BIOCHEMISTRY, BIOTECHNOLOGY, BIOPHYSICS,

BIOSCIENCES, MEDICINE, BIONUCLEAR&BIOATOMIC

SCIENCES, BIOENGINEERING
*********************
HEALTH SCIENCE &TECHNOLOGY
****************
HUMAN HEALTH SYSTEM
Author: Rajaonarisoa Toky Mahandry

Co-Authors:
 Brian Ang, Doctor in Medicine, Vision and eye health
 Eric Chudler, Professor at the University of Washington
 Eugene LeMay Jr., University of Nevada at Reno, Prentice Hall
 LaRousse
 M. Blaizot, H. Boué, A. Gama, L. Geneves, G Lascombes, Hachette
 Nachum Dafny, Ph.D., Department of Neurobiology and Anatomy, The UT Medical School at
Houston
 Perlemuter and Waligora, Masson
 Robert Proulx Heaney, John A. Creighton University Professor, Creighton University, Omaha,
Nebraska; Vice President for Health Sciences, 1971–84
 Matthew Hoffman, MD and Carol DerSarkissian, MD
 Robin Huw Crompton, Christopher Tangen, Shane W. Cummings, Bernard Wood, Britannica
Anatomy, University of Liverpool
 Sylvia S Mader, Mc Graw Hill
 Theodore L. Brown, Prentice Hall, University of Illinois at Urbana Champaign
 Warren Andrew , Professor of Anatomy, Indiana University, Indianapolis
 Wikipedia

1
 CONTENTS
FIRST PAGE 1

CONTENTS 2

AKNOWLEDGEMENTS 8

LIST OF FIGURES 9

LIST OF TABLES, CHARTS, AND DIAGRAMS 15

INTRODUCTION 16

Part one: METHODOLOGY 17

Part two : RESULTS 20

0. THE INTERNAL ORGAN SYSTEM 20

I. DIGESTIVE TRACT AND RESPIRATORY COMBINATION 23

Hard palate 23
Epiglottis 24
Larynx 24
Thyroid gland 25
Pharynx 26
Glottis 27

II. CARDIOVASCULARY SYSTEM, CIRCULATORY SYSTEM 29

THE HEART 29
The heart, power organs 29
Nerves, captors and regulators of cardiac automatism 32
Bio-Mechanism, Bio-Automatism, and/or Bio-Function of the heart and some other organs. 32
Nerve(s), Ganglion(s), blood vessel(s), all tissues, all living organisms, all organs 32

III. THE DIGESTIVE TRACT 34

THE STOMACH 34
THE PANCREAS 37
Microanatomy 39
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Development 40
Cellular development 40
Function 41
Blood glucose regulation 41
Digestion 42
Additional functions 43
Removal 43
History 43
THE COMMON BILE VESSEL 44
Clinical significance 46
History 48
LIVER 48
RECOMMENDATIONS 49

IV. RESPIRATORY SYSTEM AND LUNG 51

LUNGS 51
Gaze exchanges in the lung 52
Oxygen motion 52
Carbon dioxide 52
Color of the blood and organs and shape of organs 53

V. KIDNEY SYSTEM 54
Generality 54
Kidney functions 56
Glomerular Filtration 56
Tubular reabsorption 56
Tubular Secretion 57

VI. ADRENAL GLAND 58

Structure 58
Adrenal cortex 59
Zona glomerulosa 60
Zona fasciculate 60
Zona reticularis 60
Medulla 60
Blood supply 60
Variability 61
Function 61
Corticosteroids 61
Mineralocorticoids 61
Glucocorticoids 62
Formation 62
Androgens 64
Catecholamines 64
Gene and protein expression 64
Development 65
Cortex 65
Adrenarche 65
Medulla 65
History 66

VII. THE BLOOD SYSTEM 67

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Capillary exchange 67
Blood 67
Leucocytes 68
Lymphocytes 69
Granulocytes 69
Red blood cells 69
Platelet 70
Plasma 70
The superficial arteries and veins of face and scalp 70
The Blood Supply of the Brain 71

VIII. CELL STRUCTURES, CELL DIVISION, CELL DEVELOPMENT 74

CELL STRUCTURES 74
CELL DIVISION AND CELL DEVELOPMENT 75
Mitosis 76
Meiosis 78

IX DERM SYSTEM AND BREAST 82

DERM 82
Generality 82

Clinica and Precisions on biomatters 83

BREAST 83

Etymology and terminology 84

Anatomy 84
Glandular structure 85
Lymphatic drainage 85
Shape, texture, and support 86
Development 86
Puberty 86
Changes during the menstrual cycle 87
Pregnancy and breastfeeding 87
Menopause 88
Breastfeeding 88
Clinical significance 88
Breast cancer 88
Male breasts 88
Plastic surgery 89

X. GENITAL ORGANS 90
HUMAN MAN GENITAL AND URINE SYSTEM 90
HUMAN WOMAN GENITAL SYSTEM 92

XI. HUMAN GENESIS 94

FECONDATION 94
EMBRYON 94
Generality 94
Germinal stage 95
Fertilization 95

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Cleavage 96
Blastulation 96
Implantation 98
Embryonic disc 99
Gastrulation 99
Neurulation 101
Development of organs and organ systems 102
Blood 102
Heart and circulatory system 102
Digestive system 104
Respiratory system 104
Urinary system 104
Bladder and urethra 105
Integumentary system 105
Nervous system 105
Development of physical features 106
Ears 106
Inner ear 106
Middle ear 106
Outer ear 106
Eyes 107
Limbs 107
Clinical significance 107
FETUS 108
Etymology 108
Development in humans 108
Weeks 9 to 16 (2 to 3.6 months) 109
Weeks 17 to 25 (3.6 to 6.6 months) 109
Weeks 26 to 38 (6.6 to 8.6 months) 109
Variation in growth 109
Viability 110

Circulatory system 110

Before birth 110

Postnatal development 113

IMMUNE SYSTEM 113
DEVELOPMENTAL PROBLEMS 113
FETAL PAIN 114

XII. NEUROLOGY and THE BRAIN 115

THE BRAIN 115
Snap information of the brain 115
Neurology system 116
External environment, nerves, and the brain 117
Internal environment, nerves, and the brain 117
OVERVIEW OF THE NERVOUS SYSTEM 117
1.1The Central Nervous System (CNS) 117
1.2The Cerebral Hemispheres 123
1.3The Diencephalon 127
1.4The Brain Stem 128
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1.5The Peripheral Nervous System (PNS) 131
1.6Orientation to the Central Nervous System 133

XIII. OPHTALMOLOGY 137

EYE ANATOMY - FRONT SECTION (ANTERIOR SEGMENT) 138
EYE ANATOMY - BACK SECTION (POSTERIOR SEGMENT) 138
EYE ANATOMY - SUPPORTING TISSUES 139

XIV. OTHO‐RHINO‐LARYNGOLOGY 142

Generality 142
Paranasal sinuses 142
Structure 145
Functions 145
Development 146
X-ray images and illustrations 146
Inflammation 147
The ear 148

Nasal Cavity 149

Generality 149
Segments 150
Blood supply 150
Nerve supply 150
Function 151

XV. MUSCLES 160

Overview 160
Generality 161
The muscle groups and their actions 162
The neck 163
The back 164
Muscular system 165
Skeletal muscle 166
Cardiac muscle 166
Smooth muscle 166
Physiology 166
Contraction 166
Tendon 167
Aerobic and anaerobic muscle activity 167

XVI. BONE OR SKELETON: CARTILAGE and HARD BONE 168

GENERALITY 168
ANATOMY OF THE BONE 170
Evolutionary origin and significance 170
HUMAN SKELETON ANATOMY 171

XVII. TEETH 174

Generality 174
Anatomy and Physiology of Teeth 175
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Teeth Conditions 176
Teeth Tests 176
Teeth Treatments 176

XVIII. PARASITES, PARASITISM, AND INTRODUCTION TO VIRUS 177

Generality 177
Plasmodium 177
Worms 179
Tapeworms 179
Flukes 180
Hookworm 181

XIX. GENOMES, GENETICS, BIOCHEMISTRY, BIOTECHNOLOGY, BIOENGINEERING,

BIONUCLEAR AND/OR BIOATOMIC SCIENCES 183
GENERALITY 183
HUMAN GENETICS 183
Introduction 183
Chromosomal Inheritance 183
Deoxyribonucleic Acid DNA molecule 186
DNA Structure 186
DNA replication 187
Transcription 188
Translation 189
Isolation and Testing of DNA 191
Transformation 191
Bacterial Transformation 192
Gel Electrophoresis 194
Generalized instructions 194
Preparing the Gel Slab 194
Performing Gel Electrophoresis 195
Experimental Procedure: Gel Electrophoresis 196
Results 196
BIOMOLECULES 196
Proteins 196
Carbohydrates 198
Lipids 199
Additional elements inside the body such oligo-elements and other 200
DIETETIC AND HUMAN NUTRITION NEED 201

CONCLUSION 204
BIBLIOGRAPHY AND WEB(I)OGRAPHY 205
ABOUT THE AUTHOR 216
PHOTOS OF THE AUTHOR AND CO-AUTHORS 217

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 AKNWOLEDGEMENTS
We would like to express our deep gratitude to all individuals mentioned inside this book who have
worked so hard in order to make sciences and technology at our hands.

We would also like to attribute our sincere thanks to all organisms marked inside this book for their
real understanding in order to make available this book.

Finally, we thank our families and friends for their love and support.

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LISTS OF FIGURES
Figure 01 : The homeostasis, an internal environment of human 20
Figure 02.a: Some of the internal organs of human 21
Figure 2.b: A three dimensions representation of the internal organ of human 22
Figure 3: The mouth, an oral cavity 23
Figure 4 : Inferior maxillary 23
Figure 5: Epiglottis and muscles of larynx 24
Figure 6: Inside Larynx 25
Figure 7: Thyroide gland 26
Figure 8: Pharynx, human digestive system 27
Figure 9.a: Up view and external view of the Glottis 27
Figure 9. b: Internal view or deep dissection of the Glottis 28
Figure 10.a: External view of mammalian heart 29
Figure 10.b: Superficial heart anatomy, Anterior view 29
Figure 10.c: Superficial heart anatomy 30
Figure 11.a : Tissues of the heart 31
Figure 11.b: Internal view of mammalian heart 31
Figure 12: A frontal interior view of the heart 33
Figure 13: Nodes, nerves of the heart, a representation of its automatism 33
Figure 14: Location of the stomach in the abdomen 34
Figure 15: Situation and part of the stomach 35
Figure 16: Constituant tissues of the stomach 36
Figure 17: Ligaments of the stomach 37
Figure18. a: Location of the pancreas 37
Figure 18.b: Diagram showing different functional parts of the pancreas 38
Figure 18.c: Pancreatic islet 39
Figure 18.d: Pancreatic islet using fluorescence antibodies 39
Figure 18.e: Development of the pancreas 40
Figure 18.f: Anatomy and Physiology of the pancreas 42
Figure 18.g: Pancreas as seen on abdominal ultrasonography 44
Figure 19.a: The common bile vessel 45
Figure 19.b : Diagram of the biliary tree showing the common bile duct 45
Figure 19.c: The front border of the liver has been lifted up 46
Figure 19.d : Borderline of a dilated perihilar bile duct, measuring 8 mm 47
Figure 19 e: Dilatation of CBD due to Ampullary tumor 47
Figure 20: Disposition of liver, pancreas, duodenum, gallbladder, and stomach 48
Figure 21: The intestinale wall 50

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Figure 22: The Respiratory system 51
Figure 23 : Lung tissue 52
Figure 24.a: A single anatomy of kidney 54
Figure 24.b: Placement of vessels, renal macroscopic&microscopic anatomy 55
Figure 25.a: Internal view of nephron kidney 55
Figure 25.b: Urine formation 56
Figure 26.a: Adrenal gland 58
Figure 26.b: Adrenal glands, anterior (left) and posterior (right) surface 58
Figure 26.c: Section of human adrenal gland under the microscope, showing its different layers 59
Figure 26.d : Different hormones are produced in different zones of the cortex and medulla of the gland.Light
microscopy at magnification × 204 61
Figure 26-e : Steroidogenesis in the adrenal glands – different steps occur in different layers of the
gland 62
Figure 27.a: Capillary exchange 67
Figure 27.b: A radial representation of the internal and external view of the blood vessel and the blood 68
Figure 28.a: Blood constituants and blood cells vieed on TEM 68
Figure 28.b: Imagery of white blood cells 69
Figure 28.c: Different structures of leuocytes 69
Figure 29: Red blood cell 70
Figure 30.a: Superficial arteries and veils of face and scalp 70
Figure 30.b: Frontal view of superficial vessels in women 71
Figure 31: A simplified brain vessel 73
Figure 32: A representation of animal cell 74
Figure 33: An imagery of cell with electron apparatus 75
Figure 34.a: Duplicated chromosome 77
Figure 34.b: Interphase and mitosis 78
Figure 35.a: Meiosis 80
Figure 35.b : Simulation of homologous pair of duplicated chromosomes 81
Figure 36.a: Derm 82
Figure36.b: Morphology of human female breasts with the areola, nipple, and inframammary fold
83
Figure 36.c: The breast: cross-section scheme of the mammary gland 84
Figure 36.d: Breast development in puberty is measured with the five-stage Tanner Scale 86
Figure 36.e: Breast with visible stretch marks 87
Figure 36.f: A baby breastfeeding 88
Figure 36.g: Conventional mastectomy (top); skin sparing mastectomy and latissimus dorsi
myocutaneous flap reconstruction 89

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Figure 37.a : Human male urogenital system 90
Figure 37-b: Testis 91
Figure 38: Spermatogenesis 91
Figure 39.a : Woman genital organ 92
Figure 39.b: Female external reproductive and urinal organs 92
Figure 40.a: Follicle and Oocyte development in ovary 93
Figure 40.b: Oogenesis 94
Figure 40.c: The initial stages of human embryonic development 95
Figure 40.d: 8-cell embryo at 3 days 96
Figure 40.e: Blastocyst with an inner cell mass and trophoblast 97
Figure 40.f: Trophoblast differentiation 98
Figure 40-g : Histogenesis of the three germ layers 99
Figure 40-h : Artificially colored - gestational sac, yolk sac and embryo 99
Figure 40-i: Embryo attached to placenta in amniotic cavity 100
Figure 40-j: Neural plate 101
Figure 40-k: Neural tube development 101
Figure 40.l: Development of the heart 103
Figure 40.m: Development of brain in 8 week old embryo 105
Figure 40.n: Movements of embryo at 9 weeks gestational age 107
Figure 41-a: A human fetus, attached to placenta, at three months gestational age 108
Figure 41.b: Diagram of the human fetal circulatory system 111
Figure 41.c: 3D ultrasound of 3-inch (76 mm) fetus (about 3+1⁄2 months gestational age) 112
Figure 41.d: Fetus at 4+1⁄4 months 112
Figure 41.e: Fetus at 5 months 112
Figure 41.f: Fetus in utero inside pregnant woman 114
Figure 42.a: A brain anatomy for each labeled brain part 115
Figure 42.b: A brain anatomy for brain group labeled 116
Figure 42.c: A brain anatomy for labeled function 116
Figure 43: Motor neuron anatomy 117
Figure 1.1: Lateral view of human embryo at the beginning of the 3rd (A) and 5th (B) week of
gestation 118
Figure 1.2: Lateral (A) and ventral (B) views of the cerebral cortex, Coronal view (C) of subcortical
structures 118
Figure 1.3: The main diencephalon nuclei 119
Figure 1.4: Subcortical diencephalic and mesencephalic structures 119

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Figure 1.5: Lateral view of the metencephalon and a spinal cord section with ventral and dorsal root
fibers, and dorsal root ganglia 120
Figure 1.6: The central nervous system, which includes the spinal cord and the brain 121
Figure 1.7: The ventricular system in four different angles 122
Figure 1.8: Six cortical lobes 123
Figure 1.9: Drawing of the different cortices, sulci and gyri (A) and mid-sagittal drawing emphasizes
the limbic lobe (in green) (A) 125
Figure 1.10: The corpus callosum and its different parts 127
Figure 1.11: Mid-sagittal drawing showing the main structures of the diencephalon and
rhombencephalon 128
Figure 1.12: Mid-sagittal drawing of te brain stem 129
Figure 1.13: The main arterial blood supplies to the brain 130
Figure 1.14: The spinal cord arterial blood supply 131
Figure 1.15: The peripheral nervous system 132
Figure 1.16: The autonomic nervous system 133
Figure 1.17: Orientation of the central nervous system of the spinal cord and different brain sections
134
Figure 1.18: Schematic showing the orientation of the brain in the skull/cranium 135
Figure 1.19: Three planes of the brain section 135
Figure 44: Diagram demonstrating the front and back eye anatomy 137
Figure 45: The retina 139
Figure: 46 Eye muscles 141
Figure 47: The lacrimal system 141
Figure 48.a : A part of the Otho-Rhino-Laryngology, Coronal section 143
Figure 48.b: Paranasal sinuses seen in frotan view 144
Figure 48.c: Lateral view and/or projection of the paranasal sinuses 144
Figure 48.d: Anatomy of The Paranasal Sinuses Spaces 145
Figure 48.e: Paranasal sinuses radiograph (occipitofrontal) 146
Figure 48.f: Paranasal sinuses radiograph (occipitomental) 146
Figure 48.g: Paranasal sinuses radiograph (lateral) 147

Figure 48.h: Paranasal sinuses radiograph (occipitofrontal) 147

Figure 48.i: Paranasal sinuses radiograph (occipitomental) 147

Figure 48.j: Paranasal sinuses radiograph (lateral) 147

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Figure 48.k: 3D cast of maxillary, frontal, ethmoid and sphenoid sinuses, nasal cavity and
hypopharynx 147

Figure 49.a: Anatomy of the human ear 148

Figure 49.b: Another anatomy of the ear 148
Figure 49.c: Anatomy of the ear by matter 149
Figure 50.a: CT scan in the coronal plane, showing the ostiomeatal complex (green area) 149
Figure 50.b: Lateral wall of the nasal cavity, Nasal Cavity Anatomy 151
Figure 50.c: Nasal Cavity Definition Anatomy Functions Diagrams 152
Figure 51: Head and Nose Nasal Cavity 152
Figure 52.a: Anatomy Of The Nasal Cavity And Paranasal Sinuses 153
Figure 52.b: Nasal Cavity Labeled Anatomy Physiology 153
Figure 53: Nasal Cavity, The Big Picture Gross Anatomy 154
Figure 54: Nasal Cavity Anatomy and Physiology 155
Figure 55: Pediagenosis 156
Figure 56: Nasal Cavity by showing hypophysis 157
Figure 57: Anatomy Of The Nasal Cavity And Paranasal Sinuses 157
Figure 58: A Study Of The Functions And Anatomy Of The Human Nasal 158
Figure 59: Nasal Cavity 158
Figure 60: Easy Notes on Nasal Cavity 159
Figure 61: Healthy Person Sinus Cavities 159
Figure 62 : Discover the location and role of skeletal muscles in the human body 160
Figure 63 : Human muscular system: lateral view 161
Figure 64: Striated muscle; human biceps muscle 162
Figure 65: Human muscular system: anterior view 163
Figure 66 : Human muscular system: posterior view 163
Figure 67 : Muscles of the neck; human muscle system 164
Figure 68 : Muscles of the back; human muscle system 165
Figure 69-A: A bone anatomy 168
Figure 69-B : Another bone anatomy 169
Figure 70 : Human skeletal system , Front and back views of the human skeleton 171
Figure 71 : The Metacarpus 172
Figure 72 : Human skeleton, A diagram of the human skeleton showing bone and cartilage 173
Figure 73.a: Teeth structure 174
Figure 73.b: Structure and type of Tooth 175
Figure 74.a : Life cycle of the protest Plasmodium 178

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Figure 74.b : Human red blood cells infected by Plasmodium 178
Figure 75.a : Life cycle of the tapeworm, Taenia 179
Figure 75.b : Anatomy of Taenia 180
Figure 76: Life cycle of the blood fluke Schistosoma 181
Figure 77 : Hookworm attached to an intestine wall 182
Figure 78 : Karyotype 184
Figure 79.a: A computed and generated model of DNA 185
Figure 79.b: A schematic representation of DNA replication 186
Figure 80.a: Overview of DNA structure 187
Figure 80.b: DNA replication 188
Figure 80.c: Transcription 189
Figure 80.d : Translation 190
Figure 80.e : Bacterial transformation 192
Figure 80.f: Bacterial transformation experiment 193
Figure 80.g : Equipment and procedure for gel electrophoresis 195
Figure 80.h : Protein 196
Figure 81.a : Level of organization of a polypeptide 197
Figure 81.b : -Helix structure for a protein 198
Figure 82.a, b, c: Structure of Ribose, Deoxyribose, Glucose 199
Figure 83: Starch 199
Figure 84: Chemical reaction of 3 Fats 200
Figure 85: Emulsification of fat with emulsifier 200

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LIST OF CHARTS, DIAGRAMS, AND TABLES
Chart 01: Rova&Itokiana Methodology 18
Chart 02: Negative feedback in the HPA axis 63
Diagram 03: The brain 72
Table 04 : Structures Associated with mitosis 76

Table 05: Stages in prenatal development 110

Table 06: Messenger (mRNA) Codons 190

Table 07: Electrophoresis of Protein Samples 196
Diagram 8: Nitrogen diagram 201
Table 9: Composition of some aliments 203

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 INTRODUCTION
The human system is an interaction of the heart, blood vessels, the brain, the digestive apparatus, the
respiratory apparatus, the blood, and other organs like members, muscles and bones. The input is a
complex of drilling, drainage, circulation, and the treatment of aliments. Whereas the digestive
apparatus is the assembly of organs digesting nurtures, the heart receives and sends used and treated
blood.
By the time duration, the body corps loses its activities, meaning getting olders, due to microbe
invasions or strangers agents as bad bacteries, viruses, fungus, and parasites.
Long and complex studies, research, and work are made by searchers, medicines, biologists,
engineers, technicians, practicians, scientists, teachers, leaders and genius to maintain the corps in
good health and to stop bad microbe invasions in the human body. These studies and/or work have as
target to a domain of science as (i) technical survey of the modelization and combination of medicine,
biology, biochemistry, biomechanics, biophysics, biomathematics, biotechnology, fundamental and
applied science in bio, and others.

Excellent health science and technology do not only limit to the research of aches but also looks for
pain diminution and facilitates the human life. Many disciplines of sciences and technology as those
aforementioned lead to health discipline in medicine as gynecology, cardiology, neurology,
ophthalmology, biology, anatomy, physiology, odontology, surgery, and others disciplines of sciences
and technology.

This work includes methodology or an approach called “ROVA HENINKAJA &AMBOARA ITOKIANA
RAJAONARISOA METHODOLOGY” of formulation and modelization of complicated area in - medicine,
engineering, technology, and fundamental and applied science -.
The methodology could be applied globally and specifically to deal with disease discover known as
pathology and correspondent pharmaceutic therapethy. However, the actual ultimate goal for this
work of research is to organize and plan: (i) human physiology and anatomy, and science division, (ii)
classify and forecast variables for health sciences and technology like medicine and human
engineering research, (iii) research of nutrition, dietetic, and alimentary, (iii) the environment factors
that could affect human, (iv) the risk factors for safety including security disposition.

The work is divided into:

• A first part involving methodology and research division;
• A second part showing results.

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 Part one: METHODOLOGY
Individual(s), Institutions, Establishments, Schools, Universities, Research Centers, Hospitals,
dispensaries, laboratories, acquired deepen knowledge in each specificity in biology, mechanics,
electricity, medicine, chemistry, and other disciplines applied to human. These fields known as
biology, biomechanics, biochemistry, biotechnology are very precise and accurate.

Results of those research could be seen: (i) in books, reports, reviews, collocs, conferences, work
Show ; (ii)sold directly in workshop, library, bookshop, markets, drug shop, etc, etc. ; (iii) or in course
of teachers and/or professors; (iv) or during interview with experts ; (v) or work at workplace as
universities, laboratories, schools, technical and/or general high school, professional institutions,
technological institutions, research center, institutes, hospitals, and dispensaries; (vi) at home; (vii)
other means of publications.

One of methods used to synthesize, fraction, organize, and administrate research in human health
system is the following:

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 STEP 0 : Finality, Intention, objectives or/and vision : Systemization, patternization, and health
Retro Auto 01
science and technology
Level 01p

STEP 1 : Hypothesis, sampling, patterning, and listing of variables per sciences and
technology discipline: biochemistry, biology, biomechanics, bioacoustics, biooptics,
bioelectric, bioinformatics, biomathematics, bioelectronics, bioheat, bioenergy, and others.

Variables per organ section or concern: cardiology, gastro-enterology, pneumology, blood,

blood vessels, nerves, dermatology, muscles, bones, neurology, ophthalmology, audition
apparatus, brain, gynecology, paediatrics, stomatology, rhynology, psychology, psychiatry,
and others.

Variables per disease(s): virus disease, progeny disease, accident and/or injury diseases,
parasite disease, bacteria disease, oncology (atomgenesis and/or moleculegenesis) at a
concern organ, , and others.
Retro Auto 02
Level 02p
Variables per sexes: puberty, menstruation, gestation, and others

Variables per progeny and races: genotype, phenotype, and others

Variables per environment or surrounding like dwelling, seasons, and climate: temperature,
allergen products, pressure, moisture and others

Variables per age: 0 to around one year, around one year to puberty, puberty to gestation
(For woman), gestation to infant birth, and others

Biophysical variables: weight, dimension as high, volume, width, pressure, temperature,

time, speed, force, energy, viscosity, angle, distance, frequency, magnetic flux, ion rays,
luminous intensity, time, and others. Might study concerned organ(s), body, tissues, cells.
Could interpret physical phenomenon in chemistry.

-7
Biochemical variables (see Physical variables) and start at inferior of 10 include
phenomenon: Mixture, molecule, elements, compound, atom, pH, concentration, and
others. Might study concerned organ(s), tissues, cells, and body. Could interpret chemical
phenomenon at physical level.
Retro STEP 2 : Observation and understanding of characters
Auto 03 Biological variables: Body, organs, tissues, cells, and others. See also biophysical and
Level 03p
biochemical variables.

Retro Variables
STEP per activitie(s):
3 : Formulation physical, mental activities, and others
of variables
Auto 04
Level 04p
Variables per aliments and foods (including liquid(s), gaze(s), solid(s): type, quantity, and
Retro quality
STEP 4:of foods
Experimentation, Test and/or Evaluation, Comparison if necessary
Auto 05
Level 05p
Variables per facilities, tools, and apparatus: Imagery, biology apparatus, chemistry
apparatus, mechanical apparatus, electrical apparatus, magnetic apparatus, body organs
Retro STEP 5 : Brevetage in necessary, validation in necessary case
Auto 06 and others.
Level 06p

A retro level np is a retroaction from the concerned step (n-1) to n§ ( n§ belongs to the whole number or
integer N without n, and p belongs also to the whole number)
An Auto n is a retroaction at the same step
A feedback s is a retroaction from n to m (n strictly superior m, n and m belong to the whole number)

Chart 01: Rova&Itokiana Methodology

18
Scientific vocabularies:
Retroaction: A retroaction is a scientific and/or technological action made by adding or/and deleting variables
based on its departure.
Feedback: A feedback is a scientific and/or technological action to returning from one step to another step.

19
Part two: RESULTS
0. THE INTERNAL ORGAN SYSTEM

An Organ inside the human body depends and works together with other organs. A body of a human is
an autonomous and non‐dependent health system to other human from the moment a child leaves
mother’s milk. However, due to the life of human in his or her environment, transmissible and
infectious diseases could affect him or her if he or she is reduced in antibody; and it could affect the
same group, gene, race, progeny, and family due to the mouth, the nose, the ears, the skin, the eyes,
and sex relation of human. Most of the time when it is at work or in the environment, the bad use of
materials could lead to it. When it is in environment it could be from the air, the soil, humans, animals
and plants.
To understand in some cases actions of - organs, tissues, and cells-, let focus on the homeostasis figure
01. According to the figure 01, homeostasis is the internal environment of humans, vertebrates, and
animals. The cells return waste molecules and take nutrients from fluid in the body. The lungs and the
respiratory system carry on gas exchanges. The kidneys excrete nitrogenous wastes and other
molecules. And the digestive tract adds nutrients to the blood in order to be drained in the whole
body. The command organs understand the whole organs if the concerned subject is consciencious of
and has knowledge of his or her body because there are hormones which communicate signals from
nerves organs to the brain and vis-versa.

Homeostasis is the dynamic equilibrium of the internal environment. The internal fluids are the blood
and tissue fluids that surround and pass through tissues and cells. Exchange boundaries that
exchanges substances with the external environment are located in each organ and thereby maintain
the relative constancy of the internal environment.

20
The following photo, figure 2-a and figure 2-b, show some of internal organs inside the human body
apart from the inferior members and the brain. In general, bio-scientifically and bio-technologically,
the human body could be divided into two parts: the vital needing organs called “ life needing organs”,
and the members are called “life style necessary organs “. The “ life needing organs” are in general the
head and the trunk.

Whereas some organs in the trunk like the reproductive organs could be picked out when necessary,
some could not be picked out or could work alone when they are two or more. It is clear that to stay
healthy, human should eat and breath clean air and should be in good - biological, physical and
chemical - conditions. Psychology is also needed as a human could face pshycosis under the human
stress.

The skin is an organ which cover the whole external of the body apart from the location of the eyes.
For a normal human without malformation, all of the rest of nutrients used for internal organs is sent
to the skin while all organs are formed; whereas during the genesis of the human, the skin is among
the first organs formed. The skin is among the organs the more elastic in the human body. The skin
could take different colors according to its condition called a mutation of gene. This skin could also
take its natural colors due to the gene of its integrative gene which is called derivative genes. The skin
of the whole body could be different in chemical and physical structures; that is why there are some
places of the skin where grow hair. The skin structure participates to the formation of the type of the
hair. Finally, the skin is the location of the body to protect the body against the external environment
condition like temperature and pressure.

21
22
I. DIGESTIVE TRACT AND RESPIRATORY COMBINATION
Hard palate

The hard palate is a thin horizontal bony plate made up of two bones of the facial skeleton, located in
the roof of the mouth. The bones are the palatine process of the maxilla and the horizontal plate of
palatine bone. The hard palate spans the alveolar arch formed by the alveolar process that holds the
upper teeth (when these are developed). The curved part of each alveolar process on the jaw is called
the alveolar arch. The jaw is any opposable articulated structure at the entrance of the mouth,
typically used for grasping and manipulating food. The term jaws is also broadly applied to the whole
of the structures constituting the vault of the mouth and serving to open and close it and is part of the
body plan of humans and most animals.

Figure 4. Inferior maxillary, Own work, Gregory F. Maxwell

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Epiglottis

The epiglottis is a leaf-shaped flap in the throat that prevents food from entering the windpipe and
the lungs. It stays open during breathing, allowing air into the larynx. During swallowing, it closes to
prevent aspiration of food into the lungs, forcing the swallowed liquids or food to go along the
esophagus toward the stomach instead. It is thus the valve that diverts passage to either the trachea
or the esophagus.

The epiglottis is made of elastic cartilage covered with a mucous membrane, attached to the entrance
of the larynx. It projects upwards and backwards behind the tongue and the hyoid bone.

Figure 5. Epiglottis and muscles of larynx. Posterior view.

Henry Vandyke Carter (1918) Anatomy of the Human Body / Pearson Scott Foresman

Larynx

The larynx, commonly called the voice box, is an organ in the top of the neck involved in breathing,
producing sound and protecting the trachea against food aspiration. The opening of larynx into
pharynx known as the laryngeal inlet is about 4–5 centimeters in diameter. The larynx houses the
vocal cords, and manipulates pitch and volume, which is essential for phonation. It is situated just
below where the tract of the pharynx splits into the trachea and the esophagus. The word larynx
(plural larynges) comes from a similar Ancient Greek word (λάρυγξ lárynx).

