in
benign enlargement of the gland known as benign prostatic hypertrophy
(BPH).
Though the prostate continues to grow during most of a man's life,
problems do not
usually arise until the later years. BPH rarely causes symptoms before
age 40, but
more than half of men in their sixties and as many as 90 percent in
their seventies and
eighties have some symptoms of BPH.
28
BPH cont’d
2. The cause of BPH is not well understood. No definite information on
risk factors
exists. It has been known for some time that BPH occurs mainly in older
men and that
it doesn't develop in men whose testes were removed before puberty. For
this reason,
it is believed that factors related to aging and the testes may spur
the development of
BPH. Throughout their lives men produce testosterone, an important male
reproductive hormone, and small amounts of estrogen, a female
reproductive
hormone. The prostate converts testosterone to a more powerful androgen,
dihydrotestosterone (DHT). DHT stimulates cell growth in the tissue
that lines the
prostate gland (the glandular epithelium) and is the major cause of the
rapid prostate
enlargement that occurs between puberty and young adulthood. DHT is a
prime
suspect in prostate enlargement in later adulthood.
Some estrogen is always present in men. But as they age,
the amount of active testosterone in their blood decreases;
leaving a higher proportion of estrogen. Studies have
suggested that BPH may occur because the higher amount
of estrogen within the gland increases the activity of
substances that promote cell growth.
Recently, it has been suggested that BPH may develop as a
result of "instructions" given to cells early in life. According
to this theory, BPH occurs because cells in one section of
the gland follow these instructions and "reawaken" later in
life. These "reawakened" cells then deliver signals to other
cells in the gland, instructing them to grow or making them
more sensitive to hormones that influence growth.
3. The prostate surrounds a portion of the male urethra, the canal
through which urine
passes out of the body. As the prostate enlarges, the layer of tissue
surrounding the
gland stops it from expanding causing it to press against the urethra
like a clamp on a
garden hose.
4. As the prostate enlarges, the wall of the urinary bladder also
becomes thicker and
more irritable. The bladder now begins to contract even when it
contains small
amounts of urine, causing more frequent urination. Eventually the
bladder weakens
and loses the ability to empty itself completely. The narrowing of the
urethra and the
partial emptying of the bladder both cause many of the problems
associated with BPH.
5. Many symptoms of BPH stem from obstruction of the urethra and
gradual loss of
bladder function resulting in incomplete emptying of the bladder. The
symptoms of
BPH vary, but the most common ones involve changes or problems with
urination;
such as a hesitant, interrupted, weak stream, urgency and leaking or
dribbling, and
more frequent urination - especially at night. The size of the prostate
does not always
determine how severe the obstruction or the symptoms will be. Some men
with greatly
Male Reproductive System
29
BPH cont’d
enlarged glands have little obstruction and few symptoms while others,
whose glands
are less enlarged, have more blockage and greater problems.
6. PSA is a protein enzyme produced by cells of the prostate gland that
prevents
semen from solidifying. To rule out cancer as a cause of urinary tract
symptoms, a
prostate specific antigen (PSA) blood test is often recommend. Although
considered
to be a diagnostic test, levels of PSA in a man’s blood do not actually
confirm the
presence of malignant tumors. In addition to cancer, high PSA levels
may be traced to
BPH, infections, or inflammation of the gland. Some men have naturally
high blood
levels of the enzyme and perfectly healthy prostates. High levels of
PSA indicate cancer
in about a third of all cases. Presently, in men age 50 and older, a
PSA blood test is
normally performed in conjunction with a digital rectal exam to
evaluate the health of
the prostate gland. However, much remains unknown about the
interpretation of PSA
levels; including the test's ability to discriminate cancer from benign
prostate
conditions and the best course of action following a finding of
elevated PSA.
7. Although some of the signs of BPH and prostate cancer are the same,
having BPH
does not seem to increase the chances of getting prostate cancer.
Nevertheless, a man
who has BPH may have undetected prostate cancer at the same time or may
develop
prostate cancer in the future. For this reason, it is recommended that
all men over 40
have a rectal exam once a year to screen for prostate cancer.
TAKE HOME MESSAGE
The prostate is a walnut-sized gland that forms part of the male
reproductive system.
This gland is made of two lobes, or regions, enclosed by an outer layer
of tissue. It is
located in front of the rectum and just below the bladder, where urine
is stored.
Scientists do not know all the functions of the prostate. One of its
main roles, though,
is to squeeze fluid into the urethra as sperm move through during
sexual climax. This
fluid, which helps make up semen, energizes the sperm and makes the
vaginal canal
less acidic. Many people feel uncomfortable talking about the prostate,
since the
gland plays a role in both sex and urination. Still, prostate
enlargement is as common
a part of aging as gray hair. As life expectancy rises, so does the
occurrence of BPH. In
the United States in 2000, there were 4.5 million visits to a physician
for BPH. It is
important that men (of any age) tell their doctor about any urinary
tract problems they
may be experiencing since urinary tract infections can result in
serious medical
problems. In 8 out of 10 cases, urinary tract problems in men over the
age of 60
suggest BPH, but they also can signal other more serious conditions
that require
prompt treatment. These conditions, including prostate cancer, can be
ruled out only
by a doctor's exam.
BODIES….THE EXHIBITION
Reproductive System Gallery
Case 78
30
THE FEMALE REPRODUCTIVE SYSTEM
Placenta Previa
QUESTIONS
Q1 Where does implantation of a fertilized ovum normally take place?
Q2 What does the word “ectopic” mean? What is an ectopic pregnancy?
Q3 Where and how is the placenta normally formed?
Q4 What is the placental barrier and what is its function?
Q5 List as many functions of the placenta as you can.
PUTTING IT ALL-TOGETHER
A 40 year-old woman, pregnant for the fourth time, calls her
obstetrician during the
later part of her second trimester to report some minor painless
vaginal bleeding.
Ultrasound shows that she has placenta previa (PP) and that it is
marginal. Her doctor
tells her not to be alarmed but insists that she have a follow-up
ultrasound early in her
third trimester to again check on the location of her placenta. In the
meantime he tells
her that, if she experiences any additional vaginal bleeding, an
immediate ultrasound
will be done to find out what’s going on.
What is PP? How is PP usually diagnosed? What normally happens during
the course
of a woman’s pregnancy when she is diagnosed as having PP? What are the
risks/complications of PP for the mother and her baby? What factors
determine a
woman’s risk for developing PP?
1. Placenta previa is a condition in which the placenta develops
ectopically, low down
in the uterus next to or covering the cervix. The placenta is the
pancake-shaped organ,
normally located near the top of the uterus (fundus), which supplies
the developing
embryo and fetus with nutrients through the umbilical cord. Placenta
previa is not
usually a problem early in pregnancy; but if it persists into later
pregnancy, it can cause
serious bleeding. In some instances, this can lead to an uncontrolled
hemorrhage that
may even put the lives of the mother and baby in danger. Should this
happen, delivery
is normally done by caesarean section - or C-section. If the placenta
covers the cervix
completely, it is called a complete or total previa. If it is right on
the border of the
cervix, it is called a marginal previa. The term partial previa is
sometimes used to
describe a placenta that covers part of the cervical opening once the
cervix starts to
dilate. If the edge of the placenta is within 2 centimeters of the
cervix, but not
bordering it, it is called a low-lying placenta. The location of the
placenta is normally
checked during mid-pregnancy.
31
Placenta Previa cont’d
2. A diagnosis of PP is usually made when there is painless
bleeding during the third trimester. Bleeding from the vagina
during the second or third trimester may be the first sign of PP,
although in many cases there are no signs at all. However, there
is a 10% false positive diagnosis rate usually because of the
bladder being overfull. There is also a 7% false negative rate
typically caused from missing the PP that is located behind the
baby's head. Other reasons to suspect a PP include; premature
contractions, abnormal presentation (breech, transverse, etc.)
and a uterus that measures larger than it should according to
dates. If any bleeding occurs, it is not wise to do a vaginal exam
until an ultrasound has ruled out a PP.
3. What happens after a woman is diagnosed with PP depends on how far
along in her
pregnancy she is and how much bleeding she is experiencing. Bleeding
normally
occurs when the cervix begins to thin out or dilate (even a little),
disrupting the blood
vessels in that area. It is usually painless, can start without any
warning and range
from spotting to extremely heavy bleeding. If a woman’s bleeding is
severe, she may
have to deliver right away, even if her baby is still premature. If
bleeding is very heavy,
transfusions may be necessary until the fetus is mature enough for
delivery. Steroid
injections may also be used to speed fetal lung development.
Ultimately, the goal is to
try to keep the pregnancy going until at least 36 weeks, at which point
the baby may be
delivered by cesarean to reduce the risk of massive hemorrhage. If the
condition is
diagnosed after the 20th week of pregnancy (in the second trimester),
and a woman is
not experiencing any bleeding, there is little need to panic. Only
about 10 percent of
women who have PP noted on ultrasound at mid-pregnancy still have the
condition
when they deliver their baby. Resolution of the problem occurs because
the placenta is
likely to "migrate" farther from the cervix during the later stages of
pregnancy. Since
the placenta is implanted in the uterus, it doesn't actually move, but
it can end up
farther from the cervix as the uterus expands. Also, as the placenta
itself grows, it's
likely to grow toward the richer blood supply in the upper part of the
uterus.
A placenta that completely covers the cervix is more likely to stay
that way than one
that is bordering it (marginal) or nearby (low-lying). But such a
placenta may still move
away from the cervix. If an ultrasound reveals that the placenta is
still covering, or too
close to the cervix, a woman is usually monitored through regular
ultrasounds. She
must watch carefully for any sign of vaginal bleeding. She is usually
put on "pelvic
rest," which means no intercourse for the rest of her pregnancy, and
advised to take it
easy and avoid activities such as strenuous housework or heavy lifting
that might
provoke bleeding. It is uncommon for bleeding to occur until the later
part of the
second trimester and, about half the time, it doesn't begin until the
baby is nearly fullterm
(37 weeks). If a woman has bleeding and is Rh negative, she is usually
given a
shot of Rh immune globulin; unless the baby's father is also Rh
negative. No matter
when a woman delivers her baby, it has to be via cesarean section. With
a complete
PP, the placenta blocks the baby's way out. Even when the placenta
borders the cervix,
Female Reproductive System
32
Placenta Previa cont’d
a C-section is advised because of the possibility that profuse bleeding
might occur if
the cervix is dilated during a vaginal delivery.
4. Having PP increases a woman’s risk of heavy bleeding
(life-threatening hemorrhage)
not only during pregnancy but also during and after delivery. After
delivery of both the
baby and the placenta (the afterbirth), a woman is normally given
Pitocin or other
medications. This causes the uterus to contract, which helps stop the
bleeding from
the area where the placenta was implanted. But when a woman has PP, the
placenta is
implanted in the lower part of the uterus. This part of the uterus,
because its wall
contains far less smooth muscle, doesn't contract as well as the upper
part and thus
its contractions are not as effective at stopping the bleeding. Women
who have PP are
also more likely to have a placenta that attaches directly to the
uterine smooth muscle
and doesn't separate easily at delivery, a condition known as placenta
accreta. Placenta
accreta normally occurs in 1 of 2,500 births, but a woman’s chance of
having placenta
accreta increases significantly (approximately 1 in 10) if she has PP
when her baby is
delivered. Placenta accreta may cause severe bleeding. A hysterectomy
to control the
bleeding, in addition to a blood transfusion, may be required.
Complications to the
baby include; intrauterine growth retardation due to poor placental
perfusion and,
because of a slightly increased risk of intrauterine growth
restriction, intrauterine
hypoxia and an increased incidence of congenital anomalies.
5. There are a few predisposing factors that can increase a woman’s
risk for developing
PP. Some of these include; chronic cigarette smoking, cocaine abuse,
advanced
maternal age, increased parity (number of pregnancies), pregnancies
that involve
twins or higher-order multiples, previous cesarean sections and
previous uterine
surgery (independent of the type of incision).
TAKE HOME MESSAGE
The placenta develops within the wall of the uterus to functionally
connect the mother
and fetus. During pregnancy, it transports maternal nourishment and
removes fetal
wastes. Fetal blood and maternal blood do not mix within the placenta.
Instead, an
ultra-thin membranous barrier allows the passage of respiratory gasses,
and certain
select molecules, from one bloodstream to the other. Toxins and other
harmful
substances, however, can also pass through this thin membrane. Thus, a
pregnant
woman must carefully watch what she ingests and what she breathes!
An ectopic pregnancy develops when implantation occurs in a place
outside of the
uterus or in an abnormal place within the uterus. One such abnormal
place is low
down on the uterine wall at a point where the uterine cervix opens into
the vagina. This
condition is called PP. Placenta previa occurs in only about 1 in 250
pregnancies.
When it does occur, however, it results in some significant and often
life-threatening
consequences. Therefore, understanding the condition is necessary so
that it is not
taken lightly and the right steps are followed to ensure that nothing
tragic happens to
either the mother or her baby.
BODIES….THE EXHIBITION
Reproductive System Gallery
Case 73
33
ORGANIZATION OF THE EXHIBITION
BODIES…THE EXHIBITION is presented, primarily by function and by
system, in the
following nine galleries:
1. skeletal
2. muscular
3. nervous
4. circulatory
5. respiratory
6. digestive
7. reproductive
8. fetal (optional)
9. treated body
The information in each exhibition gallery is designed to provide
answers to the
following questions, among others:
1. What are the systems of the human body?
2. How does each system of the body function?
3. How are the body’s systems inter-related?
4. What can be done to improve and extend the life of the body?
Students are encouraged to work with these questions before they arrive
and to form
some questions of their own. As a writing exercise, answers may be
written in a journal
prepared before your visit or upon return to your school.
