HOWIT

INSIDE THE
WGRKS
How our
muscles work

Inside the
human heart

How your
brain works

An in-dept)
look at the
human eye

Explore
the human
skeleton

The body's
Examine essential
the human organs

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hand

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 Welcome to

Inside the Human Body takes you on a fascinatingjourney­

starting at the very beginning, we explore how human beings
came to exist and the ways in which our early ancestors evolved
and adapted over hundreds of thousands of years. From here
we get under the skin, taking an in-depth look at our most vital
organs and body parts, from the complexity of the human brain
to the structural support and strength offered by our muscles
and skeleton. Working in tandem with modern medicine, our
body does an amazingjob of keeping us fit and healthy-we
discover some of the body's most common complaints as well
as investigating what the future of medicine may look like.
We even tackle the body's weird and wonderful functions-
exploring everything from why we laugh to the biology of a
sneeze. This book will help you appreciate just how special you
are and ensure you never take your body for granted again!
.J L
FUTURE
, r
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HOWIT
Part of the

WQRKS bookazine series

For pren freedom

with reiponsibility
 46
9 THE STORY OF 54 Muscle power
Science of vision
ft HUMANS 58
62 The retina
The story of The human pelvis
08 humans
64
66 The lymphatic system

W HATAREWE
'
MADE OF?

20 The human body

26 Your first year

+
32 Your amazing brain
40 Your skeleton
46 Inside a blood vessel
How cells work
HEALTH AND
46
47 The heart - a vital organ
MEDICINE
Inside the liver and pancreas
Outbreak
48
What's inside your head
70
Anatomy of an Olympic athlete
so
52 Inside the knee
76
The truth about hair transplants
53 What is thermoregulation?
80
82 The antibiotic apocalypse
84 Why do we get fat?

08
The 85
Immunisation: how it keeps
you healthy
How do we heal?
85 Placebos - do they work?
Kidney transplants
story of

94
86
How cloning works
humans
88
92 Anaesthetics
Strokes
How a marathon
92
Rheumatoid arthritis explained
affects your body
93
Why is there no cure for the
common cold?
93

94 How a marathon affects

your body
96 The future of medicine
102 Why do we get headaches?
102 Asthma
103 Cramp explained
103 Blood clotting
104 How metabolism functions
105 How does the liver detoxify?
106 How do gastric bands work?
108 How skin grafts work
Is cholesterol bad for you?
109 Hypermobile joints
109 What is a fit?
 Food & your body
144 The science of happiness
148 The gut-brain axis
150 The five basic human tastes
151 Unravelling the mystery of DNA
Correcting heart rhythms

47
Carpal tunnel syndrome
What are pheromones?
Eczema explained
The 154 Inside the flu
heart 156 How we swallow
156 Why do we get drunk?
157 The human tongue
157 How do we laugh?
158 What happens when you sneeze?
158 Knee -jerk reactions explained
159 How do we touch and feel?

88

l
110
110
Why do we get angry?
What are grommets?
150
The five basic
111 Anaphylactic shock human tastes
112 Brain surgery

103
116 How hyperthermic
surgery works
116 What are probiotic bacteria?
117 What are tonsils for? Blood clotting
118 Secrets of stem cells
120 Colour blindness
120 What causes stomach ulcers?
121 Understanding chickenpox
122 The war against superbugs
123 Curing deafness
124 Ebola virus
126 How enzymes keep you alive
126 Bacteria explained
127 How to check your pulse
127 Keeping hydrated
128 Understanding diabetes
130 Perfect posture
131 How corrective lenses work
132 Inside laser eye surgery
DID YOU KNOW? The earliest human footprints found outside of Africa were discovered in Norfolk, Eng/ond

I
n the iconic March ofProgress illustration, interbreed. New species evolve through the that our understanding of human evolution is
human evolution is depicted as a single process of natural selection: environmental itself constantly evolving.
flowing process that begins with apes and pressures favour some traits over others, which While we know that modern humans and
ends with our modern selves. But in truth, our causes populations to gradually adapt or diverge chimpanzees diverged from a common ancestor
evolutionary past is a messier affair, involving an in order to have a better chance of surviving. between six and eight million years ago,
assortment of ancestors treading a multitude of Despite a fragmentary fossil record, scholars scientists are still striving to find the earliest
paths that split, stumble and intersect in have traced the evolution of hominins - that is, hominin and pin down the moment the two
ambiguous ways. the group of species including modern humans lineages split. Above all, they seek to answer the
When we draw family trees, each end branch and our ancient bipedal ancestors -back more most fundamental question in human evolution:
represents a distinct species - a grouping of than six million years. But field scientists are still what sequence of events and adaptations
individuals that are genetically similar enough to uncovering 'new' extinct hominins, meaning occurred to transform apes into humans?

Palaeoanthropologists are scientists who peer Instead, experts look at materials in close
lutionary past. As tliey try to piece proximity to tlie fossils, sucli as tlie layers of r
they were discovered m. Careful study of local
geology combined with chemical analysis allows
ancient Jiominins, hke fossils and artefacts withm the layers to be dated.
lielp to classify cl!fferent species. I. ••• I • •• •

.. .
In order to reconstruct how species evolved, it

However, the commonly used method of

. .... . . .. . . . . . .. .
revolutionised this field. Because genetic
.
passed from parent to child, fragments of ancient
•I I • If
.. ... . .
DNA can be compared to our own to reveal secrets
t THE STORY OF HUMANS

The Homo genus

What set our closest relatives apart from earlier human species?
Every human on the planet today is a member of first hominin that used stone tools. Although it heidelbergensis. They in turn evolved from Homo
one single species: Homo sapiens. Together with retained many of the ape-like body features of erectus- one of the most successful hominins in
our extinct ancestors and closest relatives, we are earlier Australopithecus, its brain was much larger. history, surviving for two million years.
part of the broader genus of Homo, whose Tool use and brain size are two of the defining For a long time, scientists have argued over
members all share unmistakably human traits. characteristics of the Homo genus. The third is an whether H. sapiens evolved within Africa before
The Homo genus emerged somewhere around upright skeleton that enables walking on two feet. spreading around the world jthe Out of Africa
three million years ago in Africa, when the region Together these changes gave an evolutionary edge hypothesisl or evolved simultaneously in many
was home to at least 11 species of hominin. The in exploiting the environment, solving problems, locations jthe multiregional hypothesisj. Recent
oldest Homo fossil - dated at 2.8 million years old and journeying over long distances. studies ofDNA suggest we descend from a single
- was a member of the species Homo habilis. Its Ourown species is thought to have evolved population living 150,000 years ago, which heavily
name means 'handy man', as it is believed to be the 200,000 years ago from the strong, athletic Homo supports the Out of Africa theory.

Petite skull ------, Increased

brain size
Homo species identifier
The skull was advanced in
Discover the characteristic features of some
shape, but with a tiny The brain size
of the most prominent members of the genus
brain case; it contained a approached the

Evolving brain puzzling mix of modern lower limit of

and primitive teeth. modern humans'
The brain was small,
but larger than in
dimensions.

the Australopithecus
species, allowing it The face was
to create the first short and wide
stone tools. with a low,
Mixed forehead and the
features and curved,
first example of
The species had a a broad,
elongated fingers,
smaller face and fleshy nose.
useful for climbing
teeth than earlier
and hanging in
trees.
hominins, but
retained a
protruding,
ape-like jaw.

H. erectus was
robust, with similar
proportions to
modern humans and
long legs suited to
upright walking and
A modern-type distance running.
foot arch, which
allowed upright
walking, with
long, ape-like Human-like
arms for tree lower body
climbing. Long, slender leg
bones and
modern-type feet
enabled an efficient,
bipedal stride.

HOMO HABILIS HOMONALEDI HOMO ERECTUS

Height: 1,1•1,2m Weight: 30-36kg Height: Approx I.Sm Weight: Approx 45kg Height: 1.45-1.Sm Weight: 40·68kg
Average brain size: 610cm3 Average brain size: 560 cm3 Average brain size: 1,050cm3
DID YDU KNOW? The term Homo sopiens comes from Latin ond meons 'wise mon'

Opposable thumbs
The grasping hands of our primate ancestors evolved as an
adaptation to life in the trees. Opposable thumbs-which are
able to move around and touch the other fingers-and flat
fingertip pads both help tree-dwellers to grab on to branches
as well as hold and manipulate small objects.
Our modern thumb has changed little since the last
common ancestor of humans and chimpanzees. It is longer,
compared to finger length, than any other primate's thumb,
An opposable thumb
giving both strength and precision. This helped our ancestors enables the hand to grip
gather a wide variety of foods and eventually develop tools. with strength and dexterity

Reorganised
skull
The skull takes the
'modern' form:
thin-walled and
Massive, high-vaulted, with
oval-shaped a rounded
skull braincase that
thick, rounded houses a very
brow ridge, angled large brain.
cheekbones, and a The face has a high,
huge brain. large nose. vertical forehead, a
less prominent nose
Flat face and subtle, divided
The face was notably brow ridges.
Thick trunk flatter than earlier
A funnel-shaped chest human species, with a
cavity and upwardly wide nasal opening,
flaring hips gave this sloping forehead and
species a shorter, stockier arched brow ridges.
body than ours.

The species was heavily Leaner trunk

built, with large joints and proportions
compact lower arms and The pelvis is narrow and
legs to conserve heat deeply curved, and the
during ice age climates. chest is barrel-shaped.

Lightly built
skeleton
The skeleton is
more delicate than
in earlier humans,
Robust skeleton with long legs,
slender fingers and
Thick shinbones, complete
toes, and lean
with bony ridges, suggest
musculature.
these people were
strongly built.

I:t•Mt•Ui ¥;1:i •]AAiii:M!AA:�; �ti

Height: 1.S-1.6m Weight: S4·6Skg
HOMO HEIDELBERGENSIS
Height: 1.6-1.Sm Weight: 51·62kg
HOMO SAPIENS
Height: 1.6-1.Sm Weight: 62-78kg
Average brain size: 1,420 cm3 Average brain size: 1,270cm 3 Average brain size: 1,350 cm3
t THE STORY OF HUMANS

In particular, it isn't clear what

. ..
became more important as a result
..

two legs; encephalisation, which is

an increase in brain-to-body mass
ratio; and civilisation - a catch-all technological t�ought required to
that includes social organisation, produce stone tools. On the otlier

communication and culture. . ..

hand, brain enlargement may only

t • tI I

other words, after humans had

figured out how to procure and cook
meat. Homo species' digestive tracts

food sources became more thinly

I ••

.
upright would also have helped
.
keep their bodies cool by reducing
the exposed skin surface area, and
moving more of the body up into the
breeze and away from the hot eartli.
Thrusting spears gave
Neanderthals the new

012
DID YOU KNOW? Life expectancy for eor/y humans wos anywhere between 15 to 30 years

Culture
How did early humans make sense of their world? Sadly,
fossils are silent on the subject of culture - language,
rituals, music and other forms of symbolic expression.
But shell beads made in Africa 100,000 years ago and
40,000-year-old cave drawings in Europe are evidence of
our ancestors' impulse to create, express and connect.

40,000-year-old cave painting of a

giant deer, in Lascaux, France
Communication
Many species communicate, but full language - with
rules for combining sounds and words - appears to be
uniquely human. One reason for this is that humans differ
from most other primates in the way our larynx - or voice
box - sits low in the throat. This allows us to shape
sounds into speech, using our lips and tongues.
Precisely when and where language originated is
unknown. The descended larynx evolved around 300,000
years ago, but experts believe spoken language only
appeared in the last 100,000 years, probably developing
out of a more basic 'proto-language' comprised of
gestures and body language in addition to simple sounds.

Cooperation
When we work together cooperatively, we tend to
achieve more in less time and with less effort. The
same was true of our ancestors. By banding
together, they could bring down larger animals in
the hunt, forage a greater variety of foods,
distribute tasks, defend resources and better
protect the group from predators.

Brain size Fire

In most mammals, brain size is proportional to body size. Harnessing fire was a turning point in human history, but
Most primates' brains exceed this ratio, but around two the evidence for how and when it happened is sparse and
million years ago, our ancestors' brains started growing hotly contested.
even larger. At the same time the brain was reordered, Charred bones and ash suggest Homo ergaster
favouring the growth of some regions, such as those used interacted with fire in Africa as early as 1.5 million years
for learning, over others, like those that govern smell. ago, but whether the fires were wild or intentionally lit is
a mystery. Better evidence of controlled use appears

Problem solving around 800,000 years ago; clusters of scorched

tool-making debris, burned seeds, and wood mark more
As brain size and complexity increased, early humans than a dozen early hearths across a site at Gesher Benot
became better equipped to tackle problems using logic Ya'aqov in Israel.
and creativity. From tool-making to crossing continents to Campfires not only provided warmth and protection
caring for the old and weak, it was this ability to interact from night-time predators; they also enabled food to be
with one another and the environment in novel ways that cooked, making it more digestible, and potentially
helped our ancestors survive in an unpredictable world. influencing human brain evolution.

013
t THE STORY OF HUMANS

How we Oase Cave, Romania

40,000 years ago
Grotta del
Cavallo, Italy
Skhul and
Qafzeh, Levant

conquere
A human face found in an ancient 43-45,000 100-120,000
cave indicates early Europeans years ago years ago
travelled from the Levant via the Two infant teeth were Skeletons and burned
shores of the Black Sea. mistakenly identified flints from an early

the planet
as Neanderthal when migratory population
·' they were first of H, sapiens who
.
e, ventured no further.

Humans went from

African natives to ..
citizens of the world
In our brief 200,000 years on Earth,
Homo sapiens -unlike any of the
human species before us -has
managed to colonise the entire
globe. But we were not the first to
venture beyond Africa, Some of our
ancestors took those initial steps at
least 1.8 million years ago.
The first waves of adventurous
hominins travelled east towards
Asia, before eventually moving
west and north into Europe. Homo
erectus spread throughout Asia,
reaching as far south asJava, and
Homo heidelbergensis dispersed
through both Asia and Europe.
As for our own species, all
Taforalt,
evidence suggests that we lived in
Morocco Jebel Faya,
82,000 Saudi Arabia
Africa for the first 100,000 years of
75,000
our 200,000-year existence. After a
shaky first migratory attempt, it years ago
Pierced, clay­ years ago
was another 30,000 years before coated shells, Middle Stone Age
we struck out again. This time probably once tools from Africa,
marked the start of a mass exodus; worn as body indicating humans
crossed from
ornaments.
Homo sapiens spread rapidly to all Ethiopia to Yemen

Return to Africa
continents except Antarctica via the Bab
within 50,000 years, making us EI-Mandeb Strait.

Jwalapuram, India
40-45,000
one of the most invasive species
74,000 years ago
years ago
the world has ever known. DNA studies show
Why the itchy feet? Some some descendants of
Stone tools discovered above and below
the first modern
scientists think we simply humans in Saudi Arabia
a thick layer of ash from the eruption of
followed the roaming animals we had returned to Africa
the Toba volcano in Indonesia,

Herto, Ethiopia Andaman Islands

ate; certainly other large predatory by 30,000 years later.

160,000 years ago 50-60,000 years ago

species made similar territorial
Border Cave, South Africa
82,000 years ago
expansions alongside us. Other Clues in DNA suggest modern
Skulls of two adults and one
experts hold the more romantic child are the oldest Homo Andamanese natives descend directly
sapiens remains ever found.
Anatomically modern skeletons were
view that wanderlust is simply discovered along with younger stone tools,
from the first south Asian settlers.
part of what makes us human.

014
 DID YOU KNOW? The oldest Homo sopiens remains were discovered in Ethiopia, Africo

Siberia Homo sapiens

43,000 years ago
Ancient tools reveal the first goes global
arrivals to inland Asia Evidence from fossils,
journeyed from the Middle artefacts and DNA tells a
East, over the Asian steppes. compelling migration story

Tianyuan
Cave, China
40,000
Central Asia
60,000 years ago
years ago
Clovis, USA
The oldest
securely dated DNA analyses reveal complex
modern human lineages and multiple waves
13,500 years ago
skeleton in China. The earliest large settlement
of colonisation.
in North America, although

Niah Great Cave, Borneo

evidence is mounting that

40,000 years ago

humans arrived 2,000-3,000
years earlier.

--------- 'Deep skull' - one of several Homo

sapiens remains found in this area
- belonged to a 15-year-old girl.

Arnhem Land, Australia "Humans ore one of the

55,000 years ago
The Malakunanja II rock shelter is most invasive species
the world hos known "
the earliest evidence of human
occupation in Australia.

Monte Verde, Chile

Lake Mungo, Australia
40,000 years ago
15,000 years ago
Hearths, wooden structures
Fossilised skeletons of a 50-year­ and pollen from distant
old man and his cremated wife. medicinal plants suggest a
swift coastal migration by boat.

015
t THE STORY OF HUMANS

Surviving adversity
How modern humans overcame
threats and evaded extinction
After over six million years of human evolution, mimic one another, communicate concepts,
Homo sapiens is the only species left standing. and learn new skills. This allows the work of
What is the secret to our success? Scientists the most skilled or intelligent to b enefit entire
believe it lies in our adaptability, our capacity for populations, instead of forcing each new
abstract thought and our ability to cooperate. generation to re-invent the wheel.
Indeed, no other animal species has adapted These characteristics made us resilient in the
to as wide a range of habitats and such face of change. During the Ice Age winters of
divergent pursuits as modern humans. As 15,000 years ago, for example, modern humans
successive waves flowed out of Africa and in eastern Europe came up with cleverways to
dispersed throughout the world, we learned in cope with the cold. By sewing clothes from
each new place how to find and eat local food animal hides, building shelters from mammoth
and to survive different climate conditions. bones, preserving dwindling food supplies in
We could not have done this without the permafrost and using fire to keep warm,
technological ingenuity, nor without the they were able to ride out the tough times
cultural transmission of ideas - the ability to together and ensure the survival of the species.

016
DID YOU KNOW? The next stage of human evolution could involve the col□nis□ti□n of Mars

A thriving
• . .
species
..

. ..
..
consequences of our act10ns; the quest10n

beyond our immediate, ind1v1dual interests.

How soil, society and science If the planet can't meet the needs of the
elevated modern humans heaving ])opulat10n, we might eventually

. .. . .. . .
The moment when modern humans have to turn our gaze outwards. Colonisation
transitioned from merely surviving to
convincingly thriving happened somewhere .
around 12,000 years ago, coinciding with the
advent of agriculture.
For millions of years leading up to this time,
..
isolated by: distance and interbreeding
.

early and modern humans alike were

preoccupied with foraging, hunting and
scavenging food. But once we discovered that
we could control the growth and breeding of
certain plants and animals, we quickly became
farmers and herders.
As these practices gained momentum,
settlements began to form around them. These
grew from villages to towns to cities as food
became more plentiful. Within them, the
human population began to explode,
eventually reaching levels where we were
unlikely to be wiped out by anything less than
a global catastrophe.
Cities became the focus of social interaction,
idea exchange and technological innovation.
The ballooning population allowed knowledge
and creative expression to flourish, as
individuals were able to specialise and learn
from each other.
Over centuries and millennia, the rate of
progress has continued to accelerate and
innovations -from the printing press to the
Internet, from surgery to vaccines, from the
wheel to global air travel -continue to make our
lives longer, safer and more rewarding.

Humanity's vast accumulation of

medical expertise keeps us
healthier than ever before

017
40
Your
skeleton

26
Your first year

20 The human body 50 What's inside your head

26 Your first year 52 Inside the knee
32 Your amazing brain 53 What is thermoregulation?
40 Your skeleton 54 Muscle power
46 Inside a blood vessel 58 Science of vision
46 How cells worl< 62 The retina
47 The heart - a vital organ 64 The human pelvis
48 Inside the liver and pancreas 66 The lymphatic system

018
 The male cerebral
cortex has about
23 billion neurons

Red blood cells

t
can live for up
to 120 days

Journey inside the body to discover

just what we are made of. . .
T
he human body is composed of an Calcium is the most abundant mineral in the between one and three per cent of our body
estimated 7 octillion (which written out human body, important for the regulation of mass and are hugely important for our proper
1s 7,000,000,000,ooo,ooo,ooo,ooo, protein production and activity. functioning. They have 8 million different
000,000) atoms, making up over 75 trillion cells. Complex cascades of chemical reactions coding genes for making proteins, compared to
At the atomic level, the human body occur within the gel-like cytoplasm and Jess than 30,000 in the human genome.
comprises about 60 elements, but the function organelles of cells - tiny structures that The bacteria that live in our digestive system
of many of them is unknown. In fact, 99 per cent perform specific functions within a cell. provide essential support too; they
of the human body is made from just six Phosphorus is used to make ferment undigested carbohydrates,
elements (see chart for specific percentages). adenosine triphosphate (ATP), allowing us to access energy we
How many
Like all other life discovered to date, we are which has high-energy phosphate hairs? couldn't otherwise digest, and
carbon-based; the biomolecules that make up bonds that can be broken in order A human head they have a role in the production
our bodies are constructed using frameworks of to power cellular processes; ATP has an average of vitamins like biotin and
of 100,000 to
carbon atoms. Carbon is almost unique among is essentially our cells' fuel. 150,000 hairs
vitamin K. Their presence in the
the elements; it is small in size and can make Cells are coated in receptors and gut also prevents 'bad' bacteria
four covalent bonds to other atoms, allowing it respond rapidly to environmental from taking hold and making us
to form the backbone of key molecules that changes, communicating via chemical unwell. Even more unusually, at least
form the human body, including proteins, fats, signals and electrical impulses. During eight per cent of the human genome is viral in
sugars and DNA. The bonds are strong enough embryonic development, chemical gradients origin. Retroviruses are able to insert their DNA
to hold the molecules in a stable structure, but tell developing cells where to go, and what cell into our chromosomes, and at several points in
not so strong that they cannot be taken apart type to become, resulting in a new person. human evolution genes that started out in
again, allowing the body to break and reform Interestingly, the majority of the cells in the viruses have become permanently entwined
molecules over and over as required. human body are not human. Microbes make up with our own genetic information.

020
DID YDU KNOW? Bone works like reinforced concrete with its collagen fibres the steel supports and the minerals cement

The structure of bones Beneath the skin

Skin has several layers with a unique function
The long bones of the body, such as the femur

Stem cells Cornified layer Largest organ

(thighbone), contain two distinct types of bone

Cortical bone of the body

Osteocyte
A layer of stem cells at The very outer layer of
The tough outer layer of the base of the the skin consists entirely
The cells that form the The skin of a human
bones contains densely epidermis divides to of flattened, dead cells.
bone matrix eventually adult measures two

l
packed cylindrical form new skin cells, These provide a
become trapped in it. square metres
structures - osteons which push upwards to protective barrier.
They help to regulate formed from concentric replace the dead ones. (22 square feet)
bone turnover. layers of bone tissue.

Epidermis
The outer layer of skin
is formed of cells
known as keratinocytes.
These cells arrange
in a multilayered
tile structure.

Dermis
Connective tissue
below the epidermis
provides cushioning and epidermis helps
and support. It also to anchor the two
carries the blood layers together,
vessels that supply preventing them
Blood vessels Within the ends of long the skin cells. from slipping.
Bone is a metabolically bones is a looser,
active tissue and a good honeycomb structure,
blood supply allows for where calcium is released
mineral exchange. from storage as required. Fat -----'
Osteoclast A layer of subcutaneous Dermis
Osteoblast ____, Osteoclasts are related to cells of adipose tissue provides
Osteoblasts make new bone, the immune system and digest cushioning and insulation, Subcutis
producing the collagen scaffold old bone to release minerals and as well as energy storage.
and laying down minerals. allow for remodelling.

Hair under the microscope Cuticle Medulla

A strand of hair can be divided into three distinct regions The outside of the hair is An open, unstructured
core runs up the
Matrix -------�
made of layers of flattened
cells that overlap, centre of the hair.
j
Cells of the matrix divide protecting the hair. ..
, ,.-:
to produce new hair.
�:.:�iliF-'--- Cortex
Papillae
Blood vessels supply
.
�i'di
·
· · �'0_,_J!j_/
�_..;;--- The body of the hair is made
from coiled strands of keratin.
nutrients to the cells of Melanin granules within the
the matrix and root. cortex lend it its colour.

Six main elements of the body (99%) Body composition by tissue type

► Oxygen: 65% ► Skeletal muscle: 36-42%

Carbon: 18% ► Fat: 13-20%

►
► Hydrogen: 10% ► Bone: 12-20%

► Nitrogen: 3% ► Skin: 16%

C> Calcium: 2% C> Brain: 2%

► Phosphorus: 1%

021
--
' WHAT ARE WE MADE OF?

The nucleus stores all Cytoplasm

sorts of genetic
Cell membrane
The cell is filled
information with a gel-like
substance that The cell is enclosed
contains thousands in a membrane,
which regulates the
transport of
substances in and
out of the celL

Close u�
with cells
There are thought to be over 200
different types of cell in the human
body, each specialised to perform a
particular function. Despite these
specialisms, their basic underlying
biology is the same.
Cells contain a nucleus, which houses
the 46 chromosomes, containing the
complete set of instructions to synthesise
all of the proteins found in the human body.
Depending on the type of cell, different genes
are switched on and off, determining which
proteins the cell will produce.
Proteins for use inside the cell are created on
ribosomes in the cytoplasm. The ribosomes read the
genetic message and assemble the corresponding Proteins that are
protein using amino acids as building blocks. Proteins to be
exported from the cell - for example, antibodies or digestive
enzymes - are constructed within a series of membranes. Here made inside a series
they gain a number of modifications which enable them to survive the of membranes.
harsh environment when they leave the cell to travel around the body.

Key cells of the body

Blood and Contractile cells Stem cells Endocrine cells
immune cells Type: Muscle Type: Undifferentiated Type: Hormones
Type: Blood These cells contain a protein ratchet Stem cells are ones that These cells generate hormones and
The cells of the blood, system, which enables them to contract. have not yet committed release them locally or into the
including red blood cells Actin and myosin form long strands, to a particular specialism. bloodstream. Their hormone-releasing
and the white blood cells which slide past one another, pulling They are found in many activity is controlled by neurotransmitters
of the immune system are all produced in the edges of the cell together. locations and provide a replicating sent from local nerves, or by other
the bone marrow. Red blood cells lack a reservoir of cells that can be used to chemical messengers, which bind to
nucleus, enabling them to pack more of Nerve cells maintain and repair the body. receptors that are on the cell surface.
the oxygen-carrying protein,
Extracellular matrix cells Germ cell
Type: Brain and nerves
haemoglobin, into their cytoplasm. Nerve cells have
specialised membranes,
Epithelial cells
Type: Connective tissue Type: Reproductive
which use molecular The cells of the body are supported by Sperm and egg cells have
Type: Skin and membranes pumps to maintain an networks of fibres including collagen and just one copy of each
The cells that cover our bodies and line electrochemical gradient; this allows them elastin. These are generated by chromosome and are
our body cavities form junctions with one to transmit electrical signals. Nerves extracellular matrix cells like fibroblasts, formed by a special type
another. Using proteins anchored between function more efficiently if they are which produce and secrete precursor of cell division called meiosis. When
their membranes, the cells join forces to insulated and many nerve cells are components that then assemble into the sperm and egg combine, the resulting cell
create strong barriers to protect the body. covered by a fatty sheath of myelin. fibres that make up the matrix. has a full set of 46 chromosomes.

022
DID YDU KNOW? The biggest molecule in the body is chromosome 1, o continuous strand of ONA containing 10 billion □toms

Types of muscle

Cardiac muscle -----=====--hll Skeletal muscle

Type: Heart Type: Voluntary
Like skeletal muscle, cardiac Skeletal muscle is responsible
muscle is striated. for moving the skeleton.
Connections between the Under the microscope it has
cells allow the contraction to characteristic striped bands,
pass in a co·ordinated wave representing the contractile
across the heart. components within the cells.

Smooth muscle -----,1+----,...,

Type: Involuntary
The smooth muscle
that lines internal
structures is more
elastic than skeletal
muscle, allowing
the intestines and
bladder, etc, to
contract even
when stretched.

023
Inside the brain Hypothalamus
The brain i s made u p of two major types of The hypothalamus controls
cells: neurons and glial cells. many vital biological
The neurons of the brain are highly functions, including
specialised cells, interconnected by long, circadian rhythm, hunger,
branching processes. They communicate thirst and body temperature.
through electrical 'action potentials', which
can travel along the axons at speeds of 1-100
metres (3.3-328 feet) per second.
When an action potential reaches the
synapse at the end of a nerve, it triggers the
release of chemical transmitters, which bind
to receptors on neighbouring nerves. Posterior pituitary
Depending on the combination of The nerves in the
neurotransmitters released - and the timing posterior pituitary release
- the target nerve will fire, propagating the the antidiuretic hormone,
signal through the brain. which inhibits urine
Glial cells, on the other hand, provide production and oxytocin,
support to the neurons and have a variety of The nuclei in the pons _ the bonding hormone.
specialist functions. Astrocytes help to take up control many functions,
excess neurotransmitters from synapses, including sleep,
\.._,.
preventing neurons from damage due to breathing, swallowing,
excessive stimulation, while oligodendrocytes bladder function and
form fatty sheaths in order to insulate nerve facial expressions.
cells in the brain and spinal cord.
The brain has significantly more protection
than the other organs of the body. It is
Medulla oblongata
shielded from mechanical stress by the thick The anterior pituitary
bones of the skull and is suspended in a generates several
The lower half of the different hormones,
cushion of cerebrospinal fluid. At the brainstem is responsible
microscopic level, the brain is protected from controlling growth,
Cerebellum
for controlling fundamental thyroid function,
potential hazards in the bloodstream by the involuntary functions like
blood-brain barrier - the cells lining the The cerebellum has an fertility and stress.
breathing and heartbeat.
capillaries are joined together by tight important role in the
junctions, controlling the passage of all co-ordination and
molecules and bacteria into the organ. timing of movement.

024
DID YDU KNOW? The red co/our of blood isn't due to iron, but the shope of the porphyrin molecule thot contains it

What role do hormones play in the body?

Angiotensin Erythropoietin Ghrelin Oxytocin Cortisol Leptin
Produced: Liver Produced: Kidney Produced: Stomach Produced: Produced: Produced: Fat
Angiotensin causes Cells in the kidney are A chemical signal Mainly in the brain Adrenal glands Made by fat tissue,
blood vessels to sensitive to blood produced mainly by This is also known as The 'stress hormone' leptin plays a
constrict, raising oxygen levels and the stomach. It acts as the 'bonding helps to increase fundamental role in
blood pressure. ACE can release this an appetite hormone' and is blood sugar by acting as a fuel gauge
inhibitors that treat hormone to stimulant, making produced at high promoting the and telling the brain
high blood pressure encourage production you feel both hungry levels during and breakdown of fat just how much fat is
inhibit its activity. of new red blood cells. or full up. after childbirth. and muscle tissue. stored in the body.

The ageing body Hair loss

Dihydrotestosterone (DHT)
The human body changes as it ages and the peak interacts with the cells of the
time for organ functionality is thought to be hair follicle, gradually slowing
around the age of 30. The body has amazing down hair growth, and
capacity for regeneration, but cells can only divide
Eyesight
causing hair to become thin
a finite number of times, and as we get older our and weak. Eventually the
ability to repair damaged tissue decreases. follicles become dormant and As the lens of the eye ages it
Dramatic changes, such as the menopause, becomes less flexible, which
produce obvious effects on the body. Female sex makes focusing on a range of
hormones are not just involved in reproduction, distances more difficult. It
but also play a role i n other processes, such as the also gradually clouds over,
maintenance of bone density. In the absence of leading to blurring of vision
oestrogen, bone mineral density decreases, which and sometimes cataracts.
can lead to osteoporosis. A similar, but less
dramatic, effect can be seen in men as
testosterone levels begin to drop.
Similar decline in functionality can be observed
throughout the human body; collagen in the skin
begins to decrease, insulated axons in the brain
shorten, and DNA damage accumulates, leading
to an ever greater risk of cancer.
However, it's not all bad. Life expectancy is on
the increase, and scientists are coming closer to
understanding - and being able to slow - the
complex processes of human ageing.

Mammals have the

capacity to regenerate
lost olfactory
receptors, however
this ability decreases
with age. Older adults
have fewer nerve
fibres in the olfactory
bulb and fewer
sensory receptors,
leading to a reduced

Hearing
sense of smell.
The auditory hair cells of
the inner ear are delicate
and, over time, become
damaged or die. Unlike
other cells in the body,
these specialist sensory
receptors are unable to
regrow, leading to
permanent hearing loss.

Fibroblasts are responsible for

producing the collagen
support network that lies
beneath the skin. As we get
older, the cells produce less
and less collagen, contributing
to the formation of wrinkles.

025
 What happens to the human body
in the first 12 months of life
W
e are born well before we're ready to one of their needs. She maintains a constant
fend for ourselves, but we learn faster temperature, digests food to supply nutrients
in our first three years than we will for and breathes to supply oxygen. She also deals
the rest of our lives. So how do we get from with waste and fends off infection. Then
vulnerable newborns unable to lift our own suddenly the baby has to fend for itself.
heads to walking, talking toddlers? As it hits the cold air of the delivery room, a
powerful inward breath pulls its lungs open and
BIRTH fills them with air. In the safety of the womb, all
Babies enter the world with a lot of growing left the oxygen the baby needed came from the
to do. From around 35 weeks of pregnancy babies umbilical cord. The lungs were full of amniotic
start becoming cramped. As the foetus gets fluid and the heart diverted blood past them
bigger it demands more and more energy, and through a hole called the foramen ovale and a
there's only so much that the mother can supply. tube called the ductus arteriosus. Suddenly the
Before they are born, their growth starts to slow. baby needs to breathe. The hole in the heart
Entering the world for the first time is a shock slams shut and blood rushes into the lungs.
to a baby's system, and the first days of life are Within hours or days after birth the tube, and
critical. Until the moment they emerge from the another that carried blood from the umbilical
womb, their mother's body has supported every cord to the heart jductus venosus), closes too.

026
DID YDU KNOW? A newborn's heart beats between 110 ond 160 times o minute, toking o breath up to once every second

027
' WHAT ARE WE MADE OF?

The other organ systems also spring into touches their cheek or lip, and the suck reflex
action. The baby has been practising breathing makes them suck if something touches the
and swallowing in the womb, and the kidneys roof of their mouth. These instincts help
have already started working. Within 24 hours with feeding.
the gut starts moving, passing a dark green or Then there are the Moro reflex and the
black, tarry substance called meconium. It palmar grasp reflex. The first happens when
contains bile, mucus, amniotic fluid and a baby feels as if they are falling. They extend
anything else the baby has ingested in utero. their arms and legs and arch their backs
Once this fluid is out of the way milk digestion before curling up. The second makes the fingers
can begin. and toes curl if you touch the palm of their hand
The newborn stomach is tiny - barely the or the soles of their feet. Together they help the
size of a marble - so the baby needs to wake baby to survive.
every few hours to feed. It can only take a few
small mouthfuls at a time.
The mother produces a thick, "Babies ore FIRST WEEKS
Brand new babies can hear and
golden-yellow breast milk born with vital respond to noises and are born
called colostrum. It's packed
with energy but is lower in re /exes built in " with the beginnings of
communication. They will turn
fat than normal breast milk, which newborns their head towards light and sound, make out
can find hard to digest. Instead, it's full of protein the face of the person holding them and cry
- perfect for a growing baby. when they are in need. It only takes a few weeks
Colostrum has a mild laxative effect, which for these skills to start to improve. They rapidly
helps to get the baby's gut moving, and it comes start to recognise the voice of their mother, and
with a secret weapon: antibodies. These soon they begin to make different noises, cooing
neutralise bacteria and viruses, sticking them and gurgling as well as crying.
together and triggering their destruction. For the first few weeks babies can only focus
Throughout pregnancy they cross from mother on objects right in front of their faces, and their
to baby via the placenta, but this type of eyes frequently cross. At this stage their
immunity is only temporary. The baby will be hand-eye coordination is poor. Very young
able to make its own, but this takes a few babies will investigate their own hands and
months. In the meantime, colostrum provides a fingers, but they can't yet use them properly, and
boost, helping to stave off infection. they often keep their hands in fists.
The newborn has some tricks of its own to help Inside, their bodies are undergoing rapid
it survive this vulnerable time. Though they change fuelled by milk. If the baby is being
have a lot to learn, babies are born with some breastfed, normal breast milk has now replaced
vital reflexes built in. These include simple colostrum. It's higher in fat and contains
things like blinking, swallowing and yawning, enzymes that help the digestive system to access
along with more complicated responses. the nutrients. It's also packed with sugars. Not TWO MONTHS OLD
The rooting reflex makes the baby turn their only do these provide energy, they also help Babies spend much of their time eating and
head or open their mouth when something friendly bacteria to colonise the large intestine. sleeping, and their bodies start to grow rapidly.
In the womb, cells divide constantly to form
Babies are ready to try their first tissues and organs, but after birth growth shifts.
meal at around six months old Rather than making new cells, babies increase
the size of the cells they already have.
The tissues of newborn babies are very
different to those of children and adults. There is
more fluid around their muscle and nerve cells,
and they have less cytoplasm inside. As the baby
develops this balance shifts. Muscle cells
expand, filling with cytoplasm and molecules
involved in contraction. Nerve cells extend,
strengthening connections and making new
ones, and the amount of fluid outside these cells
starts to fall. With newfound strength, babies
learn to push up with their hands when placed
on their tummies and start to hold their head a
little steadier, their movements becoming less
jerky and more coordinated.
Fat continues to quickly build up under the
skin, helping to keep the infant warm. By the

028
DID YDU KNOW? The overage length of o full-term newborn is 50-51cm. By their first birthday, they've grown by 25cm

Anterior fontanelle
Babies are born with a soft Skin
spot between the bones of Newborn skin may be
the skull. It closes after covered in a waxy
around 18 months. substance called vernix
and soft, fine hair called
lanugo (more common in
premature babies).