24
Figure 6. Inside Larynx Source: Toky Mahandry Rajaonarisoa , inspired from Gerazov, and at
https://en.wikipedia.org/wiki/Larynx#/media/File:Larynx.svg , Arcadian-wikipedia

Thyroid gland

The thyroid, or thyroid gland, is an endocrine gland in vertebrates. In humans it is in the neck and
consists of two connected lobes. The lower two thirds of the lobes are connected by a thin band of
tissue called the thyroid isthmus. The thyroid is located at the front of the neck, below the Adam's
apple. Microscopically, the thyroid gland secretes three hormones: the two thyroid hormones –
triiodothyronine (T3) and thyroxine (T4) – and a peptide hormone, calcitonin. The thyroid hormones
influence the metabolic rate and protein synthesis, and in children, growth and development.
Calcitonin plays a role in calcium homeostasis. Secretion of the two thyroid hormones is regulated by
thyroid-stimulating hormone (TSH), which is secreted from the anterior pituitary gland. TSH is
regulated by thyrotropin-releasing hormone (TRH), which is produced by the hypothalamus.

The thyroid gland develops in the floor of the pharynx at the base of the tongue at 3–4 weeks
gestation; it then descends in front of the pharyngeal gut, and ultimately over the next few weeks, it
migrates to the base of the neck. During migration, the thyroid remains connected to the tongue by a
narrow canal, the thyroglossal duct. At the end of the fifth week the thyroglossal duct degenerates,
and over the following two weeks the detached thyroid migrates to its final position.

25
 Figure 7: thyroid gland

Pharynx

The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and
above the oesophagus and trachea (the tubes going down to the stomach and the lungs). It is found in
vertebrates and invertebrates, though its structure varies across species. The pharynx carries food
and air to the esophagus and larynx. The flap of cartilage called the epiglottis stops food from entering
the larynx.

In humans, the pharynx is part of the digestive system and the conducting zone of the respiratory
system. (The conducting zone—which also includes the nostrils of the nose, the larynx, trachea,
bronchi, and bronchioles—filters, warms and moistens air and conducts it into the lungs). The human
pharynx is conventionally divided into three sections: the nasopharynx, oropharynx, and
laryngopharynx. It is also important in vocalization.

In humans, two sets of pharyngeal muscles form the pharynx and determine the shape of its lumen.
They are arranged as an inner layer of longitudinal muscles and an outer circular layer.

26
Glottis

Figure 9.a: Up view and external view of the Glottis

27
 Figure 9. b: Internal view or deep dissection of the Glottis

Glottis, either the space between the vocal fold and arytenoid cartilage of one side of the larynx and
those of the other side, or the structures that surround that space. See larynx. Meaning, the glottis is
the opening between the vocal folds (the rima glottidis).

28
II. CARDIOVASCULARY SYSTEM, CIRCULATORY SYSTEM
THE HEART

The heart, power organs

29
The heart is an organ composed of muscles called “cardiac muscles or myocardial muscles”. It is a
fiber of muscles with intercalated disk as shown in figure 11 a. The internal muscles are endocardium
and the external muscles are pericardium.
It is generally composed of four parts: two ventricles and two atriums: right and left. Valves are ways
of communications from an atrium to a ventricle. Those valves are called tricuspid and mitral valves
or atrioventricular valves. A valve works unidirectionally from an atrium to a ventricle. You could see
in figure 11 b, the internal parts of the heart like tissues.

Blood enters in the right vena cava at the right article and then enters to the right atrium, then gets
the right ventricle. After attempting the right ventricle, the blood is sent to the lung where the lung
puts out excessive CO2 and takes some O2. After that, the blood returns in the left atrium and passes in
the left ventricle and then send to the organism through the aorta.

The heart, the myocard is irrigated in blood by the coronary vena and artery.

The nerves systems commanding the heart contraction are autonomous in term of command. This
system is controlled by the cardiac plexus made up of sympathic and parasympathic ramifications
which transfer excitations and information from the cardio‐regulator center located in the spinal bulb.
These parts could be seen on the figure 12 and figure 13.

Inside the heart, a special tissue of automation is called “Keith and Flack nodal tissue”. The Keith and
Flack node or Keith and Flack nucleus has fusiform and cylindrical cells, with lengthened nucleus at
the middle of the cytoplasm involving a few number of myofibril. Those cells have the aspect of
muscular fibers which does not achieve embryonic development. Figure 13

At the basis of interauricular partition lays the septal nucleus. From the septal nucleus in the
interventricular partition starts a fiber bundle the “chordae tendineae”. The chordae tendineae forks
off onto two branches and continues in the internal face of each ventricle. Figure 13
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In the heart, the cardiac contraction, a wave of contraction broadcasts from the Keith and Flack
nodal to the atrium and touch ventricles to end. A hypothesis could be deduced that the node tissue
stays in embryonic state and conserves the spontaneous and rhythmic proprieties. Figure 13

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Nerves, captors and regulators of cardiac automatism

Bio-Mechanism, Bio-Automatism, and/or Bio-Function of the heart and some other organs.
The heart and its bio-mechanism, bio-automatism, and/or bio-function is autonomous in beating in
some ranges of frequency due to the Ready Self-Stocked Biochemical Substance (RSSBS) but the
frequency of beating of the heart could increase or decrease according to the situation of the subject.
That is why the transplantation of heart is possible due to RSSBS; and why when human is inactive,
the heart continues to beat.

The brain and/or the organ(s) of senses send in fact Ready in Use Biochemical Substance (RUBS)
called also: Ready in Use Chemical Mediators (RUCm) to increase or decrease in some cases the
beating of the heart. The Ready in Use Biochemical Substance (RUBS) stock, or the Ready in Use
Chemical Mediators (RUCm) stock should be found inside the blood vessel in order to not having
heart attack, high or low heart beating, some cases of low blood pressure, and some cases of high
blood pressure.

Nerve(s), Ganglion(s), blood vessel(s), all tissues, all living organisms, all organs
Those nerves are junctions:
• The ones are from the tenth pairs of skull nerves, pneumogastric nerves in which they come out
from the brain at the spinal bulb;
• The others are from the cervical dorsum in the medulla spinalis by the cervical ganglions of
orthosympathic ganglions.
All of those nervous linkages form in the cardiac region complicated nervous networks, the plexus.

The pneumogastric nerves could act on the heart due to RUBS as a moderator effect, inhibitor. The
escape phenomenon is a phenomenon of the heart signifies that inhibition action of pneumogastric on
the heart is out.

All ganglions inside the human body work as a biofilter and in the same time a biodistributor of blood
to each part of the body according to each of its place in the body. Ganglion gives axial, centripetal
or/and centrifuge motion of the blood according to:
 the viscosity of the blood;
 the quantity or/and the number or/and the concentration of: each fluid, each bacteria, each
organism, each cell, each molecule and/or each atom in each organ or/and each tissue;
 the place and position of each organism, each cell, each molecule and/or each atom in the
ganglion and/or in the blood vessel;

Therefore, a brief serial of excitation made on the star ganglion (orthosympathic) drives after a period
of latency an acceleration of the cardiac rhythm. The cardiac orthosympathic nerves seed up heart
beating. That is why, it is necessary to accelerate with apparatus the cardiac rhythm of a human who
is touched by a heart attack (cardiac arrest).

Information under axial, centripetal and/or centrifugal nervous influx from different regions of - the
circulatory apparatus, the periphery of the body, the superior nervous centers, brain - command:
arrive at the cardiac neuro‐vegetation of the spinal bulb and the spinal cord in which by its moderator
and/or its characters influence consequently the cardiac - function, biomechanism, and/or
bioautomatism - . That is why, each organ could secrete each biochemical substance. An example of
biochemical substance is discovered by T. R. Elliott in 1904; in fact, he finds that the adrenaline is a
substance which could accelerate the beating of the heart and adrenaline is from orthosympathic
cardiac nerves. Other example is in 1914 when Dale shows that acetylcholine has the same effects on

32
the heart as the pneumogastric. In addition, individual who is interested in - health sciences and
technology, biosciences, medicine, biotechnology, bioengineering, biophysics, pharmaceutics,
biochemistry, or/and bioatomic or/and bionuclear sciences and/or technology - should know the
notion of the Used State of biomatter(s) (USb). In fact, USb is the state of biomatter(s) or a substance
in each organ, tissue, or/and cell of the body of a living organism which could be Gas State (GS), Liquid
State (LS), Fluid State (FS), Solid State (SS), Blood State (BS), Bacteria State (BcS), and/or Cell State
(CS).

33
III. THE DIGESTIVE TRACT

The digestive tract is the combination of organs acting on aliments while digesting. Some of those
organs are: parotiditus, mandible, sublingual, teeth, tongue, gullet, stomach, liver, duodenum,
pancreas, kidney, intestine and/or colon, caecum, appendix, rectum, anus, spleen, and others.

Aliments are chewed by mandible, maxilla, tongue, teeth. Those organs fluidify the reaction by
chemical reactant via the parotidis gland, mandible and sublingual by saliva.
When aliments are digested by the mouth, the tongue brings nurtures to the gullet; the nurtures ass in
the stomach where aliments are brazed and digested by the gastric juice.

Some chemical reactions are followings:

Pepsin (enzyme)

Protein + Water Peptides

→

Hydrochloric acid

Amylase

Starch + Water Maltose

→
THE STOMACH
The stomach occupies the left hypochondrium. It is very mobil and placed on the superior extremity of
the left hypochondrium by the esophagus and the diaphragm. The stomach is also placed on the
inferior extremity of the left hypochondrium by the duodenum.

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The stomach is divided into two parts:
• A vertical superior part including the tuberosity and the body of the stomach ;
• An inferior part called “antrum” in which the right extremity is the pylorus. Figure 15

According to figure 14, figure 15, and figure 16, the stomach communicates with the esophagus by the
esophagus orifice or the cardia orifice at the vertebral column D11 at 2 cm of the median lign, by the
duodenal orifice or pylorus, circular, daring at the right position, behind and above of 1.5 cm of
diameter located at the right side of L1 at 3 cm at the right of the median lign.

The average dimension of the stomach is 25 cm of length, 12 cm of width, 8 cm of thickness and 1 to

1.5 liter of volume capacity. It is an internally tissues formed by the peritoneal serous membrane, the
Slanting, and longitudinal&circular muscle stratum, and mucous.

35
The gastric mucous presents two areas of secretion:
• Alkaline secretion at the antrum level;
• Developed acid secretion at the body and tuberosity;
However, a limit between those zones changes from one to another.

The stomach is surrounded by the visceral peritoneum. The omentum is formed at the little curve
linking the stomach to the spleen’s hilus and the arantius.

The gastrosplenia ligament joining the left side of the tuberosity to the spleen’s hile, is formed on the
great curve.

The gastrocolicum ligamentum links the great curve to the transversal colon. They are visceral
peritoneum.

The great tuberosity is joined with diaphragm by fibrous tissue including suspensor ligamenteum of
stomach and phrenicogastric ligamentum.

36
THE PANCREAS
The pancreas is an endocrine gland and a digestive gland with external secretion. It is linked with the
principal bile vessel and the duodenum where the excretory channels are located.
The average dimensions are 3 to 6 cm of high, 15 cm of length, 2 cm of thickness and 80 g of weight
but it might vary largely.

Figure 18. a : Location of the pancreas

37
The pancreas is an organ that makes hormones and enzymes to help digestion. The pancreas helps
break down carbohydrates, fats, and proteins. The pancreas is behind the stomach and is on the left
side of the human body.

The part of the pancreas that makes hormones is called the Islets of Langerhans. The Islets of
Langerhans are a small part (2%) of the total cells in the pancreas. The Islets of Langerhans change
which chemical they make depending on how much of other chemicals are already in the blood. So,
the pancreas works to keep the level of chemicals in balance in the body. If the Islets of Langerhans
stop working, a person will suffer from a disease called diabetes. Doctors are experimenting with
taking the Islets of Langerhans cells from a donor body and putting them into the pancreas of a person
with diabetes to make that person well.

The pancreas belongs to two systems of the body: the digestive system for its role in breaking down
nutrients, and the endocrine system for producing hormones.

The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it
is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or
heterocrine gland, i.e. it has both an endocrine and a digestive exocrine function. 99% part of pancreas
is exocrine and 1% part is endocrine. As an endocrine gland, it functions mostly to regulate blood
sugar levels, secreting the hormones insulin, glucagon, somatostatin, and pancreatic polypeptide. As a
part of the digestive system, it functions as an exocrine gland secreting pancreatic juice into the
duodenum through the pancreatic duct. This juice contains bicarbonate, which neutralizes acid
entering the duodenum from the stomach; and digestive enzymes, which break down carbohydrates,
proteins, and fats in food entering the duodenum from the stomach.

Inflammation of the pancreas is known as pancreatitis, with common causes including chronic alcohol
use and gallstones. Because of its role in the regulation of blood sugar, the pancreas is also a key organ
in diabetes mellitus. Pancreatic cancer can arise following chronic pancreatitis or due to other
reasons, and carries a very poor prognosis, as it is often identified when it has spread to other areas of
the body.

Figure 18.b : Diagram showing different functional parts of the pancreas

The pancreas is an organ that in humans lies in the abdomen, stretching from behind the stomach to
the left upper abdomen near the spleen. In adults, it is about 12–15 centimetres (4.7–5.9 in) long,
lobulated, and salmon-coloured in appearance.

38
Anatomically, the pancreas is divided into a head, neck, body, and tail. The pancreas stretches from the
inner curvature of the duodenum, where the head surrounds two blood vessels: the superior
mesenteric artery, and vein. The longest part of the pancreas, the body, stretches across behind the
stomach, and the tail of the pancreas ends adjacent to the spleen.

Two ducts, the main pancreatic duct and a smaller accessory pancreatic duct run through the body of
the pancreas. The main pancreatic duct joins with the common bile duct forming a small ballooning
called the ampulla of Vater (hepatopancreatic ampulla). This ampulla is surrounded by a muscle, the
sphincter of Oddi. This ampulla opens into the descending part of the duodenum. The opening of the
common bile duct into main pancreatic duct is controlled by sphincter of Boyden. The accessory
pancreatic duct opens into duodenum with separate openings located above the opening of the main
pancreatic duct.

Microanatomy

Figure 18.c : This image shows a pancreatic islet when pancreatic tissue is stained and viewed under a
microscope. Parts of the digestive ("exocrine") pancreas can be seen around the islet, more darkly.
These contain hazy dark purple granules of inactive digestive enzymes (zymogens).

Figure 18.d : A pancreatic islet that uses fluorescent antibodies to show the location of different cell
types in the pancreatic islet. Antibodies against glucagon, secreted by alpha cells, show their peripheral
position. Antibodies against insulin, secreted by beta cells, show the more widespread and central
position that these cells tend to have.

The pancreas contains tissue with an endocrine and exocrine role, and this division is also visible
when the pancreas is viewed under a microscope.

The majority of pancreatic tissue has a digestive role. The cells with this role form clusters (Latin:
acini) around small ducts, and are arranged in lobes that have thin fibrous walls. The cells of each
acinus secrete inactive digestive enzymes called zymogens into the small intercalated ducts which
they surround. In each acinus, the cells are pyramid-shaped and situated around the intercalated
ducts, with the nuclei resting on the basement membrane, a large endoplasmic reticulum, and a
39
number of zymogen granules visible within the cytoplasm. The intercalated ducts drain into larger
intralobular ducts within the lobule, and finally interlobular ducts. The ducts are lined by a single layer
of column-shaped cells. There is more than one layer of cells as the diameter of the ducts increases.

The tissues with an endocrine role within the pancreas exist as clusters of cells called pancreatic islets
(also called islets of Langerhans) that are distributed throughout the pancreas. Pancreatic islets
contain alpha cells, beta cells, and delta cells, each of which releases a different hormone. These cells
have characteristic positions, with alpha cells (secreting glucagon) tending to be situated around the
periphery of the islet, and beta cells (secreting insulin) more numerous and found throughout the
islet. Enterochromaffin cells are also scattered throughout the islets. Islets are composed of up to
3,000 secretory cells, and contain several small arterioles to receive blood, and venules that allow the
hormones secreted by the cells to enter the systemic circulation.

Development

Figure 18.e : Development of the pancreas

The pancreas originates from the foregut, a precursor tube to part of the digestive tract, as a dorsal and ventral bud.
As it develops, the ventral bud rotates to the other side and the two buds fuse together.

The pancreas forms during development from two buds that arise from the duodenal part of the
foregut, an embryonic tube that is a precursor to the gastrointestinal tract. It is of endodermal origin.
Pancreatic development begins with the formation of a dorsal and ventral pancreatic bud. Each joins
with the foregut through a duct. The dorsal pancreatic bud forms the neck, body, and tail of the
developed pancreas, and the ventral pancreatic bud forms the head and uncinate process.

The definitive pancreas results from rotation of the ventral bud and the fusion of the two buds. During
development, the duodenum rotates to the right, and the ventral bud rotates with it, moving to a
position that becomes more dorsal. Upon reaching its final destination, the ventral pancreatic bud is
below the larger dorsal bud, and eventually fuses with it. At this point of fusion, the main ducts of the
ventral and dorsal pancreatic buds fuse, forming the main pancreatic duct. Usually, the duct of the
dorsal bud regresses, leaving the main pancreatic duct.

Cellular development

Pancreatic progenitor cells are precursor cells that differentiate into the functional pancreatic cells,
including exocrine acinar cells, endocrine islet cells, and ductal cells. These progenitor cells are
characterised by the co-expression of the transcription factors PDX1 and NKX6-1.

40
The cells of the exocrine pancreas differentiate through molecules that induce differentiation
including follistatin, fibroblast growth factors, and activation of the Notch receptor system.
Development of the exocrine acini progresses through three successive stages. These are the
predifferentiated, protodifferentiated, and differentiated stages, which correspond to undetectable,
low, and high levels of digestive enzyme activity, respectively.

Pancreatic progenitor cells differentiate into endocrine islet cells under the influence of neurogenin-3
and ISL1, but only in the absence of notch receptor signaling. Under the direction of a Pax gene, the
endocrine precursor cells differentiate to form alpha and gamma cells. Under the direction of Pax-6,
the endocrine precursor cells differentiate to form beta and delta cells. The pancreatic islets form as
the endocrine cells migrate from the duct system to form small clusters around capillaries. This occurs
around the third month of development, and insulin and glucagon can be detected in the human fetal
circulation by the fourth or fifth month of development.

Function

The pancreas is involved in blood sugar control and metabolism within the body, and also in the
secretion of substances (collectively pancreatic juice) that help digestion. These are divided into an
"endocrine" role, relating to the secretion of insulin and other substances within pancreatic islets that
help control blood sugar levels and metabolism within the body, and an "exocrine" role, relating to the
secretion of enzymes involved in digesting substances in the digestive tract.

Blood glucose regulation

Cells within the pancreas help to maintain blood glucose levels (homeostasis). The cells that do this
are located within the pancreatic islets that are present throughout the pancreas. When blood glucose
levels are low, alpha cells secrete glucagon, which increases blood glucose levels. When blood glucose
levels are high beta cells secrete insulin to decrease glucose in blood. Delta cells in the islet also
secrete somatostatin which decreases the release of insulin and glucagon.

Glucagon acts to increase glucose levels by promoting the creation of glucose and the breakdown of
glycogen to glucose in the liver. It also decreases the uptake of glucose in fat and muscle. Glucagon
release is stimulated by low blood glucose or insulin levels, and during exercise. Insulin acts to
decrease blood glucose levels by facilitating uptake by cells (particularly skeletal muscle), and
promoting its use in the creation of proteins, fats and carbohydrates. Insulin is initially created as a
precursor form called preproinsulin. This is converted to proinsulin and cleaved by C-peptide to
insulin which is then stored in granules in beta cells. Glucose is taken into the beta cells and degraded.
The end effect of this is to cause depolarisation of the cell membrane which stimulates the release of
the insulin.

The main factor influencing the secretion of insulin and glucagon are the levels of glucose in blood
plasma. Low blood sugar stimulates glucagon release, and high blood sugar stimulates insulin release.
Other factors also influence the secretion of these hormones. Some amino acids, that are byproducts of
the digestion of protein, stimulate insulin and glucagon release. Somatostatin acts as an inhibitor of
both insulin and glucagon. The autonomic nervous system also plays a role. Activation of Beta-2
receptors of the sympathetic nervous system by catecholamines secreted from sympathetic nerves
stimulates secretion of insulin and glucagon, whereas activation of Alpha-1 receptors inhibits
secretion. M3 receptors of the parasympathetic nervous system act when stimulated by the right
vagus nerve to stimulate release of insulin from beta cells.

41
Digestion

Figure 18. f : Anatomy & Physiology of the pancreas, OpenStax College,

http://cnx.org/content/col11496/1.6/, June 19, 2013.

The pancreas has a role in digestion, highlighted here. Ducts in the pancreas (green) conduct digestive enzymes into
the duodenum. This image also shows a pancreatic islet, part of the endocrine pancreas, which contains cells
responsible for secretion of insulin and glucagon.

The pancreas plays a vital role in the digestive system. It does this by secreting a fluid that contains
digestive enzymes into the duodenum, the first part of the small intestine that receives food from the
stomach. These enzymes help to break down carbohydrates, proteins and lipids (fats). This role is
called the "exocrine" role of the pancreas. The cells that do this are arranged in clusters called acini.
Secretions into the middle of the acinus accumulate in intralobular ducts, which drain to the main
pancreatic duct, which drains directly into the duodenum. About 1.5 - 3 liters of fluid are secreted in
this manner every day.

The cells in each acinus are filled with granules containing the digestive enzymes. These are secreted
in an inactive form termed zymogens or proenzymes. When released into the duodenum, they are
activated by the enzyme enterokinase present in the lining of the duodenum. The proenzymes are
cleaved, creating a cascade of activating enzymes.

 Enzymes that break down proteins begin with activation of trypsinogen to trypsin. The free trypsin then
cleaves the rest of the trypsinogen, as well as chymotrypsinogen to its active form chymotrypsin.
 Enzymes secreted involved in the digestion of fats include lipase, phospholipase A2, lysophospholipase, and
cholesterol esterase.
 Enzymes that break down starch and other carbohydrates include amylase.

These enzymes are secreted in a fluid rich in bicarbonate. Bicarbonate helps maintain an alkaline pH
for the fluid, a pH in which most of the enzymes act most efficiently, and also helps to neutralise the
stomach acids that enter the duodenum. Secretion is influenced by hormones including secretin,
cholecystokinin, and VIP, as well as acetylcholine stimulation from the vagus nerve. Secretin is
released from the S cells which form part of the lining of the duodenum in response to stimulation by

42
gastric acid. Along with VIP, it increases the secretion of enzymes and bicarbonate. Cholecystokinin is
released from Ito cells of the lining of the duodenum and jejunum mostly in response to long chain
fatty acids, and increases the effects of secretin. At a cellular level, bicarbonate is secreted from the
acinar cells through a sodium and bicarbonate cotransporter that acts because of membrane
depolarisation caused by the cystic fibrosis transmembrane conductance regulator. Secretin and VIP
act to increase the opening of the cystic fibrosis transmembrane conductance regulator, which leads
to more membrane depolarisation and more secretion of bicarbonate.

A variety of mechanisms act to ensure that the digestive action of the pancreas does not act to digest
pancreatic tissue itself. These include the secretion of inactive enzymes (zymogens), the secretion of
the protective enzyme trypsin inhibitor, which inactivates trypsin, the changes in pH that occur with
bicarbonate secretion that stimulate digestion only when the pancreas is stimulated, and the fact that
the low calcium within cells causes inactivation of trypsin.

Additional functions

The pancreas also secretes vasoactive intestinal peptide and pancreatic polypeptide. Enterochromaffin cells
of the pancreas secrete the hormones motilin, serotonin, and substance P.

Removal

It is possible for a person to live without a pancreas, provided that the person takes insulin for proper
regulation of blood glucose concentration and pancreatic enzyme supplements to aid digestion.

History

The pancreas was first identified by Herophilus (335–280 BC), a Greek anatomist and surgeon. A few
hundred years later, Rufus of Ephesus, another Greek anatomist, gave the pancreas its name.
Etymologically, the term "pancreas", a modern Latin adaptation of Greek πάγκρεας, [πᾶν ("all", "whole"),
and κρέας ("flesh")], originally means sweetbread, although literally meaning all-flesh, presumably because
of its fleshy consistency. It was only in 1889 when Oskar Minkowski discovered that removing the pancreas
from a dog caused it to become diabetic. Insulin was later isolated from pancreatic islets by Frederick
Banting and Charles Herbert Best in 1921.

The way the tissue of the pancreas has been viewed has also changed. Previously, it was viewed using
simple staining methods such as H&E stains. Now, immunohistochemistry can be used to more easily
differentiate cell types. This involves visible antibodies to the products of certain cell types, and helps
identify with greater ease cell types such as alpha and beta cells.

43
 Figure 18.g : Pancreas as seen on abdominal ultrasonography

THE COMMON BILE VESSEL

It is constituted by the hepatic channel which follows in the hilus of the liver to the common hepatic
duct, doctus choedochus, formed by the union of hepatic duct and the cystic duct. It is eight cm of
length in general.

44
Figure 19. a: The common bile vessel

Figure 19.b : Diagram of the biliary tree showing the common bile duct

45
1. Bile ducts: 2. Intrahepatic bile ducts, 3. Left and right hepatic ducts, 4. Common hepatic duct, 5. Cystic duct, 6.
Common bile duct, 7. Ampulla of Vater, 8. Major duodenal papilla
9. Gallbladder, 10–11. Right and left lobes of liver. 12. Spleen. 13. Esophagus. 14. Stomach. 15. Pancreas: 16.
Accessory pancreatic duct, 17. Pancreatic duct. 18. Small intestine: 19. Duodenum, 20. Jejunum 21–22. Right and left
kidneys.
Figure 19 c : The front border of the liver has been lifted up (brown arrow).

The common bile duct, sometimes abbreviated CBD, is a duct in the gastrointestinal tract of
organisms that have a gallbladder. It is formed by the union of the common hepatic duct and the cystic
duct (from the gallbladder). It is later joined by the pancreatic duct to form the ampulla of Vater.
There, the two ducts are surrounded by the muscular sphincter of Oddi.

When the sphincter of Oddi is closed, newly synthesized bile from the liver is forced into storage in
the gallbladder. When open, the stored and concentrated bile exits into the duodenum. This
conduction of bile is the main function of the common bile duct. The hormone cholecystokinin, when
stimulated by a fatty meal, promotes bile secretion by increased production of hepatic bile,
contraction of the gallbladder, and relaxation of the sphincter of Oddi.

Clinical significance

Several problems can arise within the common bile duct. A diameter of more than 8 mm is regarded as
abnormal dilatation and is a sign of cholestasis.

Diameter in adult

Normal ≤ 8 mm

Mild dilatation 8 – 12 mm

46
Moderate dilatation 12 – 16 mm

Severe dilatation 16 – 20 mm

Extremely severe dilatation >20 mm

It normally gets slightly dilated after cholecystectomy, with upper limit (95% prediction interval)
being about 10 mm after a few months.

On abdominal ultrasonography, the common bile duct is generally seen most readily in the perihilar
area (the border area between the common hepatic duct and the CBD, by the hilum of the liver). The
absence of Doppler signal distinguishes it from the portal vein and hepatic artery.

Figure 19 d : Borderline of a dilated perihilar bile duct, measuring 8 mm.

Figure 19 e: Dilatation of CBD due to Ampullary tumor.

47
If clogged by a gallstone, a condition called choledocholithiasis can result. In this clogged state, the duct is
especially vulnerable to an infection called ascending cholangitis. One form of treatment is a
cholecystenterostomy. Very rare deformities of the common bile duct are cystic dilations (4 cm),
choledochoceles (cystic dilation of the ampula of Vater (3–8 cm)), and biliary atresia.

History

Blockage of the common bile duct and related jaundice has been documented since at least since the time of
Erasistratus.

LIVER
The liver lies in the upper right quadrant of the abdominal cavity under the diaphragm fig. 20. The
liver has two main lobes: the right lobe and the left lobe. The lobes are divided into lobules which
contain the cell of the liver, called hepatic cells.

Hepatic cells are small blood vessels that transport blood out of the liver in the hepatic vein.
The liver produces urea. It is the gatekeeper of the blood. The liver regulates blood composition. It
stores glucose as glycogen, and then releases glucose to keep the “blood glucose concentration” at
about 0.1%.

The liver stores excess of glucose as glycogen. Glycogen is broken down by liver cells to produce
glucose, and this glucose enters the bloodstream.
Insulin, the hormone made by pancreas, promotes the uptake and storage of glucose in the liver. The
hormone glucagon promotes the breakdown of glycogen and the release of glucose.

48
RECOMMENDATIONS

Know that your, - alimentary, nurtures, foods or diet - , enter(s) in your mouth and it will be digested
by the stomach, and your teeth will help you to break the aliments; Enzymes inside the saliva or the
saliva juice will be sent from the salivary gland inside your mouth to break the food. -The Chloride
acid, other acids, and digestive juices- are sent into the stomach to break the foods, and to mix the
foods. The mixing of the foods is accelerated by the “stomach beating”.
The movement of stomach is commanded by the brain, by an automatic movement due to the
detection of aliment (food and liquid) inside the digestive tract and by a repeating natural movement;
it appears that this motion is like the heart movement. In fact, it moves all the time but the frequency
differs largely, or simply “largely variable frequency”, according to the situation and it is very difficult
from the moment to hear from bioapparatus and to quantify this movement of the stomach called:
“Stomach beating”. To add it, most of all organs inside the body make movement apart from bone
which could make a negligible movement compared to its shape (source: Toky Mahandry
Rajaonarisoa). The saliva could break partly or totally some nurtures like candy, cooked rice,
chocolate, poisson and others when you make move your tongue and press the aliment with your
tongue and the hard palate and if you spend time for nurture breaking inside your mouth.
To understand the function of epiglottis, sphincter and chyme which are in oesophagus and in small
intestine, you could visit the https://www.niddk.nih.gov/health-information/digestive-
diseases/digestive-system-how-it-works

When the,- foods and liquid-, enter the first part of the small intestine, the phenomenon of “intestine
transit” begins. The phenomenon of “intestine transit” is made up of:
 the acts of intestinal flora or intestinal microbiota( a set of microorganisms presents in the
side of the intestine wall where the food and water are passing through the length of the
intestine and ended at the anus);
 the different movements like contraction of muscles of the small intestine;
 the small intestine state of surface or small intestine rugosity;
 osmosis phenomenon;
 and other stochastic phenomenon. (Source: Toky Mahandry Rajaonarisoa)

All of them, make pumping: the liquid, a part of the mix food, and digestive juices from the pancreas
and liver. The general shape of intestine regulates the debit of foods and liquid in the intestine which
make axial movement (forward motion and sometimes a little backward motion) of mixed food and
liquid, and centripete or/and centrifuge movement of the food and liquid according to the movement
of the intestine. ( Source: Toky Mahandry Rajaonarisoa)
The biochemical composition and structure, atom agency, temperature, number of each molecules and
atoms present at the right place, of the foods and liquid are also necessary and preponderant to all of
phenomenon of the intestinale transit. (Source: Toky Mahandry Rajaonarisoa)

Like in the stomach and in the small intestine, there are some unused cells and biomaterials which
take off from the organ walls and taken forward (sometimes backward) by the mixture of nurtures
plus liquid plus digestive liquid through its passage. All of the aforementioned said biomaterials and
cells in the above phrase go at the place where each of them is pumped or/and pushed according to:
forces of axial streaming, forces of pumping, internal forces of the foods and liquid, temperature of
the food, temperature of the intestine, characteristics of the intestine like the number of porosity and
its size while in condition of elasticity, and other stochastics situations or phenomenon. Do not also
forget that gaze might exist: in nurtures, in the chemical transformation inside the body, and sent by
microorganisms, and through the atmospheric condition; gaze might also enter through the
49
biochemical structure of the skin and gaze might traverse from its place (for example from the
external environment) to the intestine places. (Source: Toky Mahandry Rajaonarisoa)
In the large intestine, the same phenomenon, conditions, or/and situations as in small intestine
appear. (Source: Toky Mahandry Rajaonarisoa)

That are how work, - the mucosa, the submucosa, the muscularis , and the serosa-, in various layers of
the intestinal wall. Have a look at the following figure of the intestine.

50
IV. RESPIRATORY SYSTEM AND LUNG

Figure 22 : The Respiratory system

LUNGS

Lungs are located in the thoracic cavity with the heart upon the diaphragm figure 2-a, figure 2-b,
figure 22. The lung is a spongy organ named alveoli seen on figure 23. It is irregularly shaped air
spaces. The alveoli are surrounded by pulmonary capillaries, a rich network of tiny vessels. The lungs
are a single layer of squamous epithelium tissue. They are supported by a mesh of fine elastic fiber.

