Anatomy, physiology, and pathology



Anatomy, physiology, and pathology*



The body as a whole


Review tips


The content concerning the body as a whole typically creates a platform for understanding the design of the body and how the body functions.* The sciences are described in essentially a foreign language. To be able to understand this content, it is necessary to learn the language. Science studies in general, not only in this chapter, place a heavy emphasis on terminology.


This content usually is tested in the factual recall type of question, which relies on correct use of terminology. The best study skill is rote memorization of the terminology. In the answer key at the end of this chapter, many of the rationales indicate that the correct answer is the definition of the term.


Know the definition of each term and be able to use the term correctly. More complex questions use the terminology in the question and possible answers, and unless the language is deciphered, it is difficult to know what the question or the provided answers mean. There is no easy way to study terminology. Using flashcards, reading glossaries, and doing labeling exercises reinforce the definitions of the various terms. Use the study resources in this guide and the Evolve site, and make sure that when reading the textbooks, you understand what the words mean. Also, make sure to understand the meaning of the general language used to write the questions. If the meaning of a word is unclear, look it up in the dictionary.



Quick content review




• Define characteristics of life.



• Maintenance of boundaries: Keeping the internal environment distinct from the external environment


• Movement: The ability to transport the entire being, as well as internal components


• Responsiveness: The ability to sense, monitor, and respond to changes in the external environment


• Conductivity: The movement of energy from one point to another


• Growth: A normal increase in the size or number (or both) of cells


• Respiration: The absorption, transport, and use or exchange of respiratory gases (oxygen and carbon dioxide)


• Digestion: The process by which food products are broken down into simple substances to be used by individual cells


• Absorption: The transport and use of nutrients


• Secretion: The production and delivery of specialized substances for diverse functions


• Excretion: The removal of waste products


• Circulation: The movement of fluids, nutrients, secretions, and waste products from one area of the body to another


• Reproduction: The formation of a new being; also, the formation of new cells in the body to permit growth, repair, and replacement


• Metabolism: A chemical reaction that occurs in cells to effect transformation, production, or consumption of energy


• Understand the levels of organization.



• Chemical level (atoms and molecules): The chemical properties of a substance have to do with the way it reacts with other substances or responds to a change in the environment. Molecules are the smallest part of a substance that can exist independently without loss of the physical and chemical properties of the substance. Atoms combine to form molecules. The atoms most commonly found in living things are hydrogen, carbon, nitrogen, and oxygen. An atom can achieve a state of maximal stability by gaining or losing electrons to fill or empty its outer shell. A chemical reaction or chemical change results in the breakdown of substances and the formation of new ones.


• Organelle level: Molecules combine in specific ways to form organelles, the basic structures found in cells. Organelles perform specific functions within the cell; the sum property of these structures allows each cell to live. More than two dozen organelles have been identified.


• Cellular level: A cell is the basic structural and functional unit of a living organism. Cells are self-regulating, which allows them to adjust to change by attempting to remain constant and maintain homeostasis.


• Tissue level: A tissue is a group of similar cells that usually have a similar embryologic origin and are specialized for a particular function.


• Epithelial tissue covers and protects the surfaces of the body; lines cavities; specializes in moving substances into and out of the blood during secretion, excretion, and absorption; and forms many glands.


• Connective tissue is specialized to support and hold together the body and its parts, to transport substances through the body, and to protect the body from foreign substances.


• Muscle tissue has the ability to effect movement by shortening through contraction. Muscle tissue enables the body to move, maintain posture, and produce heat.


• Nervous tissue regulates and coordinates body activity quickly. Nervous tissue has developed greater excitability and conductivity than other types of tissue.



• Anatomy is the scientific study of the structures of the body and the relationships of its parts. Physiology is the scientific study of the processes and functions of the body that support life.


• Gross anatomy is the study of body structures large enough to be visible to the naked eye. Regional anatomy is the study of all of the structures of a particular area. Systemic anatomy is the study of the body divided into its systems. Surface anatomy is the study of internal body structures as they can be recognized and related to the overlying skin surface.


• An atom is the smallest particle of an element that retains the properties of that element. Molecules are the smallest parts of a substance that can exist independently without losing the physical and chemical properties of that substance.


• Metabolism refers to the chemical reactions in the body. A chemical reaction that releases energy as it breaks down complex compounds into simpler ones is catabolism. Anabolism is a chemical reaction that uses energy as it joins simple molecules together to form more complex molecules. Anabolism requires energy supplied from the molecule adenosine triphosphate (ATP). Enzymes are proteins that speed up chemical reactions but are not consumed or altered in the process. The acidity/alkalinity of a solution is measured in terms of pH.