Brown fat

01
A special type of fat
around the neck, upper
chest and kidneys
generates heat, keeping
the baby warm.

::I
C:

"ai
....
.r:.

.r:.

....
.r:.

.-�
....
Ill

:i

...... 1
"C
111

Lungs
The lungs of a newborn
are full of fluid until it
takes its first breath.

Digestive system
C:
111

Newborns struggle to break

down fat and complex
carbohydrates. The first
breast milk is rich in

Liver
easy-to-digest proteins.

The liver can't always

keep up with the
breakdown of old red

Bladder
blood cells and
newborns can often
become jaundiced.
The kidneys start
working while the baby is
still in the womb and are
ready to go from birth.

Immune cells
The baby's immune system
needs a bit of help at first.
Breast milk contains antibodies,
providing extra protection.

029
two month mark babies are already starting to It has provided energy and contributed to a and forefinger and they will test new objects by
develop social skills. They begin to follow things growing store of fat under the skin. But now the shaking and banging. They will begin cruising,
with their eyes and recognise people at a digestive system is ready for more. holding on to objects and moving around on two
distance, and they begin to smile and laugh. A newborn's digestive organs are not only legs. Some may even take their first steps.
smaller than an adult's, but they also work The hole that shunted blood through the heart
HALFWAY THROUGH differently. They make different quantities of when they were born is now fully healed over.
Babies can finally hold their heads steady at enzymes and bile and they operate at a different Back teeth are starting to come through and the
around 16 weeks of age. They will also start to pH. But at six months old things are starting to digestive system is processing full meals. The
push down with their legs if they're held above change. The first teeth come through, starting lungs have more air sacs, increasing surface area
a hard surface, and by six months they can roll with the bottom front teeth then the top. for gas exchange, and the brain has developed
over, push up to a crawling position and even Swallowing improves and the digestive system billions upon billions of new connections.
stand with support. will start to produce enzymes to break down Over the coming months, babies transform
At around this time babies also begin to use complicated meals. into toddlers. As they begin to develop their
their hands and eyes together. They reach for understanding of the world, they start wanting
objects and rake with their fingers to grab them, FIRST BIRTHDAY to be more independent. They learn to walk,
and they start to use their mouths to explore By their first birthday, babies are starting to they start to talk and they even play games.
objects further. With all this extra strength and develop complex behaviours. They have Human babies are born tiny and vulnerable, but
coordination, the grasp and Moro reflexes are no favourite things and favourite people. They start in a few short months they are already well on
longer needed. These early fail-safes fade away. to understand 'object permanence' - the idea the way to growing up.
Babies start to learn to pass toys from one hand that objects and people exist even though you
to the other. can't always see them. They look for hidden
Their eyesight improves too. By this stage they objects and they begin to grasp the effects of
are becoming more perceptive to the subtleties gravity by learning to drop things and watching
of different colours, and they start to copy facial how they fall to the ground.
movements. They recognise and express They also begin to respond to requests and
emotion and begin to make demands of their
find their voice. They own. They will copy
blow raspberries and and use gestures like
start to make consonant waving, pointing and
sounds like 'ba', 'da' and head shaking. By now
'ga', using noise to get they will also
attention and to express understand familiar
themselves. They will words and follow
also start to recognise words, especially their simple directions, as well as being able to help
own name. with tasks like dressing. Most importantly of all,
To fuel all this progress, six-month-old infants they will start to communicate using 'babble'.
often switch to solid food. As the baby grows, the Their coordination has by now improved too.
fat content of breast milk has been increasing The grasp reflex is long gone, and they can move
from about 2g/dL of colostrum !grams per objects easily from one hand to the other. They
decilitre, equivalent to 100 millilitres) to 4.9g/dL. can pick up small things between their thumb

Babies start crawling

between six and ten
months. Some skip
this step and move
to walking

030
DID YDU KNOW? Baby boys gain around 6kg in weight in their first year. Girls, on the other hand, gain around 5.5kg in weight

Before the baby is born,

most of the cartilage has
been replaced by bone,
starting from the centre.
DID YDU KNOW? When Albert Einstein died in 1955, pathologist Thomas Harvey stole his brain, cut it up ond preserved it in ;ors

Brain map Information transfer

CORPUS CALLOSUM
The brain can be divided into Latin for 'tough body', this wide sheet of
distinct structures, each with nerves connects the left and right sides
a specialist set of functions of the brain, transferring information
from one to the other.
Memory Visual and
CEREBRUM auditory
The cerebral cortex
systems
makes up the majority
MIDBRAIN
of the human brain. It
The midbrain
is divided into four
is buried near
lobes, which handle the
the centre of
most complex of tasks,
the brain and is
including planning,
home to part of the reward
memory and vision.
pathway, responsible for

Temperature
reinforcing positive

and hydration
behaviours and addiction.

HYPOTHALAMUS
The hypothalamus is
responsible for
maintaining
equilibrium within the Cerebellum means
body. It monitors and 'little brain.' It is the
adjusts a variety of control centre for
vital parameters, like
Perception
coordinated
the body's temperature
THALAMUS
movement, making
and hydration. fine adjustments
The thalamus is a
Hormones Breathing
before the signals are
switchboard for The pons is another relay
PITUITARY GLAND MEDULLA
sent to the body.
sensory information, station within the brain,
This pea-sized gland is connecting the parts allowing nerves in the The medulla is Connects nerves
connected to the of the brain and body cerebellum to contact responsible for the BRAIN STEM
hypothalamus and produces involved in perception involuntary functions The brain stem marks the end of the
hormones, passing on and movement. It pons also plays an that keep us all alive, like brain and connects the nerves to the
chemical messages instead also controls the important role in the sleep breathing, swallowing spinal cord. It contains two distinct
of electrical impulses. sleep/wake cycle. cycle and dreaming. and heartbeat. structures, the pons and the medulla.

T
he human brain is the most complicated The neurones that make up the brain crisscross
structure in the known universe. It has over one another in a vast network and each Finding peace
taken hundreds of millions ofyears of individual cell makes up to 10,000 connections, Meditation has been practised for thousands of
evolution to construct, and over the last seven building the most complex circuit in history. years as a means to relax, think, or to find
enlightenment. In 2014, an international team of
researchers, based in Norway and Australia,
million years, it has tripled in size. It weighs In 2013, a team at the Centre for Regenerative
little more than a bag of sugar, but packed Therapies in Dresden, Germany, examined collaborated to u nderstand why it is such a
inside it are 86 billion neurones, linked the formation of neurone connections in powerful tool.
There are two types of meditation;
concentrative, where a person focuses on specific
together by over 100 trillion connections in a cloned mice. They wanted to learn how much
network more powerful than even the most the structure of the brain is influenced by life thoughts; and nondirective, where they let their
advanced supercomputers ever built. experience. Because the mice were clones, each mind wander. By studying fMRI scans of
experienced meditation practitioners, the team
discovered that when you let your mind wander in
By far the largest part of the human brain is the was genetically identical, meaning that any
forebrain, and like the brains of other mammals, differences in their brains would be purely down nondirective meditation,
it is covered in a thick layer of neurones known as to their environment. brain activity
increases,
particularly in the
the cerebral cortex. But in humans, this layer has The mice lived in large cages, with lots of toys
been massively expanded. The human cerebral and places to explore, and after just a few months, parts of the brain
cortex has 1,000 times as many neurones as the differences became apparent in their brains. The involved in
emotional
processing.
same structure in a mouse, and it has not yet most excitable, outgoing, curious mice had many
stopped evolving. more new nerves and new connections than their
The smallest processing units in the cortex lazier counterparts; their brains had adapted as
are !mown as neocortical columns, where each they learnt.
contains thousands of different connections. Over While the underlying fabric of the brain is the
the course of evolution, these neocortical columns same, every neurone in every brain is different,
have been duplicated over and over again, until and each makes its own unique path. Every
space in the skull started to run out. The cortex brain is wired differently, and the unique set of
developed deep ridges and folds to fit more and connections is based on experiences.
more processing power into the same tiny space, Mapping the connections in the human brain
and if unfolded, would cover an area measuring is an enormous task and work is ongoing. The
two square metres (21.5 square feet). Human Connectome Project, launched in 2009,

033
is designed to map the intricate connections
between all of the neurones in the human brain,
in an effort analogous to the Human Genome
Project. Computers can be programmed to
trace the paths of neurones through brain-scan
images, but even the most advanced machines
make mistakes, and eveiything has to be double­
checked by a human.
As an alternative, some research teams are
trying a new approach, where instead of using
computers to analyse the data they are using
volunteers. In 2011, the online game Folclitmade
the headlines when players managed to solve a
decade-old biological question. By tapping into
the spatial skills ofvideogamers, researchers
used volunteers to solve three-dimensional
protein puzzles that a computer would struggle to
complete. By simply playing the game, hundreds
of people worked together to help solve the
structure of a protein made by a simian retrovirus
that causes AJDS-like symptoms in monkeys.
This approach is now being extended to the
field of neuroscience and crowd-sourcing is being
used to map the connections between neurones
in the back of the eye. Tracking the intricate
pathways of neurones in the brain is a difficult
task for computers, but people are much better at
spotting patterns.
EyeWire is a project designed to map the
nerve connections in the human retina. Players
are given a half-finished neurone and asked to
work through slices of the brain, colouring in
the connections. Each cube section is manually
checked multiple times by different people, so
if someone makes a mistake it is averaged out
by the community. More experienced players
oversee the work and can make changes if they
feel they are needed. This approach speeds up
the process by thousands of times.

The developing brain

Baby Infant Child

In order to fit through the birth canal, human babies must Support cells, known as glia, provide protection, By the age of ten or 11, the rapid development of new
be born well before their brains have finished developing, insulation and nutrition for the brain's nerve cells. connections in the brain has ended and a period of
so their brains grow rapidly in their first years. Throughout childhood, they continue to migrate and trimming and pruning begins. Instead of creating extra
Experiences prompt the development of new connections grow. During the first two to three years of a child's life, pathways, the brain focuses in on the most important,
between nerves, and by the time a baby is two years old, the insulating white matter of the still-developing brain strengthening and insulating those that are used more
it has 1.5 times as many synapses as an adult. begins to form. often and losing ones that are no longer valuable.

034
DID YDU KNOW? You sleep for □round o third of your life ond hove □round five dreams every night

Making memories
The human brain has an amazing capacity for retaining information

RECALL
Human
memory is
associative; it
works by
linking pieces
of information
together.
Memories are
NEURONE
CHANGES
not stored as
individual If a synapse is
entities, but used repeatedly,
reconstructed it becomes
using several increasingly
EXPLICIT MEMORY different parts sensitive to
These types of memories do not require Explicit memories are accessed consciously. of the brain. stimulation,
conscious recall and are often based on motor They can be stored as episodes, linked to a producing more
skills. By repeating tasks, like riding a bike or specific event or place, or stored by category as receptors and
playing the piano, pathways become automatic. more abstract knowledge. strengthening
the connection.

CONSOLIDATION
Once the trace of a
memory is formed,
the pathway can be
consolidated with use.
The more often a
synapse is used, the
stronger it becomes.

RECOGNITION ASSOCIATION
The brain is very good at making associations, Memories are rarely stored in isolation
and incoming information is compared to and one pathway is linked to others.
stored data, allowing us to quickly recall things Recognition and recall can both trigger
we already know or have experienced before. other related memories.

Teenager Adult Old age

Trimming and adjusting the brain starts at the back and Most growth and remodelling is complete by our Damage to the brain cannot easily be repaired, so as it
works forward, continuing into the teenage years. The early-20s, but new connections continue to form in the ages, signs of wear start to appear. Connections are lost
prefrontal cortex, involved in planning, judgement and adult brain, albeit at a much slower rate than in children. as nerve cells wither, or as debris builds up between
emotional control, is the last to be finished. Research also Staying active and providing the brain with engagement synapses, and gradually mental function can decline,
suggests that adolescents' body clocks are wired and stimulation strengthens existing connections, and leading to age-related illnesses like Alzheimer's disease
differently, so they naturally go to bed and wake up later. new pathways continue to form as we learn. and Parkinson's.

035
 Although projects like EyeWire provide a
detailed and biologically accurate picture of what
is going on inside the human brain, rebuilding the
Imaging the brain
entire structure using this method will still take Take a look at the most common techniques used to study the living brain
decades. The alternative is to simulate the brain,
taking what we already know and using it as a
scaffold to build the parts we have yet to study. By
going back and testing the model brain against
the real data, scientists can check that their
simulation is working as it should.
Japan's K Computer is one of the fastest and
most powerful in the world, and in 2014, 83,000 of
its processors were combined in order to simulate
one per cent of one second of human brain
activity. This was a huge achievement, but it took
the machine 40 minutes and barely represented a
fraction of the power of the human brain.
The problem is that most modem computers CT fMRI
Computed tomography (CT) scans use X-rays to build a Functional Magnetic Resonance Imaging detects the
are built on architecture completely different three-dimensional image of the brain. The radiation amount of oxygen present in the blood, allowing brain
to the human brain. The brain is made up of travels at different speeds through different tissues, activity to be mapped. When regions of the brain
processing cores, capable of specialising to allowing a density map to be produced. It provides become more active, their demand for blood rises and
purely structural information and is useful for they light up on the image. It captures a picture of the
perform highly specific tasks. They are less identifying tumours. activity of the entire brain every two seconds.
precise, but have much more flexibility, and most
importantly, the capacity to learn. Memories are
not stored in one particular place, and are instead
distributed across the network. In contrast,
modem computers use programs in order to
decide what to do, and they store elements in a
hierarchical memory.
In 2013, the European Commission funded the
Human Brain Project with a grant of €1 billion
(£800 million/$1.3 billion) in order to accomplish
just that. This ambitious, ten-year endeavour
aims to develop cutting-edge computational tools
to assist in the understanding of brain function,
bringing together the fragments from different PET EEG
Positron Emission Tomography uses safe radioactive Electroencephalograms take advantage of the
disciplines and providing an unprecedented isotopes to measure brain activity. By labelling oxygen electrical signals produced by nerves to produce a
map of human brain activity. The Human or sugar with radioactive tags, blood flow in the brain map of brain function. Electrodes placed on the scalp
Brain Project hopes to use this information to can be monitored. The tags emit low-energy radiation are able to detect the patterns of nerve activity
and as blood is diverted to active regions of the brain, beneath the surface. This technique is particularly
build a supercomputer capable of simulating the emissions pinpoint the locations. useful for sleep studies.
the network that makes up the human brain.
They estimate that it would take one laptop to

036
DID YDU KNOW? A human brain weighs around four times as much as a chimpanzee's brain

simulate the activity of one neurone and are examine the electrical activity and can see where project combined silicon-based techniques and
working closely with IBM to develop powerful information is being processed and stored. advancements in stem-cell biology, brain imaging
neuromorphic supercomputers. The project is a collaboration between over 100 and medical drug development.
Neuromorphic chips are computer chips institutions in 24 countries. The practical applications of this future
modelled on the architecture of the human brain. New technology is the key to modelling a technology are incredible, but we are already
IBM released a chip modelled on the human structure as complex as the human brain, and able to interface with the brain in more ways than
brain in 2014. Known as the SyNAPSE chip, it other international efforts are also in place to ever before. Light-sensitive retinal implants can
has one million 'neurones' connected by 256 provide new technology. In 2013, US President restore sight to the blind by sending electrical
million 'synapses.' They are arranged into 4,096 Barack Obama announced the Brain Research signals to the optic nerve, while auditory
'synaptic cores', which function in parallel with through Advancing Innovative Neurotechnologies brainstem implants communicate sound
one another, just like the processing cores in the (BRAIN) initiative. The NIH (National Institutes signals directly to the brain in patients who are
brain. Just like the brain, they operate on demand ofHealthl allocated £24 million ($40 million) in profoundly deaf.
and can compensate if one core happens to fail. 2014 to develop new technologies to find the best However, one of the most incredible
By feeding these computers with inputs that way to understand the brain. In order to break technological developments of all is the BrainGate
mimic biological signals, scientists can then the brain down and rebuild it accurately, the system, first revealed in 2006. The technology

037
Cutting-edge neuroscience
The human brain is one of the most complex structures in the known universe and understanding how it works is
an enormous scientific undertaking. Modern neuroscience brings together experts from a huge array of fields and by
using a combination of the most advanced technologies, medical techniques, biological research and computational
modelling, scientists are finally beginning to untangle the many profound mysteries of the human brain.

Building How mind control works

a brain Simple equipment and complex computer programming allow
our thoughts to be transmitted over the internet

EEG recording ======;;1, Signal analysis ==== :::

Large-scale
projects aim to
simulate the human
brain at every level

DNA and
neurotransmitters
At the molecular level,
scientists are able to
manipulate the 3D structures
of proteins using computer
programmes, and to model the
effects that changes might
have. Such techniques are
hugely useful in drug design.

Nerves and
support cells
In order to gain a proper
understanding of how the brain
functions, many scientists
advocate a bottom-up
approach. By creating digital
neurones based on the
underlying rules and principles
of biology, it is hoped that the
complex network of the brain
can be simulated.

Neural pathways
Some projects aim to map all
of the connections in the
human brain, generating a 3D
representation of the intricate
wiring. Others aim to simulate
the process, allowing the
computer to make its own
connections based on
biological rules.

Lobes and structures

Simulations will allow
information about different
structures in the brain to be
integrated, enabling scientists Mind control
to more closely examine the In a groundbreaking experiment in 2013, researchers at the University of
interactions between different Washington successfully linked two human brains together and proved their
areas, or even to remove one principle with a video game.
region and study it in isolation. The city is under attack by pirates, where player one, the sender, must
intercept their rockets. They can see the screen and are armed with a cannon,
Whole brain but they do not have a keyboard and cannot press 'fire'. Player two, the receiver,
In 2013, the K Computer in is sitting in another room; he cannot see the game, but he does have a keyboard.
Japan carried out one second Player one thinks about firing the cannon, and fractions of a second later, player
of simulated human brain two pushes the button, saving the city and winning the game.
activity. With 705,024 Player one was wired up to an electroencephalogram (EEG) and his brain
processor cores, it took the activity was being monitored. When he was thinking about pressing the button,
machine 40 minutes to there was a characteristic signal in the 'mu band' of the EEG, triggering the
simulate a network just one per program to send a wireless signal to player two.
cent of the size of the human Player two was wearing a specially designed coil on his scalp that generated a
brain. Advanced processors magnetic field, positioned over the part of the brain that controls contraction in
due in the next ten years or so the right hand. The signal from player one was converted into magnetic
will increase this capability stimulation, which in turn triggered electrical activity in the brain, causing player
significantly. two to involuntarily fire the cannon.

038
DID YDU KNOW? Your brain produces enough electricity to power o light bulb ond consumes 20% of the oxygen you toke in

Decoding the brain Get involved �

Computer programs can learn to decode brain-scan data
and essentially read our thoughts with EyeWire �
Training images fMRI scan Voxel pattern Citizen scientists are needed to
The program is trained using a series Functional magnetic resonance imaging The fMRI data is stored as voxel
help untangle the neurones of
of images, alongside their is used to identify the parts of the brain patterns, three-dimensional
the human retina
corresponding fMRI patterns. activated by different visual stimulation. grids of information. Developed by the Seung Lab at M IT, this
browser-based game, known as EyeWire, is a
project designed to map the neurones of the
retina. Anyone can play; all you need is a

-
c.,
z
z
=SHOE computer and an internet connection.
EyeWire is a 3D puzzle game based inside a
cube. The cube is divided into slices and hidden
within them is the path of a neurone. All you

...
01:::
=CAT
have to do is scroll through and connect the
slices together, tracing the path of the nerve cell
through the cube.
As you work, a 3D model of your progress
appears to the side of the screen and you can
earn points based on how closely your model
matches the models made by other players. You
can earn points, level up and even participate in
weekly competitions.
=SHOE Every time you play, you are mapping actual
neurones from the human retina, making a real
contribution to scientific research.
To experience EyeWire yourself and to be a
Test image Identification part of the research, simply click on the
When the subject is shown a new image, the program searches If the program cannot find an exact match, it following URL: https://eyewire.org/explore
through its training database to find the nearest match. will use its training data to find a best estimate.

uses a sensor implanted on the motor cortex of

A machine that can read your mind the brain to pick up electrical signals generated
Have you ever wished someone else could see program was then trained to associate patterns of when the patient thinks about moving. These
what you can see? In 2011, a team at the brain activity with their corresponding images.
University of California, Berkley, developed a Using this data set as a reference, the program signals are then decoded by a computer program
program that could tell what film you were was then shown new fMRI data recorded as and sent to a prosthetic limb. By carefully training
watching just by reading your brain activity. The people as they watched unknown clips. The the program to recognise specific signals, patients
program could even read the images you were program was able to compare the new data
watching and display them on screen. against its training data and guess what the test are able to move their bionic hands using just the
Volunteers were shown hours of video clips and subject was watching by compiling and averaging power of their brains.
for each one, their brain activity was mapped using the closest matches in to moving collages. The Taking electrical brain interfaces one step
functional magnetic resonance imaging (fMRI). The resulting images were eerily close to the originals.
further, at the University of California, San Diego,
researchers are using electricity to selectively
erase memories. They have shown that by using
particular frequencies of electrical pulses they
can produce changes in the nerve cells in the
brains of rats, making them forget traumatising
experiences in their past.
As we continue to learn more about the
connections in the brain, the possibilities for
interacting with it will only continue to increase.
The field of neuroscience is advancing faster
than ever before, and huge international
c·
collaborations, like the Human Brain Project and �
the BRAIN initiative, are bringing mountains of
research data together, creating resources that
will revolutionise the field of neuroscience. �
:\1
The puzzle of the human brain has been b
vexing scientists, doctors, and philosophers .1l
for thousands ofyears and understanding j
how it works is perhaps the most challenging
problem in the history of science. However, with
a combination of powerful new technology and .ii1
international collaboration, the complexity of this l
mass of neurones is starting to unravel. Very soon, i
we might even be able to rebuild a functioning �
digital brain from the bottom up. �

039
YOUR SKELETON
This incredible living framework provides
more than just structural support
T
he 206 bones of the adult human
skeleton make up a strong, flexible
framework that protects our vital
organs and allows our bodies to move, as
well as being a mineral store and stem­
cell reserve.
Bone is a composite material,
constructed from three basic ingredients:
collagen strands, a sugary protein glue and
inorganic calcium salts. The collagen fibres
are arranged in alternating layers,
crossing over one another, providing a
flexible scaffold, and calcium salts are
glued in between for strength and rigidity.
The outside of each bone is composed of
plates, or hollow tubes, of dense cortical
bone, supported on the inside by a
honeycomb network of spongy trabecular
bone. This network is slightly flexible and
helps to distribute the load, curving the
tensile and compressive forces across the
ends of the bone, while providing
maximum strength.
Spongy bone is also home to the bone
marrow, which houses stem cells capable
of producing most of the cells of the blood The major function of
and immune system. They are constantly the skeleton is to provide
active, and millions upon millions of new a structural framework
for the muscles that
red and white blood cells are produced move our bodies
every minute.
Embedded within the bone matrix are
cells known as osteocytes. They do not
move, but are capable of detecting stresses
inside the bone itself, and can trigger the
formation of new bone in a process known
as remodelling. The old bone is broken
down by large cells known as osteoclasts,
and new collagen and minerals are
deposited by smaller osteoblasts.
Together, the two cell types are able to
release and store calcium and
phosphorous in the skeleton for use
elsewhere in the body. They are under the
influence of hormones released by glands
in the brain, and when levels of minerals
run low in the body, the signals encourage
the osteoclasts to begin wearing away at
the surface of the bone, releasing minerals
into the bloodstream. When mineral levels
are high, osteoblasts lay down new bone,
replenishing the store.

040
 DID YDU KNOW? The hands ond feet contain over holf of the bones in the body, with o tot□/ of 106 between them

Epiphysis

Bone structure
The long bones are formed into tubes, closed
The ends of the long bones
act as shock absorbers,
with a casing of tough
compact bone supported
by a spongy core.

Articular cartilage
at both ends and capped with cartilage BELOW Cells
known as
Red bone marrow
The end surfaces of the
osteoclasts
bones are covered in thick,
Blood cells are produced in slippery cartilage, preventing constantly
red bone marrow, found wear at the joints. remodel the
between the gaps in the
honeycomb structure of the
spongy bone at either end.
Compact bone
Blood vessels -----� The outside of the
Blood vessels travel into bone is arranged in
and out of the bone an orderly, layered
through canals in the structure, providing
compact surface. strength and rigidity.

Spongy bone
This disorganised honeycomb
structure is more flexible than
The outside of the bone
compact bone, and its large
is covered in a layer of
surface area supports
connective tissue,
Diaphysis
blood-cell production and
""--- containing cells involved
calcium exchange.
The shafts of the long in growth and repair.
bones are constructed
from densely packed
Adult
compact bone.
The growth plate itself is
Child
Medullary cavity
turned to bone, and stops
Cartilage continues to producing cartilage,
The centre of the long form at the growth preventing the bones from
bones is filled with yellow plates, and calcium lengthening any further.
bone marrow, containing salts are added at the
mainly fat cells. secondary ossification
centre, lengthening the
bone at both ends.

How bones
grow
Growth
•: I • •::;,
. ,.
plate Ossified
. . . growth
plate
Secondary
!. �� i� ,·
ossification
: ,• ::·�:-
: :'
centre

_,ojlillof--- Blood
supply

Newborn Bone marrow cells

In the womb, most of the There are two types of bone
skeleton is made of marrow in the human body;
cartilage, but gradually yellow marrow is found in the
minerals are laid down and shafts of the long bones, like the
it is converted to bone in a femur, and red marrow is mainly
process known as found in the flat bones, like the
ossification. ribs. Yellow marrow is mostly
made up of large fat cells, whilst
red marrow contains stem cells.
These are capable of producing
most of the cells of the blood
and immune system, and
concealed within the bones are
many immature cells in the
process of development.

041
�
Skeletal system Auditory ossicles
The three smallest bones
Get to know the bones in your body with in the body can be found in
the ear, where they help to
our guide to the human skeleton transmit vibrations.

There are two major parts to the human skeleton: the axial bones and the
appendicular bones. The axial bones form the central core of the skeletal system,
including the skull, spine, rib cage and pelvis. These bones have a protective role,
supporting the central nervous system and protecting the vital organs from

Pectoral girdle
damage. The appendicular bones are attached to this central support, and include
the bones of the arms and legs. Their major function is movement, providing rigid
jointed structures onto which the muscles are attached. and collar bones work

Hyoid ----------------.....
together to anchor
the arms to the torso.
The skull
This horseshoe-shaped The skull i s constructed out of 2 2 plates of flat
bone is not attached to the bone, 21 of which are permanently fused
rest of the skeleton, but it together. The other is the mandible, or
helps to provide an anchor jawbone. They are made from a thick layer of
point for the tongue, organised cortical bone, sandwiched around a
enabling us to speak. centre of spongy bone.

Arm
The humerus makes
a ball-and-socket
joint at the shoulder,
10
years to
and a hinge joint at replace your
Sternum
the elbow.
I I ,k ::lr.: � =S•. 1
entire
The ribs are skeleton
anchored to the
sternum by

Ribs
cartilage, providing
ABOVE Females have a larger
a flexible linkage
opening inside the pelvis, Most people have 12 pairs of
and allowing the rib
aiding childbirth ribs that, together with the
cage to contract
and expand, spinal column and sternum,
form a protective cage
around the heart and lungs.

Forearm
The two bones of the
forearm split the load;
the ulna bears weight
near the elbow, and the
radius bears weight near
ABOVE The male pelvis is
the wrist.
relatively narrow and the
opening is heart-shaped
 Wrist, hand
The spine and fingers �
There are 27 bones Get your own giant
There are 33 vertebrae in the spinal
in each hand, eight 1.3m high poster to
column, divided into categories
of which make up
�
according to their shape and location. help explore every
the wrist. bone in the human
There are seven cervical in the neck,
12 thoracic vertebrae in the chest, skeleton - great for �
each of which attaches to a pair of home and schools.
ribs, and five load-bearing lumbar Drawn to scale and �
vertebrae in the lower back. The anatomically detailed
remainder of the vertebrae are fused by leading medical &
to form the sacrum and coccyx. Lower limb artist, Joanna Culley. 8-:::i
The weight of the body is A matching muscle
Ill
supported by the femur (thigh poster is also
CJ
available, all from
bone) and the tibia (shin bone),
www.uAnatomy.com. 8
while the fibula is involved in
anchoring the muscles of the foot. 9-
3C
Ill
Q
Shock absorbers rn
Between the vertebrae of the spine are disks of a springy 8
tissue known as fibrocartilage, made up of long chains of 0-
CJ
collagen and bound together by a gel of sugary proteins, ::i
known as glycoproteins. These have a strong affinity for .rn
water, so as a result, the entire tissue is filled with fluid. It
acts like suspension, compressing and deforming under
load and protecting the bones from the stress of
day-to-day impact. �
LCi'
CJ

Vertebral body
3
gJ
Each vertebra
contains a core of CJ
spongy bone and red ,-,.
bone marrow. 8
n
0-
::i-

CJ
r=--- Spinous process
::i

Muscles attach to
rn
,-,.
protruding bone at the CJ
back of each vertebra. 0-
CJ
::i
rn
CJ
::i
, _-c......L lntervertebral
Foot
a.
disk
CJ
A disk of cartilage There are 26 bones
between each vertebra in each foot, held S'
provides cushioning together by a series CJ
0::::

and protection. of ligaments.

5·
Ill
8
Articular process g
Each vertebra has four t·
articular processes,
connected to the adjacent '
vertebrae by ligaments.
'__,,' ��--­
(�·'"''"'
' WHAT ARE WE MADE OF?

Joints 15%
For individual bones to body weight
contributed by
Bone Ball-and­
function together, they
must be linked by joints the skeleton joints socket joint
The long bones of the legs
and arms both end in ball-like
Some bones, like those in the skull, do not protuberances, which fit

Pivot joint
need to move, and are permanently fused inside sockets in the hip and
shoulder, giving a wide
together with mineral sutures. These are To turn the head from left to range of motion.
known as fixed joints and provide right, the ring-shaped first
maximum stability. vertebra (known as the atlas)
rotates around a tiny spoke on
However, most bones need flexible the second vertebra (known as
linkages. In some parts of the skeleton, the axis), forming a pivot joint.
partial flexibility is sufficient, so all that the
bones require is a little cushioning to
prevent rubbing. The bones are joined by a
rigid gel-like tissue known as cartilage,
which allows for a small range of
compression and stretching. These types of
joints are used where the ribs meet the
sternum, to provide flexibility when
breathing, and between the stacked
Movements
vertebrae of the spinal column, allowing
it to bend and flex without crushing the The bones are joined
spinal cord. together with ligaments,
Most joints require a larger range of and muscles are
attached by tendons,
movement. Covering the ends of the bones allowing different joints
in cartilage provides shock absorption, but to be moved in a variety
for them to move freely in a socket, the of ways.

cartilage must be lubricated to make it

Basal joint Ellipsoid joint

slippery and wear-proof. At synovial joints,
the ends of the two bones are encased in a
The thumb is joined The bumps at the
capsule, covered on the inside by a synovial to the rest of the base of the skull fit
membrane, which fills the joint with hand by a bone called inside the ring of the
synovial fluid, allowing the bones to slide the trapezium. It is first vertebra,
shaped like a saddle allowing the head to
smoothly past one another. and allows the thumb tip up, down and
There are different types of synovial joint, to bend and pivot. from side to side.

Hinge joint
each with a different range of motion.
Ball-and-socket joints are used at the
At joints like the knee and
shoulder and hip, and provide a wide range elbow, one bone is grooved, �
{\
----+__,
of motion, allowing the curved surface at the while the other is rounded,
top end of each limb to slide inside a allowing the two to slot
together and move like a hinge.
cartilage covered cup. The knees and elbows
Gliding joint
have hinge joints, which interlock in one
plane, allowing the joint to open and close. The joints between the carpal
For areas that need to be flexible, but do not bones of the hands and the tarsa
need to move freely, such as the feet, gliding bones of the feet only allow
limited movement, enabling the
joints allow the bones to slide small bones to slide past each other.
distances without rubbing.

044
 l
DID YDU KNOW? The bone morrow produces between two ond three million new red blood cells every second

Why our joints

1
��:u�!iceps
muscle group runs
down the front of crack
the femur and The synovial fluid used to lubricate
finishes in a tendon the joints contains dissolved
attached to the gasses. The fluid is sealed within a
knee cap. capsule, so if the joint is stretched,
the capsule also stretches,
creating a vacuum as the pressure
changes, and pulling the gas out of
solution and into a bubble, which
Artery
The femoral <l[tery
supplies blood to the pops, producing a cracking sound.
lower leg, and i s
branches travel

Synovial membrane
The membrane surrounding
the interior of the joint
produces a lubricant called
synovial fluid.

Knee cap
The patella prevents the
tendons at the front of the
leg from wearing away at
the joint.

External ---­
ligaments
300+
bones in a
The joint is held
together by four
newborn baby
ligaments that
connect the
femur to the
bones of the
lower leg.
Patellar ligament
The patellar ligament
connects the kneecap to
both the quadriceps in the
thigh and the tibia in the
lower leg.

Meniscus
Each of the bones is
Synovial fluid
Cartilage
capped with a
protective layer of
cartilage, preventing
fri ion and wear.

Capsule

Inside a joint
Tibia Synovial joints prevent mobile areas of the skeleton from grinding against
The rounded ends one another as they move. The two bones are loosely connected by strips
of the fibula fit in to of connective tissue called tendons, and the two ends are encased in a
two concave slots capsule, which is lined by a synovial membrane. The bones are covered in
at the top of the smooth cartilage to prevent abrasion and the membrane produces a
tibia (shin bone). nourishing lubricant to ensure the joint moves smoothly.

045
Animal cells
A typical, non-specialised animal cell .------- Ribosomes How cells work
Nucleus
Ribosomes are spherical
bodies composed of RNA
and protein enzymes which The building blocks of life explained

C
The nucleus is often referred
to as the brain of the cell. are the site of protein
DNA is stored here and cell synthesis for the cell. ells are the building blocks of Multicellular organisms are
metabolism, all living organisms. primarily made up of eukaryotic
movement and Individual cells are classified cells which are more complex and
reproduction are
all controlled as living things, and there are can therefore specialise so the
from here. millions of organisms which are organism can become more
unicellular across the planet. complex. They do this by grouping
As they are living units, cells together to form tissues, which
consequently need energy, and then group to form organs within
therefore respire to survive. Parts of the organism.
the cell, called organelles, work like Cells reproduce to replace old,
organs of a body. Energy for the cell damaged cells in an organism, to
to process can be provided by the allow growth of a new individual. In
cell, such as through photosynthesis unicellular organisms, cell
in plants, or absorbed into the cell reproduction is obviously the only
through cell membranes and then way a population will grow.
processed within it by the Prokaryotes favour binary fission,
The cytoplasm is
mitochondrion. Single cells operate where all genetic information is
a thick, almost like this, and there are billions of doubled and then the cell divides

Mitochondria
jelly-like material unicellular organisms that survive into two new, identical cells.
which supports and
protects organelles of the cell.
independently or within Eukaryote cells use either mitosis,
Mitochondria are small,
multicellular organisms. These which results in two identical
Cell membrane
bean-shaped organelles
------� which release chemical single cell organisms are generally organisms or cells, or meiosis, which
Present in animal and plant cells, energy for the cell by prokaryotic cells, which are much results in each new cell having half
this acts as a boundary layer to processing glucose that is
protect the cell from unwanted provided for, or produced smaller and have fewer organelles, the number of chromosomes of the
chemicals. by, the cell. most importantly lacking a nucleus. original cell.

046
DID YDU KNOW? The heart pumps □bout 1 million barrels of blood during the overage lifetime

Superior and
inferior vena cava
These large veins carry

The heart ­
a vital organ
blood back to the heart
from organs above and
below the heart,
respectively. This blood has
already been stripped of its
oxygen supply, and thus is a
dark red or bluish colour.