51
Gaze enter inside the nose orifices and pass the trachea, bronchi, bronchioles, the lungs, the blood
vessels; and finally reach cells , tissues and organs of the body. Figure 22.

Gaze exchanges in the lung

It is a fluid mechanism respecting the living convection, living temperature conduction and living
thermal radiation laws with matter’s transportation and state change. The diffusion of gaze through a
permeable lining the alveolis to the simple squamous epithelial cells, permits the respiratory
exchanges in the lungs and in the tissues. Human has a large surface superior of 150 m² of pulmonary
alveolis walls and blood capillary in the lung.

Oxygen motion
Whereas the partial pression of oxygen in the alveolis is at an average of 103 mm of mercury; the
pression of the blood inside the lung is 40 mm of mercury. The oxygen diffuses, from the alveolis to
the lung, blood capillaries; in addition, oxygen is dissolved in the plasma. And finally, it combines with
hemoglobin to form the oxyhemoglobin.

Carbon dioxide
The partial pressure of carbon dioxide in the blood arriving at the lung is at an average of 46 mm of
mercure; the partial pressure in the alveolis is at 40 mm of mercury. The carbon dioxide moves from
the blood to the alveolus. It is the carbon dioxide dissolved in the plasma which leaves the blood. Its
departure motion brings the dissociation of the following carbonated compounds of the blood:
hemoglobin carbonate, HKCO3, HNaCO3. In other words, the dissociated carbon gaze plus other gazes
arrive in the plasma with other molecules and atoms; and then by diffusion, they enter into the empty
spaces of the alveolis.

As illustration, carbon dioxide is carried in the blood as bicarbonate ions:

CO2+H2O → H2CO3 → HCO3 +H+

Carbonic acid Bicarbonate ion

52
Color of the blood and organs and shape of organs
The blood which leaves the lungs to the left atrium of the heart, in the pulmonary vena, is around
reddish depending on race and progeny, and input. In fact, PRGG (Progeny, Race, Genomes, and/or
Genetics) could be find inside organs, tissues, and cells like: the lungs, spinal cord, the skins, and
others.

53
V. KIDNEY SYSTEM
Generality
The kidneys have a form of beans. It (They) is an organ located in the abdominal cavity along the
dorsal wall.
It has three portions: 1./ the renal cortex, a granular region, 2./ the renal medulla, a pyramid form, 3./
and the renal pelvis, where urine collects. A kidney, viewed by microscope, contains millions of
nephrons. Fig. 24

The efferent arteriole grows, leaves, and tends from the glomerular capsule called Bowman’s capsule;
then enters the peritubular capillary network that surrounding the proximal convoluted tubule, the
loop of the nephron (loop of Henle), and the distal convoluted tubule. Distal convoluted tubules from
several nephrons enter one collecting duct.

The kidney is an organ of urinary apparatus of vertebrates. It has multiple functions: hormonals, the
regulation of the blood pressure and eliminate toxins. It works then, by filtration and for urine
excretion, of the hydro-electrolytic equilibrium of the blood and for the organism in general.

Figure 24.a : a single anatomy of kidney

54
55
Kidney function: (See Fig. 25.a)

The kidney contributes to homeostasis by excreting nitrogenous waste and other wastes, and by
regulating blood volume and pH.

Urine formation requires three steps:

1. Glomerular filtration requires the movement of molecules from the glomerulus to the inside of the
glomerular capsule.
2. Tubular reabsorption requires the movement of molecules from the proximal convoluted tubule to
the peritubular capillary network.
3. Tubular secretion requires the movement of molecules from the peritubular capillary network to
the distal convoluted tubule.

The two parts not considered in this discussion, - the loop of the nephron and the collecting duct-, are
both active in water reabsorption. Regulation of water reabsorption maintains blood volume at the
proper level.

Figure 25.b : Urine formation

Glomerular Filtration

Substances entering the glomerulus with proteins, glucose, amino acids, salts, urea, others, and water.
Blood

pressure causes small molecules of glucose, amino acids, salts, urea, and water to exit the blood and
enter the glomerular capsule. The fluid in the glomerular capsule is called the filtrate.

Tubular reabsorption

When the filtrate enters the proximal convoluted tubule, it contains water, glucose, amino acids, urea,
and salts. Enough water, salts, and other substances like acid(s) are passively reabsorbed to maintain
blood volume and pH.
56
Tubular Secretion

Tubular secretion occurs primarly at the distal convoluted tubule. During tubular secretion, certain
substances- for example, penicillin and histamine- are actively secreted from the peritubular capillary
into the fluid of the tubule. Also, hydrogen ions and ammonia are secreted as required.

57
VI. ADRENAL GLAND

Figure 26.a : Adrenal gland, EEOC

The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety
of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the
kidneys. Each gland has an outer cortex which produces steroid hormones and an inner medulla. The
adrenal cortex itself is divided into three main zones: the zona glomerulosa, the zona fasciculata and
the zona reticularis.

The adrenal cortex produces three main types of steroid hormones: mineralocorticoids,
glucocorticoids, and androgens. Mineralocorticoids (such as aldosterone) produced in the zona
glomerulosa help in the regulation of blood pressure and electrolyte balance. The glucocorticoids
cortisol and cortisone are synthesized in the zona fasciculata; their functions include the regulation of
metabolism and immune system suppression. The innermost layer of the cortex, the zona reticularis,
produces androgens that are converted to fully functional sex hormones in the gonads and other
target organs. The production of steroid hormones is called steroidogenesis, and involves a number of
reactions and processes that take place in cortical cells. The medulla produces the catecholamines,
which function to produce a rapid response throughout the body in stress situations.

A number of endocrine diseases involve dysfunctions of the adrenal gland. Overproduction of cortisol
leads to Cushing's syndrome, whereas insufficient production is associated with Addison's disease.
Congenital adrenal hyperplasia is a genetic disease produced by dysregulation of endocrine control
mechanisms. A variety of tumors can arise from adrenal tissue and are commonly found in medical
imaging when searching for other diseases.

Structure

Figure 26.b: Adrenal glands, anterior (left) and posterior (right) surface. Mikael Häggström,
M.D

58
The adrenal glands are located on both sides of the body in the retroperitoneum, above and slightly
medial to the kidneys. In humans, the right adrenal gland is pyramidal in shape, whereas the left is
semilunar or crescent shaped and somewhat larger. The adrenal glands measure approximately 3 cm
in width, 5.0 cm in length, and up to 1.0 cm in thickness. Their combined weight in an adult human
ranges from 7 to 10 grams. The glands are yellowish in colour.

The adrenal glands are surrounded by a fatty capsule and lie within the renal fascia, which also
surrounds the kidneys. A weak septum (wall) of connective tissue separates the glands from the
kidneys. The adrenal glands are directly below the diaphragm, and are attached to the crura of the
diaphragm by the renal fascia.

Each adrenal gland has two distinct parts, each with a unique function, the outer adrenal cortex and
the inner medulla, both of which produce hormones.

Adrenal cortex

Figure 26.c : Section of human adrenal gland under the microscope, showing its different
layers, Jpogi

From the surface to the center: zona glomerulosa, zona fasciculata, zona reticularis, medulla. In the
medulla, the central adrenomedullary vein is visible.

The adrenal cortex is the outer region and also the largest part of an adrenal gland. It is divided into
three separate zones: zona glomerulosa, zona fasciculata and zona reticularis. Each zone is
responsible for producing specific hormones. The adrenal cortex is the outermost layer of the adrenal
gland. Within the cortex are three layers, called "zones". When viewed under a microscope each layer
has a distinct appearance, and each has a different function. The adrenal cortex is devoted to
production of hormones, namely aldosterone, cortisol, and androgens.

59
Zona glomerulosa

The outermost zone of the adrenal cortex is the zona glomerulosa. It lies immediately under the
fibrous capsule of the gland. Cells in this layer form oval groups, separated by thin strands of
connective tissue from the fibrous capsule of the gland and carry wide capillaries.

This layer is the main site for production of aldosterone, a mineralocorticoid, by the action of the
enzyme aldosterone synthase. Aldosterone plays an important role in the long-term regulation of
blood pressure.

Zona fasciculata

The zona fasciculata is situated between the zona glomerulosa and zona reticularis. Cells in this layer
are responsible for producing glucocorticoids such as cortisol. It is the largest of the three layers,
accounting for nearly 80% of the volume of the cortex. In the zona fasciculata, cells are arranged in
columns radially oriented towards the medulla. Cells contain numerous lipid droplets, abundant
mitochondria and a complex smooth endoplasmic reticulum.

Zona reticularis

The innermost cortical layer, the zona reticularis, lies directly adjacent to the medulla. It produces
androgens, mainly dehydroepiandrosterone (DHEA), DHEA sulfate (DHEA-S), and androstenedione
(the precursor to testosterone) in humans. Its small cells form irregular cords and clusters, separated
by capillaries and connective tissue. The cells contain relatively small quantities of cytoplasm and lipid
droplets, and sometimes display brown lipofuscin pigment.

Medulla

The adrenal medulla is at the centre of each adrenal gland, and is surrounded by the adrenal cortex.
The chromaffin cells of the medulla are the body's main source of the catecholamines, such as
adrenaline and noradrenaline, released by the medulla. Approximately 20% noradrenaline
(norepinephrine) and 80% adrenaline (epinephrine) are secreted here.

The adrenal medulla is driven by the sympathetic nervous system via preganglionic fibers originating
in the thoracic spinal cord, from vertebrae T5–T11. Because it is innervated by preganglionic nerve
fibers, the adrenal medulla can be considered as a specialized sympathetic ganglion. Unlike other
sympathetic ganglia, however, the adrenal medulla lacks distinct synapses and releases its secretions
directly into the blood.

Blood supply

The adrenal glands have one of the greatest blood supply rates per gram of tissue of any organ: up to
60 small arteries may enter each gland. Three arteries usually supply each adrenal gland:

 The superior suprarenal artery, a branch of the inferior phrenic artery

 The middle suprarenal artery, a direct branch of the abdominal aorta
 The inferior suprarenal artery, a branch of the renal artery

These blood vessels supply a network of small arteries within the capsule of the adrenal glands. Thin
strands of the capsule enter the glands, carrying blood to them.

Venous blood is drained from the glands by the suprarenal veins, usually one for each gland:

60
  The right suprarenal vein drains into the inferior vena cava
 The left suprarenal vein drains into the left renal vein or the left inferior phrenic vein.

The central adrenomedullary vein, in the adrenal medulla, is an unusual type of blood vessel. Its
structure is different from the other veins in that the smooth muscle in its tunica media (the middle
layer of the vessel) is arranged in conspicuous, longitudinally oriented bundles.

Variability

The adrenal glands may not develop at all, or may be fused in the midline behind the aorta. These are
associated with other congenital abnormalities, such as failure of the kidneys to develop, or fused
kidneys. The gland may develop with a partial or complete absence of the cortex, or may develop in an
unusual location.

Function

Figure 26.d : Different hormones are produced in different zones of the cortex and medulla of the gland.
Light microscopy at magnification × 204, OpenStax College

The adrenal gland secretes a number of different hormones which are metabolised by enzymes either
within the gland or in other parts of the body. These hormones are involved in a number of essential
biological functions.

Corticosteroids

Corticosteroids are a group of steroid hormones produced from the cortex of the adrenal gland, from
which they are named.

 Mineralocorticoids such as aldosterone regulate salt ("mineral") balance and blood volume.
 Glucocorticoids such as cortisol influence metabolism rates of proteins, fats and sugars
("glucose").
 Androgens such as dehydroepiandrosterone.

Mineralocorticoids

The adrenal gland produces aldosterone, a mineralocorticoid, which is important in the regulation of
salt ("mineral") balance and blood volume. In the kidneys, aldosterone acts on the distal convoluted
tubules and the collecting ducts by increasing the reabsorption of sodium and the excretion of both
potassium and hydrogen ions. Aldosterone is responsible for the reabsorption of about 2% of filtered
glomerular filtrate. Sodium retention is also a response of the distal colon and sweat glands to
aldosterone receptor stimulation. Angiotensin II and extracellular potassium are the two main
61
regulators of aldosterone production. The amount of sodium present in the body affects the
extracellular volume, which in turn influences blood pressure. Therefore, the effects of aldosterone in
sodium retention are important for the regulation of blood pressure.

Glucocorticoids

Cortisol is the main glucocorticoid in humans. In species that do not create cortisol, this role is played
by corticosterone instead. Glucocorticoids have many effects on metabolism. As their name suggests,
they increase the circulating level of glucose. This is the result of an increase in the mobilization of
amino acids from protein and the stimulation of synthesis of glucose from these amino acids in the
liver. In addition, they increase the levels of free fatty acids, which cells can use as an alternative to
glucose to obtain energy. Glucocorticoids also have effects unrelated to the regulation of blood sugar
levels, including the suppression of the immune system and a potent anti-inflammatory effect. Cortisol
reduces the capacity of osteoblasts to produce new bone tissue and decreases the absorption of
calcium in the gastrointestinal tract.

The adrenal gland secretes a basal level of cortisol but can also produce bursts of the hormone in
response to adrenocorticotropic hormone (ACTH) from the anterior pituitary. Cortisol is not evenly
released during the day – its concentrations in the blood are highest in the early morning and lowest
in the evening as a result of the circadian rhythm of ACTH secretion. Cortisone is an inactive product
of the action of the enzyme 11β-HSD on cortisol. The reaction catalyzed by 11β-HSD is reversible,
which means that it can turn administered cortisone into cortisol, the biologically active hormone.

Formation

Figure 26-e : Steroidogenesis in the adrenal glands – different steps occur in different layers of
the gland

62
All corticosteroid hormones share cholesterol as a common precursor. Therefore, the first step in
steroidogenesis is cholesterol uptake or synthesis. Cells that produce steroid hormones can acquire
cholesterol through two paths. The main source is through dietary cholesterol transported via the
blood as cholesterol esters within low density lipoproteins (LDL). LDL enters the cells through
receptor-mediated endocytosis. The other source of cholesterol is synthesis in the cell's endoplasmic
reticulum. Synthesis can compensate when LDL levels are abnormally low. In the lysosome,
cholesterol esters are converted to free cholesterol, which is then used for steroidogenesis or stored
in the cell.

The initial part of conversion of cholesterol into steroid hormones involves a number of enzymes of
the cytochrome P450 family that are located in the inner membrane of mitochondria. Transport of
cholesterol from the outer to the inner membrane is facilitated by steroidogenic acute regulatory
protein and is the rate-limiting step of steroid synthesis.

The layers of the adrenal gland differ by function, with each layer having distinct enzymes that
produce different hormones from a common precursor. The first enzymatic step in the production of
all steroid hormones is cleavage of the cholesterol side chain, a reaction that forms pregnenolone as a
product and is catalyzed by the enzyme P450scc, also known as cholesterol desmolase. After the
production of pregnenolone, specific enzymes of each cortical layer further modify it. Enzymes
involved in this process include both mitochondrial and microsomal P450s and hydroxysteroid
dehydrogenases. Usually a number of intermediate steps in which pregnenolone is modified several
times are required to form the functional hormones. Enzymes that catalyze reactions in these
metabolic pathways are involved in a number of endocrine diseases. For example, the most common
form of congenital adrenal hyperplasia develops as a result of deficiency of 21-hydroxylase, an
enzyme involved in an intermediate step of cortisol production.

Regulation

Chart 02: Negative feedback in the HPA axis, DRosenbach

Glucocorticoids are under the regulatory influence of the hypothalamus-pituitary-adrenal (HPA) axis.
Glucocorticoid synthesis is stimulated by adrenocorticotropic hormone (ACTH), a hormone released
into the bloodstream by the anterior pituitary. In turn, production of ACTH is stimulated by the
presence of corticotropin-releasing hormone (CRH), which is released by neurons of the
hypothalamus. ACTH acts on the adrenal cells first by increasing the levels of StAR within the cells,
and then of all steroidogenic P450 enzymes. The HPA axis is an example of a negative feedback
system, in which cortisol itself acts as a direct inhibitor of both CRH and ACTH synthesis. The HPA axis
also interacts with the immune system through increased secretion of ACTH at the presence of certain
molecules of the inflammatory response.

63
Mineralocorticoid secretion is regulated mainly by the renin–angiotensin–aldosterone system (RAAS),
the concentration of potassium, and to a lesser extent the concentration of ACTH. Sensors of blood
pressure in the juxtaglomerular apparatus of the kidneys release the enzyme renin into the blood,
which starts a cascade of reactions that lead to formation of angiotensin II. Angiotensin receptors in
cells of the zona glomerulosa recognize the substance, and upon binding they stimulate the release of
aldosterone.

Androgens

Cells in zona reticularis of the adrenal glands produce male sex hormones, or androgens, the most
important of which is DHEA. In general, these hormones do not have an overall effect in the male
body, and are converted to more potent androgens such as testosterone and DHT or to estrogens
(female sex hormones) in the gonads, acting in this way as a metabolic intermediate.

Catecholamines

Primarily referred to in the United States as epinephrine and norepinephrine, adrenaline and
noradrenaline are catecholamines, water-soluble compounds that have a structure made of a catechol
group and an amine group. The adrenal glands are responsible for most of the adrenaline that
circulates in the body, but only for a small amount of circulating noradrenaline. These hormones are
released by the adrenal medulla, which contains a dense network of blood vessels. Adrenaline and
noradrenaline act at adrenoreceptors throughout the body, with effects that include an increase in
blood pressure and heart rate. actions of adrenaline and noradrenaline are responsible for the fight or
flight response, characterised by a quickening of breathing and heart rate, an increase in blood
pressure, and constriction of blood vessels in many parts of the body.

Formation

Catecholamines are produced in chromaffin cells in the medulla of the adrenal gland, from tyrosine, a
non-essential amino acid derived from food or produced from phenylalanine in the liver. The enzyme
tyrosine hydroxylase converts tyrosine to L-DOPA in the first step of catecholamine synthesis. L-DOPA
is then converted to dopamine before it can be turned into noradrenaline. In the cytosol,
noradrenaline is converted to epinephrine by the enzyme phenylethanolamine N-methyltransferase
(PNMT) and stored in granules. Glucocorticoids produced in the adrenal cortex stimulate the
synthesis of catecholamines by increasing the levels of tyrosine hydroxylase and PNMT.

Catecholamine release is stimulated by the activation of the sympathetic nervous system. Splanchnic
nerves of the sympathetic nervous system innervate the medulla of the adrenal gland. When activated,
it evokes the release of catecholamines from the storage granules by stimulating the opening of
calcium channels in the cell membrane.

Gene and protein expression

The human genome includes approximately 20,000 protein coding genes and 70% of these genes are
expressed in the normal adult adrenal glands. Only some 250 genes are more specifically expressed in
the adrenal glands compared to other organs and tissues. The adrenal-gland-specific genes with the
highest level of expression include members of the cytochrome P450 superfamily of enzymes.
Corresponding proteins are expressed in the different compartments of the adrenal gland, such as
CYP11A1, HSD3B2 and FDX1 involved in steroid hormone synthesis and expressed in cortical cell
layers, and PNMT and DBH involved in noradrenaline and adrenaline synthesis and expressed in the
medulla.

64
Development

The adrenal glands are composed of two heterogenous types of tissue. In the center is the adrenal
medulla, which produces adrenaline and noradrenaline and releases them into the bloodstream, as
part of the sympathetic nervous system. Surrounding the medulla is the cortex, which produces a
variety of steroid hormones. These tissues come from different embryological precursors and have
distinct prenatal development paths. The cortex of the adrenal gland is derived from mesoderm,
whereas the medulla is derived from the neural crest, which is of ectodermal origin.

The adrenal glands in a newborn baby are much larger as a proportion of the body size than in an
adult. For example, at age three months the glands are four times the size of the kidneys. The size of
the glands decreases relatively after birth, mainly because of shrinkage of the cortex. The cortex,
which almost completely disappears by age 1, develops again from age 4–5. The glands weigh about 1
g at birth and develop to an adult weight of about 4 grams each. In a fetus the glands are first
detectable after the sixth week of development.

Cortex

Adrenal cortex tissue is derived from the intermediate mesoderm. It first appears 33 days after
fertilisation, shows steroid hormone production capabilities by the eighth week and undergoes rapid
growth during the first trimester of pregnancy. The fetal adrenal cortex is different from its adult
counterpart, as it is composed of two distinct zones: the inner "fetal" zone, which carries most of the
hormone-producing activity, and the outer "definitive" zone, which is in a proliferative phase. The
fetal zone produces large amounts of adrenal androgens (male sex hormones) that are used by the
placenta for estrogen biosynthesis. Cortical development of the adrenal gland is regulated mostly by
ACTH, a hormone produced by the pituitary gland that stimulates cortisol synthesis. During
midgestation, the fetal zone occupies most of the cortical volume and produces 100–200 mg/day of
DHEA-S, an androgen and precursor of both androgens and estrogens (female sex hormones). Adrenal
hormones, especially glucocorticoids such as cortisol, are essential for prenatal development of
organs, particularly for the maturation of the lungs. The adrenal gland decreases in size after birth
because of the rapid disappearance of the fetal zone, with a corresponding decrease in androgen
secretion.

Adrenarche

During early childhood androgen synthesis and secretion remain low, but several years before
puberty (from 6–8 years of age) changes occur in both anatomical and functional aspects of cortical
androgen production that lead to increased secretion of the steroids DHEA and DHEA-S. These
changes are part of a process called adrenarche, which has only been described in humans and some
other primates. Adrenarche is independent of ACTH or gonadotropins and correlates with a
progressive thickening of the zona reticularis layer of the cortex. Functionally, adrenarche provides a
source of androgens for the development of axillary and pubic hair before the beginning of puberty.

Medulla

The adrenal medulla is derived from neural crest cells, which come from the ectoderm layer of the
embryo. These cells migrate from their initial position and aggregate in the vicinity of the dorsal aorta,
a primitive blood vessel, which activates the differentiation of these cells through the release of
proteins known as BMPs. These cells then undergo a second migration from the dorsal aorta to form
the adrenal medulla and other organs of the sympathetic nervous system. Cells of the adrenal medulla
are called chromaffin cells because they contain granules that stain with chromium salts, a
characteristic not present in all sympathetic organs. Glucocorticoids produced in the adrenal cortex

65
were once thought to be responsible for the differentiation of chromaffin cells. More recent research
suggests that BMP-4 secreted in adrenal tissue is the main responsible for this, and that
glucocorticoids only play a role in the subsequent development of the cells.

History

Bartolomeo Eustachi, an Italian anatomist, is credited with the first description of the adrenal glands
in 1563–4. However, these publications were part of the papal library and did not receive public
attention, which was first received with Caspar Bartholin the Elder's illustrations in 1611.

The adrenal glands are named for their location relative to the kidneys. The term "adrenal" comes
from ad- (Latin, "near") and renes (Latin, "kidney"). Similarly, "suprarenal", as termed by Jean Riolan
the Younger in 1629, is derived from the Latin supra (Latin: "above") and renes (Latin: kidney). The
suprarenal nature of the glands was not truly accepted until the 19th century, as anatomists clarified
the ductless nature of the glands and their likely secretory role – prior to this, there was some debate
as to whether the glands were indeed suprarenal or part of the kidney.

One of the most recognized works on the adrenal glands came in 1855 with the publication of On the
Constitutional and Local Effects of Disease of the Suprarenal Capsule, by the English physician Thomas
Addison with George Trousseau. Edward Calvin Kendall, Philip Hench and Tadeusz Reichstein were
then awarded the 1950 Nobel Prize in Physiology or Medicine for their discoveries on the structure
and effects of the adrenal hormones.

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VII. THE BLOOD SYSTEM

Capillary exchange
Tissue fluid is continually created and refreshed at the capillaries when certain molecules leave the
blood and others are picked up by the blood.

blood
The blood is a fluid in the vessels or capillaries made up of: plasma and cells in suspension such as
leucocytes, red blood cells or erythrocytes, platelets or thrombocyte. Inside the plasma, there are
biomolecules and bioatoms like shown in the following figures. Know that red blood cells carry
oxygen combined with the respiratory pigment hemoglobin to the cells of the body. CO 2 could be
broken into C and O2. White blood cells could protect the body against bad microbes like infection.
White blood cell could be neutrophil, lymphocyte, eosinophil, basophil, or monocyte.

Here inside this book, we also introduce the notion of little molecules, mid molecules, and great
molecules to the scientific and technological communities in order to facilitate the use of substances in
life. Then, each molecule or substance differs from one another due to its composition. The interior
zona of the pentagon or hexagon is in general the place of laminar flow ; whereas, the zona between
the represented blood vessel and -the pentagon or hexagon zona – is a place of turbulent flow until the
subject is in rest and he is full.

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Leucocytes
Leucocytes are cells which have nucleus in the blood. It exists three varieties: granulocytes,
lymphocytes, and monocytes.

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Lymphocytes
Lymphocytes are cells having little nucleus with reduced cytoplasm in the blood, spinal, and
lymphoïd tissues. They play important acts in the elaboration of immunitary response.
It exists T lymphocyte and B lymphocyte.

Granulocytes
Granulocytes are cells with multiple lobed nucleus and have specific granulation. It exists 3
granulocytes: the neutrophyl granulocyte, basophilic granulocyte, and eosinophilic granulocyte.

Red blood cells

Red cells are cells of the blood without nucleus. They are disk shaped, coblate, biconcave which
contain hemoglobin. They have normally a diameter of 7.2 to 7.9 μm, a width f 2μm in the periphery
and 1 μm in the center, and an average of volume of 90 μm3.
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Platelet
Platelets are cells without nucleus playing tremendous acts in hemostasis and in the coagulation with an
average number of 150 000 to 400 000/ mm3.

Plasma
Plasma is the fluid where leucocytes, red cells, and platelet are in suspension.

The superficial arteries and veins of face and scalp

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Figure 30.b : Frontal view of superficial vessels in women, Laura - Ory's Nails & Aesthetic, and
Instyleaesthetics

The Blood Supply of the Brain

Diagram 03: The brain

Food and oxygen are carried to the brain by many blood vessels. These vessels are found on the
surface of the brain and deep within the brain. The blood vessels (and nerves) enter the brain through
holes in the skull called foramina

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Although the brain is only about 2% of the total body weight in humans, it receives 15-20% of the
body's blood supply. Because brain cells will die if the supply of blood which carries oxygen is
stopped, the brain has top priority for the blood. Even if other organs need blood, the body attempts
to supply the brain with a constant flow of blood.

The blood brings many materials necessary for the brain to function properly. The blood also removes
materials from the brain.

In fact, a quantity of Carbon Dioxide is also necessary for the brain and most of organs inside the body
but organs might reject some quantity of Carbon Dioxide. It is the same for other substances. (Source:
RAJAONARISOA Toky Mahandry)

Blood is supplied to the entire brain by 2 pairs of arteries: the internal carotid arteries and vertebral
arteries. As you can see in the figure below, the right and left vertebral arteries come together at the
base of the brain to form a single basilar artery. The basilar artery joins the blood supply of the
internal carotid arteries in a ring at the base of the brain. This ring of arteries is called the circle of
Willis. The circle of Willis provides a safety mechanism...if one of the arteries gets blocked, the "circle"
will still provide the brain with blood.

Base of the Brain

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Figure 31: A simplified brain vessel, Chudler, Professor, University of Washington

https://faculty.washington.edu/chudler/vessel.html

73
VIII. CELL STRUCTURES, CELL DIVISION, CELL DEVELOPMENT
CELL STRUCTURES

As shown in figure 32 (a generalized drawing) and figure 33, viewed from a transmission electron
micrograph, an animal cell is eukaryotic cell which has nucleus, that is surrounding by a nuclear
envelope, and contains nucleoplasm.

The plasma membrane is a phospholipid bilayer with embedded proteins which defines cell boundary,
regulates of molecule passage into and out of cell.

The nucleus is a nuclear envelope surrounding nucleoplasm, chromatin, and nucleoli which stores of
genetic information synthesis of DNA and RNA.

The nucleolus is a concentrated area of chromatin, RNA, and proteins. It works to form ribosome.

The ribosome is a protein and RNA in two subunits which is a protein synthesizer.

The endoplasmic reticulum (ER) is a membranous, flattened channels and tubular canals which is a
synthesizer and/or modifier of proteins and other substances, and transport by vesicle formation.

The rough ER is a studded with ribosome which is a protein synthesizer.

The smooth ER is rough ER that does not have ribosome. Its function varies depending on cells. As
example, it is a lipid synthesizer in some cells.

The golgi apparatus is a stack of membranous saccules which processes, packages, and distributes
proteins and lipids.

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The vacuole and vesicle are membranous sacs that storage of substances.

The lysosome is membranous vesicle containing digestive enzymes that is intracellular digester.

The peroxisome is membranous vesicle containing specific enzymes that work as metabolizer.

The mitochondrion is a membranous cristae bounded by an outer membrane that is the cellular part
of respiration.

CELL DIVISION AND CELL DEVELOPMENT

Human, who is involved in the multicellular organisms, has two type of cell life cycles and is
mentioned by nuclear divisions such as mitosis and meiosis. Karyokinesis, also named “mitosis”, the
produced new nuclei gains the same number of chromosomes as the producer or parental nucleus.
When the cytoplasm splits , called cytokinesis, two daughter cells are created. In human, as in
multicellular organisms, mitosis allows growth and repair of tissues.

Discussing about the meiosis, the meiosis concerns only some of cells for human as for multicellular
organism. The final produced cell for meiosis receives half number of chromosomes compared to its
parental cell or producer cell. Assortment of the chromosomes occurs and the daughter cells have
various combinations of the reduced number of chromosomes . Meiosis also contributes to
recombination of genetic material by a process called crossing-over. Meiosis is a part of
gametogenesis, the production of gametes.

This part of this book, examines both mitotic and meiotic cell division to show their similarities and
differences. At the start of both types of divisions, the parental nucleus, surrounded by a double

75
membrane (the nuclear envelope), contains one or more nucleoli (concentrated region of RNA) and
chromatin (threadlike strand of DNA) suspended in a transparent liquid called nucleoplasm. During
division, the nuclear envelope fragments and a spindle appears. Spindle fibers assist the movement of
chromosomes as they move into daughter nuclei.

Nucleus Large membrane-bounded structure containing the chromosomes and acting as a control
center for the cells
Nucleolus An organelle found inside the nucleus; composed largely of RNA for ribosome formation
Chromosome Rod-shaped structure in the nucleus that is seen during mitosis and meiosis and that contains
the hereditary units or genes
Chromatids The two identical parts of a chromosome following DNA replication
Centromere A constriction where duplicates (sister chromatids) of a chromosome are held together
Centrosome The central microtubule-organizing center of cells; consists of granular material; contains two
centrioles
Spindle Microtubule structure that brings about chromosome movement during cell division
Centriole A short, cylindrical organelle that contains microtubules and that is associated with the
formation of the spindle during cell division
Aster Short, radiating fibers produced by the centrioles; important during mitosis and meiosis
Table 04 : Structures Associated with mitosis

Mitosis

Mitosis is nuclear division that results in two new nuclei, each having the same number of chromosomes as the
original nucleus. The parental cell is the cell that divides, and the resulting cells are called daughter cells.

When division is about to begin, chromatin starts to condense to form visible, rodlike, sister chromatids that
are held together at the centromere.

The phases of mitosis are prophase, prometaphase, metaphase, anaphase, and telophase in that order. The
spindle is a structure that appears and brings about an orderly distribution of chromosomes to the daughter
cell nuclei. A spindle has fibers that stretch between two poles. Spindle fibers are bundles of microtubules,
which are protein cylinder found in the cytoplasm that can assemble and disassemble. The centrosome, which
is the main microtubule-organizing center of the cell, divides before mitosis so that each pole of the spindle has
a centrosome. There are two barrel-shaped organelles called centrioles, in each centrosome and asters, which
are arrays of short microtubules radiating from the poles.