Upon viewing the exhibition, teachers and students will…
1. appreciate the sanctity and integrity of human life;
2. learn about the anatomy and complex systems of the human body;
3. learn how medical technology enhances one’s quality of life;
4. become interested in their own body, how and why it works;
5. appreciate what it takes to care for the human body;
6. discover how daily choices affect the human body’s health and
well-being;
7. initiate conversations with friends and family about what it takes
to sustain
a healthy human body;
8. respect the human body in life and death;
9. understand that, regardless of how different we appear to be, the
human
body and its systems are much the same inside; and
10. explore careers in science, medicine and healthcare.
34
Floor Plan of BODIES…THE EXHIBITION
35
TEACHER’S GUIDE TO EXHIBITION GALLERIES
The nine galleries use full-body specimens to teach about the system or
systems around which
that gallery is designed. In addition, each gallery contains several
cases featuring individual
organs and sections of the body that relate to these systems. Refer to
the floor plan as you
review the material; it indicates the location of the cases and
specimens. Please note that all
specimens on display are subject to change.
Take time to view the projected images that appear on the walls of the
galleries. These are
artists’ representations of cells and tissues, enlarged thousands of
times!
THE SKELETAL GALLERY
CASE 1
Sphenoid Bone
This butterfly-shaped bone is called the “keystone” of the cranium
because it connects with every bone
of the skull except the lower jawbone or mandible. The sphenoid bone
also contains the sphenoid
sinuses, which help lighten the skull and give the voice resonance. As
we age, the sphenoid sinuses
enlarge and our voices deepen.
Maxilla
The paired maxillary bones form the upper jaw and create the floors of
the orbits (eye sockets), as well
as the hard palate, or roof of the mouth. If these bones do not join
during fetal development, a cleft
palate will result, leaving an opening between the mouth and nasal
cavity, which creates great difficulty
for nursing infants.
Top of Adult Skull
Internal and External Surfaces of the Base of the Skull
These unusual views of the skull allow you to see the complex
composition of bone at the base of the
skull and the several openings (foramina) that allow blood vessels and
nerves to pass into and out of
the cranial cavity. The largest of these openings, the foramen magnum,
is the point at which the spinal
cord connects with the brain. Notice also the zygomatic (cheek) arches
on either side of the skull; they
provide the bony foundation for the cheeks and are points of attachment
for some of the muscles of
mastication and facial expression.
Fetal Skull
This specimen demonstrates that the skull is made up of many flat
bones, which do not fuse fully before
birth. Instead, they are joined by fibrous connective tissue at the
fontanelles, or gaps, between them.
These fontanelles allow the baby’s head to change shape to accommodate
its passage through the birth
canal. Most bones of the skull fuse into immoveable joints, known as
sutures, during the first two years
after birth. The mandible (lower jawbone) is the only moveable joint of
the adult skull.
There are 200 types of cells in the body; 75 trillion cells total.
36
CASE 2
Elbow Joint (Hinge joint)
The elbow joint is formed of three bones: the humerus, and the radius
and ulna (bones of the forearm).
The humerus widens to connect with the radius and ulna, forming the
elbow joint. The elbow is a hinge
joint, allowing you to flex and extend your forearm. Immediately below
the elbow, another joint is
formed between the radius and ulna, allowing you to rotate your palm
upward (supination) and
downward (pronation).
Knee Joint (Hinge Joint)
The knee is the most complex joint in the body. It forms where the
convex end of the femur meets the
flattened end of the tibia (shinbone). The third bone of the knee, the
patella (kneecap), is imbedded
within the tendon of a powerful thigh muscle and helps stabilize the
knee. The knee joint allows the tibia
to move back and forth with some rotation.
Knee Joint Cartilage
The dense cartilage rings, visible at the top of this specimen, are
found within every healthy
knee joint. Known as menisci, these rings absorb shock and reduce wear
to the bone ends.
They also deepen the surface of the tibia, making the knee more stable,
while allowing for a
small amount of rotation. The menisci can sometimes be torn from the
bone following a
blow to the knee, particularly when the joint is over-rotated or the
leg is fully extended. This
often results in debilitating pain.
Knee Joint with Sagittal Cut
CASE 3
Hip Joint (Ball and Socket Joint)
One of the strongest and most stable joints in the body, the hip joint,
forms where the ball at the head
of the femur (thighbone) fits into the acetabulum (socket) of the
hipbone. This joint structure allows for
rotation, as well as forward, backward, and side-to-side movement. Held
in place by five ligaments and
tough connective tissue deep in the joint, the hip joint often
withstands 400 pounds of force in everyday
activity.
Bony Pelvis (Male)
The bony pelvis is a deep, basin-like structure formed of the hipbones
and sacrum. It provides a strong
and stable support for the spinal column and protects the reproductive
organs. In addition, the bony
pelvis connects with the bones of the lower limbs at the hip joints.
The bones of the pelvis meet in the
front at the pubic symphysis, where they are held together by
cartilage; this cartilage softens during
childbirth, allowing the pelvis to widen.
Fetal Hip Bone
During fetal development the hipbone begins as three separate bones,
which are connected by cartilage.
These three separate bones do not fully fuse until the age of sixteen.
Genetic factors and multiple
dislocations during childhood may lead to hip dysplasia, resulting in a
shallow acetabulum that affects
mechanics of the lower leg.
37
CASE 4
Bones, Muscles + Cartilage
Perhaps more than any other example in this Exhibition, this specimen
shows you how you are held
together and upright. This dissection demonstrates the important
relationship between the bones of
our skeletons and the cartilage and muscle attached to these bones.
CASE 5
Expanded Skull
Bones of the skull are divided into two types: flat bones and irregular
bones. The flat bones of the
cranium surround and protect the brain. The irregular facial bones form
the bony framework of the face,
the orbits surrounding the eye, the nasal cavity, and the roof and wall
of the mouth.
CASE 6
Atlas and Axis Vertebrae
The first two vertebrae of the spine, the atlas and axis, allow the
head to rotate and nod.
Cervical Vertebra
The seven cervical vertebrae are the least robust of the vertebral
column, yet are strong
enough to support the neck and allow for a wide range of motion.
Thoracic Vertebra
The 12 thoracic vertebrae are slightly larger than the cervical
vertebrae; each connects
with one of the 12 ribs.
Lumbar Vertebra
The five lumbar vertebrae are the largest and strongest of all the
vertebrae. Called the small of the back,
they bear the greatest amount of weight and thus provide the greatest
amount of support.
Sacrum
The sacrum is composed of five fused vertebrae. It forms part of the
bony pelvis and connects with the
coccyx or tailbone.
Intervertebral Discs
The intervertebral discs between each vertebra provide mobility and
absorb shock. Composed of dense,
fibrous cartilage with a pulpy, hydrated core, these discs change shape
under pressure as the spine
bends and turns. As we age, our discs become less hydrated, causing us
to lose height. In a herniated
disc, the outer ring tears and some of the pulpy core is lost, leading
to compression of and damage to
the spinal cord.
38
The Vertebral Column
Humans are vertebrates, meaning they have an internal bony skeleton, a
distinction shared with all
mammals as well as fish, amphibians, reptiles, and birds.
The human vertebral column, or spine, typically consists of 33
vertebrae, which support and stabilize
the upper body while forming a strong and flexible housing for the
spinal cord. In addition, the spine
has three natural curves that help it distribute weight and absorb
shock.
CASE 7
Sternum (Flat Bone)
The sternum is a flat bone located at the center of your chest. Like
the flat bones of the ribs, skull, and
pelvis, the sternum acts as armor to protect vital internal organs. One
side of this sternum has been cut
to reveal the spongy bone within. Spongy bone distributes the force of
impact and contains red bone
marrow.
Cross Section of Femur Bone (Long Bone)
The ends of the long bones contain spongy bone tissue, which is
visible in the cross-section of femur shown here. Spongy bone
tissue makes bones lighter and distributes forces over a wider
surface area. The outer layer and shafts of the long bones are
made of compact bone tissue, which provides protection and
support. The centers of the long bones have hollow spaces that
contain marrow. Red bone marrow is the site of red blood cell
production and creates more than two billion new blood cells per
second.
Tibia (Long Bone)
The tibia, or shinbone, is the second longest and second heaviest bone
of the body after the femur.
Epiphyseal Line
An epiphyseal line represents the former location of a growth plate.
Located at the ends of a bone, the
growth plates are the points at which all long bones grow in length.
When you reach your height the
epiphyseal growth plates disappear and a thin white line is all that
remains.
CASE 8
The Whole Skeleton
The skeleton derives its name from the Greek skeletos, which means dry.
But the bones of the body are
anything but dry; they are dynamic organisms that reinvent themselves
in response to repeated stress
and repair themselves when broken. Visible on this specimen are the
bones and joints of the body.
39
CASE 9
Shoulder with Open Joint Capsule
Like all moveable joints, the shoulder is a synovial joint, meaning its
bones are contained within a
capsule lined by a synovial membrane. This membrane secretes synovial
fluid, a thick liquid that allows
for almost frictionless movement within the joint. Synovial fluid is so
effective as a lubricant that
scientists are trying to duplicate it for use in machinery.
Shoulder Joint
The shoulder joint is formed by the articulation of three bones: the
humerus (arm bone), the clavicle
(collar bone), and the scapula (shoulder blade). The clavicle acts as a
strut, holding the humerus away
from the body, while the free floating scapula, held in place only by
muscles, allows the humerus a wide
range of motion. Although it is strengthened by the tendons of four
important muscles (the rotator
cuff), the shoulder joint remains relatively unstable. A sudden force
can easily dislocate the humerus
from its shallow socket and the rotator cuff muscles can be damaged
through extreme movements or
strenuous exercise.
CASE 10
Auditory Ossicles
Our skulls include the smallest bones in our bodies. Called auditory
ossicles (hearing bones), these
bones are located within the temporal bones of the skull and have
distinct shapes for which they are
named. They are the malleas (hammer), the incus (anvil) and the stapes
(stirrup). Connected by the
smallest moveable joints in the body, these bones transfer sound as
vibrations from the eardrum to the
inner ear. This efficient structure allows us to hear even the faintest
sounds.
Temporal Bone With Auditory Ossicles
This specimen allows you to see deep into the
middle ear cavity where the auditory ossicles are
located. The eardrum, or tympanic membrane,
marks the edge of the middle ear and the
beginning of the ossicles, which transfer
vibrations to the much smaller oval window at the
edge of the inner ear. Two small muscles attach
to the ossicles and contract to protect the
eardrum and oval window from loud noises. Also visible is the bony
labyrinth which helps tell the brain
the position of the head, thus helping maintain balance. Diseases of
the inner ear may result in hearing
loss, tinninitus, or vertigo.
40
THE MUSCULAR GALLERY
There are more than 600 skeletal muscles in the human body. When
muscles are stimulated,
the fibers within them contract, or shorten, to cause movement.
Case 11
The Bones of the Foot and Ankle
The 26 bones in the foot have a very similar arrangement to those of
the hand, but serve different
purposes. While the hand can manipulate delicate objects, the bones of
the foot work as a lever to raise
the body and transmit thrust when walking and running. The ankle is
comprised of a series of gliding
joints like the wrist, but it permits a more limited range of motion
and thus more stability.
Deep Anatomy of the Foot
The skin and soft tissue have been removed from this specimen to
illustrate the ligaments and several
of the tendons that insert to the tarsal (ankle) bones. The tarsal
bones, their ligaments, and the muscles
that attach to them assist in forming the arches of the foot.
In addition, this specimen shows the ligaments and articular cartilages
of the metatarsal-phalangeal
joints, which are comparable to the knuckles of the hand.
Muscle of the Top of the Foot
The muscles that extend the foot and toes are primarily located on the
front of the leg. The supporting
tendons of these muscles cross the back of the foot and are held in
place by fibrous membranes.
Muscles of the Sole of the Foot
The sole of the foot has four layers of muscles and tendons that keep
us balanced when standing or in
motion. This dissection clearly reveals the flexor tendons; these
fanning shiny cords, visible at the
center, allow us to curl the very ends of our toes.
Joints of the Foot
The bones of the foot and ankle make up a complex array of joints,
allowing them to: act as a lever to
move us forward; to create arches that distribute weight; and to be in
close association in order to keep
us stable. On this specimen, the top portion of bone has been removed
to illustrate the ankle’s articular
cavities, ligaments, and cartilage. Connected by these small joints and
ligaments, the seven tarsal
(ankle) bones help form the arch of the foot and allow for complex
motion within the ankle.
CASE 12
Bones of the Hand
Joints of the Hand
The carpal, metacarpal, and phalanges of the hand and wrist are
connected through multiple small joints that work together to produce
the motion of the wrist and fingers. This relationship of bones helps
create the fine motions needed to thread a needle or tie a shoelace. If
these joints become affected by arthritis—characterized by the
breakdown of protective cartilage at the end of the bones—the actions
of daily living can become extremely difficult.
