Saturday, 19 June 2010
Thursday, 10 June 2010
The Larynx
The larynx (plural larynges), colloquially known as the "voice box", is an organ in the neck of mammals involved in protecting of the trachea and sound production. It manipulates pitch and volume. The larynx houses the vocal folds, which are an essential component of phonation. The vocal folds are situated just below where the tract of the pharynx splits into the trachea and the esophagus.
The larynx is found in the anterior neck at the level of the C3-C6 vertebrea. It connects the inferior part of the pharynx (hypopharynx) with the trachea. The laryngeal skeleton consists of nine cartilages: three single (thyroid, cricoid, and epiglottic) and three paired (arytenoid, corniculate, and cuneiform). The hyoid bone is not part of the larynx, though it is connected to it. The larynx extends vertically from the tip of the epiglottis to the inferior border of the cricoid cartilage. The intristic and extrinsic muscles and paired and unpaired cartilages are listed and described below.
Sound is generated in the larynx, and that is where pitch and volume are manipulated. The strength of expiration from the lungs also contributes to loudness.
Fine manipulation of the larynx is used to generate a source sound with a particular fundamental frequency, or pitch. This source sound is altered as it travels through the vocal tract, configured differently based on the position of the tongue, lips, mouth, and pharynx. The process of altering a source sound as it passes through the filter of the vocal tract creates the many different vowel and consonant sounds of the world's languages as well as tone, certain realizations of stress and other types of linguistic prosody. The larynx also has a similar function as the lungs in creating pressure differences required for sound production; a constricted larynx can be raised or lowered affecting the volume of the oral cavity as necessary in glottalic consonants.
The vocal folds can be held close together (by adducting the arytenoid cartilages), so that they vibrate (see phonation). The muscles attached to the arytenoid cartilages control the degree of opening. Vocal fold length and tension can be controlled by rocking the thyroid cartilage forward and backward on the cricoid cartilage (either directly by contracting the cricothyroids or indirectly by changing the vertical position of the larynx), by manipulating the tension of the muscles within the vocal folds, and by moving the arytenoids forward or backward. This causes the pitch produced during phonation to rise or fall. In most males the vocal cords are longer and with a greater mass, producing a deeper pitch.
The vocal apparatus consists of two pairs of mucosal folds. These folds are false vocal cords (vestibular folds) and true vocal cords (folds). The false vocal cords are covered by respiratory epithelium, while the true vocal cords are covered by stratified squamous epithelium. The false vocal cords are not responsible for sound production, but rather for resonance. The exceptions to this are found in Tibetan Chant and Kargyraa, a style of Tuvan Throat Singing. Both make use of the false vocal cords to create an undertone. These false vocal cords do not contain muscle, while the true vocal cords do have skeletal muscle.
During swallowing, the backward motion of the tongue forces the epiglottis over the glottis' opening to prevent swallowed material from entering the larynx which leads to the lungs; the larynx is also pulled upwards to assist this process. Stimulation of the larynx by ingested matter produces a strong cough reflex to protect the lungs.
The larynx is innervated by branches of the vagus nerve on each side. Sensory innervation to the glottis and laryngeal vestibule is by the internal branch of the superior laryngeal nerve. The external branch of the superior laryngeal nerve innervates the cricothyroid muscle. Motor innervation to all other muscles of the larynx and sensory innervation to the subglottis is by the recurrent laryngeal nerve. While the sensory input described above is (general) visceral sensation (diffuse, poorly localized), the vocal fold also receives general somatic sensory innervation (proprioceptive and touch) by the superior laryngeal nerve.
Injury to the external laryngeal nerve causes weakened phonation because the vocal cords cannot be tightened. Injury to one of the recurrent laryngeal nerves produces hoarseness, if both are damaged the voice may or may not be preserved, but breathing becomes difficult.
Intrinsic muscles associated with the larynx
Cricothyroid muscles lengthen and stretch the vocal folds.
Posterior cricoarytenoid muscles abduct and externally rotate the arytenoid cartilages, resulting in abducted vocal cords.
Lateral cricoarytenoid muscles adduct and internally rotate the arytenoid cartilages, which can result in adducted vocal folds.
Transverse arytenoid muscle adducts the arytenoid cartilages, resulting in adducted vocal cords.
Oblique arytenoid muscles narrow the laryngeal inlet by constricting the distance between the arytenoid cartilages and epiglottis.
Vocalis muscles adjust tension in vocal folds.
Thyroarytenoid muscles - sphincter of vestibule, narrowing the laryngeal inlet.
Notably, the only muscle capable of separating the vocal chords for normal breathing is the posterior cricoarytenoid. If this muscle is incapacitated on both sides, the inability to pull the vocal cords apart (abduct) will cause difficulty breathing. Bilateral injury to the recurrent laryngeal nerve would cause this condition. It is also worth noting that all muscles are innervated by the recurrent laryngeal branch of the vagus except the cricothyroid muscle, which is innervated by the external laryngeal branch of the vagus.
Extrinsic muscles associated with the larynx
Thyrohyoid muscles
Sternothyroid muscles
Inferior constrictor muscles
Digastric
Stylohyoid
Mylohyoid
Geniohyoid
Hyoglossus
In most animals, including infant humans and apes, the larynx is situated very high in the throat—a position that allows it to couple more easily with the nasal passages, so that breathing and eating are not done with the same apparatus. However, some aquatic mammals, large deer, and adult humans have descended larynges. An adult human, unlike apes, cannot raise the larynx enough to directly couple it to the nasal passage. Despite its presence in non-aquatic deer, proponents of the aquatic ape hypothesis claim that the similarity between the descended larynx in humans and aquatic mammals supports their theory.
Some linguists have suggested that the descended larynx, by extending the length of the vocal tract and thereby increasing the variety of sounds humans could produce, was a critical element in the development of speech and language. Others cite the presence of descended larynges in non-linguistic animals, as well as the ubiquity of nonverbal communication and language among humans, as counterevidence against this claim.
In most animals, including infant humans and apes, the larynx is situated very high in the throat—a position that allows it to couple more easily with the nasal passages, so that breathing and eating are not done with the same apparatus. However, some aquatic mammals, large deer, and adult humans have descended larynges. An adult human, unlike apes, cannot raise the larynx enough to directly couple it to the nasal passage. Despite its presence in non-aquatic deer, proponents of the aquatic ape hypothesis claim that the similarity between the descended larynx in humans and aquatic mammals supports their theory.
Some linguists have suggested that the descended larynx, by extending the length of the vocal tract and thereby increasing the variety of sounds humans could produce, was a critical element in the development of speech and language. Others cite the presence of descended larynges in non-linguistic animals, as well as the ubiquity of nonverbal communication and language among humans, as counterevidence against this claim.
There are several things that can cause a larynx to not function properly. Some symptoms are hoarseness, loss of voice, pain in the throat or ears, and breathing difficulties. The world's first successful larynx transplant took place in 1999 at the Cleveland Clinic.
Acute laryngitis is the sudden
Two , immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction.
Most tetrapod species possess a larynx, but its structure is typically simpler than that found in mammals. The cartilages surrounding the larynx are apparently a remnant of the original gill arches in fish, and are a common feature, but not all are always present. For example, the thyroid cartilage is found only in mammals. Similarly, only mammals possess a true epiglottis, although a flap of non-cartilagenous mucosa is found in a similar position in many other groups. In modern amphibians, the laryngeal skeleton is considerably reduced; frogs have only the cricoid and arytenoid cartilages, while salamanders possess only the arytenoids.
Vocal cords are found only in mammals, and a few lizards. As a result, many reptiles and amphibians are essentially voiceless; frogs use ridges in the trachea to modulate sound, while birds have a separate sound-producing organ, the syrinx.