Prophase

The chromosomes continue to compact, the nucleolus disappears, and the nuclear envelope
fragments. The spindle begins to assemble as the centrosomes, each containing two centrioles,
migrate to the poles.
During prophase, the chromosomes have no apparent orientation within the cell. The already
duplicated chromosomes are composed of two sister chromatids held together at a centromere.
Prometaphase
The mitotic spindle occupies the region formerly occupied by the nucleus. Short microtubules radiate
out in a starlike aster from the pair of centrioles located in each centrosome.
The spindle consists of poles, asters, and fibers, which are bundles of parallel microtubules. The sister
chromatids capture spindle fibers coming from opposite poles.
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Metaphase
The sister chromatids are now attached to the spindle and the chromosomes are aligned at the
metaphase plate (equator) of the spindle.
Anaphase
At the start of anaphase, the sister chromatids of each chromosome separate at the centromere, giving
rise to two daughter chromosomes. Daughter chromosomes, each with a centromere and having one
chromatid, begin to move toward opposite poles. Each pole receives one of each kind and therefore
has the diploid number of daughter chromosomes.
On figure 34.a, following DNA replication, a duplicated chromosome contains two sister chromatids,
each containing copies of the same genes. The two chromatids are held together at a centromere. The
first photo is a photomicrograph of a duplicated and compacted chromosome; and the second photo in
this diagram shows one chromatid indicated by the shaded box.

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Figure 34.b : Interphase and mitosis

Cytokinesis

Cytokinesis, division of the cytoplasm, usually accompanies mitosis. During cytokinesis each daughter
cell receives a share of organelles that duplicated during interphase. Cytokinesis begins in anaphase,
continue in telophase, and reaches completion by the start of the next interphase.

A cleavage furrow, which is an indentation of the membrane between the daughter nuclei, begins as
anaphase draws to a close. The cleavage furrow deepens as a band of actin filaments called the
contractile ring slowly constricts the cell, forming two daughter cells.

Meiosis

Meiosis is a form of nuclear division in which the chromosome number is reduced by half. A diploid
(2n) nucleus contains the full number of chromosomes, and a haploid (n) nucleus contains half as
many. While the nucleus of the parental cell has the diploid number of chromosomes, the daughter
nuclei, after meiosis is complete, have the haploid number of chromosomes. In sexually reproducing
78
species, meiosis prevents the chromosome number from doubling with each generation when sperm
and egg nuclei fuse.

Exactly the same phases of nuclear division are present in meiosis as in mitosis. However, in meiosis,
this stages occur twice-during meiosis I and meiosis II. A diploid nucleus contains homologous
chromosomes, chromosomes that look alike and carry genes for the same traits. During meiosis I,
homologous chromosomes that are already double-stranded, have sister chromatids, undergo
synapsis (line up next to one another). During synapsis, the nonsister chromatids exchange genetic
material; this is symbolized by an exchange of color. (This exchange of genetic material is called
crossing over). Following synapsis, the homologous chromosomes separate. Independent assortment
of chromosomes occurs; either chromosome of a homologous pair may occur in a daughter cell with
either chromosome of any other pair.

During meiosis II, the sister chromatids of each chromosomes separate at the centromere. Because
meiosis has two divisions, four daughter cells result.

Meiosis I

During prophase I, the spindle appears while the nuclear envelope and nucleolus disappear.
Homologous chromosomes undergo synapsis forming bivalents. At metaphase I, bivalents line up at
the metaphase plate of the spindle. During anaphase I, homologous chromosomes separate and the
chromosomes (still composed of two chromatids) move to the pole of the spindle. Each pole receives
one-half the total number of chromosomes. In telophase I, the nuclear envelope and the nucleolus
reappear as the spindle disappears. Each new nucleus contains one from each pair of chromosomes.

Meiosis II

At the beginning of prophase II, a spindle appears. Each chromosomes with its two chromatids
attaches to the spindle independently. During metaphase II, the chromosomes are lined up at the
metaphase plate. During anaphase II, the centromeres divide and the chromatids separate and move
toward the poles. In telophase II, the spindle disappears as nuclear envelope reappears. Each new
nucleus contains the haploid number of chromosomes. Notice that meiosis II is exactly like mitosis
except that the nuclei of the parental cell and the daughter cells are haploid.

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 Meiosis II

Prophase II

Figure 35.a: Meiosis

On the following figure, figure 35 b, individual(s) could see beads and other shaped-materials linked
by “ thread or/and magnetic” in order to simulate chromosomes.

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Figure 35 b : Simulation of homologous pair of duplicated chromosomes .

81
IX DERM SYSTEM AND BREAST
DERM

Generality

The skin is globally divided into three parts: the epidermis, the dermis and the subcutaneous layer. In
epiderm, it is found the free nerve endings. In the dermis, we could find sensory receptors, the hair
follicle, the arrector pili muscle, the sweat gland, the hair root. In the subcutaneous layer is found the
adipose tissues, fat, nerve, artery, vein paths.

The skin covers the entire exterior of the human body. Skin functions include protection, water
retention, sensory reception, body temperature regulation, and vitamin D synthesis.

Epidermis:

The epidermis is composed of stratified squamous epithelium. The outer cells of the epidermis are
nonliving and create a waterproof covering that prevents excessive water loss. These cells may be
replaced because an inner epidermal layer is composed of living cells that constantly produce new
cells.

Dermis

The dermis is composed of connective tissue. You could identify blood vessels, nerves, sense organs,
and also the expanded portions of oil (sebaceous) and sweat glands and hair follicles.

Subcutaneous layer

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This is a layer of adipose tissue that lies beneath the skin proper and serves to insulate and protect
inner body parts.

Clinica and Precisions on biomatters

The skin could increase in shape known generally as volume in all ages, and also could diminue in
shape in all ages; the concern depends on way of life including biomatters and energy presences, type
and structure of blood vessels and each ganglion in each part of the body to make a centripetal
motion of blood or/and biomatter or landing of biomatter or also called first health arrival
welcome (FHAW) of unhealthy biomatters. In reverse, the centrifuge motion of the biomatters
or/and a take off of biomatter known as the transfer of biomatters especially the plasma concern, in
the - principal blood vessels, secondary vessels, tertiary vessels and quaternary vessels - such veins
which contains the biomatters could also appear.

Meaning that all biomatters in the plasma, in the direction sense from other organs to skin one which:

 could traverse the carrier biomatter between skin and other organs,
 or/and could be put on the skin structure during blood flow,

could become a structure of the skin.

In reverse, all biomatters in the skin, in the direction sense from skin to other organs could be part of
the blood. Consequently the skin is also a location of stockage of biomatters of all types which could be
stocked.

In addition, the skin is the only organ of the human body compared to the teeth and the bones which
could react against unwanted biomatters and which could expulse unwanted biomatters depending
on the structure of the skin and way of life that is why it is called first health arrival welcome or
(FHAW).

Therefore, one of among challenges of dermatologists, doctor in medicine, physicists, bioscientists and
biotechnologists are to produce medicaments for skin which could expulse unwanted biomatters out
of the body.

BREAST

Breast

Figure36.b: Morphology of human female breasts with the areola, nipple, and inframammary fold

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The breast is one of two prominences located on the upper ventral region of the torso of primates. In
females, it serves as the mammary gland, which produces and secretes milk to feed infants Both
females and males develop breasts from the same embryological tissues. At puberty, estrogens, in
conjunction with growth hormone, cause breast development in female humans and to a much lesser
extent in other primates. Breast development in other primate females generally only occurs with
pregnancy.

Subcutaneous fat covers and envelops a network of ducts that converge on the nipple, and these
tissues give the breast its size and shape. At the ends of the ducts are lobules, or clusters of alveoli,
where milk is produced and stored in response to hormonal signals. During pregnancy, the breast
responds to a complex interaction of hormones, including estrogens, progesterone, and prolactin, that
mediate the completion of its development, namely lobuloalveolar maturation, in preparation of
lactation and breastfeeding.

Etymology and terminology

The English word breast derives from the Old English word brēost ('breast, bosom') from Proto-
Germanic *breustam (breast), from the Proto-Indo-European base bhreus– (to swell, to sprout). The
breast spelling conforms to the Scottish and North English dialectal pronunciations. The Merriam-
Webster Dictionary states that "Middle English brest, [comes] from Old English brēost; akin to Old High
German brust..., Old Irish brú [belly], [and] Russian bryukho"; the first known usage of the term was
before the 12th century.

Anatomy

Figure 36.c: The breast: cross-section scheme of the mammary gland.

1. Chest wall, 2. Pectoralis muscles, 3. Lobules, 4. Nipple, 5. Areola, 6. Milk duct, 7. Fatty tissue, 8. Skin

In women, the breasts overlie the pectoralis major muscles and usually extend from the level of the
second rib to the level of the sixth rib in the front of the human rib cage; thus, the breasts cover much
of the chest area and the chest walls. At the front of the chest, the breast tissue can extend from the
84
clavicle (collarbone) to the middle of the sternum (breastbone). At the sides of the chest, the breast
tissue can extend into the axilla (armpit), and can reach as far to the back as the latissimus dorsi
muscle, extending from the lower back to the humerus bone (the bone of the upper arm). As a
mammary gland, the breast is composed of differing layers of tissue, predominantly two types:
adipose tissue; and glandular tissue, which affects the lactation functions of the breasts.

Morphologically the breast is tear-shaped. The superficial tissue layer (superficial fascia) is separated from
the skin by 0.5–2.5 cm of subcutaneous fat (adipose tissue). The suspensory Cooper's ligaments are fibrous-
tissue prolongations that radiate from the superficial fascia to the skin envelope. The female adult breast
contains 14–18 irregular lactiferous lobes that converge at the nipple. The 2.0–4.5 mm milk ducts are
immediately surrounded with dense connective tissue that support the glands. Milk exits the breast through
the nipple, which is surrounded by a pigmented area of skin called the areola. The size of the areola can vary
widely among women. The areola contains modified sweat glands known as Montgomery's glands. These
glands secrete oily fluid that lubricate and protect the nipple during breastfeeding. Volatile compounds in
these secretions may also serve as an olfactory stimulus for the newborn's appetite.

The dimensions and weight of the breast vary widely among women. A small-to-medium-sized breast
weighs 500 grams (1.1 pounds) or less, and a large breast can weigh approximately 750 to 1,000 grams (1.7
to 2.2 pounds) or more. The tissue composition ratios of the breast also vary among women. Some women's
breasts have varying proportions of glandular tissue than of adipose or connective tissues. The fat-to-
connective-tissue ratio determines the density or firmness of the breast. During a woman's life, her breasts
change size, shape, and weight due to hormonal changes during puberty, the menstrual cycle, pregnancy,
breastfeeding, and menopause.

Glandular structure

The breast is an apocrine gland that produces the milk used to feed an infant. The nipple of the breast is
surrounded by the areola (nipple-areola complex). The areola has many sebaceous glands, and the skin color
varies from pink to dark brown. The basic units of the breast are the terminal duct lobular units (TDLUs),
which produce the fatty breast milk. They give the breast its offspring-feeding functions as a mammary
gland. They are distributed throughout the body of the breast. Approximately two-thirds of the lactiferous
tissue is within 30 mm of the base of the nipple. The terminal lactiferous ducts drain the milk from TDLUs
into 4–18 lactiferous ducts, which drain to the nipple. The milk-glands-to-fat ratio is 2:1 in a lactating
woman, and 1:1 in a non-lactating woman. In addition to the milk glands, the breast is also composed of
connective tissues (collagen, elastin), white fat, and the suspensory Cooper's ligaments. Sensation in the
breast is provided by the peripheral nervous system innervation by means of the front (anterior) and side
(lateral) cutaneous branches of the fourth-, fifth-, and sixth intercostal nerves. The T-4 nerve (Thoracic
spinal nerve 4), which innervates the dermatomic area, supplies sensation to the nipple-areola complex.

Lymphatic drainage

Approximately 75% of the lymph from the breast travels to the axillary lymph nodes on the same side
of the body, whilst 25% of the lymph travels to the parasternal nodes (beside the sternum bone). A
small amount of remaining lymph travels to the other breast and to the abdominal lymph nodes. The
subareolar region has a lymphatic plexus known as the "subareolar plexus of Sappey". The axillary
lymph nodes include the pectoral (chest), subscapular (under the scapula), and humeral (humerus-
bone area) lymph-node groups, which drain to the central axillary lymph nodes and to the apical
axillary lymph nodes. The lymphatic drainage of the breasts is especially relevant to oncology because
breast cancer is common to the mammary gland, and cancer cells can metastasize (break away) from
a tumour and be dispersed to other parts of the body by means of the lymphatic system.

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Shape, texture, and support

The morphologic variations in the size, shape, volume, tissue density, pectoral locale, and spacing of
the breasts determine their natural shape, appearance, and position on a woman's chest. Breast size
and other characteristics do not predict the fat-to-milk-gland ratio or the potential for the woman to
nurse an infant. The size and the shape of the breasts are influenced by normal-life hormonal changes
(thelarche, menstruation, pregnancy, menopause) and medical conditions (e.g. virginal breast
hypertrophy). The shape of the breasts is naturally determined by the support of the suspensory
Cooper's ligaments, the underlying muscle and bone structures of the chest, and by the skin envelope.
The suspensory ligaments sustain the breast from the clavicle (collarbone) and the clavico-pectoral
fascia (collarbone and chest) by traversing and encompassing the fat and milk-gland tissues. The
breast is positioned, affixed to, and supported upon the chest wall, while its shape is established and
maintained by the skin envelope. In most women, one breast is slightly larger than the other. More
obvious and persistent asymmetry in breast size occurs in up to 25% of women.

The base of each breast is attached to the chest by the deep fascia over the pectoralis major muscles.
The space between the breast and the pectoralis major muscle, called retromammary space, gives
mobility to the breast. The chest (thoracic cavity) progressively slopes outwards from the thoracic
inlet (atop the breastbone) and above to the lowest ribs that support the breasts. The inframammary
fold, where the lower portion of the breast meets the chest, is an anatomic feature created by the
adherence of the breast skin and the underlying connective tissues of the chest; the IMF is the lower-
most extent of the anatomic breast. Normal breast tissue typically has a texture that feels nodular or
granular, to an extent that varies considerably from woman to woman.

The study The Evolution of the Human Breast (2001) proposed that the rounded shape of a woman's
breast evolved to prevent the sucking infant offspring from suffocating while feeding at the teat; that
is, because of the human infant's small jaw, which did not project from the face to reach the nipple, he
or she might block the nostrils against the mother's breast if it were of a flatter form (cf. common
chimpanzee). Theoretically, as the human jaw receded into the face, the woman's body compensated
with round breasts.

Development

The breasts are principally composed of adipose, glandular, and connective tissues. Because these
tissues have hormone receptors, their sizes and volumes fluctuate according to the hormonal changes
particular to thelarche (sprouting of breasts), menstruation (egg production), pregnancy
(reproduction), lactation (feeding of offspring), and menopause (end of menstruation).

Puberty

Figure 36.d: Breast development in puberty is measured with the five-stage Tanner Scale
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The morphological structure of the human breast is identical in males and females until puberty. For
pubescent girls in thelarche (the breast-development stage), the female sex hormones (principally
estrogens) in conjunction with growth hormone promote the sprouting, growth, and development of
the breasts. During this time, the mammary glands grow in size and volume and begin resting on the
chest. These development stages of secondary sex characteristics (breasts, pubic hair, etc.) are
illustrated in the five-stage Tanner Scale.

During thelarche the developing breasts are sometimes of unequal size, and usually the left breast is
slightly larger. This condition of asymmetry is transitory and statistically normal in female physical
and sexual development. Medical conditions can cause overdevelopment (e.g., virginal breast
hypertrophy, macromastia) or underdevelopment (e.g., tuberous breast deformity, micromastia) in
girls and women.

Approximately two years after the onset of puberty (a girl's first menstrual cycle), estrogen and
growth hormone stimulate the development and growth of the glandular fat and suspensory tissues
that compose the breast. This continues for approximately four years until the final shape of the
breast (size, volume, density) is established at about the age of 21. Mammoplasia (breast
enlargement) in girls begins at puberty, unlike all other primates in which breasts enlarge only during
lactation.

Figure 36.e: Breast with visible stretch marks

Changes during the menstrual cycle

During the menstrual cycle, the breasts are enlarged by premenstrual water retention and temporary
growth.

Pregnancy and breastfeeding

The breasts reach full maturity only when a woman's first pregnancy occurs. Changes to the breasts
are among the first signs of pregnancy. The breasts become larger, the nipple-areola complex becomes
larger and darker, the Montgomery's glands enlarge, and veins sometimes become more visible.
Breast tenderness during pregnancy is common, especially during the first trimester. By mid-
pregnancy, the breast is physiologically capable of lactation and some women can express colostrum,
a form of breast milk.

Pregnancy causes elevated levels of the hormone prolactin, which has a key role in the production of
milk. However, milk production is blocked by the hormones progesterone and estrogen until after
delivery, when progesterone and estrogen levels plummet.

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Menopause

At menopause, breast atrophy occurs. The breasts can decrease in size when the levels of circulating
estrogen decline. The adipose tissue and milk glands also begin to wither. The breasts can also
become enlarged from adverse side effects of combined oral contraceptive pills. The size of the
breasts can also increase and decrease in response to weight fluctuations.

Breastfeeding

Figure 36.f: A baby breastfeeding

The primary function of the breasts, as mammary glands, is the nourishing of an infant with breast milk.
Milk is produced in milk-secreting cells in the alveoli. When the breasts are stimulated by the suckling of
her baby, the mother's brain secretes oxytocin. High levels of oxytocin trigger the contraction of muscle
cells surrounding the alveoli, causing milk to flow along the ducts that connect the alveoli to the nipple.

Full-term newborns have an instinct and a need to suck on a nipple, and breastfed babies nurse for both
nutrition and for comfort. Breast milk provides all necessary nutrients for the first six months of life, and
then remains an important source of nutrition, alongside solid foods, until at least one or two years of age.

Clinical significance

The breast is susceptible to numerous benign and malignant conditions. The most frequent benign
conditions are puerperal mastitis, fibrocystic breast changes and mastalgia.

Lactation unrelated to pregnancy is known as galactorrhea. It can be caused by certain drugs (such as
antipsychotic medications), extreme physical stress, or endocrine disorders. Lactation in newborns is
caused by hormones from the mother that crossed into the baby's bloodstream during pregnancy.

Breast cancer

Breast cancer is the most common cause of cancer death among women and it is one of the leading
causes of death among women. Factors that appear to be implicated in decreasing the risk of breast
cancer are regular breast examinations by health care professionals, regular mammograms, self-
examination of breasts, healthy diet, and exercise to decrease excess body fat, and breastfeeding.

Male breasts

Both females and males develop breasts from the same embryological tissues. Normally, males
produce lower levels of estrogens and higher levels of androgens, namely testosterone, which
suppress the effects of estrogens in developing excessive breast tissue. In boys and men, abnormal
breast development is manifested as gynecomastia, the consequence of a biochemical imbalance
88
between the normal levels of estrogen and testosterone in the male body. Around 70% of boys
temporarily develop breast tissue during adolescence. The condition usually resolves by itself within
two years. When male lactation occurs, it is considered a symptom of a disorder of the pituitary gland.

Plastic surgery

Figure 36.g: Conventional mastectomy (top); skin sparing mastectomy and latissimus dorsi
myocutaneous flap reconstruction, prior to nipple reconstruction and tattooing (bottom).

Plastic surgery can be performed to augment or reduce the size of breasts, or reconstruct the breast in cases
of deformative disease, such as breast cancer.Breast augmentation and breast lift (mastopexy) procedures are
done only for cosmetic reasons, whereas breast reduction is sometimes medically indicated. In cases where a
woman's breasts are severely asymmetrical, surgery can be performed to either enlarge the smaller breast,
reduce the size of the larger breast, or both.

Breast augmentation surgery generally does not interfere with future ability to breastfeed. Breast reduction
surgery more frequently leads to decreased sensation in the nipple-areola complex, and to low milk supply
in women who choose to breastfeed. Implants can interfere with mammography (breast x-rays images).

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X. GENITAL ORGANS

HUMAN MAN GENITAL AND URINE SYSTEM

The system is generally composed of: ureter, seminal vesicle, bulbourethral, gland, epididymis, testis,
penis, urethra, glans penis, vas deferens, prostate, gland, urinary bladder. The testis is internally made
up of seminiferous tubules. Testes produce sperm (the male gametes).
A testis contains seminiferous tubules, where sperm formation takes place, and interstitial cells
scattered in the spaces between seminiferous tubules. Interstitial cells produce the male sex hormone
testosterone.

Figure 37.a : Human male urogenital system

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 Figure 37.b: Testis

The seminiferous tubule is circular structures. The seminiferous tubule is the location where sperm
formation takes place. Generally on microscope, mature sperm look like thin, fine, dark lines, in the
middle of the tubule.
Interstitial cells, which produce the male sex hormone testosterone, are between the tubules.

Gametogenesis is the formation of gametes (sex cells) in human and animals. The gametes are sperm
and egg in humans. Fertilization occurs when sperm and egg nuclei fuse.
There are four sperm as a result of spermatogenesis. In fact, spermatogenesis produces four viable
sperm. And sperm have 23 chromosomes.

HUMAN WOMAN GENITAL SYSTEM

The system of woman urogenital is globally constituted of : oviducts, ovaries, uterus, cervix, vagina,
rectum, urinary bladder, vulva, clitoris, urethra, and others. It is labeled on the following figure the :
ovary, oviduct, uterus, uterine cavity, cervix, and vagina. Inside the ovary, the egg cell takes its
development. The follicle or elementary histological creation could also be seen inside the ovary.

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The ovaries produce oocytes (the female gametes). An ovary contains follicles in various stages of
maturation. Ovarian follicles produce the female sex hormones estrogen and progesterone. One or
more follicles complete maturation during each cycle and produce an egg.

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On the following figure, you could find the primary follicles; each of the primary follicle contains a
primary oocyte.
Then, the follicle develops and gets,- shape and structures-; and it is called secondary follicles when
getting the “mid-size shape and structures”.
Reaching the late -moment, size, and structure-, it becomes a vesicular (Graafian) follicle and it is
ready to inject or release the secondary oocyte during the ovulation period.

Meiosis I results in a secondary oocyte and one polar body. A polar body is a nonfunctioning cell that
will desintegrate. A secondary oocyte does not undergo meiosis II unless fertilization (fusion of egg
and sperm) occurs. At the completion of oogenesis, there is a single egg and at least two polar bodies.
Egg has 23 chromosomes. Therefore, following fertlization, the zygote has 46 chromosomes.

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XI. HUMAN GENESIS
FECONDATION

Fecondation is the union of two gametes male and female which have different chromosomes
generally for human XX and XY. In agriculture, scientists and/or engineers while doing biotechnology
are able to ameliorate plant fecondation and/or plant chromosomes by unifying different
chromosomes according to biochemical and biophysical conditions; and that is why we could see the
result of the unification of “apple and peach”, or “peach and peer”, or other plants (see animals).

The actual tremendous challenge for scientists and/or engineers is how to create a gamete outside of
an organism body? Or How to create a gamete partly outside an organism body?

Actually, engineered or artificial insemination could be made by taking a male gamete and putting the
male gamete inside the female gamete. This scientific procedure is more accurate and precise; in
addition, you could chose the more perfect human according to each choice of an individual or a
family.

Actual biotechnology also allow the growth of oogenesis; here the possibility is like just before the
nidation and circlage will be one of the among solutions.

EMBRYON
Generality

Human embryonic development, or human embryogenesis, refers to the development and

formation of the human embryo. It is characterised by the processes of cell division and cellular
differentiation of the embryo that occurs during the early stages of development. In biological terms,
the development of the human body entails growth from a one-celled zygote to an adult human being.
Fertilisation occurs when the sperm cell successfully enters and fuses with an egg cell (ovum). The
genetic material of the sperm and egg then combine to form a single cell called a zygote and the
germinal stage of development commences. Embryonic development in the human, covers the first
eight weeks of development; at the beginning of the ninth week the embryo is termed a fetus. Human

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embryology is the study of this development during the first eight weeks after fertilisation. The
normal period of gestation (pregnancy) is about nine months or 40 weeks.

Figure 40-c : The initial stages of human embryonic development, Zephyris

The germinal stage refers to the time from fertilization through the development of the early embryo
until implantation is completed in the uterus. The germinal stage takes around 10 days. During this
stage, the zygote begins to divide, in a process called cleavage. A blastocyst is then formed and
implanted in the uterus. Embryogenesis continues with the next stage of gastrulation, when the three
germ layers of the embryo form in a process called histogenesis, and the processes of neurulation and
organogenesis follow.

In comparison to the embryo, the fetus has more recognizable external features and a more complete
set of developing organs. The entire process of embryogenesis involves coordinated spatial and
temporal changes in gene expression, cell growth and cellular differentiation. A nearly identical
process occurs in other species, especially among chordates.

Germinal stage

Fertilization

Fertilization takes place when the spermatozoon has successfully entered the ovum and the two sets
of genetic material carried by the gametes fuse together, resulting in the zygote (a single diploid cell).
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This usually takes place in the ampulla of one of the fallopian tubes. The zygote contains the combined
genetic material carried by both the male and female gametes which consists of the 23 chromosomes
from the nucleus of the ovum and the 23 chromosomes from the nucleus of the sperm. The 46
chromosomes undergo changes prior to the mitotic division which leads to the formation of the
embryo having two cells.

Successful fertilization is enabled by three processes, which also act as controls to ensure species-
specificity. The first is that of chemotaxis which directs the movement of the sperm towards the ovum.
Secondly there is an adhesive compatibility between the sperm and the egg. With the sperm adhered
to the ovum, the third process of acrosomal reaction takes place; the front part of the spermatozoan
head is capped by an acrosome which contains digestive enzymes to break down the zona pellucida
and allow its entry. The entry of the sperm causes calcium to be released which blocks entry to other
sperm cells. A parallel reaction takes place in the ovum called the zona reaction. This sees the release
of cortical granules that release enzymes which digest sperm receptor proteins, thus preventing
polyspermy. The granules also fuse with the plasma membrane and modify the zona pellucida in such
a way as to prevent further sperm entry.

Cleavage

Figure 40-d: 8-cell embryo, at 3 days, ekem

The beginning of the cleavage process is marked when the zygote divides through mitosis into two
cells. This mitosis continues and the first two cells divide into four cells, then into eight cells and so on.
Each division takes from 12 to 24 hours. The zygote is large compared to any other cell and undergoes
cleavage without any overall increase in size. This means that with each successive subdivision, the
ratio of nuclear to cytoplasmic material increases. Initially the dividing cells, called blastomeres
(blastos Greek for sprout), are undifferentiated and aggregated into a sphere enclosed within the
membrane of glycoproteins (termed the zona pellucida) of the ovum. When eight blastomeres have
formed they begin to develop gap junctions, enabling them to develop in an integrated way and co-
ordinate their response to physiological signals and environmental cues.

When the cells number around sixteen the solid sphere of cells within the zona pellucida is referred to
as a morula At this stage the cells start to bind firmly together in a process called compaction, and
cleavage continues as cellular differentiation.

Blastulation

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 Figure 40-e: Blastocyst with an inner cell mass and trophoblast.

Cleavage itself is the first stage in blastulation, the process of forming the blastocyst. Cells differentiate
into an outer layer of cells (collectively called the trophoblast) and an inner cell mass. With further
compaction the individual outer blastomeres, the trophoblasts, become indistinguishable. They are
still enclosed within the zona pellucida. This compaction serves to make the structure watertight,
containing the fluid that the cells will later secrete. The inner mass of cells differentiate to become
embryoblasts and polarise at one end. They close together and form gap junctions, which facilitate
cellular communication. This polarisation leaves a cavity, the blastocoel, creating a structure that is
now termed the blastocyst. (In animals other than mammals, this is called the blastula.) The
trophoblasts secrete fluid into the blastocoel. The resulting increase in size of the blastocyst causes it
to hatch through the zona pellucida, which then disintegrates.

The inner cell mass will give rise to the pre-embryo, the amnion, yolk sac and allantois, while the fetal
part of the placenta will form from the outer trophoblast layer. The embryo plus its membranes is
called the conceptus, and by this stage the conceptus has reached the uterus. The zona pellucida
ultimately disappears completely, and the now exposed cells of the trophoblast allow the blastocyst to
attach itself to the endometrium, where it will implant. The formation of the hypoblast and epiblast,
which are the two main layers of the bilaminar germ disc, occurs at the beginning of the second week.
Either the embryoblast or the trophoblast will turn into two sub-layers. The inner cells will turn into
the hypoblast layer, which will surround the other layer, called the epiblast, and these layers will form
the embryonic disc that will develop into the embryo. The trophoblast will also develop two sub-
layers: the cytotrophoblast, which is in front of the syncytiotrophoblast, which in turn lies within the
endometrium. Next, another layer called the exocoelomic membrane or Heuser’s membrane will
appear and surround the cytotrophoblast, as well as the primitive yolk sac. The syncytiotrophoblast
will grow and will enter a phase called lacunar stage, in which some vacuoles will appear and be filled
by blood in the following days. The development of the yolk sac starts with the hypoblastic flat cells
that form the exocoelomic membrane, which will coat the inner part of the cytotrophoblast to form
the primitive yolk sac. An erosion of the endothelial lining of the maternal capillaries by the
syncytiotrophoblastic cells of the sinusoids will form where the blood will begin to penetrate and flow
through the trophoblast to give rise to the uteroplacental circulation. Subsequently new cells derived
from yolk sac will be established between trophoblast and exocelomic membrane and will give rise to
extra-embryonic mesoderm, which will form the chorionic cavity.

At the end of the second week of development, some cells of the trophoblast penetrate and form
rounded columns into the syncytiotrophoblast. These columns are known as primary villi. At the same
time, other migrating cells form into the exocelomic cavity a new cavity named the secondary or
definitive yolk sac, smaller than the primitive yolk sac.
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Implantation

Figure 40-f: Trophoblast differentiation, Henry Vandyke Carter

After ovulation, the endometrial lining becomes transformed into a secretory lining in preparation of
accepting the embryo. It becomes thickened, with its secretory glands becoming elongated, and is
increasingly vascular. This lining of the uterine cavity (or womb) is now known as the decidua, and it
produces a great number of large decidual cells in its increased interglandular tissue. The blastomeres
in the blastocyst are arranged into an outer layer called the trophoblast. The trophoblast then
differentiates into an inner layer, the cytotrophoblast, and an outer layer, the syncytiotrophoblast. The
cytotrophoblast contains cuboidal epithelial cells and is the source of dividing cells, and the
syncytiotrophoblast is a syncytial layer without cell boundaries.

The syncytiotrophoblast implants the blastocyst in the decidual epithelium by projections of chorionic
villi, forming the embryonic part of the placenta. The placenta develops once the blastocyst is
implanted, connecting the embryo to the uterine wall. The decidua here is termed the decidua basalis;
it lies between the blastocyst and the myometrium and forms the maternal part of the placenta. The
implantation is assisted by hydrolytic enzymes that erode the epithelium. The syncytiotrophoblast
also produces human chorionic gonadotropin, a hormone that stimulates the release of progesterone
from the corpus luteum. Progesterone enriches the uterus with a thick lining of blood vessels and
capillaries so that it can oxygenate and sustain the developing embryo. The uterus liberates sugar
from stored glycogen from its cells to nourish the embryo.[13] The villi begin to branch and contain
blood vessels of the embryo. Other villi, called terminal or free villi, exchange nutrients. The embryo is
joined to the trophoblastic shell by a narrow connecting stalk that develops into the umbilical cord to
attach the placenta to the embryo. Arteries in the decidua are remodelled to increase the maternal
blood flow into the intervillous spaces of the placenta, allowing gas exchange and the transfer of
nutrients to the embryo. Waste products from the embryo will diffuse across the placenta.

As the syncytiotrophoblast starts to penetrate the uterine wall, the inner cell mass (embryoblast) also
develops. The inner cell mass is the source of embryonic stem cells, which are pluripotent and can
develop into any one of the three germ layer cells, and which have the potency to give rise to all the
tissues and organs.