41
Wrist Joint
The eight small bones of the wrist, the carpal bones, create a series
of gliding joints that allow for a wide
range of movement. They are held together by a dense band of connective
tissue that also covers the
carpal tunnel. A U-shaped cavity just below the palm, the carpal tunnel
is the area through which several
tendons and the median nerve pass to the hand. Swelling within the
tunnel, caused by repetitious
movement, puts pressure on the median nerve and leads to carpal tunnel
syndrome, today’s high tech
malady.
Muscles of Hand Showing Deep Palmar Arch
Muscles of Hand Showing Superficial Palmar Arch
Muscles of the Hand
Nineteen muscles control the movement of the hand. Four of these
muscles, the lumbricals, place the
hand in writing position; seven others, the interosseous, help perform
movements like typing and
playing the piano.
CASE 13
Balance + Muscle Strength
This specimen carrying a football exemplifies the muscular development
that can be achieved through
exercise and weight training. As they grow, muscles become larger and
stronger as the connective
tissue around them begins to toughen.
CASE 14
The Skeleton + Its Muscles
This unique presentation, both created from the same specimen, displays
the supporting skeleton and
the covering of skeletal muscles that were formerly attached to it.
These systems would be of no use
without the other and each plays an essential role in body movement.
CASE 15
Muscles of the Upper Limb
The numerous muscles of the upper limb constantly work together to
perform tasks like writing, lifting, and sipping coffee. These muscles
include:
Deltoid. Named for its triangular shape, delta in Greek, the deltoid
muscle
joins the upper arm to the shoulder. It helps lift the arm away from
the side
of the body, and allows forward, backward, and side-to-side movement.
Biceps Brachii. The word “biceps” comes from the Latin words bi, meaning
two, and cephalon, meaning head. The two heads at one end of the biceps
attach to the top of the arm and shoulder. The single head attaches to
the
forearm.
Supinator and Pronator. These two muscles are named for the actions they
perform. Turn your palm upward—that is the supinator muscle working.
Turn your palm down—that is the pronator at work. These two muscles are
called antagonists because they cause opposite motions.
42
Muscles of the Lower Limb. The muscles of the lower limb are the
largest in the body and make us
bipedal and mobile. They include:
Gluteus Maximus. The largest muscle in the body; it helps us keep our
balance, and move the thigh.
Quadriceps. This four-headed muscle makes up most of the muscle mass on
the front and outside of
the thigh and joins into the powerful patellar tendon just above the
knee.
Gastrocnemius. One of three muscles that form the prominence of the
calf, this large muscle connects
to the achilles tendon, the strongest tendon in the body and helps us
stand upright.
CASE 16
Muscle Attachments + Layering
This unique dissection of a running man allows you to see the
relationship of the body’s muscle layers
and demonstrates the points at which these layers attach to the
skeleton.
CASE 17
Muscle Control + Core Muscles
The dynamic pose of this specimen with a basketball illustrates the
body’s remarkable agility and
balance. This is achieved through the precise control of several
skeletal muscle groups working
together. It takes 19 muscles to move the hand and the wrist, but not
all of those muscles are within
the hand. Some of these muscles are located in the forearm and are
connected to the hand and fingers
via tendons, known as extensors and flexors.
CASE 18
Cardiac Muscle Tissue
Cardiac muscle tissue, which causes the movement of the heart, shares
characteristics with both
skeletal and smooth muscle. In addition, all cardiac muscle cells are
controlled by one nucleus which
allows them to contract in unison; essential for a proper heartbeat.
Urinary Bladder
The urinary bladder is a hollow, muscular organ, which stores urine.
Its smooth muscles change size,
shape, and position according to the amount of urine it contains.
Arterial Wall
The arteries possess strong, elastic walls and include smooth muscle
cells. They can quickly expand and
contract, ensuring fast and efficient blood flow.
43
THE NERVOUS SYSTEM GALLERY
The nervous system controls and integrates activities of the body. The
central nervous system consists
of the brain and spinal cord. The peripheral nervous system consists of
the spinal nerves and the
cranial nerves. Several peripheral (spinal) nerve networks, called
plexi, originate from the spinal cord
and branch out to eventually reach the skin and muscles of the upper
and lower limbs.
CASE 19
Transparent Section of Cerebrum
CASE 20
Brain Stem
The oldest part of the brain and the continuous link between the upper
brain and the spinal cord, the
brain stem controls several of the body’s most vital functions,
including heartbeat and respiration. It is
divided into three regions as it ascends from the spinal cord:
Medulla Oblongata. The link to the spinal cord. Controls heartbeat,
respiration, and blood pressure, as
well as sneezing, coughing and hiccups.
Pons. The bridge between the cerebellum and cerebrum.
Mid-brain. Contains reflex centers for vision, hearing and touch. In
threatening situations, these reflex
centers immediately respond by closing the eyes, tensing the hearing
muscles, or pulling away from
danger.
Section of Face showing Trigeminal Nerve
Twelve cranial nerves arise directly from the brain to control and
monitor the structures of the face.
Nine of these nerves originate from the brain stem; these include the
vestibulocochlear nerves that
control hearing and balance, the facial nerve that controls the muscles
of facial expression, and the
trigeminal nerve.
The trigeminal nerve, exposed on this specimen, supplies nerve impulses
to the skin on the face and
scalp, the teeth, the mucous membranes in the nose, mouth, and eye, and
to the muscles of
mastication (chewing). The trigeminal nerve is mainly composed of
sensory nerves. It allows you to
feel your skin stretch when you open your mouth wide and is the reason
you can feel the texture of the
foods you eat. A branch of the trigeminal nerve is also very important
to dentists: it is the nerve they
numb before dental procedures such as drilling.
Brain Stem with Trigeminal Nerve
CASE 21
Nerves
The intricate nerves of the head are dissected here, as are the nerves
that control digestion and
respiration. The opened cranial cavity of the back of this specimen
reveals the unique blood flow within
the brain.
44
CASE 22
The Central and Peripheral Nervous System
This remarkable dissection offers a nearly complete view of the central
and peripheral nervous systems.
The brain and spinal cord are clearly visible as are all the spinal
nerves. At the base of the spinal cord
you can see the lumbar enlargement and the cauda equina —dozens of
nerve rootlets that branch from
the spinal cord. In addition, both the lumbosacral and the brachial
plexi are visible, as are several of the
cranial nerves that innervate the face and head.
Like the brain’s protective membranes, three layers of the meninges
surround the spinal cord. The outer
fibrous layer of the meninges is called the dura mater, while the inner
and most delicate layer is called
the pia mater. An intermediate layer is called the arachnoid because
the fibers within it resemble a
spider’s web.
The specimen is also displayed with its eyes and optic nerves. The size
of the eyes does not change
between infancy and adulthood, thus children’s eyes are large in
comparison to their brains and skulls
giving them that wide-eyed look.
CASE 23
The Cerebellum
The cerebellum is the cauliflower-shaped organ at the base of the
brain. Meaning “little brain” in Latin,
the cerebellum controls equilibrium and regulates our muscular
movements. It is because of your
cerebellum that you are able to stand on one foot, button your shirt,
and walk smoothly through this
exhibition.
Cerebral Dura Mater with Whole Brain
The brain is surrounded by three meninges, or protective membranes,
which supply it with blood and
nutrients. The tough and fibrous outer layer, called the dura mater, is
shown here. It supports the brain
and divides the cranial cavity into smaller compartments.
Insular Lobe
Hippocampus
CASE 24
Brain Ventricles and Cerebrospinal Fluid
Inside the brain are an interconnected series of hollow spaces called
ventricles that are filled with
cerebrospinal fluid. Made within the ventricles, this water-like fluid
circulates between the layers of the
meninges, cushioning the brain and spinal cord, and removing their
wastes. The cerebrospinal fluid is
continuously produced, circulated and reabsorbed. If a blockage
prevents the cerebrospinal fluid from
circulating, the ventricles can enlarge, putting pressure on the brain.
This condition is known as
hydrocephalus (water on the brain).
Cerebrum with Hydrocephalus
45
Stroke
The brain requires a massive and continual blood supply. If this blood
supply is interrupted, even for a few minutes, brain tissues will begin
to
die.
This is the case with stroke. It is caused by a blockage (thrombosis) or
rupture in one or more of the brain’s blood vessels. In the case of a
rupture, a broken vessel fills part of the brain with blood, increasing
pressure, and causing further tissue death. Those with high blood
pressure and arteriosclerosis are at the greatest risk. Symptoms of
stroke include paralysis, language and vision impairment. There are
600,000 new cases of stroke annually in the United States. The brain
section in this case is an example of a large-scale debilitating
stroke. Top view of cross section of the head
Thrombosis (Blockage of Cerebral Artery)
CASE 25
Half Brain Showing Location of Pituitary Gland
Pituitary Gland
Known as the master gland, the pituitary plays a very important role in
the functioning of the glands in
the endocrine system. It secretes the hormones that control all the
other glands of this delicate and
essential system, which influences every cell, organ, and function of
our body.
Thyroid Gland
The largest of the endocrine glands, the thyroid, is located just below
the voice box. It produces
hormones that regulate body metabolism. In certain cases, the thyroid
becomes overactive, increasing
metabolism and raising blood pressure. Those with this condition, known
as Grave’s Disease, often
appear to have very large eyes. Grave’s disease is often treated by
removal or destruction of the thyroid.
The thyroid hormone is then replaced with a synthetic hormone that is
taken daily. In other cases, the
thyroid is under-active causing lethargy and weight gain. This, too, is
regulated with synthetic
hormones.
Thymus Gland
The thymus gland lies underneath the top of the breastbone. A very
important gland during childhood
and puberty, the thymus produces T-lymphocytes (T-cells), white blood
cells responsible for immunity.
T-cells help recognize and destroy invading bacteria, viruses, abnormal
cells, and foreign tissue.
Experiments done on animals have shown that if the thymus is removed
before birth, the animal’s
immune system cannot recognize foreign tissue and cannot fight off
cancer cells.
Thyroid Cancer
Thyroid cancer is both a rare clinical disease and a rare cause of
death; the gland is more often affected
by a benign tumor known as an adenema. These tumors can occur in any
age group, but occur more
commonly in young adults. Until recently, adenomas were surgically
removed upon their discovery to
prevent cancerous change. However, current research suggests that the
risk of cancerous changes is
slight, allowing physicians time to monitor adenomas before deciding
upon surgery.
46
CASE 26
The Whole Brain
The brain is the mysterious organ of the central nervous system
and is essential for all bodily functions. Weighing only 2.6 pounds
on average, it contains billions of nerve cells, which are in constant
communication with each other and the body. Some brain cells
make connections with over 10,000 others in a split-second.
CASE 27
The Brain
The exposed brain of this seated figure offers an excellent view of the
main organ of the central nervous
system, which controls everything we do; every thought, action and
emotion. As the main conduit
between the brain and the body, the spinal cord transmits millions of
nerve impulses per second at
speeds exceeding 270 miles per hour.
CASE 28
Creativity + Bodily Control
This specimen of a musical conductor illustrates the nearly countless
number of tasks the brain
executes, from the most basic to the highly complex. The thickest and
longest nerve in the body, the
sciatic nerve, is also visible on this dissection.
THE CIRCULATORY SYSTEM GALLERY
CASE 23: C1.a: The Heart
CASE 29
Heart
CASE 30
Chambers of the heart
CASE 31
Heart with Visible Cardiac Valves
CASE 32
The blood vessels of the heart
Case 33
Casting Specimen of Pancreas and Spleen
Every drop of blood in the body passes through the heart once each
minute.
47
CASE 34
Arteries of the upper Limb
Arteries and veins of upper Limb
CASE 35
Arteries of the lower Limb
Arteries and veins of the lower Limb
CASE 36
Artery of the Jejunum
CASE 37
Blood Vessels of the Ileum
CASE 38
Arteries of the Stomach
CASE 39
Arteries of the Ileum
CASE 40
The arteries of the thoracic wall
CASE 41
The blood vessel of the iliocecal junction
CASE 42
Arteries of the kidney
CASE 43
Blood Vessels
This specimen was prepared using a special casting method. The blood
vessels were first injected with
a colored polymer. Once the polymer hardened, the remaining body tissue
was removed by a corrosive
chemical to reveal the intricate matrix of the blood vessels.
CASE 44
Arteries of the head with skull
CASE 45
The bronchial tree and pulmonary veins
CASE 46
Casting specimen of associated heart and lungs
CASE 47
Bronchial Tree and Pulmonary Artery
CASE 48
The venous valves
48
THE RESPIRATORY GALLERY
CASE 49
Spleen
Located high in the left side of the abdomen, the spleen helps form
blood in a developing fetus and,
though not essential to an adult, continues to filter blood and fight
disease throughout life. Red blood
cells squeeze through narrow pores within the spleen and older, more
brittle, cells are destroyed here.
The spleen also contains the largest concentration of lymphatic tissue
in the body and assists the
immune system in isolating and destroying harmful organisms.
Megalosplenia (Enlarged Spleen)
Because the spleen acts as a filter for the blood and the immune
system, it may become enlarged due to
infections or diseases of the blood. The most common cause of
enlargement is malaria, a disease
endemic to mosquito-infested tropical and sub-tropical areas, which
affects the body’s red blood cells.
The Epstein-Bar virus, which causes mononucleosis, also leads to
swelling of the spleen. If the spleen
ruptures due to infection, it must be removed in emergency surgery.
Removal of the spleen may lead to
a weakened immune system.
