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Directional terms describe position relative to a reference point, and for the limbs the reference point is the trunk. Proximal means closer to that attachment, while distal means farther from it. Lateral and superficial describe side-to-side position and depth respectively, not distance along a limb.
A sagittal plane runs front to back and divides the body into right and left portions; when the portions are equal the plane is called midsagittal or median. Coronal planes divide the body into front and back, and transverse planes divide it into upper and lower portions. Oblique planes cut at an angle and produce no standard halves.
The thoracic cavity is enclosed by the rib cage and the diaphragm and houses the heart within the mediastinum together with the lungs in the pleural cavities. The abdominal and pelvic cavities lie below the diaphragm and contain the digestive and urogenital organs. The cranial cavity encloses the brain.
The adult skeleton is conventionally described as having 206 bones, divided into the axial skeleton and the appendicular skeleton. The newborn has more individual bones because several elements have not yet fused. Fusion during growth reduces the count to the adult figure.
The knee is a synovial joint because the articulating surfaces are separated by a fluid-filled cavity within a joint capsule. Its movements are predominantly flexion and extension in one plane, which makes it a hinge type. Fibrous and cartilaginous joints lack a synovial cavity and permit little or no movement.
Oxygenated blood returning from the lungs enters the left atrium and passes through the mitral valve into the left ventricle. The thick muscular wall of the left ventricle generates the pressure needed to eject blood into the aorta through the aortic valve. The right side of the heart handles deoxygenated blood destined for the lungs.
Arteries are defined by the direction of flow, carrying blood away from the heart regardless of its oxygen content. Veins return blood towards the heart, and capillaries form the exchange network between the two. Lymphatic vessels carry lymph rather than blood.
The alveoli are tiny air sacs whose walls are only one cell thick and are surrounded by a dense capillary network, giving a very large surface area for diffusion. Oxygen diffuses into the blood and carbon dioxide diffuses out across this respiratory membrane. The bronchi and trachea are conducting airways, and the pleura is a serous membrane.
The common carotid artery is large, superficial in the neck and gives direct supply to the head and neck, which makes it the preferred injection site for that region. The radial artery serves the forearm and hand and the popliteal artery serves the lower leg. The subclavian artery lies deep and is less accessible.
The atrioventricular valves sit between each atrium and its ventricle; the right-sided one has three cusps and is the tricuspid valve. It prevents backflow from the right ventricle into the right atrium during systole. The valve between the right ventricle and pulmonary trunk is the pulmonary valve, and the left atrioventricular valve is the bicuspid or mitral valve.
Erythrocytes contain haemoglobin, which binds oxygen in the lungs and releases it in the tissues, so they carry almost all of the blood's oxygen. Leukocytes are concerned with defence and thrombocytes with clotting. Plasma proteins contribute to osmotic pressure, transport and immunity rather than bulk oxygen carriage.
The diaphragm is a dome-shaped sheet of muscle separating the thorax from the abdomen. When it contracts it flattens and increases the vertical dimension of the thoracic cavity, drawing air in. The abdominal and pectoral muscles are accessory muscles used only in forced breathing.
The epiglottis is a cartilage flap attached to the tongue base that folds down over the laryngeal inlet as the larynx rises during swallowing. This diverts the bolus into the oesophagus and protects the airway. The glottis is the opening itself, which the epiglottis covers.
Each kidney contains about a million nephrons, each consisting of a renal corpuscle and a tubule. Filtration, reabsorption and secretion along the nephron produce urine and regulate water and electrolyte balance. The other options are the units of the lung, liver and nervous system respectively.
The olfactory nerve is the first cranial nerve and arises from receptors in the nasal mucosa, passing through the cribriform plate to the olfactory bulb. The optic nerve is the second cranial nerve and serves vision. The trigeminal and facial nerves carry general sensation and motor supply to the face.
The dura mater is the tough outer layer lying against the skull, the arachnoid mater is the delicate middle layer, and the pia mater is the thin inner layer closely applied to the brain surface. Cerebrospinal fluid circulates in the subarachnoid space between the arachnoid and pia. This fixed order is the basis for describing meningeal spaces.