Your heart is a turbocharged double­

pumping muscle that beats more than 40
million times everyyear

N
Pulmonary veins ot only doesyour heartdo
After the blood collects amazing things, it does so
oxygen from the lungs, it
returns to the heart via
tirelessly, from the moment
the pulmonary veins. you're born !actually, even a bit before
thenl to the instant thatyou die. It
weighs somewhere between eight and
12 ounces - slightly more if you're male,
less if you're female. Its sole purpose is to
push blood through your circulatory
Blood brimming with system, providing crucial oxygen and
oxygen and other
other nutrients to all your organs.
nutrients collects here.
The heart is considered a double
contracts, the blood pump because the right half sends 'used'
passes through the
blood to your lungs. There, the blood
mitral valve and enters
the left ventricle under drops off a load of carbon dioxide and
picks up some fresh oxygen, which you
have helpfully provided by breathing.
Then the oxygenated blood returns to
the left half of the heart. This 'heart-to­
The left ventricle must
send blood on a longer lungs-to-heart-again' trip is known as
journey than the right pulmonary circulation. The left side of
ventricle, so it has the heart then pumps this oxygenated
thicker walls and uses
about three times as blood to every organ in your body other
much energy. Luckily, than your lungs. Your brain, your skin,
the left atrium's the muscles in your thigh, your spleen
- they all get blood land therefore
oxygenl by virtue of your beating heart.
Even the heart itself gets blood, via a
special set ofveins and arteries known
as the coronary system. The myocardial
muscle within the wall of the heart
needs oxygen and other nutrients to
keep beating. Unfortunately, the
coronary arteries that do this job are
very narrow, between 1.7 and 2.2
millimetres in diameter. If they become
Tricuspid valve cloggedwith cholesterol or other fatty
When the right atrium contracts, it deposits, the heart stops working.
pushes blood through the tricuspid
valve, a one-way valve leading
down into the right ventricle. What's inside Of course, the relatively simple
concept of the double pump is fairly

your heart
complex in practice. A series of valves
control blood flow to the heart's four
Right ventricle
Blood enters the right ventricle under pressure from the atrium's
Find out how your
chambers, allow for the build-up of
contraction, giving it a boost much like the turbocharger in a high­ enough blood pressure to get the job
performance car. The ventricle contracts and pumps blood through the
pulmonary valve, into the pulmonary artery and toward the lungs.
heart pumps blood done, and directthe blood to the correct
around your body veins and arteries.

047
Inside the liver
and pancreas
How do these vital organs work together to digest food?
Lobes
The liver is split into four
lobes: right, left, caudate
and quadrate. The right
lobe is the largest.

W
eighing more than a bag of sugar, the (part of the small intestineI, the gallbladder is
liver is the largest of all the internal stimulated to secrete this bile, which travels
organs. It's located mostly in the through the bile duct and reaches the
right side of your abdominal cavity and is duodenum. Here it breaks down complex fat
capable of holding roughly ten per cent of your molecules into smaller, circular globules -a
body's total blood volume, with around a process called emulsification. These globules
quarter of your blood supply passing through it are smaller and have a larger total surface area,
every minute. making them easier to digest.
The liver has many roles in the body, one of The pancreas also plays a role in digestion, as
which is producing bile, the substance that it produces substances that help to break down
breaks up fat molecules to aid digestion. Up to food. When the stomach and duodenum are
one litre of this greenish-yellow liquid is stretched by the presence of a meal, the
produced and released every day, containing a pancreas is triggered to deliver an assortment
combination of salts, water, cholesterol and a of enzymes in a cocktail known as pancreatic
pigment called bilirubin. Bile travels from the juice. An enzyme called amylase breaks down
liver to the gallbladder, where it is stored. When starches, while trypsin digests proteins and
a fat-containing food reaches the duodenum lipase works on fatty acids.
Bile ducts Sinusoids ---------�
Once bile has been made in These small blood vessels provide
the liver's hepatocyte cells, the place for molecules to transfer
it's secreted into the bile between the blood and the
ducts and flows into the
gallbladder to be stored.

T�e portal
tnad -----1-,
Providing the
main entry and
exit routes for
the liver, the
portal venule,
bile duct and the
hepatic artery
are referred to as
the portal triad.

Portal venule
Liver This small vein carries nutrient-rich blood
Central
vein
from the intestines to the sinusoids,

lobules where hepatocyte cells generate energy.

Once the new
The lobules consist of rows of hepatocytes (liver cells), bile ducts and blood molecules have
vessels. Roughly 100,000 of these hexagonal-shaped structures sit within the passed into the
sinusoid
organ, each consisting of a central vein surrounded by six hepatic portal veins channels, the
and six hepatic arteries. These blood vessels are connected by sinusoids, which blood flows to
are small tubes joining the central vein to the surrounding veins and arteries. the heart via the
hepatic veins
The products from digestion are transported in the blood to the sinusoids, and the inferior
where they can be absorbed into the hepatocytes. vena cava.

048
DID YDU KNOW? The liver is able to regenerate itself - up to half of it con be removed ond will eventually grow bock

- Oesophagus
Liver metabolism
Roughly 25 centimetres long, this Metabolism is more than just the body's way of breaking down food into
muscular tube carries food, liquids and the energy we need to survive - it's the conversion of one chemical
saliva from the throat to the stomach.
compound into another. In the liver, cells called hepatocytes perform
many key metabolic tasks. These cells work to convert proteins, fats and
carbohydrates into molecules that the body can use or store. For
example, much of the glucose that passes through the liver is absorbed
by the hepatocytes, which stockpile it as a larger molecule, glycogen.
This is easier to store and can be quickly turned back into glucose when
it's required.
The liver is responsible for maintaining the
body's blood glucose levels. If there is no
glucose available, the liver breaks down the
stored glycogen instead. By absorbing and
releasing glucose, the hepatocytes help to
maintain a balance in the body, preventing

•
dangerous spikes or drops in your
blood sugar level.

__.....,...._ Pancreatic duct

Pancreatic juice is
secreted into this
duct before passing
into the common bile
duct, which leads to
the duodenum.

--- Pancreas
Sitting behind the
stomach, this triangular
gland produces enzymes
that help break down all
major food groups.

Duodenum
The shortest part of the small

Hepatic tissue Muscle fibres Adipose cells Cellular growth

intestine, this is where bile and

and repair
pancreatic juice perform their
digestive functions.
If there is excess Both the liver's These cells store
glucose in the body, muscle cells and excess fatty acids in A process called
the hormone insulin hepatic cells are able the form of anabolism builds
triggers the liver's to store glycogen long-chain fat amino acids into
hepatocyte cells to within them. molecules. proteins, which can
convert glucose then be used to
into glycogen. construct cells and
produce enzymes.

"Around o quarter of
your blood supply
posses through your
liver every minute"
049
 's inside
your head
A look at how our thinking
machines are put together

F
rom birth, the head of a baby will grow
very rapidly. By the age of two the bones
will have fused together, although growth
continues until the age of seven during which
the shape and size of the skull are altered. An
adult human head is made from 22 bones. Eight
are present in the cranium, and 14 form the face.
Together they make the skull, which provides a
framework for all the features of our head.
The primary purpose of the skull is to
prevent damage to the brain. Without it, even a
small force against the head could cause serious
brain damage. Before birth, the skull develops
holes in which are found the various features of
Parietal Occipital
the head. The bones Protects the top and sides Forms the lower back of the skull,
The skull has three main structural of the skull of the brain, and provides
a roof for the skull.
and enables movement of the head
by connecting to the spine.
features. Cavities known as orbits contain the The purpose of all the
eyes, providing protection but also allowing bones in our head
muscles, nerves, blood supply and tissue to
reach the eyes. Paranasal sinuses house the
nasal cavity and also contain air-filled spaces,
which are responsible for making people sound
different. Finally, the head is held together by
sutures, which are soft fibres at birth but later

Temporal
harden to give the appearance of stitches. They
become immovable joints which stop the head
falling apart. Houses the ears and
=��== Frontal
This bone is our forehead.
The muscles of the head are stretched over the cranium. c::== �
protects the sides of
Italsoformstheupper
part ofthe orbits, which
the bones in the cranium and face like sheets. store the eyes.
There are two main categories of muscles. The
muscles of facial expressions are responsible for
moving the mouth, altering the chin and Zygomatic lC;;;;;;;;;=====:::!I

----
Also known as the cheek
moving the cheeks to assist eating and bone, and forms part of ====== Sphenoid
breathing. Muscles of the eye sockets. Slots into the
surrounding bones, and
forms the base of the
cranium and the back of
opening and the eye sockets.
closing the jaw and

Vomer ======�
allow sideways
movements.
Separates the nasal
Smaller cavity into two halves
muscles control for the two nostrils.

Ethmoid i======== Mandible

other portions of
the face
including the The centre of the face behind the The largest and only movable
nose, the ethmoid supports the bone In the lace, and the bone to
inner ear and
nasal cavityand the eyes. which the teeth are attached.
the eye.

050
DID YDU KNOW? By measuring the skull, forensic anthropologists con determine the age, race and gender of o skeleton

Scalp
Head anatomy Sheet-like muscles
The main features of the head keep our scalps
that keep us operational flexible, an important
trait for nourishing the

Brain
skin and hair.

The brain is as soft as butter,

and thereforemustbewell
protected. It controls all
functions in the body.
Made ofeight flat
bones andjoined
together by sutures,
the cranium protects
the brain from
bumps and knocks.

Eyes
Two groups
hold the eye
movement, !
control and

Spine
The spine connects to
the skull, allowing us
to move our heads and
look around.

Nose Jaw
Nasal muscles operate Chewing is primarily
the nostrils and assist controlled bystrong muscles in
several facial features the jaw,which can produce a
such as frowning. great amount of pressure.

Mouth Tongue
Muscles in the mouth help Helping us to talk, the
movement, allowing us to chew tongue also assists in
and make facial expressions. eating and tastingfood.

Your eyes are held in place Astrongjawand teeth

but with the freedom allowusto chewand
to move digest food

051
 he knee is the largest ana also
one of the most complexjomts
in the body, allowing us

.. . ..
and work together to allow for
•• •
thighbone (femur). This rotates on top
of the shinbone (tibia) and ttie
kneecaR (patella), the latter of whicli
moves in a groove between the femur
DID YDU KNOW? The condition of normal body temperature is known os normothermio

What is
thermoregulation?
Why do humans need to maintain a constant internal body temperature of 37 C?
°

Y
our cells work best when the heading for shade when we're exposed to too can more easily radiate heat away, but it also
temperature inside your body is 37 much Sun. releases sweat through the pores. The body
degrees Celsius (98.6 degrees If that doesn't help, the body also has a emits heat to vaporise the moisture from the
Fahrenheit). Thermoregulation is a homeostatic number of automatic responses that help skin, cooling us in the process.
function that enables you to maintain this core regulate temperature. The main organ involved Conversely, when your surroundings grow
temperature independent of how hot or cold is the skin, which is controlled by the cold, your blood vessels constrict (narrow),
your surroundings are. autonomic nervous system. When your reducing the flow of blood to the surface. The
Humans are able to regulate body surroundings heat up, the brain triggers a hairs on your skin stand on end and you may
temperature via a combination of internal series of chemicals which tell your blood shiver and get goosebumps as the skin's
processes and external actions. The latter vessels to dilate (widen). This not only brings arrector pili muscles contract, pulling the hairs
includes behavioural responses, such as warm blood to the surface of the skin where it erect to trap air near the skin's surface.

Thermoregulation
in action
Learn how breathing
through your nose can
regulate temperature

Inhaling Exhaling
When you breathe in cold air When you breathe the warm
through your nose, heat from air from your lungs out
the many tiny blood vessels in through your nose, the heat is
the nasal cavity is transferred transferred from the air to the
to the cool air entering the nasal blood vessels, which
body. The inhaled air warms warms up your nose and cools
up and, at the same time, the down the air you exhale.
nose cools down.

053
 Why are some people strong
but others wea1<, and how
does exercise and training
increase muscle strength7

Greater pectoral

M
uscles are often taken for granted. constructed that allows us
Responsible for every move you to develop them.
make, the primary goal of a muscle A muscle is made up of
is to turn energy into motion. Muscles are fibres -each muscle will boast
broken down into three categories. Skeletal a higher or lower amount-that fall
muscles are the type that people in the gym into two distinct groups:
train and what individuals are most slow twitching (type I fibresj and fast
commonly aware of. Smooth are the twitching (type II fibresj.
involuntary muscles such as blood vessels, Type I muscles utilise the oxygen
airways and your bladder. The final category in your body better to generate
is cardiac, the muscles of the heart. Itis more fuel, also known as adenosine
Obliquus externus abdominis
skeletal muscle, however, that allows triphosphate jATPj. They can take extra
humans to both shape their bodies and strain and, more often than not, fatigue
increase their strength. slower. Type II muscles, on the other hand,
Skeletal muscles are incredibly complex, are the opposite. Not needing oxygen to

Rectus abdominis
designed to contract when asked to perform generate fuel, they create spurts of strength
any action. If you perform a bicep curl, for and exhaust far quicker. The distinctions
example, your brain will send a signal to the are similar to that of a marathon runner and
nerve cells indicating that it's time for the a sprinter, with the former relying on their
biceps to engage. It's the same process for muscles taking longer to break down and
each muscle that's within the skeletal the latter using the intensity and force of
category, but it's the way these are the faster twitching fibres to peak quickly.

054
DID YDU KNOW? The gluteus m□ximus - that's your bottom - is the largest muscle in the human body

"Your body will

remember how strong
you ore, even if you
stop training "

It's these processes that allow us to both opposite will make the muscle more visible, is a
manipulate a muscle and make it stronger. myth. Instead, when you train with heavy
Every time you lift a weight you're tearing these weights and force your muscles to expend all
muscle fibres apart, forcing the body to repair their ATP, you put the body in a state to recruit
them. Once healed, the fibres are thicker than more muscle fibres and stimulate those that are
before, a process that can be manipulated with missed when focusing on lighter weights.
the right diet. Bodybuilders get protein into You're essentially teaching your muscles that
their system as soon as possible after a they can become stronger. It won't suddenly
workout, as the substance is broken down into make them bigger, but it will activate more
amino acids that are used to produce and fibres that in turn help you lift more. This type
repair muscles. Your diet can even influence of training produces a form of muscle
how effective this is: fast-acting carbohydrates hypertrophy, which, in this instance, is
play an important role in spiking insulin levels, increasing the size of your muscle cells.
which in turn replace muscle glycogen (reserve Hypertrophy can be manipulated to both boost
source of glucose) used during training. Such a muscular strength or simply focus on
process will also filter protein where it's increasing body mass.
needed, for maximum recovery and growth. Your body will also remember how strong
This is why muscles get bigger and stronger you are, even if you stop training. Although
with rest, and not at the gym where you're in you'd have to work back up to your previous
fact breaking and destroying them. level, it would take half the time thanks to
These principles shift across in terms of how muscle memory. Following the same approach
muscles get stronger, too. The notion that lifting as how we remember to perform everyday
heavy weights at a lower rep range will tasks, your muscles get used to the same
increase body mass, whereas doing the movement and adapt accordingly.

055
Shoulders Deltoid Chest
MUSCLES Formed round the shoulder, it

IN FRONT
Exercise name: Military press Exercise name: Bench press
How to do it: Using weights, bend your
has anterior, posteriorand
lateral fibres to support rotation How to do it: Lie on a bench and grab a

Trapezius
legs, lift up the bar in line withyour barbell, handsaboutshoulderwidth.
and the pectorals and lats.

Pectoralis major
shoulders and push fromyour deltoids Bring the bar to chest level and lower
until your arms are straight. Repeat. until arms are at 90°. Push upwards.
Details: With the correctweightand A superficial muscle that moves the
intensity, it'll tear manymuscles apart scapulae (in the rotator cuff) and Agym favourite, the pectorals Details: The bench press isn't merely
beneficialforyourchest; italsoworks
· ·•,.\. supports the arm. also have the pectoralis minor
1.-- ·
andincreaseyourstrength. your shoulders and triceps.

Biceps brachii
near the upper chest.
..... •···\.
Q <�t{(
Consists of a long and short head to,
among other things, allow rotation
of the forearm and elbow.

Rectus abdominus
STRENGTH RATING: ./',/t,/t,/t,/• STRENGTH RATING: ./',/',/',/',/'

Mid-section
Known to the greaterworld
Biceps
as 'abs' ora 'six-pack', itis
Exercise name: Side plank possible to possess an
eight-pack, or even Exercise name: Bicep curl
How to do it: Lay on your side and ten-pad<. How to do it: Raise a dumbbell from
hoist your body up using the leg and your side up toyourshoulder rotating
armyou're resting on. Hold this the arm so the palm with the weight
position for as long asyou can. faces up. Then lower and repeat.
Details: The side plankwill trigger Details: The biceps' relatively small
bothabdominals and mid-section, for size compared to othermuscle groups
a more efficient centre ofgravity. means they'requite easyto target.

Forearm
Vastus lateralis
o different muscles,
mis one of the most
The largest part ofyour solthe entire body.
STRENGTH RATING: ./',/',/',/',/' quadriceps muscle, the quad also STRENGTH RATING: ./',/',/',/',/'
has the rectus lemoris, vastus

Calves Foreanns
medialis and vastus intermedius.

Gastrocnemius ------➔
Exercise name: Calf raise Exercise name: Hammer curls
How to do it: Using a Smith machine, Meaning 'stomach olleg', the calve is How to do it: Hold a dumbbell in each
stand under the barbell and place it on handwith palms facingyourbody.
yourtrapezius muscles. Push from incredibly hard to develop due to the Curl theweightuptoyourchest,
calves andstand on your tiptoes. pressure it is put under on a daily basis. keepingelbows locked. Lower down.
Details: Extremely difficultto Details:Performed with aheavy
enhance, the calfraisewhen done weight,you can improveyour grip and
with a barbell will target this muscle. increase armstrength.

STRENGTH RATING: ./',/',/',/',/' STRENGTH RATING: ./',/',/',/',/'

056
DID YDU KNOW? Many people with muscular physiques hove 'unhealthy' BMis, □s muscle weighs more than fot.

------ Splenius
Upper arms
MUSCLES Located in the neck, the

BEHIND
Exercise name: Tricep kickback
splenius is responsible
for head extension. How to do it: Take one dumbell and
hold it byyour side. With the elbow

Triceps ---------� Rhomboideus

locked pointing to the ceiling, extend
your arm behindyou till it's straight.

As the name suggests there's three Working in conjunction Details: Tricep extensions hit the three
parts to the muscle: the long, lateral with the trapezius, the different heads that make up a large
rhomboids connect the part of theupper arm at once.
and medial head.
scapula !shoulder blade)

Latissimus dorsi
with the vertebrae.

Meaning 'broadest of the

bad<', the lats, as they're
commonly called, are
an essential muscle STRENGTH RATING: ,/',/',/',/',/'
for strengthening the
entire body.
Back
Exercise name: Deadlift
How to do it: Laybarbell on the floor.
Put shins to the bar, bend knees and
pushfrom the legs. When bar passes
hips, straighten back and stand up.

External oblique
Details: The deadlift utilises every
muscle inyour body, fromyour back to
your hamstrings.
The largest and outermost
of the three muscles of the �
1~\
�r 1
Gluteus maximus
lateral anterior abdomen.

The largest muscle in the body,

your bottom has to be strong to
keep the lowerpart in a
correct position. STRENGTH RATING: ,/',/',/',/',/'

Hamstrings Quadriceps

Biceps femoris
Exercise name: Hamstring curls Exercise name: Squats
How to do it: Usea hamstring curl How to do it: Using barbell ina squat
machine and lock legs into position. rack, place bar on trapezius. Back
Push against the foam pad untilyour Containing two parts, the straight, bend knees until hamstrings
legs areat90° and goback to the start. long head is an integral parallel withfloor. Push from legs.
and important part of
Details: Curls will provide extra the hamstring. Details: Squats target all ofyour
support to squats, meaningyou'll be leg muscles, as well as most ofyour
able to lift more weight fromyour legs. upperonestoo.

@-:r �
1 1- �

STRENGTH RATING: ,/',/',/',/',/' STRENGTH RATING: ,/',/',/',/',/'

Wheys and means

Many bodybuilders will supplement
their diet with nutritional products - or
even illegal drugs - to enhance their
physique. Discover these common
methods of bulking up...
WHEY PROTEIN CREATINE ANABOLIC STEROIDS
A must for anyone trying to increase A natural substance already found in Ranging from injectables - such as
size/strength, getting enough protein the body, creatine is an amino acid pure testosterone which enables the
is crucial. Not only is it the building compound that stores energy, body to grow beyond its means - and
block for muscles -amino acids Supplementing with creatine can stop orals, steroids enter the muscle cells
construct protein which then builds ATP levels (the substance that starts to and stimulate them, which increases
muscle -but eating enough (usually drain when muscles are contracted) their production, Due to this, more
around 1.5-2.og per lb of bodyweight) from depleting as quickly, meaning cells will be developed, making the
will see the body start to grow, you can lift more weight for longer, body bigger,

057
SCIENCE
Fovea
This pit at the centre of the
back of the eye is rich in light
receptors and is responsible
for sharp central vision.

OF VISION
Uncovering one of the most complex
Optic nerve
constructs in the natural world Signals from the retina
travel to the brain via the

T
he structure of the human eye is muscles in the iris, which contract and optic nerve, a bundle of
fibres that exits through
the back of the eye.
so complex that it's difficult to relax to alter the size of the pupil. The
believe that it's not the product of light first passes through a tough
intelligent design but by looking at the protective sheet called the cornea, and
eyes of other animals, scientists have then moves into the lens. This adjustable
shown that it evolved very gradually from structure bends the light, focusing it
a simple light-dark sensor over the down to a point on the retina, at the back
course of around 100 million years. of the eye.
The eye functions in a very similar The retina is covered in millions of
way to a camera, with an opening light-sensitive receptors known as rods
through which the light enters, a lens for and cones. Each receptor contains
focusing and a light-sensitive membrane pigment molecules, which change shape
at the back. when they are hit by light, triggering an
The amount of light that enters the eye electrical message that travels to the
is controlled by the circular and radial brain via the optic nerve.

Seeing in three dimensions

Each eye sees a slightly different image, allowing the brain to perceive depth
Our eyes are only able to produce two-dimensional images, but with some
clever processing, the brain is able to build these flat pictures into a
three-dimensional view. Our eyes are positioned about five centimetres
(two inches) apart, so each sees the world from a slightly different angle.
The brain compares the two pictures, using the differences to create the Individual
illusion of depth. image
Due to the positioning
of our eyes, when
objects are closer than
about 5.5m (18ft) away,
each eye sees a slightly
different angle.

Combined image
The incoming signals
from both eyes are
compared in the brain,
and the subtle
differences are used to
create a three­
dimensional image.

Try it for yourself

By holding your hand in Retina Iris
front of your face and The retina is covered in This circular muscle
closing one eye at a receptors that detect light. controls the size of
time, it is easy to see It is highly pigmented, the pupil, allowing it
the different 2D views preventing the light from to be closed down in
perceived by each eye. scattering and ensuring a bright light, or opened
crisp image. wide in the dark.

058
DID YDU KNOW? 285 million people in the world ore estimated to be visually impaired ond 39 million of them ore blind

..--------- Ciliary body Vision problems

This tissue surrounds the
lens and contains the The most common problems
muscles responsible for with our eyesight
Farsightedness (hyperopia)
changing its shape.

If the eye is too short, the cornea is too flat, or if

the lens sits too far back, incoming light is
focused behind the retina, making nearby
Sciera objects appear blurry, particularly in the dark.
A tough white
membrane known as
the sclera helps to
maintain the eye's
spherical shape.

Nearsightedness (myopia)
If the eye is too long, or the cornea and lens are
too curved, the light is focused before it hits
the back of the eye, and then starts to defocus
again as it reaches the retina, making distant
objects difficult to see.

Colour-blindness
This rare condition is often linked to a gene on
the X-chromosome and occurs more commonly
in men than in women. A defect in the cone
��,::S:�-1 cells of the eye reduces the number of colours
that can be detected.

The eyes are shielded by several layers of protection.

They are almost completely encased in bone at the
back and insulated from shock by layers of muscle
and connective tissue. The front is kept moist with
tears and constantly wiped by the eyelids, while the
hairs of the eyebrows and eyelashes catch any debris
that might fall in .

..------- Lachrymal gland

Tears are produced here
and wash across to the
inner corner of the eye,
helping to clean and
nourish the surface.

Cornea
The pupil and iris are Eyelashes
Lens covered in a tough, Eyebrows Eyelashes not only catch
The lens is responsible for transparent The arch of the eyebrows dust before it enters the
focusing the light, and can membrane, which helps to keep sweat and eye, they are also sensitive,
change shape to The pupil is a hole that provides protection rain away from the eyes, like whiskers, and the
accommodate objects allows light to reach and contributes to channelling it down the slightest unexpected touch
near and far from the eye. the back of the eye. focusing the light. sides of the face. triggers a protective blink.

059
' WHAT ARE WE MADE OF?

Colour vision
Why humans see the world in so many colours
Open your eyes, and you are met with an array full-colour image at the centre of
of different colours, but amazingly you can only our vision. The remainder of the
detect three different wavelengths of light, retina is dominated by 120 million
corresponding to green, blue, and red. rod cells, which detect light, but
Combining these three signals in the brain not colour.
creates millions of different shades. We are so used to seeing the world
Each eye has between 6 and 7 million cone in red, green and blue that it might
cells, containing one of three colour-sensitive seem strange to think that most other
proteins known as opsins. When photons of animals cannot, but three-coloured vision
light hit the opsins, they change shape, like our own is relatively unusual. Some
triggering a cascade that produces electrical species of fish, reptiles and birds have four­
signals, which in turn transmit the messages to colour vision, able to see red, green, blue and
the brain. Well over half of our cone cells ultraviolet or infrared light, but during gene duplication gave some species the ability
respond to red light, around a third to green mammalian evolution, two of the four cone to see red, providing a significant evolutionary
light, and just two per cent to blue light, giving types were lost, leaving most modern advantage in picking out ripe red fruit against
us vision focused around the yellow-green mammals with dichromatic vision -seeing in the green leaves.
region of the spectrum. shades of just yellow and blue. Even today, not all primates can see in three
The vast majority of the cone cells in the This was not a problem for many early colours; some have dichromatic vision, and
human eye are located in the centre of the mammals, because they were largely many nocturnal monkeys only see in black and
retina, on a spot known as the fovea, measuring nocturnal, and lived underground, where there white. It is all down to environment; if you don't
just fractions of a millimetre across. Light is was little need for good colour vision. However, need to see all of the colours in order to survive,
focused on this point, providing a crisp, when primates started moving into the trees, a then why waste energy making the pigments?

Amacrine and bipolar cells Retina

Light and colour These cells transfer information from Light is detected by a
multilayered membrane
the rods and cones to the ganglion cells.
As light hits the back of the at the back of the eye.
eye, it interacts with two
different types of cell; rods
and cones

Sciera
The white part of the
eye continues all the
way to the back of the
retina, providing
structural support.

Pigment
epithelium
This dense sheet of
cells contains dark
pigment granules,
which absorb excess
light, preventing it
from scattering
inside the eye.

Blood vessels
Cone cell _____.,,..
The retina's inner layers
receive their nutrients
The human eye has three from a network of
types of light-sensitive blood vessels on the
cone cell, each for a inside of the eye.
different wavelength of
light, red, green and blue
respectively.
Horizontal cells Ganglion cells
Choroid These act like a The ganglion cells
Rod cell This layer at the back of switchboard, selecting are neurones, and
Rod cells cannot detect the eye contains blood which information to are responsible for
colour, but are extremely vessels that provide pass on to the brain and transmitting
sensitive to light, allowing oxygen and nutrients to helping to increase incoming visual
us to see in the dark. the retina's outer layers. contrast and definition. signals to the brain.

060
DID YDU KNOW? The eye muse/es ore the most active muse/es in the body. They move more thon 100,000 times o doy

How we see
Look around you - do you know what you're seeing with?
The back of the eye is covered in a layer of adjacent signals, filtering out some of the brain, and vice versa, allowing the images from
light-sensitive cells measuring just fractions of information before passing it on to the brain. both eyes to be combined and compared.
a millimetre in thickness. When photons of This helps to improve contrast and definition. The signals enter the brain via the thalamus,
light hit the pigments inside the cells, it triggers The neurones travel across the back surface which separates the incoming information into
a cascade of signals, which pass through a toward the optic nerve, which relays the two parts, one containing colour and detail,
series of different connections b efore they are information into the brain. and the other movement and contrast. The
transmitted to the brain. As the two optic nerves enter the brain, they messages then move to the back of the brain,
First, they move through interneurones and cross over, coming together at a point known as and into the visual cortex. The cortex is laid out
then to neurones known as ganglion cells. the optic chiasm. Here, signals from the left side so that it mirrors the back of the retina,
These cells are cross-linked, able to compare of both eyes are diverted to the left side of the allowing a detailed image to be reconstructed.

Optic nerve
Thalamus Visual cortex
The thalamus is situated deep inside the brain, The visual cortex
Information from the light-sensitive
involved in relaying sensory information, made up of six
cells in the eyes is passed to the
Optic nerve
The optic nerve including vision, hearing and touch. separate parts,
brain via the optic nerve
carries signals located right at the
away from the back of the brain.
eye and toward
the brain.

Focusing
Object The lens changes shape
As light hits an object, depending on the distance
it is reflected, bouncing to the object, focusing the
away from its surface light onto the retina.
in all directions.

Primary
visual
cortex
Arranged like a
map of the
retina, it has a
large area
Lens ---------"I dedicated to the
As light passes
fovea - the
through the lens, its region of the eye
path is bent, focusing responsible for
the waves in toward detailed colour
the retina. vision.
Optic tract ____, Optic chiasm
The optic nerve extends The optic nerves from each eye Lateral geniculate
toward a region of the cross over as they enter the nucleus (LGN)
thalamus known as the lateral brain. The signals from the left There are LGNs, one on the left, and one
geniculate nucleus (LGN). side of each eye go to the left on the right. They act as relays and send
side of the brain, and vice versa. the information on to the visual cortex.

Quick-fire questions
WhJ. do we see in black and Why does our eyesight get Why do our eyes jump Why do some animals have their
white at night? worse as we get older? instead of moving eyes on the sides of their head?
The colour-sensitive cone cells in the As the eye ages, the lens becomes around smoothly? Forward-facing eyes are incredibly useful
eye function like slow camera film less flexible, making it increasingly Movement of the eye is controlled for primates, who need to be able to
- they produce highly detailed difficult to focus on nearby objects. by the brainstem. Our vision accurately judge depth when jumping
images, but require lots of light to Luckily, this is easily corrected with would be blurry if our eyes moved between trees, for example, and for
work. In contrast, light-sensitive rod glasses. Cloudy areas, known as smoothly, so they jump in steps predators who need to pinpoint their prey.
cells are like fast film. They respond cataracts, can also start to appear known as saccades. The brain In contrast, prey animals need to be able to
to low levels of light, but cannot within the lens, making vision appear stitches the images together, like watch for danger, and often sacrifice
detect colour, producing a grainy, blurred or misty, but this can often the frames in a film, producing the binocular vision for a more rounded view of
black-and-white image. be fixed with simple surgery. illusion of continuous movement. their environment.

061
The retina
How does this photosensitive
Retina anatomy
The eye is one of the most
complex structures in the
body - and the retina plays
a vital role . . .

layer enable us to see pictures? Amacrine cells

T
These are responsible
for 70 per cent of the
he retina is a special type of photoreceptors' input
and they regulate
light-sensitive tissue located in
the bipolar cells.
the interior of the eye that's so
analogous to brain tissue, it's considered
a part of the central nervous system. If
you consider our eyes to be cameras, then
the retina is the film. However, the retina
does much more than just send a 'picture'
to the brain - it actually has to compress
the image so that it can be conveyed
via the optic nerve, because the
photoreceptors in the retina can take in
more information than the optic nerve
can convey.
Although it looks like a single layer, the
retina is actually very complex and
comprises ten layers of nerve cells, all of
which are connected by synapses.
Within each of these layers are several
different types of cells: the
photoreceptors called rods and cones,
photosensitive ganglion cells, bipolar
cells and other cells that assist with
regulating light input as well as
processing and transmitting images.
Rods and cones each have their own
function. Rods are more sensitive to light
and are responsible for night vision and
peripheral vision; each one can respond
to a single photon, or particle, of light.
Cones, on the other hand, work in bright
light and are responsible for seeing
colour, fine detail and rapid movements.
Until the Nineties, it was thought that

Blind spot
only rods and cones were involved in
sight. Then researchers discovered a THE BLIND SPOT TEST
much rarer type of cell called

• •
photosensitive ganglion cells. These cells We all have a blind spot, or scotoma - a
help regulate pupil size and the light/ place on the retina where there are no
photoreceptive cells to perceive light.
dark cycle, or circadian rhythms, that we
Known as the optic disc, this area is
function by.
where the optic nerve passes through the
Light reaches the rods and cones by retina on the way to the brain. Although

Macula
first passing through transparent layers the blind spot is sizeable, we don't notice
of nerve cells. When it reaches these it. That's because the blind spot in each
Thisyellow­
photoreceptors, the light causes eye is in a different place, so the other eye coloured area
'fills in' the blanks. To the right we have of the retina
chemical changes in the rods and cones.
included a 'blind spot test'. When you contains a high
The raw data is sent back through the close your left eye and focus on the circle, concentration of
layers of nerve cells, which process and then slowly get closer to the page, the plus cone cells that
are responsible
encode the image before sending it via sign will vanish! for sharpness of
the optic nerve to the brain. ..._______________________________,,, vision.

062
 DID YDU KNOW? Octopus eyes hove nerves ottoched to the reor of the retina, meaning they don't hove o blind spot like humans

Fovea Synapses
Thiscurvedpitin
the centre ofthe Neurons work together to combine data from rod
macula contains
almost no rods and cone cells into messages that travel to the brain
and provides the
most detailed
vision.

------ Optic nerve

This nerve is also called
cranial nerve two and
conveys the visual
information perceived
and processed by the eye
to the brain.

Bipolar cells Photoreceptors

Each bipolar cell These neurons interconnect Rods and cones each

Ganglion cells Bipolar cells

corresponds to a different types of transmit their own
specific cone or photoreceptors and also input during the
rod cell. regulate their function. vision process.
This type of neuron Bipolar cells synapse, or
receives the raw communicate, with rods or
information from cones and are responsible for
the photoreceptors 30 per cent of the signals from
(rods and cones). the photoreceptors.

�
@)

Retinal scan
Iris scanning is the more common beam of infrared light is reflected by
form of biometrics when it comes to the capillaries. The resulting unique
eyes, but did you know that our pattern is then stored as code
retinas also have special identifying within a database. Retinal scanners

Rods and cones

characteristics? It all comes down to are fast and reliable, but the
the complex network of blood downside is that the scanners are
Theretina containsabout120 vessels in the retina; even twins' expensive and the pattern can
million rods and 5 million cones, retinas are different. When you look change over time with certain
which are intermingled throughout into a retinal scanner, a low-energy diseases or other eye problems.
the retina exceptfor the macula.

063
 DID YDU KNOW? Forensic anthropologists con use the pelvis to determine □ skeleton's sex ond □/so guess its □ge □t death

Male vs female
Differences between the male and
female pelvis are numerous and
stem, primarily, from the female's
reproductive system. For example,
the female pelvic basin is broader
than the male equivalent, the
pubic symphysis short and the
pubic bones connect in a wider
angle with each other. In addition,
the coccyx has a greater degree of
movement and the two acetabula
are spaced farther apart. All
together these allow a rounded
and spacious birth canal - which
hasn't been an evolutionary
priority in the male of the species.

-
---
 The lymphatic system
Learn what role our lymphatic system plays in keeping nasty bugs at bay

T
he red blood cells that carry oxygen around internal organs. But the tubes do not These organs manage immune surveillance; if
around our bodies travel through blood make a circuit and there is no pump. The fluid, an antigen- presenting cell (APC) of the immune
vessels suspended in fluid known as known as lymph, relies on the contraction of system encounters a pathogen, it will return to
plasma. It moves through vessels at such nearby muscles to return to the circulation at the the nearest lymph node with intel about the
pressure that plasma can leak into the tissues. subclavian veins near the collarbones. intruder. The specialist attack cells of the
The lymphatic system helps remove it from the The lymphatic system is also a transport route immune system, lymphocytes, circulate
tissues and return it to the circulation. for the immune system. At intervals along the through the lymphatic system, scanning for
The lymphatic system is similar to the lymphatic vessels are between around 600 and matching patterns and, if one is found, they use
circulatory system, in that it is composed of a 700 lymph nodes. Larger organs like the spleen the lymph node as a base to adapt until an army
series of vessels, found mostly in the skin and and thymus are also connected to the network. of enemy-specific clones is created.