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Embryonic disc

The embryoblast forms an embryonic disc, which is a bilaminar disc of two layers, an upper layer
called the epiblast (primitive ectoderm) and a lower layer called the hypoblast (primitive endoderm).
The disc is stretched between what will become the amniotic cavity and the yolk sac. The epiblast is
adjacent to the trophoblast and made of columnar cells; the hypoblast is closest to the blastocyst
cavity and made of cuboidal cells. The epiblast migrates away from the trophoblast downwards,
forming the amniotic cavity, the lining of which is formed from amnioblasts developed from the
epiblast. The hypoblast is pushed down and forms the yolk sac (exocoelomic cavity) lining. Some
hypoblast cells migrate along the inner cytotrophoblast lining of the blastocoel, secreting an
extracellular matrix along the way. These hypoblast cells and extracellular matrix are called Heuser's
membrane (or the exocoelomic membrane), and they cover the blastocoel to form the yolk sac (or
exocoelomic cavity). Cells of the hypoblast migrate along the outer edges of this reticulum and form
the extraembryonic mesoderm; this disrupts the extraembryonic reticulum. Soon pockets form in the
reticulum, which ultimately coalesce to form the chorionic cavity (extraembryonic coelom).

Gastrulation

Figure 40-g : Histogenesis of the three germ layers, http://cnx.org/

Figure 40-h : Artificially colored - gestational sac, yolk sac and embryo (measuring 3 mm at 5
weeks), Mikael Häggström

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Figure 40-i : Embryo attached to placenta in amniotic cavity, OpenStax College

The primitive streak, a linear band of cells formed by the migrating epiblast, appears, and this marks
the beginning of gastrulation, which takes place around the seventeenth day (week 3) after
fertilisation. The process of gastrulation reorganises the two-layer embryo into a three-layer embryo,
and also gives the embryo its specific head-to-tail, and front-to-back orientation, by way of the
primitive streak which establishes bilateral symmetry. A primitive node (or primitive knot) forms in
front of the primitive streak which is the organiser of neurulation. A primitive pit forms as a
depression in the centre of the primitive node which connects to the notochord which lies directly
underneath. The node has arisen from epiblasts of the amniotic cavity floor, and it is this node that
induces the formation of the neural plate which serves as the basis for the nervous system. The neural
plate will form opposite the primitive streak from ectodermal tissue which thickens and flattens into
the neural plate. The epiblast in that region moves down into the streak at the location of the primitive
pit where the process called ingression, which leads to the formation of the mesoderm takes place.
This ingression sees the cells from the epiblast move into the primitive streak in an epithelial-
mesenchymal transition; epithelial cells become mesenchymal stem cells, multipotent stromal cells
that can differentiate into various cell types. The hypoblast is pushed out of the way and goes on to
form the amnion. The epiblast keeps moving and forms a second layer, the mesoderm. The epiblast
has now differentiated into the three germ layers of the embryo, so that the bilaminar disc is now a
trilaminar disc, the gastrula.

The three germ layers are the ectoderm, mesoderm and endoderm, and are formed as three
overlapping flat discs. It is from these three layers that all the structures and organs of the body will
be derived through the processes of somitogenesis, histogenesis and organogenesis. The embryonic
endoderm is formed by invagination of epiblastic cells that migrate to the hypoblast, while the
mesoderm is formed by the cells that develop between the epiblast and endoderm. In general, all germ
layers will derive from the epiblast. The upper layer of ectoderm will give rise to the outermost layer
of skin, central and peripheral nervous systems, eyes, inner ear, and many connective tissues. The
middle layer of mesoderm will give rise to the heart and the beginning of the circulatory system as
well as the bones, muscles and kidneys. The inner layer of endoderm will serve as the starting point
for the development of the lungs, intestine, thyroid, pancreas and bladder.
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Following ingression, a blastopore develops where the cells have ingressed, in one side of the embryo
and it deepens to become the archenteron, the first formative stage of the gut. As in all deuterostomes,
the blastopore becomes the anus whilst the gut tunnels through the embryo to the other side where
the opening becomes the mouth. With a functioning digestive tube, gastrulation is now completed and
the next stage of neurulation can begin.

Neurulation

Figure 40-j : Neural plate, NikNaks

Figure 40-k : Neural tube development, Goodlett, C.R., and Horn, K.H.

Following gastrulation, the ectoderm gives rise to epithelial and neural tissue, and the gastrula is now
referred to as the neurula. The neural plate that has formed as a thickened plate from the ectoderm,
continues to broaden and its ends start to fold upwards as neural folds. Neurulation refers to this
folding process whereby the neural plate is transformed into the neural tube, and this takes place
during the fourth week. They fold, along a shallow neural groove which has formed as a dividing
median line in the neural plate. This deepens as the folds continue to gain height, when they will meet
and close together at the neural crest. The cells that migrate through the most cranial part of the
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primitive line form the paraxial mesoderm, which will give rise to the somitomeres that in the process
of somitogenesis will differentiate into somites that will form the sclerotomes, the syndetomes the
myotomes and the dermatomes to form cartilage and bone, tendons, dermis (skin), and muscle. The
intermediate mesoderm gives rise to the urogenital tract and consists of cells that migrate from the
middle region of the primitive line. Other cells migrate through the caudal part of the primitive line
and form the lateral mesoderm, and those cells migrating by the most caudal part contribute to the
extraembryonic mesoderm.

The embryonic disc begins flat and round, but eventually elongates to have a wider cephalic part and
narrow-shaped caudal end. At the beginning, the primitive line extends in cephalic direction and 18
days after fertilization returns caudally until it disappears. In the cephalic portion, the germ layer
shows specific differentiation at the beginning of the 4th week, while in the caudal portion it occurs at
the end of the 4th week. Cranial and caudal neuropores become progressively smaller until they close
completely (by day 26) forming the neural tube.

Development of organs and organ systems

Organogenesis is the development of the organs that begins during the third to eighth week, and
continues until birth. Sometimes full development, as in the lungs, continues after birth. Different
organs take part in the development of the many organ systems of the body.

Blood

Haematopoietic stem cells that give rise to all the blood cells develop from the mesoderm. The
development of blood formation takes place in clusters of blood cells, known as blood islands, in the
yolk sac. Blood islands develop outside the embryo, on the umbilical vesicle, allantois, connecting
stalk, and chorion, from mesodermal hemangioblasts.

In the centre of a blood island, hemangioblasts form the haematopoietic stem cells that are the
precursor to all types of blood cell. In the periphery of a blood island the hemangioblasts differentiate
into angioblasts the precursors to the blood vessels.

Heart and circulatory system

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 Figure 40.l: Development of the heart

The heart is the first functional organ to develop and starts to beat and pump blood at around 22 days.
Cardiac myoblasts and blood islands in the splanchnopleuric mesenchyme on each side of the neural
plate, give rise to the cardiogenic region. This is a horseshoe-shaped area near to the head of the
embryo. By day 19, following cell signalling, two strands begin to form as tubes in this region, as a
lumen develops within them. These two endocardial tubes grow and by day 21 have migrated towards
each other and fused to form a single primitive heart tube, the tubular heart. This is enabled by the
folding of the embryo which pushes the tubes into the thoracic cavity.

Also at the same time that the endocardial tubes are forming, vasculogenesis (the development of the
circulatory system) has begun. This starts on day 18 with cells in the splanchnopleuric mesoderm
differentiating into angioblasts that develop into flattened endothelial cells. These join to form small
vesicles called angiocysts which join up to form long vessels called angioblastic cords. These cords
develop into a pervasive network of plexuses in the formation of the vascular network. This network
grows by the additional budding and sprouting of new vessels in the process of angiogenesis.
Following vasculogenesis and the development of an early vasculature, a stage of vascular
remodelling takes place.

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The tubular heart quickly forms five distinct regions. From head to tail, these are the infundibulum,
bulbus cordis, primitive ventricle, primitive atrium, and the sinus venosus. Initially, all venous blood
flows into the sinus venosus, and is propelled from tail to head to the truncus arteriosus. This will
divide to form the aorta and pulmonary artery; the bulbus cordis will develop into the right
(primitive) ventricle; the primitive ventricle will form the left ventricle; the primitive atrium will
become the front parts of the left and right atria and their appendages, and the sinus venosus will
develop into the posterior part of the right atrium, the sinoatrial node and the coronary sinus.

Cardiac looping begins to shape the heart as one of the processes of morphogenesis, and this
completes by the end of the fourth week. Programmed cell death (apoptosis) at the joining surfaces
enables fusion to take place.[21] In the middle of the fourth week, the sinus venosus receives blood
from the three major veins: the vitelline, the umbilical and the common cardinal veins.

During the first two months of development, the interatrial septum begins to form. This septum
divides the primitive atrium into a right and a left atrium. Firstly it starts as a crescent-shaped piece of
tissue which grows downwards as the septum primum. The crescent shape prevents the complete
closure of the atria allowing blood to be shunted from the right to the left atrium through the opening
known as the ostium primum. This closes with further development of the system but before it does, a
second opening (the ostium secundum) begins to form in the upper atrium enabling the continued
shunting of blood.

A second septum (the septum secundum) begins to form to the right of the septum primum. This also
leaves a small opening, the foramen ovale which is continuous with the previous opening of the
ostium secundum. The septum primum is reduced to a small flap that acts as the valve of the foramen
ovale and this remains until its closure at birth. Between the ventricles the septum inferius also forms
which develops into the muscular interventricular septum.

Digestive system

The digestive system starts to develop from the third week and by the twelfth week, the organs have
correctly positioned themselves.

Respiratory system

The respiratory system develops from the lung bud, which appears in the ventral wall of the foregut
about four weeks into development. The lung bud forms the trachea and two lateral growths known
as the bronchial buds, which enlarge at the beginning of the fifth week to form the left and right main
bronchi. These bronchi in turn form secondary (lobar) bronchi; three on the right and two on the left
(reflecting the number of lung lobes). Tertiary bronchi form from secondary bronchi.

While the internal lining of the larynx originates from the lung bud, its cartilages and muscles
originate from the fourth and sixth pharyngeal arches.

Urinary system

Kidneys

Three different kidney systems form in the developing embryo: the pronephros, the mesonephros and
the metanephros. Only the metanephros develops into the permanent kidney. All three are derived
from the intermediate mesoderm.

Pronephros

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The pronephros derives from the intermediate mesoderm in the cervical region. It is not functional
and degenerates before the end of the fourth week.

Mesonephros

The mesonephros derives from intermediate mesoderm in the upper thoracic to upper lumbar
segments. Excretory tubules are formed and enter the mesonephric duct, which ends in the cloaca.
The mesonephric duct atrophies in females, but participate in development of the reproductive
system in males.

Metanephros

The metanephros appears in the fifth week of development. An outgrowth of the mesonephric duct,
the ureteric bud, penetrates metanephric tissue to form the primitive renal pelvis, renal calyces and
renal pyramids. The ureter is also formed.

Bladder and urethra

Between the fourth and seventh weeks of development, the urorectal septum divides the cloaca into
the urogenital sinus and the anal canal. The upper part of the urogenital sinus forms the bladder,
while the lower part forms the urethra.

Integumentary system

The superficial layer of the skin, the epidermis, is derived from the ectoderm. The deeper layer, the
dermis, is derived from mesenchyme.

The formation of the epidermis begins in the second month of development and it acquires its
definitive arrangement at the end of the fourth month. The ectoderm divides to form a flat layer of
cells on the surface known as the periderm. Further division forms the individual layers of the
epidermis.

The mesenchyme that will form the dermis is derived from three sources:

 The mesenchyme that forms the dermis in the limbs and body wall derives from the lateral
plate mesoderm
 The mesenchyme that forms the dermis in the back derives from paraxial mesoderm
 The mesenchyme that forms the dermis in the face and neck derives from neural crest cells

Nervous system

Figure 40.m: Development of brain in 8 week old embryo

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Late in the fourth week, the superior part of the neural tube bends ventrally as the cephalic flexure at
the level of the future midbrain—the mesencephalon. Above the mesencephalon is the
prosencephalon (future forebrain) and beneath it is the rhombencephalon (future hindbrain).

Cranial neural crest cells migrate to the pharyngeal arches as neural stem cells, where they develop in
the process of neurogenesis into neurons.

The optical vesicle (which eventually becomes the optic nerve, retina and iris) forms at the basal plate
of the prosencephalon. The alar plate of the prosencephalon expands to form the cerebral
hemispheres (the telencephalon) whilst its basal plate becomes the diencephalon. Finally, the optic
vesicle grows to form an optic outgrowth.

Development of physical features

Ears

The inner ear, middle ear and outer ear have distinct embryological origins.

Inner ear

At about 22 days into development, the ectoderm on each side of the rhombencephalon thickens to
form otic placodes. These placodes invaginate to form otic pits, and then otic vesicles. The otic vesicles
then form ventral and dorsal components.

The ventral component forms the saccule and the cochlear duct. In the sixth week of development the
cochlear duct emerges and penetrates the surrounding mesenchyme, travelling in a spiral shape until
it forms 2.5 turns by the end of the eighth week. The saccule is the remaining part of the ventral
component. It remains connected to the cochlear duct via the narrow ductus reuniens.

The dorsal component forms the utricle and semicircular canals.

Middle ear

The tympanic cavity and eustachian tube are derived from the first pharyngeal pouch (a cavity lined
by endoderm). The distal part of the cleft, the tubotympanic recess, widens to create the tympanic
cavity. The proximal part of the cleft remains narrow and creates the eustachian tube.

The bones of the middle ear, the ossicles, derive from the cartilages of the pharyngeal arches. The
malleus and incus derive from the cartilage of the first pharyngeal arch, whereas the stapes derives
from the cartilage of the second pharyngeal arch.

Outer ear

The external auditory meatus develops from the dorsal portion of the first pharyngeal cleft. Six
auricular hillocks, which are mesenchymal proliferations at the dorsal aspects of the first and second
pharyngeal arches, form the auricle of the ear.

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Eyes

The eyes begin to develop from the third week to the tenth week.

Figure 40.n: Movements of embryo at 9 weeks gestational age.

Limbs

At the end of the fourth week limb development begins. Limb buds appear on the ventrolateral aspect
of the body. They consist of an outer layer of ectoderm and an inner part consisting of mesenchyme
which is derived from the parietal layer of lateral plate mesoderm. Ectodermal cells at the distal end
of the buds form the apical ectodermal ridge, which creates an area of rapidly proliferating
mesenchymal cells known as the progress zone. Cartilage (some of which ultimately becomes bone)
and muscle develop from the mesenchyme.

Clinical significance

Toxic exposures in the embryonic period can be the cause of major congenital malformations, since
the precursors of the major organ systems are now developing.

Each cell of the preimplantation embryo has the potential to form all of the different cell types in the
developing embryo. This cell potency means that some cells can be removed from the preimplantation
embryo and the remaining cells will compensate for their absence. This has allowed the development
of a technique known as preimplantation genetic diagnosis, whereby a small number of cells from the
preimplantation embryo created by IVF, can be removed by biopsy and subjected to genetic diagnosis.
This allows embryos that are not affected by defined genetic diseases to be selected and then
transferred to the mother's uterus.

Sacrococcygeal teratomas, tumours formed from different types of tissue, that can form, are thought
to be related to primitive streak remnants, which ordinarily disappear.

First arch syndromes are congenital disorders of facial deformities, caused by the failure of neural
crest cells to migrate to the first pharyngeal arch.

Spina bifida a congenital disorder is the result of the incomplete closure of the neural tube.

Vertically transmitted infections can be passed from the mother to the unborn child at any stage of its
development.

Hypoxia a condition of inadequate oxygen supply can be a serious consequence of a preterm or

premature birth.

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FETUS

A fetus or foetus (/ˈ iːtəs/; plural fetuses, feti, foetuses, or foeti) is the unborn offspring of an animal
that develops from an embryo. Following embryonic development the fetal stage of development
takes place. In human prenatal development, fetal development begins from the ninth week after
fertilisation (or eleventh week gestational age) and continues until birth. Prenatal development is a
continuum, with no clear defining feature distinguishing an embryo from a fetus. However, a fetus is
characterized by the presence of all the major body organs, though they will not yet be fully developed
and functional and some not yet situated in their final anatomical location.

Etymology

The word fetus (plural fetuses or feti) is related to the Latin fētus ("offspring", "bringing forth",
"hatching of young") and the Greek "φυτώ" to plant. The predominant British, Irish, and
Commonwealth spelling is foetus, which has been in use since at least 1594. The spelling with -oe-
arose in Late Latin, in which the distinction between the vowel sounds -oe- and -e- had been lost. This
spelling is the most common in most Commonwealth nations, except in the medical literature, where
fetus is used. The more classical spelling fetus is used in Canada and the United States. In addition,
fetus is now the standard English spelling throughout the world in medical journals. The spelling
faetus was also used historically.

Development in humans

Weeks 9 to 16 (2 to 3.6 months)

Figure 41-a : A human fetus, attached to placenta, at three months gestational age, National
Museum of Health and Medicine, Whashington DC,

In humans, the fetal stage starts nine weeks after fertilization. At the start of the fetal stage, the fetus is
typically about 30 millimetres (1.2 in) in length from crown-rump, and weighs about 8 grams. The
head makes up nearly half of the size of the fetus. Breathing-like movements of the fetus are necessary
for the stimulation of lung development, rather than for obtaining oxygen. The heart, hands, feet, brain
and other organs are present, but are only at the beginning of development and have minimal
operation. The genitalia of the fetus starts to form and placenta becomes fully functional during week
9.

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At this point in development, uncontrolled movements and twitches occur as muscles, the brain, and
pathways begin to develop.

Weeks 17 to 25 (3.6 to 6.6 months)

A woman pregnant for the first time (nulliparous) typically feels fetal movements at about 21 weeks,
whereas a woman who has given birth before will typically feel movements by 20 weeks. By the end
of the fifth month, the fetus is about 20 cm (8 inches) long.

Weeks 26 to 38 (6.6 to 8.6 months)

The amount of body fat rapidly increases. Lungs are not fully mature. Thalamic brain connections,
which mediate sensory input, form. Bones are fully developed, but are still soft and pliable. Iron,
calcium, and phosphorus become more abundant. Fingernails reach the end of the fingertips. The
lanugo, or fine hair, begins to disappear, until it is gone except on the upper arms and shoulders. Small
breast buds are present on both sexes. Head hair becomes coarse and thicker. Birth is imminent and
occurs around the 38th week after fertilization. The fetus is considered full-term between weeks 36
and 40, when it is sufficiently developed for life outside the uterus. It may be 48 to 53 cm (19 to
21 inches) in length, when born. Control of movement is limited at birth, and purposeful voluntary
movements develop all the way until puberty.

Variation in growth

There is much variation in the growth of the human fetus. When fetal size is less than expected, the
condition is known as intrauterine growth restriction (IUGR) also called fetal growth restriction
(FGR); factors affecting fetal growth can be maternal, placental, or fetal.

Maternal factors include maternal weight, body mass index, nutritional state, emotional stress, toxin
exposure (including tobacco, alcohol, heroin, and other drugs which can also harm the fetus in other
ways), and uterine blood flow.

Placental factors include size, microstructure (densities and architecture), umbilical blood flow,
transporters and binding proteins, nutrient utilization and nutrient production.

Fetal factors include the fetus genome, nutrient production, and hormone output. Also, female fetuses
tend to weigh less than males, at full term.

Fetal growth is often classified as follows: small for gestational age (SGA), appropriate for gestational
age (AGA), and large for gestational age (LGA). SGA can result in low birth weight, although premature
birth can also result in low birth weight. Low birth weight increases risk for perinatal mortality (death
shortly after birth), asphyxia, hypothermia, polycythemia, hypocalcemia, immune dysfunction,
neurologic abnormalities, and other long-term health problems. SGA may be associated with growth
delay, or it may instead be associated with absolute stunting of growth.

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Viability

Table 05: Stages in prenatal development, showing viability and point of 50% chance of survival at
bottom. Weeks and months numbered by gestation. Häggström, Mikael (2014). "Medical gallery of
Mikael Häggström 2014". WikiJournal of Medicine 1 (2).

Fetal viability refers to a point in fetal development at which the fetus may survive outside the womb.
The lower limit of viability is approximately 5+3⁄4 months gestational age and is usually later.

There is no sharp limit of development, age, or weight at which a fetus automatically becomes viable.
According to data from 2003–05, survival rates are 20–35% for babies born at 23 weeks of gestation
(5+3⁄4 months); 50–70% at 24–25 weeks (6 – 6+1⁄4 months); and >90% at 26–27 weeks (6+1⁄2 –
6+3⁄4 months) and over. It is rare for a baby weighing less than 1.1 pounds (0.50 kg) to survive.

When such premature babies are born, the main causes of mortality are that the respiratory system
and the central nervous system are not completely differentiated. If given expert postnatal care, some
preterm babies weighing less than 1.1 pounds (0.50 kg) may survive, and are referred to as extremely
low birth weight or immature infants.

Preterm birth is the most common cause of infant mortality, causing almost 30 percent of neonatal
deaths. At an occurrence rate of 5% to 18% of all deliveries, it is also more common than postmature
birth, which occurs in 3% to 12% of pregnancies.

Circulatory system

Before birth

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Figure 41-b: Diagram of the human fetal circulatory system. Henry Vandyke Carter and one more
author - Henry Gray (1918)

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The heart and blood vessels of the circulatory system, form relatively early during embryonic
development, but continue to grow and develop in complexity in the growing fetus. A functional
circulatory system is a biological necessity, since mammalian tissues can not grow more than a few
cell layers thick without an active blood supply. The prenatal circulation of blood is different from
postnatal circulation, mainly because the lungs are not in use. The fetus obtains oxygen and nutrients
from the mother through the placenta and the umbilical cord.

Blood from the placenta is carried to the fetus by the umbilical vein. About half of this enters the fetal
ductus venosus and is carried to the inferior vena cava, while the other half enters the liver proper
from the inferior border of the liver. The branch of the umbilical vein that supplies the right lobe of
the liver first joins with the portal vein. The blood then moves to the right atrium of the heart. In the
fetus, there is an opening between the right and left atrium (the foramen ovale), and most of the blood
flows from the right into the left atrium, thus bypassing pulmonary circulation. The majority of blood
flow is into the left ventricle from where it is pumped through the aorta into the body. Some of the
blood moves from the aorta through the internal iliac arteries to the umbilical arteries, and re-enters
the placenta, where carbon dioxide and other waste products from the fetus are taken up and enter
the woman's circulation.

Some of the blood from the right atrium does not enter the left atrium, but enters the right ventricle
and is pumped into the pulmonary artery. In the fetus, there is a special connection between the
pulmonary artery and the aorta, called the ductus arteriosus, which directs most of this blood away
from the lungs (which aren't being used for respiration at this point as the fetus is suspended in
amniotic fluid).

Figure 41.c: 3D ultrasound of 3-inch (76 mm) fetus (about 3+1⁄2 months gestational age),
Biagio Azzarelli

Figure 41.d: Fetus at 4+1⁄4 months, Jenny Cu

Figure 41.e: Fetus at 5 months, Staecker

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Postnatal development

With the first breath after birth, the system changes suddenly. Pulmonary resistance is reduced
dramatically, prompting more blood to move into the pulmonary arteries from the right atrium and
ventricle of the heart and less to flow through the foramen ovale into the left atrium. The blood from
the lungs travels through the pulmonary veins to the left atrium, producing an increase in pressure
that pushes the septum primum against the septum secundum, closing the foramen ovale and
completing the separation of the newborn's circulatory system into the standard left and right sides.
Thereafter, the foramen ovale is known as the fossa ovalis.

The ductus arteriosus normally closes within one or two days of birth, leaving the ligamentum
arteriosum, while the umbilical vein and ductus venosus usually closes within two to five days after
birth, leaving, respectively, the liver's ligamentum teres and ligamentum venosus.

IMMUNE SYSTEM

The placenta functions as a maternal-fetal barrier against the transmission of microbes. When this is
insufficient, mother-to-child transmission of infectious diseases can occur.

Maternal IgG antibodies cross the placenta, giving the fetus passive immunity against those diseases
for which the mother has antibodies. This transfer of antibodies in humans begins as early as the fifth
month (gestational age) and certainly by the sixth month.

DEVELOPMENTAL PROBLEMS

A developing fetus is highly susceptible to anomalies in its growth and metabolism, increasing the risk
of birth defects. One area of concern is the lifestyle choices made during pregnancy. Diet is especially
important in the early stages of development. Studies show that supplementation of the person's diet
with folic acid reduces the risk of spina bifida and other neural tube defects. Another dietary concern
is whether breakfast is eaten. Skipping breakfast could lead to extended periods of lower than normal
nutrients in the maternal blood, leading to a higher risk of prematurity, or birth defects.

Alcohol consumption may increase the risk of the development of fetal alcohol syndrome, a condition
leading to intellectual disability in some infants. Smoking during pregnancy may also lead to
miscarriages and low birth weight (2500 grams, 5.5 lb). Low birth weight is a concern for medical
providers due to the tendency of these infants, described as "premature by weight", to have a higher
risk of secondary medical problems.

X-rays are known to have possible adverse effects on the development of the fetus, and the risks need
to be weighed against the benefits.

Congenital disorders are acquired before birth. Infants with certain congenital heart defects can
survive only as long as the ductus remains open: in such cases the closure of the ductus can be delayed
by the administration of prostaglandins to permit sufficient time for the surgical correction of the
anomalies. Conversely, in cases of patent ductus arteriosus, where the ductus does not properly close,
drugs that inhibit prostaglandin synthesis can be used to encourage its closure, so that surgery can be
avoided.

Other heart birth defects include ventricular septal defect, pulmonary atresia, and tetralogy of Fallot.

An abdominal pregnancy can result in the death of the fetus and where this is rarely not resolved it
can lead to its formation into a lithopedion.

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FETAL PAIN

Fetal pain, its existence and its implications are debated politically and academically. According to the
conclusions of a review published in 2005, "Evidence regarding the capacity for fetal pain is limited
but indicates that fetal perception of pain is unlikely before the third trimester." However,
developmental neurobiologists argue that the establishment of thalamocortical connections (at about
6+1⁄2 months) is an essential event with regard to fetal perception of pain. Nevertheless, the
perception of pain involves sensory, emotional and cognitive factors and it is "impossible to know"
when pain is experienced, even if it is known when thalamocortical connections are established. Some
authors argue that fetal pain is possible from the second half of pregnancy: “The available scientific
evidence makes it possible, even probable, that fetal pain perception occurs well before late gestation”
wrote KJS Anand in the journal of the IASP.

Whether a fetus has the ability to feel pain and suffering is part of the abortion debate. In the United
States, for example, anti-abortion advocates have proposed legislation that would require providers of
abortions to inform pregnant women that their fetuses may feel pain during the procedure and that
would require each person to accept or decline anesthesia for the fetus.

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XII. NEUROLOGY and THE BRAIN

THE BRAIN
The human brain is the organ commanding the human body. It is the support and command of:
 voluntary motions of other organs,
 psychological and/or psychical activities.
 It helps the human body for all senses.
In addition, the brain stocks bioinformation (biodata) like: sound records, image records, touch
records, smelling records, taste records, pain records, and others. The brain then could reproduce
each of those bioinformation or invent other bioinformation according to the stocked biodata.

Snap information of the brain

The encephalon or the brain is formed by the telencephalon, the diencephalon, the cerebellum and the
brain stem in general and at its first genesis.

The cerebrum is divided into three parts: the intermediate cerebrum or diencephalon, and the
telencephalons symetric and pair.

The nevrax is the assembly of the central nervous system such as the cerebrum, the brain stem and
the spinal cord.

The pons is found between the diencephalons and they are hold vertically. On its lateral face is fixed
the sensitive and motion trigeminal nerves. It trims laterally to its posterior face which forms the
forth triangular superior ventriculi cerebri.

The nerves of the nervus system are sensoriels, sensitives, parasympatics, motions and mixts.

Figure 42.a : A brain anatomy for each labeled brain part

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 Figure 42.b : A brain anatomy for brain group labelled

Figure 42.c : A brain anatomy for labeled function

Neurology system

The neurology system is a complex of:

 (i)internal organs system as shown in the homeostasis and the brain,
 (ii)external organ system as epiderm, cornea, and the brain,
 (iii) the environment ( imagery, sounds, temperature, etc) and organs.

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External environment, nerves, and the brain
The bioinformation (biodata) is received by the external organ; then, the biodata is transmitted
through the nerves to the brain working as: - receptor of bioinformation firstly, as treater of
information secondly, and as bioinformation transmitter thirdly.
Organs in relation with the external environment of the body are: the eyes, the auditory apparatus as
ears , the smelling aparatus as rhino, the tasting organs like the tongue, and others.

Internal environment, nerves, and the brain

The biodata (bioinformation) is produced by the internal organ; then, the biodata is transmitted
through the nerves to the brain working as –receptor of bioinformation firstly, as treater of biodata
secondly, and as biodata transmitter thirdly. Organs in relation with the internal environment of the
body are: the heart, the lungs, the intestines, the members, the spinal cord and other organs.

Nervous tissue is composed of two types of cells: neurons that transmit messages and neuroglia that
largely service the neurons. Motor neurons, which take messages from the spinal cord to the muscles
are often used to exemplify typical neurons.
Motor neurons have several dendrites, processes that take signals to a cell body, where the nucleus is
located and an axon that takes nerve impulses away from cell body.

Figure 43 :Motor neuron anatomy

OVERVIEW OF THE NERVOUS SYSTEM

Nachum Dafny, Ph.D., Department of Neurobiology and Anatomy, The UT Medical School at Houston

The human nervous system is divided into the central nervous system (CNS) and the peripheral nervous
system (PNS). The CNS, in turn, is divided into the brain and the spinal cord, which lie in the cranial
cavity of the skull and the vertebral canal, respectively. The CNS and the PNS, acting in concert, integrate
sensory information and control motor and cognitive functions.

1.1The Central Nervous System (CNS)

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The adult human brain weighs between 1,200 to 1,500 g and contains about one trillion cells. It
occupies a volume of about 1400 cc - approximately 2% of the total body weight, and receives 20% of
the blood, oxygen, and calories supplied to the body. The adult spinal cord is approximately 40 to 50
cm long and occupies about 150 cc. The brain and the spinal cord arise in early development from the
neural tube, which expands in the front of the embryo to form the three primary brain divisions: the
prosencephalon (forebrain), mesencephalon (midbrain), and rhombencephalon (hindbrain)
(Figure 1.1A). These three vesicles further differentiate into five subdivisions: telencephalon,
diencephalon, mesencephalon, metencephalon, and the myelencephalon (Figure 1.1B). The
mesencephalon, metencephalon, and the myelencephalon comprise the brain stem.

The telencephalon includes the cerebral cortex (cortex is the outer layer of the brain), which
represents the highest level of neuronal organization and function (Figures 1.2A and 1.2B). The
cerebral cortex consists of various types of cortices (such as the olfactory bulbs, Figure 1.2B) as well
as closely related subcortical structures such as the caudate nucleus, putamen, globus, amygdala and
the hippocampal formation (Figure 1.2C).

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The diencephalon consists of a complex collection of nuclei lying symmetrically on either side of the
midline. The diencephalon includes the thalamus, hypothalamus, epithalamus and subthalamus
(Figure 1.3).

The mesencephalon (or midbrain) consists of several structures around the cerebral aqueduct such
as the periaqueductal gray (or central gray), the mesencephalic reticular formation, the substantia
nigra, the red nucleus (Figure 1.4), the superior and inferior colliculi, the cerebral peduncles, some
cranial nerve nuclei, and the projection of sensory and motor pathways.

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 Figure 1.5
Lateral view of the metencephalon and a spinal cord section with ventral and dorsal root
fibers, and dorsal root ganglia.

The metencephalon includes the pons and the cerebellum. The myelencephalon (spinal cord-like)
includes the open and closed medulla, sensory and motor nuclei, projection of sensory and motor
pathways, and some cranial nerve nuclei.

The caudal end of the myelencephalon develops into the spinal cord. The spinal cord is an elongated
cylindrical structure lying within the vertebral canal, which includes the central canal and the

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surrounding gray matter. The gray matter is composed of neurons and their supporting cells and is
enclosed by the white matter that is composed of a dense layer of ascending and descending nerve
fibers. The spinal cord is an essential link between the peripheral nervous system and the brain; it
conveys sensory information originating from different external and internal sites via 31 pairs of
spinal nerves (Figure 1.5). These nerves make synaptic connections in the spinal cord or in the
medulla oblongata and ascend to subcortical nuclei.

Figure 1.6 The central nervous system, which includes the spinal cord and the brain, is the most
protected organ in the human body. It is protected from the external environment by three barriers:
skull, meninges, and cerebral spinal fluid (CSF).