• A cell is the basic structural and functional unit of a living organism. Interphase is the period when the cell grows and carries on most of its activities. Mitosis occurs when the cell divides; it is the process by which the cell reproduces itself. Meiosis is a special form of mitosis that halves the number of chromosomes in reproductive cells. Hypertrophy is an increase in the size of a cell; atrophy is a decrease in cell size.


• Organelles are the basic structures inside the cells, and they perform specific functions. Diffusion is the movement of ions and molecules from an area of higher concentration to that an area of lower concentration. Bringing substances into the cell by forming vesicles is endocytosis, and transporting substances out of the cell is exocytosis.


• A tissue is a group of similar cells that usually have a similar embryologic origin and that are specialized for a particular function. The tissue surface that faces the inside of the body is known as the basal surface.


• Epithelial tissue covers and protects the surfaces of the body; lines body cavities; specializes in moving substances into and out of the blood during secretion, excretion, and absorption; and forms many glands. A membrane is a thin, sheetlike layer of tissue that covers a cell, an organ, or a structure; lines tubes or cavities; or divides and separates one part from another.


• Connective tissue is specialized to support and hold together the body and its parts, to transport substances through the body, and to protect it from foreign substances. Within the matrix of connective tissue is a shapeless or amorphous ground substance containing molecules that expand when bound with electrolytes and water molecules. Of all the hundreds of different protein compounds in the body, collagen is the most abundant, accounting for more than one fourth of the protein in the body.


• Collagenous fibers are strong fibers with minimal stretch capacity. They have a high degree of tensile strength, which allows them to withstand longitudinal stress. Reticular fibers are delicate connective tissue fibers that occur in networks, which support small structures such as capillaries, nerve fibers, and the basement membrane. Elastic fibers are extensible and elastic. They are made from a protein called elastin, which returns to its original length after it is stretched.


• Muscle tissue provides movement, maintains posture, and produces heat. Skeletal muscle fibers are made up of large, cross-striated cells connected to the skeleton and under voluntary control of the nervous system. Cardiac muscle fibers are small, striated, involuntary fibers that enable the heart to pump blood. Smooth muscle fibers are neither striated nor voluntary. They help regulate blood flow through the cardiovascular system, propel food through the gut, and squeeze secretions from glands.


• Nervous tissue is able to regulate and coordinate body activity quickly. Nervous tissue has developed more excitability and conductivity than other types of tissue.



Factual recall questions




1. Adenosine triphosphate releases energy in muscles through what process?



2. The substance between cell tissues made up of ground substance and fibers is called ______.



3. The complementary relationship of opposites is described by ______.



4. The chemical reaction that occurs in cells to effect transformation, production, or consumption of energy is ______.



5. Atomic bonding to form molecules occurs because of the action among ______.



6. The most stable atomic bond is the ______ bond.



7. When chemical bonds are broken and new ones are formed, what has occurred?



8. The physiologic process that converts food and air into energy is called ______.



9. In which of the following chemical reactions are complex compounds formed?



10. Which of the following organelles is involved in the manufacture of proteins?



11. The most abundant component in cells is ______.



12. Cell division is the reproductive process of cells called ______.



13. When a cell is able to perform a specialized function, the structure of the cell is modified. This is called ______.



14. Basement membrane connects epithelial tissue to what type of tissue?



15. Which of the following is considered a cutaneous membrane?



16. Which of the following membranes lines cavities not open to the external environment and many organs?



17. Which of the following type of tissue is the most abundant in the body?



18. Specialization of connective tissue is focused toward ______.



19. The connective tissue type with the greatest blood flow is ______.



20. The type of connective tissue most often found in ligaments and tendons is ______.



21. Which of the following cell types is found in the connective tissue matrix that secretes bone?



22. What property of collagen may make it viable in the generation of electrical potentials ?



23. Which of the following would be considered yin?



24. If a bruise is charted as located on the client’s thigh, which of the following correctly describes where the bruise is located?



25. The terms basement membrane and reticular fibers relate to which of the following?




Application/concept identification and clinical reasoning/synthesis questions




1. In the relationship of anatomy and physiology, the phrase “structure and function” means ______.



2. How is physiology used in the application of massage?



3. Characteristics of life involve which of the following concepts?



4. Homeostasis often begins at what level of body organization?



5. The concept of yang as compared with atomic structure is ______.



6. Which type of atomic bond holds DNA together?



7. How does massage affect chemical reactions?



8. Why is the study of chemical actions in the body important to the massage professional?



9. The diverse forms of connective tissue are attributed to ______.



10. Which of the following tissues is most likely to be damaged from wear and tear of the hip or knee joint?



11. Massage methods applied to connective tissue affect its thixotropic properties by ______.



12. The Asian healing theory of the law of five elements relates best to which structures?



13. A massage therapist notices that a client’s heart rate has decreased and the client’s breathing has become slower and deeper. Which of the following best describes this outcome from the massage?