Swollen lymph glands

are often a sure sign of
infection or disease

When the lymphatic

system goes wrong
One of the most common problems associated
with the lymphatic system is blockage. If any of
the vessels becomes occluded, fluid cannot be
properly drained from the tissues and from that
point it begins to accumulate. This condition,
medically known as lymphoedema, results in a
buildup of fluid in the limbs, causing swelling.
Certain species of parasitic worm rely on the
human lymphatic system for part of their life

I
cycle, and the presence of a worm infection can
be one cause of lymphoedema. This is further
complicated by the immune system, which
responds to the worms, and any bacteria they
might be infected with, leading to thickening of
the skin and a condition known as elephantiasis.
Illness also affects the lymph nodes, which
become swollen during i nfection as immune
cells divide. Sometimes, cancerous
transformation occurs in one of the immune
cells, leading to lymphoma and eventually
forming a tumour in the node.

066
DID YDU KNOW? As lymph travels through the lymph nodes it picks up immune cells, which then return to the blood

Capillary fluid exchange in action Subclavian vein

See how lymph is transferred between the Lymph is returned to

Arteriolar end
circulatory and lymphatic systems the circulatory system

Lymphatic capillary
at blood vessels near
the collarbones.

The capillaries of the

•
lymphatic system are blind
ending, meaning the system

Blood
does not form a closed loop.

capillary
Instead, all vessels run
towards the heart.

Hydrostatic
pressure
..., The force of the heartbeat

Blood
creates pressure as blood

flow
tries to squeeze through
narrow vessels. This then
causes fluid to leak

Oncotic pressure
through gaps in capillaries.

Proteins in the blood

cannot pass across the
capillary wall. This creates
oncotic pressure, drawing
water back into the
circulation from the tissues.

Fluid leakage
Interstitial space Venular end
Most fluid that leaks out
of the circulation is
recaptured by the effects
of oncotic pressure. Any
that remains enters the
lymphatic system.

Efferent vessel
There are fewer exit
than entry points in the
lymph node, increasing
the internal pressure of

Lymphatic system
the fluid in the
incoming vessels, and
allowing the lymph to With vessels mainly in the
be filtered. skin, the lymphatic system
(shown in green) does not
follow the same course as
the circulatory system.

The lymph nodes are

distributed along the
Immune cells can enter lymphatic vessels. They
and exit the lymph node can sometimes be felt as
through its dedicated smooth, bean-like lumps in
the neck and groin.

�'""''
Medulla ',,\ 1------�'j Nodules
I I

This central area contains antigen­

presenting cells (APCs). Lymphocytes
� Around the outside of the lymph node
are nodules containing populations of
I J
travelling through the medulla scan antibody-producing B-cells. When
the APCs for information about activated, they divide to produce
potential infections in the body. enough cells to counter an infection.

067
103 104
How
Blood clotting metabolism
functions

70 Outbreak 93 Rheumatoid arthritis 108 Is cholesterol bad for you?

explained
76 Anatomy of an 109 Hypermobile joints
Olympic athlete 93 Why is there no cure for the
common cold? 109 What is a fit?
So The truth about hair
transplants 94 How a marathon affects 110 Why do we get angry?
your body
82 The antibiotic apocalypse 110 What are grommets?
96 The future of medicine
84 Why do we get fat? 111 Anaphylactic shock
102 Why do we get headaches?
84 Immunisation: how it 112 Brain surgery
keeps you healthy 102 Asthma
116 How hyperthermic
85 How do we heal? 103 Cramp explained surgery works
85 Placebos - do they work? 103 Blood clotting 116 What are probiotic bacteria?
86 I{idney transplants 104 How metabolism functions 117 What are tonsils for?
88 How cloning works 105 How does the liver detoxify? 118 Secrets of stem cells
92 Anaesthetics 106 How do gastric bands work? 120 Colour blindness
92 Strokes 108 How skin grafts work 120 What causes stomach ulcers?

068
88
121 Understanding chickenpox
122 The war against superbugs
12J Curing deafness
124 Ebola virus
126 How enzymes keep you alive
126 Bacteria explained
127 How to check your pulse
127 l{eeping hydrated
128 Understanding diabetes
1JO Perfect posture
1J1 How corrective lenses work
1J2 Inside laser eye surgery

069
DID YOU KNOW? Our most common gene provides no benefit to us, but some viruses use the protein it encodes to infect us

H
uman history is punctuated by a number of
terrifying pandemics. These global outbreaks of
disease will, without a doubt, remain a real threat to
humanity for the foreseeable future, however our growing
knowledge of medicine and how the diseases work makes
us better equipped than ever to fight them.
The word 'disease' encompasses the wide range of
ailments from which we can suffer. The ones that cause
epidemics and pandemics are infectious diseases - those
that can spread from one person to another.
Infectious diseases include everything from the common
cold to HIV/AIDS. They are caused by biological agents (or
pathogens) - frequently bacteria and viruses but also
parasites, fungi and prions (such as bovine spongiform
encephalopathy, also known as mad cow disease).
Most micro-organisms living either on or inside our
bodies are totally harmless. In fact, our bodies contain up to
ten times more bacterial cells than they do human cells.
This still leaves a good few handfuls of pathogens intent on
ensuring their survival at our expense.
Whether it's the common flu virus or more unusual bugs,
these pathogens have evolved a whole arsenal of tricks to
hop from one human to another, spreading through coughs
and sneezes, bodily fluids and more.
Some even hitchhike on another organism that does all
the legwork for them - known as a vector. Malaria is a good
example of a vector-dependent disease. Caused by a
parasite, malaria is carried by mosquitoes, which spread the
illness between humans when they bite them. Despite these
clever tactics, it's relatively rare for a pathogen to infect

071
enough people to spark a pandemic. One reason is that our
bodies possess a highly effective defence against their Inside influenza
onslaught: the immune system. Meet the influenza virion, an expert
As we're exposed to diseases, our immune systems cell hijacker and repeat offender
when it comes to causing pandemics
develop tailor-made antibodies to latch onto attackers and
either neutralise them or earmark them for destruction.
Lipid envelope
Over time, your body builds up a vast catalogue of
antibodies. A pathogen's first attack might cause a full­ This protective layer is
blown infection, but if a repeat invasion occurs, the immune shed by the virus once
system responds swiftly to defuse the attack. it enters a target cell.

As a result land also thanks to vaccinationj, a substantial

proportion of the population is resistant to common
diseases, making it hard for these pathogens to infect
enough people at one time to cause a pandemic. Chickenpox,
for instance, is highly contagious, but after a person has
RNP
been attacked by it once, their body 'remembers' the The RNP inside is used to
intruder and the vast majority are immune to it for life. hijack the target cell,
Pandemics therefore tend to be triggered by pathogens forcing it to make more
viral proteins and RNA.
which we have had very little exposure to and which can
catch our immune systems unawares.
Historically, diseases from other countries could do just
that. When European settlers arrived in North America, they
introduced diseases which Native Americans had never
encountered before, such as measles, influenza and
smallpox. These pathogens set off waves of deadly epidemics
which killed over 90 per cent of the indigenous population.
Nowadays, regular international travel spreads pathogens
around, meaning 'old' diseases aren't a threat. The ones to
worry about are new diseases !or variants of known
diseasesj, which all come from one source: animals.
The animals most likely to pass on their diseases are our
closest relatives, the great apes. The HIV virus, for example,
has been traced back to chimpanzees in Africa who were
eaten by humans in the first half of the 20th century.
Like many other zoonoses !diseases which cross the
species barrierl HIV first infected a few isolated humans, but
as the virus evolved it crossed another very important
The virion (or virus
hurdle: it acquired the ability to transmit from one person to particle) is roughly
another. Once a disease possesses the capability to do this, it spherical and measures
really does become a ticking time bomb. just 80-120nm across - a
hundred times smaller
While it's relatively easy for a pathogen to make the leap than a bacterium.
from an ape to us, or vice versa, much greater leaps are
possible. Very few of us come into contact with apes, but we
have a much closer relationship with domestic animals. A
precursor to the influenza virus which caused the 1918
However, it wasn't until 1796 that the first successful
Spanish Flu is thought to have existed first in wild birds,
vaccination was produced.
then in domestic pigs, before jumping over to people.
Throughout the 18th century, smallpox was a leading
For millennia humans were entirely at the mercy of
cause of death around the world. English physician Edward
disease, but the late-18th century saw the invention of our
Jenner noticed that milkmaids who had caught an illness
best weapon against infection: the vaccine.
called cowpox seemed to be immune to smallpox. By
Vaccines fool the immune system into thinking it's being
injecting patients with pus taken from cowpox sores, he was
attacked by a pathogen, stimulating it to create an army of
able to confirm his hypothesis and the first vaccine was
antibodies and killer T-cells specific to this disease. If we
born. Vaccination was adopted across the globe and
ever encounter the real thing, our bodies are therefore
smallpox was officially eradicated in 1979.
primed to fight off the infection.
Jenner's landmark work with smallpox paved the way for
To do this a tiny amount of the pathogen !usually
a wide variety of vaccines to be created. In the late-19th
attenuated, which means weakenedl is injected into the
century, microbiology pioneer Louis Pasteur developed
body - this process is known as inoculation. It might come as
vaccines against anthrax and rabies. A key innovation was
a surprise but people were actually experimenting with
that Pasteur's method consisted of treating pathogens to
inoculation in China and India as long ago as 1000 BCE.
render them totally harmless.

072
DID YOU KNOW? The word voccination comes from the Latin 'vacco' [cow], due to EdwardJenner's cowpox research

Surface proteins
Haemagglutinin and
neuraminidase are vital
to the virion's function,
making them great
targets for antibodies
and antiviral drugs.

Haemagglutinin Neuraminidase
This spike-shaped protein is one of the Once its job is done, the neuraminidase
flu's key weapons, helping the virion stick enzyme clips polysaccharide chains
to a target cell to begin its attack. allowing the virion to leave the cell.

M2 ion channel Ribonucleoprotein

The M2 protein lets hydrogen pass into The virion's genetic code consists of six
the virion, increasing its acidity and to eight segments of RNA, encased in a
exposing its RNA. protein sheath (making up the RNP).

The Great Plague

Probably the deadliest pandemic in human history,
the Great Plague, or Black Death, ravaged Europe
from 1348-1350, killing up to half of the population
in that short time. At its root was the bubonic
plague-causing Yersinia pestis bacterium.
Originating in Asia, the plague first struck in
China where it killed approximately 25 million
people. It then spread i nto Europe following the Silk
Road. Y pestis bacteria were carried by fleas, who
themselves hitchhiked on the rats that thrived in the
hulls of merchant ships.
After first landing on the shores of Italy in 1347,
the Black Death had swept as far north as England
by the following summer and continued onward to
Germany and Scandinavia in 1348.
Highly infectious, the disease struck and killed its
victims with startling speed. The telltale sign of
infection was the appearance of swollen lymph
glands - called buboes - typically around the groin,
neck and armpits. Sufferers then developed a high
fever and began to vomit blood, usually dying within
a week of the first symptoms showing. With no
effective cure to keep it in check, the plague
returned repeatedly for the next 300 years.

073
 In the following century, new vaccines were
developed at an astonishing rate. American How pandemics go global
microbiologist Maurice Hilleman alone led the Track how three of the most common diseases spread around the world...
invention of over 30 vaccines (including those ■ Smallpox ■ Leprosy Malaria

• Location: Europe
against measles, mumps, hepatitis A, hepatitis B
and meningitis). Widespread vaccination for Location: Americas Location: Date: C. 327 BCE
Date: c. 1600 North America & Europe Alexander the Great's
Following a familiar Date: 1950s
common pathogens means that most of the
army returns from India,
population is now resistant to them, preventing pattern, malaria Malaria largely disappears from bringing leprosy to Europe.
epidemics and forever changing our relationship spreads to the New Europe and North America
World from Europe. thanks to mosquito control and
improved living standards.
with diseases which plagued humanity for C> �------
centuries or even millennia.
But while it is easy to create vaccines against
some diseases, others are far more elusive due to
the rapid changes they undergo. The most
notorious of these shape-shifters is the HIV virus.
HIV has one of the highest mutation rates known,
reshuffling its genes constantly to change the
shape of its surface proteins. By modifying its
disguise, it makes itself unrecognisable to
antibodies, dodging the immune system's
guardsmen. Developing a vaccine against HIV is
therefore a tremendous challenge. HIV also
attacks the immune system directly.
Other diseases, such as influenza, are relatively
easy to vaccinate against once a new strain has
been identified, however the unpredictability of
outbreaks means that they are still a real threat.
Influenza exists principally in wild birds, but • Location: The Americas
Date: 1500-1600
European settlers transmit
every so often a new strain of the virus will
become transmissible between humans, sparking smallpox to native
epidemics and even pandemics, such as the HN51 populations with
virus. The time and location of these spillovers are devastating results.

virtually impossible to predict, though monitoring

wild birds is one way of keeping an eye out for new
strains of the virus which have the potential to
make the leap.
• Location: ------­
North America, South
In a number of ways, modern society leaves us
more exposed to pandemics than we were in the America & Caribbean
Date: c. 1750
Colonialists spread
past. For one thing, nowadays about 50 per cent of
Colonialists introduce
us live in cities where we come into contact with a
leprosy to the Americas - a leprosy to the western
huge number of people on a daily basis, movement only intensified African continent.
facilitating the spread of disease. by the slave trade.
The ever-growing number of international
flights also accelerates transmission, allowing
pathogens to hop from one continent to another in
a matter of hours. In 2003, SARS (severe acute Smallpox
Following the discovery of a
vaccine this acute and often-fatal
respiratory syndrome) spread to 29 countries
across three continents in just a few months. contagious disease has now been
Despite this, our understanding of pathogens is eradicated. Smallpox develops i n
those exposed t o the Variola virus.
Following exposure the virus
continually improving. SARS was a brand-new
disease, but the global medical community incubates for a period of usually
rapidly got to know its idiosyncrasies and brought 12-14 days during which time the
individual is not contagious. After
incubation, however, the sufferer
it under control. While we don't have a vaccine for
HIV yet, treatments have improved dramatically, will experience feverishness,
and public health measures have helped to reduce sickness and headaches before
developing the dreaded rash. This
is when the victim is at their most
or stabilise infection rates in most countries.
Pandemics will inevitably continue to strike in contagious. The itchy red spots
years to come, but we can rest assured that we are become fluid-filled pustules that
scab over. The victim will remain
contagious till all the scabs fall off.
b etter armed than ever in our eternal battle
against pathogens.

074
DID YOU KNOW? The World Health Organisation uses o six- stage scale to classify the severity of on influenza pandemic

• Location: Egypt • Location: Europe • Location: China Location: China

Date: 1145 BCE Date: c. 15D0 Date: c. 250 BCE Date: 2600 BCE
Earliest evidence of Smallpox becomes First documented cases of Earliest written report
smallpox DNA found established, possibly as a leprosy in China, probably of malaria in China.
in mummies. result of increased travel spread by traders.
during the Crusades.
Location: Europe
Date: c. 1500
Malaria extends its
reach into northern
Europe as trade

• Location: India
Date: 2000 BCE
The oldest known case of
leprosy is recorded.

Smallpox origin • Location: India

Date: 500 BCE
• Location: Egyptian traders
North-east Africa bring smallpox to
Date: c. 10,000 BCE India, where it thrives
The smallpox virus for 2,000 years.
appears as animals
are domesticated.
Location: Worldwide
Date: c. 1850
At the peak of its spread,
malaria threatens half of
the world's population. @84•/l;r.iMi·
From informative timelines to

• Location: Somalia
fascinating articles, find a mine of
Malar a origin
Date: 1977
information on diseases and the
Location: Africa Last reported
development of the vaccine at

Date: 10,000 BCE case of naturally

www.historyofvaccines.org - an

Like modern man, contracted smallpox.

online resource that was put

malaria emerges in
together by the College of

Africa and follows

Physicians of Philadelphia.

humans migrating
into Eurasia.

Malaria
Though malaria is not contagious (ie releases some saliva which acts as
not passed from person to person an anticoagulant to keep the blood
W·ihii·hmttl like a cold) this disease endemic to flowing. In doing so she also passes
• Location: East Africa the tropics is a widespread killer. It's deadly parasites into the victim's
Date: C. 40,000 BCE transmitted by the presence of a bloodstream. Flu-like symptoms
Leprosy bacterium believed certain single-celled parasite in the usually occur between ten days and
to originate in eastern saliva of female mosquitoes. When four weeks after infection, however
Africa or the Middle East. the mosquito pierces the skin of her the parasite can lie dormant in the
victim with a straw-like proboscis liver for up to four years before
mouthpart to obtain blood, she also making the victim sick.

075
 Olympian
anatomy
Brain -----------­
Whether a runner is sprinting 100
metres 1328 feet) or a pentathlete is
guiding their horse, with years of
training the brain ofan Olympian
changes and grows in harmony
with other physical developments.

Skeleton --------­
As a part ofany physical training,
bones strengthen with the
stresses that muscles place upon
them. Caucasians tend to have
light bones while Polynesians
naturally have a higher bone
density, which can be genetically
advantageous for certain sports.

Cardiovascular system ---­

Astrong heart and big lungs mean
an athlete can last a long time in
any event. Ahighred blood cell
count will increase oxygen
delivered to the muscles and a
good circulation means oxygen
will get where it's most required.

How do these real-life superhumans

differ from your average Joe?
W
hen we talk about These are feats of fantasy, but we don't very differently. Think of their bodies as
superhumans, shooting lasers have to look to the world of fiction for highly specialised machines that have
and turning invisible aside, truly astonishing human physical acts. upgraded themselves through years of
there's a process of comparable feats that In fact, a lot of sports people capable of training, elevating them above the vast
we normally run through. So, for testing the boundaries of the biological majority of us to become significantly
example, the average guy might be able machine that is the human body will faster and stronger, react quicker, last
to sprint at 29 kilometres (18 miles) per currently be busy preparing for the longer, improve balance, accuracy,
hour but Superman can travel faster Tokyo Olympics in 2020. dexterity and endure levels of self­
than a speeding bullet (roughly 1,300 So what is it exactly that's stopping inflicted physical discomfort that most
kilometres/Boo miles per hour). any of us from stepping up to the starting of us would quickly buckle under the
Similarly, a strong person might be line and providing a serious challenge to stress of.
able to lug a 70-kilogram (150-pound) Usain Bolt or the next great sprinter for It seems unfair but, genetically,
canister around a pub, but in the 100-metre gold medal? The answer many, if not most of us aren't
comparison The Thing could tow a might seem obvious, but even though even on an even keel with
14,000-kilogram (31,000-pound) we're made of the same fundamental Olympians when we're
double-decker bus. building blocks, Olympians are built born, as many athletes

076
DID YOU KNOW? In 1968, Hons-Gunnar Li/jenwo/1 become the first person to be tested positive for a banned substance, a/coho/

Muscles
These can be divided into two
main groups: fast-twitch fibres
produce power and are great for
sprinters and power lifters; while
slow-twitch fibres contract more
slowly but are more efficient,
making them more suitable for
endurance athletes.
 have a natural leaning towards world record for the 100-metre sprint

Super­ superhuman traits. For example, long

limbs, a large pool (up to 90 per cent) of
(ratified by the International Association
for Athletics Federations) was 10.8 seconds,

human
slow-twitch muscle fibres and a set by Luther Cary in 1891. The benchmark
cardiovascular system with a huge range ten-second barrier wasn't broken until
means Kenyans tend to dominate distance 1968 and Usain Bolt smashed his own

abilities events over 5,000 metres (16,400 feet). Even

outside of racial predispositions, and
world record in Berlin in 2009 with a
blistering 9.58-second run.
Football regardless of the best training techniques, While over a century of socioeconomic
You often hear people referred to as some people are just genetically improvements have helped open the
'footballgeniuses', and there's more truth overqualified for a certain sport and will Olympic achievements up to everyone, the
in that than you might at first think.
Top-flight footballers are mental leave their fellow competitors for dust. Games themselves have provided a
strategists akin to brilliant chess players. The Olympic Games themselves have competitive platform from which Olympic

Athletics
also been a catalyst for Herculean athletes have been able to further
achievements. Before the first modern distinguish themselves from the everyday
Runners need more fast or slow-twitch
muscle fibres !depending on the event),
Olympic Games under the International man, proving they're capable of
throwers need core strength and hand-eye Olympic Committee in 1896, the first official superhuman things.
co-ordination, whilejumpers need
flexibility and leg strength.

Swimming
Swimmerswith longer bodies and a bigger
arm span than height, plus big hands and
feet to propel them through the water,
tend to perform better than others.

Modem pentathlon
As the pentathlon combines target
shooting, fencing, swimming, equestrian
show-jumping and cross-country running
events, a pool of all-round Olympic ability
is needed to succeed.

Table tennis
Fast-twitch muscle fibres and lightning
reactions are a must, but the best players
instinctively knowwhere to plant their
feet and have the endurance to last for
several hours ofintense play.

Cycling (road)
Cardiovascular endurance and strong legs

Ten seconds to gold

are a given, butjust as important is mental
strength, helpingyou to keep goingwhen a
lesser athlete would give in.

Off the block . .

•
Drive phase . .....:
'
90% max velocity .
..;.;..... ..... ............................1
Stride phase . Max velocity . . .. . . .. . . .... . .. . .. .
o.14seconds 11second) 12-3 seconds) l3-4seconds) l5seconds)

078
DID YOU KNOW? The very first recorded Olympic event [in Greece, 776 BCE] wos □ 192m (630ft] dash

Super­
human
abilities
Gymnastics (artistic)
"Repoxygen is another Incredible balance and flexibility aside,
more than any other athlete, gymnasts
gene-therapy □gent require a strength-to-weight ratio that
belies their slight frame.
that con boost red
blood cell production " Rowing
Again, long, strong limbs make for the
longest strokes and the best rowers.
Olympic rowers need to overcome lactic
acid burn from anaerobic bursts that
would cripple lesser men.

Boxing
Unlike most other Olympic sports, boxers
are expected to endure a degree of injury
to the head and body, yet continue

It's all in the genes

performing at their peak. In addition to
overall athletic ability, an ironjaw and a
certain 'grit' are vital.
Currently, the only way we can take charge ofour own destiny and give
ourselves a fighting chance of competing in the Olympic Games is by hard work Weightlifting
and dedication-though that doesn't guarantee we'll even come close to Weightlifters are extreme specialists,
becoming Olympic-standard. Modern technology may change that however: focusing large overall muscle mass into
feats of power and strength. Technique
'gene-doping' is the term given to a wave of genetic technologies that may allow and endurance should never be
an athlete to change their DNA in favour of becoming faster, stronger and underplayed, as only a flawlessly
all-round better at their event. PPAR-o (peroxisome proliferator-activated executed lift will secure full marks.
receptor alpha) affects muscle-cell metabolism and can potentially boost
strength and power, as well as affect fat metabolism for a leaner physique.
Archery
Repoxygen is another gene-therapy agent that can boost red blood cell Archers need long, strong arms and
production, increasing the amount of oxygen delivered to the muscles. back muscles, hawk-eye vision and
Even though either of these might put the average person on a genetic par with focus to the point that the archer can
Olympic superheroes, using them to increase performance in professional sports temporarily lower their heart rate.
is illegal, akin to using anabolic steroids and other banned substances. Currently,
however, there's no way to test for such gene-altering drugs.

I I
� fl';

� ?-- � Diving
tt
'
More than any other event, concentration
and absolute focus are vital to a diver,

;
Lift phase . ............. :
.............. .................... .. .... ................ .......................... .. .
Full sprint
because entering the water from such
lofty heights with the wrong posture can
be seriously dangerous.
(6seconds) (6-10 seconds)

079
+ HEALTH AND MEDICINE

The truth How to perform

a hair transplant

about hair
The basic steps in
performing a strip harvest of
hair, the most commonly

transplants
used method

Footballer
Wayne Rooney
has famously
had a hair
transplant

How this surgical technique

battles baldness
M
ale pattern baldness is common,
although in some people it can lead to
concerns over appearance and even a
severe loss of confidence. Most choose to accept it,
but others are fighting the balding process.
Modern science has recently updated ancient
techniques, meaning that hair transplants can
now reliably restore normal hair patterns.
Patients are carefully screened before
undergoing hair transplantation, similar to
patients before any cosmetic procedures. While
hair transplants can restore self-confidence, it's
important that they aren't used to fix problems in scar
patients' lives that can't be solved through a The two resultant
change in appearance alone. skin edges are
closed, leaving a
Hair transplants have been practised as far thin scar, although
back as the 19th century. However, it is only in the this is typically
last 20 years that modern techniques have Jed to covered with
surrounding hair.
reliable and realistic results. Currently, two
techniques are used the most. The first involves
taking a thin strip of hair from the back of the �---------- 8 New hair
I The micrografts are
scalp, removing the hair follicles and implanting 'f inserted into these
them to the front of the hairline. The second holes, orientated so
doesn't involve removing a strip; rather, small the hair grows in the
right direction.
units of two to four follicles are removed and then
transplanted in the required area.
These techniques have become so
sophisticated that the direction of the hair follicle
is controlled when implanting it in the new site.
This gives a natural hair-growth direction and a
realistic pattern. These procedures aren't
without risks, though. They can be painful, and
as with any surgical wound, infection can set in.
There is also no guarantee of success as baldness
can recur. However, it is a generally successful
procedure and can restore lost confidence.
DID YOU KNOW? Discovery of boldness genes in 2008 suggests moternol or paternal [or both] inheritance is possible

4 Stripping 5 Cleaning up , '

back The resulting How hair is lost
The strip is micrografts are The most common type of
carefully cut into trimmed of underlying baldness is male pattern
small blocks of two fat and excess tissues baldness, which can affect 50
to four hair follicles. from the side. per cent of men over the age of
50. Typically, the hair on the
temples thins while the hair on
the top of the head recedes. It
usually takes around ten years
for the hair to recede fully,
leaving a small rim around the
sides and back.
Changes in signalling of the
6 Size
D ifferent sized
grafts are used male sex hormone
depending on d ihydrotestosterone (DHT) is
where they are primarily responsible. The hairs
placed along the on the head become susceptible
'new' hairline. to it, which causes thinning and
then hair loss. Why the chest or
beard hair isn't affected is
unknown. This type of age­
related baldness can affect
Compare the two types of procedure women too, but is less common.
The two most common techniques are FUE is done under local anaesthetic Different types of hair loss
strip harvesting and follicular unit and takes longer; sometimes two to also exist. These include patchy
extraction (FUE). Strip harvesting three treatments on separate days. hair loss on the scalp (leaving
involves a strip of skin and hair being Individual hair follicles are stripped out tufts), loss of all body hair (head,
surgically removed from the back of the using a special device and then chest, arms and legs), and
scalp. Although it is successful and fast, implanted in the front of the scalp. universal hair loss (all hair
it requires a general anaesthetic and There's no scar or need for general including eyebrows and
leaves a small scar. anaesthetic, and it's very precise. eyelashes).

strip Hair transplant science

ip contains all of has improved greatly in
licles and under! the last 20 years
, containing 1,
llicles

081
DID YOU KNOW? The first antibiotic, penicillin, wos discovered by occident when o blob of mould got into on experiment

Antibiotics shut
cell factories The war on bacteria
Antibiotic Antibiotics
Bacteria have molecular factories Antibiotics work by attacking bacteria, but

stop division
that make the molecules they the bugs are fighting back
need to survive. Some antibiotics
shut them down. Some antibiotics
interfere with bacteria's

Antibiotics
genetic code, preventing

burst bacteria
them from dividing.

Some antibiotics
stop bacteria
building their
protective cell wall;
the pressure builds
and they pop.

Bacteria
neutralise
antibiotics
Bacteria change
their molecules
Some bacteria make
molecules that stick to
antibiotics and stop Antibiotics work by

Bacteria pump antibiotics out

them working. clinging on to bacterial
molecules, so if the
If antibiotics do get inside bacteria, some are bacteria can change

Bacteria block
able to pump them straight out again. their shape, they can

antibiotic entry
sometimes escape.

Some bacteria have

developed ways to stop
antibiotics from getting
through their cell walls.

Arm yourself with information

Knowledge is the most powerful
weapon we have against an antibiotic
apocalypse, here are two top places to
learn more:

• The World Health Organisation

www.who.int
Working in over 150 countries, the
World Health Organisation are leading
the fight against antibiotic resistance.
Their social media accounts are a great
place for bite-sized news and updates.

• Bugs and Drugs

www.antibioticresistance.org.uk
With funding from the British
Government's Department of Health,
the National Electronic Library of
Infection have made a one-stop hub of
information about antibiotic resistance.

083
+ HEALTH AND MEDICINE

Why do we get fat?

As the obesity epidemic grows, it is important to
understand just what causes us to gain weight

D
aily calorie intake for an average adult patterns of societies have also contributed to
is set between 2,000 and 2,5ookcals and the problem as average levels of physical
recommended fat intake is between 70 activity have reduced. Eating patterns have
and 90 grams. The body needs this level of also changed due to lifestyle changes. Busy
calories in order to function at maximum lives and more focus being placed on careers
efficiency. However, if we consume more than has led to the advent of the 'ready meal' and an
is needed to run our body, it stores these extra increase in the number of takeaways eaten -
calories as fat. These fat stores can serve as a which are often very high in saturated fat and
reserve if we don't eat enough, but if someone calories. Genes can also have an impact on
consistently over-eats, they'll become weight gain, but most cases ofobesity that we
overweight as the body continues to store the see are actually due to average calorie intake
excess calories. increasing, with actual need reducing.
Obesity is becoming more prevalent across Over the last 20 years, child obesity levels
the world, within developed and developing have also been increasing dramatically, again
countries. Highly calorific food and snacks, primarily due to physical exertion decreasing
with generally poor nutritional value, have and calorific intake increasing. This is of
become more widely and cheaply available particular concern because of the many health
and the amount of saturated fat being problems associated with obesity such as type
consumed by an average adult is much higher 2 diabetes, cardiovascular disease, strokes and
than 20 years ago. Changes in behavioural certain forms of cancer among others.

Working out your body mass index (BMI)

""""''
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120
(26Slb,)

110
(24....
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100
(220lbs)

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60
(13llb$)

50
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,
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40
150 155 160 165 170 175 180 185 190 195 200 205 21(
(4ft9") (Sftl") (5ft 3") (5ft 4") (5ft 6'') (5ft 7'') (5ft 9") (6ft 1'') (6ft 2'') (6ft 4") (6ft 6'') (6ft 7") (6ft 9")

Height [cm]

084
DID VDU KNOW? The tongue ond the inside of the mouth ore the fastest healing ports of our bodies

How do we heal?
We always expect our bodies to heal when we
3. Parts of the brain
The areas involved are the left
dorsolateral prefrontal cortex,
the pregenual rostral right
anterior cingulate, the right

injure ourselves, but how does this happen?

H
ealing can be defined as the the proliferative phase and the
restoration of injured tissue maturation phase. The inflammatory
back to usual function. There phase is when bacteria is killed off by
are two main ways in which tissue macrophages and phagocytic cells
heals; regeneration and repair. and growth hormones released
Healing involves the removal and encourage cell growth in the area of
replacement of damaged tissue, and damage. The following stage is when
most organs will use both methods to the wound starts closing up and
fix damage -although cardiac muscle filling with collagen, which will form
cells and neurons are examples of the scar tissue. During the final
cells that cannot use regeneration. maturation phase, healing tissue is
Regeneration is when cells replicate replaced with stronger collagen and
within the same tissue mass that was unnecessary tissue produced during
damaged. These then replace the the earlier phases is removed.
cells that have been damaged or died.
Most cells in the body can repair
damage in this manner, but the
surrounding collagen network must
remain in good condition for this to be
able to occur.
ased activity is due to
Repair takes place when the se of endorphins, the
damaged tissue cannot replicate cells tural painkillers.

of the same type, and scar tissue is

Placebos - do
then formed. Repair is made up of
three stages; the inflammatory phase,

they work?
1. Skin injury 2. Clotting
Blood vessels in the dennis become damaged The body's repair cells, which include
when the skin is broken which results in fibroblasts, travel towards the injury site and
bleeding at the site of the injury. the blood fonns a clot.

What are placebos, how do they

actually work, and can they
really cure disease?

T
he placebo effect occurs when a patient with a condition
responds positively to a treatment that doesn't have any
medical value. It is thought to alleviate conditions due to
the patient believing they are being treated, and
psychologically they start to feel better.
It is thought that the improvements often seen with placebos
3. Plugging 4. Scab might be due to conditioned responses (for example, taking
A plug of fibrous tissue is fonned within the A scab is formed by the fibrous plug hardening. medicines makes you feel better, therefore you feel better
clot by the fibroblasts. This allows new tissue
to form beneath the protection of the plug.
It will eventually fall off but may leave some
scarring at the location of the wound.
because you're taking medicine). However, sceptics commonly
state that the so-called placebo effect is actually only seen
because patients want to please the doctors or testers, and that
in truth placebos have no effect at all.
Ultimately, placebos will not cure physical conditions -they
can only affect the individual's mental state, which may be seen
to then aid physical and mental recovery. With some patients
and some illnesses, a placebo is potentially a
very powerful mental and psychological tool for use in a
number of cases, but often is not a valid replacement
for treatment.

085
The kidneys are the body's
natural filters. You can survive
on just one, but when that fails
you may need a transplant

KidneY.
transplants
T
ransplanting organs is a transplant. The number of patients fortune. For those who are declared national register to a suitable
complex process, although it registered for a kidney transplant brain-dead, the beating heart will recipient. A 'retrieval' team from a
can give a new lease of life to increases each year, and has risen keep the kidneys perfused until central transplant unit (of which
recipients. The kidney is the most by 50 per cent since 2000. they are ready to be removed. In there are 20 based around the UKl
frequently transplanted organ, Kidney transplants come from some patients, the ventilator will be will go to whichever hospital the
both in the UK and around the two main sources: the living and switched off and it's a race against donor is in. They will remove the
world. However, there is a the recently deceased. If a healthy, time to harvest organs. Either way, organs, while the recipient is being
discrepancy between the number compatible family member is consent from the family is needed, prepared in the base hospital.
of patients waiting for a transplant willing to donate a kidney, they can even at such an emotional and During the tricky operation, the
and the number of available organs; survive with just one remaining pressurised time. new kidney is 'plumbed' into the
only around one third of those kidney. In other cases, someone When a suitable organ becomes pelvis, leaving the old, non­
waiting per year receive their else's tragedy is another person's available, it is matched via a functioning ones in-situ.

1. The donor 2. Out with the old? 3. Into the pelvis

How to The donor kidney is harvested, including enough length of artery, As long as there's no question of cancer, An incision is made in the lower

�rform a
vein and ureter (which carries urine to the bladder) to allow the original kidneys are left in place. part of the abdomen to gain
tension-free implantation into the recipient. access into the pelvis.

kidney 7. What's that

transplant lump?
The new kidney can
Transplanting a kidney is a be felt underneath
case of careful and clever the scar in the
plumbing. The first step is to recipient. These
harvest the donor kidney, and patients are often
then it's a dash to transplant recruited to medical
student exams-be
the new kidney into the prepared!
recipient. When the brain-dead
donor is transferred to the
operating theatre for organ
harvest, they are treatedwith
8. Catheter
the same care and respect as if
they were still alive. When
A catheter is left in-situ
consent has been given for fora short while, so
multiple organ harvest, a cut is that the urine output of
made from the top of the chest thenew kidney can be
to the bottom of the pelvis. The measured exactly.
heart and lungs are retrieved
first, followed by the
abdominal organs.

5. Plumbing it in
4. Make space! 6. The final link J
The renal arteryand vein are connected to the
corresponding iliac artery and vein in the recipient's body.
Holes (arteriotomies) are created in the main arteries, and
the kidney's vessels are anastomosed (a surgical join
The surgeon will create space in the pelvis, and identify the large
vessels which run from the heart to the leg (the iliac arteries and
The ureter, which drains urine from the kidney, is
connected tothe bladder. This allows the kidney to i
·;:;
between two tubes using sutures). veins). The new kidney's vessels will be connected to these. function in the same way as one of the original kidneys. ,'.;

086
DID YOU KNOW? Of the millions of people in the UK suffering from kidney disease, 50,000 will suffer end-stage reno/ failure

Domino
transplants
Patient 1 needs a new kidney but their
family member isn't compatible.
Patientz also needs a kidney and has
an incompatible family member as
well. However, patient z's relation is
compatible with patient 1 and vice
versa. The surgeon arranges a swap
-a 'paired' transplant. A longer line of
patients and family members
swapping compatible kidneys can be
arranged-a 'daisy-chain' transplant.
A 'good Samaritan' donor, who isn't
related to any ofthe recipients, can
start the process. This first recipient's
family member will subsequently
donate to someone else-a 'domino'
transplant effect which can go on for
several cycles.

Who is suitable? Antibody

If the antigens are too dissimilar, the host's existing
Of the several million people in the UK with kidney
immune system thinks the newkidney is a foreign invader
disease, only around 50,ooowill develop end-stage and attacks it with antibodies, leading to rejection.
renal failure IESRF). For these people, dialysis or kidney
transplantation are the only options. Kidney damage
from diabetes is the most common cause of
transplantation. Other causes include damage from
high blood pressure, chronic kidney scarring !chronic
pyelonephritis) and polycystic kidney disease !the
normal kidney tissue is replaced with multiple cysts);
many other less common causes exist.
Patients must be selected carefully due to the scarcity
oforgans. Those with widespread cancer, severely
calcified arteries, persistent substance abuse and
unstable mental problems mean that transplants are
likely to fail and so these patients areunsuitable to
receive a precious kidney transplant.