The inferior vena cava collects venous blood from all structures below the diaphragm and empties into the right atrium. The superior vena cava drains the head, neck, thorax and upper limbs. The pulmonary veins carry oxygenated blood from the lungs to the left atrium, and the portal vein is part of the hepatic circulation.
The common iliac artery divides into internal and external iliac arteries; the external iliac passes under the inguinal ligament and becomes the femoral artery. The femoral artery then continues down the thigh and becomes the popliteal artery behind the knee. The internal iliac supplies the pelvis.
The endocrine islets of the pancreas contain beta cells that secrete insulin and alpha cells that secrete glucagon, the two hormones that regulate blood glucose. The liver stores glycogen but does not secrete these hormones. The adrenal and thyroid glands produce unrelated hormones such as cortisol, adrenaline and thyroxine.
Sutures are fibrous joints in which thin layers of connective tissue bind the skull bones, and they become largely ossified in the adult. Gomphoses are the peg-and-socket fibrous joints holding teeth in the jaw, and syndesmoses are fibrous joints with a ligamentous sheet such as the distal tibiofibular joint. Symphyses are cartilaginous joints.
The pulmonary veins are the only veins in the body that carry oxygenated blood, and they open into the left atrium. From there blood passes through the mitral valve into the left ventricle for systemic ejection. The pulmonary arteries carry deoxygenated blood from the right ventricle to the lungs, and the venae cavae open into the right atrium.
The thoracic duct ascends through the thorax and empties into the venous system at the junction of the left subclavian and left internal jugular veins. It drains the lower body, abdomen, thorax, left upper limb and left side of the head and neck. The right lymphatic duct performs the equivalent function on the right side.
The right and left coronary arteries arise from the ascending aorta immediately above the aortic valve, so they receive blood during ventricular relaxation when the valve cusps fill. The aortic arch gives rise to the great vessels of the head, neck and upper limb. The coronary sinus is a venous channel draining the heart muscle into the right atrium.
The brachial plexus is formed by the anterior rami of the fifth cervical to the first thoracic roots, conventionally written C5 to T1. These fibres reorganise into trunks, divisions, cords and terminal nerves supplying the upper limb. The cervical plexus arises from C1 to C4, and the lumbosacral plexus from lumbar and sacral roots.
The right ventricle ejects blood into the pulmonary circulation, a short low-pressure circuit, so it needs far less force than the left ventricle, which must overcome systemic resistance. Both ventricles beat at the same rate and receive equivalent volumes of blood per beat. Wall thickness therefore reflects the pressure each chamber must generate, not cell number or rate.
Muscle tissue is classified by structure and control. Cardiac muscle shows cross-striations like skeletal muscle but is governed by the autonomic nervous system and its own conducting system, so it contracts without conscious input. Smooth muscle is involuntary but not striated, and skeletal muscle is striated but voluntary.
The skin consists of the epidermis, dermis and subcutaneous (hypodermal) layer. The dermis is the fibrous layer that houses the glands, hair follicles, blood vessels and nerve endings. The epidermis is avascular epithelium, and the hypodermis is mainly adipose tissue.
The vertebral column is divided into regions with fixed counts in the normal adult: seven cervical, twelve thoracic, five lumbar, five fused sacral and four fused coccygeal segments. The cervical region therefore contains seven vertebrae, the first two being the atlas and axis.
Veins operate at low pressure, so many of them contain pocket valves that prevent blood from running backwards, particularly in the limbs where flow must travel against gravity. Arteries and arterioles carry high-pressure flow and do not require valves. Capillaries are a single cell thick and have no valves.
The hypothalamus is the chief homeostatic control centre of the brain. It monitors blood composition and temperature and coordinates endocrine output largely through its control of the pituitary gland. The medulla governs vital reflexes, the cerebellum coordinates movement, and the thalamus relays sensory impulses.
Albumin is the most abundant plasma protein and its large molecular size keeps it within the capillaries, where it exerts an osmotic pull that holds fluid in the vascular compartment. A fall in albumin therefore promotes oedema. Fibrinogen and prothrombin are clotting factors, and globulins are largely involved in transport and immunity.
The jejunum occupies the middle portion of the small intestine and has the richest supply of villi and a thick, well-vascularised wall, making it the main absorptive region. The duodenum receives bile and pancreatic juice and is largely regulatory and digestive, while the ileum absorbs vitamin B12 and bile salts. The caecum is part of the large intestine.