14. Which of the following statements defines homeostasis?



15. A client reports that she has hormonal imbalance related to a diet low in lipids, which means that the diet is ______.





Mechanisms of health and disease


Review tips


The content regarding mechanisms of health and disease is targeted to physiology and anatomy. This content can be tested with all three question types, although the factual recall question is most commonly used because language is still the main focus. Information in this content area is often used in case study types of questions, which combine massage application with physiologic outcomes. These questions are based on the clinical reasoning and synthesis model. Be aware of this factor in future chapters when the content becomes more complex.


As explained previously, you must know the definitions of the terms and you must be able to use the terms correctly. More complex questions use the terminology in the question and possible answers, and unless you can decipher the language, you will not know what the question or the provided answers mean. There is no easy way to study terminology. Using flashcards, reading glossaries, and doing labeling exercises reinforce the definitions of the various terms. Use the study tools in this guide and on the Evolve site, and make sure that when you read your textbooks, you know what the words mean. Also, make sure that you understand the meaning of the general language used to write the questions. If you are not sure of the meaning of a word, look it up in a glossary or dictionary. One of the challenges of any entry-level study is learning the ABCs of the system. It does not matter what you are studying—massage, computers, cooking, carpentry—you have to learn the names and meanings of the materials and equipment. For massage, this means you must learn anatomy and physiology medical terminology.



Quick content review




• Homeostasis is the relatively constant state maintained by the physiology of the body.


• Afferent signals move toward a particular center or point of reference, whereas efferent signals move away from a particular center or point of reference.


• Biologic rhythms represent the internal, periodic timing of an organism generated within the body. Entrainment is the synchronization of rhythms.


• Pathology is the study of disease.


• Congenital disease is something present at birth, not something accrued during life, whereas inherited disease is acquired naturally, not as a result of circumstance.


• Etiology is the study of all the factors involved in causing a disease.


• Uncontrolled cell division, or hyperplasia, can result in a neoplasm or an abnormal growth of new tissue called a tumor.


• A benign tumor is a contained and encapsulated neoplasm. Anaplasia is the reproduction of abnormal and undifferentiated cells that fail to mature into specialized cell types.


• Cancer is a nonencapsulated malignant cell mass that invades surrounding tissue. These cells have the devastating ability to break away from the primary tumor and form secondary cancer masses in a process called metastases.


• Inflammation is a protective response of the tissues to irritation or injury. The inflammatory response has four primary signs: heat, redness, swelling, and pain.


• Pain is an unpleasant complex, private, abstract experience. Acute pain can be a symptom of a disease condition or a temporary aspect of medical treatment. The pain acts as a warning signal, activating the sympathetic nervous system, and is usually temporary, of sudden onset, and easily localized. Chronic pain persists or recurs for indefinite periods, usually for longer than 6 months. The pain frequently has an obscure onset, and the character and quality of the pain may change over time. The pain is usually diffuse and poorly localized.


• Somatic pain arises from stimulation of receptors in the skin, in which case it is called superficial somatic pain, or from stimulation of receptors in skeletal muscles, joints, tendons, and fasciae, in which case it is deep somatic pain.


• Visceral pain results from stimulation of receptors in the viscera or internal organs.


• Phantom pain frequently is experienced by persons who have had a limb amputated and experience pain or other sensations in the extremity, as if the limb were still there. Pain may be brought on by mechanical, electrical, thermal, or chemical stimuli.



Factual recall questions




1. The common relationship between yin/yang, the five-element theory, and ayurvedic dosha is ______.



2. Ayurvedic theory classifies physiologic functions by ______.



3. Which of the following represents principles of movement?



4. Any stimulus that disrupts internal homeostasis is called ______.



5. A sensor mechanism, an integration/control center, and an effector mechanism are parts of a ______.



6. Feedback that reverses the original stimulus, thereby stabilizing physiologic function, is ______.



7. Biologic rhythms are related to ______.



8. A similarity between the traditional chakra system and biologic oscillators is ______.



9. Evidence of a healthy state includes ______.



10. The study of disease processes is called ______.



11. A group of signs and symptoms that identify a pathologic condition linked to a common cause is called a ______.



12. A disease with a vague onset that develops slowly and remains active for a long time is considered ______.



13. Which of the following is considered to be a pathogenic organism?



14. A neoplasm resulting from hyperplasia that is contained and encapsulated is considered ______.



15. Reproduction of abnormal and undifferentiated cells that fail to mature into specialized cell types is called ______.