CASE 50
Smoker’s Lungs with Heart
These shrunken and darkened lungs illustrate the tar build-up and
disease that
often accompanies cigarette smoking. The tars in tobacco permeate and
blacken
lung tissue. The accumulation of smoking debris within the lungs leads
to the
breakdown of the alveoli, greatly decreasing the surface area of the
lung and
depriving every organ in the body, including the heart, of much needed
oxygen.
Section of Lung with Emphysema
Emphysema comes from the Greek word for inflation and refers to an
over-extension of the alveoli. This
inflation occurs as the thin walls of the alveoli rupture if they are
obstructed. The lungs may be
obstructed by many different types of debris, but the most common is
debris from cigarette smoking.
As lung tissue continues to deteriorate, it begins to fill with fluid,
leading to a near-permanent state of
pneumonia resulting in a chronic cough, loss of appetite, and fatigue.
Lung with Cancer
Bronchogenic carcinoma of the lung most often starts in one of the air
passageways and not in the lung
tissue itself. These cancers can go undetected for some time and often
develop into advanced diseases
before they are discovered. Early symptoms include a dry, irritated
cough and the slow onset of
breathlessness. The leading cause of lung cancer is chronic cigarette
smoking.
Lobe of Lung with Cancer
Because the lungs are naturally divided into independent segments, one
portion of the lung may be
removed without affecting breathing in other regions. In the case of
lung disease or cancer, surgeons
often remove the compromised section of lung, hoping to keep the
disease from spreading. This
specimen came from a surgery in which a portion of lung was removed to
save the individual’s life.
49
CASE 51
Lungs and Heart of Fetus
During fetal development, oxygen is delivered to the fetus via the
umbilical cord. The lungs are not used
until birth when the infant takes its first breath.
Healthy Lungs and Heart
These healthy lungs show some dark pigmentation, the normal amount of
discoloration resulting from the inhaled pollutants in our air. Special
cells
within the lungs sweep these pollutants out of the airway and deposit
them in
the lung tissue, allowing oxygen and carbon dioxide to be exchanged
normally.
CASE 52
Tuberculosis of Small Intestine
Tuberculosis of the small intestine is thought to begin when bacteria
is coughed up and swallowed.
Because it is resistant to gastric acid, the bacteria enters the small
intestine and becomes lodged in
lymphoid tissue. This can lead to erosion of the intestinal lining.
Tuberculosis of Kidney
Tuberculosis of the kidneys arises almost always from a blood-borne
spread of tuberculosis from the
lungs. In advanced stages of tuberculosis, the kidney becomes a hollow
sac-like structure. Occasionally,
the original site of infection (e.g., the lungs) will heal, but the
kidney will remain infected. Renal
tuberculosis can lead to death either from uremia (kidney failure) or
from chronic wasting and loss of
kidney function from the uncontrolled tuberculosis infection.
Section of Lung with Tuberculosis
Pulmonary Tuberculosis
CASE 53
Cancer of the Larynx
Although it is not common form of cancer, carcinoma of the larynx
occurs directly upon the vocal cords.
This accounts for the progressive hoarseness and difficulty swallowing
associated with this cancer.
When they do occur, however, tumors of the larynx have a high mortality
rate.
Front of Larynx
Back of Larynx
Vocal Cords
The lower segment of the larynx contains the vocal cords, two ligaments
of elastic tissue covered with
gathered mucous membrane that enable speech. We speak by pushing air
from the lungs into the larynx
and vibrating the vocal cords; the closer the vocal cords draw
together, the higher the pitch of your voice.
The tongue and lips convert the vocal cords’ vibrations into speech.
50
Segmental Bronchi
As its name suggests, the bronchial tree branches into smaller and
smaller segments as it enters the
lungs. These branches eventually end at one of millions of alveoli
where carbon dioxide is exchanged for
oxygen. The lung is actually divided into only 20 segments. These
segments are functionally separate
regions in the lungs, which receive their own blood supply and can
continue to operate if another
segment is removed. This is nature’s way of insuring that breathing
will continue if other parts of the
lung become diseased.
Alveoli
The bronchial tree ends in air sacs, or alveoli, that branch out like
clusters of grapes. Only one cell thick,
the walls of the alveoli are in direct contact with the capillary walls
of the pulmonary veins. It is across
this fragile membrane that life-supporting gas exchange occurs; here
carbon dioxide is diffused from the
bloodstream and exhaled, while oxygen is absorbed into the bloodstream
and circulated to every organ
in the body. The lungs contain approximately 300 million of these
alveoli that, if stretched out, would
cover half a football field.
CASE 54
The Respiratory System
The respiratory system consists of a number of successive,
interconnected, structures (air passageways)
that begin in the nose and end in millions of alveoli deep in the
lungs. The conducting division of the
respiratory system includes the nasal cavity, nasopharynx, larynx,
trachea, bronchi, and bronchioles,
which cleanses, humidifies, and directs the air we breathe into the
lungs. In most instances, the walls of
the conducting division contain cartilage, which prevents the air
passageways from collapsing.
Once inhaled, air enters the respiratory division of the respiratory
system. It passes into the alveoli
where oxygen and carbon dioxide are exchanged across a thin blood-air
membrane: red blood cells
absorb oxygen from the inhaled air and release carbon dioxide that is
then exhaled.
CASE 55
The Mediastinum
The central portion of the thoracic cavity is called the mediastinum, a
thick partition that contains the
heart, esophagus, trachea, and the thymus gland. It lies in the midline
of the chest, dividing it into two
smaller compartments: the pleural cavities that hold the lungs.
Diaphragm
The diaphragm, visible at the top of this specimen, is essential for
life. This strong, flat muscle divides
the thoracic and abdominal cavities and is the main muscle used in
breathing. When at rest, the
diaphragm forms a high dome; when the diaphragm contracts, the dome
moves towards the abdomen
creating a vacuum, expanding the chest cavity, and making room for
outside air. The average adult takes
15 breaths per minute; babies take 40.
CASE 56
Respiration + Circulation
This dissection of a man throwing a baseball displays many of the
body’s major arteries. In particular, it
demonstrates the delicate interior architecture of the lungs.
51
THE DIGESTIVE GALLERY
CASE 57
Muscles of Mastication, the Tongue and Taste Buds
Digestion of food begins in the mouth, with the teeth and tongue. The
teeth tear, bite, and grind food
(mastication), mixing it with saliva. The tongue moves food between the
teeth to assist with chewing
and swallowing. When food is swallowed, a cartilaginous flap of tissue,
called the epiglottis, closes off
the airway to prevent us from choking. Food then enters the esophagus,
a ten-inch long muscular tube,
where it is transported to the stomach by peristalsis (muscular
contractions).
Taste buds lie between the grooves on the surface of the tongue and
tell the brain what the body is
ingesting and what enzymes it needs to break it down. Each person has
between 2000 and 5000 taste
buds, with women generally having more than men
Muscles of Mastication
Pharynx
The pharynx is commonly known as the throat. It is the passage for air
and food, and contains the larynx
(voice box). Its opening from the mouth is protected by the tonsils,
which have open pits to catch
bacteria and viruses. The pharynx also contains the epiglottis, a
leaf-shaped flap of tissue just behind
the tongue that prevents food or liquid from entering the airway when
swallowing.
Section of Head Showing Location of Parotid Gland
The Ducts of the Parotid Gland
These delicate glands carry saliva from the parotid gland, the largest
of all salivary glands, and deliver it
into the mouth. Saliva begins breaking down carbohydrates in food as
soon as it enters your mouth.
The major ducts of the parotid gland open into both sides of the mouth
opposite the upper second
molars. Because it they are constantly being bathed by saliva, the
upper second molars often
accumulate more plaque than any of the other teeth within the mouth.
CASE 58
Normal Gallbladder
The gallbladder attaches to the lower surface of the liver and stores
bile, a greenish-brown fluid that is
essential for digestion. Bile breaks down fats and also helps carry
certain toxic wastes created by the
liver out of the body.
Adenocarcinoma of the Gallbladder
Cancer of the gallbladder is a common disease in the gastrointestinal
tract. In its early stages, the
cancer has few symptoms, but later symptoms include pain, nausea,
vomiting, intolerance to fatty
foods, jaundice, and weight loss. The lack of early symptoms often
leads to a delayed diagnosis and a
low curability rate for the disease. Only 20 percent of such cancers
are surgically treatable.
52
The Liver
The heaviest single organ in the body, weighing close to 3.5 pounds
(1.58 kilograms) in an average
adult, the liver serves several metabolic functions. It produces bile,
key to the proper digestion of fats,
stores vitamin A, and creates several proteins essential to blood flow
and clotting. The liver also receives
glucose-rich blood returning from the digestive tract. It converts much
of this glucose into glycogen, the
sugar your body’s cells use for energy.
Cirrhosis of the Liver
Along with storing sugars, the liver also removes and destroys
ingested toxins, including alcohol, drugs, and microbes.
Improper diet that often accompanies alcohol and drug abuse
can lead to the death of liver cells and to their replacement by
scar tissue. This disease is known as cirrhosis and is visible on
this specimen. Other diseases, such as liver cancer and hepatitis,
can severely damage the liver as well. A liver transplant is often
the only way to treat these conditions.
Canal System of Liver
This special dissection reveals the hepatic portal venous system, one
of the pathways that blood takes
through the liver. This pathway receives blood from the capillaries of
the small intestine and delivers the
absorbed nutrients in that blood to the sinusoidal capillaries of the
liver for processing.
Healthy Liver
Liver Cancer
The liver is a common site for secondary cancers to occur because of
its high blood flow. Tumors
arising in the colon, pancreas, stomach, lung or breast can spread to
the liver as their cells become
more prevalent in the blood.
On this specimen, you can clearly see cancer’s devastating effects in
two ways: cancer cells both destroy
the liver’s healthy cells and take much needed blood for their own
growth. On this specimen, you can
see the larger blood vessels that correspond to the tumor’s development
in the liver.
CASE 59
The Stomach
In the stomach, three layers of muscle churn partially digested food
with powerful gastric juices, turning
the food into a paste-like substance and killing many bacteria that
might otherwise bring disease to the
body.
Stomach with Rugae
The stomach contains many rugae (folds), which expand to create more
surface area
as the stomach fills with food. Cells within the rugae produce both
mucus and
digestive juices. We feel full from eating when nerve receptors in the
stomach tell the
brain that the stomach has stretched to capacity. Ignoring this feeling
can lead to
overeating and destructive weight gain.
53
Stomach and Duodenum
After food is broken down in the stomach, it enters the duodenum, a
one-foot long, C-shaped section at
the beginning of the small intestine. Here food is mixed with bile from
the liver and enzymes from the
pancreas to further digest it into carbohydrates, nucleic acids,
proteins, and fats--the four nutrients
needed for life. These nutrients are then absorbed into the bloodstream
as the digested food travels
through the small intestine. The pancreas also plays a vital role in
controlling blood sugar levels in the
body, secreting the hormone insulin when blood sugar levels are high
and the hormone glucagon—a
sugar the body uses for energy—when they are low.
Small Intestine with Mesentery
The small intestine attaches to the body wall with a connective tissue
called mesentery. It wraps around
the intestine like a sling and holds it in place. Blood vessels,
visible as dark lines on this specimen,
travel through the mesentery to reach the intestine, carrying oxygen
and nutrients to the intestine and
wastes and absorbed molecules away from it.
Section of Small Intestine
The small intestine performs most of the digestion and absorption of
nutrients in the digestive tract.
Over ten feet long, it contains several million villi and microvilli.
These microscopic, finger-like
projections reach into the hollow spaces of the intestine and increase
the small intestine’s surface area
over one thousand times. Through these projections, digested molecules
pass into the bloodstream and
are carried to the liver for further processing.
Cecum and Vermiform Appendix
The cecum marks the very beginning of the colon (large intestine).
Unlike the
walls of the small intestine, which have permanent folds, the colon’s
inner wall
is smooth. The small piece of tissue at the bottom of this specimen is
the
vermiform (worm-like) appendix. Once needed by our ancestors when they
ate
rougher foods, it is now an evolutionary relic.
Section of Colon
The colon (large intestine) is the end of the digestive tract. It
converts digested food into feces for
excretion. Digested food moves through the colon by peristalsis
(muscular contractions) in the colon
walls. In some cases, due to stress, the walls in one area of the colon
contract more intensely, causing
discomfort and flatulence, a condition known as irritable bowl syndrome
or spastic colon.
Rectum and Anal Canal
As it leaves the lower portion of the colon, undigested food and other
body waste pass into the rectum
where they are stored until the body discards then as feces through the
anal canal. The rectum and the
lower portion of the colon are sometimes the site of constipation,
which occurs when the feces hardens
and becomes too dry to pass out of the anal canal. This is generally
caused by lack of exercise plus
insufficient fiber and liquid in the diet.
54
Gastric Cancer Invading the Spleen
Cancerous tissue in the stomach lining results in a breakdown of the
stomach’s rugae, which are then
replaced by hard, smooth cells. While gastric cancer may feel much like
an ulcer, it can be fatal if not
treated. The best way to detect stomach cancer is through the use of a
long flexible tube called an
endoscope, which is swallowed by the patient allowing physicians to
examine the lining of the stomach.
Milk, fresh vegetables, vitamin C and frozen foods all appear to reduce
the risk of stomach cancer.