Wednesday, 24 March 2010
esophagus
The esophagus or oesophagus (see spelling differences), sometimes known as the gullet, is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. The word esophagus is derived from the Latin œsophagus, which derives from the Greek word oisophagos , lit. "entrance for eating." In humans the esophagus is continuous with the laryngeal part of the pharynx at the level of the C6 vertebra. The esophagus passes through a hole in the diaphragm at the level of the tenth thoracic vertebrae (T10). It is usually about 25–30 cm long and connects the mouth to the stomach. It is divided into abdominal parts.
The layers of the esophagus are as follows:
mucosa (mucus)
nonkeratinized stratified squamous epithelium: is rapidly turned over, and serves a protective effect due to the high volume transit of food, saliva and mucus.
lamina propria: sparse.
muscularis mucosae: smooth muscle
submucosa: Contains the mucous secreting glands (esophageal glands), and connective structures termed papillae.
muscularis externa (or "muscularis propria"): composition varies in different parts of the esophagus, to correspond with the conscious control over swallowing in the upper portions and the autonomic control in the lower portions:
upper third, or superior part: striated muscle
middle third, smooth muscle and striated muscle
inferior third: predominantly smooth muscle
adventitia
The junction between the esophagus and the stomach (the gastroesophageal junction or GE junction) is not actually considered a valve, although it is sometimes called the cardiac sphincter, cardia or cardias, although it is actually better resembles a stricture.
In most fish, the esophagus is extremely short, primarily due to the length of the pharynx (which is associated with the gills). However, some fish, including lampreys, chimaeras, and lungfish, have no true stomach, so that the oesophagus effectively runs from the pharynx directly to the intestine, and is therefore somewhat longer.
In tetrapods, the pharynx is much shorter, and the esophagus correspondingly longer, than in fish. In amphibians, sharks and rays, the esophageal epithelium is ciliated, helping to wash food along, in addition to the action of muscular peristalsis. In the majority of vertebrates, the esophagus is simply a connecting tube, but in birds, it is extended towards the lower end to form a crop for storing food before it enters the true stomach.
A structure with the same name is often found in invertebrates, including molluscs and arthropods, connecting the oral cavity with the stomach
In most fish, the esophagus is extremely short, primarily due to the length of the pharynx (which is associated with the gills). However, some fish, including lampreys, chimaeras, and lungfish, have no true stomach, so that the oesophagus effectively runs from the pharynx directly to the intestine, and is therefore somewhat longer.crimeajewel.
In tetrapods, the pharynx is much shorter, and the esophagus correspondingly longer, than in fish. In amphibians, sharks and rays, the esophageal epithelium is ciliated, helping to wash food along, in addition to the action of muscular peristalsis. In the majority of vertebrates, the esophagus is simply a connecting tube, but in birds, it is extended towards the lower end to form a crop for storing food before it enters the true stomach.
A structure with the same name is often found in invertebrates, including molluscs and arthropods, connecting the oral cavity with the stomach
Globus pharyngis (also known as globus sensation, globus or, somewhat outdatedly, globus hystericus; commonly referred to as having a "lump in one's throat") is the persistent sensation of having phlegm or some other sort of obstruction in the throat when there is none. Swallowing can be performed normally, so it is not a true case of dysphagia, but it can become quite irritating. One may also feel mild chest pain or even severe pain with a clicking sensation when swallowing.
The "lump in the throat" sensation that characterizes globus pharyngis is often caused by inflammation of one or more parts of the throat, such as the larynx or hypopharynx, due to Cricopharyngeal Spasm, gastroesophageal reflux or oesophageal dysmotility.
In some cases the cause is unknown and symptoms may be attributed to a psychogenic cause i.e. a somatoform or anxiety disorder. It has been recognised as a symptom of depression, which responds to anti-depressive treatment.
A less common cause, distinguished by a "lump in the throat" accompanied with clicking sensation and considerable pain when swallowing, maybe due to thyroid-cartilage rubbing against anomalous asymmetrical laryngeal anatomy e.g. the superior cornu abrading against the thyroid lamina,surgically trimming the offending thyroid-cartilage provides immediate relief in all cases. However this cause is frequently misdiagnosed, despite requiring a simple clinical examination involving careful palpation of the neck side to side which elicits the same click sensation (laryngeal crepitus) and pain as when swallowing, most cases are due to prior trauma to the neck. High resolution computed tomographic (CT) or MRI scan of the larynx is usually required to fully understand the anomalous laryngeal anatomy. Anterior displacement the thyroid ala on the affected side while swallowing can help resolve symptoms.
Wednesday, 9 December 2009
The Liver
The liver is a vital organ present in vertebrates and some other animals; it has a wide range of functions, a few of which are detoxification, protein synthesis, and production of biochemicals necessary for digestion. The liver is necessary for survival; there is currently no way to compensate for the absence of liver function.
The liver plays a major role in metabolism and has a number of functions in the body, including glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification. The liver is also the largest gland in the human body. It lies below the diaphragm in the thoracic region of the abdomen. It produces bile, an alkaline compound which aids in digestion, via the emulsification of lipids. It also performs and regulates a wide variety of high-volume biochemical reactions requiring highly specialized tissues, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions.
Medical terms related to the liver often start in hepato- or hepatic from the Greek word for liver, hēpar (ήπαρ)
An adult human liver normally weighs between 1.4-1.6 kg (3.1-3.5 lb), and is a soft, pinkish-brown, triangular organ. Averaging about the size of an American football in adults, it is both the largest internal organ and the largest gland in the human body (not considering the skin).
It is located in the right upper quadrant of the abdominal cavity, resting just below the diaphragm. The liver lies to the right of the stomach and overlies the gallbladder.
The liver receives a dual blood supply consisting of the hepatic portal vein and hepatic arteries. Supplying approximately 75% of the liver's blood supply, the hepatic portal vein carries venous blood drained from the spleen,gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remainder of its blood flow. Oxygen is provided from both sources; approximately half of the liver's oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries. Blood flows through the sinusoids and empties into the central vein of each lobule. The central veins coalesce into hepatic veins, which leave the liver and empty into the inferior vena cava. it occupies most of the right+ hypochondriac region,epigastric region and left hypochondriac region
The bile produced in the liver is collected in bile canaliculi, which merge to form bile ducts. Within the liver, these ducts are called intrahepatic bile ducts, and once they exit the liver they are considered extrahepatic. The extrahepatic ducts eventually drain into the right and left hepatic ducts, which in turn merge to form the common hepatic duct. The cystic duct from the gallbladder joins with the common hepatic duct to form the common bile duct. The term biliary tree is derived from the arboreal branches of the bile ducts. The intrahepatic bile ducts form the most distant branches of this tree.
Bile can either drain directly into the duodenum via the common bile duct or be temporarily stored in the gallbladder via the cystic duct. The common bile duct and the pancreatic duct enter the duodenum together at the ampulla of Vater.
Apart from a patch where it connects to the diaphragm (the so-called "bare area"), the liver is covered entirely by visceral peritoneum, a thin, double-layered membrane that reduces friction against other organs. The peritoneum folds back on itself to form the falciform ligament and the right and left triangular ligaments.
These "ligaments" are in no way related to the true anatomic ligaments in joints, and have essentially no functional importance, but they are easily recognizable surface landmarks.
Traditional gross anatomy divided the liver into four lobes based on surface features. The falciform ligament is visible on the front (anterior side) of the liver. This divides the liver into a left anatomical lobe, and a right anatomical lobe.
If the liver flipped over, to look at it from behind (the visceral surface), there are two additional lobes between the right and left. These are the caudate lobe (the more superior), and below this the quadrate lobe.
From behind, the lobes are divided up by the ligamentum venosum and ligamentum teres (anything left of these is the left lobe), the tarnsverse fissure (or porta hepatis) divides the caudate from the quadrate lobe, and the right sagittal fossa, which the inferior vena cava runs over, separates these two lobes from the right lobe.
Each of the lobes is made up of lobules; a vein goes from the centre of each lobule which then joins to the hepatic vein to carry blood out from the liver.