The meninges are composed by three fibrous connective tissues (Figure 1.6). The most external is a
dense collagenous connective tissue envelope known as the dura mater (Latin for “hard mother”). The
second, or the intermediated membrane, is a delicate non-vascular membrane of fine collagenous
layer of reticular fibers forming a web-like membrane, known as the arachnoid (Greek for “spider”). It
is separated from the inner pia layer by subarachnoid space, which is filled with cerebrospinal fluid.
The inner most delicate connective tissue membrane of collagenous is the pia mater, a thin
translucent elastic membrane adherent to the surface of the brain and the spinal cord. Blood vessels
located on the surface of the brain and the spinal cord are found on top of the pia matter. The

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meninges are subject to viral and bacterial infection known as meningitis, a life-threatening condition
that requires immediate medical treatment.

The space between the skull and the dura is known as the epidural space. The space between the dura
and the arachnoid is known as the subdural space. The space between the arachnoid and the pia is
known as the subarachnoid space. In this space, there is a clear liquid known as the CSF. The CSF
serves to support the CNS, and to cushion as well as protect it from physical shock and trauma. The
CSF is produced by the choroid plexus, which is composed of a specialized secretory ependymal layer
located in the ventricular system.

The ventricular system is a derivative of the primitive embryonic neural canal. This system is an
interconnected series of spaces within the brain, which contains the CSF (Figure 1.7).

In general, the CNS can be divided into three main functional components: the sensory system, the
motor system, and homeostatic and higher brain functions. The sensory system consists of the
somatosensory, viscerosensory, auditory, vestibular, olfactory, gustatory, and visual systems. The
motor system consists of motor units, and the somatic (skeletal muscle) system, the spinal reflexes,
the visceral (autonomic) system, the cerebellum, several subcortical and cortical sites, as well as the
brain stem ocular motor control system. The homeostatic and higher functional system includes the
hypothalamus, cortical areas involved in motivation, insight, personality, language, memory,
imagination, creativity, thinking, judgment, mental processing, and subcortical areas involved in
learning, thought, consciousness, memory, attention, emotional state, sleep and arousal cycles.

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1.2 The Cerebral Hemispheres

The largest and most obvious parts of the human brain are the cerebral hemispheres. The cerebrum
has an outer layer - the cortex, which is composed of neurons and their supporting cells, and in living
brain, has a gray color thus called the gray matter. Under the gray matter is the white matter, which is
composed of myelinated ascending and descending nerve fibers, and in living brain have a white color.
Embedded deep within the white matter are aggregates of neurons exhibiting gray color and known
as subcortical nuclei. The cerebral hemispheres are partially separate from each other along the
midline by the interhemispheric fissure (deep groove) the falx cerebri (Figure 1.8A); Posteriorly, there
is a transverse fissure that separates the cerebral hemisphere from the cerebellum, and contains the
tentorium cerebellum. The hemispheres are connected by a large C-shaped fiber bundle, the corpus
callosum, which carries information between the two hemispheres.

For descriptive purposes each cerebral hemisphere can be divided into six lobes. Four of these lobes
are named according to the overlying bones of the skull as follows: frontal, parietal, occipital and
temporal (Figures 1.8A and 1.8B), the fifth one is located internally to the lateral sulcus – the insular
lobes (Figure 1.8B and 1.8D), and the sixth lobe is the limbic lobe (Figure 1.8C) which contains the
limbic system nuclei. Neither the insular lobe nor the limbic lobe is a true lobe. Although the
boundaries of the various lobes are somewhat arbitrary, the cortical areas in each lobe are
histologically distinctive.

The surface of the cerebral cortex is highly convoluted with folds (gyri), separate from each other by
elongated grooves (sulci). These convolutions allow for the expansion of the cortical surface area
without increasing the size of the brain. On the lateral surface of the cerebral hemisphere there are
two major deep grooves-sulci (or fissure), the lateral fissure (of Sylvian) and the central sulci (of
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Rolando), these sulci provide landmarks for topographical orientation (Figure 1.9A). The central
sulcus separates the frontal lobe from the parietal lobe and runs from the superior margin of the
hemisphere near its midpoint obliquely downward and forward until it nearly meets the lateral
fissure (Figures 1.8A and 1.8B). The lateral fissure, separating the frontal and parietal lobes from the
temporal lobe, begins inferiorly in the basal surface of the brain and extends laterally posteriorly and
upward, separating the frontal and parietal lobes from the temporal lobe (Figure 1.9A). The frontal
lobe is the portion which is rostral to the central sulcus and above the lateral fissure, and it occupies
the anterior one third of the hemispheres (Figures 1.8 and 1.9). The boundaries of the parietal lobe
are not precise, except for its rostral border – the central sulcus. The occipital lobe is the portion
which is caudal to the parietal lobe (Figures 1.8 and 1.9). Along the lateral surface of the hemisphere,
an imaginary line connecting the tip of the parietal-occipital sulcus and the preoccipital notch (Figure
1.9A), separate the parietal lobe from the occipital lobe. On the medial surface of the hemisphere
(Figure 1.9B), parieto-occipital sulcus forms the rostral boundary of the parietal lobe. The temporal
lobe lies ventral to the lateral sulcus, and on its lateral surface, it displays three diagonal oriented
convolutions-the superior, middle, and inferior temporal gyri (Figure 1.9A). The insula lies in the
depths of the lateral sulcus. It has a triangular cortical area with gyri and sulci (Figures 1.8B and 1.8D,
and Figure 1.9A). The limbic lobe consists of several cortical and subcortical areas (Figure 1.9B).

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The cerebral cortex is a functionally organized organ. A functionally organized system is a set of
neurons linked together to convey a specific type(s) of information to accomplish a particular task. It
is possible to identify on the cerebral cortex primary sensory areas, secondary sensory areas, primary
motor area, premotor area, supplementary motor area and association areas, which are devoted to the
integration of motor and sensory information, intellectual activity, thinking and comprehension,
execution of language, memory storage and recall.

The frontal lobe is the largest of the brain lobes and is comprised of four gyri, precentral gyrus that
parallels the central sulcus, and three horizontal gyri: the superior, middle, and inferior frontal gyri.
The inferior frontal gyrus is comprised of three parts: the orbital, the triangular and opercular. The
term opercular refers to the “lips of the lateral fissure. Finally, the straight gyrus (gyrus rectus) and
the orbital gyri form the base of the frontal lobe (Figure 1.9B). Four general functional areas are in the
frontal lobe. They are the primary motor cortex, where all parts of the body are represented, the
premotor and supplementary motor areas. A region concerned with the motor mechanisms of speech
formulation comprised of the opercular and triangular parts of the inferior frontal gyrus are known as
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Broca’s speech area, and the remainder of the prefrontal cortex is involved in mental activity,
personality insight, foresight, and reward. The orbital portion of the prefrontal cortex is important in
the appropriate switching between mental sets and the regulation of emotion.

The parietal lobe is comprised of three gyri: postcentral gyrus, superior and inferior parietal gyri
(Figure 1.9A). The postcentral gyrus is immediately behind the central sulcus which forms its anterior
boundary. The postcentral gyrus comprises the primary somatosensory cortex which is concerned
with somatosensory reception, integration and processing sensory information from the surface of
the body and from the viscera, and is important for the formulation of perception. Caudal to the
postcentral gyrus is the inferior parietal gyrus. The intraparietal sulcus separates the posterior
parietal gyrus from the inferior parietal gyrus. The inferior parietal gyrus represents the cortical
association area which integrates and processes sensory information from multiple modalities such as
auditory and visual information. The inferior parietal gyrus, which is known as Wernicke's area, is
also important for language and reading skills, whereas the superior parietal gyrus is concerned with
body image and spatial orientations.

The temporal lobe is formed by three obliquely oriented gyri: the superior, middle, and inferior
temporal gyri (Figure 1.9A). Inferomedial to the inferior temporal gyrus are the occipitotemporal and
the parahippocampal gyri, which are separated by the collateral sulcus. The upper surface of the
superior temporal gyrus, which extends into the lateral fissure, is called the transverse temporal gyrus
(of Heschl) and is the primary auditory cortex. The caudal part of the superior temporal gyrus, which
extends up to the parietal cortex, forms part of Wernicke’s area. Wernicke’s area is concerned, in part,
with processing the auditory information and is important in the comprehension of language. The
inferior part of the temporal lobe (i.e., the occipitotemporal gyri) is involved in visual and cognitive
processing. More medially is the parahippocampal gyrus, which is involved in learning and memory.
Portions of the frontal, parietal, and temporal lobes, which are adjacent to the lateral sulcus and
overlie the insular cortex, are known as the operculum. The inferomedial surface of the temporal lobe
is made up of the uncus and the parahippocampal gyrus medially. The inferior surface of the temporal
lobe rests on the tentorium cerebelli.

The occipital lobe is the most caudal part of the brain, lies on the tentorium cerebelli (Figure 1.9A)
and is comprised of several irregular lateral gyri. On its medial surface, there is a prominent fissure –
the calcarine fissure and parieto-occipital sulcus. The calcarine fissure (sulcus) and the parieto-
occipital sulcus also define a cortical region known as the cuneus. The cuneus sulcus divides the
occipital lobe into the cuneus dorsally and ventrally into the lingual gyrus. The occipital lobe contains
the primary and higher-order visual cortex.

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The insula lobe is located deep inside the lateral fissure and can be seen only when the temporal and
the frontal lobes are separated (Figures 1.8B and 1.8D). The insula is characterized by several long
gyri and sulci, the gyri breves and gyri longi. There is some evidence that the insular cortical areas are
involved in nociception and regulation of autonomic function.

The limbic lobe is not a true lobe and is comprised of several cortical regions such as the cingulate
and parahippocampal gyri, some subcortical areas like the hippocampus, amygdala, septum, and other
areas with their respective ascending and descending connections (Figures 1.8C and 1.9B). The limbic
lobe is involved in memory and learning, drive related behavior, and emotional function.

There are subcortical areas in the telencephalon like the basal ganglia and the amygdaloid nucleus
complex. The corpus callosum is a collection of nerve fibers that connect the two hemispheres. The
corpus callosum is divided into rostrum (head), body, the most rostrally part is the genu (knee) with
connecting the rostrum and the body, and the splenium at the caudal extremity (Figure 1.10). The
corpus callosum plays an important role in transferring information from one hemisphere to the
other.

1.3 The Diencephalon

The second major derivative of the prosencephalon is the diencephalon. The diencephalon is the
most rostral structure of the brain stem; it is embedded in the inferior aspect of the cerebrum. The
posterior commissure is the junctional landmark between the diencephalon and the mesencephalon.
Caudally, the diencephalon is continuous with the tegmentum of the midbrain. During development
the diencephalon differentiates into four regions: thalamus, hypothalamus, subthalamus and
epithalamus (Figure 1.11) The epithalamus comprises the stria medullaris habenular trigone, pineal
gland and the posterior commissure
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1.4 The Brain Stem

The brain stem consists of mesencephalon (midbrain), metencephalon, and myelencephalon. The
metencephalon and myelencephalon together compose the rhombencephalon (hindbrain), which
divides into pons, and medulla oblongata (Figures 1.11 and 1.12).

Mesencephalon (midbrain) is continuous with the diencephalon rostrally and with the pons caudally.
The midbrain is the smallest part of the brain stem, being about 2 cm in length. It consists of a tectum
posteriorly, a tegmentum inferiorly, and a base anteriorly. The tectum forms the roof of the cerebral
aqueduct, which connects the third ventricle with the fourth ventricle and the tegmentum its floor.
The base of the midbrain consists of the cerebral peduncle, which contain nerve fibers descending
from the cerebral cortex. The nuclei of the 3rd (oculomotor), the 4th (trochlear) and part of the 5th
(trigeminal) are located in the midbrain tegmentum. The red nucleus and the substantia nigra, two
prominent nuclei, are also found in the midbrain tegmentum. The midbrain tectum is formed by two
pairs of rounded structures: the superior and inferior colliculi. The superior and inferior colliculi
(Figure 1.12) are involved in visual and auditory functions respectively.

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Pons is continuous with the midbrain and is composed of two parts, the pontine tegmentum (located
internally) and the basilar pons. At the level of the pons, the cerebral aqueduct has expanded to form
the fourth ventricle (Figure 1.12). The cerebellum is situated posterior to the pons and forms part of
the roof (tectum) of the forth ventricle. The pons contains nuclei that receive axons from various
cortical areas. Projections from the axons of these pontine neurons form large transverse fiber
bundles that traverse the pons and ascend to the contralateral cerebellum via the middle cerebellar
peduncles. Also, within the pons base and tegmentum are longitudinally ascending and descending
fibers. The nuclei of the 5th (trigeminal), 6th (abducens), 7th (facial) and the 8th (vestibulocochlear)
nerves are located in the pons tegmentum.

Medulla Oblongata (myelencephalon is also known as the medulla). The medulla lies between the
pons rostrally and the spinal cord caudally. It is continuous with the spinal cord just above to foramen
magnum and the first spinal nerve. The posterior surface of the medulla forms the caudal half of the
fourth ventricle floor and the cerebellum, its roof (Figure 1.12). The base of the medulla is formed by
the pyramidal-descending fibers from the cerebral cortex. The medulla tegmentum contains
ascending and descending fibers and nuclei from the 9th (glossopharyngeal), 10th (vagus), 11th
(accessory) and the 12th (hypoglossal) nerves. The corticospinal fibers (pyramid) are alongside the
anterior median fissure, and decussate (cross the midline) to the contralateral side on their way to the
spinal cord. Other prominent structures in the medulla are the inferior olive, and the inferior
cerebellar peduncle. The medulla contains nuclei which regulate respiration, swallowing, sweating,
gastric secretion, cardiac, and vasomotor activity.

The arterial blood supply to the brain is derived from two arterial systems: the carotid system and
the vertebrobasilar system. A series of an anastomotic channels lying at the base of the brain, known
as the circle of Willis, permits communication between these two systems (Figure 1.13).
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The arterial blood supply to the spinal cord is derived from two branches of vertebral artery, the
anterior and two posterior spinal arteries which run the length of the spinal cord and form an
irregular plexus around it (Figure 1.14).

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1.5 The Peripheral Nervous System (PNS)

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The PNS includes 31 pairs of spinal nerves, 12 pairs of cranial nerves, the autonomic nervous system
and the ganglia (groups of nerve cells outside the CNS) associated with them. Also included in the PNS
are the sensory receptor organs. The receptor organs are scattered in all parts of the body, sense and
perceive changes from external and internal organs, then transform this information to electrical
signals, which are carried via an extensive nervous network to the CNS (Figure 1.15). The cranial and
spinal nerves contain nerve fibers that conduct information to-afferent-(Latin for carry toward) and
from-efferent (Latin for carry away) the CNS. Afferent fibers convey sensory information from sensory
receptors in the skin, mucous membranes, and internal organs and from the eye, ear, nose and mouth
to the CNS; the efferent fibers convey signals from cortical and subcortical centers to the spinal cord
and from there to the muscle or autonomic ganglia that innervate the visceral organs. The afferent
(sensory) fibers enter the spinal cord via the dorsal (posterior) root, and the efferent (motor) fibers
exit the spinal cord via the ventral (anterior) root. The spinal nerve is formed by the joining of the
dorsal and the ventral roots. The cranial nerves leave the skull and the spinal cord nerves leave the
vertebrae through openings in the bone called foramina (Latin for opening).

The PNS is divided into two systems: the visceral system and the somatic system. The visceral system
is also known as the autonomic system. The autonomic nervous system (ANS) is often considered a
separate entity; although composed partially in the PNS and partially in the CNS, it interfaces between
the PNS and the CNS. The primary function of the ANS is to regulate and control unconsciousness
functions including visceral, smooth muscle, cardiac muscle, vessels, and glandular function (Figure
1.16). The ANS can be divided into three subdivisions:

1. The sympathetic (or the thoracolumbar) subdivision associated with neurons located in the spinal gray
between the thoracic and the upper lumbar levels;
2. The parasympathetic (or craniosacral) subdivision is associated with the 3rd, 7th, 9th and the 10th cranial
nerves as well as with the 2nd, 3rd, and 4th sacral nerves;

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 3. The enteric subdivision is a complex neuronal network within the walls of the gastrointestinal system and
contains more neurons than the spinal cord. The visceral (autonomic) system regulates the internal organs
outside the realm of conscious control. The PNS component of the somatic system includes the sensory
receptors and the neurons innervating them and their nerve fibers entering the spinal cord. The visceral and
the somatic nervous system are primarily concerned with their own functions, but also work in harmony
with other aspects of the nervous system.

1.6 Orientation to the Central Nervous System

This section illustrates representative sections through the CNS in order to acquaint the reader with
prominent structures and help in the recognition of the level and orientation of the section. It also
provides landmarks for locating nuclei and tracts involved in sensory and motor functions. Directional
terms are used in describing the locations of structures in the CNS.

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Keep in mind that certain terms were developed to describe the nervous system of quadrupeds and
may have a slightly different meaning when applied to bipeds. For example, the ventral surface of the
quadruped spinal cord is comparable to the anterior surface of the biped (Figure 1.18). In the
following descriptions, the terms are applied to a standing human. The terms rostral and anterior
refer to a direction towards the face/nose. The terms caudal and posterior refer to a direction towards
the buttocks/tail. The terms inferior and superior generally refer to spatial relationships in a vertical
direction (Figure 1.18). A coronal section is parallel to the vertical plane and a midcoronal section
would divide the head into anterior and posterior halves (Figure 1.19). The sagittal section is also
parallel to the vertical plane, but a midsagittal section would divide the head into right and left halves.
The horizontal (axial) section is parallel to the horizontal plane and a mid-horizontal section would
divide the head into superior and inferior halves. Transverse or cross sections of the spinal cord of
humans are taken in a plane perpendicular to the vertical (i.e., in the horizontal plane of the head).
Most electromagnetic imaging techniques produce images of the brain in the coronal, horizontal
(axial) and sagittal planes. The representative sections are transverse sections through the spinal cord
and brain stem and coronal sections through the telencephalon and diencephalon (Figure 1.17).

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Transverse Section through the Spinal Cord. Figure 1.17A illustrates a section taken at the level of the
thoracic spinal cord. The spinal cord neuron (gray matter) form a central core taking a butterfly
configuration that is surrounded by nerve fibers (white matter). In the left and right halves of the
spinal cord, the gray matter is organized into a dorsal horn and ventral horn with the intermediate
gray located between them. In the thoracic spinal cord, which is illustrated in this figure, a lateral horn
extends laterally from the intermediate gray (Figure 1.17A). The spinal cord white matter is
subdivided into the posterior white column, the anterior white column and the lateral white column.
The anterior white commissure joins the two halves of the spinal cord and is located ventral to the
intermediate gray. The dorsal root fibers enter the spinal cord at the dorsolateral sulcus and the fibers
of the ventral root fibers exit the spinal cord in numerous fine bundles through the ventral funiculus
(see Figure 1.5).

Transverse Section through the Medulla. Figure 1.17B is a section taken at the level of the upper
medulla. Landmark structures include the fourth ventricle, hypoglossal nucleus, inferior cerebellar
peduncle, inferior olivary complex and the pyramids. As in the spinal cord section, the fiber tracts, the
inferior cerebellar peduncle and pyramids, appear light in this section whereas the nuclei in the
inferior olivary complex appear dark.

Transverse Section through the Pons. Figure 1.17C is a section taken at the level of the mid pons.
Landmark structures include the fourth ventricle, the pons tegmentum, which includes the abducens
nuclei; the pons base, which includes the corticofugal fibers and pontine nuclei; and the middle
cerebellar peduncles.

Coronal Section through the Rostral Telencephalon. Figure 1.17D is a section taken at the level of the
decussation of the anterior commissure. Landmark structures include the head of the caudate nucleus,
the anterior limb of the internal capsule, the globus pallidus and putamen (important for controlling
motor functions). The anterior commissure, a fiber bundle connecting the right and left frontal lobes,
can be seen decussating (crossing the midline). The corpus callosum forms a thick band of decussating

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nerve fibers located above the lateral ventricles. Below the telencephalon afferent nerve fibers from
each eye decussate in the optic chiasm and join uncrossed fibers to form the optic tract.

Coronal Section through the Midbrain-Diencephalon Junction. Figure 1.17E is a section taken at the
level of the junction of the midbrain with the diencephalon. Notice that the plane of section differs
from those of the previous sections. At this level, a landmark structure of the diencephalon is the
thalamus, which surrounds the third ventricle. The posterior limb of the internal capsule separates
the thalamus from the surrounding telencephalic structures (i.e., the globus pallidus and putamen).
Lateral to the putamen is the insula while more dorsomedially the corpus callosum overlies the
cavities of the lateral ventricles. Below the third ventricle are the red nucleus, substantia nigra and
crus cerebri of the midbrain, which are the continuation of the internal capsule.

Section through the Midbrain. Figure 1.17F is a section that shows the main midbrain nuclei which
include the tectum (superior colliculi) the periaqueductal gray, the red nuclei, substantia nigra and the
cerebral peduncles.

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XIII. OPHTALMOLOGY, by Brian Ang, Dr. MD

The eye as shown in the following figure is among the human organs responsible of imagery. It capts
all images depending on its angle of view, the distance, the colors, the brightness or/and the darkness.
As an organ, the eye also feels temperature, tastes, sense of touch, and other senses.
The eye is made up of sclera, choroid, retina, fovea centralis, the optic nerve, the blind spot, fovea
centralis, posterior compartment filled with vitreous humor, ciliary body, lens, iris, pupil, cornea,
anterior compartment filled with aqueous humor.

How well do you know about the anatomy of the eyeball?

An understanding of eye anatomy provides a better insight of just how amazing the eye is. The eye is a
small organ, measuring around 24 millimeters in diameter and length at its full adult size. Despite the
small size, many cells in the eye work together to enable you to see in different ways.
In general, the camera provides the best analogy for how the eye works. The eye is a camera, where
the eyelid is the shutter, the crystalline lens is the lens, and the retina is the film. In addition, the optic
nerve is the cable that connects the eye (camera) to the brain (computer).
To help with eye anatomy, it is useful to differentiate the eye into 3 parts:
- Front section (anterior segment);
- Back section (posterior segment);
- Surrounding supporting tissues.

(Image reproduced with permission from Dave Carlson - Carlson Stock Art)

Figure 44: Diagram demonstrating the front and back eye anatomy
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EYE ANATOMY - FRONT SECTION (ANTERIOR SEGMENT)

The eye anatomy at the front comprises the following tissues: conjunctiva, sclera, cornea, iris, ciliary
body and crystalline lens.
The conjunctiva is the thin layer that lines the front of the sclera and also the inner surfaces of the
eyelids. It contains glands that secrete lubricating fluids as well as lymphoid tissue. The conjunctiva is
therefore important in keeping the eye moist and in protecting the eye from infection.
The sclera is the tough outer coat of the eye. It is the white part of the eye. It maintains the structural
integrity of the eye and provides support for all the other eye tissues. The extraocular muscles are
attached to the sclera - the anchor points on the sclera allow the eyeball to move when the extraocular
muscles contract.
The cornea is the clear, front window of the eye. It is transparent; this allows light to enter the
eyeball. As light passes through the cornea, it becomes refracted. Together with the lens, the cornea is
responsible for focusing light onto the retina. The space in between the cornea and lens is called the
anterior chamber, which is filled by aqueous humor. The aqueous humor provides nutrients and
oxygen to the cornea.
The iris is the colored part of the eye. It is a membrane that sits between the cornea and the lens. The
iris color depends on the amount of pigment in the iris. Those with dark brown irides have a lot of iris
pigment. The pupil is the round opening in the center of the iris. The iris is responsible for controlling
the amount of light that enters the eye through the pupil. When there is too much light, the iris
muscles constrict the pupil to restrict the amount of light entering the eye. Conversely, when it is dark,
the iris muscles dilate the pupil to allow as much light to enter the eye as possible.
The crystalline lens is located just behind the iris. It is held in place in the eye by zonules (also known
as suspensory ligaments) that attach it to the ciliary body. Along with the cornea, it is responsible for
focusing light onto the retina. It is able to change its thickness, and thus can change the focus from far
to near objects and vice versa (i.e. accommodate).
The ciliary body is positioned just behind the iris. Its two main functions are to produce aqueous
humor and to change the thickness of the lens by stretching or relaxing the zonules that are attached
to it.

EYE ANATOMY - BACK SECTION (POSTERIOR SEGMENT)

The eye anatomy at the back comprises the following: vitreous humor, retina, choroid and optic nerve.

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The vitreous humor is the jelly-like substance that fills the vitreous cavity between the lens and the
retina. It is transparent and thus allows light to be focused onto the retina. The vitreous humor also
helps the eye to maintain its shape and turgidity
The retina is the light-sensitive innermost lining of the eyeball. It comprises the retinal pigment
epithelial layer and neurosensory retina. The retinal pigment epithelium helps to maintain and
support the neurosensory retina. The neurosensory retina detects, absorbs and processes the light
that enters the eye. Retinal photoreceptor cells in the neurosensory retina collect light signals and
convert them to bio-electrical signals, which are then sent to the optic nerve. There are two types of
photoreceptor cells: rods and cones.
Rod photoreceptors are located in the peripheral retina,
and are responsible for night vision and detection of
motion.

Cone photoreceptors are mostly concentrated at the

macula (center of the retina) and are important for fine
detailed visual acuity and color vision. Any damage to the
macula, such as in macular degeneration, will cause
blurring of the central vision.

Figure 45: The retina

The optic nerve is composed of over one million nerve fibers. It transmits bio-electrical information
from the neurosensory retina to the brain, so that the brain can interpret what it is that you are
seeing. Your vision can be affected by damage to the optic nerve, such as in glaucoma and optic
neuritis.
The choroid is the layer between the retina and sclera. It is full of blood vessels and is responsible for
supplying nutrients to the retina. The dark melanin pigment in the choroid absorbs any excess light in
the eye.

EYE ANATOMY - SUPPORTING TISSUES

Eye anatomy is not limited to the eyeball itself. There are also important supporting structures, and
these include the eyelids, extraocular muscles and lacrimal drainage system.

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The eyelids protect the eyes from any external trauma. Blinking the eyelids maintains the tear film,
which keeps the eye moist. The upper and lower eyelids have a tough fibrous plate called the tarsal
plate, which provides support and rigidity to the lid. These plates also contain meibomian glands,
which produce oil that helps to stabilize the tear film. Dysfunction of the meibomian glands can result
in inflammation of the eyelids and blepharitis.

The extraocular muscles move the eye. There are six muscles that are attached to the sclera at one
end and the eye socket at the other end. The six muscles are the superior rectus, inferior rectus, lateral
rectus, medial rectus, superior oblique and inferior oblique muscles. These muscles work together so
that both eyes will view the object at the same time.

Figure 46: Eye muscles

The lacrimal system produces, distributes and drains the tears that are important to keep the surface
of the eye moist. The lacrimal gland located under the upper eyelid produces tears. When you blink,
the tears are distributed throughout the eye surface. The tears are then drained through the punctum,
lacrimal canaliculi, nasolacrimal sac and nasolacrimal duct to eventually enter the nose.

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 Figure 47: The lacrimal system

http://www.vision-and-eye-health.com/

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XIV. OTHO‐RHINO‐LARYNGOLOGY

Generality
Otorhinolaryngology (/oʊtoʊˌraɪnoʊˌlærənˈɡɒlədʒi/ oh-toh-RYE-noh-LAR-ən-GOL-ə-jee, abbreviated ORL
and also known as otolaryngology, otolaryngology – head and neck surgery (ORL–H&N or OHNS), or
ear, nose, and throat (ENT), is a surgical subspecialty within medicine that deals with the surgical and
medical management of conditions of the head and neck. Doctors who specialize in this area are called
otorhinolaryngologists, otolaryngologists, head and neck surgeons, or ENT surgeons or physicians. Patients
seek treatment from an otorhinolaryngologist for diseases of the ear, nose, throat, base of the skull, head, and
neck. In the following figure 48 a, b,c, you could see the paranasal sinuses, coronal section.

Paranasal sinuses
Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity. The
maxillary sinuses are located under the eyes; the frontal sinuses are above the eyes; the ethmoidal
sinuses are between the eyes and the sphenoidal sinuses are behind the eyes. The sinuses are named
for the facial bones in which they are located.

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Figure 48.a: A part of the Otho-Rhino-Laryngology, Coronal section

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 Figure 48.b: Paranasal sinuses seen in frotan view

Figure 48.c: Lateral view and/or projection of the paranasal sinuses

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Figure 48.d: Anatomy Of The Paranasal Sinuses Spaces Between The Advanced Medical Supplies
Human Teaching Nasal Cavity Anatomy Model For School Buy Medical Model Human Teaching Model
Nasal Cavity Model Product On

Structure

Humans possess four paired paranasal sinuses, divided into subgroups that are named according to
the bones within which the sinuses lie:

 The maxillary sinuses, the largest of the paranasal sinuses, are under the eyes, in the maxillary bones
(open in the back of the semilunar hiatus of the nose). They are innervated by the trigeminal nerve (CN
V2).
 The frontal sinuses, superior to the eyes, in the frontal bone, which forms the hard part of the forehead.
They are also innervated by the trigeminal nerve (CN V1).
 The ethmoidal sinuses, which are formed from several discrete air cells within the ethmoid bone
between the nose and the eyes. They are innervated by the ethmoidal nerves, which branch from the
nasociliary nerve of the trigeminal nerve (CN V1).
 The sphenoidal sinuses, in the sphenoid bone. They are innervated by the trigeminal nerve (CN V1 and
V2).

The paranasal air sinuses are lined with respiratory epithelium (ciliated pseudostratified columnar
epithelium).

Functions

One known function of the paranasal sinuses is the production of nitric oxide and other substances, which
also functions as a facilitator of oxygen uptake.

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Some other functions of paranasal sinuses are:

 Contribute to create antibodies for the head parts of the body,

 Contribute to create substances for the restructuration of some parts of the head,
 Contribute to the creation of saliva and other substances of some head glands,
 Help selecting and smelling different smells.
 Increased voice resonance,
 Providing a shockproof "buffer" in case of injuries,
 Humidification and warming of the inhaled air, as a result of slow air flow in the sinuses.
 Perform the function of a sensory system of air signals (a baroreceptor organ that responds to changes in
environmental pressure).

Development

Paranasal sinuses form developmentally through excavation of bone by air-filled sacs (pneumatic
diverticula) from the nasal cavity. This process begins prenatally (intrauterine life), and it continues through
the course of an organism's lifetime.

The results of experimental studies suggest that the natural ventilation rate of a sinus with a single sinus
ostium (opening) is extremely slow. Such limited ventilation may be protective for the sinus, as it would
help prevent drying of its mucosal surface and maintain a near-sterile environment with high carbon dioxide
concentrations and minimal pathogen access. Thus composition of gas content in the maxillary sinus is
similar to venous blood, with high carbon dioxide and lower oxygen levels compared to breathing air.

At birth only the maxillary sinus and the ethmoid sinus are developed but not yet pneumatized; only by the
age of seven they are fully aerated. The sphenoid sinus appears at the age of three, and the frontal sinuses
first appear at the age of six, and fully develop during adulthood.

X-ray images and illustrations

Figure 48.e: Paranasal sinuses radiograph (occipitofrontal)

Figure 48.f: Paranasal sinuses radiograph (occipitomental)

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 Figure 48.g: Paranasal sinuses radiograph (lateral)

Figure 48.h: Paranasal sinuses radiograph (occipitofrontal)

Figure 48.i: Paranasal sinuses radiograph (occipitomental)

Figure 48.j: Paranasal sinuses radiograph (lateral)

Figure 48.k: 3D cast of maxillary, frontal, ethmoid and sphenoid sinuses, nasal cavity and
hypopharynx.

Inflammation

The paranasal sinuses are joined to the nasal cavity via small orifices called ostia. These become
blocked easily by allergic inflammation, or by swelling in the nasal lining that occurs with a cold. If this
happens, normal drainage of mucus within the sinuses is disrupted, and sinusitis may occur.

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The ear

The ear is the organ of the human responsible for capting sonore and audition. This system is counted
in decibel. A too much noise can provok a disability of the ear. Responsible of road as police and
others must stop people who create too much noise for the public security. It is divided into outer ear,
middle ear, and inner ear. The sound receives by the pinna and the auditory channel is conducted to
the auditory channel; the sound creates vibration at the maileus or hammer; and it creates a signal in
the incus(anvil). After the signal is received by the assembly round window and vestibule. The
cochlear and vestibular nerves transport the signal to the encephalon. The eustachian or auditory
tube create a sound depression for protecting the ear.