CASE 60
The Whole Viscera
The vital organs of respiration, digestion, circulation, and
reproduction are contained within the body’s
thoracic, abdominal, and pelvic cavities. They are aligned within us in
an amazing, compact, and
efficient relationship, performing hundreds of functions
simultaneously, while continuously maintaining
and remaking themselves.
CASE 61
The Alimentary System (Digestive Tract)
A fibro-muscular tube that runs from mouth to anus, the digestive tract
is one of the world’s most
efficient dis-assembly lines. It uses a combination of mechanical and
chemical processes to break down
the foods we eat, converting them to nutrients the body can use for
fuel. Once swallowed, food moves
through the digestive tract by the process of peristalsis, waves of
muscular contractions that propel
food from the esophagus to the rectum. On average, it takes 24 hours
for food to pass through the
canal.
CASE 62
The Vital Organs
This dissection provides a rare view into the compact and complex
relationships that exist between
many of the body’s major organs. This specimen was cut into right and
left halves along the midline of
the body.
CASE 63
Gastric Polyps
Polyps, benign tumors that develop in the digestive tract, can signify
changes in the tissue that may lead
to cancer. They are very small and usually develop singly. Polyps
occurring in large numbers are termed
polyposis.
Ascariasis
Ascariasis is an infection caused by the parasitic roundworm Ascaris
lumbricoides. Poor sanitation and
poor personal hygiene are contributing factors to this disease. Early
signs of its presence include lack of
appetite, fatigue, and weight fluctuations. Adult worms live in the
intestine and when infestation is great
can cause abdominal discomfort, intestinal obstructions, and
malnutrition. As part of their life cycle,
larval worms migrate through the lungs of their host causing a cough
and discomfort while breathing.
Effective medications are available, but in severe cases surgery may be
necessary to clear internal
blockages.
55
The relationship of liver, stomach, pancreas, and spleen
This view of the close positioning between the stomach, liver, spleen,
and pancreas helps demonstrate
how each organ depends upon the other during the process of digestion.
CASE 64
Greater Omentum
The greater omentum secures and supports the stomach and part of the
small intestines, supplying
them with nerves and blood vessels. A connective tissue, it is also one
of the areas where the body
stores fat. The omentum is known as the “guardian of the abdominal
cavity” because it contains cells
that help guard against infections.
CASE 65
Aorta with Atherosclerosis
Atherosclerosis (hardening of the arteries) develops when plaques
(fatty deposits) form in the lining of
the arteries. These plaques narrow the affected blood vessels,
sometimes causing aneurysms, a bulge
on the aorta, which may rupture. Smoking and high cholesterol increase
the risk for this disease.
Atherosclerosis is the main cause of death in developed nations.
Normal Aorta
The aorta is the largest artery in the body. It carries oxygenated
blood away from the heart and branches
into many smaller arteries that supply the head, neck, and arms, as
well as the organs in the chest,
abdomen, pelvis, and legs. Like all arteries, the aorta has thick and
muscular walls that can expand or
contract to accommodate the volume of blood passing through them. The
health of the arteries’ walls is
a contributing factor to blood pressure.
CASE 66
Adipose Tissue
This specimen displays the distribution of fat in an overweight female.
Excess weight aggravates
conditions such as high blood pressure and diabetes. The greatest
health risk posed by obesity is a
shortened life span.
THE REPRODUCTIVE AND URINARY SYSTEM GALLERY
CASE 67
The Kidneys
These specimens reveal some of the kidney’s inner structure, including
the renal artery, which delivers
blood for filtering, and the renal cortex where the actual filtration
of blood occurs. The hollow space
within the kidney is the renal sinus. It marks the beginning of the
ureters, which carry urine drop by drop
to the bladder.
The whole kidney specimen also exhibits an adrenal gland. Located on
top of the kidneys, the adrenal
glands produce hormones that influence metabolism and the body’s
response to stress. These
hormones are sometimes called adrenaline after the gland that creates
them.
56
Horseshoe Kidney
The term “horseshoe kidney” refers to a condition in which both kidneys
are fused in early embryonic
life giving them the appearance of a horseshoe. A fairly common
condition, it occurs in approximately
one of every 400 births. The kidneys will continue to function under
this condition, but may suffer from
a lack of blood supply. Those with a horseshoe kidney sometimes have
other genetic disorders of the
skeletal, digestive, and cardiovascular systems.
Left and Right Kidneys
This unique specimen exhibits a double ureter on its right kidney. A
double ureter does not seem to
affect the amount of urine that flows to the bladder.
Blood Vessels of Kidney
This special dissection reveals the amazing network of blood vessels
within
the kidneys. Blood enters the kidney through the renal artery (visible
in the
center of this specimen) and passes into ever-smaller blood vessels
until it
reaches one of over one million nephrons (filtering units). Here great
pressure forces blood and proteins through a fine membrane leaving waste
materials, water, electrolytes, and salts behind.
Filtered blood returns to the body, while the captured material moves
toward the bladder. However, most of the water, electrolytes and salts
are
re-absorbed into the bloodstream before they reach the bladder. If this
did
not occur, we would produce almost 50 gallons of urine per day. In your
lifetime, however, you will urinate 12,000 gallons.
Kidney with Hydronephrosis
Hydronephrosis is a condition that develops when the normal flow of
urine leaving the kidney is
somehow obstructed. When such an obstruction occurs, urine backs up
into the kidney causing it to
swell. If the condition progresses unchecked, it can eventually destroy
the kidney tubules. When both
kidneys are affected, total kidney failure may result.
Cross Section of Kidney
Kidney Cancer (Carcinoma of the Kidney)
Very little is known about the causes of kidney cancer, but it is very
rare for it to occur in both kidneys.
Research has shown that cigarette smoking increases the risk of
developing cancer of the kidney, as
does exposure to cadmium, asbestos and lead paints. Diabetes, obesity,
chronic kidney failure, and high
blood pressure, may also increase the risk of developing cancer of the
kidney. Those with a family
history of kidney cancer should be checked regularly for this disease.
CASE 68
Transverse Section of Thorax at Level of Lung
CASE 69
Transverse Section of Abdomen at Level of Liver
CASE 70
Transverse Section of Abdomen at Level of Kidney
57
Male sperm are the smallest cells in the human body.
CASE 71
The Male Body
This specimen exhibits the organs of the male reproductive system.
Female Reproductive and Urinary Systems
CASE 72
Symmetry
This specimen helps us understand the relationship between the surface
of the body and the bones and
organs beneath it.
CASE 73
The female reproductive systems stores, releases, and incubates the
egg, or female sex cell, which
creates new human life when joined with a male sperm cell.
1. Ovaries. Contain more than 250,000 ova, or eggs. All the eggs an
ovary will ever have are present at birth. Alternating between left and
right, ovaries release an egg each month by a process called ovulation.
2. Uterine (Fallopian) Tubes. Capture the egg when it is breaks
through the wall of the ovary and transport it to the uterus. Most
pregnancies begin in the uterine tubes.
3. Uterus (Womb). The site where a fertilized egg implants and
develops. It has a blood-rich lining that is shed each month
(menstruation), if fertilization does not occur.
4. Cervix. Lower portion of the uterus that opens into the vagina. It
softens prior to delivery for easier passage of the fetus into the birth
canal. Cervical cancer is one of the most common cancers in women
and can often be detected with a yearly Pap test.
5. Vagina (Birth Canal). A fibro-muscular tube that connects the
uterus and external genitalia. It is capable of expanding during
delivery
to allow for easier childbirth.
6. External Genitalia. Consists of several protective folds of skin that
surround the openings of the vagina and urethra. One of these folds
corresponds to the male scrotum, while another surrounds the
clitoris, the female equivalent of the male penis.
Female Urogenital System
Median-Sagittal Section of Female Pelvic Cavity
Superior View of Female Pelvic Cavity
The Female Internal Genital Organs (With IUD)
58
CASE 74
The Male Reproductive and Urinary Systems
The male reproductive system creates and delivers sperm, the male sex
cell, which when joined with the
egg or female sex cells, causes fertilization. Its organs include:
1. Testis (Testicle). Where sperm and hormones are produced.
They are contained within the scrotum outside of the main body
cavity because they best produce sperm at 2 degrees below
normal body temperature.
2. Spermatic Cord. Carries sperm out of the testes. It also
contains the testicular artery and the cremaster muscle, which
lifts the testes closer to the body in cold weather.
3. Seminal Vesicle. Small glands that lie behind the urinary
bladder, which secrete most (75 percent) of the seminal fluid.
4. Prostate Gland. A single gland, shaped like an inverted
pyramid; it surrounds the urethra as it leaves the urinary bladder.
Its secretions account for approximately 25 percent of the
seminal fluid.
5. Penis. Contains erectile tissue and a portion of the urethra,
which carries urine and seminal fluid out of the body.
6. This specimen also exhibits one of the adrenal glands. Located
on top of the kidneys, the adrenal glands produce hormones that
influence metabolism and the body’s response to stress. These
hormones are sometimes called adrenalin after the gland that
creates them.
Male Urogenital System
Superior view of Male Reproductive System
Median-Sagittal Section of Male Pelvic Cavity
The Cavenous Body of Penis
CASE 75
The Female Body
This specimen illustrates features of the female reproductive system.
Women have a bell-shaped pelvis
and wider hips to assist in childbirth.
Female eggs are the largest cells in the human body.
59
CASE 76
The Breasts with Glandular Milk Ducts
Breast Cancer
Breast cancer affects approximately five per cent of the female
population and is thought to be caused
by high estrogen levels. These tumors can go undetected for some time
because they are usually not
painful. Because the later stages of breast cancer can be extremely
fatal, women over 50, or with a family
history of breast cancer, should have a yearly mammography to detect
the disease in its earliest stages
when it is highly treatable.
CASE 77
Teratoma
Teratomas are rare tumors composed of multiple tissues such as skin,
teeth, and hair that develop in
abnormal locations. Such abnormalities within the ovary (dermoid
teratomas) mainly occur during
reproductive life and sometimes develop during pregnancy. In almost all
cases, these teratomas are
curable.
Dermoid Cyst of Frontal Lobe
A dermoid cyst is a type of teratoma, a benign tumor that originates
from some of the cells that later
form the skin. These tumors most often occur close to the body’s
midline, sometimes growing in the
spine and, rarely, in the midline of the brain. Dermoid cysts in the
brain and spine are sometimes found
in children who have experienced episodes of meningitis. Treatment
normally involves their surgical
removal.
Ovarian Cyst
Ovarian cysts are relatively common and can occur in females of all
ages. These hollow fluid-filled
structures are usually small and asymptomatic. Complications can occur,
however, including an
enlarged ovary, a disturbed menstrual cycle, damaged ovarian blood
supply, and infertility.
Intramural Uterine Fibroid
A fibroid within the uterus is a benign tumor consisting of a sphere of
muscle and fibrous tissue. It may
occur in the uterine smooth muscle (intramural) or within the uterine
lining (submucosal).
CASE 78
Benign Prostatic Hyperplasia
The prostate gland secretes some of the fluids that create semen. As
men age, the prostate may
increase up to five or six times its normal size, a condition known as
benign prostatic hyperplasia. This
sometimes leads to an obstructed urinary flow, as was the case with
this specimen, which also resulted
in swelling of the urinary bladder. While enlargement of the prostate
does not lead to cancer of the
prostate, men over 50 should have regular screening for prostate cancer.
Prostate and Seminal Vesicles
Shaped like an inverted pyramid, the prostate gland supplies semen with
25 percent of its fluid, mainly
an alkaline solution that neutralizes the vagina’s acidity allowing
sperm to live. The urethra passes
through the prostate and carries both sperm and urine out of the body.
60
The seminal vesicles are coiled tubes at either side of the prostate
through which sperm pass before
reaching the prostate. Here sperm mixes with a fructose-based
secretion, which provides 60 percent of
the fluid that creates semen.
CASE 79
Blood Vessels of Placenta
OPTIONAL: THE FETAL GALLERY
NOTE: All embryos and fetuses died of natural causes in utero.
CASE 80
Placenta (fetal side)
The placenta acts as a lung for the developing fetus receiving
deoxygenated fetal blood from the fetus
and delivering oxygen-rich blood to it.
Placenta (Uterine Side)
The placenta forms within the wall of the uterus from a combination of
uterine and fetal tissue. There is
no mixing of embryonic and maternal blood in the placenta. Instead, all
exchange between these two
separate circulations takes place across a very thin cellular barrier.
However, the placental barrier
cannot stop harmful chemicals. If such substances are ingested during
the embryonic period, they can
cause birth defects and have other serious consequences on the process
of normal development.
CASE 81
Fetus (9 weeks)
Fetus (13 weeks)
Fetus (16 weeks)
Fetus (24 weeks)
CASE 82
Transparent Fetal Section
CASE 83
Transparent Fetal Section
NOTE: If you wish to tour The Fetal Development Gallery, continue
with the exhibition notes. If you do not wish to view the Fetal
Development Gallery, please turn to Page 62 of this guide.
61
CASE 84
Transparent Fetal Section
CASE 85
Fetal Bone Development (20 weeks)
CASE 86
Fetal Bone Development (16 weeks)
CASE 87
Fetal Bone Development (14 weeks)
CASE 88
Fetal Bone Development (12 weeks)
CASE 89
Embryonic and Fetal Development
The 40 weeks of in utero development are divided into two extended time
periods; the embryonic
period that runs through the end of the eighth week; and the fetal
period, which extends from the ninth
week until birth. The embryonic period is characterized by the
development of the body’s organs and,
while the fetal period is characterized primarily by their increased
growth.