On the surface of the lobules there are ducts, veins and arteries that carry fluids to and from them.
The central area where the common bile duct,hepatic portal vein, and hepatic artery proper enter is the hilum or "porta hepatis". The duct, vein, and artery divide into left and right branches, and the portions of the liver supplied by these branches constitute the functional left and right lobes.
The functional lobes are separated by an imaginary plane joining the gallbladder fossa to the inferior vena cava. The plane separates the liver into the true right and left lobes. The middle hepatic vein also demarcates the true right and left lobes. The right lobe is further divided into an anterior and posterior segment by the right hepatic vein. The left lobe is divided into the medial and lateral segments by the left hepatic vein. The fissure for the ligamentum teres also separates the medial and lateral segments. The medial segment is also called the quadrate lobe. In the widely used Couinaud(or "French") system, the functional lobes are further divided into a total of eight subsegments based on a transverse plane through the bifurcation of the main portal vein. The caudate lobe is a separate structure which receives blood flow from both the right- and left-sided vascular branches.
The various functions of the liver are carried out by the liver cells or hepatocytes. Currently, there is no artificial organ or device capable of emulating all the functions of the liver. Some functions can be emulated by liver dialysis, an experimental treatment for liver failure.
The liver stores a multitude of substances, including glucose (in the form of glycogen), vitamin A (1–2 years' supply), vitamin D (1–4 months' supply), vitamin B12,iron and copper.
The liver is responsible for immunological effects- the reticuloendothelial system of the liver contains many immunologically active cells, acting as a 'sieve' for antigens carried to it via the portal system.
The liver produces albumin, the major osmolar component of blood serum.
The liver synthesizes angiotensinogen, a hormone that is responsible for raising the blood pressure when activated by renin, a kidney enzyme that is released when the juxtaglomerular apparatus senses low blood pressure.
The breakdown of insulin and other hormones.
The liver breaks down hemoglobin, creating metabolites that are added to bile as pigment (bilirubin and bilverdin).
The liver breaks down toxic substances and most medicinal products in a process called drug metabolism. This sometimes results in toxication, when the metabolite is more toxic than its precursor. Preferably, the toxins are conjugated to avail excretion in bile or urine.
The liver converts ammonia to urea.
Many diseases of the liver are accompanied by jaundice caused by increased levels of bilirubin in the system. The bilirubin results from the breakup of the hemoglobin of dead red blood cells; normally, the liver removes bilirubin from the blood and excretes it through bile.
There are also many pediatric liver diseases, including biliary atresia, alpha-1 antitrypsin deficiency, alagille syndrome, progressive familial intrahepatic cholestasis, and Langerhans cell histiocytosis to name but a few.
Liver diseases may be diagnosed by liver function tests, for example, by production of acute phase proteins..
The liver is the only internal human organ capable of natural regeneration of lost tissue; as little as 25% of a liver can regenerate into a whole liver. A human liver is known to grow back in no less than 8 years, due to hyptochronatin cells in the remaining liver.
This is predominantly due to the hepatocytes re-entering the cell cycle. That is, the hepatocytes go from the quiescent G0 phase to the G1 phase and undergo mitosis. This process is activated by the p75 receptors. There is also some evidence of bipotential stem cells, called ovaloctes or hepatic oval cells, which are thought to reside in the canals of Hering. These cells can differentiate into either hepatocytes or cholangiocytes, the latter being the cells that line the bile ducts.
The liver plays a major role in metabolism and has a number of functions in the body, including glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification. The liver is also the largest gland in the human body. It lies below the diaphragm in the thoracic region of the abdomen. It produces bile, an alkaline compound which aids in digestion, via the emulsification of lipids. It also performs and regulates a wide variety of high-volume biochemical reactions requiring highly specialized tissues, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions.
Medical terms related to the liver often start in hepato- or hepatic from the Greek word for liver, hēpar (ήπαρ)
An adult human liver normally weighs between 1.4-1.6 kg (3.1-3.5 lb), and is a soft, pinkish-brown, triangular organ. Averaging about the size of an American football in adults, it is both the largest internal organ and the largest gland in the human body (not considering the skin).
It is located in the right upper quadrant of the abdominal cavity, resting just below the diaphragm. The liver lies to the right of the stomach and overlies the gallbladder.
The liver receives a dual blood supply consisting of the hepatic portal vein and hepatic arteries. Supplying approximately 75% of the liver's blood supply, the hepatic portal vein carries venous blood drained from the spleen,gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remainder of its blood flow. Oxygen is provided from both sources; approximately half of the liver's oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries. Blood flows through the sinusoids and empties into the central vein of each lobule. The central veins coalesce into hepatic veins, which leave the liver and empty into the inferior vena cava. it occupies most of the right+ hypochondriac region,epigastric region and left hypochondriac region
The bile produced in the liver is collected in bile canaliculi, which merge to form bile ducts. Within the liver, these ducts are called intrahepatic bile ducts, and once they exit the liver they are considered extrahepatic. The extrahepatic ducts eventually drain into the right and left hepatic ducts, which in turn merge to form the common hepatic duct. The cystic duct from the gallbladder joins with the common hepatic duct to form the common bile duct. The term biliary tree is derived from the arboreal branches of the bile ducts. The intrahepatic bile ducts form the most distant branches of this tree.
Bile can either drain directly into the duodenum via the common bile duct or be temporarily stored in the gallbladder via the cystic duct. The common bile duct and the pancreatic duct enter the duodenum together at the ampulla of Vater.
Apart from a patch where it connects to the diaphragm (the so-called "bare area"), the liver is covered entirely by visceral peritoneum, a thin, double-layered membrane that reduces friction against other organs. The peritoneum folds back on itself to form the falciform ligament and the right and left triangular ligaments.
These "ligaments" are in no way related to the true anatomic ligaments in joints, and have essentially no functional importance, but they are easily recognizable surface landmarks.
Traditional gross anatomy divided the liver into four lobes based on surface features. The falciform ligament is visible on the front (anterior side) of the liver. This divides the liver into a left anatomical lobe, and a right anatomical lobe.
If the liver flipped over, to look at it from behind (the visceral surface), there are two additional lobes between the right and left. These are the caudate lobe (the more superior), and below this the quadrate lobe.
From behind, the lobes are divided up by the ligamentum venosum and ligamentum teres (anything left of these is the left lobe), the tarnsverse fissure (or porta hepatis) divides the caudate from the quadrate lobe, and the right sagittal fossa, which the inferior vena cava runs over, separates these two lobes from the right lobe.
Each of the lobes is made up of lobules; a vein goes from the centre of each lobule which then joins to the hepatic vein to carry blood out from the liver.
On the surface of the lobules there are ducts, veins and arteries that carry fluids to and from them.
The central area where the common bile duct,hepatic portal vein, and hepatic artery proper enter is the hilum or "porta hepatis". The duct, vein, and artery divide into left and right branches, and the portions of the liver supplied by these branches constitute the functional left and right lobes.
The functional lobes are separated by an imaginary plane joining the gallbladder fossa to the inferior vena cava. The plane separates the liver into the true right and left lobes. The middle hepatic vein also demarcates the true right and left lobes. The right lobe is further divided into an anterior and posterior segment by the right hepatic vein. The left lobe is divided into the medial and lateral segments by the left hepatic vein. The fissure for the ligamentum teres also separates the medial and lateral segments. The medial segment is also called the quadrate lobe. In the widely used Couinaud(or "French") system, the functional lobes are further divided into a total of eight subsegments based on a transverse plane through the bifurcation of the main portal vein. The caudate lobe is a separate structure which receives blood flow from both the right- and left-sided vascular branches.
The various functions of the liver are carried out by the liver cells or hepatocytes. Currently, there is no artificial organ or device capable of emulating all the functions of the liver. Some functions can be emulated by liver dialysis, an experimental treatment for liver failure.