Antigens
Antigens from the recipient kidney's ABO
blood group and HLA system should be as
close a match to the donor's as possible.

When things go wrong...

Kidneys need to be carefully matched to suitable donors, or
' ..: ;;_-; '""�-',:�:?/(tt� rejection of the new organ will set in fast. Rejection occurs when
the host body's natural antibodies think the new tissue is a foreign
-.;. invader and attacks; careful pre-operative matching helps limit
the degree of this attack. The most important match is via the ABO
blood group type-the blood group must match or rejection is fast
and aggressive. Next, the body's HLA !human leukocyte antigen)
system should be as close a match as possible, although it doesn't
need to be perfect. Incorrect matches here can lead to rejection
over longer periods of time. After the operation, patients are
started on anti-rejection medicines which suppress the host's
immune system limmunosuppressants such as Tacrolimus,
Akidney Azathioprine or Prednisolone). Patients are monitored for the rest
transplant can
olfera new
of their lives for signs of rejection. These immunosuppressants
lease oflife aren't without their risks-since they suppress the body's natural
defences, the risks of infections and cancers are higher.

087
How cloning works
From Dolly the sheep to stem cell farms, we explore the
myths and reality of cloning

I
nside the nucleus of every living cell is DNA, full set of chromosomes that is unique from or liver cells that carry a full copy of DNA. To
the genetic blueprint that makes each living either parent. create a clone using this method, scientists
creature unique. In rare cases, a fertilised A fertilised egg is called a zygote. As the extract the nucleus of an adult somatic cell and
egg will divide and separate inside the womb, zygote divides and develops into an embryo, insert it into an 'enucleated' egg cell from a
forming two embryos with the same DNA. The the same copy of DNA is passed along to every second animal, ie an egg whose nucleus and
resulting identical twins, which make up a cell in the organism, whether it's a liver cell, original genetic material has been destroyed or
scant 0.2 per cent of the world's population, are eye cell or brain cell. The cells ultimately look removed. Lab technicians execute these
nature's perfect clones. and behave differently because different genes manoeuvres with pipette needles 2/10,oooth of
When we think of artificial cloning, most of along the DNA strand are expressed to perform an inch wide.
us tend to fall back on bad science-fiction different cell functions. Scientists then use a precision jolt of
movies where teams of evil scientists replicate The earliest artificial cloning efforts in the electricity or a chemical trigger to stimulate cell
humans with giant photocopiers or grow late-197os were quite basic. In a procedure division in the transplanted egg. Instead of
armies of clone babies in glass-walled tanks. called artificial embryo twinning, scientists generating more specialised somatic cells -as
The reality of artificial cloning is much closer to mimicked the natural twinning process by you might expect DNA from an 'adult' cell to do
Mother Nature's model. physically dividing an early embryo into -the transplanted DNA reboots to its original
When scientists set out to artificially jor individual cells that had yet to specialise. After orders and starts to create an embryo. The
asexually) clone an organism, they take their a day or two in a Petri dish, the developing resulting foetus, implanted into a surrogate
cues from natural jor sexual) reproduction. In identical embryos were implanted into a mother, grows to become an exact genetic clone
sexual reproduction, the sperm and egg cells surrogate mother and brought to term. of the animal that donated the somatic cell.
each carry a single set of chromosomes But the most effective artificial cloning Somatic cell transfer is often used for
containing exactly half of each parent's genes. method to date - the one that brought us Dolly reproductive cloning - making copies of
When the sperm fertilises the egg, the two the sheep in 1996-is called somatic cell nuclear organisms with highly desirable genetic traits.
halves of the genetic map combine to form a transfer. Somatic cells are 'body' cells like skin For example, the same researchers who cloned

088
DID YOU KNOW? The success rote of cloning by somatic eel/ nuclear transfer is only between one ond four per cent

Cloning is a very
controversial
topic for many people

hormones to ensure

1. Sexual reproduction
egg procuction

The original embryo carries exactly half

The science
Early
of cloning
of the mother's chromosomes and half

embryo
of the father's, creating an organism
with unique DNA.

Artificial 2. Separation 3. Growing

embryos
Stem cells

embryo
In the earliest days
of cell division, The isolated stem

+ + + +
researchers can cells are placed in
physically divide the culture where they

twinning 4. Transplantation
embryonic cell are stimulated with
cluster into chemicals to
individual stem cells. restart cell division.
Each cell carries the Each cloned embryo is
In a few days, a
organism's full implanted into a
new cluster of
surrogate mother, who
Identical twins are a fluke. When genetic record. embryonic stem
will carry the growing
cells has formed.
the fertilised egg is only days old, it fetus to term.

New embryo
spontaneously and inexplicably
splits into two equal clusters of
stem cells, each carrying the exact
same genetic blueprint.
Researchers can mimic this process
in the lab by physically separating
individual stem cells during the
earliest moments of cell division
and implanting the identical
embryos into surrogate mothers.

5. Herd of clones
The genetic makeup of the
surrogate mothers has no effect
on the offspring. Each calf carries
the same exact combination of the
original parents' DNA, resulting in
identical physical traits.

Dolly have also cloned a genetically In 2008, the US Food and Drug
modified sheep named Polly whose Administration approved the sale of
milk contains a protein that aids foods containing milk and meat
blood clotting in haemophiliacs. By from cloned animals, although the
producing thousands of clones of prohibitive cost of cloning has kept
Polly, scientists can isolate more and cloned food off the shelves so far. The
more of the protein to manufacture European Union has made no such
blood-clotting drugs. approvals, although breeders
Cattle, sheep, pigs and other throughout Europe are already
animals have been bred by farmers using imported semen and embryos
for millennia to produce leaner, from cloned animals bred in the US.
protein-rich meat and more Scientists have also used
flavourful milk. But conventional reproductive cloning to bring
breeding still allows for a genetic endangered species back from the
roll of the dice, which can brink of extinction. In 2001,
occasionally result in small, sickly researchers used somatic cell
offspring. Successful reproductive nuclear transfer to clone an
cloning, some say, would ensure a endangered gaur ox. Unfortunately,
steady supply of only the fittest and the animal died soon after birth
healthiest animals. from an infection. Since then,

089
 Dolly the
sheep
A remarkable breakthrough that
changed the world of cloning
Dolly the sheep was the celebrity of the cloning world.
Back in 1996, after 276 failed attempts, researchers at the
Roslin Institute in Scotland became the first scientists to
successfully clone a mammal. The method was somatic
cell nuclear transfer, in which the nucleus of an egg cell is
sucked out and replaced with the nucleus of a normal
body cell !or 'somatic' cell) from an adult sheep. Using
electrical impulses, the egg is induced to divide, growing
into an embryo that shares the identical genetic material
as the somatic cell donor. This requires sensitive
manipulations of cellular material at the microscopic
level, explaining the low success rate. Dolly's life in the
spotlight was relatively short-lived and she died at age
six. One drawback of somatic nuclear transfer is that the

1. In vitro fertilisation
another ox and three African wildcats age of the donor cell seems to affect the longevity of the
have been successfully cloned to cloned organism.
Egg cells are surgically removed
repopulate their species. from a female and mixed with
The first cloned cat was born in 2001 sperm cells in a laboratory culture
that's conducive to fertilisation.
and a firm in South Korea produced the

)
first cloned canine in 2005. Since then,
passionate pet owners have paid as

2. Blastocyst
much as £600 a year to preserve their
b eloved cat or dog's tissue for post­ Once the egg is fertilised, it
mortem cloning, a process that runs to becomes a zygote and begins to
divide and multiply. Five days later,
nearly £100,000. a cluster of 100 cells has formed,
Not all cloning experiments have been called a blastocyst.

for the sake of reproduction, though.

With therapeutic cloning, the goal of
researchers is to isolate and replicate
3. Locating stem cells From stem cell
to body part
stem cells in order to study their The inner ring of the blastocyst is
composed primarily of
potentially life-saving applications.
undifferentiated stem cells, the
Stem cells are undifferentiated cells that 'blank slates' that will become
organ cells, nerve cells, bone cells
carry a full copy of an organism's DNA, Embryonic stem cells are 'pluripotent', meaning they can
and reproductive cells.
but have yet to express any of their genes grow to become any specialised cell in the body. Nature has

4. Harvesting stem cells

as skin cells, bone cells, sperm cells or its own complex mechanisms for differentiating stem cells
any other adult cell. Researchers can into brain, muscle or bone, involving both genetic and
program stem cells to grow specific Researchers remove the stem
environmental markers. In the lab, researchers can isolate
cells from the blastocyst and place
organ tissue, like healthy brain cells to them in a nutrient-filled culture embryonic stem cells in culture and provide the right
treat Alzheimer's sufferers or medium to stimulate growth.
chemical triggers to grow fresh skin cells and even organs.
replacement bone marrow cells for

5. Differentiation
cancer patients.
Therapeutic cloning also relies on the
somatic cell nuclear transfer method. In Batches of stem cells are transferred to
other culture dishes where they are
2007, researchers harvested stem cells stimulated with chemicals, and even
from cloned rhesus monkey embryos. It segments of genes to grow into
specialised cells.
takes about five days for a cloned

6. Organ formation
embryo to reach the blastocyst phase,
when the total cell count has grown to
around 100. At this size, stem cells can be In recent years, researchers have
found success growing bladder and
extracted and placed in a nutrient-rich skin cells on prefab scaffolds that
culture medium where they grow into mould the cells into the shape of the
desired body part.
complete stem cell 'lines'.

090
DID YOU KNOW? Cloned onimols don't olwoys look identical. The first cloned cot hod o different coloured coot than its match

�-­
1. The donor 5. Enucleation 4. Donor egg
Macleod2010

Researchers chose a six-year-old Finn Using a miniature drilling Meanwhile,

Dorset ewe as the donor animal, since pipette mounted on a researchers removed
its pure white coat and white face specialised microscope, a batch of eggs from
would be easily distinguishable from the scientists bored an adult Scottish
other breeds. through the cell wall Blackface ewe, easily
and sucked out the distinguishable by
her dark facial
markings.

How to make
a sheep 9. Implantation

10. Birth of Dolly

The embryo was
then implanted into
another Scottish
Dolly entered the world on 5 July 1996, sharing Blackface ewe and
the identical white coat and white face of the carried to term in the
mammary tissue donor and none of the markings surrogate mother.
of either the egg donor or surrogate mother.

2. Somatic cells

7. Fertilisation
Researchers removed a
small amount of somatic
cells from the mammary
Using another jolt of electricity,
tissue of the ewe. Yes,
researchers induced proteins in the
Dolly the sheep is named
cytoplasm of the egg cell to 'reprogram'
after Dolly Parton.
the genes of the somatic cell to grow an
embryo, not more mammary tissue.

@ @ @

8. Embryo
@ @

3. Low-nutrient culture 6. Electroporation formation

To inhibit cell division, the donor cells The enucleated egg cells and somatic cells are Placed in a nutrient-rich culture
were placed in a low-nutrient culture placed in together and zapped with an electric medium, the egg cell began to divide
medium until nuclear transfer. field, causing cells to fuse and share a nucleus. and grow until it formed a blastocyst.

The risks
of cloning
Cloning is far from an exact science. Dolly was the
277th cloned embryo and the first to survive. But even
Dolly only lived to six years old, half the average life
span of her species. Several genetic abnormalities
have surfaced in cloned animals, including high birth
weight, organ defects and premature ageing. The
culprit, many believe, is the age of the
somatic donor cell. Chromosomes
get shorter over time as they
divide and multiply. At some
point, the chromosome
becomes too short to divide
and the cell dies. It appears
that a somatic cell's
chromosomal clock is not
fully reset when it's
implanted into an egg,
resulting in shorter life
spans and sudden
organ failure.
 Anaesthetics
How doctors take the pain away
T
here are two main types of anaesthetic prevents nerves transmitting sensations of
used to nullify pain in the body. First, pain to the brain.
there's local anaesthetic, which is General anaesthetics work in a similar
used in conjunction with a sedative to limit manner, again reducing nerve transmission
sensation to a particular part of the body. It is in synapses. Commonly inhaled, they operate
usually injected, where it becomes ionised on the central nervous system, temporarily
and blocks channels of sodium within the reducing the transmission between synapses
nerves transmitting information to and in the nerves. The entire body becomes
from the brain. These sodium channels - insensitive to pain and the patient will lose
known as synapses -are like bridges across consciousness, although vital bodily
which signals can travel. Blocking these functions remain active.

Numbing the pain How anaesthetics stop nerves

sending pain signals to the brain
Sodium channels Block
These synapses allow The ionised anaesthetic
the transmission of the can now blod, the
impulse which interacts transmissionsatthe

Nerve Inserted
with the brain. synapses.

The nerve is connected to The local anaesthetic is

the cell membrane, inserted into the
Anaesthetic makes operations which transmits signals intended area, where it
much more bearable for all to and from the brain. becomes ionised.
DID YOU KNOW? Rheumatoid arthritis is the second most common arthritic disease ofter osteoarthritis

Rheumatoid Development of the condition

The cellular mechanisms, proteins and antibodies
arthritis explained involved in the development of rheumatoid arthritis
B-cells Osteoclasts T-cells
How does this condition cause intense
B-cells are lymphocytes Osteoclasts are terminally Similar to B-cells, T-cells
(white blood cells) that differentiated cells of the differ in the fact thatthey

inflammation of joints and the eventual

make antibodies to combat macrophage lineage that have special receptors on
antigens. These cells re-absorb bone matrix. In their surface. Theyassist

destruction of cartilage tissue?

internalise antigens before rheumatoid arthritis, they the maturation of B-cells
presenting them to T-cells. aidjoint destruction. into plasma cells.

R
heumatoid arthritis is a chronic cause unwanted/abnormal levels of
and progressive disease. inflammation and tissue/bone
Through inflammation destruction. Inflammation is caused
throughout the connective tissues of by a heavily abnormal interaction
the body, it causes irreversible between B-cells and T-cells (see
damage to joints. The disease 'Development ofthe condition'
develops when a person's body boxoutl, a process that causes a
generates an autoimmune response variety of proteins, antibodies and
a mistaken immune system reaction other cells to be released which break
against the body's own tissues - that down joint cartilage among other
attacks its joint components instead of damaging activities.
invading organisms.

Plasma cells Macrophages Synovial membrane

As of now, scientists are unsure of
what instigates the autoimmune Plasma cells develop The role of the Thesynovialmembraneis
response, but it is thought that it when B-cells are macrophage is to the soft tissue that lines the
involves a body's genetic susceptibility activated under engulfand digest non-cartilaginous surfaces
stimulation by T-cells. cellular debris and withinjoints. With
to certain viruses. Regardless, once They are a larger and pathogens, stimulate rheumatoid arthritis, the
activated by such a cause, a series of more specialised B-cells and release synovium becomes
antibody-producing cell. enzymes and proteins. irritated and enlarged.
immune system reactions proceed to

WhY. is there no cure

for the common cold?
A general term for over 200 different viruses, why is
the common cold so 'incurable'?

T
he common cold is a viral infection that and rupture from the cells to spread to cells in
attacks the upper respiratory tract, the rest of the upper respiratory tract.
including the nasal cavity, the pharynx While we can treat the symptoms of a cold, we
(back of the mouthl and the larynx (voice boxl. cannot find a single cure as there are so many
Every child can get up to 12 colds a year, and types of virus and they mutate rapidly.
in adulthood we continue to get them on a Therefore, in the time it takes to develop a
regular basis. vaccine, it is no longer useful.
The symptoms of a cold are sneezing, a runny
A heavy cold
nose, a sore throat and nasal congestion. Young (sometimes referred
children can also run a high temperature. In the to as 'man flu') can
first three days, the cold is highly contagious and be debilitating
is spread to anyone who inhales or touches
anything contaminated by the virus. A cold lasts
about a week, although a cough can persist for
several days afterwards.
Rhinoviruses, coronaviruses,
coxsackieviruses and adenoviruses are just
some of the many different types of cold viruses.
These viruses stick to the cells of the adenoids at
the back ofyour throat. They quickly reproduce

093
How a marathon
affects your body
Long-distance running puts
tremendous strain on the A running
body. Read on for tips on how commentary. . .
to train and run safely Step-by-step guide to your body
round the London marathon course

0
Mile
markers

At 13 miles, your stores ofglycogen

are getting low. The body begins
to burn lat at this stage and your
thirst continues.

� 26.2 miles (42.2km)

, HOMEWARD BOUND
Yourjoints maybe sore, you
maywell feel mentally and
physically exhausted, but the
finish is in sight. One final push
before glory is all yours.

094
 DID YOU KNOW? The London Marathon course is the only one in the world that is run in two hemispheres - east and west

Post-marathon advice
The body is going to feel pretty used and abused post­
marathon. Fight the urge to sit or lie down immediately
Hitting 'the wall' To help prevent hitting 'the wall'
'The wall' is a metaphorical term to
afterwards-keep walking to avoid cramping. Refuel and describe the marathon runner's runners should carbo-load before a
rehydrate yourself, and change into dry clothes before the worst nightmare. It hits at around the race, which means eatingpasta the day
cold sets in. In the evening it's wise to replace those carbs 20-mile marker, making the hardcore before. It's often recommended to fuel
you've used during the race, then take an easy walk the next runner feel temporarily 'pooped', up during the race by consuming carb
day. Avoid any temptation to run. It's recommended to take while plaguing the inexperienced gels or beans while you run.
one day off per mile you've run, to aid your recovery. runner with agonising body cramps
and dehydration.
This stage happens when the body's

20 miles (32.1km)
glycogen supplies run out and the body

THE WALL
instead switches to fat reserves for fuel.
Glycogen comes from carbohydrates in
At 20 miles yourglycogen supplies have run our food and is stored in the liver and
out and your muscles now break down your muscles. We can store around 7,500KJ of
fat to fuel themselves. Blood sugar is low glycogen in our bodies, and you'll use
making you feel faint. Joints become sore
from the impact of running on the road.
up 400KJ of this per mile.

6.5 miles (10.4km) 3.25 miles (5.2km)

GETTING IN THE ZONE THE BLOOD
At 6.5 miles the heart rate steadies STARTS PUMPING
•
to135 beats per minute. The body At3.25 miles, the heart rate is
is using glycogen from the liver to raised to around 140 beats per
fuel itself. You start to feelthirsty. minute !the average resting rate is
75). Yourbody temperature rises
from 37 degrees to 40 degrees. You
begin to sweat.

22 miles (35.4km)
EXHAUSTION
At 22 miles, your heart is under
extreme stress. This is the point in
a marathon when most heart
attacks occur. Your pace is slow,
likelihood of dehydration is high.

Start line - 0 miles

SLOW START
Unless you're a celeb or an elite
athlete, it takes around five
minutes to cross the start line. The
first eight miles is full of

"
bottlenecks, so it's a slowstart.

095
DID YDU KNOW? In 2014 scientists grew o whole argon, co/led o thymus, inside o mouse using stem cells

How germs spread

Body fluids Skin to skin contact

Blood, saliva, semen and breast milk can Some infections are quickly spread by
all carry disease direct contact
Liquids provide an excellent way for pathogens Chickenpox, cold sores, head lice and warts can
to travel from one place to another. Precautions all be transmitted by touching someone with
are always taken when dealing with body fluids the infection; the viruses, bacteria, or parasites
in hospitals and labs, because contaminated simply move from one person to another. Some
body fluids can transmit diseases like mumps, of these examples can also survive on
hepatitis and HIV. inanimate surfaces for a short time.

Food and drink Droplets

Contaminated food and drink carry Pathogens can be transmitted short
pathogens into the gut distances by drops of liquid in the air
The acidity of the stomach provides some Tiny drops of fluid released by a cough or a
protection against infection, but it can't stop sneeze travel around a metre before they settle
everything. Pathogens enter through the onto door handles, surfaces and skin. It's an
mouth, and either set up home in the digestive easy way for respiratory infections to spread.
tract, or move into the body through its walls. Examples include colds, flu and rubella.

Training the immune system

Vaccinations are like a training program for When the vaccination has been injected, your When you encounter the real pathogen, your
your immune system, giving it a sneak peek at immune system comes to have a look. It will immune system will be ready to respond.
enemies that it might encounter in the future examine the parts of the pathogen and work Instead of spending time working out what to
so that it can prepare in advance. They can be out the best way to attack, as though it were do, the memory cells left over from the
made in different ways, but usually contain fighting the real thing. After the vaccine has vaccine instantly clone themselves,
inactive bacteria or viruses, or examples of been cleared up, some of the cells that fought it producing an army of cells that can clear the
molecules that the pathogens make. remain in the body on patrol as 'memory cells'. infection before you get sick.

097
 HEALTH AND MEDICINE

m·llion
The end of HIV
How do you hunt down a virus that's hiding
In 2015, nearly 37 million in your own immune system?
people were living with HIV Human immunodeficiency virus,
more commonly known as HIV,
Over half of
hijacks the immune system. The
people with HIV
virus gets inside, inserts its genetic
can't access
code into the genome of a cell, and
treatment
transforms it into a factory to make

·­·--
more of the virus. While this is
C happening, the cell is unable to
0 function normally, and gradually as
more and more cells are taken over,
the immune system is left seriously

•
weakened. The result is known as

,s:.
people die as a result of acquired immune deficiency
syndrome (AIDSI.
AIDS each year
HIV is now treatable with a
combination therapy that stops the
virus from replicating. The amount of

••
virus often dips so low in the blood
HIV is transmitted through that the disease can't be passed on.
Transmission from mother to child is
body fluids, including blood,
also being eliminated with new
semen and breast milk

ttttt
drugs. However, not everyone has
access to treatment.
8 out of 10
pregnant women The gold standard forthe future of

ttt *
with HIV receive HIV medicine would be a vaccine that
treatment to
can teach the immune system to
minimise the risk
neutralise the virus with a coating of
HIV
to their child
antibodies. In theory, this could be
used not only to prevent infection, but CD4 Cells
HIV infects the
also to stop the disease coming back
immune system,
AIDS
if*
in people who have some virus still
crippling the
hiding in their systems.
body's defences This is a huge challenge; the virus Stands for acquired immune
shape-shifts to avoid detection, and deficiency syndrome
Is the disease caused by HIV
HIV
the immune system doesn't usually Stands for human
respond. But new vaccines are being Takes advantage of the immunodeficiency virus
trialled all the time, and as our damaged immune system Is the virus that causes AIDS
understanding of HIV and the that is unable to fight it It infects the immune system
of people with HIV don't immune system improves, we are People die due to infection or Infection compromises the
inching closer to making it a reality. resulting cancer cells of the immune system
know they're infected

Antiretroviral
therapy stops the 1983 1987 Future
Scientists discover that human The first drug A vaccine is
virus replicating immunodeficiency virus (HIV) is treatment for HIV, developed to train
the cause of acquired immune azidothymidine, the immune system
deficiency syndrome (AIDS). is approved. to attack HIV.
Condoms, HIV puts Timeline
HIV testing, people at
and risk of
circumcision catching
1981 1985 1996 2007 Future
help to other Men in California start Commercial Triple-drug therapy A single patient A drug is
reduce diseases like to fall ill with unusual blood tests for HIV is introduced, in Berlin is cured developed to
infections after their are invented, turning HIV by a pioneering reveal HIV
transmission tuberculosis immune systems allowing screening infection into a bone marrow lurking in
become weakened. to begin. long-term disease. transplant. dormant cells.

098
DID YOU KNOW? The highest death rotes for heart disease ore in Eastern Europe ond Centro/ Asia

Can cancer be cured?

14 ·-­
C
0
Huge progress has been made over the past century,
but what happens next?
Cancer is an ancient disease; tumours have been found immune system to recognise cancer cells, or a routine
IE
in Egyptian mummies, and even in the fossils of blood or breath test could be developed to pick up the people are diagnosed
dinosaurs. It happens when genes involved in growth earliest signs of the disease. However, the likelihood of with cancer each year
and repair go wrong. Affected cells make copy upon cancer increases with age, and with people living longer
copy of themselves, and these new cells start to break the incidence is rising.
away, travelling around the body and making yet more For those who do develop the disease, several
copies elsewhere. futuristic treatment options are already being people die of
If cancer is caught early, it can already be cured. If the developed. Future humans could end up having their cancer each
tumour is removed, the cancer is gone. However, once immune systems retrained and augmented, or they year
the cancer has spread it is harder to treat, and the more might receive genetically engineered viruses designed
it spreads, the less likely people are to survive. specifically to infect and kill the tumour. We might even Lung cancer is
Stopping cancer before it really starts would be the be able to switch genes on and offinside tumour cells to the most
best option. Vaccinations might be used to train the halt their growth. common type
of cancer
The future of cancer medicine in men
Matching people to the right treatment could
be the answer to controlling cancer
Breast cancer is
the most
common type
of cancer in
women

The older
you are, the
more likely
you are to
get cancer

Group of patients Genetic testing Treatment matching

Several people might have The patients are tested to find out Patients are matched with treatments
brain cancer, but not all the exact genetic and chemical that specifically target the
brain cancers are the same. makeup of their tumour. weaknesses of their own cancer.
Cancer is not contagious, but
Where is the cancer cure? it can be genetic
Cancer gets a lot of research money, and thousands upon some cancer cells develop ways to avoid them. The big
thousands of scientists are working to try to find the cure, so challenge is that everyone is different, and so too are
where is it? If you can cut the tumour out before it has a everyone's cancers. And tumours don't just differ between
Viral
chance to spread, you can cure it, but if any cells have escaped people, they also change over time. The challenge is to find infections
they need to be found. Radiotherapy and chemotherapy can out how they change, and how these different weaknesses
help to mop up stragglers, but they don't always work, and can be targeted with treatments.
can cause
some
cancers
1880s 1950s Future
The first mastectomy is Smoking is finally Personalised medicine The earlier
performed, finally shown to cause lung becomes reality, with patients
providing treatment for cancer, encouraging matched to treatments based
cancer is
breast cancer. millions to give up. on their genes.
detected,
Timeline the easier
it is to treat

1846 1903 1949 1990s Future

Radium is used The first A simple blood
Lifestyle
The invention of Cancer mortality
general anaesthetic to treat skin chemotherapy drug starts to drop in test is developed
changes could
paves the way for cancer, in what is is approved. It is developed countries to pick up the prevent a third
surgery to finally the first example nitrogen mustard, a as diagnoses and very earliest
remove tumours. of radiotherapy. WWII weapon. treatment improve. signs of cancer.
of cancers

099
 Eliminating malaria
This deadly disease is carried by mosquitoes, but work
days it takes for malaria
parasites to reproduce inside
is being done around the world to wipe it out
a mosquito Just one mosquito bite is enough to kill you in some Malaria parasites can't reproduce without both
parts of the world. Inside the midgut of Anopheles mosquitoes and humans, giving us a tantalising
mosquitoes, gametocytes from the plasmodium opportunity to eliminate them. One idea is to genetically
parasite mature and combine. These are the equivalent modify colonies of mosquitoes and release them to
of human sperm and eggs, and the result is hundreds of breed with their wild counterparts; this could be used
newly formed parasites ready to infect their next victim. to introduce damaging genetic traits into the
The parasites migrate up to the mosquito's salivary population, either killing the parasites, or killing the
glands, and when it feeds again they enter the human mosquitoes themselves. Another option is to develop

Malaria was first written

bloodstream. They infect cells in the liver and begin to fungi that can infect and kill the insects.

about in Ancient China in

divide, before spreading back into the blood. As they Other options for elimination include designing new

2700 BCE
continue to grow, the cells split open, releasing even insecticides to keep insect numbers down, and
more parasites and causing havoc for the body. developing a vaccine to halt transmission.

Global
elimination

(
is tough
billion people live in regions The World Health Organisation
Infection
where they could catch malaria
first initiated an attempt to rid
the world of malaria in 1955. The The gametocytes
idea was to use a combined mature and combine
attack, spraying houses to get Gametocytes inside the mosquito. Bite
rid of the mosquitoes, and using The malaria parasite's Parasites enter blood
antimalarials to kill the parasites. as the mosquito feeds.
equivalent of sperm
people die of malaria each year They had some successes in
areas where the climate was
and eggs.

700/4
moderate and mosquitoes thrive
only during certain seasons, but Infection cycle
in other places the program of malaria
didn't work as well.
Mosquitoes started to
become resistant to pesticides,
and the parasites resistant to
of malaria deaths are children Infection
More spread
treatments. This, combined with
wars, political unrest, and The parasites start
under the age of 5 patchy access to resources, The mosquitoes pass to grow in the liver.
meant that coordinating a the parasite on.
Malaria is caused global attack against malaria

by parasites that
became impossible.
In 2015, the WHO reissued
infect humans their challenge. But today we
and mosquitoes are facing even stronger
versions of the parasite and
vector, and new weapons are Spread Transfer
Spraying houses needed to eliminate them. Mosquitoes catch the The parasites move
parasite from the blood. into red blood cells .
with insecticide is
_,,.,,.;
........_
the best way to
stop transmission 1880 1939 Future
The parasite that causes The DDT pesticide is Malaria-carrying
malaria is discovered in invented, allowing people to mosquitoes are wiped
... countries blood samples taken control numbers of out by genetically
reported from patients. malaria-carrying mosquitoes. modified insect mates.
ro
..... cases of Timeline
malaria
ro
....J

1600s 1897 1951 2015 Future

Peruvian tree bark is It's discovered that Malaria is wiped out in The World Health The world is

214 Million used to treat

malaria, eventually
mosquitoes are
able to transmit
the US after a
government eradication
Organisation
endorses a new
declared malaria
free thanks to
cases of malaria in 2015 leading to the malaria from one program sprays strategy to eliminate the eradication
modern drug quinine. person to another. millions of homes. malaria for good. campaign.

100
DID YOU KNOW? The earliest example of human cancer is a 1.7 million year old fossil with a bone tumour

Halting heart Cardiovascular disease killed

attacks and strokes

Diseases of the heart How heart disease starts
million people in 2012

and blood vessels are the The slow accumulation of fat can lead to a deadly blood clot
Heart attack
world's biggest killers symptoms include
chest, arm and
When the body's arteries and veins ,_ ................. ,_ !11!1!. 0 00 jaw pain, sweating
become clogged with fat, rough
and vomiting

G
plaques form and narrow the tubes.
As the blood tries to force its way
through the narrow space it swirls Someone has
and twists, and more damage is done. a stroke
The fatal blow comes when parts of 0 0
every 2
the blockage break away. Clotting seconds f
molecules in the blood interpret the H·
roughness as a cut that needs to be There are over l\
sealed. They start to build a clot, and 2.5 million heart ·,.

9
as the circulating blob gets larger, it attack and •,
eventually becomes lodged in the stroke survivors
tubes, cutting off the blood supply. in the UK
The damage can't always be

d
repaired, but the latest research could Men are more
change that for the future. Stem cells likely to die of
are cells that haven't yet decided heart disease
which part of the body to become. than women

• • • • • •
II
With some coaxing in the lab, they
can be converted into new blood cells,
new skin cells, or even new heart
muscle. Harvard scientists have 1 Normal vessel 2 Disruption 3 Plaque 4 Clotting
already made a life-size beating heart Healthy blood vessels When a blockage Fatty deposits in A clot starts to form
have smooth internal appears in the the wall of the on the roughened
by convincing stem cells to become walls, allowing the vessel, the blood blood vessel cause surface, and the A third of adults in the UK
heart muscle and growing them on a blood to slip easily quickly becomes it to bulge, blood vessel have high cholesterol

8
scaffold. In the future, custom organ around the body. backed up. narrowing the tube. becomes clogged.

replacements could be made The most importa nt

artificially on demand. risk factors are "\'
If this doesn't work, another option smoking, diet, \
11
is gene therapy, which is already exercise and
being trialled for heart failure. Genes alcohol intake
are delivered to the cells, telling them
to make different molecules, and Stroke
potentially allowing the body to b e symptoms
reprogrammed from the inside out. include sudden
weakness on
1930 1967 Future one side of
The defibrillator is The first human heart Custom-grown the body,
invented, allowing transplant is performed, replacement hearts are confusion and
stopped hearts to be allowing damaged organs produced from people's
restarted with electricity. to be replaced. own stem cells. slurred speech
Timeline

1899 1958 1960 1987 Future

Pharmaceutical The first implantable The first heart The first cholesterol- Gene therapy is Heart disease and stroke are
company Bayer pacemaker is bypass surgery was lowering statin drug used to reverse
begin manufacturing installed, allowing performed to divert hits the market, the damage the first and second most
a new drug called the heart to be blood around helping to prevent done by heart common causes of death
aspirin in Germany. controlled. damaged vessels. heart attacks. attacks.

101
 Asthma
Why does this disease make
it difficult for sufferers
to breathe?

A
sthma is caused by the sudden contraction of
smooth muscles in the airways of the body. This is
normally due to unusually viscous mucus being
produced in abundance in the bronchial mucous glands.
One of the primary causes of asthma is the narrowing of
bronchial tubes because of inflammation. Asthmatics are
overly sensitive (hyperreactive) to stimulants in the
environment that can cause the bronchial muscles and
tubes to contract. Tubes become irritated and swollen, in
turn producing excess mucus and blocking the flow of air.
While asthma is often hereditary, it can also be acquired
through prolonged exposure to substances such as solder
and sulphite.
In severe asthma attacks, the accumulation of additional
mucus from the bronchial tree can also inhibit airflow
within the airways, making it more difficult for an asthma
sufferer to breathe. There are several things that can trigger
an asthma attack, including exercising and traffic fumes. To
overcome an attack, an asthma inhaler can be used to relax
the muscles and widen the bronchial tubes so that normal
breathing can be resumed.

102
DID YOU KNOW? Writers' cramp occurs in the hands ond lower arms but is octuo//y o form of dystonio, o neuro/ogico/ condition

Cramp explained Rest

At rest the calf
muscle is in its
Why do our muscles tense up? relaxed position.

C
Stretch
ramp is an involuntary contraction of a muscle, often in a When the leg is bent
limb such as the leg, that can cause pain and discomfort or stretched the call
musclewill
for seconds, minutes or, in extreme cases, for several contract, and then
hours. They are most common after or during exercise, relaxwhenitisnot.
coinciding with low blood sugar levels, dehydration and a high
loss of salt from sweating. Although the full range of causes is
something of a mystery due to limited research in the area, Cramp
Prolonged stretching
cramp is believed to be the result of muscle fatigue. If a muscle ofthe leg prevents the
has been shortened through prolonged use but is repeatedly calfmuscle from
relaxing, which can
stimulated, it isn't able to properly relax. A reflex arc from the lead to cramp.
central nervous system to the muscle informs it to continue
contracting when it is not necessary, leading to a painful spasm
known as cramp as the muscle continually attempts to contract.
This is why athletes pushed beyond their limits, such as football
players who have to play extra time in a soccer match, and
long-distance runners, will often experience this condition.

Blood clotting
Fonnation of a blood clot
1. Skin layer
Composed of a water­
resistant and protective
layer called the How the body: reacts to blood vessel
damage to aia. the healing process
epidermis; beneath it is

T
the dermis layer that
consists ofblood vessels
and connective tissue. hrough the action of the same time allows the blood to
thrombin system, coagulation continue circulating. As the skin
Epidennis
of the blood occurs instantly heals, plasmin enzymes break down
Dennis
at the location where there is a cut or the webs of fibrin and the clot is

2. Cut
other injury to the skin. The blood eventually dissolved into the body.
clot, which consists of a combination Clots can also form in blood
If skin is cut, platelets in
the blood vessels of the of cellular platelets and sticky strings vessels due to inactivity, old age,
damagedarea become of fibrin, forms a plug in the damaged obesity, smoking, poor diet or
'sticky' and clump
together at the blood vessels. during pregnancy. This condition is
damaged site to form a The clot stops blood from freely known as thrombosis and can lead to
white clot. Other flowing out of the body and at the an embolism.
chemical reactions
createstickyweb-like
strands of fibrin that Old age, obesity and
adhere to the damaged smoking can lead to clots
blood vessel wall, to forming in blood vessels
form a red clot.

Strands of fibrin
Platelets

3. Healing
The blood clot stops
blood escaping from
the wound, and allows
the normal circulation
ofthe red blood cells
which transport
oxygen around the
bodyandthewhite
blood cells that protect
it against infection.
White blood cell
Red blood cell

103
 How fast is your
metabolism?
Metabolism doesn't
just affect your ability
to gain or lose weight
The basal metabolic rate iBMR)
measures how fast a person's
body uses energy !in calories)
while at rest. If you eat too many
calories, the body will store the
energy as fat for later use. Those
with a lowBMR burn fewer
calories while at rest and will
have a tendency to ga in weight.
Hormones play a key role in
metabolism - eg thyroxine is a
hormone produced by the
thyroid gland which affects the
speed of metabolism. An
overactive thyroid can result in
energy being used too fast,
resulting in hyperactivity and
weight loss. The hormone
insulin is released by the
The skin is the biggest organ pancreas in response to elevated
in our body and nutrients blood glucose - usually after
from our food are delivered meals. It pushes blood sugar into
through the bloodstream to
the skin to promote repair the cells and triggers an increase
and rejuvenation. in anabolic activities.
It's common for people to
blame a slow metabolism for
their weight problems, but
usually this is unsubstantiated
and more likely a result of poor
diet and lifestyle choices.