Figure 49-b: Another anatomy of the ear, Uploaded by Nawal Hossam El Boghdady at
www.researchgate.net/
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 Figure 49.c: Anatomy of the ear by matter, www.neurosurgicalatlas.com

Nasal Cavity

Generality

The term "nasal cavity" can refer to each of the two cavities of the nose, or to the two sides combined.

Figure 50.a: CT scan in the coronal plane, showing the ostiomeatal complex (green area).

The lateral wall of each nasal cavity mainly consists of the maxilla. However, there is a deficiency that is
compensated for by the perpendicular plate of the palatine bone, the medial pterygoid plate, the labyrinth of
ethmoid and the inferior concha. The paranasal sinuses are connected to the nasal cavity through small
orifices called ostia. Most of these ostia communicate with the nose through the lateral nasal wall, via a
semi-lunar depression in it known as the semilunar hiatus. The hiatus is bound laterally by a projection
known as the uncinate process. This region is called the ostiomeatal complex.

The roof of each nasal cavity is formed in its upper third to one half by the nasal bone and more inferiorly by
the junctions of the upper lateral cartilage and nasal septum. Connective tissue and skin cover the bony and
cartilaginous components of the nasal dorsum.

The floor of the nasal cavities, which also form the roof of the mouth, is made up by the bones of the hard
palate: the horizontal plate of the palatine bone posteriorly and the palatine process of the maxilla anteriorly.
The most anterior part of the nasal cavity is the nasal vestibule. The vestibule is enclosed by the cartilages
of the nose and lined by the same epithelium of the skin (stratified squamous, keratinized). Within the
vestibule this changes into the typical respiratory epithelium that lines the rest of the nasal cavity and
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respiratory tract. Inside the nostrils of the vestibule are the nasal hair, which filter dust and other matter that
are breathed in. The back of the cavity blends, via the choanae, into the nasopharynx.

The nasal cavity is divided in two by the vertical nasal septum. On the side of each nasal cavity are three
horizontal outgrowths called nasal conchae (singular "concha") or turbinates. These turbinates disrupt the
airflow, directing air toward the olfactory epithelium on the surface of the turbinates and the septum. The
vomeronasal organ is located at the back of the septum and has a role in pheromone detection.

Segments

The nasal cavity is divided into two segments: the respiratory segment and the olfactory segment.

 The respiratory segment comprises most of each nasal cavity, and is lined with ciliated pseudostratified
columnar epithelium (also called respiratory epithelium). The conchae, or turbinates, are located in this
region. The turbinates have a very vascularized lamina propria (erectile tissue) allowing the venous
plexuses of their mucosa to engorge with blood, restricting airflow and causing air to be directed to the
other side of the nose, which acts in concert by shunting blood out of its turbinates. This cycle occurs
approximately every two and a half hours.
 The olfactory segment is lined with a specialized type of pseudostratified columnar epithelium, known
as olfactory epithelium, which contains receptors for the sense of the smell. This segment is located in
and beneath the mucosa of the roof of each nasal cavity and the medial side of each middle turbinate.
Histological sections appear yellowish-brown due to the presence of lipofuscin pigments. Olfactory
mucosal cell types include bipolar neurons, supporting (sustentacular) cells, basal cells, and Bowman's
glands. The axons of the bipolar neurons form the olfactory nerve (cranial nerve I) which enters the
brain through the cribriform plate. Bowman's glands are serous glands in the lamina propria, whose
secretions trap and dissolve odoriferous substances.

Blood supply

There is a rich blood supply to the nasal cavity. In some animals, such as dogs, the capillary beds
flowing through the nasal cavity help cool the blood flow to the brain.

Blood supply comes from branches of both the internal and external carotid artery, including
branches of the facial artery and maxillary artery. The named arteries of the nose are:

 Sphenopalatine artery and greater palatine artery, branches of the maxillary artery.
 Anterior ethmoidal artery and posterior ethmoidal artery, branches of the ophthalmic artery
 Septal branches of the superior labial artery, a branch of the facial artery, which supplies the
vestibule of the nasal cavity.

Nerve supply

Innervation of the nasal cavity responsible for the sense of smell is via the olfactory nerve, which
sends microscopic fibers from the olfactory bulb through the cribriform plate to reach the top of the
nasal cavity.

General sensory innervation is by branches of the trigeminal nerve (V1 & V2):

 Nasociliary nerve (V1)

 Nasopalatine nerve (V2)
 Posterior nasal branches of Maxillary nerve (V2)

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The nasal cavity is innervated by autonomic fibers. Sympathetic innervation to the blood vessels of the
mucosa causes them to constrict, while the control of secretion by the mucous glands is carried on
postganglionic parasympathetic nerve fibers originating from the facial nerve.

Function

The two nasal cavities condition the air to be received by the other areas of the respiratory tract.
Owing to the large surface area provided by the nasal conchae (also known as turbinates), the air
passing through the nasal cavity is warmed or cooled to within 1 degree of body temperature. In
addition, the air is humidified, and dust and other particulate matter is removed by nasal hair in the
nostrils. The entire mucosa of the nasal cavity is covered by a blanket of mucus, which lies superficial
to the microscopic cilia and also filters inspired air. The cilia of the respiratory epithelium move the
secreted mucus and particulate matter posteriorly towards the pharynx where it passes into the
esophagus and is digested in the stomach. The nasal cavity also houses the sense of smell and
contributes greatly to taste sensation through its posterior communication with the mouth via the
choanae.

Figure 50.b: Lateral wall of the nasal cavity, Nasal Cavity Anatomy

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Figure 50.c: Nasal Cavity Definition Anatomy Functions Diagrams

Figure 51: Head and Nose Nasal Cavity

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Figure 52.a: Anatomy Of The Nasal Cavity And Paranasal Sinuses, Neupsy Key

Figure 52.b: Nasal Cavity Labeled Anatomy Physiology, Flickr

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Figure 53: Nasal Cavity, The Big Picture Gross Anatomy

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Figure 54: Nasal Cavity Anatomy and Physiology, Anomalies On Ct Scan

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Figure 55: Pediagenosis

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 Figure 56: Nasal Cavity by showing hypophysis

Figure 57: Anatomy Of The Nasal Cavity And Paranasal Sinuses, Neupsy Key

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Figure 58: A Study of The Functions And Anatomy Of The Human Nasal

Figure 59: Nasal Cavity, Anatomy Britannica

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 Figure 60: Easy Notes on Nasal Cavity, Learn In Just 4 Minutes

Human Anatomical Nasal Cavity Throat Anatomy Medical Model For Science Classroom Study Display
Teaching Medical Model

Figure 61: Pin by Sue Sparks On For Healthy Person Sinus Cavities

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XV. MUSCLES
Overview
Muscles are the parts of the human body which are the most found in some human. Whereas some
human have muscles more than other human, the common need for human talking about muscles is
first the internal muscles and then the ability of some parts of the muscles to execute what an human
needs to do.
Meaning that: in order to:
1. lift heavy weight, you need to have strong muscles which support generally compression
tensile stress, torsion stress, cutting stress in some parts of the body like the arm muscles, the
legs and feet muscles, the abdomen muscles, the neck muscles, and other muscles.
2. jump, you need to have strong muscles which support generally traction tensile, compression
tensile at the ankles and knees while landing, cutting stress in some parts of the body like the
legs and feet muscles, the abdomen muscles, the neck muscles, and other muscles.
3. resist to long running, you need to have strong muscles which support generally to fatigue
stress, torsion stress, cutting stress in some parts of the body like the arm muscles, the legs
and feet muscles, the abdomen muscles, the neck muscles, and other muscles.
4. Others.

To have strong muscles depends then on your objectives and/or goals.

In general, muscles are made up by tissue of fibers constituted by cells. But each human has his or her
own fibers characteristics depending on fluid biomechanics, energy, and biochemistry inside the body
and each parts of the body (his or her parts of the body).

WRITTEN BY Robin Huw Crompton, Christopher Tangen, Shane W. Cummings, Bernard Wood, Britannica

Anatomy, University of Liverpool.

Figure 62 : Discover the location and role of skeletal muscles in the human body

Skeletal muscles are attached to the bones by tendons.

Created and produced by QA International. © QA International, 2010. All rights reserved. www.qa-international.com

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Generality

Human muscle system, the muscles of the human body that work the skeletal system, that are under
voluntary control, and that are concerned with movement, posture, and balance. Broadly considered, human
muscle—like the muscles of all vertebrates—is often divided into striated muscle (or skeletal muscle),
smooth muscle, and cardiac muscle. Smooth muscle is under involuntary control and is found in the walls of
blood vessels and of structures such as the urinary bladder, the intestines, and the stomach. Cardiac muscle
makes up the mass of the heart and is responsible for the rhythmic contractions of that vital pumping organ;
it too is under involuntary control. With very few exceptions, the arrangement of smooth muscle and cardiac
muscle in humans is identical to the arrangement found in other vertebrate animals.

Figure 63 : Human muscular system: lateral view, Encyclopædia Britannica, Inc.

This part is concerned with the skeletal muscles of the human body, with emphasis on muscle
movements and the changes that have occurred in human skeletal musculature as a result of the long
evolutionary process that involved the assumption of upright posture. Smooth muscle and cardiac
muscle and the physiology of muscle contraction are treated at great length in the article muscle. For
descriptions of disorders that affect the human muscle system, see muscle disease.

161
 Figure 64: Striated muscle; human biceps muscle

The structure of striated, or skeletal, muscle. Striated muscle tissue, such as the tissue of the human
biceps muscle, consists of long fine fibres, each of which is in effect a bundle of finer myofibrils. Within
each myofibril are filaments of the proteins myosin and actin; these filaments slide past one another
as the muscle contracts and expands. On each myofibril, regularly occurring dark bands, called Z lines,
can be seen where actin and myosin filaments overlap. The region between two Z lines is called a
sarcomere; sarcomeres can be considered the primary structural and functional unit of muscle tissue.

Encyclopædia Britannica, Inc.

The muscle groups and their actions

The following sections provide a basic framework for the understanding of gross human muscular anatomy,
with descriptions of the large muscle groups and their actions. The various muscle groups work in a
coordinated fashion to control the movements of the human body.

162
 Figure 65: Human muscular system: anterior view, Encyclopædia Britannica, Inc.

Figure 66 : Human muscular system: posterior view, Encyclopædia Britannica, Inc.

The neck

The motion of the neck is described in terms of rotation, flexion, extension, and side bending (i.e., the
motion used to touch the ear to the shoulder). The direction of the action can be ipsilateral, which refers to
movement in the direction of the contracting muscle, or contralateral, which refers to movement away from
the side of the contracting muscle.

163
Figure 67 : Muscles of the neck; human muscle system, Encyclopædia Britannica, Inc.

Rotation is one of the most-important actions of the cervical (neck) spine. Rotation is accomplished
primarily by the sternocleidomastoid muscle, which bends the neck to the ipsilateral side and rotates
the neck contralaterally. Together, the sternocleidomastoid muscles on both sides of the neck act to
flex the neck and raise the sternum to assist in forced inhalation. The anterior and middle scalene
muscles, which also are located at the sides of the neck, act ipsilaterally to rotate the neck, as well as to
elevate the first rib. The splenius capitis and splenius cervicis, which are located in the back of the
neck, work to rotate the head.

Side bending also is an important action of the cervical spine. The sternocleidomastoid muscles are
involved in cervical side bending. The posterior scalene muscles, located on the lower sides of the
neck, ipsilaterally bend the neck to the side and elevate the second rib. The splenius capitis and
splenius cervicis also assist in neck side bending. The erector spinae muscles (iliocostalis, longissimus,
and spinalis) are large, deep muscles that extend the length of the back. All three act to ipsilaterally
side bend the neck.

Neck flexion refers to the motion used to touch the chin to the chest. It is accomplished primarily by
the sternocleidomastoid muscles, with assistance from the longus colli and the longus capitis, which
are found in the front of the neck. Neck extension is the opposite of flexion and is accomplished by
many of the same muscles that are used for other neck movements, including the splenius cervicis,
splenius capitis, iliocostalis, longissimus, and spinalis muscles.

The back

The back contains the origins of many of the muscles that are involved in the movement of the neck
and shoulders. In addition, the axial skeleton that runs vertically through the back protects the spinal
cord, which innervates almost all the muscles in the body.

164
 Figure 68 : muscles of the back; human muscle system, Encyclopædia Britannica, Inc.

Multiple muscles in the back function specifically in movements of the back. The erector spinae
muscles, for example, extend the back (bend it backward) and side bend the back. The semispinalis
dorsi and semispinalis capitis muscles also extend the back. The small muscles of the vertebrae (the
multifidi and rotators) help rotate, extend, and side bend the back. The quadratus lumborum muscle
in the lower back side bends the lumbar spine and aids in the inspiration of air through its stabilizing
affects at its insertion at the 12th rib (the last of the floating ribs). The scapula (shoulder blade) is
elevated by the trapezius muscle, which runs from the back of the neck to the middle of the back, by
the rhomboid major and rhomboid minor muscles in the upper back, and by the levator scapulae
muscle, which runs along the side and back of the neck.

Muscular system, from Wikipedia

The muscular system is an organ system consisting of skeletal, smooth and cardiac muscles. It
permits movement of the body, maintains posture and circulates blood throughout the body. The
muscular systems in vertebrates are controlled through the nervous system although some muscles
(such as the cardiac muscle) can be completely autonomous. Together with the skeletal system in the
human, it forms the musculoskeletal system, which is responsible for movement of the body.

There are three distinct types of muscles: skeletal muscles, cardiac or heart muscles, and smooth
(non-striated) muscles. Muscles provide strength, balance, posture, movement and heat for the body
to keep warm.

There are more than 600 muscles in the human body. A kind of elastic tissue makes up each muscle,
which consists of thousands, or tens of thousands, of small muscle fibers. Each fiber comprises many
tiny strands called fibrils. Impulses from nerve cells control the contraction of each muscle fiber.

165
Skeletal muscle

Skeletal muscles, like other striated muscles, are composed of muscle cells, called muscle fibers, which
are in turn composed of myofibrils, which are composed of sarcomeres, the basic building block of
striated muscle tissue. Upon stimulation by an action potential, skeletal muscles perform a
coordinated contraction by shortening each sarcomere. The best proposed model for understanding
contraction is the sliding filament model of muscle contraction. Within the sarcomere, actin and
myosin fibers overlap in a contractile motion towards each other. Myosin filaments have club-shaped
myosin heads that project toward the actin filaments. and provide attachment points on binding sites
for the actin filaments. The myosin heads move in a coordinated style; they swivel toward the center
of the sarcomere, detach and then reattach to the nearest active site of the actin filament. This is called
a ratchet type drive system.

This process consumes large amounts of adenosine triphosphate (ATP), the energy source of the cell.
ATP binds to the cross bridges between myosin heads and actin filaments. The release of energy
powers the swiveling of the myosin head. When ATP is used, it becomes adenosine diphosphate
(ADP), and since muscles store little ATP, they must continuously replace the discharged ADP with
ATP. Muscle tissue also contains a stored supply of a fast acting recharge chemical, creatine
phosphate, which when necessary can assist with the rapid regeneration of ADP into ATP.

Calcium ions are required for each cycle of the sarcomere. Calcium is released from the sarcoplasmic
reticulum into the sarcomere when a muscle is stimulated to contract. This calcium uncovers the actin
binding sites. When the muscle no longer needs to contract, the calcium ions are pumped from the
sarcomere and back into storage in the sarcoplasmic reticulum.

Cardiac muscle

Heart muscles are distinct from skeletal muscles because the muscle fibers are laterally connected to
each other. Furthermore, just as with smooth muscles, their movement is involuntary. Heart muscles
are controlled by the sinus node influenced by the autonomic nervous system.

Smooth muscle

Smooth muscles are controlled directly by the autonomic nervous system and are involuntary,
meaning that they are incapable of being moved by conscious thought. Functions such as heartbeat
and lungs (which are capable of being willingly controlled, be it to a limited extent) are involuntary
muscles but are not smooth muscles.

Physiology

Contraction

Neuromuscular junctions are the focal point where a motor neuron attaches to a muscle.
Acetylcholine, (a neurotransmitter used in skeletal muscle contraction) is released from the axon
terminal of the nerve cell when an action potential reaches the microscopic junction called a synapse.
A group of chemical messengers cross the synapse and stimulate the formation of electrical changes,
which are produced in the muscle cell when the acetylcholine binds to receptors on its surface.
Calcium is released from its storage area in the cell's sarcoplasmic reticulum. An impulse from a nerve
cell causes calcium release and brings about a single, short muscle contraction called a muscle twitch.
If there is a problem at the neuromuscular junction, a very prolonged contraction may occur, such as
166
the muscle contractions that result from tetanus. Also, a loss of function at the junction can produce
paralysis.

Skeletal muscles are organized into hundreds of motor units, each of which involves a motor neuron,
attached by a series of thin finger-like structures called axon terminals. These attach to and control
discrete bundles of muscle fibers. A coordinated and fine tuned response to a specific circumstance
will involve controlling the precise number of motor units used. While individual muscle units
contract as a unit, the entire muscle can contract on a predetermined basis due to the structure of the
motor unit. Motor unit coordination, balance, and control frequently come under the direction of the
cerebellum of the brain. This allows for complex muscular coordination with little conscious effort,
such as when one drives a car without thinking about the process.

Tendon

A tendon is a piece of connective tissue that connects a muscle to a bone. When a muscle contracts, it
pulls against the skeleton to create movement. A tendon connects this muscle to a bone, making this
function possible.

Aerobic and anaerobic muscle activity

At rest, the body produces the majority of its ATP aerobically in the mitochondria without producing
lactic acid or other fatiguing byproducts. During exercise, the method of ATP production varies
depending on the fitness of the individual as well as the duration and intensity of exercise. At lower
activity levels, when exercise continues for a long duration (several minutes or longer), energy is
produced aerobically by combining oxygen with carbohydrates and fats stored in the body.

During activity that is higher in intensity, with possible duration decreasing as intensity increases,
ATP production can switch to anaerobic pathways, such as the use of the creatine phosphate and the
phosphagen system or anaerobic glycolysis. Aerobic ATP production is biochemically much slower
and can only be used for long-duration, low-intensity exercise, but produces no fatiguing waste
products that can not be removed immediately from the sarcomere and the body, and it results in a
much greater number of ATP molecules per fat or carbohydrate molecule. Aerobic training allows the
oxygen delivery system to be more efficient, allowing aerobic metabolism to begin quicker. Anaerobic
ATP production produces ATP much faster and allows near-maximal intensity exercise, but also
produces significant amounts of lactic acid which renders high-intensity exercise unsustainable for
more than several minutes. The phosphagen system is also anaerobic. It allows for the highest levels
of exercise intensity, but intramuscular stores of phosphocreatine are very limited and can only
provide energy for exercises lasting up to ten seconds. Recovery is very quick, with full creatine stores
regenerated within five minutes.

167
XVI. BONE OR SKELETON: CARTILAGE and HARD BONE

GENERALITY
The bone is the ossature of the body. Organs are handed by bones. Generally, the bone is made up of a
central canal, canaliculi, stecyte within lacuna and osteon. A cartilage is also a bone constituted by
matrix and chondrocytes in lacunae. A cartilage is elastic.

The bone or skeleton is the standing, the sitting, and the ossature structure of human. Some parts of
the skeleton help other organs to complete their function.
The following figure shows the skeleton of the human and an internal figure of a bone.

Figure 69-A: A bone anatomy

168
 Figure 69-B : Another bone anatomy, https://www.istockphoto.com/

The bone could increase in shape known generally as volume in all ages, and also could diminue in
shape in all ages; the concern depends on way of life including biomatters and energy presences, type
and structure of blood vessels and each ganglion in each part of the body to make a centripetal
motion of blood or/and biomatter or landing of biomatter to the structure of the bone. In reverse,
the centrifuge motion of the biomatters or/and a take off of biomatter known as the transfer of
biomatters especially the plasma concern, in the - principal blood vessels, secondary vessels, tertiary
vessels and quaternary vessels - such veins which contains the biomatters could also appear.

Meaning that all biomatters in the plasma, in the direction sense from other organs to bone one:

 could traverse the carrier biomatter between bones and other organs,
 or/and could be put on the bone structure during blood flow,

could become a structure of the bone.

In reverse, all biomatters in the bone, in the direction sense from bone to other organs could be part of
the blood. Consequently the bone is also a location of stockage of biomatters of all types which could
be stocked.

169
ANATOMY OF THE BONE: WRITTEN BY Robert Proulx Heaney

John A. Creighton University Professor, Creighton University, Omaha, Nebraska; Vice President for Health Sciences,
1971–84. Coauthor of Skeletal Renewal and Metabolic Bone Diseases.

Bone, rigid body tissue consisting of cells embedded in an abundant hard intercellular material. The
two principal components of this material, collagen and calcium phosphate, distinguish bone from
such other hard tissues as chitin, enamel, and shell. Bone tissue makes up the individual bones of the
human skeletal system and the skeletons of other vertebrates.

The functions of bone include (1) structural support for the mechanical action of soft tissues, such as
the contraction of muscles and the expansion of lungs, (2) protection of soft organs and tissues, as by
the skull, (3) provision of a protective site for specialized tissues such as the blood-forming system
(bone marrow), and (4) a mineral reservoir, whereby the endocrine system regulates the level of
calcium and phosphate in the circulating body fluids.

Evolutionary origin and significance

Bone is found only in vertebrates, and, among modern vertebrates, it is found only in bony fish and
higher classes. Although ancestors of the cyclostomes and elasmobranchs had armoured headcases,
which served largely a protective function and appear to have been true bone, modern cyclostomes
have only an endoskeleton, or inner skeleton, of noncalcified cartilage and elasmobranchs a skeleton
of calcified cartilage. Although a rigid endoskeleton performs obvious body supportive functions for
land-living vertebrates, it is doubtful that bone offered any such mechanical advantage to the teleost
(bony fish) in which it first appeared, for in a supporting aquatic environment great structural rigidity
is not essential for maintaining body configuration. The sharks and rays are superb examples of
mechanical engineering efficiency, and their perseverance from the Devonian Period attests to the
suitability of their nonbony endoskeleton.

In modern vertebrates, true bone is found only in animals capable of controlling the osmotic and ionic
composition of their internal fluid environment. Marine invertebrates exhibit interstitial fluid
compositions essentially the same as that of the surrounding seawater. Early signs of regulability are
seen in cyclostomes and elasmobranchs, but only at or above the level of true bone fishes does the
composition of the internal body fluids become constant. The mechanisms involved in this regulation
are numerous and complex and include both the kidney and the gills. Fresh and marine waters
provide abundant calcium but only traces of phosphate; because relatively high levels of phosphate
are characteristic of the body fluids of higher vertebrates, it seems likely that a large, readily available
internal phosphate reservoir would confer significant independence of external environment on bony
vertebrates. With the emergence of terrestrial forms, the availability of calcium regulation became
equally significant. Along with the kidney and the various component glands of the endocrine system,
bone has contributed to development of internal fluid homeostasis—the maintenance of a constant
chemical composition. This was a necessary step for the emergence of terrestrial vertebrates.
Furthermore, out of the buoyancy of water, structural rigidity of bone afforded mechanical advantages
that are the most obvious features of the modern vertebrate skeleton.

170
HUMAN SKELETON ANATOMY
WRITTEN BY Warren Andrew

Professor of Anatomy, Indiana University, Indianapolis, 1958–82. Author of Textbook of Comparative Histology.

Human skeleton, the internal skeleton that serves as a framework for the body. This framework consists of
many individual bones and cartilages. There also are bands of fibrous connective tissue—the ligaments and
the tendons—in intimate relationship with the parts of the skeleton. This article is concerned primarily with
the gross structure and the function of the skeleton of the normal human adult.

Figure 70 : Human skeletal system , Front and back views of the human skeleton, Encyclopædia
Britannica, Inc.

171
 Figure 71 : The Metacarpus

The human skeleton, like that of other vertebrates, consists of two principal subdivisions, each with
origins distinct from the others and each presenting certain individual features. These are (1) the
axial, comprising the vertebral column—the spine—and much of the skull, and (2) the appendicular,
to which the pelvic (hip) and pectoral (shoulder) girdles and the bones and cartilages of the limbs
belong. Discussed in this article as part of the axial skeleton is a third subdivision, the visceral,
comprising the lower jaw, some elements of the upper jaw, and the branchial arches, including the
hyoid bone.

When one considers the relation of these subdivisions of the skeleton to the soft parts of the human
body—such as the nervous system, the digestive system, the respiratory system, the cardiovascular
system, and the voluntary muscles of the muscle system—it is clear that the functions of the skeleton
are of three different types: support, protection, and motion. Of these functions, support is the most
primitive and the oldest; likewise, the axial part of the skeleton was the first to evolve. The vertebral
column, corresponding to the notochord in lower organisms, is the main support of the trunk.

172
Figure 72 : Human skeleton, A diagram of the human skeleton showing bone and cartilage.
Encyclopædia Britannica, Inc.

The central nervous system lies largely within the axial skeleton, the brain being well protected by the
cranium and the spinal cord by the vertebral column, by means of the bony neural arches (the arches
of bone that encircle the spinal cord) and the intervening ligaments.

A distinctive characteristic of humans as compared with other mammals is erect posture. The human
body is to some extent like a walking tower that moves on pillars, represented by the legs.
Tremendous advantages have been gained from this erect posture, the chief among which has been
the freeing of the arms for a great variety of uses. Nevertheless, erect posture has created a number of
mechanical problems—in particular, weight bearing. These problems have had to be met by
adaptations of the skeletal system.

Protection of the heart, lungs, and other organs and structures in the chest creates a problem
somewhat different from that of the central nervous system. These organs, the function of which
involves motion, expansion, and contraction, must have a flexible and elastic protective covering. Such
a covering is provided by the bony thoracic basket, or rib cage, which forms the skeleton of the wall of
the chest, or thorax. The connection of the ribs to the breastbone—the sternum—is in all cases a
secondary one, brought about by the relatively pliable rib (costal) cartilages. The small joints between
the ribs and the vertebrae permit a gliding motion of the ribs on the vertebrae during breathing and
other activities. The motion is limited by the ligamentous attachments between ribs and vertebrae.

The third general function of the skeleton is that of motion. The great majority of the skeletal muscles
are firmly anchored to the skeleton, usually to at least two bones and in some cases to many bones.
Thus, the motions of the body and its parts, all the way from the lunge of the football player to the
delicate manipulations of a handicraft artist or of the use of complicated instruments by a scientist,
are made possible by separate and individual engineering arrangements between muscle and bone.

173
XVII. TEETH
Generality
The teeth could increase in shape known generally as volume in all ages, and also could diminue in
shape in all ages; the concern depends on: way of life including biomatters and energy presences, type
and structure of blood vessels and each ganglion in each part of the body to make a centripetal
motion of blood or/and biomatter or landing of biomatter to the structure of the teeth. In reverse,
the centrifuge motion of the biomatters or/and a take off of biomatter known as the transfer of
biomatters especially the plasma concern, in the - principal blood vessels, secondary vessels, tertiary
vessels and quaternary vessels - such veins which contains the biomatters could also appear.

Meaning that all biomatters in the plasma, in the direction sense from other organs to teeth one
which:

 could traverse the carrier biomatter between teeth and other organs,
 or/and could be put on the teeth structure during blood flow,

could become a structure of the teeth.

In reverse, all biomatters in the teeth, in the direction sense from teeth to other organs could be part
of the blood. Consequently the teeth is also a location of stockage of biomatters of all types which
could be stocked.

Figure 73.a: Teeth structure

174
Anatomy and Physiology of Teeth

By Matthew Hoffman, MD , Medically Reviewed by Carol DerSarkissian, MD on June 28, 2020, edited in this book on
July 05, 2021

Figure 73.b: Structure and type of Tooth

The teeth are the hardest substances in the human body. Besides being essential for chewing, the
teeth play an important role in speech. Parts of the teeth include:

• Enamel: The hardest, white outer part of the tooth. Enamel is mostly made of calcium phosphate, a
rock-hard mineral.
• Dentin: A layer underlying the enamel. It is a hard tissue that contains microscopic tubes. When the
enamel is damaged, heat or cold can enter the tooth through these paths and cause sensitivity or pain.
• Pulp: The softer, living inner structure of teeth. Blood vessels and nerves run through the pulp of the
teeth.
• Cementum: A layer of connective tissue that binds the roots of the teeth firmly to the gums and
jawbone.
• Periodontal ligament: Tissue that helps hold the teeth tightly against the jaw.

A normal adult mouth has 32 teeth, which (except for wisdom teeth) have erupted by about age 13:

• Incisors (8 total): The middlemost four teeth on the upper and lower jaws.
• Canines (4 total): The pointed teeth just outside the incisors.
• Premolars (8 total): Teeth between the canines and molars.
• Molars (8 total): Flat teeth in the rear of the mouth, best at grinding food.
• Wisdom teeth or third molars (4 total): These teeth erupt at around age 18, but are often surgically
removed to prevent displacement of other teeth.

The crown of each tooth projects into the mouth. The root of each tooth descends below the gum line,
into the jaw.

175
Teeth Conditions

 Cavities (caries): Bacteria evade removal by brushing and saliva and damage the enamel and
deeper structures of teeth. Most cavities occur on molars and premolars.
 Tooth decay: A general name for disease of the teeth, including cavities.
 Periodontitis: Inflammation of the deeper structures of the teeth (periodontal ligament,
jawbone, and cementum). Poor oral hygiene is usually to blame.
 Gingivitis: Inflammation of the surface portion of the gums, around and between the crowns of
the teeth. Plaque and tartar buildup can lead to gingivitis.
 Plaque: A sticky, colorless film made of bacteria and the substances they secrete. Plaque
develops quickly on teeth after eating sugary food, but can be easily brushed off.
 Tartar: If plaque is not removed, it mixes with minerals to become tartar, a harder substance.
Tartar requires professional cleaning for removal.
 Overbite: The upper teeth protrude significantly over the lower teeth.
 Underbite: The lower teeth protrude significantly past the upper teeth.
 Teeth grinding (bruxism): Stress, anxiety, or sleep disorders can cause teeth grinding, usually
during sleep. A dull headache or sore jaw can be symptoms.
 Tooth sensitivity: When one or more teeth become sensitive to hot or cold, it may mean the
dentin is exposed.

Teeth Tests

 Teeth X-ray films: X-ray pictures of the teeth may detect cavities below the gum line, or that are
too small to identify otherwise.
 Teeth examination: By viewing and gently manipulating the teeth, a dentist can detect potential
teeth problems.

Teeth Treatments

 Brushing teeth: Daily brushing of the teeth removes plaque and helps prevent cavities.
 Flossing teeth: Using floss or an approved dental gum cleaner cleans teeth below the gum line,
where brushing cannot reach.
 Rinsing teeth: Rinsing daily with an antiseptic mouthwash kills bacteria that cause bad breath
and gum disease.
 Teeth cleaning: Professional teeth cleaning every six months may help prevent teeth and gum
disease.
 Tooth filling: Drilling out the diseased part of a tooth and packing the space with a mineral
filling can prevent a cavity from destroying the tooth.
 Root canal: The deep pulp of a tooth is drilled out, cleaned, and filled. A root canal is done when
damage to the teeth has affected the deep pulp.
 Tooth extraction: If a tooth is too damaged to repair with a filling or root canal, it may be
removed. Wisdom teeth are often extracted to prevent displacement of the other teeth.
 Braces: An artificial device or system that places teeth under tension for a long period of time.
Eventually, braces can help crooked teeth become realigned.
 Mouth guard: A plastic mouthpiece can provide protection from teeth grinding and injury
during sports.
 Dental sealants: A plastic sealant applied to the teeth can help block bacteria from hiding in
crevices on teeth surfaces. Sealants can help prevent cavities.
 Teeth whitening: Over-the-counter and professional chemical treatments can bleach teeth to a
brighter white. Tooth sensitivity is the most common side effect.

176
XVIII. PARASITES, PARASITISM, AND INTRODUCTION TO VIRUS
Generality

Parasites are organisms which nourish from other organisms. Parasite’s organisms then do not work
but they only take profits from other organisms. Parasitism is a relation between two species in which
one species –the parasite- derives nourishment from the other – the host- and usually does the host
some harm. However, it is better for the parasite if the host is not killed.