The liver stores a multitude of substances, including glucose (in the form of glycogen), vitamin A (1–2 years' supply), vitamin D (1–4 months' supply), vitamin B12,iron and copper.
The liver is responsible for immunological effects- the reticuloendothelial system of the liver contains many immunologically active cells, acting as a 'sieve' for antigens carried to it via the portal system.
The liver produces albumin, the major osmolar component of blood serum.
The liver synthesizes angiotensinogen, a hormone that is responsible for raising the blood pressure when activated by renin, a kidney enzyme that is released when the juxtaglomerular apparatus senses low blood pressure.
The breakdown of insulin and other hormones.
The liver breaks down hemoglobin, creating metabolites that are added to bile as pigment (bilirubin and bilverdin).
The liver breaks down toxic substances and most medicinal products in a process called drug metabolism. This sometimes results in toxication, when the metabolite is more toxic than its precursor. Preferably, the toxins are conjugated to avail excretion in bile or urine.
The liver converts ammonia to urea.
Many diseases of the liver are accompanied by jaundice caused by increased levels of bilirubin in the system. The bilirubin results from the breakup of the hemoglobin of dead red blood cells; normally, the liver removes bilirubin from the blood and excretes it through bile.
There are also many pediatric liver diseases, including biliary atresia, alpha-1 antitrypsin deficiency, alagille syndrome, progressive familial intrahepatic cholestasis, and Langerhans cell histiocytosis to name but a few.
Liver diseases may be diagnosed by liver function tests, for example, by production of acute phase proteins..
The liver is the only internal human organ capable of natural regeneration of lost tissue; as little as 25% of a liver can regenerate into a whole liver. A human liver is known to grow back in no less than 8 years, due to hyptochronatin cells in the remaining liver.
This is predominantly due to the hepatocytes re-entering the cell cycle. That is, the hepatocytes go from the quiescent G0 phase to the G1 phase and undergo mitosis. This process is activated by the p75 receptors. There is also some evidence of bipotential stem cells, called ovaloctes or hepatic oval cells, which are thought to reside in the canals of Hering. These cells can differentiate into either hepatocytes or cholangiocytes, the latter being the cells that line the bile ducts.
Saturday, 7 November 2009
Vertebrae
A vertebra (plural: vertebrae) is an individual bone in the flexible column that defines vertebrate animals, e.g. humans. The vertebral column encases and protects the spinal cord, which runs from the base of the cranium down the dorsal side of the animal until reaching the pelvis. From there, vertebra continue into the tail.
Vertebrae are defined by regions. Cervical vertebrae are those in the neck area, and can range from a single vertebra in amphibians, to seven in most mammals and reptiles, and as many as 25 in swans or 76 in the extinct plesiosaur Elasmosaurus. The dorsal vertebrae range from the bottom of the neck to the top of the pelvis. Dorsal vertebrae attached to ribs are called thoracic vertebrae, while those without ribs are called lumbar vertebrae. The sacral vertebrae are those in the pelvic region, and range from one in amphibians, to two in most birds and modern reptiles, or up to 3 to 5 in mammals. When more than one sacral vertebrae are fused into a single structure, it is called the sacrum. The synsacrum is a similar fused structure found in birds that is composed of the sacral, lumbar, and some of the thoracic and caudal vertebra, as well as the pelvic girdle. Caudal vertebra compose the tail, and the final few can be fused into the pygostyle in birds, or into the coccygeal or tail bone in chimpanzees or humans.
Individual vertebra are composed of a centrum (body), arches protruding from the top and bottom of the centrum, and various processes projecting from the centrum and/or arches. An arch extending from the top of the centrum is called a neural arch, while the hemal arch or chevron is found underneath the centrum in the caudal (tail) vertebrae of fish, most reptiles, some birds, and some mammals with long tails. The vertebral processes can either give the structure rigidity, help them articulate with ribs, or serve as muscle attachment points. Common types are tranverse process, diapophyses, parapophyses, and zygapophyses (both the cranial zygapophyses and the caudal zygapophyses).
Amphicelous refers to a centrum that is concave at both ends, similar to those found in most fish. Opisthocoelous centra are convex in the front and concave in the back, similar to those of most salamanders. In contrast, procelous centra are concave in the front and convex in the back, as found in most frogs and modern reptiles. Centra with flat ends are acelous, like those in mammals. Birds have heterocelous centra, shaped like saddles at both ends.
There are normally thirty-three (33) vertebrae in humans, including the five that are fused to form the sacrum (the others are separated by intervertebral discs)) and the four coccygeal bones which form the tailbone. The upper three regions comprise the remaining 24, and are grouped under the names cervical (7 vertebrae), thoracic (12 vertebrae) and lumbar (5 vertebrae), according to the regions they occupy. This number is sometimes increased by an additional vertebra in one region, or it may be diminished in one region, the deficiency often being supplied by an additional vertebra in another. The number of cervical vertebrae is, however, very rarely increased or diminished.
With the exception of the first and second cervical, the true or movable vertebrae (the upper three regions) present certain common characteristics which are best studied by examining one from the middle of the thoracic region.
A typical vertebra consists of two essential parts: an anterior (front) segment, which is the vertebral body; and a posterior part – the vertebral (neural) arch – which encloses the vertebral foramen. The vertebral arch is formed by a pair of pedicles and a pair of laminae, and supports seven processes, four articular, two transverse, and one spinous, the latter also being known as the neural spine.
When the vertebrae are articulated with each other, the bodies form a strong pillar for the support of the head and trunk, and the vertebral foramina constitute a canal for the protection of the medulla spinalis (spinal cord). In between every pair of vertebrae are two apertures, the intervertebral foramina, one on either side, for the transmission of the spinal nerves and vessels.
Two transverse process and one spinous process are posterior to (behind) the vertebral body. The spinous process comes out the back, one transverse process comes out the left, and one on the right. The spinous processes of the cervical and lumbar regions can be felt through the skin. Superior and inferior articular facets on each vertebra act to restrict the range of movement possible. These facets are joined by a thin portion of the neural arch called the pars interarticulars.
The centra of the vertebra can be classified based upon the fusion of its elements. In aspidospondyly, bones such as the neural spine, the pleurocentrum and the intercentrum are separate ossifications. Fused elements however, classify a vertebra as having holospondyly.
A vertebra can also be described in terms of the shape of the ends of the centra. Humans are said to be acoelous, or with flat ends. These flat ends of the centra are especially good at supporting and distributing compressive forces. Amphicoelus vertebra is represented by both ends of the centra being concave. This shape is common in fish, where most motion is limited. Amphicoelus centra often are integrated with a full notochord. Procoelus vertebra are anteriorly concave, and posteriorly convex. An opisthocoelus vertebra however, possess anterior convexity, and posterior concavity. Heterocoelous vertebrae are saddle shaped at each end of the centra. This type of configuration is seen in turtles that retract their necks, and birds, because it permits extensive lateral and vertical flexion motion without stretching the nerve cord too extensively or wringing it about its long axis.
These seven (7) bones are generally small and delicate. Their spinous processes are short (with the exception of C2 and C7, which have palpable spinous processes). Numbered top-to-bottom from C1-C7,atlas (C1) and axis (C2), are the vertebrae that allow the neck and head so much movement. For the most part, the atlanto-occipital joint allows the skull to move up and down, while the atlanto-axial joint allows the upper neck to twist left and right. The axis also sits upon the first intervertebral disk of the spinal column. All mammals except manatees and sloths have seven cervical vertebrae, whatever the length of the neck.
Cervical vertebrae possess transverse foramina to allow for the vertebral arteries to pass through on their way to the foramen magnum to end in the circle of Willis. These are the smallest, lightest vertebrae and the vertebral foramina are triangular in shape. The spinous processes are short and often bifurcated (the spinous process of C7, however, is not bifurcated, and is substantially longer than that of the other cervical spinous processes).