How metabolism functions

Metabolism is vital for life - if it stops, you die

M
etabolism is a series of chemical These nutrients enter the body's cells
reactions in the body, which through the blood and are used either to
convert the food we eat into the power the body, build muscle and repair
energy that we use for growth, movement damage or are stored for later use. So the
and healing. Metabolic reactions occur process of metabolism is the building up of
simultaneously to keep us healthy. tissues, muscle and energy stores and the
Metabolism begins with plants and breaking down of energy stores and fat to
photosynthesis - the process whereby a generate energywhen it is required.
plant absorbs energy from sunlight Anabolism !constructive metabolism) is
enabling it to create sugars from water and all about building and storing: it supports
carbon dioxide. We eat the plants, taking in the growth of new cells, the maintenance
this energy as carbohydrates, which of body tissues and the storage of energy for
release glucose into the bloodstream to use in the future.
fuel the body. Digestive enzym es break The reverse is catabolism !destructive
protein from food down into its individual metabolism), which produces energy for
constituents, called amino acids. Fats are cellular activity. Catabolism releases
converted into fatty acids, and glucose, mostly from carbohydrates and
carbohydrates become sugars, all of which stored fat, which provides energy to heat
are slowly released into the bloodstream as the body and enable movement on
part of the digestive process. demand.

104
DID YOU KNOW? The liver □/so produces proteins necessary for blood clotting and transporting nutrients □round the body

How does the

Toxins come in
many shapes and
sizes and must all

liver detoxify?
be processed by
the liver for
excretion

Optimal performance of the liver is

integral to preventing disease
T
oxins enter the body in food, toxins which have been absorbed
water, through the skin and by through the intestines. The toxins are
inhalation. These toxins - such either neutralised, or converted into a
as pesticides, pharmaceutical drugs, more chemically active form which is
chemicals and water-borne pollutants then neutralised, to be safely excreted.
- end up in our bloodstream, and our A healthy liver will manufacture
liver filters the blood to remove them. approximately one litre (1.75 pintsl of
Toxins are also created by biochemical bile per day to transport toxins out of
reactions in the body. Toxins affect us the body. If the liver is sluggish, toxins
in many ways, from drunkenness can build up, causing inflammation and
caused by alcohol to the side-effects of oxidative stress. Toxins which are not
certain medication. eliminated return to the bloodstream
The liver transforms fat-soluble and are eventually stored in fatty
toxins into a water-soluble form. This tissues where they pose less of an
enables them to be released through immediate threat. In the longer term,
the kidneys for elimination in urine, or however, the slow release of these
into bile for elimination through the toxins back into the bloodstream can
colon. Enzymes chemically break down lead to a number of diseases.

A LIVER LOBULE CLOSE UP�---- Central vein

Hepatocytes
Hepatocytes are the
The centralveinreceives blood
from the sinusoids and returns itto
The liver at work
Sinusoid Bile duct Hepatocyte
circulation via the hepatic vein.
predominant cells ofthe This blood vessel carries Bile is largely produced by Hepatocytes
liver, making up an nutrients and oxygen from breaking down cholesterol, manufacture bile and
estimated 80 per cent ofthe the portal and hepatic bile salts, water and secrete it into small
organ's mass. They perform arteries past the hepatocytes bilirubin -which is a channelswhich drain
metabolic and endocrine and back to the centralvein. product ofred blood cells. into the bile ducts.
functions as well as
detoxification.

Branch of
portal vein
Thisvein delivers
nutrient-rich
blood foruse by
the hepatocytes.

Branch of
hepatic artery
This artery delivers
oxygen-rich blood
foruse bythe
V
hepatocytes.

Branch of bile duct

This is a long tube-like Kupffer cell
Fat-storing cell Red blood cell
structure that carries bile, Kupffer cells partly line the
secreted by the liver and sinusoids and destroy
needed for digestion, These cells contain fat These cells carry

White blood cell

microbes and dead cells.
towards the intestine. which regulates local blood oxygen to the body's
flow to the hepatocytes. tissues. They contain
These cells are part of the Theyplay a keyrole in iron-rich haemoglobin,
immune system and help our repairing cells in the liver which is the pigment
bodies fight offinfection. when they're damaged. that makes blood red.

105
 Gastric bands
only work in
conjunction
with a strict
diet plan

Gastric bands aren't just for cosmetic purposes -

they can help to prevent health problems too

G
astric bands are inflatable circular
balloons that are placed around the
top of the stomach. They reduce the
total capacity of the sack-like organ, so when
the patient eats, their stomach wall stretches
sooner and tells their brain that they are full,
but with a smaller volume of food. This leads
to a lower daily calorific intake and, as part of
a controlled diet and exercise regime, results
in weight loss.
The band is typically placed with keyhole
(or laparoscopic) surgery, leading to smaller
scars, less pain and a shorter hospital stay.
However, patients first need a vigorous
workout. They must try and lose weight
through conventional methods and
medications, which may take up to six
months. All patients undergoing weight-loss
surgery must see a health psychologist too.
The patients should be mentally prepared
and positive that a gastric band will help
them slim down as part of a holistic approach
- for example, it won't work if they continue to
eat pizza and chips at every meal!
The band is placed in position in its
deflated state. Through a port placed just
under the skin, its size can be adjusted
incrementally, leading to a controlled rate of
weight loss; uncontrolled, over-quick weight
loss can be very dangerous.
As with any medical procedure, there are
potential risks and complications. The band
can slip or become too tight around the
stomach, leading to pain and visits to the
emergency department. In these
circumstances, deflating the band through
the port b eneath the skin solves most
problems in the short term.

"Over-quick
weight loss
canoe ver�
dangerous
106
 DID YOU KNOW? The first odjustob/e gastric bond wos patented by Dr Dog Ho/Iberg in Sweden in 1985

How healthy are you? Prior to any surgery,

patients must try
and lose weight via
The body mass index IBM!) is commonly used The disadvantage of the BM! system is that it non-invasive
to estimate a person's body fat. Itis utilised doesn't take into account people's differing methods like
around the globe, including by the World body proportions or muscle bulk. Athletes with exercise or drugs
Health Organisation. It estimates a person's lots of muscle, for example, would be classified
body size by dividing their weight by their as being overweight and thus unhealthy,
height squared lie BM! = weight in kilograms/ although they're probably very fit. Some
height in metres squared). The advantages are children who grow at different rates may be

.. .. . .. .
that it is easy to use, is the same for males and classed as outside normal ranges too, whereas
'
' '
females and, in adults, is age independent. In they are in factjustin a growth spurt. That's

. . . . . .. . . .
' ' children, it is used slightly differently and why BM! must be used in conjunction with the
correct values vary according to age. person's overall fitness and appearance, and
The BM! reading corresponds to categories of should be measured at several points overtime
underweight, normal, overweight and obese. to detect trends.

HOW DOES OBESITY

AFFECT YOU INSIDE?
Gastric bands don'tjustmake people look better. There
are serious consequences of obesity on the internal
organs, which have health implications that are very
expensive to treat. Thus gastric bands can improve
health and be cost-effective in the long term.

The heart What's the

Obesity reflects underlying high-circulating
triglycerides and poor health. This
'circulating fat' can block the coronary
altemative?
arteries, leading to angina or heart attacks All patients should start with a regime
!myocardial infarctions). of healthy eating and exercise before
considering surgery. Medications

The lungs
should be tried next and, combined
with the right lifestyle, most people will
When obese people have a layer offat lose weight and regain their health.
sitting on their chest wall, combined However, some people don't manage to
with fat from the abdomen preventing
complete expansion of the lungs, it can lose weight, despite trying hard, so
lead to breathing problems. This is worse surgery is the only option left.
at nightwhen lying flat and can cause An alternative to the gastric band is
sleep apnoea, where all breathing stops. the sleevegastrectomy. During this

The abdominal wall

procedure, most of the stomach is
removed, leaving a sleeve-shaped tube.
Everyone has a fatty layer on their In a similar way to gastric bands, the
abdominal wall. In obesity, this is patient feels full sooner, reducing the
often larger and it reflects what's calorific intake. Gastric bands are not
going on inside too.
permanent and can be removed, but

The muscles
they can also slip out of place. Sleeve
gastrectomies are permanent and won't
Everyone has rectus dislodge, but the procedure is more
abdominis (six-pack) muscles,
even ifthey're buried between
invasive and there are other potential
layers of fatty adipose tissue. complications that will need to be
discussed thoroughly with the surgeon.

The liver
During a gastric bypass, on the other
hand, a small pouch of the stomach is
Obesity can lead to fatty liver created which is connected to the small
disease (FLD), which in turn can intestine lower down. This has a
progress to serious scarring ofthe malabsorption effect, which ultimately
organ I known as cirrhosis).
means that fewer calories from what is

The pancreas
ingested are taken into the body.
There are other forms of intervention,
Obese people are at a higher risk of such as intragastric balloons, but not
developing diabetes, which is related enough evidence exists to assess them
to changes within the pancreas.
properly. Finally, abdominoplasty la
The kidneys
'tummy tuck') is a quick way to get rid of
some excess abdominal fat without
High levels of circulating fats can
block the arteries feeding the kidneys, changing anything inside; this is purely
causing hypertension. There are other cosmetic surgery though and has no
effects on the kidneys too, although internal health benefits.
these are not fully understood as yet.

107
How skin grafts work Skin graft surgery
When our body's largest
organ is damaged,
sometimes it needs a
helping hand to heal Gauze

S
A sterile gauze
kin grafting is a medical is applied while the skin
procedure where a portion of attaches and a new
blood supply establishes.
skin is removed and stitched
onto another part of the body. There
are many cosmetic and medical
reasons why this might be necessary:
serious burns, surgery, tattoo removal
and some medical conditions (skin
cancer or diabetes, for example)
might all necessitate skin grafting.
Autografts are skin grafts taken areas require
stapling.
from the patient's own body, usually
the buttocks, neck or back of the arm.
Depending on the size of the area that
it's removed from, it's then stitched or
stapled closed again and the new skin
applied to the injured area. Allografts
and xenografts, meanwhile -taken
from other humans and animals,
respectively-are temporary grafts.
But perhaps most interesting is the
artificial 'skin' called lntegra, made of
animal collagen that gives the
damaged part an organic scaffolding
for new skin to grow into. This is
usually used in cases of extreme
burns where there isn't enough
healthy skin for an autograft.
DID YOU KNOW? Estimates suggest that one in five people in the UK hove hypermobi/e joints

Hypennobile jo•nts
Are super-bendy people simply more flexible than the
majonty of us, or 1s tnere a physiological explanation?

T
here's always one in a but no life-threatening
group: the 'double­ complications. Marfan
jointed' person who can syndrome, on the other hand,
bend their thumbs back to can be much more serious: in
touch their wrists, or wrap their addition to limb dislocation,
legs behind their head. We sufferers of the more serious
often think of these people as form can experience problems
especially flexible, and with their vision, nervous
Itmaymake a cool
sometimes they are. But often system and potentially fatal party trick, but acts
hypermobile joints are heart problems, all as a result of like this can indicate
indicative of an underlying weakened connective tissues. serious maladies
medical condition. Clinical diagnosis of
Hypermobility syndrome hypermobility syndrome is
(HMS) is a combination of made using the Beighton score,
genetic conditions that lead to a nine-point criteria that
muscles, tendons and requires the suspected HMS
ligaments that are formed patient to attempt certain
differently, and are usually postures and thus confirm or
more fragile and prone to rule out certain conditions.
injury. Benign joint Treatment might include
hypermobility syndrome (BJHS) pain-killing drugs, although a
can be considered a low level of high level of fitness and a
hypermobility where 'bendy' healthy lifestyle will often help
joints can result in some pain in milder cases.

What is a fit?
Why do some people experience
these violent tiodi1y convulsions?

A
fit, also known as a seizure affected and can be as simple as a
or convulsion, focal seizure which might result
is when abnormal in eye rolling or muscle
electrical activity in the brain contraction, or as dramatic as a
changes a person's behaviour. 'grand ma!'. In the latter, the entire
This can be caused by many body can experience violent
things and take many forms, but muscle contractions and clenched
the most common 'fit' is one teeth for several minutes.
caused by epilepsy. Injury to the Sometimes the fit can halt
brain, drug misuse, breathing and leave the victim
birth defects and other with a blue pallor, making them
medical conditions can potentially life threatening.
all result in epilepsy, Seizures are sometimes
which causes the brain preceded by distinct tastes,
to become excitable and sounds or smells, called auras,
its neurons to send out and can have a number of triggers,
abnormal signals. including stress, fever and, in
Symptoms depend on some epileptic cases, flashing
the part of the brain lights like strobes.

109
+ HEALTH AND MEDICINE

Why do we
get angry?
Learn what happens when someone loses it. . .

A
nger is one of the six universal our emotional memories. Anger is a
emotions experienced by humans primitive form of self-preservation and it's
- the others being happiness, fear, the limbic system that invokes our natural
sadness, disgust and surprise. Our instincts such as the fight-or-flight
emotions are the response to fear. When a
largely unconscious stimulus triggers the
physical responses we amygdala, a flood of
have to stimuli. hormones - such as
While we use the adrenaline - is produced
cerebral cortex in the automatically to warn
brain to think logically the body to prepare for
and make judgements, action. Because anger is
anger is controlled by controlled by the
the limbic system, a emotional centre of the
group of structures brain - rather than the
buried lower down in 'thinking' part - an
the primitive regions of angry person can
the brain.A temporarily lose control
sophisticated network of their actions as well as
of nerve pathways the things they say. This
controls instinct and is why we often refer to
governs such emotions someone as 'losing it'
as fear and rage. We get angry to protect when they get really mad.
ourselves from danger if something We exhibit anger in a variety of ways,
threatens us, our belongings or anyone including facial expressions, raising of the
that we care about. voice and more aggressive behaviour.
Within the limbic system is the We communicate this emotion for others to
amygdala, a structure in which we store read and respond to.

Exploring the limbic system

Cerebral cortex Thalamus Caudate nucleus

Hippocampus Corpus callosum

Olfactory bulb

Cerebellum Reticular formation Amygdala

110
DID YOU KNOW? Some unfortunate people con even experience on allergic reaction to exercise

Anaphylactic shock
Learn about this potentially life-threatening condition and what can bring it on

A
naphylaxis, otherwise known as threat. When the substance (known as an
anaphylactic shock, is a potentially allergen) enters the body through the skin, Treating anaphylaxis
Anaphylactic shock can be serious, especially if
it's undiagnosed. Fortunately most people are
deadly allergic reaction. It can be inhaled into the lungs or ingested through the
brought on by any number of conditions, but it's mouth, the reaction between the allergens and aware of their allergies and can avoid the foods
usually triggered by ingesting food that the the immune system's antibodies releases a or substances that cause a reaction. Asthmatics,
for example, have an inhaler for when they feel
an asthma attack coming on. In emergencies, an
person is allergic to - such as nuts, eggs or number of chemicals from cells in the blood
shellfish, being stung by an insect, or coming and tissue. This includes histamine, which auto-injector device is used to shoot adrenaline
into contact with a particular drug or chemical. causes swelling in the contact area, although it into the thigh. The adrenaline counteracts the
symptoms of the reaction by constricting blood
vessels, which raises blood pressure, opens up
Signs someone is experiencing anaphylaxis can spread to the whole of the body depending
include respiratory difficulties, dizziness, red on the severity of the reaction. the airways and suppresses the release of
rashes and other skin changes, plus a form of Blood pressure falls and breathing can be histamine. The patient usually sees a very rapid
improvement once the adrenaline has been
administered, although they will generally
subcutaneous swelling called angioedema. restricted, especially if the swelling is around
Anaphylaxis is essentially an overreaction to the throat. In asthmatics, the allergic effect require supervision in hospital for a day or two to
a toxin, such as wasp venom, or a bad reaction takes place in the lungs, which is why an ensure the allergens are out of their system.
to a substance that the body perceives as a asthma attack is particularly dangerous.

Normal reaction Allergic reaction

4. Immune
1. Contact 2. Macrophages 1. Contact 2. Histamine 3. Angioedema
In the case of a wasp specialists As before, the allergens
The macrophages ingest The antibodies attach The allergic antibodies The histamine produced
sting, or skin contact the allergens and bring penetrate the skin and the produced attach to the results in excessive
allergy, the allergens themselves to immune allergic reaction begins.
them into the bloodstream. specialists - mastocytes mastocytes and swelling in the area.
penetrate the skin. basophils, but they
and basophils - and carry
the particles away. create histamine instead.

3. Antibodies
The macrophages present
the particles to the
immune T-cells
(lymphocytes), which
produce antibodies.
 -
Discover one of the most challenging of
all medical specialties. If you thought Let's look
rocket scientists had to pay attention to inside the
detail, wait until you meet this lot. . . skull . . .
T
here is still so much we and MRI scans allow for 3D ..
··•·····

-
don't know about the reconstructions and images that The skull
. ,,>___
,...:
human brain. However, if we couldn't have even dreamed of The skull is a rigid bony box
that surrounds and protects .
something goes wrong and it needs a few years ago. This allows
the brain. However, itwon't .·
an operation, you will find yourself neurosurgeons to plan the precise stretch to accommodate any
in need of a neurosurgeon. These timing and nature of surgery ­ increases in pressure inside,
so bleeding can rapidly :=·
guys can operate on the vast where to cut and how deep to make compress the brain.
number of structures within the the incision. The imaging falls
brain and spinal cord, and have a within a team approach to caring The pituitary gland
full arsenal of techniques and - for these patients, as the team is The pituitary is a gland that . •·
literally- cutting-edge just as important as the technology.
helps regulate the C
hormones in your body. If
technologies to hand. Surgery is becoming less it's producing too many
hormones and won't settle,
A neurosurgeon's workload invasive as time goes on. The surgery can be carried out
comes in two main forms. The advantages of this are smaller on it. .. via the nose.
emergencywork is often a result of incisions, less disruption to
road traffic accidents or fights, and surrounding tissues, less pain and
often affects young men with head shorter hospital stays. Surgeons
injuries. These patients may have now often use powerful
bleeding within the skull, which is microscopes with bright lights to
exerting pressure on the brain - help them remain as precise as
the neurosurgeon must relieve that possible. These microscopic
pressure. There is also the planned techniques require a huge amount
work, where neurosurgeons try to of skill, dexterity and hand-eye
remove tumours with meticulous co-ordination that would impress
detail to surrounding structures. even a fighter pilot.
The technology starts a long way New neuro-navigation
before the operation. Advanced CT techniques and robotic surgery can

The meninges
The meninges are thethree layers that surround the
brainandspinal cord. They help carryblood and
nutrients to and from the brain, but they can also go
wrong-tumours can develop fromtheir surface.

The brainstem
The brainstem is vital to keepyour lungs
breathing and your heart beating. Surgery
here isverydifficult, as it's so inaccessible.

112
DID YOU KNOW? Evidence shows thot people were operating on the brain □round 2□00BC ond the Stone Ages

"Advanced CT ond MRI

scans □/low for 3 □
reconstructions ond
images that we couldn 't
hove even dreamed of o
few years □go "

Why do you need

brain surgery?
Some of the common reasons for
performing brain surgery
Trauma
Often following road traffic accidents or fights, head injuries are
common - especially inyoung men. They can range from minor to life­
threatening. Sometimes surgerywon't help, but if the bleeding can be
stopped in time, you need a neurosurgeon.
Appropriate procedure: Craniotomy

• The grey matter

Procedure length: 1-4 hours
Recovery time: Weeks to months
u The grey matter contains complex areas of Effectiveness of procedure: Ifearly enough, completelyeffective. lflate, it

■■■■■ ■■■
memory, personalityand function. Surgery can be devastating.
�
\- here can have few effects, or it can have
j! devastating effects, such as taking away
Severity of condition: Difficulty of surgery:

Tumours
.' your memories or changing
.,
' your personality.

The ventricles
Brain tumours present themselves in a variety ofways -some people have
headaches, some have co-ordination problems, and some have no
The ventricles allowa special fluid - symptoms at all. Metastatic tumours, where growth is from another
cerebrospinal fluid -to circulate around the source !such as breast or bowel), are the most common type.
Appropriate procedure: Craniotomy or stereotatic surgery
brain. If theyget blocked, the brain can
Procedure length: 2-12 hours
swell rapidly and the pressure causes
Recovery time: Weeks

■■■■■ ■■■■
headaches as the meninges stretch.
Effectiveness of procedure: Ranges from no effects to severe effects.

The cerebellum
Severity of condition: Difficulty of surgery:

Cerebral aneurysms
The cerebellum controls your fine
movements. Surgery here can leave you
with balance problems. Swellings in the fine blood vessels within the brain can burst, leading to
life-devastating bleeding. Preventing the bleedingis the trick here.
Appropriate procedure: Endovascular coiling

Layers surrounding
Procedure length: 1-3 hours
Recovery time: Days

the brain
Effectiveness of procedure: If coiled before a majorbleed, it's likelyto

■■■■
provide an excellent outcome.
■■
Arachnoid Connective
Severity of condition: Difficulty of surgery:

mater tissue
Epilepsy
Skin Surgery for epilepsy isn't for everyone. In some cases, where medicines
Dura
can't control the fits, surgerymay be appropriate if the fits are arising from
mater
onearea.
Appropriate procedure: Temporal lobectomy
Procedure length: 2-4 hours
Recovery time: Days

■■ ■■■
Effectiveness of procedure: 950/o chance of success in selected patients.
Severity of condition: Difficulty of surgery:

Parkinson's disease
.
. ,';f:i·

Pia
,;,:-!::.:''
Some patients with Parkinson's disease will benefit from some extra

. mater
stimulation of their nerves. Implanting a special nerve 'pacemaker' isn't
easy, but this deep brain stinlulation can produce stronger signals.

Cranium
Appropriate procedure: Deep brain stimulation

- bone of
Procedure length: 2-4 hours

the skull
Recovery time: Days

■■■ ■■■■
Effectiveness of procedure: Medium to good.

Blood vessels in the White and grey

subarachnoid space matter of the l:>rain
Severity of condition: Difficulty of surgery:

113
The right
help brain surgeons get to the hard-to-access neurosurgery to be carried out with the
places, which previously would have been patient awake. However, there are pain
tools for inaccessible. Special scanning cameras and receptors in the skin, muscles and linings that

the job ...

computers are used during the operation and surround the brain, so it certainly isn't for
are matched to a pre-existing scan to guide everyone and it isn't performed everywhere.
Discover the
the surgeon's hand - much like the satellite Incredibly, there are bits of your brain that
navigation systems used by drivers. Neuro­ you can survive without- and you might not
equipment used endoscopy, which involves the use of tiny even notice any difference. It really depends
by brain surgeons cameras to access the brain, is opening up on which part of the brain is removed - if you
many new opportunities in brain surgery. were to remove even a small part of the
Incredibly, it's possible to access the brain via brainstem, for example, you would die
a tiny cut in the back of the nose, too. instantly. On the other hand, removing or
The brain is the network hub of the human cutting larger parts of the main brain can
body, co-ordinating all of the sensations we leave just a few effects, such as memory
feel and then providing instructions for the problems. However, these discoveries were
complex movements we perform. Although it often made at the peril of surgeons operating
receives all of the pain signals from the body, and experimenting on patients in years gone
the brain itself doesn't have pain receptors. by, which are now lessons confined to the
Guglielmi This means that there is potential for history books.
detachable coil
These platinum wires are fed
into small aneurysms
(enlarged arteries) within the
brain via an artery in the
groin. Once coiled up inside
the aneurysm sac, they
stop blood flow and thus
prevent bleeding.

Surgical
microclamps
These small clamps can be
used tograb tumours to
help the surgeon dissect
them away from
surrounding structures.

High­
performance
microscope
These powerful microscopes
with bright lights enable
surgeons to operate through
tiny incisions or keyholes,
which prevents damage to
those important
surrounding structures.

114
DID YOU KNOW? Parkinson's patients con hove tiny stem cells transplanted into their brains to stimulate new neurone growth

The right
tools for
the job. . .
Discover the
equipment used
by brain surgeons

Navigation
systems
This computer system
merges pre-operative CT and
MRI scans with intra­
operative information
gathered from lasers and
infrared. The result is a 'map',
which surgeons
use to navigate to
difficult-to-find tumours.

Burr-hole drill
Although not used much any
more in the Western world, a
drill is usedto evacuate
blood clots which form

Time critical! Scalp

around the brain following
accidents. They are still used
in some parts of the world.
A haemorrhage needs urgent
attention to save a life Dura mater

Clot
A bloodvessel has broken,
forming a clot (haematoma).

Under pressure
The clot is causing increased
pressure within the skull,
squeezing the brain. Haemostat
A vital surgical tool, a
Skull
Since the skull is rigid, the brain is forced downwards haemostatis a scissor-shaped
towards the only exit -into the spinal column. This device used to control
rapidly leads to death unless treated, as it damages the bleeding. They are locked in
vital brainstem. place via aseries of
interlocking teeth, which can
Life-saving bevariedaccording to the
In true life-saving surgery, a surgeon will cut
away a small piece of skull (craniotomy), clear amount of pressure needed.
away the clot and stop the bleeding.

115
How hypothermic Super-cold surgery
step-by-step

surgery works -
Hypothermic surgery requires
a deep understanding of how
cells work at a molecular level

1. Cooling
Cooling the body to extreme temperatures Using cold saline solutions
infused into the circulation
makes cutting-edge procedures possible

D
and ice placed around the
heart, the body's core
uring cardiac surgery, the heart will temperature is reduced.

2. Cardioplegia
sometimes need to be stopped to allow surgeons
to perform delicate procedures, such as replacing
A potassium-rich solution
valves. If left uncorrected, the subsequent lack of is used to paralyse the
oxygen supplywould lead to brain damage within heart muscles - a process
known as cardioplegia.

3. Cell membrane
minutes. Cardiopulmonary bypass can overcome most
of these effects, although it is technically not possible in
all patients. The cold temperature
Hypothermic cardiac surgery can now be used to stabilises ion transfer
across cell membranes in
overcome these limitations. The body is cooled from its the body, protecting them
normal 37 degrees Celsius !98.6 degrees Fahrenheit) to as from the low-oxygen state.

4. Warming up
low as 24 degrees Celsius !75.2 degrees Fahrenheit). Cold
saline solutions are infused into the bloodstream via the Once surgery is done, the
major vessels and the heart is surrounded by ice. This body is re-warmed slowly.
stabilises cell membranes and reduces the metabolic rate. The cells start to
re-function as oxygen
Once cool enough, the heart is stopped using a potassium­ returns to them.

5. Jump-start
rich solution. In this reduced oxygen-dependent state, the
body can temporarily survive without the heart beating.
The crucial moment comes
When surgery is completed, the potassium solution is when defibrillators are
rinsed out and the body re-warmed before the heart is placed against the heart's
restarted. Hypothermic cooling isn't without its risks, muscular wall and an
electrical current is used to
though; there is a chance that once a procedure is finished shock it back to a
and the body re-warmed, the heart might not restart. beating state.
DID YOU KNOW? Surgery to remove the tonsils, known os o tonsillectomy, is carried out under genera/ onoesthetic

What are
tonsils for?
What purpose do these fleshy lumps
in the back of our throats serve?

Tonsil
locations
Where you can find
the three pairs of
tonsils in your head

T
onsils are the small masses of flesh
found in pairs at the back of the throats
of many mammals. In humans the word
is actually used to describe three sets of this Palatine tonsils Lingual tonsils Pharyngeal tonsils
spongy lymphatic tissue: the lingual tonsils, These are the best­ The lingual tonsils are These are otherwise
known pair of tonsils, as found at the rear of your known as the adenoids
the pharyngeal tonsils and the more commonly they're clearly visible at tongue - one at either and are located at the
recognised palatine tonsils. the back of your throat. side in your lower jaw. back of the sinuses.
The palatine tonsils are the oval bits that ....-
hang down from either side at the back of your
throat-you can see them if you open your
mouth wide in the mirror. Although the full Lots of bed rest, fluids
purpose of the palatine tonsils isn't yet and pain relief like
paracetamol are all
understood, because they produce antibodies recommended for
and because of their prominent position in the treating tonsillitis
throat, they're thought to be the first line of
defence against potential infection in both the
respiratory and digestive tracts.
The pharyngeal tonsils are also known as the
adenoids. These are found tucked away in the
nasal pharynx and serve a similar purpose to
the palatine tonsils but shrink in adulthood.
Finally, the lingual tonsils are found at the
back of the tongue towards the root where it
attaches and, if you poke your tongue right out,
you should be able to spot them. These are
drained very efficiently by mucous glands and,
as a result, they very rarely get infected.

117
 Stem cell milestones
It's still early days, but stem cells show every intention of
keeping their promises. Pioneering surgeon Paolo Macchiarini,
based at Sweden's Karolinska Institute, carried out the first
organ transplant using a windpipe grown from adult stem cells
in 2008. Since then, he has built new tracheas for several
patients using a synthetic scaffold.
Research i nto therapy for type-I diabetes has also made
impressive progress. Sufferers' lymphocytes (a key part of the
body's immune system) attack the pancreas, preventing the
production of insulin. Exposing them to healthy lymphocytes
grown from cord blood stem cells, however, appears to
're-educate' them, limiting their harmful behaviour.
Induced pluripotent stem cells (otherwise known as iPSCs)
obtained by manipulating mature specialised cells could well
resolve the ethical controversy which currently restricts
embryonic stem cell research.
DID YOU KNOW? So/omonders' impressive stem cells mean they con regenerate their legs, heart, brain, spine and more

What can ESCs

be used for?
1. In vitro
fertilisation (IVF)
Inside an unassuming bundle of
embryonic stem cells lies a
great deal of medical potential ... Egg and sperm meet in
the lab. The fertilised
egg develops through a
process of cell division.
3. Blastocyst
A week after fertilisation,
embryonic stem cells can
be extracted from the 2. Morula
early-stage embryo. During the first few
divisions, all the
resulting cells remain
undifferentiated.

4b. Lab culture

Under the right conditions,
these stem cells can give
4a. Differentiation rise to any type of cell
By altering the cells' genetic found in the human body,
material or their environment, including skin, muscle,
scientists are able to blood, neurons and bone.
manipulate cell differentiation.

5a. Muscle cells

5c. Bone grafts
5b. Neurons
Scientists believe muscle
cells grown from stem cells Embryonic stem cells could
could slow the progress of Healthy brain cells grown be used to grow bone grafts
muscular dystrophy and even in the lab could treat which may eventually help
repair damaged hearts. Parkinson's, multiple patients with breaks,
sclerosis and spinal injuries. fractures or birth defects.

Stem cells to the rescue

Allowing researchers to watch cell specialisation Parkinson's. Trials suggest, for instance, that
unfold before their eyes, stem cells deliver injecting failing hearts with stem cells could grant
unprecedented insight into many diseases and them a new lease of life.
birth defects. Stem cells share many traits with Tissues made from stem cells may also enable
cancer cells and could therefore reveal some of new medications to be tested on human cells in
their secrets; some speculate that cancer may the early stages of drug development. One day,
even be driven by out-of-control stem cells. entire organs might be grown in the lab from
Many future treatments aim to harness stem patients' own stem cells, dramatically cutting
cells' regenerative properties. Healthy cell and waiting lists for organ donors. In the meantime,
tissue transplants could patch up patients with a scientists need plenty more time to research the
variety of different complaints, from diabetes to finer details of controlling cell differentiation.
'
119
Colour
blindness
Why do some people have trouble
distinguishing between colours?

T
he human eye has three
types of light-detecting cone
cells, which contain
pigments sensitive to different
wavelengths of light: long (redj,
medium (greenl and short (bluej. The
differences in the overlapping
signals from all three are used by
the brain to perceive colour.
Colour blindness occurs when one
or more of the cone cells do not work occurs much less frequently.
properly. The most common form of Research has shown that
colour blindness (which accounts for individuals unable to use colour to
over 95 per cent of casesj affects differentiate between objects
perception oflight at longer develop superior visual skills with
wavelengths, leading to difficulty regard to identifying texture and
distinguishing between red and shape. This enables them to see
green. Yellow-blue colour blindness 'through' colour camouflage in a
occurs occasionally, and a few way that people with normal
people can't see any colour at all. three-colour vision cannot.

What causes stomach ulcers?

Originally thought to be the result of stress, we now know that bacteria are the culprits ...

N An ulcer in the making Helicobacter pylori Gastrin

ormally a thick layer of
alkaline mucus effectively Once bacteria breach the stomach lining, 1t can Bacteria burrow through The inflammatory
no longer protect itself from its acidic contents ... the mucus in the stomach response increases
to escape damage by acid. production of the
protects the cells lining the

Neutralising
stomach from the low pH of stomach They stick strongly to the hormone gastrin. This

stomach acid
acid. If this mucus becomes cells of the interior lining. in turn stimulates the
formation of more
disrupted, however, acid comes into H pylori break down urea stomach acid.
contact with the organ's lining, to make ammonia. This
is used to produce
bicarbonate to neutralise
damaging the cells and resulting in
an ulcer. dangerous stomach acid.
Around 60 per cent of stomach
ulcers are caused by inflammation

Ammonia
due to chronic infection by the
--:--:----.
The ammonia made by
bacterium Helicobacter pylori.
Bacterial by-products cause damage the bacteria as a defence
to the cells lining the stomach, against acid damages the
cells lining the stomach,
causing inflammation.
causing a breakdown of the top
layers of tissue.

Enzymes -----�=�--�-... Damage

Non-steroidal anti-inflammatory

H pylori produce proteases As the cells become

drugs (NSAIDsl, like ibuprofen and
aspirin, also cause stomach ulcers in and phospholipases damaged a wound opens
large doses. They disrupt the enzymes that damage up in the stomach wall. If
the proteins and cell this becomes deep enough
membranes of the it can perforate blood •
enzymes responsible for mucus
production, diminishing the stomach cells. vessels causing bleeding. �
protective barrier.

120
DID YOU KNOW? The chickenpox vaccine wos developed byJoponese physician Michioki Tokohoshi

Understanding
chickenpox
Discover the biology behind the infamous
childhood ailment and why it never really
goes away. . .

C
hickenpox is a strain of the Varicella accompanied by a fever. The blisters burst, scab
zoster virus, which many of us have over and fall off within a few days, but new
experienced during our youth. Most waves of spots can emerge to replace them; it
prominent in children under ten, the virus is usually takes one to two weeks for the body to dormant
contracted through coughing and sneezing or regain control. Chickenpox is rarely serious but state within
transferred on shared objects, which makes it is important not to interfere with the scabs as the body as your
schools a prime location. infection can make it more severe. immune system keeps it under
The most famous symptom is the appearance A vaccine is only offered in extreme wraps. The infection can break out again later
of small itchy red spots, which vary in size from circumstances when an individual may have a and reappear as shingles. A rash builds up on a
10-20 millimetres (0.4-0.8 inches) across. The weak immune system or be particularly certain point of the body and the symptoms
extent can vary but in most cases they cover the vulnerable to the disease. return, most commonly in people over 50. On
face, arms, legs, stomach and back. These After the outbreak, chickenpox doesn't average, three in every 1,000 people contract
develop into fluid-filled blisters and are often disappear entirely. The disease lies in a shingles in the UK each year.

When chickenpox strikes back... Grown-up

Get under the skin to see how shingles can catch the body unawares
chickenpox
90 per cent of adults are immune
if they've had the disease as a
child but it still affects adults and
teenagers. If you develop
�---11-----+------- Blisters emerge chickenpox at a later age, all the

Start of the illness ---------�

Blisters become visible and symptoms are more severe, with
inflamed rashes appear on more chronic pain, headaches and
The virus infiltrates the all affected areas. sore throats; therefore, there is
skin and causes greater need for treatment, such
inflammation and a as pain relief and soothing creams.
burning sensation. The disease tends to affect
adults more dramatically as it can
now mutate into a variety of other
strains, such as shingles or, in
extreme cases, lead to
Don't scratch! encephalitis, postherpetic
The blisters then neuralgia or pneumonia. However,
harden into scabs and the chances of this happening are
fall off. Scratching at only around ten per cent.
the spots makes the
healing process slower.
Low immunity ,_.,________,,
The Varicella virus
becomes active -'-----+- Future effects
when the immune In around 10-20 per
system is weak, cent of people who
overcoming the have shingles, the
body's natural nerve fibres become
defences. damaged which can
lead to postherpetic
neuralgia (nerve pain).

Dormancy ------'...---------'
Once the immune system regain
control, the virus retreats and lies
dormant in the body's nervous
system, but it can return later.