The adrenal gland has two functional zones: the cortex secretes steroid hormones such as cortisol and aldosterone, while the medulla secretes catecholamines, chiefly adrenaline with some noradrenaline. Insulin comes from the pancreatic islets. Adrenaline is therefore the medullary product.
The spleen acts as a blood filter, and its macrophages destroy aged or damaged red blood cells and recycle their iron. It also stores platelets and mounts immune responses to blood-borne antigens. Digestive enzymes come from the pancreas, clotting factors mainly from the liver, and bile is stored in the gallbladder.
Arterial blood is normally slightly alkaline, held within the narrow range of pH 7.35 to 7.45 by buffer systems, respiration and renal regulation. Values below 7.35 represent acidaemia and above 7.45 alkalaemia. The body tolerates only small deviations before cellular function is impaired.
The sinoatrial node lies in the wall of the right atrium near the opening of the superior vena cava, where it acts as the natural pacemaker. Its impulse spreads across the atria to the atrioventricular node and then down the ventricular conducting system. Deoxygenated blood returning from the body arrives in this same chamber.
Flexion of the elbow is produced by the anterior compartment muscles of the arm, chiefly brachialis assisted by biceps brachii. Muscles that cross the joint posteriorly, such as triceps brachii, extend it instead. Deltoid and latissimus dorsi act mainly at the shoulder.
Sperm are formed in the seminiferous tubules of the testis, then pass to the epididymis where they mature and are stored. From there they travel along the vas deferens, join secretions from the seminal vesicle to form the ejaculatory duct, and finally leave through the urethra. Any other ordering disrupts this anatomical continuity.
Both kidneys lie retroperitoneally, but the large right lobe of the liver occupies the space immediately above the right kidney and pushes it downward. The left kidney lies beneath the spleen and diaphragm at a slightly higher level. Ureter length and adrenal size do not determine renal position.
Closure of the atrioventricular valves marks the start of ventricular systole. For a brief period all four valves are shut and the ventricles contract without changing volume, so pressure rises sharply until it exceeds aortic pressure and the aortic valve opens. Ventricular ejection then follows.
Rigor mortis begins in the small, metabolically active muscles of the face and neck, then spreads downwards over the trunk and limbs. It later passes off in the same head-to-foot sequence as proteolysis advances.
Once the circulation stops, blood drains from the capillaries and collects under gravity in the venules and capillaries of the dependent parts of the body. This produces the characteristic purple-red discoloration that later becomes fixed as vessels break down.
Cocci are spherical cells, which may occur singly, in pairs, chains or clusters. Rod-shaped cells are bacilli, helical cells are spirilla, and comma-shaped cells are vibrios.
Autolysis is self-digestion of cells by enzymes released from their own lysosomes after death, before bacterial putrefaction becomes dominant. It is not dependent on micro-organisms and is accelerated in enzyme-rich organs such as the pancreas.
Clostridium perfringens is an anaerobic, spore-forming bacillus that produces tissue-destroying toxins and gas in devitalised tissue. Embalmers should treat wounds and exudate from suspected cases with particular care.
Hepatitis B is a blood-borne virus transmitted by percutaneous injury, contamination of broken skin, or splash to mucous membranes. Intact skin is an effective barrier, and airborne spread is not a recognised route.
Coagulase-negative staphylococci, chiefly Staphylococcus epidermidis, are the dominant commensals of the skin and can become opportunistic pathogens if a device or wound is present. Their presence on a swab therefore does not necessarily indicate infection.
Rigor persists while actin-myosin cross-bridges remain and ATP cannot be regenerated. As autolysis advances, proteolytic enzymes degrade the muscle proteins, the cross-bridges fail and the muscles soften.
Formaldehyde is a cross-linking alkylating agent that reacts with amino, thiol and hydroxyl groups, denaturing proteins and inactivating nucleic acids. This broad, non-specific action underlies its wide antimicrobial spectrum.
Methicillin-resistant Staphylococcus aureus typically colonises the anterior nares, from which it can be transferred to skin and wounds by the hands. This is why nasal carriage matters in cross-infection control.