The twelve (12) thoracic bones and their transverse processes have surfaces that articulate with the ribs. Some rotation can occur between the thoracic vertebrae, but their connection with the rib cage prevents much flexion or other excursion. They may also be known as 'dorsal vertebrae', in the human context.
Bodies are roughly heart-shaped and are about as wide anterio-posterioly as they are in the transverse dimension. Vertebral foramina are roughly circular in shape.
These five (5) vertebrae are very robust in construction, as they must support more weight than other vertebrae. They allow significant flexion and extension, moderate lateral flexion (sidebending), and a small degree of rotation. The discs between these vertebrae create a lumbar lordosis (curvature that is concave posteriorly) in the human spine.
There are five (5) vertebrae (S1-S5) and they are fused in maturity, with no intervertebral discs.
There are usually four (4) and rarely 3-5 vertebrae (Co1-Co5), with no intervertebral discs. Many animals have a greater number of "tail vertebrae" and, in animals, they are more commonly known as "caudal vertebrae." Pain at the coccyx,(tailbone) is known as coccydynia.
The striking segmented pattern of the human spine is established during embryogenesis when the precursor of the vertebrae, the somites, are rhythmically added to the forming posterior part of the embryo. In humans, somite formation begins around the third week post-fertilization and continues until a total of around 52 somites are formed. The somites are epithelial spheres that contain the precursors of the vertebrae, the ribs, the skeletal muscles of the body wall and limbs, and the dermis of the back. The periodicity of somite distribution and production is thought to be imposed by a molecular oscillator or clock acting in cells of the presomitic mesoderm (PSM). Somites form soon after the beginning of gastrulation, on both sides of the neural tube from a tissue called the presomitic mesoderm (PSM). The PSM is part of the paraxial mesoderm and is generated caudally by gastrulation when cells ingress through the primitive streak, and later, through the tail bud. Soon after their formation, somites become subdivided into the dermomyotome dorsally, which gives rise to the muscles and dermis, and the sclerotome ventrally which will form the spine components. Sclerotomes become subvidided into an anterior and a posterior compartment. This subdivision plays a key role in the definitive patterning of vertebrae which form when the posterior part of one somite fuses to the anterior part of the consecutive somite during a process termed resegmentation. Disruption of the somitogenesis process in humans results in diseases such as congenital scoliosis. So far, the human homologues of three genes associated to the mouse segmentation clock (MESP2, DLL3 and LFNG) have been shown to be mutated in human patients with human congenital scoliosis suggesting that the mechanisms involved in vertebral segmentation are conserved across vertebrates. In humans the first four somites are incoporated in the basi-occipital bone of the skull and the next 33 somites will form the vertebrae. The remaining posterior somites degenerate. During the fourth week of embryonic development, the sclerotomes shift their position to surround the spinal cord and the notochord. The sclerotome is made of mesoderm and originates from the ventromedial part of the somites. This column of tissue has a segmented appearance, with alternating areas of dense and less dense areas.
As the sclerotome develops, it condenses further eventually developing into the vertebral body. Development of the appropriate shapes of the vertebral bodies is regulated by HOX genes.
The less dense tissue that separates the sclerotome segments develop into the intervertebral discs.
The notochord disappears in the sclerotome (vertebral body) segments, but persists in the region of the intervertebral discs as the nucleus pulposus.. The nucleus pulposus and the fibers of the annulus fibrosus make up the intervertebral disc.
The primary curves (thoracic and sacral curvatures) form during fetal development. The secondary curves develop after birth. The cervical curvature forms as a result of lifting the head and the lumbar curvature forms as a result of walking.
There are various defects associated with vertebral development.Scoliosis will result in improper fusion of the vertebrae. In Klippel-Feil anomaly patients have two or more cervical vertebrae that are fused together, along with other associated birth defects. One of the most serious defects is failure of the vertebral arches to fuse. This results in a condition called spina bifida. There are several variations of spina bifida that reflect the severity of the defect.
The vertebrae of lobe-finned fishes consist of three discrete bony elements. The vertebral arch surrounds the spinal cord, and is of broadly similar form to that found in most other vertebrates. Just beneath the arch lies a small plate-like pleurocentrum, which protects the upper surface of the notochord, and below that, a larger arch-shaped intercentrum to protect the lower border. Both of these structures are embedded within a single cylindrical mass of cartilage. A similar arrangement was found in primitive tetrapods, but, in the evolutionary line that led to reptiles (and hence, also to mammals and birds), the intercentrum became partially or wholly replaced by an enlarged pleurocentrum, which in turn became the bony vertebral body.
In most ray-finned fishes, including all teleosts, these two structures are fused with, and embedded within, a solid piece of bone superficially resembling the vertebral body of mammals. In living amphibians, there is simply a cylindrical piece of bone below the vertebral arch, with no trace of the separate elements present in the early tetrapods.
In cartilagenous fish, such as sharks, the vertebrae consist of two cartilagenous tubes. The upper tube is formed from the vertebral arches, but also includes additional cartilagenous structures filling in the gaps between the vertebrae, and so enclosing the spinal cord in an essentially continuous sheath. The lower tube surrounds the notochord, and has a complex structure, often including multiple layers of calcification.
Lampreys have vertebral arches, but nothing resembling the vertebral bodies found in all higher vertebrates. Even the arches are discontinous, consisting of separate pieces of arch-shaped cartilage around the spinal cord in most parts of the body, changing to long strips of cartilage above and below in the tail region.Hagfishes lack a true vertebral column, and are therefore not properly considered vertebrates, but a few tiny neural arches are present in the tail
Vertebrae are defined by regions. Cervical vertebrae are those in the neck area, and can range from a single vertebra in amphibians, to seven in most mammals and reptiles, and as many as 25 in swans or 76 in the extinct plesiosaur Elasmosaurus. The dorsal vertebrae range from the bottom of the neck to the top of the pelvis. Dorsal vertebrae attached to ribs are called thoracic vertebrae, while those without ribs are called lumbar vertebrae. The sacral vertebrae are those in the pelvic region, and range from one in amphibians, to two in most birds and modern reptiles, or up to 3 to 5 in mammals. When more than one sacral vertebrae are fused into a single structure, it is called the sacrum. The synsacrum is a similar fused structure found in birds that is composed of the sacral, lumbar, and some of the thoracic and caudal vertebra, as well as the pelvic girdle. Caudal vertebra compose the tail, and the final few can be fused into the pygostyle in birds, or into the coccygeal or tail bone in chimpanzees or humans.
Individual vertebra are composed of a centrum (body), arches protruding from the top and bottom of the centrum, and various processes projecting from the centrum and/or arches. An arch extending from the top of the centrum is called a neural arch, while the hemal arch or chevron is found underneath the centrum in the caudal (tail) vertebrae of fish, most reptiles, some birds, and some mammals with long tails. The vertebral processes can either give the structure rigidity, help them articulate with ribs, or serve as muscle attachment points. Common types are tranverse process, diapophyses, parapophyses, and zygapophyses (both the cranial zygapophyses and the caudal zygapophyses).
Amphicelous refers to a centrum that is concave at both ends, similar to those found in most fish. Opisthocoelous centra are convex in the front and concave in the back, similar to those of most salamanders. In contrast, procelous centra are concave in the front and convex in the back, as found in most frogs and modern reptiles. Centra with flat ends are acelous, like those in mammals. Birds have heterocelous centra, shaped like saddles at both ends.
There are normally thirty-three (33) vertebrae in humans, including the five that are fused to form the sacrum (the others are separated by intervertebral discs)) and the four coccygeal bones which form the tailbone. The upper three regions comprise the remaining 24, and are grouped under the names cervical (7 vertebrae), thoracic (12 vertebrae) and lumbar (5 vertebrae), according to the regions they occupy. This number is sometimes increased by an additional vertebra in one region, or it may be diminished in one region, the deficiency often being supplied by an additional vertebra in another. The number of cervical vertebrae is, however, very rarely increased or diminished.