121
The war against
superbugs
Learn how bacteria will hide, change, lie and
How antibiotic
resistance
cheat to evade antibiotics and secure their survival develops
B Normal function
acteria are vital to our survival. They the few bacteria left over are the strongest of the
help us digest food, keep our skin clean bunch and are resistant to the current crop of
from more harmful organisms and help antibiotics; this is true survival of the fittest. Antibiotics target
bacterial cells, by
develop our advanced immunity while we're The lasting bacteria then multiply, become changing the signals of
young. However, they can also cause disease, stronger and are able to survive attacks from their outer wall, their
which ranges from simple eye infections to other antibiotics. This is known as 'multidrug membrane shape,
impairing DNA function
life-threating illnesses. resistance' and has led to certain bacteria being in the cell or by blocking
Antibiotics were discovered in 1928 and ominously called 'superbugs.' protein synthesis.
almost overnight they changed what were once Over the last 30 years, it's been stated that too

Changing the
fatal diseases into trivial infections. But despite many antibiotics have been prescribed, which

landing zone
effective medication, bacteria are smart and has contributed to this resistance. This is why
know how to fight back. They can change their doctors no longer give antibiotics for simple
shape, hide in plain sight and alter their surface colds; they have no effect on viruses but Bacteria can change the
shape and structure of
appearance. After an attack from antibiotics, contribute to antibiotic resistance. the molecules that
antibiotics target,

The revenge of the superbug meaning they can't

recognise them and
rendering them useless.
How the toughest bacteria are taking over

Bottom of the Resistance

food chain in humans One in, one out
Modern farming Antibiotics given Antibiotics enter
techniques mean for simple bacterial cells via
animals are given illnesses lead to special pumps. The
antibiotics to keep resistance in bacteria can develop
them healthy. They healthy people. more exit than entry
subsequently develop pumps, meaning the
resistant bacteria in antibiotic is exited faster
their guts. than it can enter.

Realm of the
superbug
Entry policy
The remaining bacteria are

Entering
now resistant to even the

hospitals
strongest antibiotics and are Bacteria can stop
called superbugs. They antibiotics entering:
spread as patients move and As patients enter and they can change the
shape of entry pumps

Entering our
on healthcare staff who go leave hospitals, these
and reduce the size of

food chain
between patients. tough bugs start
growing in wards and pores in their surface,

Community
nursing homes. meaning the antibiotics

resistance
The resistant bacteria are too large to enter.
in food and vegetables
can remain in the
human gut once we've
Community resistance

Inactivation
gradually develops,
eaten them. helping the toughest
bacteria to establish
and spread. The strongest bacteria
develop special

Crop circles Weak targets Future strategies

enzymes, which can
destroy the key parts of
Fertiliser used on They cause infections, Doctors only prescribe an antibiotic before
crops contains animal

,
secondary to the main antibiotics for as short they have a chance to
take effect.

,
matter, which also reason the patient is in a time as possible. New
contains the resistant hospital. Doctors treat and smarter antibiotics
bacteria, increasing

J l'
these, but some tackle even the
their spread. bacteria still remain. toughest of resistance.

122 J
DID VDU KNOW? Around one in six of the UK population is believed to hove some form of hearing loss

Curing
Hearing loss can
occur due to old
age or damage
to the ear

deafness
We're getting ever closer to How ears work
restoring the gift of hearing How do our ears turn invisible

T
waves into sound?
here are more than 250 million people in
the world who suffer from hearing loss
Making waves
or deafness, but it seems there is hope Noise travels in waves, which enter
for them now. the eardrum, either directly or guided
Humans are able to hear things thanks to there by the grooves in your ear.
thousands of tiny hairs just inside their ears
To the brain
that vibrate when sound waves hit them. These electrical signals get
Sensory hearing loss occurs when they die or sent to the brain where the
vibrations get transmitted Organ of Corti
into sounds. This tiny organ contains
become damaged, meaning that they are no
longer able to perform that action. This usually thousands of tiny hairs
happens when the ear has been subjected to that sense the impulses
and convert them into
electrical signals.
loud noises or the hair no longer regrows, often
due to old age or natural degeneration.
Fortunately, scientists have been working
hard to reverse that process. A study by British
scientists has found that there is a protein
contained in the body called Notch that stops
new ear hair cells growing from stem cells.
They have developed a drug that blocks this
protein, meaning the body can regrow those
crucial ear hairs.
A second experiment carried out by the
Cochlea
University of Kansas injected a harmless virus The waves move
Atohl to the cochlea
This gene is contained in a
into the ears of patients, which had a gene
where they enter
called Atoh1 in it, which stimulated the growth harmless virus injected the organ of Corti.
of the sensory hairs. into the cochlea.
While we are still an awfully long way from
being able to cure deafness from birth, these
developments mean that people who have
steadily lost their hearing could soon have it
back, as loud and clear as ever.
Damage -----t--t-----....::::,,,--=w.,&....=�
Loud noises can wear
Help for hearing away the hairs, which don't
regrow as you get older.
While the prospect of regrowing sensory hair
cells and curing deafness is really exciting, there
have been ways of helping people hear for a long
while now. Ear trumpets were used in the 17th
century as a popular way of helping people hear
as they provided a much wider area for the
sound waves to get trapped in. .------ Regrow
Nowadays, digital hearing aids are the norm. The injected Atohl gene
They are placed in the ear and a receiver stimulates the formation
registers the sound wave. A silicon chip then of new hair cells.
converts the sound waves into electrical signals,
which are then released into the ear. They are
basically just a way of capturing sounds the ear
wouldn't have heard otherwise.
Failing that, cupping your hand behind your t-\-1---+---- Back to normal
ear gives you an extra 12 decibels of sound, so New hair cells replace the
you can try that as a small temporary boost if dead ones, helping people
you're in a loud room! to hear again.

123
DID YOU KNOW? Men who hove recovered from Ebola con still transmit it through their semen seven weeks ofter recovery
+ HEALTH AND MEDICINE

How enzymes
keep you alive
The proteins that speed up your body's
chemical reacti ons

E
nzymes increase the undergoes a reaction such as
speed of reactions inside dividing or merging with
cells by lowering the another molecule without
energy-activation requirement having to expel energy in a
for molecular reactions. collision with another molecule.
Molecules need to react with The enzyme releases it and
each other to reproduce, but our floats on within the cell's
bodies provide neither the heat cytoplasm. The molecule and
nor the pressure required for active site need to match up
these reactions. perfectly in order for the
Each cell contains thousands sped-up reaction to take place.
of enzymes, which are amino For example, a lactose molecule
acid strings rolled up into a ball would fit into a lactase enzyme's
called a globular protein. Each active site, but not that of a
enzyme contains a gap called an maltase enzyme. Interestingly
active site into which a molecule enough, enzymes don't get used
can fit. Once inside the crack, up in the process, so they can
the molecule -which becomes theoretically continue to speed Enzymes such as
trypsin work to help
known as a substrate- up reactions indefinitely. break down proteins
DID YOU KNOW? Studies show thot over 70 per cent of schoolchildren don't drink enough water during the doy

How to
check
You can check
your pulse on your
neck or wrist

your pulse
See whether you have a
regular or irregular heart rate

Beats per minute

Count the number of beats
per minute using the second
hand on a watch. The
average resting heart rate is
between 6O-lOObpm.

Light pressure
Use gentle pressure to
feel for your pulse and
reposition your fingers
if necessary.

Finger position ------------�

Place your index and
middle finger just below
the wrist crease and base
of the thumb.

C
hecking your own pulse is a good way your other hand below the crease of the
to keep track of your heart rate. wrist, in line with the base of your thumb and
Monitoring it while you're resting is the next to the tendon. Use gentle pressure and
best way to get an accurate reading, as rhythm feel carefully for a beating pulse. If you're
can increase at different times during the day, checking your pulse in your neck, place the
especially when you're exercising. same two fingers just b elow the jawline next
It's possible to check your radial pulse on to your windpipe.
your wrist or on your neck. This is because Once you've located your pulse, use the
arteries pass close to the skin in these areas. second hand on a watch to count the number
To take your wrist pulse, simply turn over one of b eats per minute. A normal resting heart
of your hands so that the palm is facing up. rate for an adult should be around 60 to 100
Now place the index and middle finger from beats per minute.
Understanding
diabetes
Peek inside the body to see
5 Extreme levels
Unusable glucose is excreted
in the urine but over time
continuously high levels can
damage organs such as the eyes.

2 Absorption
The glucose, which
what happens when blood is an energy source for
body cells, moves into
sugar gets out of control the bloodstream.

G
orging on a rich, moist piece of chocolate
cake is a guilty pleasure for many, but
people with diabetes have to think twice
before taking a bite. Diabetes is a long-term
medical condition where the body can't process
sugar in the bloodstream properly, so sweet
treats can be dangerous for more than just
their waistline.
Sugar in the blood comes from what we ! Digestion
The stomach breaks
down the food that has
eat and drink and is regulated by the
hormone insulin, which is produced by been eaten to release
glucose (shown in blue),
a type of sugar.
the pancreas. This organ is about 15
centimetres long and located behind
the stomach. The pancreas mainly
secretes digestive enzymes, but a
small part produces hormones.
Insulin is produced by beta cells,
which are clustered in groups called
the islets of Langerhans (named
after the scientistwho first
described them).
In diabetes, the normal process of
producing insulin and regulating
3 Signalling insulin
Normally, rising blood glucose
4 Glucose build-up
Without insulin to let
would be detected and the the glucose into cells, the
pancreas would produce insulin glucose levels in the blood
blood sugar goes awry. This can

(shown in green), but in type 1 build up, leading to

happen in two different ways. In type 1 diabetes,
the pancreas doesn't produce any insulin diabetes no insulin is produced. hyperglycaemia.
because the body's immune system attacks the

Insulin unlocks the

beta cells and kills them. In type 2, not enough
How
glucose channel
insulin is produced, or the body becomes

l
resistant to insulin and is unable to respond to it. insulin works Glucose
Both types can lead to high blood sugar levels Sugar, i n its simplest form as Insulin Glucose channel
glucose, is an energy source Glucose (open)
channel
called hyperglycaemia, which can damage the
for our body's cells. It moves
into cells most efficiently (closed)
eyes, kidneys, nerves and blood vessels over time.
The symptoms for both types of diabetes when a signal is given by the
include extreme thirst, urinating more hormone insulin. When blood I
glucose rises after a meal,
insulin is released from the
frequently, tiredness, unexplained weight loss,
blurred vision and the slow healing of cuts. Both pancreas into the bloodstream
types can develop at any age, but type 2 diabetes and acts like a key to unlock
and open the glucose channels
on the cell surface, allowing
is much more common, and is often associated
with obesity. glucose to enter. When there
There is currently no cure for diabetes. People is no insulin or the cells can't
respond to it, the levels of
sugar in the blood build up,
with type 1 diabetes have to control their blood
sugar for the rest of their lives by monitoring the leading to hyperglycaemia.
Conversely, when blood Insulin
receptor Body cell
levels and injecting insulin. People with type 2
glucose gets too low, it is
known as hypoglycaemia.
diabetes have to make lifestyle changes, and
often need to take medication.

128
DID YOU KNOW? 3.5 million people in the UK ore diagnosed with diabetes, ond o further 549,000 hove it but ore not yet diagnosed

Diabetes and exercise

Exercise can cause blood glucose levels to fluctuate,
though this is less drastic in people with type 2
d iabetes than those with type 1. Low blood sugar
(hypoglycaemia) can occur because muscles use
glucose as energy and the body becomes more
sensitive to insulin. High blood sugar (hyperglycaemia)
can be triggered by other hormones, such as
adrenaline, which are released during exercise.
Maintaining an optimal blood sugar target in type 1
d iabetes requires balancing the insulin dose with what
the person eats and drinks and the amount of exercise
they do, taking into account external factors like
temperature. Everyone's diabetes is different and
individuals react differently to exercise. Physical
activity, however, can help improve blood glucose
management and the efficient working of insulin.
Cycling is a physically challenging endurance sport
and Team Novo Nordisk, an all-diabetes pro-cycling
team, must monitor their blood glucose before, during
and after racing with a continuous glucose monitor.
The cyclists will 'carb-load' (eat high carbohydrate
foods) before a race and will have a high-carbohydrate
drink afterwards. During a race, riders frequently
check their blood glucose. If their blood sugar is above
target, they may take medication to lower it, and if the
level is below target, they may consume a
carbohydrate-rich food or drink to bring it back up.

Type 2 diabetes 2 Absorption

4 resistance
1nsulin
The glucose, which Despite the insulin, the
is an energy source for glucose channels don't
When cells stop responding to
body cells, moves into unlock and most of
insulin, blood sugar levels rise
the bloodstream. the glucose can't get
"High blood into the cells.

sugar levels con

domoge the
eyes, kidneys,
nerves ond
blood vessels
over time "

! Digestion
The stomach breaks
down the food that has
been eaten to release
glucose, a type of sugar. 7
5 More insulin
production
At first, the pancreas
responds by producing
more insulin, but it
cannot sustain this for
a long period.

3 1nsulin
production 6 Glucose build-up
The pancreas produces As insulin production
insulin, which moves with slows, the levels of glucose
the glucose through the in the blood increase,
bloodstream to the leading to hyperglycaemia.
body's cells.

129
+ HEALTH AND MEDICINE

Perfect posture
Find out how being a serial sloucher
affects more than just your spine

C
hances are most of you reading this aren't knees and ankles. This correct positioning
sitting or standing properly. Students and may take some practice, but as you retrain your
office workers know only too well how muscles it becomes second nature.
easy it is to slip into a slouch while spending all In addition to putting stress on your bones and
day working at a desk. This prolonged poor muscles, bad posture affects how efficiently we
posture puts stress on the neck, shoulders and breathe. Hunching the shoulders restricts the
spine, contributing to problems such as postural amount by which the rib cage can expand,
hunchback and spinal misalignment. reducing lung capacity by as much as 30 per cent.
Good posture ensures that you can stand, sit Poor posture has also been linked to
or lie down in positions that put the least strain neurological issues and heart disease.
on your body's muscles and ligaments. A quick A surprising side effect of posture is that it can
way to check your posture is to make sure your change how people think. A study by Ohio State
earlobes are aligned over the middle ofyour University in the US found that people who sat
shoulders, your shoulders are in line with your up straight exhibited a more confident and
hips, and your hips are directly above your positive outlook than those who slumped over.

130
DID YOU KNOW? Corrective lenses ore prescribed by someone co/led on optometrist

How corrective
lenses work
An important tool for sight deficiencies, corrective
lenses restore 20/20 vision and reduce eye strain

I
n optics, a lens is a transparent substance highly complex profile. This allows bifocal and
(usually glass) that is used to form an image trifocal lenses to be produced, where different
of an object by focusing rays of light to a parts of the lens are shaped and hold powers
designated point. In eyeglasses, lenses are used suitable for various distances of focus.
to correct a wide variety of eye defects including
myopia, hyperopia and astigmatism. This is
achieved by shaping the lenses into various
optical profiles, the most common of which is
ophthalmic convex-concave. Here, both the
front and back of the lens surface has a positive
radius, resulting in a convergent front surface
and divergent back surface. This difference
creates the corrective power of the lens, so in
order to treat hyperopia a convergent lens is
used, where the front surface is stronger than
the rear (narrowing the incoming light's focus);
for myopia, the reverse is used, with the rear
surface holding a greater magnitude (widening
the light's focus point).
Modern corrective lenses can be formed with
multiple spherical surfaces, granting them a

How lenses can be used to treat myopia and hyperopia

Myopia (short­
sightedness)
A refractive defect of the eye in
which collimated !parallel) light is
forced to produce images in front
of the retina instead of upon it,
myopia is treated through the use
of a concave lens. This causes
incoming light to enter the cornea
at a different angle and diverge on
the retina.

Hyperopia (long­
sightedness)
Avision defect usually caused by
the eyeball being too short or its
cornea not being rounded enough
during development, hyperopia
causes difficultyin focusing on
nearobjects. ltis treated bythe
application ofa concave lens,
which adjusts the focus of
incoming light so it accurately
displays on the retina.

131
 Reshaping
Glasses or contact lenses As the cornea is curved,
can correct vision by they will slice a bit off the
bending the light rays as front so the light isn't
they enter your eye. This refracted so much and
helps the rays to focus on can reach the retina at the
the retina so we can see.
DID YOU KNOW? Eye surgeons ore co/led ophtho/mo/ogists, which is Greek for 'study of eyes'

The newest technique on

the market i sto implant a
lens into the eye, which
does much the same as
glasses and doesn't
reshape the cornea.

The lens is also responsible

for bending light. As it
travels through, it will hit
The cornea the curved lens of the eye
The very front of the eye is and continue bending. This
curved in order to bend is not involved in laser eye
light towards the retina. If surgery, though.
this is too curved, light is
overly bent and doesn't
reach the retina.
 I

Food & your body

144 The science of happiness
u+8 The gut-brain axis
150 The five basic human tastes
151 Unravelling the
mystery of DNA
152 Correcting heart rhythms
152 Carpal tunnel syndrome
153 What are pheromones?
153 Eczema explained
154 Inside the flu
156 How we swallow
156 Why do we get drunlc?
157 The human tongue
157 How do we laugh?
158 What happens when
you sneeze?
158 l{nee-jerk reactions
explained
159 How do we touch and feel?

134
\
150
The five basic
human tastes

How do we touch
and feel? 159 144 The
science of
happiness

135
 Join us as we unravel all
nine metres of your
digestive system

T
he digestive tract is a long, muscular tube that
runs the entire length of your body. It is separated
into five distinct sections, each with its own
particular and specialised function.
Digestion begins in the mouth. As you chew your food,
saliva is released, providing a slippery lubricant and
kick-starting the break down of carbohydrates with an
enzyme known as amylase. Touch receptors in your
mouth tell you when it is time to swallow, and as your
tongue comes upward, the food is pushed to the back of
your throat.
As you swallow, you pass control of digestion over
to your automatic motor functions. A flap of skin
called the epiglottis folds down to cover the voice
box, and the entrance to the lungs, and then a
wave pushes the mouthful all the way down
the oesophagus. When the food reaches
your stomach, it passes through a ring of
muscle known as the cardiac sphincter,
which prevents it from coming back out
the way it came in.
The inside of the stomach is a hostile
environment, where the cells lining the
walls pump out hydrochloric acid and
protein-digesting enzymes. The
presence of food triggers stretch
receptors in the stomach lining, which in
turn trigger a series of rhythmic
contractions. These churn the stomach
contents, mixing in the acid and enzymes, grinding
down the food.
At the bottom of the stomach there is a second ring of
muscle called the pyloric sphincter, which acts as a
gatekeeper to the small intestine. The sphincter prevents
DID YDU KNOW? Biologic□/ washing powder uses digestive enzymes to break down the stains on dirty laundry

anything larger than about two centimetres 10.8

inches) in diameter passing through, returning Journey of
it to the body of the stomach until it has been
ground down further. This ensures that by the
your food Saliva makes each mouthful
It can take up to 48 slippery, allowing it to slide
time it reaches the small intestine, your food is easily down the oesophagus
hours for a meal to travel
a runny, slightly lumpy paste, and is ready for through your body to the stomach.
the next stage of digestion.
The small intestine is the site of chemical

Add acid and enzymes

digestion. Here, the pancreas adds digestive

Chew
enzymes, and the liver adds a generous squirt The stomach produces
of alkaline bile, delivered via the gall bladder. hydrochloric acid, and
This bile not only neutralises the burning Digestion begins in the protein-digesting enzymes.

Add more enzymes

stomach acid, it also acts a little like washing­ mouth, where our teeth start
work on grinding food into
up liquid on dirty dinner dishes, helping to manageable chunks.
The pancreas produces

Add bile
separate the food particles and forcing fats to
digestive enzymes, which are
disperse into tiny bubbles. added to the mixture as it
Muscles in the small intestine continue to As the liquid passes into the enters the small
squeeze and mix the contents together, intestines, stomach acid intestine.
is neutralised by
allowing the enzymes to get to work inside the alkaline bile from
paste. As the nutrients are released, they are the liver.
then absorbed over the walls of the intestine
and into the bloodstream.
To ensure that everything keeps moving
through the system, every five to ten minutes a
wave of muscle contractions begins at the
stomach and travels all the way down the
intestines. Known as the migrating motor
complex !MMC), this wave squeezes the
digestive system like a tube of toothpaste,

Ferment waste
urging its contents further toward the colon.

----- Churn
As the food progresses through the system to
the small intestine, more and more of the Bacteria living in the
large intestine help The muscles of the
nutrients are released by enzyme activity, and with the breakdown of
waste, releasing even
stomach rhythmically
by the time it reaches the large intestine, most
more nutrients.
churn its contents,
of the useful material has been absorbed into mechanically breaking

Absorb nutrients
the bloodstream. However, the digestive the food down into a
lumpy paste.
process is not yet over, and here, bacteria help As the enzymes begin to
to break down even more ofwhat's left of the release nutrients, they are
undigested food. absorbed across the lining
of the small intestine into
The large intestine also absorbs most of the the bloodstream. ----

Get rid of waste Remove water

remaining water, leaving behind a combination
of undigested material, dead cells and bacteria.
When the waste has completed its journey All that is left at the The large intestine
through the large intestine it goes to the rectum end of the digestive absorbs excess
process is a water from the
for storage until there is a convenient time to get combination of food as it passes
rid of it. indigestible material, through.
dead cells and bacteria.
Sense Anatomy of a
human tongue
of taste
Circumvallate papillae
These large bumps are found at the
back of the tongue, each surrounded
by a dip that collects saliva.
Contrary to popular belief, all five tastes can
be detected almost anywhere on the tongue

Taste tells us whether our Muscle Blood supply

food is safe to eat, but smell There are eight The tongue receives
muscles in the blood from the lingual
gives it flavour tongue that alter artery and it drains out
its shape and through the lingual veins.
The human tongue is able to detect five change its position.
different tastes: sweet, sour, salty, bitter and
umami !savoury), providing us with a quick
way to distinguish between different types Nerves
The front and back
of the tongue send
of food. Sweet foods contain sugar and are a
good source of energy. Salty foods provide
Posterior taste information to
sodium, which is vital for nerve function, but tongue the brain.
deadly in high quantities. Bitter foods might About a third of the
tongue is hidden
right at the back of
contain poison.
Babies are born with a natural preference for the mouth.
sweet food and a dislike of bitter, providing a
biological safeguard that encourages them to
eat safe, high-calorie food. However, nutrition
is not that simple. Many vegetables are bitter Papillae Foliate
The tongue is
papillae
These contain
but not poisonous and so learning to like them
covered in tiny
taste receptors
bumps, but not all
comes with experience.
and are located on
The degree to which we can detect different of them contain
the back edges of
taste buds.
the tongue, where
tastes varies, and appears to be dictated by our
individual anatomy. The p opulation can be saliva drips down
broadly divided into three categories based on the cheeks.
Filiform papillae
the number of taste buds on their tongue. Most of the tongue is
covered in thin, rough
bumps that contain no
Those with the fewest are known as 'non­
Anterior tongue
taste receptors.
The visible part of the
tasters', those with an average number are
tongue is responsible for
known as 'tasters', and those with many more
taste buds than the rest of the population are the majority of taste
'supertasters.' Supertasters are especially detection.

sensitive to taste and will react much more

strongly than the rest of the population. As a
Gustatory hair
result, they tend to really dislike bitter foods Each taste cell ends with a
like green vegetables and coffee, and often shy tiny hair, covered in
receptors that allow it to
detect chemicals dissolved
away from rich desserts and sugary sweets.
Though these anatomical differences can in the saliva.
explain some of our food preferences, most of What is a
our individual likes and dislikes are not down
to taste, but to flavour; the combination of taste
taste bud? Basal cell
Ageing or damaged
Pore taste cells are replaced
A tiny gap at the top of the by the basal cells
and smell.
The act of chewing food releases chemicals taste bud allows saliva to waiting underneath.
known as volatiles, which evaporate rapidly. touch the taste cells.
As we swallow, some of the air inside the
mouth is forced up toward the nose, carrying Sensory cell
Support cell Each cell is sensitive
The taste cells are to one of the five
these volatiles with it. Here, they bind to
receptors on olfactory cells, triggering sensory surrounded by an tastes, but all types
messages to the brain. envelope of non-tasting are found together in
support cells. a single taste bud.
Recently, scientists have found that these
olfactory receptors can detect as many as 1
trillion different odours. Taste and smell are Synapse Nerve
Taste cells do not transmit the Messages are relayed
signals to the brain themselves, to the brain via a nerve
strongly linked to emotion and memory, and
as a result, experience is a powerful decider in instead passing the message that exits at the bottom
the development of our likes and dislikes. over to a nerve cell. of the taste bud.

138
DID YDU KNOW? Stomach ulcers were long thought to be mused by stress, but it's now known the culprit is □ bacterial infection

Inside the stomach Fundus Rugae

Excess gas is collected at The lining of the stomach
This muscular bag Oesophagus the top of the stomach, is stretchy and expandable,
turns your dinner into Food travels from the where it can be pushed out and when relaxed, it curls
mouth to the stomach and up by the diaphragm. up into characteristic folds.
an acidic soup via a muscular tube
that runs behind the
The stomach acts as a holding chamber, windpipe.
receiving food from the mouth and preparing Body
it to be processed in the small intestine. At The central portion of the
stomach helps to create
rest, the stomach is around the size of a fist, downward pressure,
and its lining is curled into a convoluted keeping food moving in the
network of folds known as rugae. As you eat, right direction.

Cardiac
sphincter
these folds stretch out, allowing an adult to

Muscle layers
eat around a litre 10.26 gallons) of food in one
sitting. Stretching of the stomach walls A ring of muscle at
the top of the There are three
triggers rhythmic contractions, mixing the stomach stops the layers of muscle in
food with acid and protein-digesting acidic contents the stomach wall,
moving back into each running in a
enzymes, grinding it to a paste in preparation
the oesophagus. different direction.
for the next stage of digestion.

Antrum
Duodenum The bottom part of
The stomach the stomach
empties its generates powerful
contents into the grinding
first section of the contractions.
small intestine.

Pyloric
sphincter
A ring of muscle at
the base of the Stomach lining
stomach prevents The lining is covered in
the contents from microscopic pits that
leaking out before produce mucus, acid and
they are ready. protein-digesting enzymes.

Chewing
the fat
iii iii Fat has a bad reputation,
but the truth is, your body
needs it
Every single cell in your body is
surrounded by a membrane made
of fats; it insulates your nerves and
it provides a valuable energy
reserve. Eating fat also provides a
number of vitamins and essential
fatty acids the body can't make on
its own. Saturated fats (the solid
fats found in meat and dairy) and
trans fats (found in hydrogenated
vegetable oil and many processed
foods) have shown to raise
cholesterol, which can lead to
circulatory problems, but
unsaturated fats (the liquid fats
found in plants and fish) can have
the opposite effect, and are
considered good for your health.

139
 Large intestine Brush border
The second part of the The cells that make up the Villi
intestine absorbs water intestinal wall are covered The cells that line the walls
in microscopic fingers of the small intestine are
known as microvilli. arranged into folds
known as villi.

Small intestine
The first part of the
intestine is responsible for
breaking food down and
absorbing the nutrients.

Appendix ____,
Small vein
Before exiting the body,
waste products are stored
Near the start of the large in a small pouch known as
Nutrients travel across
intestine is a blind-ending tube the rectum.
the wall of the intestine
known as the appendix - its
into the blood stream.

Lymph vessel ______.

function is largely unknown.

Small
artery ._____ Intestinal crypt
The intestines
Fatty acids are transported
away from the intestines via
the lymphatic system. Each of the Between the villi are
villi has a rich crypts containing
blood supply. mucus-producing cells.
After leaving the stomach, food must pass
through over 7m (23ft) of intestines
The stomach contents enter the intestine are added by the pancreas. The enzymes act like small intestine. The remaining undigested
gradually, allowing time for the liquid food to be molecular scissors, breaking proteins, material passes into the large intestine, which
processed. First the acid is neutralised by bile, carbohydrates and fats down into building blocks absorbs water, leaving behind solid waste that
provided by the liver, and then digestive enzymes small enough to be carried over the wall of the can then be passed out of the body.

• • " I.. "

oacteria have a different set of enzymes. They
are able to break indigestible material down
even furtlier, allowmg us to absor

..
resident S!)ec1es living in their large intestine
nutrients, mainly in the form of fatty acids.

. .
The presence of these helpful bacteria also
. .

... dangerous pathogens, helping to keep

infections at bay.
Tlie gut and its resident oacteria are 111
highly acidK and the small intestine is filled constant communicat1on, picking up on
diemical signals released into tlie
t. These signals can liave far-
sustaining a microscop1c world.
..
reaching effects, and the types of bacteria

140
DID YDU KNOW? The human mouth produces 1-2 /itres of so/iv□ every doy

The first part of the digestive system prepares enzyme, each used to break down a different
the food for the next stage, ensuring it is broken type of molecule. Proteases clip amino acids from
into a fine paste, mixed to form a homogenous proteins, lipases break fats down into fatty acids
fluid, and shocked with acid to limit the potential and glycerol, and carbohydrases turn long chains
for dangerous infection. However, it is not until of carbohydrate into sugars. These small blocks
food reaches the small intestine that the can be absorbed into the bloodstream, where
microscopic breakdown and absorption of they're distributed around the body, used to build
nutrients really begins. our own biological molecules, or broken down
At the start of the small intestine, the liver and burnt for energy. The body requires different
injects alkaline bile into the acidic liquid food, quantities of each of the nutrients, and can
neutralising its pH and preparing it for the sometimes convert one into another if supplies
introduction of digestive enzymes. are running low. However, there are a number of
Bile also helps to emulsify fats. Fats are not nutrients that cannot be synthesised by the body
water soluble, so they tend to clump together in at all or in high enough quantities, and these Some
large globules to hide from and avoid the must be obtained directly from the diet. These of
surrounding water, but bile acts a little like essential nutrients include some types of amino these, like
washing-up liquid, separating the fats out into acids, fatty acids like omega-3 and omega-6, and calcium,
smaller blobs. all of the vitamins and minerals needed. make up vital
Nowthatthe food is nicely mixed and Vitamins and minerals are organic and structural components
separated, the enzymes can get to work. The inorganic compounds required by the body in of our bodies, while others, like
pancreas produces a cocktail of three kinds of small amounts for various different functions. vitamin C, are involved in biochemical reactions.

FOOD YOU'LL WHAT THE BODY

FIND IT IN USES IT FOR
I RON-RICH FOOD Iron is a key component of
haemoglobin, the red pigment that
carries oxygen in our blood.
Without it, oxygen cannot be
transported effectively, resulting in
iron-deficiency anaemia. This is
most often caused by blood loss,
so as a result, women are much
more likely to be deficient of iron
than men.

Folic acid is essential for the

synthesis of DNA and without it
the production of red blood cells
starts to slow down. It is also
extremely important in the
formation of the central nervous
system, and during the first 12
weeks of pregnancy, folic acid
supplementation is recommended
to pregnant women.
Broccoli

Vitamin D is involved in bone

formation in the body, so
deficiency of vitamin D in
children can result in bone
deformity. Luckily, this vitamin is
easy to obtain. Not only can
vitamin D be found in oily fish,
eggs and dairy products, but our
bodies can also make it
themselves using sunlight.

Cells use a combination of

potassium and sodium to maintain
their internal electrical balance.
Potassium is vital to ensure
muscles are able to contract
properly and nerves are able to
transmit their messages. It is
easily obtained in the diet and
deficiency is incredibly rare unless
there is damage to the kidneys.
Dried apricots Avocados

141
Hunger is one of the
body's most basic and
fundamental
Food addiction
sensations, and it Research into food shown to activate the same reward
originates in the addiction is pathway that lights up when addictive
stomach. When the relatively new and drugs are ingested. In alcoholics, cocaine
stomach is empty, it the results are addicts and heroin addicts, the number of
begins to produce a hotly debated, but dopamine receptors in the reward
hormone known as there is increasing pathway is lower than in the rest of the
ghrelin. This then travels evidence that food population and the same thing is found in
to a region of the brain can elicit some of the obesity. It is thought that people with fewer
known as the hypothalamus. same brain responses as dopamine receptors might need to
The hypothalamus is addictive substances like over-stimulate their brains to experience
responsible for maintaining a constant, cocaine. In overweight people, the same rewards as normal people, and
optimum state; keeping the body at a set overeating can become a compulsion therefore turn to alcohol, drugs, or perhaps
temperature, regulating hormones and that is difficult to control, and has been even food.
monitoring hydration. The arrival of ghrelin is a
signal that energy levels might be about to dip, so
it triggers the production of a second hormone,
neuropeptide Y. This hormone promotes eating.
The cue to stop eating is much more subtle. The
stomach has stretch receptors, and will signal to
the brain that it is full. But what happens if the
stomach is empty, but there is already enough
energy stored in the system? Fat stores produce a
hormone known as leptin, which tells the brain
exactly how much energy the body has in reserve.
When leptin levels are high, the hypothalamus

Food and the brain Why do we crave these foods? makes hormones that suppress appetite. The
trouble is that with high levels of fat, we can
become resistant to the leptin message, similar
to insulin resistance in type-II diabetes. If the
brain does not know there is enough fat, we just
keep eating.
Cravings are slightly different. These are
generated not in the stomach, but in the brain.
There are three main areas of the brain
implicated in food cravings, the hippocampus,
the insula and the caudate.
Humans have been programmed through
evolution to enjoy fatty and sugary foods; eating
them ensures we have enough energy to survive.
The hippocampus is involved in gathering
sensory information, and processing it for
long-term memory storage, and with food
cravings, these memories become associated
with activation of the brain's reward circuitry. The
more we enjoy eating a food, the more likely we
are to crave it.
Mental images are thought to play an important
role in food cravings and picturing food makes it
much harder to resist. But thinking about other
visual images can help to curb the cravings and
distract your brain.
Digestion happens subconsciously, but you do
have a manual override, and what your brain
thinks it wants isn't always what it needs.

142
DID YDU KNOW? The digestive system hos its own dedicated nervous system, known os the enteric nervous system

Tea
In England, drinking tea is a national pastime. The main chemicals in tea are Chocolate
known as polyphenols, and each cup contains around 200 milligrams (0.007
ounces). The polyphenols are large molecules made up of smaller building Chocolate is one of the foods most commonly
blocks, which are known as catechins. When these catechins react with associated with happiness, particularly the
oxygen, they make two types of chemical; theaflavins, which make the hormone serotonin. The chocolate itself does
orange-brown colour of tea, and thearubigins, which are thought to contribute contain the precursor to serotonin, an amino acid
to the taste. The different amounts of the chemicals present in the tea are known as tryptophan, but this is also found in
very dependent on the life of the plants and the many other foods, including meat. Chocolate also
processing of the leaves. contains phenylethylamine, a molecule
chemically similar to amphetamine, but it is
broken down in the digestive system,
and does not reach the brain
intact. The feel-good factor of
chocolate is more likely to be
down to its fat and sugar content,
and a property known as
mouthfeel. Chocolate is among the
only foods that melts at close to
body temperature.

THE LENGTH OF AN
AVERAGE STOMACH
AFTER A MEAL

Coffee
Coffee contains over
1,000 different aroma
compounds, responsible
for its unmistakable smell. Bacon
Around 12 per cent of the green
coffee bean is made up of a set of chemicals The distinctive smell of bacon is, as most of us have probably
known as chlorogenic acids, and when the beans experienced, hard to resist. That fact is all down to the
are roasted, most of these acids begin to break chemistry of cooking meat. As the bacon is heated, the amino
down. Some produce the brown-coloured acids that make up the muscle protein react with reducing
compounds that give coffee its characteristic sugars present in the bacon fat. This process, known as the
dark colour, while others produce the bitter­ Maillard reaction, occurs only at high temperatures and
tasting chemicals responsible for its taste. Coffee produces over 150 different volatile molecules, each able to
also contains high quantities of caffeine, around interact with different smell receptors in the nose. Most of the
100 milligrams (0.0035 ounces) in every cup. It delicious smell of bacon is attributed to a group of nitrogen­
works on receptors in the heart and brain, containing compounds known as pyridines and pyrazines.
blocking the action of a natural neurotransmitter
and acting as a stimulant.