Embryo (8 weeks)
Embryo (7 weeks)
Embryo (5 weeks)
Embryo (4 weeks)
Embryo (18 days)
CASE 90
Visceral Hernia
A visceral hernia occurs when some or all of the fetus’ digestive
organs form outside the body.
CASE 91
Anencephalia
Anencephaly occurs when the "cephalic" or head end of the embryo’s
neural tube fails to close between
the third and fourth week of development. This results in the absence
of a major portion of the brain,
skull, and scalp. Infants with this disorder are born without a
forebrain, the front, thinking and
coordinating part of the brain. The remaining brain tissue is often
exposed - not covered by bone or
skin. The cause of anencephaly is unknown. Although it is thought that
a mother's diet and vitamin
intake may play a role, scientists believe that many other factors are
also involved. Recent studies have
shown that the addition of folic acid (vitamin B9) to the diet of women
of childbearing age may
significantly reduce the incidence of neural tube defects.
62
CASE 92
Bifid Spine
Spina Bifida develops during the first month of pregnancy. It is a
congenital defect in which the
embryo’s spinal column does not fuse properly, leaving the spinal cord
and its protective membranes
vulnerable. In some extreme cases, the spinal cord and nerves are
exposed at birth. While surgery can
repair the opening after birth, the resulting nerve damage is permanent
and may lead to paralysis of the
lower limbs. With proper care, most children with spina bifida live
well into adulthood.
THE TREATED BODY GALLERY
CASE 93
Vertebrates
Humans are vertebrates, a category of animals with an internal bony
skeleton. Whales also belong to
this class, as do fish, amphibians, reptiles, and birds. Although each
type of vertebrate is unique, all
have a head, ribs, and a vertebral column with a tail—or remainder of
one. In this case are examples of
the similarities between the human and the whale’s bony structure.
Whale Vertebra
Human Vertebra
Human Costal Bone
Whale Costal Bone
CASE 94
Carcinoma of the Esophagus
Carcinoma of the esophagus accounts for about five percent of all
visceral carcinomas found in men,
and occurs most often after the age of 50. There are few symptoms in
the early stages of the disease and
tumors can grow unchecked until they begin to block the esophagus.
Because the survival rate is low
(less than ten percent), early detection is crucial.
Cancer of the Rectum
Colon cancer frequently occurs at either end of the colon—in the area
of your right hip where the colon
begins, or near the rectum where it ends. Cancers near the rectum are
often detected earlier than those
deeper in the colon. Early detection is the key to surviving colon
cancer. The most effective method of
detection is colonoscopy, in which a fiber optic camera is used to
inspect the entire length of the colon.
Physicians recommend that anyone over 50 receive a colonoscopy every
3-5 years.
Purulent Osteomyelitis of Tibia
Osteomyelitis is a bone infection often caused by bacteria called
Staphylococcus Aureus. Both the bone
and the bone marrow are often simultaneously affected. While any bone
in the body can be affected, the
common sites of localization are the long tubular bones. Bones can
become infected in several ways,
both via blood-borne bacteria and through direct infection, which
occurs after a cut or severe fracture.
A bone also may become infected when its blood supply is disrupted.
This can happen in older people
with atherosclerosis, narrowing of the blood vessels, or in association
with diabetes. Most infections of
this kind occur in the toes or feet.
63
Larynx with Multiple Polyps
Polyps are the most common type of benign tumor affecting the larynx
and are usually found on the true
vocal cords. They often develop in heavy smokers or in individuals,
such as singers, who impose great
strain on their larynx. In singers these polyps are frequently referred
to as “singer’s nodes.” Because of
their location, they characteristically cause changes in the voice and
progressive hoarseness. Though
benign, polyps must be closely monitored to ensure they do not become
malignant.
Osteogenic Sarcoma of Femur
Bone is constantly regenerating itself, but in the case of osteogenic
sarcoma, bone cells grow out of
control. This type of bone cancer occurs most often in the lower end of
the femur. A highly malignant
cancer, osteogenic sarcoma is most common in young adults.
Hodgkin’s Disease Involving Perigastric Nodes
Hodgkin’s disease is a malignant form of cancer that affects the lymph
nodes. Hodgkin’s sarcoma is the
most malignant form of the disease, one that usually leads to death
within two years. This form of the
disease is most frequent in the middle-aged and elderly and affects
males and females equally. It usually
manifests with the sudden enlargement of groups of lymph nodes. The
disease then spreads to all
lymph nodes of the body, particularly those of the GI tract, lung,
liver, spleen, pancreas, and bones. It
can also affect the central nervous system. Symptoms usually follow a
rapid course of progressive
weakness and weight loss.
Squamous Cell Carcinoma of Leg
A squamous cell carcinoma of the skin is a form of skin cancer, which
is usually the result of long term
sun damage to the skin. It enlarges slowly and steadily, sometimes
invading neighboring tissue and can
also spread to distant parts of the body. If not removed completely,
the cancer can go deep into the skin
and metastasize to the internal organs causing death. Anyone with a
substantial history of sun exposure
can develop squamous cell carcinoma. But people who have fair skin,
light hair, and blue, green, or gray
eyes are at highest risk. Those whose occupations require long hours
outdoors or who spend extensive
leisure time in the sun are in particular jeopardy.
CASE 95
Transverse Human Sections
These body sections came from one specimen. They show you in actuality
what magnetic resonance
imaging techniques (MRI) “see” when they scan a human body.
MRI uses a magnetic field created by powerful electromagnets to
stimulate hydrogen atoms in the body.
These atoms then give off radio signals that are collected by a special
scanner and turned into images
that look remarkably like the body segments you see here. Transverse
body segments such as these, as
well as the vertical segments elsewhere in this gallery, can assist
physicians as they study relational
anatomy, which is essential to reading MRI images.
CASE 96
Medical Prostheses + Surgical Tools
This specimen illustrates techniques used to heal or replace damaged
bones, as well as the surgical
tools that assist these techniques. Bone has the amazing ability to
mend itself when broken. Optimal
healing occurs when the broken ends of a bone are properly aligned.
64
CASE 97
Form + Function
The pose of this specimen illustrates the dynamic beauty of the human
body. You can see how the
body¹s operating systems and its supporting organs contribute to
the way the body functions with grace
and agility.
CASE 98
Aneurysm of Descending Aorta
Blood vessels, both arteries and veins, are susceptible to a variety of
different diseases. One of the most
striking results of all forms of vascular disease is the formation of
an aneurysm. An aneurysm is a
localized abnormal dilation of any vessel. Aneurysms may occur in any
artery and vein of the body, but
are most common and most significant in the aorta. Aortic aneurysms
produce serious clinical disease
and often cause death by rupture. One of the most common causes of
aortic aneurysms is
arteriosclerosis.
Cardiac Malformation
In the adult cardiovascular system, the heart is a double pump,
delivering blood to the body and lungs.
In the developing fetus, however, blood does not receive oxygen from
the lungs, but via the umbilical
cord and the placenta. For this reason, the heart of a fetus has an
opening between its two upper
chambers, bypassing the flow of blood to the lungs. Known as the
foramen ovale, this opening in the
heart wall closes shortly after birth. If it fails to close,
deoxygenated blood is returned to general
circulation, which makes a baby look blue and deprives it of the oxygen
it needs to develop. Openings in
the heart can now quickly be corrected through surgery.
Pulmonary Congestion
Mitral Stenosis
Enlarged Heart Cardiomyopathy (Mitral Stinosis)
The mitral heart valve controls blood flow from the heart to the body.
CASE 99
Cerebral Abscess
If the brain becomes infected by a bacteria or fungus, white blood
cells will quickly attack the invader
and try to contain it. The resulting pus and inflammation can lead to a
brain abscess as with this
specimen.
Congenital Deformity of Brain
The Brainstem
The brainstem consists of the midbrain, pons, and medulla oblongata. It
is overlaid by the cerebellum
and is continuous with the spinal cord through the foramen magnum at
the base of the skull.
Neurological functions located in the brainstem include those necessary
for survival (breathing,
digestion, heart rate, blood pressure) and for arousal (being awake and
alert). Most of the cranial nerves
come from the brainstem. The brainstem is the pathway for all fiber
tracts passing up and down from
peripheral nerves and spinal cord to the highest parts of the brain, in
particular to the cerebral
hemispheres.
65
Brain Section with Glioma
The nervous system consists of two different types of cells: nerve
cells, which conduct nerve impulses,
and neuroglia, which support nerve cells. Neuroglia means “nerve glue”.
The name is appropriate
because these cells are responsible for holding neurons in place. In
addition, neuroglia cells protect the
nerve cells and produce myelin, which insulates nerve fibers, aiding in
the conduction of nerve
impulses. Despite all of their supporting roles, neuroglia are also the
cells in the brain that can grow
out of control and create very invasive brain tumors known as gliomas.
CASE 100
Inside + Out
Each of us is physically unique, from the shade of our skin to the size
and shape of our organs.
CASE 101
Skin
Skin acts as a protective shield. The heaviest and largest organ of the
body, weighing approximately 11
pounds and covering over 2 square yards, it is comprised of two layers:
the dermis and the epidermis.
The inner layer, the dermis, contains our nerve receptors, blood
vessels, hair follicles, and sweat and oil
glands. The blood vessels in the dermis nourish skin cells and help us
maintain a constant body
temperature, dilating when we are hot and constricting when we are
cold. Sweat glands also keep us
from overheating, coating the skin with moisture that takes away heat
when it evaporates. Oil glands
keep the layers of the skin supple, especially the outer layer, the
epidermis.
The epidermis is composed of mature skin cells that conjoin and harden,
providing our first line of
defense, protecting us from dehydration, dampness, radiation, and
millions of microbes each day. Our
nails and hair are derived from the epidermis. Skin cells regenerate
rapidly and are shed constantly;
much of the dust in your home comes from these cells.
66
CASE 102
Your Body
67
Alveoli: al- v - -l s: a small cavity or pit: as a: a socket for a
tooth b: an air cell of the
lungs c: an acinus of a compound gland d: any of the pits in the wall
of the stomach
into which the glands open
Antagonist Muscle: a muscle that contracts with and limits the action
of an agonist
with which it is paired
Appendix: narrow blind tube usually about three or four inches (7.6 to
10.2
centimeters) long that extends from the cecum in the lower right-hand
part of the
abdomen, has much lymphoid wall tissue, normally communicates with the
cavity of
the cecum, and represents an atrophied terminal part of the cecum
Artery: any of the tubular branching muscular- and elastic-walled
vessels that carry
blood from the heart through the body
Articulation: a joint between bones or cartilages in the vertebrate
skeleton that is
immovable when the bones are directly united, slightly movable when
they are united
by an intervening substance, or more or less freely movable when the
articular surfaces
are covered with smooth cartilage and surrounded by an articular capsule
Atrium: an anatomical cavity or passage ; especially : a chamber of the
heart that
receives blood from the veins and forces it into a ventricle or
ventricles
Autonomic Nervous System: part of the vertebrate nervous system that
innervates
smooth and cardiac muscle and glandular tissues and governs involuntary
actions (as
secretion, vasoconstriction, or peristalsis) and that consists of the
sympathetic
nervous system and the parasympathetic nervous system -- called also
vegetative
nervous system
Birth Canal: the channel formed by the cervix, vagina, and vulva
through which the
mammalian fetus is expelled during birth
Bone Marrow: a soft highly vascular modified connective tissue that
occupies the
cavities and cancellous part of most bones and occurs in two forms: a:
a whitish or
yellowish bone marrow consisting chiefly of fat cells and predominating
in the cavities
of the long bones
Bone: one of the hard parts of the skeleton of a vertebrate
Bronchi: either of the two primary divisions of the trachea that lead
respectively into
the right and the left lung
Bronchial Tree: bronchial tree: the bronchi together with their branches
Glossary for BODIES…THE EXHIBITION
68
Bronchiole: brä -k - l: a minute thin-walled branch of a bronchus
Cardiac Muscle Tissue: named because it is found in the heart. Cells
are joined to one
another by intercalated discs which allow the "synchronization" of the
heartbeat.
Cardiac muscle is branched, striated muscle.