With the exception of the first and second cervical, the true or movable vertebrae (the upper three regions) present certain common characteristics which are best studied by examining one from the middle of the thoracic region.
A typical vertebra consists of two essential parts: an anterior (front) segment, which is the vertebral body; and a posterior part – the vertebral (neural) arch – which encloses the vertebral foramen. The vertebral arch is formed by a pair of pedicles and a pair of laminae, and supports seven processes, four articular, two transverse, and one spinous, the latter also being known as the neural spine.
When the vertebrae are articulated with each other, the bodies form a strong pillar for the support of the head and trunk, and the vertebral foramina constitute a canal for the protection of the medulla spinalis (spinal cord). In between every pair of vertebrae are two apertures, the intervertebral foramina, one on either side, for the transmission of the spinal nerves and vessels.
Two transverse process and one spinous process are posterior to (behind) the vertebral body. The spinous process comes out the back, one transverse process comes out the left, and one on the right. The spinous processes of the cervical and lumbar regions can be felt through the skin. Superior and inferior articular facets on each vertebra act to restrict the range of movement possible. These facets are joined by a thin portion of the neural arch called the pars interarticulars.
The centra of the vertebra can be classified based upon the fusion of its elements. In aspidospondyly, bones such as the neural spine, the pleurocentrum and the intercentrum are separate ossifications. Fused elements however, classify a vertebra as having holospondyly.
A vertebra can also be described in terms of the shape of the ends of the centra. Humans are said to be acoelous, or with flat ends. These flat ends of the centra are especially good at supporting and distributing compressive forces. Amphicoelus vertebra is represented by both ends of the centra being concave. This shape is common in fish, where most motion is limited. Amphicoelus centra often are integrated with a full notochord. Procoelus vertebra are anteriorly concave, and posteriorly convex. An opisthocoelus vertebra however, possess anterior convexity, and posterior concavity. Heterocoelous vertebrae are saddle shaped at each end of the centra. This type of configuration is seen in turtles that retract their necks, and birds, because it permits extensive lateral and vertical flexion motion without stretching the nerve cord too extensively or wringing it about its long axis.
These seven (7) bones are generally small and delicate. Their spinous processes are short (with the exception of C2 and C7, which have palpable spinous processes). Numbered top-to-bottom from C1-C7,atlas (C1) and axis (C2), are the vertebrae that allow the neck and head so much movement. For the most part, the atlanto-occipital joint allows the skull to move up and down, while the atlanto-axial joint allows the upper neck to twist left and right. The axis also sits upon the first intervertebral disk of the spinal column. All mammals except manatees and sloths have seven cervical vertebrae, whatever the length of the neck.
Cervical vertebrae possess transverse foramina to allow for the vertebral arteries to pass through on their way to the foramen magnum to end in the circle of Willis. These are the smallest, lightest vertebrae and the vertebral foramina are triangular in shape. The spinous processes are short and often bifurcated (the spinous process of C7, however, is not bifurcated, and is substantially longer than that of the other cervical spinous processes).
The twelve (12) thoracic bones and their transverse processes have surfaces that articulate with the ribs. Some rotation can occur between the thoracic vertebrae, but their connection with the rib cage prevents much flexion or other excursion. They may also be known as 'dorsal vertebrae', in the human context.
Bodies are roughly heart-shaped and are about as wide anterio-posterioly as they are in the transverse dimension. Vertebral foramina are roughly circular in shape.
These five (5) vertebrae are very robust in construction, as they must support more weight than other vertebrae. They allow significant flexion and extension, moderate lateral flexion (sidebending), and a small degree of rotation. The discs between these vertebrae create a lumbar lordosis (curvature that is concave posteriorly) in the human spine.
There are five (5) vertebrae (S1-S5) and they are fused in maturity, with no intervertebral discs.
There are usually four (4) and rarely 3-5 vertebrae (Co1-Co5), with no intervertebral discs. Many animals have a greater number of "tail vertebrae" and, in animals, they are more commonly known as "caudal vertebrae." Pain at the coccyx,(tailbone) is known as coccydynia.
The striking segmented pattern of the human spine is established during embryogenesis when the precursor of the vertebrae, the somites, are rhythmically added to the forming posterior part of the embryo. In humans, somite formation begins around the third week post-fertilization and continues until a total of around 52 somites are formed. The somites are epithelial spheres that contain the precursors of the vertebrae, the ribs, the skeletal muscles of the body wall and limbs, and the dermis of the back. The periodicity of somite distribution and production is thought to be imposed by a molecular oscillator or clock acting in cells of the presomitic mesoderm (PSM). Somites form soon after the beginning of gastrulation, on both sides of the neural tube from a tissue called the presomitic mesoderm (PSM). The PSM is part of the paraxial mesoderm and is generated caudally by gastrulation when cells ingress through the primitive streak, and later, through the tail bud. Soon after their formation, somites become subdivided into the dermomyotome dorsally, which gives rise to the muscles and dermis, and the sclerotome ventrally which will form the spine components. Sclerotomes become subvidided into an anterior and a posterior compartment. This subdivision plays a key role in the definitive patterning of vertebrae which form when the posterior part of one somite fuses to the anterior part of the consecutive somite during a process termed resegmentation. Disruption of the somitogenesis process in humans results in diseases such as congenital scoliosis. So far, the human homologues of three genes associated to the mouse segmentation clock (MESP2, DLL3 and LFNG) have been shown to be mutated in human patients with human congenital scoliosis suggesting that the mechanisms involved in vertebral segmentation are conserved across vertebrates. In humans the first four somites are incoporated in the basi-occipital bone of the skull and the next 33 somites will form the vertebrae. The remaining posterior somites degenerate. During the fourth week of embryonic development, the sclerotomes shift their position to surround the spinal cord and the notochord. The sclerotome is made of mesoderm and originates from the ventromedial part of the somites. This column of tissue has a segmented appearance, with alternating areas of dense and less dense areas.
As the sclerotome develops, it condenses further eventually developing into the vertebral body. Development of the appropriate shapes of the vertebral bodies is regulated by HOX genes.
The less dense tissue that separates the sclerotome segments develop into the intervertebral discs.
The notochord disappears in the sclerotome (vertebral body) segments, but persists in the region of the intervertebral discs as the nucleus pulposus.. The nucleus pulposus and the fibers of the annulus fibrosus make up the intervertebral disc.
The primary curves (thoracic and sacral curvatures) form during fetal development. The secondary curves develop after birth. The cervical curvature forms as a result of lifting the head and the lumbar curvature forms as a result of walking.
There are various defects associated with vertebral development.Scoliosis will result in improper fusion of the vertebrae. In Klippel-Feil anomaly patients have two or more cervical vertebrae that are fused together, along with other associated birth defects. One of the most serious defects is failure of the vertebral arches to fuse. This results in a condition called spina bifida. There are several variations of spina bifida that reflect the severity of the defect.
The vertebrae of lobe-finned fishes consist of three discrete bony elements. The vertebral arch surrounds the spinal cord, and is of broadly similar form to that found in most other vertebrates. Just beneath the arch lies a small plate-like pleurocentrum, which protects the upper surface of the notochord, and below that, a larger arch-shaped intercentrum to protect the lower border. Both of these structures are embedded within a single cylindrical mass of cartilage. A similar arrangement was found in primitive tetrapods, but, in the evolutionary line that led to reptiles (and hence, also to mammals and birds), the intercentrum became partially or wholly replaced by an enlarged pleurocentrum, which in turn became the bony vertebral body.
In most ray-finned fishes, including all teleosts, these two structures are fused with, and embedded within, a solid piece of bone superficially resembling the vertebral body of mammals. In living amphibians, there is simply a cylindrical piece of bone below the vertebral arch, with no trace of the separate elements present in the early tetrapods.
In cartilagenous fish, such as sharks, the vertebrae consist of two cartilagenous tubes. The upper tube is formed from the vertebral arches, but also includes additional cartilagenous structures filling in the gaps between the vertebrae, and so enclosing the spinal cord in an essentially continuous sheath. The lower tube surrounds the notochord, and has a complex structure, often including multiple layers of calcification.