143
 Human emotions are governed by a complex mix of chemicals
and electricity - learn all about our moody biology. . .

T
he human brain weighs just over a information gathered from investigations in
kilogram (2.2 pounds I and plays host to animals, has enabled us to draw up a map of Compound emotions
an estimated 86 billion neurons, and at emotional connections in the body. Research by Ohio State University found that we
may have as many as 21 distinct and complex
least as many supporting glial cells. Signals are A notable area of the brain when it comes to emotional expressions - a few demonstrated in
transmitted along each nerve electrically, by mood is the limbic system (see opposite I -a the images above. Hybrid emotions include being
gradients of charged ions, and each neuron small cluster of interconnected regions 'angrily surprised' or 'happily disgusted' and
appear when conflicting feelings are experienced
makes hundreds of connections to those involved in memory storage and decision­ simultaneously. For instance, you may be sad
around it. making. The limbic system is directly something has ended but happy that you have
At each of the 300 trillion synapses in the connected to the olfactory bulb, which experienced it. Previous studies suggested that
we only had six emotions.
human brain, chemicals known as processes incoming smell signals from the
neurotransmitters relay messages from one nose, providing the biological link that allows
nerve to another. Each neurotransmitter has a odours to recall a memory. Research by the involved in reward and reinforcement. Damage
set of corresponding receptors, which can be Kavli Institute for Systems Neuroscience in to part of the basal ganglia, known as the
activatory or inhibitory, helping nerves to fire, Norway found that smell-based memories are ventral pallidum, causes anhedonia - the
or suppressing their activity. This enormous triggered with the activation of corresponding inability to experience pleasure. The
chemical and electrical system provides the brain waves to those experienced on initially orbitofrontal cortex, located above the eyes,
complex network that enables us to feel experiencing the scent. also activates in response to positive
emotion, from the all-consuming addiction of The nucleus accumbens links the limbic experiences, and is thought to play a role in
love, to the raw devastation of grief. system to other areas of the brain also involved evaluating reward versus punishment.
Techniques like functional magnetic in the processing of emotion. For instance, the Another approach to the study of complex
resonance imaging jfMR!l have helped reveal basal ganglia, at the base of the forebrain, has emotions like happiness is to break them down
areas of the brain involved in processing been well studied for its role in the planning into smaller parts. Pleasure is evolutionarily
different emotional responses. This data, in and co-ordination of movement, but certain ancient and is based on a chemical reward
combination with case studies of patients with areas also light up in response to positive system that acts as a biological incentive to
damage to certain areas of their brains, and emotional stimuli and are thought to be repeat beneficial behaviour. There are several

144
DID YDU KNOW? Serotonin is found in some insect venom ond p/ont spines; it con muse pain, tingling ond nouseo

The emotion
control centre
Discover the key elements of the limbic
system, one of the main regions of the
brain which processes our feelings

Hypothalamus
The limbic system
influences the rest of
the body through
nerve and hormone
signals transmitted
via the hypothalamus
and pituitary gland.

Incoming information from

the nose is passed directly
through the limbic system,
which is why scents are so
closely tied to our

These two almond­

shaped bundles of
brain cells co-ordinate
the behavioural and
physiological response
to incoming emotional
stimuli, particularly
fear and anxiety.

How do drugs
alter our mood?
Humans have been modifying their brain
chemistry for medical, religious and recreational
purposes for centuries, despite the many risks.
Stimulants like caffeine, nicotine, cocaine and
amphetamine affect the release of the fight-or­
flight chemicals adrenaline and noradrenaline,
increasing alertness. While euphoriants like
MDMA cause a surge of serotonin, which in turn
leads to the release of bonding hormone
oxytocin, resulting in a sense of euphoria.
Depressants, including sedatives, hypnotics
and alcohol, work on the GABA receptor system
to dampen brain activity. GABA is an inhibitory
neurotransmitter, and blocks nerve activity,
resulting in relaxation and reduced anxiety. Some
depressants have anti-convulsant effects, so are
used as a treatment for epilepsy.
Opioids also modulate nerve signals. Opium,
along with related drugs like morphine, have a
similar structure to natural endorphins and bind
to their receptors in the brain and spinal cord,
resulting in pain relief and euphoria.
' /

145
 Laughter vs stress
'reward pathways' in the brain, but the most
studied is the mesolimbic pathway.
The pathway transmits dopamine signals These two opposing states have very different

Raised blood
from nerves in the middle of the brain, upward effects on the body, as we reveal here ...

pressure
Euphoria ----------.
and forward, to the limbic system and the
prefrontal cortex, which are involved in Stress causes the heart to
emotional processing. Under normal Laughter causes the beat faster and the blood
release of endorphins vessels to constrict, raising
natural opiates that give a blood pressure.
conditions, this pathway serves as a motivator
for positive actions, producing pleasurable sense of wellbeing.
feelings that reinforce beneficial behaviour like

Reduced pain ---------t--\\T�;,,.

eating high-calorie food, social interaction and

Muscle tension
reproduction. Activation of the pathway also
Endorphin release as a
result of laughter also acts
aids in memory retention, increasing the
In response to stress, the
likelihood that the action will be repeated in as a natural painkiller. body prepares the muscles
the future. for activity; very strong
emotions like anxiety and
Increased ------�
Unfortunately, the pleasurable feedback is so
anger can lead to shaking.
blood flow
strong that abuse of the pathway is common.

Laughing relaxes
Many illicit substances, including cocaine,
amphetamine and MDMA, affect the the blood vessels,
increasing blood flow
Stomach
mesolimbic pathway, resulting in a pleasurable
to the body's tissues.
cramps
reward, but also contributing to habituation

In emotionally
and addiction.
It's not all about the brain though. The challenging
feelings associated with emotions are the result situations, the
brain diverts blood
away from the
of a complex mixture of incoming sensory
messages that come from all over the body. digestive system,
The autonomic nervous system (more prioritising the
commonly known as ANS) is the subconscious muscles and brain.

Sweaty palms
arm of the peripheral nervous system, and is
responsible for bodily functions that are not
As part of the
fight-or-flight
response, the
/
Can we fake a smile? sympathetic nervous
Faking emotions is harder than it seems. Humans
are social animals and have evolved extremely system activates
good facial recognition skills - so if something sweat glands on the
isn't quite right, we are quick to notice. The hands, feet and in
the armpits.
Improved --H+-+....,k.
muscles around our mouths are under fine

immunity
voluntary nerve control, which not only provides
the range of motion required for speech, but also
enables us to fake a smile. But people are not There is some
easily deceived. Facial expressions involve a evidence that
multitude of subtle, involuntary muscle laughter can
movements, and re-creating them is incredibly have a positive
difficult. The forehead and eyebrows are effect on the
particularly challenging, as the muscles are function
mostly under subconscious control. It is hard to of the immune
system. (which is produced in the
achieve the same expression with voluntary adrenal glands; not shown)
muscle contraction, and our eyes are often the suppresses the activity of
biggest giveaway when a smile isn't genuine. the immune system.

Mapping out
emotions
The complex human emotions are the
result of sensory signals from the rest
of the body. Researchers at Finland's
Aalto University charted the areas of the
body most commonly associated with
different feelings to produce maps of
where we experience the major
emotions. The images demonstrate how
different emotions trigger different
levels of sensation around the body. Here
high levels of sensation are represented
with warmer hues, and vice versa. Anger Fear Disgust Happiness Sadness Surprise Neutral Anxiety Love

146
 DID YDU KNOW? Two-thirds of coup/es con smell eoch other's emotions ond detect o difference between feor ond happiness

"There ore sever□/

'reword pathways '
in the broin "

S
........................................................................•........•

happiest
countries
(UN's World Happiness Report, 2017)
I. Norway
2. Denmark
3. Iceland
4. Switzerland
5. Finland

occupations in
the (2014)
Publican
under our voluntary control, such as heart rate, Sensory feedback produced by the effects of
Elementary construction
digestion and sweating; it too is wired in to the the autonomic nervous system contribute to Debt collection
limbic system. many of the familiar feelings associated with
The ANS has two distinct components with emotions. Stimulation of the heart by
opposing functions. The sympathetic nervous adrenaline and noradrenaline as part of the HAPPIEST and
system uses the neurotransmitters adrenaline
and noradrenaline to prepare the body for 'fight
fight-or-flight response produces the rapid
palpitations associated with anger, fear and
SADDEST states
or flight', raising the heart rate and mobilising embarrassment. Its actions on the digestive in the United States
resources to fuel the muscles. The system cause 'butterflies in the stomach', and (Gallup-Healthways Well-Being Index, 2013)
parasympathetic nervous system uses activity at the glands on the hands, feet and in HAPPIEST SADDEST
acetylcholine to allow the body to rest and the armpits, leads to sweating when nervous. 1. North Dakota 1. West Virginia
digest, slowing the heart and breathing, and More passive emotions, like sadness or 2. South Dakota 2. Kentucky
3. Nebraska 3. Mississippi
diverting the blood supply to the gut. contentment, on the other hand, require little
physical response, and the parasympathetic
nervous system takes control of the heart,
slowing its rate. Feelings of contentment and
Fight or flight relief are often accompanied by deep, slow
The autonomic nervous system is responsible for breathing - another indicator of
the control of heart rate, blood pressure and Of 129 gold medal ceremonies at the
respiration, and governs the function of most of
parasympathetic activity.
London 2012 01 m ics, 25 per cent of
the internal organs. It's divided into two parts. The The limbic system is also connected to the la.:l.l:.l.[.;.J.:L:!ll.il.1.11:i.sa.:::�·W!L!.>
' compared to just
sympathetic nervous system is responsible for the body via the hypothalamus. This small region, eight per cent of male competitors
fight-or-flight response and is behind raised heart
rate, sweating, nausea and shaking associated
located on the underside of the brain, links the
with action-based emotions like anger and anxiety. nervous system to the endocrine system, which
While the parasympathetic nervous system has SMILIEST
Brazi I
produces hormones - some of which are key
the opposite effect and plays a bigger role in more
passive emotions like sorrow and contentment.
mediators of mood and emotion. For example, country
corticotropin-releasing hormone is produced in
response to stress, and leads to the release of Travel app Jetpac analysed INSTAGRAM
the stress hormone cortisol from the adrenal IMAGES BY COUNTRY, ranking photos based
on whether the subject had a wide grin or a
glands above the kidneys.
tight-lipped smile. Brazil finished first, while
The regulation of emotion is not just the USA lagged behind in 33rd place. The UK
restricted to one area of the brain - it involves ranked 62nd and Japan came bottom
almost the entire body. Reducing the
bewildering complexity of human emotion
down to anatomy, physiology and, ultimately,
brain chemistry, might seem clinical and overly
simplistic, but in reality, the fact that humans
are capable of experiencing such an and . • ,
extraordinary range of abstract feelings is one according to the
of the greatest wonders of biology, with many London School of
Contempt Pride Shame Envy chemical puzzles still waiting to be solved in Economics (2013)
this area.

147
The gut-brain axis
How does the bacteria in your gut act like a 'second brain'?

W
e all know that our mood and transmit nerve impulses) to trigger the neurons cells at an injury site. Researchers believe
behaviour is controlled by the brain, in your digestive tract, which in turn send microglia also play a role in the regulation of
but are we overlooking another signals to your brain via the vagus nerve. Some appetite and metabolism.
important aspect of our neurobiology? studies have shown that certain species of gut Although there are few human studies at the
There is an increasing amount of evidence to bacteria can produce serotonin, an important moment, animal studies have linked the activity
suggest that the activity of bacteria in your gut neurotransmitter that plays a role in regulating of gut bacteria to a variety of conditions,
can significantly affect your brain. This your appetite and mood. including Parkinson's disease, obesity,
relationship is called the gut-brain axis, and A second proposed method is that microbes in depression, anxiety, schizophrenia and
while its exact mechanisms and significance the gut produce molecules called metabolites as cardiovascular disease, and they may also cause
haven't been fully figured out, it is thought that by-products when they break down our food. certain types of strokes.
the microbes colonising your digestive tract are These metabolites can stimulate an increase in While much more research will be needed to
responsible for complex interactions between the production of neurotransmitters by cells that further investigate these initial findings, if
your digestive system and the nervous, line the gut (epithelial cells), which activate the links are confirmed it could
endocrine and immune systems. vagus nerve. For example, a recent study found revolutionise how we treat
Your intestines are filled with bacteria. When that some gut microbes can produce the fatty certain neurological
0 0
you think of bacteria you probably think of the
germs that make you sick, but we actually have a
acids butyrate and tyramine, which promote the
production of serotonin by certain cells.
disorders. Perhaps in
the future doctors 0 O oo
will be prescribing 0
8
lot to thank these tiny microorganisms for. We The third hypothesis is that gut bacteria can
rely on 'good' bacteria to help break down food,
produce vital nutrients and defend us against
harmful bacteria. But this could just be the tip of
influence the brain indirectly by triggering the
immune system. Gut bacteria can stimulate
immune cells to produce small proteins called
supplement
treatments.
/CQ
pro biotic diets to O o
OO 0
the iceberg. Scientists speculate that gut cytokines, which travel through the

Neurotransmitter
microbes can send signals to the brain via three bloodstream to the brain. It is thought that these
production
different methods. proteins can influence the development and
The first involves bacteria releasing activity of microglia (the brain's immune cells), Some bacteria have been
neurotransmitters (chemicals that help to which are responsible for removing damaged found to stimulate the
production of serotonin
- a neurotransmitter
that helps regulate mood
- by cells in the
intestinal wall.

Scientists are only just beginning to understand the

Positive influences
impact your microbiome can have on your brain

Probiotic supplements with good

bacteria and prebiotic foods full
of fibre that nourish our good
bacteria can help to promote a
healthy microbiome.

Your intestines
contain a vast
network of nerves
(shown left, in
yellow), providing
communication
links between your
brain and gut

148
DID YDU KNOW? There ore over mo trillion microbes in the human gut!

Fermented
foods, such as
sauerkraut and
kimchi, contain

Gut feeling Vagus nerve

probiotics

How can your microbiome The vagus nerve provides

influence your brain? a communication
pathway between the gut
and the brain.

....___ Immune stimulation

0 ---............ Bacteria can encourage immune
cells to release small proteins
called cytokines, which can
affect immune cells in the brain.

Metabolite
production
The by-products of
bacteria metabolism
can affect the activity
of cells in the

Two-way street
blood-brain barrier.
Immune cells

Gut health and

o O
function can influence
gut bacteria activity

C) and vice versa.

A study involving gut microbe

transplants between mice found
that certain behavioural traits were
also transferred, ie a previously shy
mouse would explore more after

Negative
Disrupted receiving transplants of bacteria

influences
gut bacteria
from a more adventurous mouse

Pathogenic bacteria
and/or the use of
antibiotics can
change the balance
of beneficial bacterial
species in the gut.

Probiotics Metabolites
 Taste qualities are found in
all areas of the tongue, very tiny, sensitive
although some regions are hairs called microvilli
more sensitive than others which send
messages to your
brain about
how something
tastes

The five basic -•

human tastes
Building a map of the tongue

T
here is general agreement that humans shown that newborns in particular, who need a alkali metal ions. Potassium and lithium
have five basic tastes, although the fifth high calorie intake to grow, demonstrate a produce a similar taste as they are most closely
taste 'primary' has only been recently preference for sugar concentrations sweeter related to sodium.
officially recognised. Sweetness, bitterness, than lactose, which is found in breast milk. Sourness detects acidity. The way we
sourness and saltiness were joined by Bitterness can be detected in very low levels measure the degree of sourness is through
savouriness in 2002. Several other sensations and is generally perceived to be an unpleasant rating sour substances against dilute
that the tongue can recognise have been or sharp taste. Many toxic substances in nature hydrochloric. The mechanism involved in
identified but are not classified as tastes. are known to be bitter and there is an argument detecting sourness is similar to saltiness in
Sweetness is associated primarily with simple proposed by evolutionary scientists that that taste is caused by a concentration of ions -
carbohydrates -of which sugar is one of the bitterness sensitivity is an evolutionary defence in this case hydrogen ions.
most common. The way sweetness is detected is mechanism. Humans, however, have now Savouriness is the newest of the recognised
complex and only recently has the current developed various techniques to make previous basic tastes and the taste is produced by
model of multiple binding sites between the inedible bitter substances edible through fermented or aged foods. Glutamate is a common
receptors and sweet substance itself been reducing their toxicity, often through cooking. compound that can cause this taste and
proposed and accepted. A sweet taste infers that The taste of saltiness is produced by the consequently savouriness is considered
the substance is high in energy and studies have presence of sodium ions, or other closely related fundamental to Eastern cuisine.

150
DID YOU KNOW? A digit□/ version of Stephen Hawkings' DNA is stored on the ISS

Unravellin the
mystery o DNA
In 1953, James Watson and Francis 1. DNA
Crick discovered that the DNA A chromosome contains

molecule resembles a coiled mass of DNA and

the proteins that control

a double helix, one of

how it works

science's most 3. Coiled

significant A strand of DNA would be about
three metres in length if uncoiled

revelations
4. Base pairs
DNA strands contain about 3 billion
of these nucleotide base pairs,
comprising either adenine with
thymine or guanine with cytosine

5. Sides
Sugar-phosphates form the sides of
the DNA 'spiral staircase'

D
eoxyribonucleic acid, better known as DNA, is the To build a protein, DNA is copied to a type of RNA
building block of all cells. DNA not only makes the (ribonucleic acid) called messenger RNA (mRNA). Two types
proteins that determine our biological traits, it also of special RNA molecules, called transfer RNA (tRNA) and
gets copied and passed from generation to generation. ribosomes (rRNA), use amino acids to build the protein using
Changes in DNA overtime result in the evolution of traits in a the pattern described in the mRNA. Sometimes several
species. Although scientists had learned about DNA and different proteins are made from the mRNA. This is called
suspected its genetic function since the 1890s, its exact protein synthesis.
structure wasn't known until 1953. When a cell needs to reproduce, all of its genetic
Cambridge University scientists James Watson and information must copy over to the new cells. This means
Francis Crick won the 1962 Nobel Prize in Medicine, along that the DNA must replicate itself. Enzymes, hormones and
with Maurice Wilkins, for discovering that the molecule was other chemicals in the body drive this process. Essentially
a double helix - two ladder-like strands twisted together the double helix zips apart and enzymes copy the codons,
that resemble a spiral staircase. check the copies for accuracy, and seal up the strands. The
These long molecules are twisted, along with various frequency with which replication occurs depends on the
proteins, into a single chromosome. While DNA structure type of cell in which the DNA resides. Cells in our skin, for
looks complicated, it comprises just four sugars called example, are constantly dividing, so the DNA in those cells
nucleotide bases: adenine (A), thymine (T), cytosine (C) and is constantly replicating itself.
guanine (G). These four sugars are strung together to form a Sometimes there are minor changes made in the
sequence, similar to the way that letters of the alphabet processes of DNA replication and protein synthesis. Because
form words, and words form sentences. Groups of three there are some repeater codons, these variations don't
nucleotides form 'words' called codons, which form always cause a problem. Often they result in a positive
'sentences' called genes. These genes contain information outcome, such as increased survival of certain types of
on how and when to build a protein from a combination of diseases. However, depending on the variation, mutations
20 different amino acids. can occur that can ultimately result in hereditary diseases.

151
Correcting heart rhythms
How can a little electricity be used to fix a heart that's beating off-kilter?
8. Low energy 3. Timing the shock
Resetting an abnormal The heart is vulnerable
heart beat uses fairly when it is between beats,
low-energy shocks of so to prevent a cardiac
just 50-200 joules. arrest, the shock is timed to
6. Natural pacemaker �=====ii-­ coincide with the pumping
The heart has its own internal of the ventricles.
pacemaker known as the
sinoatrial node. Delivering a
BEFORE CARDIOVERSION
small electric shock to this
resynchronises the organ's
natural electrical activity.

fast, or at an irregular
pace, it becomes unable
to effectively pump

5. Electric shocks �
blood around the body.

Low-energy electric shocks

are delivered to the heart 1. Paddles
through the electrodes. Atrial fibrillation

2. Conductive gel
AFTER CARDIOVERSION
A saltwater-based gel is
used so the current can 7. Cardioversion
machine
The machine records the
electrical activity of the
heart and calculates the
electric shocks required
to restore the organ to
its normal rhythm.
Normal ECG

Carpal tunnel syndrome

What is it about the anatomy of the wrist that leads to tingling and numbness? Tendons

T
In the carpal tunnel,
he tendons and nerves it can cause numbness, Carpal bones the tendons of the
of the human wrist tingling and pins and needles fingers surround
travel through a in a specific pattern across the median nerve.

narrow tunnel. The carpal the hand.

Carpal tunnel
bones form an arch, covered The pain is often most
on the underside of the wrist severe at night because the
A narrow passage
by the tough carpal ligament. wrists are held flexed during made of small bones
This stiff tunnel has no sleep, compressing the nerve and a band of tissue
that acts as a pulley

be as simple as immobilising Median nerve

room to expand, so if the even further. Treatment can
for the tendons.
ligaments become inflamed
This major nerve
they can compress the the joint at night-time. sends messages
median nerve. The median In more serious cases between the brain
nerve carries sensory though, steroids may be used and the hand.
information from the thumb, to reduce inflammation, and Carpal tunnel syndrome is associated Synovium
index finger, middle finger as a last resort, the carpal with heavy repetitive motion in the wrist. A membrane around
If the ligaments inside the wrist become the tendons secretes
and half ofthe ring finger, so ligament can also be cut to
inflamed, the nerve feeding the hand is a lubricating fluid to
when the nerve is compressed release the pressure. crushed causing tingling and numbness keep joints flexible.

152
DID YOU KNOW? Scientists hove been searching for □ human pheromone for decodes, but ore yet to find one

What are pheromones?

The science behind the chemicals which have a big effect on how animals act

P
heromones are a means of chemical Plants also use pheromones. For example,
communication between animals, when an antelope eats the leaves of an acacia tree,
allowing ants to form orderly lines in it releases ethylene. This chemical alarm signal is
search of food, tigers to mark their territory and effective for up to 45 metres (150 feet), and causes
newborn rabbits to find their mother for milk. surrounding acacia trees to produce bitter-tasting
Insects have multiple sense organs located tannin to discourage the antelope from grazing
on their antennae, while many animals have a more. Some plants can also produce pheromones
specialist organ in the nose that is known as the that alter insect behaviour.
vomeronasal organ (VNO). The VNO is linked by Whether or not humans are sensitive to
nerves to the hypothalamus -the region of the pheromones is debated. We don't always have a
brain connecting the nervous system to the VNO, and our gene coding for the receptors look
endocrine (hormone) system. Incoming signals inactive. Still, in some animals normal nasal
can potentially affect a range of behaviours and tissue can also detect pheromones, so there is a
physiologies, from aggression to reproduction. chance that humans might too.

Eczema explained
What causes the skin to react to otherwise harmless material?
czema is a broad term for a range of
Under the skin •
skin conditions, but the most
common form is atopic dermatitis. What happens inside the body when eczema flares up?
People with this condition have very Ceramides ----------------,
reactive skin, which mounts an The membranes of skin cells contain waxy
inflammatory response when in contact lipids to prevent moisture evaporation, but
these are often deficient in eczema.
with irritants and allergens. Mast cells
release histamine, which can lead to
Allergen
itching and scratching, forming sores open
-----�
to infection. Eczema is commonly
triggered by the same
Allergen
There is thought to be a genetic element
things as many
entry route
to the disease and a gene involved in
allergies - anything
retaining water in the skin has been from pet hair to certain The cells of the skin are
identified as a potential contributor, but types of food. normally tightly bound
there are many factors. together to prevent
contaminants from
Eczema can be treated with steroids, entering the body, but in
which suppress immune system activity, eczema there are gaps.

Inflammatory
dampening the inflammation so skin can
Water loss
heal. In serious cases, immunosuppressant •..---i===r--:---==ra;,;---;f-- response
drugs -used to prevent transplant The skin is less able The immune system
rejection -can be used to weaken the to retain water, produces a response to
leading to dryness allergens beneath the skin, ·-
immune system so it no longer causes and irritation. leading to redness, itching i
'<
inflammation in the skin. and inflammation. 9

153
Inside the flu
We reveal how this common winter bug stays
The virus in focus
Take a closer look at the anatomy
that makes up a single flu virion

one step ahead of our immune system

RNA

T
he influenza virus infects a staggering circulating in the population. Each subsequent The genetic material of
the flu virus is stored on
5 million people worldwide every year, the virus has usually changed sufficiently several strands of
single year, travelling from person to that the vaccine is no longer effective. ribonucleic acid (RNA).

Haemagglutinin -----,
person in airborne droplets, and causing chills, However, research suggests that some cells of
fever, sore throat, runny nose, headaches and the immune system can recognise proteins
muscle pain. from the core of the virus. These are essential to Spiky protein haemagglutinin coats
the outside of the virion, allowing it
The flu virus changes gradually by a process viral function, and mutate far more slowly, so to stick to, enter and infect cells of
known as antigenic drift. As the virus developing a vaccine against these important the throat and lungs.
replicates, single nucleotide errors occur in the proteins could help T-cells to develop long-term
viral genome, causing minute changes to the immunity to the bug.
proteins that coat the outside of the virus. The
immune system recognises these proteins to
detect and destroy the infection, so as they
change, the ability of the body to recognise the
virus decreases, preventing people from
building up immunity.
Not only does the virus make continual,
subtle changes to its genome and proteins, but
it also occasionally develops huge mutations. If
a host becomes infected by more than one
strain of flu virus, and the two meet inside a
single cell, there is a chance that their genomes
will mix together, consequently producing new,
mutant flu virus. This is a rather rare
occurrence, but can form dangerous new
strains of flu - the swine flu jH1N1l pandemic of
2009 was found to contain genetic information
from four different viruses: one human, one
avian and two swine influenza.
This is one of the reasons that a universal
vaccine against all types of flu is such a
challenge. Currently, a seasonal flu jab is
developed everyyear, to match the flu that is

Get to know your ABCs ...

Influenza A Influenza B Influenza C

Matrix -----­
The natural hosts of influenza A are Influenza B prefers a human host and This produces only mild disease,
wild water birds. Transfer to is less common. It mutates slowly, and most adults have been infected
domestic poultry exposes humans enabling most to build up immunity, at some point in their life. It infects Beneath the membrane
to the virus and can result in but it doesn't last for ever. It rarely humans and pigs, but is far less is a protein shell, which
cross-species infection. The HlNl infects other species, preventing the common than influenza A and B. It provides the virion with
Spanish flu of 1918 and the H5Nl creation of the new, mutant strains can cause local epidemics, but does strength and structure.
bird flu of 2004 were influenza A. that cause pandemics. not lead to pandemic flu.

154
DID YDU KNOW? Influenza A viruses ore named ofter the two mo;or proteins that cover their outer membrane

Neuraminidase
This surface protein is an ------------ Lipid bilayer
enzyme, which helps the virus The outer layer of the virion
to eat through cell defences and is a lipid membrane. It is not
breach the cell membrane. produced by the virus, but is
Drugs like Relenza and Tamiflu stolen from the membrane
inhibit this process. of the host cell.

155
I PROCESSES AND BODILY FUNCTIONS

How we swallow
The process of getting your food from mouth to stomach
Soft palate Tongue Cycle ends
Roof of your mouth The tongue pushes The tongue pushes forward,
closes over to protect the bolus to the soft palate retracts and
nasal cavity. back of the throat. epiglottis flips up so you can
breathe after swallowing.

----,
Into the
The bolus oesophagus
Either liquid or chewed Epiglottis folds over to The soft palate
food that has been stop the bolus entering pushes the bolus into
coated in saliva. .__ ....,.-,.;;;.,-...a. �- the trachea. the oesophagus.

S
wallowing is a whirlwind of action that going down the windpipe thanks to the down the wrong pipe.' This is called
all happens in a rapid but controlled epiglottis, a small flap of skin folding over the pulmonary aspiration and occurs when the
order. Your tongue pushes the chewed larynx. This forces what you are swallowing to epiglottis hasn't covered the trachea in time
food !bolus) to the back of your throat and the head down the oesophagus. All of this and the bolus has entered your breathing
muscle on the roof of your mouth - your soft happens in less than a second. tube. This uncomfortable sensation generally
palate - pushes the food or drink down into However, sometimes things do go wrong. ends with you coughing and spluttering until
the pharynx. The bolus is prevented from We've all experienced food or drink 'going it is cleared.

Why do we get drunk? Ethanol

It's the drug of choice for many, but just how does alcohol get you
drunk, and why do we suffer from the side effects?
moleculeThe particular shape of an

T
ethanol molecule makes it ideally
here are actually many kinds of alcohol in theories. The slow reactions, slurred speech and suited to getting humans drunk.
Slight differences in the charge at
each end of the molecule make it
the chemical world, but the one we drink memory loss of a drunk are probably caused by
the most is ethanol. It's the particular shape ethanol attaching to glutamate receptors in your both water and fat soluble.
of an ethanol molecule that gives a glass of beer or a brain's neural circuitry. These receptors normally
shot of the hard stuff its specific effects on the receive chemical signals from other parts of the Red atom = Oxygen
human brain. The molecule is very tiny, made up of brain, but instead they get an ethanol molecule. White atoms = Hydrogen
just two carbon atoms, six hydrogen atoms, and one This disrupts the flow of signals and generally slows Black atoms = Carbon

oxygen atom. Ethanol is water soluble, which the whole brain down.
means it enters the blood stream readily, there to be Ethanol also binds to GABA lgamma­
carried quickly to all parts of the body !most notably aminobutyric acid) receptors, which normally
the liver and the brain). It's also fat soluble; like an serve to slow down brain activity. Unlike glutamate
all-access pass through various cell membranes receptors, ethanol actually makes GABA receptors
and other places that are normally off limits. more receptive, causing the brain to slow down
A certain portion of the ethanol you drink passes even more. But alcohol isn't simply a depressant,
throughyour stomach to your small intestine, is because it also stimulates the production of
absorbed into your bloodstream and carried to your dopamine and endorphins, chemicals that
brain. That's what we're really concerned with. produce feelings of pleasure. Research hasn't yet
Research has not conclusively determined exactly revealed the exact mechanism involved, but it
how ethanol accomplishes all of its various effects may be similarto the way ethanol stimulates the
in the brain, butthere are some well-supported GABA receptors.

156
DID YDU KNOW? We con burn 10-40 co/ories o doy by toughing for ;ust 15 minutes

The human tongue

0
A versatile organ that allows
you to both taste and talk
n our tongues, we have up to 10,000 taste buds that
can distinguish between sweet, sour, bitter, salty
and savoury flavours. As food is dissolved by our
saliva, it meets taste receptor cells inside the taste buds that, Human
when stimulated, send signals to the cerebral cortex.
tongue
muscles
Receptors in the tongue also respond to other stimuli like
pain, temperature and pressure.

Palatoglossus
The tongue consists of eight muscles: four ofthem are

extrinsic muscle
�--
extrinsic muscles that are anchored to bone and change the
position of the tongue, and four are intrinsic muscles that are Elevates the back of
not anchored to bone and change the shape of the organ. the tongue.

Styloglossus
Besides guiding food as we chew and swallow it, these

extrinsic muscle
muscles also give us the ability to speak. In combination with .____
the mouth, jaws and cheeks the tongue moves to articulate
Moves the tongue upwards
Genioglossus
sounds that emanate from the vocal folds of the larynx.
and can also retractit.

extrinsic muscle
Sticks out the tongue and can ---- Hyoid bone
depress the centre of it. The hyoglossus and
genioglossus muscles are

Tongue -----�
attached to this bone.

Hyoglossus
Taste buds cluster

extrinsic muscle
around papillae, which ----
are protrusions on the
surface of the tongue. Depresses or retracts
The intrinsic muscles are the tongue.
contained in the tongue.

How do we laugh?
Which muscles react when we find something
funny and why is laughter so hard to fake?

L
aughing can sometimes be mechanisms which are used for coughing
completely involuntary and and speaking: namely, the lungs and the
involves a complex series of larynx. When we're breathing normally,
muscles, which is whyit's so difficult to air from the lungs passes freely through
fake and also why an active effort is the completely open vocal cords in the
required to suppress laughter. larynx. When they close, air cannot pass,
In the face, the zygomaticus major and however when they're partially open,
minor anchor at the cheekbones and they generate some form of sound.
stretch down towards the jaw to pull the Laughter is the result when we exhale
facial expression upward; on top of this, while the vocal cords close, with the
the zygomaticus major also pulls the respiratory muscles periodically
upper lip upward and outward. activating to produce the characteristic
The sound ofour rhythmic sound of laughing.
The risorius muscle is used to smile,
but affects a smaller portion of the face
and is easier to control than the
zygomatic muscles. As a result, the
risorius is more often used to feign
amusement, hence why fake laughter is
easy to detect.

157
What happens s:e�.:.
when you sneeze�
step
■
r+---F-+-1<:-'���';t-\---
Toge�e�����

How does this automatic reflex expel

offending irritant,
saliva and mucus

unwanted irritants from the body?

from inside the
mouth and nasal

W
cavity are also

1. Irritation �
hen we breathe in, the inhaled air expelled from the
bodyat up to
can contain dust, chemicals and other
16okm/h 1100mph).
irritants that can be harmful to the Prior to irritation, the diaphragm
muscles are relaxed. When an

,__,___..________ 5. Sneeze
body, particularly to organs in the respiratory irritant enters the body, nerve
system like the lungs. While the tiny hairs inside endings in the lining of the nose
signal to the brain. The throat reopens
the nostrils (cilia) trap many of these particles, suddenly, explosively
some will often get through. To help you out, your forcing air out of the

3. Intake of breath ---�

body reacts to try and forcibly expel the offending body, making the chest
cavity contract sharply.
particles via the sneeze reflex arc. The diaphragm relaxes
Contraction of the diaphragm
There are a number of other reasons why we causes a sharp intake of breath. once again.

4. Air pressure
sneeze, including to clear the nasal passages
whenyou have a cold, to expel allergens if you
are allergic to something, and interestingly even rises
bright sunlight can cause some people to sneeze; The brain signals to
the throat to close.
this is specifically called photic sneezing.
2. Muscles contract
This, combinedwith
When a stimuli is detected by the nerve the contraction of the
abdominal muscles,
endings in the nose, impulses are sent to the The brain tells the raises the air pressure
brain, which initiates a chain of physiological respiratory muscles - inside the lungs.
including throat, chest and
events that enable the body to rid itself of the diaphragm -to contract.
unwelcome item.

3. lnterneuron
The mterneuron provides a
connert1on between the
sensory and motor neurons

actors often test the knee-Jerk, or ..

...
" ,,
It

••
4. Motor neuron your thigh muscle (quadriceps) to contract and the lower le to
The motor, or efferent
extend. When struck, impulses travel along a pathway in the
) neuron, earnes the nerve
impulse to the muscles dorsal root ganglion, a oundle of nerves in the L4 level of tlie
spinal cord. Reflex actions are performed independently of the
15rain. Tlits allows tliem to happen almost mstantaneously - 111
aoout 50 milliseconds in tlie case of the knee-jerk reflex. This
reflex helps you to ma111ta111 balance and posture when you
walk, w1tliout liav111g to tli111k aoou •f I

:
DID YDU KNOW? What is sensed is referred to os o 'sense datum', while sensation refers to o mento/ process

Merkel's discs
Under
Roughdisc-shaped structures, Merkel's discs are
located atthe dermis-epidermis borderand
detect veryfaint touch and light pressure. The
the skin
discs are the culmination of free neuron endings
and consist of a Merkel cell in close apposition to

Free nerve endings

an enlarged nerve terminal.

Often penetrating the epidermis, the

free nerve endings react to heat and
cold, allowing detection of
temperature changes through the
skin. Other endings are nociceptors
!sensory receptors that send nerve
signals to the spinal cord and brain)

How do
and detect pain.

we touch
and feel?
Sensation is the act of
detecting different aspects of
touch. But how does it work?
T
he skin is the largest sense organ of the human body. By
sending nerve impulses jsignalsl to the sensory area of
the brain, the skin can respond quickly and accurately
to external stimuli in the detection of pain, texture and
temperature, among others. This enables us to experience
sensations, including the many 'sense datums' ja term coined
by eminent scholar Bertrand Russell to separate the process of
sensing to that which is being sensedl, involved with touch.
This is achieved through a collection of sensory receptors
within the skin, most of which are mechanoreceptors, sensors
that specifically respond to mechanical pressure, distortion
and vibration. In addition to mechanoreceptors, human skin
also packs thermoreceptors for the detection of changes in
temperature and, importantly, pain-detecting nociceptors. The
positioning of each type of sensor in the dermis (one of the
skin's three main layersl is directly linked to its role, with large
receptors designed to detect pressure changes located deep

Meissner's corpuscle
within, while smaller sensors are designed to detect light

Ruffini's corpuscle
touch, near the surface. Common to areas of highly sensitive, hairless
Each receptor consists of free nerve endings either skin -such as palms, fingertips, eyelids and lips­
One of the skin's slowly adapting Meissner's corpuscles are rapidly adaptive enclosed
encapsulated within a tissue cell - such as with Ruffin i's mechanoreceptors, Ruffini's corpuscles receptors that are sensitive to faint touch and pressure.
corpuscles (see annotationsl - or unencapsulated and left loose. consist of a branching neuron ending They have the highest sensitivity in detecting
surrounded by an oval-shaped capsule vibrations too, sensing ranges under 50Hz.
Sensory receptors can be roughly split into two main groups that detects thestretching of the skin
dependent on their rate of adaption jie how fast the receptor and deep sustained pressure. When
adapts its frequency of action potentials/signalsl, with some located in the fingertips, they also
detect sliding, aiding grip.
slowly adapting and others rapidly adapting to external stimuli.
Merkel's discs, for example, are slowly adapting, maintaining a

Pacinian corpuscle
high firing rate for a sustained period of time, delivering
impulses to the brain for longer. Pacinian corpuscles, on the
One of the largest mechanoreceptors, the
other hand, are rapidly adapting, quickly amending their firing Pacinian corpuscle is layered like an onion,
rate depending on context jie if a vibration is detected through andwhen deformed by outside forces it
detects strongly sustained pressure.
the skin, which then stops, the Pacinian sensor stops sending Interestingly, it can also detect rapid
signals to the brain quickerj. vibrations between ranges of 200-300Hz.

159
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