Cartilage: a usually translucent somewhat elastic tissue that composes
most of the
skeleton of vertebrate embryos and except for a small number of
structures (as some
joints, respiratory passages, and the external ear) is replaced by bone
during
ossification in the higher vertebrates
CAT Scan: a sectional view of the body constructed by computed
tomography
Cecum: s -k m: a cavity open at one end (as the blind end of a duct);
especially: the
blind pouch at the beginning of the large intestine into which the
ileum opens from
one side and which is continuous with the colon
Central Nervous System: the part of the nervous system which in
vertebrates consists
of the brain and spinal cord, to which sensory impulses are transmitted
and from
which motor impulses pass out, and which supervises and coordinates the
activity of
the entire nervous system
Cervix: a constricted portion of an organ or part: as a: the narrow
lower or outer end of
the uterus b: the constricted cementoenamel junction on a tooth
Colon: the part of the large intestine that extends from the cecum to
the rectum
Compact Bone Tissue: The compact noncancellous portion of bone that
consists
largely of concentric lamellar osteons and interstitial lamellae
Conchae: kä -k : the largest and deepest concavity of the external
ear
Contraction: k n- trak-sh n: the shortening and thickening of a
functioning muscle or
muscle fiber
Diaphragm: a body partition of muscle and connective tissue ;
specifically : the
partition separating the chest and abdominal cavities in mammals
69
Digestion: 1 palate, 2 salivary glands, 3 tongue, 4 epiglottis, 5
esophagus, 6 stomach, 7
liver, 8 gallbladder, 9 pancreas, 10 duodenum, 11 jejunum, 12 ileum
(10, 11, and 12
comprise the small intestine), 13 cecum, 14 ascending colon, 15
transverse colon, 16
descending colon, 17 sigmoid flexure, 18 rectum (13-18 comprise the
large intestine),
19 anus, 20 vermiform appendix
Duodenum: d(y)ü- - d -n m: the first, shortest, and widest part of
the small intestine
that in humans is about 10 inches (25 centimeters) long and that
extends from the
pylorus to the undersurface of the liver where it descends for a
variable distance and
receives the bile and pancreatic ducts and then bends to the left and
finally upward to
join the jejunum near the second lumbar vertebra
Epididymus: ep- - did- -m s:a system of ductules that emerges
posteriorly from the
testis, holds sperm during maturation, and forms a tangled mass before
uniting into a
single coiled duct which comprises the highly convoluted body and tail
of the system
and is continuous with the vas deferens
70
Foramen (Foramina): f - r -m n: a small opening, perforation, or orifice
Glial Cells: gl - l: of, relating to, or comprising neuroglia
Gray Matter: neural tissue especially of the brain and spinal cord that
contains cell
bodies as well as nerve fibers, has a brownish gray color, and forms
most of the cortex
and nuclei of the brain, the columns of the spinal cord, and the bodies
of ganglia
Ilium: il- - m: the dorsal, upper, and largest one of the three bones
composing either
lateral half of the pelvis that in humans is broad and expanded above
and narrower
below where it joins with the ischium and pubis to form part of the
acetabulum
Internal Respiration: the exchange of gases (as oxygen and carbon
dioxide) between
the cells of the body and the blood by way of the fluid bathing the
cells
Jejunum: ji- jü-n m: the section of the small intestine that
comprises the first two fifths
beyond the duodenum and that is larger, thicker-walled, and more
vascular and has
more circular folds and fewer Peyer's patches than the ileum
Ligament: a tough band of tissue that serves to connect the articular
extremities of
bones or to support or retain an organ in place and is usually composed
of coarse
bundles of dense white fibrous tissue parallel or closely interlaced,
pliant, and flexible,
but not extensible
Liver: a large very vascular glandular organ of vertebrates that
secretes bile and causes
important changes in many of the substances contained in the blood
which passes
through it (as by converting sugars into glycogen which it stores up
until required and
by forming urea), that in humans is the largest gland in the body,
weighs from 40 to 60
ounces (1100 to 1700 grams)
MRI: magnetic resonance imaging -- a noninvasive diagnostic technique
that produces
computerized images of internal body tissues and is based on nuclear
magnetic
resonance of atoms within the body induced by the application of radio
waves
Neuroglia: neu·ro·glia: supporting tissue that is
intermingled with the essential
elements of nervous tissue especially in the brain, spinal cord, and
ganglia, is of
ectodermal origin, and is composed of a network of fine fibrils and of
flattened stellate
cells with numerous radiating fibrillar processes
Neuron: one of the cells that constitute nervous tissue, that have the
property of
transmitting and receiving nervous impulses
71
Ovary: one of the typically paired essential female reproductive organs
that produce
eggs and in vertebrates female sex hormones, that occur in the adult
human as oval
flattened bodies about one and a half inches (four centimeters) long
suspended from
the dorsal surface of the broad ligament of either side, that arise
from the
mesonephros, and that consist of a vascular fibrous stroma enclosing
developing egg
cells
Pancreas: pa -kr - s: a large lobulated gland that in humans lies in
front of the upper
lumbar vertebrae and behind the stomach and is somewhat hammer-shaped
and
firmly attached anteriorly to the curve of the duodenum with which it
communicates
through one or more pancreatic ducts and that consists of (1) tubular
acini secreting
digestive enzymes which pass to the intestine and function in the
breakdown of
proteins, fats, and carbohydrates; (2) modified acinar cells that form
islets of
Langerhans between the tubules and secrete the hormones insulin and
glucagon; and
(3) a firm connective-tissue capsule that extends supportive strands
into the organ
Peripheral Nervous System: the part of the nervous system that is
outside the central
nervous system and comprises the cranial nerves excepting the optic
nerve, the spinal
nerves, and the autonomic nervous system
Peristalsis: per- - st l-s s: successive waves of involuntary
contraction passing along the
walls of a hollow muscular structure (as the esophagus or intestine)
and forcing the
contents onward
Placenta: the vascular organ in mammals except monotremes and
marsupials that
unites the fetus to the maternal uterus and mediates its metabolic
exchanges through
a more or less intimate association of uterine mucosal with chorionic
and usually
allantoic tissues permitting exchange of material by diffusion between
the maternal
and fetal vascular systems but without direct contact between maternal
and fetal blood
and typically involving the interlocking of fingerlike vascular
chorionic villi with
corresponding modified areas of the uterine mucosa
Prime Mover: a muscle that on contracting is automatically checked and
controlled by
the opposing simultaneous contraction of another muscle -- called also
agonist
muscle
Prostate: a firm partly muscular partly glandular body that is situated
about the base of
the mammalian male urethra and secretes an alkaline viscid fluid which
is a major
constituent of the ejaculatory fluid
Prosthesis: an artificial device to replace or augment a missing or
impaired part of the
body
72
Reproductive System: left male, right female. 1 bladder, 2 seminal
vesicle, 3 vas
deferens, 4 pubic symphysis, 5 prostate, 6 urethra, 7 penis, 8
epididymis, 9 glans
penis, 10 foreskin, 11 testis, 12 scrotum, 13 Cowper's gland, 14
ejaculatory duct, 15
bladder, 16 mons pubis, 17 pubic symphysis, 18 urethra, 19 clitoris, 20
labia minora,
21 labia majora, 22 vagina, 23 cervix, 24 uterus, 25 ovary, 26 fimbria,
27 fallopian tube
Rugae: rü-g : an anatomical fold or wrinkle especially of the
viscera -- usually used in
plural <the rugae of an empty stomach>
Seminal Vesicle: either of a pair of glandular pouches that lie one on
either side of the
male reproductive tract and that in human males secrete a sugar- and
proteincontaining
fluid into the ejaculatory duct
Skeletal Muscle Tissue: attached to bones by tendons, is associated
with the body's
voluntary movements. Skeletal muscle is striated muscle. Unlike cardiac
muscle, the
cells are not branched.
Smooth Muscle Tissue: muscle tissue that lacks cross striations, that
is made up of
elongated spindle-shaped cells having a central nucleus, and that is
found in
vertebrate visceral structures (as the stomach and bladder) as thin
sheets performing
functions not subject to conscious control by the mind and in all or
most of the
musculature of invertebrates other than arthropods
Spongy Bone Tissue: Bone in which the spicules form a latticework, with
interstices
filled with embryonic connective tissue or bone marrow.
Synapse: the place at which a nervous impulse passes from one neuron to
another
Synergist Muscle: an organ (as a muscle) that acts in concert with
another to enhance
its effect
73
Tendon: a tough cord or band of dense white fibrous connective tissue
that unites a
muscle with some other part, transmits the force which the muscle
exerts, and is
continuous with the connective-tissue epimysium and perimysium of the
muscle and
when inserted into a bone with the periosteum of the bone
Testes: typically paired male reproductive gland that usually consists
largely of
seminiferous tubules from the epithelium of which spermatozoa develop,
that
corresponds to the ovary of the female and in craniate vertebrates
develops from the
genital ridges of the embryo, and that in most mammals descends into
the scrotum
before the attainment of sexual maturity and in many cases before birth
Trabeculae: tr - bek-y -l : one of a pair of longitudinally directed
more or less curved
cartilaginous rods in the developing skull of a vertebrate that develop
under the
anterior part of the brain on each side of the pituitary gland and
subsequently fuse
with each other and with the parachordal cartilages to form the base of
the
cartilaginous cranium
Trachea: tra·chea: the main trunk of the system of tubes by
which air passes to and
from the lungs that is about four inches (10 centimeters) long and
somewhat less than
an inch (2.5 centimeters) in diameter, extends down the front of the
neck from the
larynx, divides in two to form the bronchi, has walls of fibrous and
muscular tissue
stiffened by incomplete cartilaginous rings which keep it from
collapsing, and is lined
with mucous membrane whose epithelium is composed of columnar ciliated
mucussecreting
cells
Turbinates: any of three thin bony plates on the lateral wall of the
nasal fossa on each
side with or without their covering of mucous membrane: a separate
curved bony plate
that is the largest of the three and separates the inferior and middle
meatuses of the
nose -- called also inferior concha, inferior nasal concha, inferior
turbinate, inferior
turbinate bone, maxilloturbinal
Urethra: the canal that in most mammals carries off the urine from the
bladder and in
the male serves also as a genital duct
Uterine Tube: (fallopian tube) either of the pair of tubes that carry
the eggs from the
ovary to the uterus
Uterus: an organ in female mammals for containing and usually for
nourishing the
young during development previous to birth that consists of a greatly
modified and
enlarged section of an oviduct or of the two oviducts united, that has
thick walls
consisting of an external serous coat, a very thick muscular coat of
smooth muscle,
and a mucous coat containing numerous glands, and that during pregnancy
undergoes great increase in size and change in the condition of its
walls -- called also
womb
74
Vas Deferens: a sperm-carrying duct especially of a higher vertebrate
that in humans is
a small but thick-walled tube about two feet (0.6 meter) long formed by
the union of
the vasa efferentia, is greatly convoluted in its proximal portion,
begins at and is
continuous with the tail of the epididymis, runs in the spermatic cord
through the
inguinal canal, and descends into the pelvis where it joins the duct of
the seminal
vesicle to form the ejaculatory duct
Vein: any of the tubular branching vessels that carry blood from the
capillaries toward
the heart and have thinner walls than the arteries and often valves at
intervals to
prevent reflux of the blood which flows in a steady stream and is in
most cases darkcolored
due to the presence of reduced hemoglobin
Ventricle: cavity of a bodily part or organ: as a : a chamber of the
heart which receives
blood from a corresponding atrium and from which blood is forced into
the arteries b :
one of the system of communicating cavities in the brain that are
continuous with the
central canal of the spinal cord, that like it are derived from the
medullary canal of the
embryo, that are lined with an epithelial ependyma, and that contain a
serous fluid c : a
fossa or pouch on each side of the larynx between the false vocal cords
above and the
true vocal cords below
White Matter: neural tissue that consists largely of myelinated nerve
fibers, has a
whitish color, and underlies the gray matter of the brain and spinal
cord or is gathered
into nerves
<http://www.teachkidspeace.org/section.php?id=3>
Africa
Mozambique:
The Children of War by Wray Herbert ¨C U.S. News &
World Report
December 20, 2004 Alfredo Betuel Macamo and Joaquim
Fernando Quive
live only a couple of hundred yards from each other, and they share a
lot of
history and culture. These two 23-year-old men grew up in the same
primitive village near Malehice in the rural Mozambican province of
Gaza, and both
still live there today. It's a poor place, and neither Macamo nor Quive
is doing that great financially. Macamo is struggling to raise three
kids
¨D 6, 3, and a 4-month-old ¨D by harvesting reeds on a
riverbank. Quive does
odd jobs when he can find them, though these days he doesn't work much
at
all.
They both live in small reed huts with dirt floors and no running water.
Despite all they have in common, Macamo and Quive are worlds apart
psychologically and socially. When I visited Macamo recently, I was
greeted not only by him but by 12 members of his extended family, all
decked out
in traditional African garb. We sat around in plastic chairs, the kind
you
buy at Kmart, or on mats under the mafureira tree that is the center of
their yard, and talked about Macamo's life, past and present. It was
celebratory.
Quive's home is a lonelier place. It has two huts, but the larger of the
two ¨D his father's ¨D sits empty. His father has been expelled
from the
village for stealing a radio. Quive occupies the smaller hut in a grim,
empty
yard.
He doesn't have any chairs, but he borrows a couple of the Kmart chairs
from a neighbor and lays out a reed mat for a visitor. Quive has also
dressed
up, in a silky white shirt. But there's no family here, just Quive.
I'm talking to Macamo and Quive, and other young men in a few villages
nearby, because of something they all have in common. During the 16-year
civil war that devastated this sprawling coastal nation in southeastern
Africa, Macamo, Quive, and their neighbors were all *child soldiers*,
abducted from their villages as kids and taken to distant camps run by
the rebel forces trying to topple the government at the time. All,
eventually, escaped and through circuitous routes ended up in the
Lhanguene
orphanage in Maputo, the capital city to the south. All the boys were
eventually
reunited with their families in their natal villages, and that's where
most live
today. And there the commonalities end.
U.S. News first reported on these *child soldiers* in 1989, when the war
was still raging. The purpose of my trip to this beautiful but primitive
region of Africa was to revisit the *child soldiers* 15 years later, to
see how
they are doing now that the civil war is over and they have resumed
something like a normal life. Most, like Macamo and Quive, are men now.
Some, like Macamo, are raising kids of their own. All suffer to some
degree from their abductions and their experience of war as children.
Some are
doing better than others.