Lampreys have vertebral arches, but nothing resembling the vertebral bodies found in all higher vertebrates. Even the arches are discontinous, consisting of separate pieces of arch-shaped cartilage around the spinal cord in most parts of the body, changing to long strips of cartilage above and below in the tail region.Hagfishes lack a true vertebral column, and are therefore not properly considered vertebrates, but a few tiny neural arches are present in the tail
The Nose
Anatomically, a nose is a protuberance in vertebrates that houses the nostrils, or nares, which admit and expel air for respiration in conjunction with the mouth. Behind the nose is the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passes through the pharynx, shared with the digestive system, and then into the rest of the respiratory system. In humans, the nose is located centrally on the face; on most other mammals, it is on the upper tip of the snout.
In cetaceans, the nose has been reduced to the nostrils, which have migrated to the top of the head, producing a more streamlined body shape and the ability to breathe while mostly submerged. Conversely, the elephant's nose has elaborated into a long, muscular, manipulative organ called the trunk.
As an interface between the body and the external world, the nose and associated structures frequently perform additional functions concerned with conditioning entering air (for instance, by warming and/or humidifying it, also for flicking if moving and by mostly reclaiming moisture from the air before it is exhaled (as occurs most efficiently in camels). The nose hairs are able to stop unwanted particles from entering the lungs.
In most mammals, the nose is the primary large organ for smelling. As the animal sniffs, the air flows through the nose and over structures called tubinates in the nasal cavity. Turbulent flow will promote mixing of the air in the nasal cavity allowing the molecules of a newly inhaled breath of air to reach the sensitive epithelium as fast as possible. Laminar flow would imply a stationary layer of air around the epithelium only to be entered by diffusion. Sniffing will cause more turbulence also. At the olfactory epithelium, odor molecules carried by the air dissolve in the fluid-covered cilia of the olfactory receptor neurons, where they bind to specific receptor proteins causing a depolarization of the receptor cell. At the glomeruli, dendrites of many receptor cells sensitive to the same kind of odor converge and from there a signal is forwarded to the brain's olfactory region.
In cetaceans, the nose has been reduced to the nostrils, which have migrated to the top of the head, producing a more streamlined body shape and the ability to breathe while mostly submerged. Conversely, the elephant's nose has elaborated into a long, muscular, manipulative organ called the trunk.
As an interface between the body and the external world, the nose and associated structures frequently perform additional functions concerned with conditioning entering air (for instance, by warming and/or humidifying it, also for flicking if moving and by mostly reclaiming moisture from the air before it is exhaled (as occurs most efficiently in camels). The nose hairs are able to stop unwanted particles from entering the lungs.
In most mammals, the nose is the primary large organ for smelling. As the animal sniffs, the air flows through the nose and over structures called tubinates in the nasal cavity. Turbulent flow will promote mixing of the air in the nasal cavity allowing the molecules of a newly inhaled breath of air to reach the sensitive epithelium as fast as possible. Laminar flow would imply a stationary layer of air around the epithelium only to be entered by diffusion. Sniffing will cause more turbulence also. At the olfactory epithelium, odor molecules carried by the air dissolve in the fluid-covered cilia of the olfactory receptor neurons, where they bind to specific receptor proteins causing a depolarization of the receptor cell. At the glomeruli, dendrites of many receptor cells sensitive to the same kind of odor converge and from there a signal is forwarded to the brain's olfactory region.
Thursday, 5 November 2009
the Spine
In human anatomy, the vertebral column (backbone or spine) is a column usually consisting of 33 vertebrae, the sacrum,intervertebral discs, and the coccyx situated in the dorsal aspect of the torso, separated by spinal discs. It houses the and protects the spinal cord in its spinal canal.
Viewed laterally the vertebral column presents several curves, which correspond to the different regions of the column, and are called cervical, thoracic,lumbar, and pelvic.
The cervical curve, convex forward, begins at the apex of the odontoid (tooth-like) process, and ends at the middle of the second thoracic vertebra; it is the least marked of all the curves.
The thoracic curve, concave forward, begins at the middle of the second and ends at the middle of the twelfth thoracic vertebra. Its most prominent point behind corresponds to the spinous process of the seventh thoracic vertebra. This curve is known as a tt curve.
The lumbar curve is more marked in the female than in the male; it begins at the middle of the last thoracic vertebra, and ends at the sacrovertebral angle. It is convex anteriorly, the convexity of the lower three vertebrae being much greater than that of the upper two. This curve is described as a lordotic curve.
The pelvic curve begins at the sacrovertebral articulation, and ends at the point of the coccyx; its concavity is directed downward and forward. .
The thoracic and pelvic curves are termed primary curves, because they alone are present during fetal life. The cervical and lumbar curves are compensatory or secondary, and are developed after birth, the former when the child is able to hold up its head (at three or four months) and to sit upright (at nine months), the latter at twelve or eighteen months, when the child begins to walk.
There are a total of 33 vertebrae in the vertebral column, if assuming 4 coccygeal vertebrae.
The individual vertebrae, named according to region and position, from superior to inferior, are:
Cervical: 7 vertebrae (C1–C7)
C1 is known as "atlas" and supports the head, C2 is known as "axis"
Possesses bifid spinous processes, which is absent in C1 and C7
Small-bodied
Thoracic: 12 vertebrae (T1–T12)
Distinguished by the presence of costal facets for the articulation of the heads of ribs
Body is intermediate in size between the cervical and lumbar vertebrae
Lumbar: 5 vertebrae (L1–L5)
Has a large body
Does not have costal facets nor transverse process foramina
Sacral: 5 (fused) vertebrae (S1–S5)
Coccygeal: 4 (3–5) (fused) vertebrae (Tailbone)
When viewed from in front, the width of the bodies of the vertebrae is seen to increase from the second cervical to the first thoracic; there is then a slight diminution in the next three vertebrae; below this there is again a gradual and progressive increase in width as low as the sacrovertebral angle. From this point there is a rapid diminution, to the apex of the coccyx.
The posterior surface of the vertebral column presents in the median line the spinous processes. In the cervical region (with the exception of the second and seventh vertebrae) these are short and horizontal, with bifid extremities. In the upper part of the thoracic region they are directed obliquely downward; in the middle they are almost vertical, and in the lower part they are nearly horizontal. In the lumbar region they are nearly horizontal. The spinous processes are separated by considerable intervals in the lumbar region, by narrower intervals in the neck, and are closely approximated in the middle of the thoracic region. Occasionally one of these processes deviates a little from the median line — a fact to be remembered in practice, as irregularities of this sort are attendant also on fractures or displacements of the vertebral column. On either side of the spinous processes is the vertebral groove formed by the laminae in the cervical and lumbar regions, where it is shallow, and by the laminae and transverse processes in the thoracic region, where it is deep and broad; these grooves lodge the deep muscles of the back. Lateral to the vertebral grooves are the articular processes, and still more laterally the transverse processes. In the thoracic region, the transverse processes stand backward, on a plane considerably behind that of the same processes in the cervical and lumbar regions. In the cervical region, the transverse processes are placed in front of the articular processes, lateral to the pedicles and between the intervertebral foramina. In the thoracic region they are posterior to the pedicles, intervertebral foramina, and articular processes. In the lumbar region they are in front of the articular processes, but behind the intervertebral foramina.
Lateral surfaces
The lateral surfaces are separated from the posterior surface by the articular processes in the cervical and lumbar regions, and by the transverse processes in the thoracic region. They present, in front, the sides of the bodies of the vertebrae, marked in the thoracic region by the facets for articulation with the heads of the ribs. More posteriorly are the intervertebral foramina, formed by the juxtaposition of the vertebral notches, oval in shape, smallest in the cervical and upper part of the thoracic regions, and gradually increasing in size to the last lumbar. They transmit the spinal nerves and are situated between the transverse processes in the cervical region, and in front of them in the thoracic and lumbar regions.