The notion of parasites is in close relation of the knowledge of viruses as viruses are obligate parasites
as they are incapable of reproducing on their own. When viruses invades a cell, it takes over the cell’s
metabolic machinery and causes the cell to reproduce more viruses. A virus could mutate to another
shape and structure but the range of measurement of viruses does not change.

Some bacteria, protozoans, fungi, and worms are also parasites. These are usually extracellular
parasites that obtain nutrients from their host.

Plasmodium

Organisms in the genus Plasmodium cause malaria in humans. Members of this genus have no means
of locomotion and are dispersed by infected mosquitoes.

The life cycle of the protest plasmodium is the following: Asexual reproduction of Plasmodium occurs
in humans, while sexual reproduction takes place within the Anopheles mosquito.

177
 Figure 74-a : Life cycle of the protest Plasmodium

Following is a photo of the human red blood cells infected by plasmodium. In fact, plasmodium forms
spores inside human red blood cells.

Figure 74-b : Human red blood cells infected by Plasmodium

178
Worms

A variety of organisms, such as flatworms, roundworms, and segmented worms, are referred to
simply as “worms” and some are parasites that infect humans. Warms are multicellular animals of
considerable size, compared to the parasites examined thus far in this laboratory. All parasitic worms
have various modifications suited to their parasitic way of life.

Tapeworms

Tapeworms are parasitic flatworms that live in the intestines of vertebrate animals, including humans.
The worms consist of a scolex (head), most of which have suckers and hooks, and proglottids
(segments of the body). Ripe proglottids detach and pass out with the hos’s feces, scattering fertilized
eggs on the ground. If pigs or cattle happen to ingest these, larvae develop and eventually become
encysted in muscle that humans may eat in poorly cooked or raw meat. Upon digestion, a bladder
worm that escapes from the cyst develops into a new tapeworm that attaches to the intestinal wall.

Figure 75.a : Life cycle of the tapeworm, Taenia

179
 Figure 75.b : Anatomy of Taenia

Flukes

There are many different types of flukes usually designated by the type of organ they inhabit; for
example, there are blood, liver, and lung flukes. While the structure may vary slightly, in general the
fluke body tends to be oval to elongate with no definite head except that an oral sucker surrounded by
sensory papillae is at the anterior end. Usually there is at least one other sucker for attachment to the
host. Inside there is a reduced digestive system, reduced nervous system, and excretory system. As
excepted, there is a well-developed reproductive system.

The human blood fluke, Schistosoma mansoni, is a flatworm that has separate sexes. Female worms
are round, long, and slender (1.2-2.6 cm in length), while males are shorter and flattened.

The males look cylindrical during copulation, however, because their body wall incurves to form a
canal in which the female resides.

Following copulation, the females leave the male worms to deposit their eggs in small venules, close to
the human intestinal passageway (lumen). The eggs have sharp spines and secrete an enzyme that
causes enough damage to allow the eggs to escape into intestine. The eggs are liberated from the
human body by way of the feces. In frsh water, the eggs rupture, and the miracidia (ciliated larvae)
that escape swim in search of appropriate snail hosts. If successful, they penetrate the snails and then
undergo a cycle of development, giving rise to a large number of cercariae ( tadpole-shaped larvae).
Humans are infected when the cercariae penetrate the skin in water and invade the circulatory
system. Young flukes mature in the human liver; as adults, they take up residence in blood vessels
near the intestines.

Schistosomiasis, infection of humans caused by blood flukes and other parasites, is an extremely
prevalent disease in some region of the globes, especially according to infrastructures, environment,
water treatment inacommodation, and animal life ecology evolution.

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 Figure 76: Life cycle of the blood fluke Schistosoma

Hookworm

Necator americanus (literally “the American killer) is a roundworm that causes hookworm disease in
humans. Before adequate sanitation, this animal was a common cause of death in the United States.
Other species infested other regions of the earth. Hookworm eggs are passed in human feces, and
when deposited on moist, sandy soil, the larvae develop and hatch within twenty four to forty-eight
hours. After about seven days, they become infective larvae. Then they extend their bodies into the air
and remain waving about in this position until they contact human skin. After penetrating the skin, the
adult lives in the intestinal tract of the human host.

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Figure 77: Hookworm attached to an intestine wall

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XIX. GENOMES, GENETICS, BIOCHEMISTRY, BIOTECHNOLOGY, BIOENGINEERING,
BIONUCLEAR AND/OR BIOATOMIC SCIENCES

GENERALITY
All living cells are composed of particles at the scale of molecules and atoms. In this part, we could
study or/and see: genomes, genetics, biomechanics, biochemistry, bioengineering, biotechnology,
bionuclear or/and bioatomic sciences and other biosciences&biotechnology.
Note that some phrases and photos are from books of : (i) LeMay, Brown, and Bursten, the Central
Science, in Prentice Hall – (ii)Mader, Biology, Mc Graw Hill‐ (iii)Dictionnaire de Medecine, sixième
edition Flammarion, and other books.

HUMAN GENETICS
Introduction
A zygote receives 23 pairs of chromosomes when the gametes unite during fertilization. One of each
pair is inherited from the male parent and the other from the female parent. Thereafter, due to the
process of cell division, each body cell contains copies of these chromosomes in the nucleus.
Twenty-two pairs of the chromosomes are autosomes and one pair is the sex chromosomes. Males
receive an X and Y chromosome, while females receive two X chromosomes. Chromosomal inheritance
has a marked effect on the general anatomy and physiology of the individual. It is a question of stuff in
the right place, meaning if the individual has one less chromosome than usual, called a monosomy, or
one more chromosome than usual called a trisomy, a syndrome results. A syndrome is a group of
symptoms that appear together and tend to indicate the presence of a particular disorder.
Monosomies and trisomies arise due to nondisjunction of chromosomes. Nondisjunction occurs
during meiosis I when the members chromatids fail to separate and both daughter chromosomes go
into the same gamete.
Genes, the units of heredity that control specific characteristics of an individual, are arranged in a
linear fashion along the chromosomes. Alternate forms of a gene having the same position (locus) on a
pair of chromosomes and affecting the same trait are called alleles. The sex chromosomes carry genes,
just as the autosomes do. Some of these genes determine the sex of the individual (that is, wether the
individual has testes or ovaries), but most of the genes on the sex chromosomes conrol traits
unrelated to sexual characteristics. They are called sex-linked genes because they are on the sex
chromosomes. Most of the sex-linked genes are on the X chromosomes. These are called X-linked
genes.

Chromosomal Inheritance
To view the chromosomal inheritance, cells can be treated and photographed just prior to division.
Prior to birth, cells can be obtained by amniocentesis, a procedure in which a physician uses a long
needle to withdraw a portion of the amniotic fluid containing fetal cells. In chorionic villi sampling,
cells are removed from the chorion. In either case, the fetal cells are cultured, and then a karyotype of
the chromosomes is prepared. Karyotyps can also be done using white blood cells from an adult.
Notice that a karyotype displays the chromosomes by homologous pairs. They are called homologous
pairs because they have the same size and shape.
In the karyotype of males, it is possible to see that the X chromosome is larger and the Y chromosome
is the smaller of the sex chromosomes. Females have two X chromosomes of the same size.

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Figure 78: Karyotype

Deoxyribonucleic Acid DNA molecule

DNA molecules consist of two deoxyribonucleic acid chains or strands that are wound together in the
form of a double helix as shown in figure 79. The drawing on the right (b) has been simplified to show
the essential features of the structure. The sugar and the phosphate groups form the backbone of each
strand. The bases in layers are represented by Thymine: T, Adenine: A, Cytosine: C, and Guanine: G.
They are attached to sugars. The two strands are held together by attractions between the bases in
one strand and those in the other strand. These attractions involve both London dispersion
interactions and hydrogen bonds. T and A are partners as C and G.

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Figure 79.a: A computed and generated model of DNA, in Chemistry, the Central Science, T. L.
Brown, E. LeMay Jr, and B. Bursten, Prentice Hall, 2001

The two strands of DNA unwind during cell division, and new complementary strands are constructed on the
unraveling strands figure 80. This process results in two identical double‐helix DNA structures, each
containing one strand from the original structure and one newly synthesized strand.
This replication process allows for the transmission of genetic information when cells divide. The structure of
DNA is also the key to understanding protein synthesis, the means by which viruses infect cells, and many other
poblems of central importance to modern biology.

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Figure 79.b: A schematic representation of DNA replication, T. L. Brown, E. LeMay Jr., B.
Bursten, Prentice Hall, 2001

Prior to cell division, DNA replicates so that each daughter cell receives a complete copy of the genetic
material. Replication is dependent upon complementary base pairing. DNA is double stranded, and the strands
are hydrogen-bonded by the nitrogenous bases thymine (T), adenine (A), cytosine (C), and guanine (G). During
replication, the original DNA strands separate, and the new strands have base sequences that are
complementary to the old strands.
In addition to replicating, DNA also controls protein synthesis, which involves transcription and translation.
During transcription, an RNA (ribonucleic acid) strand, called messenger RNA (mRNA), forms and is
complementary to a DNA strand. Again, complementary base pairing occurs, but in this case, the base uracil (U)
in RNA pairs with the base A in DNA.
During translation, another type of RNA, called transfer RNA (tRNA), carries amino acids to the cellular
ribosomes, where protein is synthesized. Complementary base pairing again plays a role.
Transformation, which is when organisms receive foreign DNA that enables them to produce a protein they
previously were unable to make.

The structure of DNA lends itself to replication when a DNA molecule is copied. DNA replication is a necessary
part of chromosomal duplication, which precedes cell division.

DNA Structure

DNA is a polymer because it is a chain of nucleotide monomers. Each nucleotide is composed of three
molecules: a 5-carbon sugar (deoxyribose), a phosphate, and a nitrogen-containing base. There are four types
of bases: adenine (A), cytosine (C), guanine (G), and thymine (T).
DNA is double stranded. The strands form a double helix resembling a twisted ladder. The sides of the ladder
are sugar-phosphate molecules and the rungs are made up of two bases joined by hydrogen bonds.
Complementary base pairing refers to the fact that adenine (A) is always paired with thymine (T), and cytosine
(C) is always paired with guanine (G).

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The double helix structure is a twisted ladder. DNA unwound shows that the sides of the ladder are composed
of sugar and phosphate molecules and that the rungs are paired nitrogen-containing bases.

DNA replication

Complementary base pairing aids replication. During replication, the double helix unwinds, and new
nucleotides pair with their complementary bases. In the end, there are two exact copies of the original strand.

Replication is called semiconservative because each new double helix is composed of an old (parental) strand
and a new (daughter) strand.

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Figure 80.B : DNA replication

DNA and Protein Synthesis

DNA stores information regarding the order in which amino acids are to be joined to make a protein. The
genetic code is a triplet code. Each code word or codon consists of three bases that signify a particular amino
acid. Protein synthesis reuires the processes of transcription and translation. During transcription, which takes
place in the nucleus, an RNA molecule called messenger RNA (mRNA) is made complementary to one of the
DNA strands. During translation, amino acids are joined in the order directed by the sequence of bases in
mRNA.

Transcription
During transcription, DNA is used as a template for messenger RNA (mRNA) formation. Like DNA, RNA is a
polynucleotide. However, RNA is single stranded, and its nucleotides contain the sugar ribose, instead of
deoxyribose, and the base uracil (U), instead of thymine. During mRNA formation, RNA nucleotides pair in a
complementary manner to the nucleotides in DNA: T pairs with A, A pairs with U, and C pairs with G. Following
complementary base pairing, the RNA conveys the genetic information from DNA in the nucleus to the
ribosome in the cytoplasm.

During transcription, complementary RNA is made off a DNA template. At the point of attachment of RNA
polymerase, the DNA helix unwinds and unzips, and complementary RNA nucleotides are joined together. After
RNA nucleotides are joined together. After RNA polymerase has passed by, the DNA strands rejoin and the RNA
transcript dangles to the side.

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 Figure 80.C : Transcription

Translation
Messenger RNA (mRNA) leaves the nucleus and goes to the ribosomes. Transfer RNAs (tRNAs) transport amino
acids to the ribosomes where the anticodons of tRNA and the codons of mRNA bind by complementary base
pairing. This causes the amino acids to be joined in a sequence specified by the codons of mRNA, and therefore
by the sequence of bases in DNA.

Translation takes place in the cytoplasm. During translation, the sequence of mRNA codons determines the
sequence of amino acids in a polypeptide. Small molecules of transfer RNA (tRNA) are located in the cytoplasm.
At one end, a tRNA bears a particular amino acid, and at the other end, it has a certain anticodon, three bases
that are complementary to an mRNA codon. As before, A pair with U, and C pairs with G. As ribosomes
containing ribosomal RNA (rRNA) pass along the mRNA, tRNA anticodons pair with mRNA codons by
complementary base pairing. The order in which the tRNA molecules line up determines the order in which
amino acids are joined to form a polypeptide. Polypeptide formation is called translation because an mRNA
nucleotide sequence is translated into a sequence of amino acids. Polypeptides differ from one another by the
sequence of their amino acids. (A protein contains one or more polypeptides.)

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First Base Second Base Third Base
U C A G
U UUU UCU UAU UGU U
phenylalanine serine Tyrosine Cysteine
UUC UCC UAC UGC C
phenylalanine Serine Tyrosine Cysteine
UUA UCA UAA UGA A
Leucine serine Stop Stop
UUG UCG UAG UGG G
leucine serine stop Tryptophan
C CUU CCU CAU CGU U
leucine proline Histidine Arginine
CUC CCC CAC CGC G
leucine Proline Histidine Arginine

CUA CCA CAA CGA A

leucine proline Glutamine arginine
CUG CCG CAG CGG G
leucine proline Glutamine Arginine
A AUU ACU AAU AGU U
isoleucine threonine Asparagines Serine
AUC ACC AAC AGC C
isoleucine threonine Asparagines serine
AUA ACA AAA AGA A
isoleucine threonine Lysine Arginine
AUG (start) ACG AAG AGG G
methionine threonine Lysine arginine
G GUU GCU GAU GGU U
valine alanine Aspartate Glycine
GUC GCC GAC GGC C
valine alanine Aspartate Glycine
GUA GCA GAA GGA A
valine alanine Glutamate Glycine
GUG GCG GAG GGG G
valine alanine Glutamate glycine

Table 06: Messenger (mRNA) Codons

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Isolation and Testing of DNA
DNA can be isolated from the cells of any organism with a procedure used worldwide in biotechnology
laboratories. You will extract DNA from an onion filtrate that contains DNA in solution. Your instructor
prepared the filtrate by treating a ground-up onion with detergent and salt (NaCl). The detergent emulsifies
and forms complexes with the lipids and proteins of the plasma membrane, causing them to precipitate out of
solution. Then the cell contents, including DNA, become suspended in solution. The salt interacts with the DNA,
causing it to coalesce (come together) and making it ready to be removed. The mixture is then filtered to
produce a filtrate that contains the DNA.
You will use diphenylamine to test for DNA. It reacts with deoxyribose to produce a blue color, which indicates
that DNA is present.

Transformation
Transformation occurs when organisms receive foreign DNA that enables them to produce a protein they
previously were unable to make. Bacterial, plant, and animal cells are now routinely transformed.
Transformation of embryonic plant cells and animal egg cells results in improved crops and farm animals. Gene
therapy in humans requires the transformation of human cells.
Bacteria are transformed when they take up plasmids, self-replicating circles of extrachromosomal DNA. The
plasmids are isolated and enzymatically sliced open. DNA from another source then is inserted into them. The
plasmids now contain recombined or recombinant DNA, and when they are taken up, the new bacterial host
can produce a new and different protein. By this method, bacteria have been bioengineered to produce human
insulin.

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 Figure 80.E : Bacterial transformation

Bacterial Transformation
In the experiment described in the following figure, bacteria (Escherichia coli) will receive a plasmid, called
pAMP, that contains a gene for ampicillin resistance. This gene will make E. coli resistant to the antibiotic
ampicillin, so that it can grow in a medium that contains ampicillin.
In the procedure, rapidly growing E.coli cells are suspended in cold calcium chloride (Ca CL 2) and saturated
with plasmid DNA. Then they are exposed to a brief heat shock (40-42°C). After this treatment, E coli is more
likely to be transformed.

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 Figure 80.F: Bacterial transformation experiment

Experimental Procedure: Bacterial Transformation

Read through the entire procedure before beginning.
1. Obtain three sterile transformation tubes with caps and four sterile calibrated droppers. Label the tubes
+, -, and C (control).
2. Work on all three tubes at once, as follows:
a. Place each tube in its own Styrofoam coffee cup filled with crushed ice.
b. Use the first sterile dropper to add 0.5 ml of calcium chloride to each tube. Do not use this
dropper again. Dispose of it properly.
3. Your instructor will inoculate tube + with E. coli from a culture growing on Luria agar. ( Your instructor
is very careful not to transfer any of the agar the E. coli is growing on, as the agar will inhibit
transformation.) Use a sterile dropper to gently aspirate the fluid to obtain a uniform cell suspension.
Properly dispose of this dropper. Next, your instructor will add one drop of pAMP (plasmid) to this
tube.
4. Your instructor will inoculate tube – with E. coli. Use a sterile dropper to gently aspirate the cells to
obtain a uniform cell suspension . Properly dispose of the dropper.
5. Your instructor will add one drop of pAMP to the tube C.
6. After inoculation, let each tube stand in its ice cup for 10 to 20 minutes. In table …., indicate the
contents of each tube with check marks
7. Near the end of the 10 to 20 minute period, set up a water bath (using hot/cold tap water), and
maintain the temperature at exactly 42°C. Now, simultaneously place all the tubes in the 42 °C water
bath for exactly 90 seconds (the heat treatment helps the bacteria take up the plasmids)
8. Immediately after the 90-second heat treatment, return each tube to its ice cup for 10 minutes. The
bacteria now recover from the shock of the heat treatment.

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 9. Remove the tubes from the ice.
10. Use a sterile dropper to add one full dropper of Luria broth with ampicillin (LB+ AMP) to each tube.
Properly dispose of the dropper.
11. Snap transformation tubes closed, and incubate them for at least 48 hours at 37°C.
12. After 48 hours, look for growth of E. coli. Growth is indicated if a tube appears cloudy. Complete Table…
(If you do not actually do the experiment, fill in all columns except observed results)

Gel Electrophoresis
The two most widely used techniques for separating molecules in biotechnology are chromatography and gel
electrophoresis. Chromatography separates molecules on the basis of their solubility and size. Gel
electrophoresis separates molecules on the basis of their charge and size.
Gel electrophoresis has many applications. It has been used to distinguish cancer types, to test for genetic
disorders, to assess an individual’s risk of coronary disease, and to determine he nucleotide sequences in many
organisms, including humans. During gel electrophoresis, charged macromolecules migrate across a span of gel
because they are placed in an electrical field. The gel acts like a sieve to retard the passage of molecules
according to their size and shape. In addition, negatively charged molecules migrate toward the positive
electrode, while positively charged molecules migrate toward the negative electrode.
Almost all gel electrophoresis is carried out with horizontal gel slabs because such gels are very simple to
prepare and load. First, the gel is poured onto a glass plate, and wells are formed. The plate is installed on a
platform in an electrophoresis chamber, and buffer is added. Samples ar loaded into the wells, and then the
electrical current, which causes the molecules to migrate, is turned on. With staining, the various
macromolecules appear as a series of bands spread fro one end of the gel to the other.

Mixtures of proteins (or nucleic acids) are placed in wells near one end of a gel slab. The resulting series of
bands demonstrate that the macromolecules migrated in the presence of an electric charge at a rate dependent
on the molecules’ charge and size. For proteins, the rate of migration largely depends on the degree of
electronegativity. For nucleic acids, the rate of migration largely depends on molecular size.

Generalized instructions
These instructions are applicable in a general way to carrying out gel electrophoresis. Your instructor may have
specific instructions for you according to the equipment you are using and the experiment you are doing.

Preparing the Gel Slab

Precast gel slabs can be purchased, or you also can easily prepare your own by following these directions:
1. Prepare a mold for your gel solution by, for example, simply taping all the edges of a glass plate. Or, if
available, place a glass slide on the support deck of acasting tray, and tape the ends of the support deck
securely. (Fig. 11.8a and b).
2. Add agarose pwder (amount directed by your instructor)to a measured quantity of electrophoresis
buffer in a test tube.
3. Heat the test tube in aboiling water bath until the agarose dissolves. After boiling for about 1 minute,
remove the test tube, and let it cool for 2 to 3 minutes.
4. Pour the warm agarose solution into the mold (casting tray) (Fig. 11. 8b)
5. Immediately insert a comb into the gel, pushing down gently. The teeth of the comb should come rest
0.5-1.0 mm above the glass slide. The comb will form wells to receive your samples (Fig. 11.8c).
6. After the gel is completely set (about 15 minutes), carefully remove the tape strips, and lift the comb
straight up and away from the gel. You now have a line of wells that can be filled with macromolecular
samples (Fig. 11. 8d).

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 Figure 80-G : Equipment and procedure for gel electrophoresis

Performing Gel Electrophoresis

Follow these directions when performing electrophoresis:
1. Transfer the gel (in the casting tray, if so directed) to the electrophoresis chamber. Position the gel so
that the wells are closest to the negative electrode.
2. Slowly add just enough electrophoresis buffer to completely cover the gel to a depth of 1-3 mm.
3. Load a number of wells as direted by your instructor, using a micropipette (see the box on
micropipetting technique). Dispense 10µl of each sample into a different well (see Fig. 11.8d). Be sure
that the sample is all the way down in the tip of the pipette. Place the tip of the pipette below the
surface of the buffer and just into the well, being careful not to puncture the well bottom. Slowly release
the sample into the well. The density of the sample will make it sink into the well. (Your instructor may
have made an extra gel for you to practice loading.) Rinse the micropipette between samples by
drawing and expelling distilled water three times.
4. Close the lid of the electrophoresis chamber. Connect the cables with the power supply off. When ready,
turn on the power supply (see Fig. 11. 8e).
5. Terinate electrophoresis before the samples have come to within ¼ cm of the positive electrode end of
the gel. Turn off the electricity and disconnect the cables.
6. Remove your gel slab (or casting tray), and analyze your results. Measure the distance of each band
from the sample wells.

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Experimental Procedure: Gel Electrophoresis
1. As you have practiced, load the wells with 10 µl of each of the following four samples, which are already in
sample buffer. Except for serum albumin, these proteins are pigments and therefore do not need a tracking
dye. A blue tracking dye has been added to the sample buffer for albumin.
a. Cytochrome c: This is one of the cytochromes in the electron transport system found in mitochondria.
Te molecule consists of a polypeptide chain and an iron-containing heme group. The heme group gives
the molecule an orange-brown color.
b. Myoglobin: Myoglobin, like hemoglobin, is a red respiratory pigment that also has an iron-containing
heme group. Myoglobin binds to and stores oxygen in muscles.
c. Phycocyanin: This is the pigment that gives a blue-green color to cyanobacteria. It helps absorb light
energy and assists these organisms in carrying on photosynthesis.
d. Serum albumin: This molecule is found in blood, where it transports many smaller molecules. Because
it is not naturally colored, a blue tracking dye has been added to the sample buffer.
2. Allow electrophoresis to occur.
3. At the completion of electrophoresis, which may be as soon as 6 minutes after the start, you will see various
bands in each lane. Measure the distance in centimeters of each band from the sample wells, and complete
the following Table.

Sample Distance Migrated (cm)

Cytochrome c
Myoglobin
Phycocyanin
Serum albumin

Table 07: Electrophoresis of Protein Samples

Results
Proteins differ from one another not only in size (dimension) but also in charge. The charge differences of
proteins at the same pH are largely due to the differences in their R groups. The pH affects the charge of protein
because it affects whether or not groups like amino (NH2 ) and carboxyl (COOH) groups ionize. Amino
groups become in acidic solutions, and carboxyl groups become in basic solutions.

Figure 80-H : Protein

BIOMOLECULES

Proteins
Proteins are macromolecules in all living cells. They are major components of animal’s tissues. They are key
parts of skin, cartilages, muscles and other tissues. Some proteins catalyze reaction, transport oxygen, serve as
hormones to regulate specific body process and perform other tasks.

The general formula for alpha amino acid is:

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Amino acids differ from one another in the nature of their R groups.

Proteins have numerous functions in cells. One important category of proteins is enzymes, organic catalysts
that speed up metabolic reactions. In addition, the contractile elements of muscle cells contain protein
filaments

A primary structure is the arrangement or sequence of amino acids along a protein chain. Linus Pauling and R B
Corey first proosed the secondary structure arrangements the α‐helix. Fig. 30 The tertiary structure is the
overall shape of a protein patterning by kinks, bends, and sections of rodlike and helical structure. Fig. 30

Figure 81.a : Level of organization of a polypeptide

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 Figure 81.b : -Helix structure for a protein

Two or more amino acids combination create peptide. A dipeptide is a combination of two amino
acids as shown on the aforementionned figure. A water molecule removes during condensation
synthesis.

Carbohydrates
Carbohydrates are molecules that are chain of sugars. A monosaccharide is a glucose which has only
one sugar unit fig. 82 a, b, c . Maltose which has two sugar units is a disaccharide seen on the fig. 82-a
upper right. By looking at the figure 83, a starch is a polysaccharide constituted of a chain of glucose
units .

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Figure 82-a, b, c: Structure of Ribose, Deoxyribose, Glucose

Lipids

199
Lipids are compounds that are insoluble in water and soluble in solvents such as alcohol and ether. Lipids
include fats, oils, phospholipids, steroids and cholesterol. Fats and oils are typically composed of three
molecules of fatty acids bonded to one molecule of glycerol.

Figure 84: Chemical reaction of 3 Fats

Emulsification of lipids
Some molecules are polar and non‐polar. A water molecule is polar; therefore, it is solvent of polar molecules.
An emulsifier causes a fat dispersion because it contains molecule with both polar and nonpolar ends. Bile salts
are emulsifier and products by the digestive tract. Tween and detergents are commercially produced
emulsifier.

Additional elements inside the body such oligo-elements and others:

If an individual wants to add on his or her diet, or inside his or her body input additional elements, he
or she could refer to the Mendleiv table, other additional element(s) such as Iron (Fe), Calcium (Ca),
Silicium (Si), Magnesium (Mg), Manganese (Mn),.., and others.
However, know that you could not for example eat a solid made by [n(Fe-Fe)] or/and [n(Fe-C)]
according to its dimension or its shape; because, this matter or/and substance might be a sharp one
in accordance with its shape, and also this matter could not be swallowed according to its dimension.
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DIETETIC AND HUMAN NUTRITION NEED

Human needs body input including: 1./ aliments or nurtures (inside is water or liquid solutions), 2./ gaze
(inside O2, CO2, CO, …)
 to growth,
 to make the brain and the entire body in good health and shape,
 to work,
 to move,
 to breath,
 and to make a motion of his or her body.

According to scientific research, body input and body output could be evaluated according to the following
biological, biophysical, bioscientific, biotechnology, medicine, bioatomical, bionuclear, and/or biochemical
laws:

• First law : matter conservation, or at least:

o matter dimunition with respect for good function or/and mechanism of the organism, tissue,
organs, or/and body;
o matter augmentation with respect for good function or/and mechanism of the organism, tissue,
organs, or/and body;
Matter conservation follows the rules of molecule(s) and/or atom(s) conservation.

• Second law: energy conservation, or at least:

o slightly variation of energy.

The temperature TEB of the external environment that the human body could support are the following
(however each individual has to consider the duration and each concerned tissue or/and organ):

Temperature of the external environment (for shadow):

Frequent temperature -10°C  TB  39°C
Exceptional high temperature 39°C  TB  100°C
Exceptional low temperature -50°C  TB  -10°C
a
Example of matter conservation
An example of matter conservation following the first law is the nitrogen conservation.

Diagram 8: Nitrogen diagram

Input (Nitrogen)-Output (Nitrogen) = Taken (Nitrogen) by organism

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The second law brings the research to following formulas:
The energy report is:

With: S is the energy check‐up, M is the metabolic consumption, W is the providing work, R is
the radiation, C is the convection, K is the conduction, E is the evaporation

The following result is a table of foods and nurtures according to some molecules inside each agricultural
product like water, proteins, lipids, glucids, minerals, vitamins and calories: (Table by : Randoin, Le Gallic, and
Causeret in Biology M Blaizot and al), Know that the USDA and other organism(s) in the world also provide
table of molecules from agricultural products:

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Table 9: Composition of some aliments
203
 CONCLUSION

To conclude, the human system, especially the body and life of human organism are complex and are
constructed with tiny molecules and atoms starting from its beginning until the end of life of the
human.

The anatomy is essential and necessary in order to know the body and to intervene in each need.

Genome, Genetics, or/and bionuclear&bioatomic sciences and technology differ human to animals and
make also diversify the human structure.
If we count the number of human genogenematics, they are equal to “the number of human since
the beginning of the human life to the end of human life” times “the existed kind of molecules
with or without atom(s) with or without substance(s) inside the body” times “the existed
shape(s) of human, body, organs, tissue during his or her life”. Meaning that one human could not
resemble identically to another one even for twin according to the human system. The best way to
understand the human genogenematics of twin is to separate some twin having the same sexe in two
different conditions of life. In addition, a human could live his or her own life according to human
system.

In human system, we could also consider that reasons why we need other people are because: we live
inside a family, we live with our coworkers, we live inside a society. But, a human could live its own
life independently to other people if he or she has his or her own needs.

In health sciences and technology including medicine, symptoms could describe more a health
phenomenon than the name of diseases; however, the name of diseases might be a consequences of
different symptoms. In fact, the name of disease(s) is from the classification of bad organism or/and
bad health phenomenon.

Atom(s), Molecules, Aliment, certain range of energy rays, certain gaze, adequate physical work are
necessary « input » for a good health and shape of the organism. Aliments, precisely and accurately
Atom(s), Molecules, Substances are for example necessary to nourish the body corps which is an
assembly of cells and living organisms and almost inert materials.

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*******************
Britannica, BRITANNICA
Hachette, HACHETTE
LaRousse, LAROUSSE
Elsevier-Masson, ELSEVIER-MASSON
Mc Graw Hill, MC GRAW HILL
Prentice Hall, PRENTICE HALL
Valhen, VALHEN
Vidal, VIDAL
Wikipedia, WIKIPEDIA
*************************

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PHOTOS OF THE AUTHOR AND CO-AUTHORS

Photo of the Co-Author(s):

Eugene H. LeMay Jr., Emeritus Professor of Chemistry, University of Nevada at Reno

216
T. L. Brown, Professor Emeritus of Chemistry, University of Illinois at Urbana Champaign

Brian Ang, Doctor in Medicine, Vision and eye health

Robert P. Heaney, professor in the Creighton University School of Medicine, researcher in the
Creighton University Osteoporosis Research Center, and holder of the John A. Creighton University
Professorship, an all-university chair named in honor of the University’s founder.

217
Nachum Dafny, Ph.D., Professor, Neurobiology & Anatomy, the UT Medical School, University of
Texas at Houston

Robin Huw Crompton, Professor at University of Liverpool

Sylvia S Mader, Mc Graw Hill

Eric Chudler, Professor at the University of Washington

218
 ABSTRACT :
The work in this book concerned general and specific medicine and anatomy. Biochemistry, biotechnology,
biosciences, biology, or/and bioengineering is more likely seen throughout the book. In fact, the book makes
see internal health known as internal medicine inside the work but external health known as external
medicine is also seen inside.

Nerves, ganglions, Blood vessel and blood composition inside the human body are treated in order to make
clear understanding of these concerned. Organs, tissues, and cells inside internal medicine are also shown.

Genetics is also a tremendous concern inside this book in order to help physicians and readers choose
solutions in the case of diseases of gene or genome diseases.

Heart anatomy and function are also demonstrated inside this work. Digestive tract is also seen. Respiratory
system and lung also appears inside this book. Kidney system is also seen. Brain structure is also treated.
Cell structures, cell division, cell development are also explained.

The more reader(s) read or consult deeply this book, the more he or she discovered many other human
organs, tissues, cells inside this book.

Key words: Medicine, Biotechnology, Biosciences, Life sciences, Biochemistry, Biology, Bioengineering

Domain :
Sciences du Vivant [q-bio] ou Life science

219