*Soldiers and Spies*
Mozambique has not known much other than war since the mid-1960s; until
the 1990s, many Mozambicans grew up not knowing what peace looked like.
First, there was the 10-year revolutionary war to oust the Portuguese,
who had
colonized the country in the 1500s and ruled it for more than four
centuries. The Portuguese were finally challenged by the Mozambique
Liberation Front, or Frelimo, the Marxist insurgency that ousted the
colonizers in 1975. But as soon as Frelimo prevailed and the Portuguese
fled, the new Frelimo government faced an insurgency of its own,
financed mostly by what was then the neighboring nation of Rhodesia and
later by
South Africa. The guerrillas, known as the Mozambique National
Resistance, or *Renamo*, were based mostly in the rural north. They had
no
particular ideology, other than their desire to oust Frelimo.
That's where the *child soldiers* came in. The *Renamo* leaders began
recruiting from rural villages, and if they couldn't recruit
able-bodied young boys, they simply kidnapped them. Most of the
recruits were 12, 13, 14
years old, but some were as young as 6. The youngest boys often served
as porters and servants to *Renamo* officers, or as spies, but most were
systematically trained to be soldiers. They were exposed to the noise of
rifle blasts, to desensitize them. They were ordered to kill cattle;
then, when they got used to that, to kill other humans, often those who
ignored orders or tried to escape. The perimeters of the rebels' camps
were
often littered with the skulls of those who had tried to escape but
failed.
It is remarkable, given all of the terrorist indoctrination, that
*Renamo*converted so few of the kids it captured. Perhaps because
* Renamo* stood for nothing, perhaps because its soldiers were so
brutal, it appears that most of the *child soldiers* in its ragtag
ranks never
stopped thinking of themselves as captives or victims. Some certainly
"went
*Renamo*" out of self-preservation, and some even liked their newfound
power as
warriors, but most kept their minds focused on finding a chance to
escape.
Inevitably, given *Renamo's* obvious lack of soldierly
deportment and
order, the opportunities eventually presented themselves. Rafael Vicente
Saveca's chance came when his camp was switching locations. Rafael was
sent by *
Renamo* officers to fetch water. He seized the chance to flee, hiding in
huts in friendly villages before finally returning to his village, near
Chibuto. To avoid recapture, or worse, Rafael disappeared, wandering for
months, until Frelimo soldiers finally detained him in a prisoner-of-war
camp.
A lot of Mozambican boys like Rafael had similar experiences. The
*Renamo*camps were heavily policed, but the boys managed to escape
during battles or
while on missions to gather wood or hunt for food. Then, often, they
would vanish into the bush, moving from village to village at night,
resting
and hiding during the day. The stretch of bush between Maputo and Gaza
is
pretty desolate even today. Back in the late 1980s it was salted with
land
mines, almost constantly policed by government and guerrilla troops.
Like Rafael, many of *Renamo's* *child soldiers* ended up in Frelimo
jails before they were transferred to the Lhanguene orphanage in Maputo.
Orphanage, actually, is something of a misnomer. The kids at Lhanguene
came from such tightly knit, extended families that their language
hardly
distinguished between father and uncle, sibling or cousin. With such
large families, and such tight bonds among members, the true orphan at
Lhanguene was rare. But calling Lhanguene an orphanage had
public-relations value
for the Frelimo government, because it was a visible reminder of
*Renamo's*brutality toward Mozambique's children. Whatever its
significance to the larger world, Lhanguene was a safe haven for the
kids lucky enough to
find their way there ¨D and the first step on their uncertain
journey of healing.
*Power of Soccer*
There were thousands of boys abducted by *Renamo* and forced to train as
soldiers. Some were with the rebel forces just months, others for as
long as three years. The person who has treated and studied these kids
most
intensely is psychologist Neil Boothby. Now a professor of public health
at Columbia University, Boothby at the time worked for Save the
Children,
the international aid organization that works to assist kids around the
globe whose lives have been disrupted by war, including the deslocados
who
ended up at the Lhanguene orphanage.
The interventions at Lhanguene were deceptively simple. Indeed, when I
asked the men about their time at Lhanguene, without exception the
first thing
they mentioned was playing soccer. At first I just noted this and
dismissed it as a childish memory, but when it came up again and again
I began to
realize that soccer wasn't trivial to these *child soldiers*'
psychological
recovery. What they wanted more than anything ¨D and Boothby's later
research
with many other * child soldiers* documented this ¨D was to once
again
to be "like everyone else." Playing soccer did a lot of things ¨D it
re-established rules and sense of fair play ¨D but perhaps most
important, it made them
feel "normal" in their own minds. In psychological jargon, they were
moving
from a survival mentality, which they had adopted of necessity, to a
security
mentality normal for their age. In other words, they were learning to
become kids again.
Other interventions more directly involved resolving the wartime traumas
of these children. They were encouraged, for example, to draw pictures,
and
when they did their drawings included typical childhood things like
houses and family ¨D but they also included, often tucked off in a
corner, an
automatic weapon, a slain body. Such drawings provided an opening for
discussion about the horrific experiences they were reluctant to bring
up themselves. So did the use of psychodramas, which were explicit
opportunities for the kids to act out, and denounce, the hateful acts of
* Renamo*, and in addition to celebrate the virtues of nation,
community,
and family.
I asked Boothby at one point if there was a clear greatest success story
among the kids with whom he worked to heal and reconnect with their
homes and families. He explained that there are three dimensions that
define
success and failure for these young men: financial success, marital
stability, and the classical measures of mental health, like clear
thinking
and emotional steadiness.
If you're talking about traditional western ideals of career and
financial
success, almost none of these former *child soldiers* could be called
successful. One, Angelo Jose Macouvele, went on to become a professional
photographer, working both in Mozambique and in the much more affluent
South Africa. But he is the exception. Most are subsistence farmers,
raising
maize and beans to feed their own families, then looking for real
currency
income where they can find it.
Take the case of Israel Armando Massingue, who was abducted by *Renamo*
in 1987, when he was 14 years old; he's in his early 30s today. He
dresses
in western clothes, including an "America on the Rise" T-shirt. He is
handsome and fit, like a college running back, with an engaging smile.
He is the
president of the local equivalent of the PTA. His wife, Saugina Salvador
Sitoe, attests that he is a good husband: He doesn't drink and he isn't
rough with me, she says.
Yet Massingue cannot find work. He raises his food crops right now, but
he is more ambitious than that and feels he just needs a leg up to start
some sort of small business. He dreams of getting a small piece of
property where
he could build a furnace, and produce concrete blocks for construction,
or perhaps have a small chicken farm. But such dreams are a long shot.
Massingue is representative of how these young men were often
financially crippled by their abductions and forced servitude in the
*Renamo*
forces.
Typically, teenagers from rural Mozambique will venture away from home
for a few years, often to South Africa to work in the mines, and earn
enough money
to return home with a financial stake. They use their savings to attract
a bride, they marry, and raise families. These young men never got to
South Africa and lost those prime earning years.
They also lost their chances for a decent education. Basic education is
not an entitlement in Mozambique; the cost of textbooks alone makes
schooling prohibitively expensive for many, especially those in rural
areas. Yet
most of the boys from Lhanguene, who were all offered stipends to resume
their education once they were back home, turned them down. They wanted
to
make up for lost time, to get on with the lives that had been
interrupted. So
Macamo, who had gotten only to fourth grade, never resumed his
schooling. Massingue did try to go back to school, but then he was
drafted into the
Frelimo Army and lost even more time. Now in his 30s, he sees education
as a luxury he can't afford to indulge.
Yet despite their poor financial fortunes, many are married and raising
families. By that measure, Boothby notes, most would be considered
successes, though raising families in such abject poverty is tough.
Massingue and Sitoe's infant daughter had died just days before I
visited, the second of their two children to die. The cause of death
isn't known.
Macamo has also lost one child. Losing children is not uncommon in rural
Mozambique.
Despite such losses and the accompanying grief, Massingue and Macamo
would have to be considered successes in terms of social functioning.
Certainly compared with Firinice Nharala. Firinice was only 6 when he
was abducted
by *Renamo* and witnessed the brutal murder of family members who were
Frelimo supporters. When he ended up at Lhanguene, he was mute, and
although he
later regained his voice, he was by all reports never completely healthy
again. He was delusional much of the time, and in his early 20s he was
still living in the care of his mother. That is where I was supposed to
meet
him, but I never got the chance. Ten days before I arrived in
Mozambique, Nharala
drowned in a nearby lake while fishing.
Quive is another who never really recovered from his wartime experience.
He has never married, and his prospects aren't very good. The fact is
hedoesn't have much to offer. His teeth are rotten, and he has no
income.
Indeed, he represents the walking wounded of the children's civil war.
He
spent two years in a *Renamo* base camp, working as a colonel's
bodyguard.
In that role, he would have both witnessed and committed some brutal
acts.
He says he still has nightmares and flashbacks about his time with
*Renamo*, sometimes so disabling that they keep him from doing even the
simplest
work.
One day, while cutting wood with a machete, he had flashbacks so severe
that he nearly severed his arm, and he hasn't worked much since. If he
were
in America, he would most likely be diagnosed with post-traumatic stress
disorder, or PTSD, and treated with psychotherapeutic techniques and
perhaps psychiatric medications.
*Stress and Culture*
Diagnosis and healing in Mozambique are very different from western
practices, but there are interesting commonalities as well. I spent some
time talking to traditional healers, known locally as curandeiros:
Rosalina Mondlane and Teresa Xitlango live and work in the same
Malehice village
as Macamo and Quive. Beatriz Armando Massingue lives in Israel's
village;
she's his sister. These women are highly regarded in their communities.
They
have all apprenticed to other healers for three to five years, and
although the
specifics of their healing practices appear to vary a bit, they all
share some general beliefs about mental health and psychotherapy.
They wouldn't use those words, of course, though when pushed they do
come up with words for conditions that are roughly translatable to our
psychiatric diagnoses. For example, the Shangana word kuxukuvala is a
close
equivalent of what we would call clinical depression. Kuxukuvala is
characterized
by abnormal sadness and emotional paralysis. Similarly, Quive and others
are thought to suffer from npfuka, which corresponds pretty well to what
American psychiatrists would label PTSD. It has the symptoms of
nightmares and flashbacks to specific experiences of trauma and
violence.
But the Mozambican healers' theories about the causes of such stress
disorders are quite different. They believe, for example, that when a
soldier murders someone, the spirit of the dead takes up residence in
the killer ¨D even if the murder has been coerced, as with the
*child
soldiers*.
For the sake of mental stability, the spirit of the victim must be
driven out.
To that end, the healers might heat a concoction of local herbs and have
the returning soldiers breathe it in to accomplish spiritual cleansing.
Or
they might kill a chicken or a goat, mix the blood with water, then use
this
potion to "vaccinate" them through pinpricks in the arm. If the healers
sense the need for a stronger treatment, they might take the child down
to the riverside, because certain spirits are known to reside in the
water
or in the riverbanks and exposure to these spirits can be tonic. All of
this must be done before the emotionally traumatized child is allowed to
re-enter the household, to prevent contamination of the home. The
healers appear to
have an innate sense of what American mental health practitioners call
psychiatric prevention; they assume that such trauma and stress will
take a toll even if it hasn't already, so they intervene immediately to
ward
off illness by realigning the spirits.
It's impossible to know which specific elements of these healing
practices helped the returning *child soldiers*, but it's clear that
the cleansing
rituals were essential to the kids' transitions back to community and
family life. When the civil war came to an end, there was a widespread
fear
that the boys who had served under *Renamo* would be socially tainted
and
unwelcome back in their villages because of their "treason" and the
hideousness of their war crimes. Indeed, this idea was perpetuated by
the Frelimo government, which saw PR value in the idea that *Renamo* had
ruined these kids' lives. But the rejections never happened. Most of
the kids
were welcomed back with compassion, even joy, and the healers' belief in
recovery certainly helped the communities embrace their victimized
sons.
Back home. So why have some done so much better after the war than
others? Put another way, why aren't all of the former *child soldiers*
psychological wrecks given what they were put through? The answer is no
doubt complex, but
at least two factors appear important to the survivors' resilience. The
first is the amount of time the child spent with *Renamo*. Some, like
Macamo
and Rafael Saveca, escaped after just a couple of months, while others,
like
Quive, were in * Renamo* camps for two years or more. According to
Boothby's analysis, there is an emotional "threshold" somewhere between
months and
years. Once passed, it's much harder to repair the psychological
damage.
Then there is family. All of these kids got basically the same
psychological help at Lhanguene, and almost all went through some kind
of cleansing
ritual upon returning to their villages. But Macamo and Massingue came
home to
large, exuberant families. Quive, by contrast, came home to a
disintegrating household. His parents had split up while he was gone,
and when he sided
with his mother, his father disowned him. The village healers, Mondlane
and Xitlango, say Quive's mother is unstable; they use a Shangana word
that
roughly translates as "she sleeps around." Indeed, she and her latest
boyfriend left the village soon after Quive returned.
So Quive has not had much emotional support at home. But consider that
he is one of the lucky *child soldiers*. He at least ended up at
Lhanguene,
where he benefited from Save the Children's model therapy program. When
the
civil war ended in 1992, both Frelimo and *Renamo* denied ever enlisting
children in their war efforts, so about 25,000 kids were left to
reintegrate
themselves into their communities without any help whatsoever. Those
young men's life stories are not known.