T3 is at level of medial part of spine of scapula. T7 is at inferior angle of the scapula. L4 is at highest point of iliac crest. S2 is at the level of posterior superior iliac spine. T12 can be found by identifying the lowest pair of ribs and tracing them to their thoracic attachment. Furthermore, C7 is easily localized as a prominence at the lower part of the neck.
The vertebral canal follows the different curves of the column; it is large and triangular in those parts of the column which enjoy the greatest freedom of movement, such as the cervical and lumbar regions; and is small and rounded in the thoracic region, where motion is more limited.
Occasionally the coalescence of the laminae is not completed, and consequently a cleft is left in the arches of the vertebrae, through which a protrusion of the spinal membranes (dura mater and arachnoid), and generally of the spinal cord (medulla spinalis) itself, takes place, constituting the malformation known as spina bifida. This condition is most common in the lumbosacral region, but it may occur in the thoracic or cervical region, or the arches throughout the whole length of the canal may remain incomplete.
The following abnormal curvatures may occur in some people:
Kyphosis is an exaggerated kyphotic (posterior) curvature in the thoracic region. This produces the so-called "humpback" or "dowager's hump", a condition commonly observed in osteoporosis.
Lordosis is an exaggerated lordotic (anterior) curvature of the lumbar region, "swayback". Temporary lordosis is common among pregnant women.
Retrolisthesis is a posterior displacement of one vertebral body with respect to the adjacent vertebral segment to a degree less than a luxation (dislocation).
Scoliosis, lateral curvature, is the most common abnormal curvature, occurring in 0.5% of the population. It is more common among females and may result from unequal growth of the two sides of one or more vertebrae. It can also be caused by pulmonary atelectasis (partial or complete deflation of one or more lobes of the lungs) as observed in asthma or pneumothorax.
Viewed laterally the vertebral column presents several curves, which correspond to the different regions of the column, and are called cervical, thoracic,lumbar, and pelvic.
The cervical curve, convex forward, begins at the apex of the odontoid (tooth-like) process, and ends at the middle of the second thoracic vertebra; it is the least marked of all the curves.
The thoracic curve, concave forward, begins at the middle of the second and ends at the middle of the twelfth thoracic vertebra. Its most prominent point behind corresponds to the spinous process of the seventh thoracic vertebra. This curve is known as a tt curve.
The lumbar curve is more marked in the female than in the male; it begins at the middle of the last thoracic vertebra, and ends at the sacrovertebral angle. It is convex anteriorly, the convexity of the lower three vertebrae being much greater than that of the upper two. This curve is described as a lordotic curve.
The pelvic curve begins at the sacrovertebral articulation, and ends at the point of the coccyx; its concavity is directed downward and forward. .
The thoracic and pelvic curves are termed primary curves, because they alone are present during fetal life. The cervical and lumbar curves are compensatory or secondary, and are developed after birth, the former when the child is able to hold up its head (at three or four months) and to sit upright (at nine months), the latter at twelve or eighteen months, when the child begins to walk.
There are a total of 33 vertebrae in the vertebral column, if assuming 4 coccygeal vertebrae.
The individual vertebrae, named according to region and position, from superior to inferior, are:
Cervical: 7 vertebrae (C1–C7)
C1 is known as "atlas" and supports the head, C2 is known as "axis"
Possesses bifid spinous processes, which is absent in C1 and C7
Small-bodied
Thoracic: 12 vertebrae (T1–T12)
Distinguished by the presence of costal facets for the articulation of the heads of ribs
Body is intermediate in size between the cervical and lumbar vertebrae
Lumbar: 5 vertebrae (L1–L5)
Has a large body
Does not have costal facets nor transverse process foramina
Sacral: 5 (fused) vertebrae (S1–S5)
Coccygeal: 4 (3–5) (fused) vertebrae (Tailbone)
When viewed from in front, the width of the bodies of the vertebrae is seen to increase from the second cervical to the first thoracic; there is then a slight diminution in the next three vertebrae; below this there is again a gradual and progressive increase in width as low as the sacrovertebral angle. From this point there is a rapid diminution, to the apex of the coccyx.
The posterior surface of the vertebral column presents in the median line the spinous processes. In the cervical region (with the exception of the second and seventh vertebrae) these are short and horizontal, with bifid extremities. In the upper part of the thoracic region they are directed obliquely downward; in the middle they are almost vertical, and in the lower part they are nearly horizontal. In the lumbar region they are nearly horizontal. The spinous processes are separated by considerable intervals in the lumbar region, by narrower intervals in the neck, and are closely approximated in the middle of the thoracic region. Occasionally one of these processes deviates a little from the median line — a fact to be remembered in practice, as irregularities of this sort are attendant also on fractures or displacements of the vertebral column. On either side of the spinous processes is the vertebral groove formed by the laminae in the cervical and lumbar regions, where it is shallow, and by the laminae and transverse processes in the thoracic region, where it is deep and broad; these grooves lodge the deep muscles of the back. Lateral to the vertebral grooves are the articular processes, and still more laterally the transverse processes. In the thoracic region, the transverse processes stand backward, on a plane considerably behind that of the same processes in the cervical and lumbar regions. In the cervical region, the transverse processes are placed in front of the articular processes, lateral to the pedicles and between the intervertebral foramina. In the thoracic region they are posterior to the pedicles, intervertebral foramina, and articular processes. In the lumbar region they are in front of the articular processes, but behind the intervertebral foramina.
Lateral surfaces
The lateral surfaces are separated from the posterior surface by the articular processes in the cervical and lumbar regions, and by the transverse processes in the thoracic region. They present, in front, the sides of the bodies of the vertebrae, marked in the thoracic region by the facets for articulation with the heads of the ribs. More posteriorly are the intervertebral foramina, formed by the juxtaposition of the vertebral notches, oval in shape, smallest in the cervical and upper part of the thoracic regions, and gradually increasing in size to the last lumbar. They transmit the spinal nerves and are situated between the transverse processes in the cervical region, and in front of them in the thoracic and lumbar regions.
T3 is at level of medial part of spine of scapula. T7 is at inferior angle of the scapula. L4 is at highest point of iliac crest. S2 is at the level of posterior superior iliac spine. T12 can be found by identifying the lowest pair of ribs and tracing them to their thoracic attachment. Furthermore, C7 is easily localized as a prominence at the lower part of the neck.
The vertebral canal follows the different curves of the column; it is large and triangular in those parts of the column which enjoy the greatest freedom of movement, such as the cervical and lumbar regions; and is small and rounded in the thoracic region, where motion is more limited.
Occasionally the coalescence of the laminae is not completed, and consequently a cleft is left in the arches of the vertebrae, through which a protrusion of the spinal membranes (dura mater and arachnoid), and generally of the spinal cord (medulla spinalis) itself, takes place, constituting the malformation known as spina bifida. This condition is most common in the lumbosacral region, but it may occur in the thoracic or cervical region, or the arches throughout the whole length of the canal may remain incomplete.
The following abnormal curvatures may occur in some people:
Kyphosis is an exaggerated kyphotic (posterior) curvature in the thoracic region. This produces the so-called "humpback" or "dowager's hump", a condition commonly observed in osteoporosis.
Lordosis is an exaggerated lordotic (anterior) curvature of the lumbar region, "swayback". Temporary lordosis is common among pregnant women.
Retrolisthesis is a posterior displacement of one vertebral body with respect to the adjacent vertebral segment to a degree less than a luxation (dislocation).
Scoliosis, lateral curvature, is the most common abnormal curvature, occurring in 0.5% of the population. It is more common among females and may result from unequal growth of the two sides of one or more vertebrae. It can also be caused by pulmonary atelectasis (partial or complete deflation of one or more lobes of the lungs) as observed in asthma or pneumothorax.
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