16. Heat, redness, swelling, and pain are signs of ______.



17. Inflammatory exudate that accumulates during an inflammatory process ______.



18. Which of the following is an inflammatory mediator that dilates blood vessels?



19. The purpose of increased tissue fluid volume during inflammation is to ______.



20. Tissue repair for regeneration of functional cells is accomplished by which type of cell?



21. Tissue repair that results in a scar is called ______.



22. A major component of scar tissue is ______.



23. Genetics, age, lifestyle, stress, environment, and preexisting conditions are considered ______.



24. What do people complain about most to their health care professionals?



25. Potential tissue damage is signaled by ______.



26. The sensory mechanisms for pain are called ______.



27. The term for pain that is poorly localized, nauseating, and associated with sweating and blood pressure changes is ______.



28. Which of the following terms describes pain that may be a symptom of an organ disorder?



29. Pain that arises from stimulation of receptors in the skin or from stimulation of receptors in skeletal muscles, joints, tendons, and fasciae is called ______.



30. A massage application that creates superficial somatic pain that blocks transmission of deep somatic or visceral pain is called ______.



31. When pain is felt in a surface area away from the stimulated receptors, particularly in organs, it is called ______.



32. Aspirin is used in pain management because its effects include ______.



33. According to Hans Selye, the overall response of the body to stress is called the ______.



34. A common breathing disturbance in excessive or long-term stress is ______.



35. At which life stage is homeostasis most effectively maintained?




Application/concept identification and clinical reasoning/synthesis questions




1. A reduction in blood pressure as a massage outcome is characterized as a ______.



2. Massage that simulates sensory receptors to encourage homeostatic mechanisms is best described as which of the following?



3. What do biofeedback, massage, aromatherapy, medication, and hypnosis all have in common?



4. A client has noticed hair loss, mouth ulcers, and bladder urgency. These symptoms are related because they are ______.



5. Feedback is an essential aspect of homeostasis because of ______.



6. The effects of massage are processed by the body as a ______.



7. Many benefits of massage are a result of ______.



8. People experience relaxed mood states when ______.



9. Relaxed ordered entrainment is produced by ______.



10. Relaxation methods that focus on breathing produce entrainment because ______.



11. The chronic form of inflammation may be helped with what form of massage?



12. The treatment approach for systemic inflammatory responses and fibromyalgia include being ______.



13. A client’s low back pain returns within 3 hours of receiving massage. What organ may be the cause for referred back pain?



14. Massage used as a pain management strategy is a form of ______.



15. If a pathologic condition occurs because of a state of “too much” or “not enough,” then health would result because of ______.



16. The first response of the alarm reaction is the ______.



17. Many aspects of ancient healing wisdom are being shown as valid stress management strategies because of ______.



18. A client complains of an aching pain just under the ribs to the right of the midline, under the right scapula, and in the right neck and shoulder area. This pain has been occurring more frequently and is now almost constant. The referred pain pattern might indicate problems with what organ?



19. The client asks for very deep pressure. The massage professional keeps asking whether the pressure is causing discomfort, and the client says no. It seems that any deeper pressure may cause bruising and other tissue damage. This client may be exhibiting ______.



20. A client has had to deal with multiple stressors, including a death in the family and having a car stolen. The client is 69 years old, is sleeping poorly, and tells the massage therapist about feeling unable to deal with it all. The most logical explanation is the client’s ______.





Medical terminology


Review tips


The content about medical terminology is all about language. When studying, memorize all of the lists of prefixes, root words, and suffixes that combine to make medical terms—just like sounding out words using phonics. If you know what the parts mean, you can decipher what the word means.


This is another area for which you have to memorize the language. Again, use the study aids in this text, read glossaries, and look up words you do not understand. It may be helpful to obtain a medical terminology textbook and use it as a self-teaching tool. Elsevier has many medical terminology books and dictionaries from which to choose.



Quick content review




• A word element is part of a word. A prefix is placed at the beginning of a word to alter the meaning of the word. A vowel added between two roots or a root and a suffix to make pronunciation easier is a combining vowel. The root word element contains the basic meaning of the word, and the suffix is placed at the end of a root to change the meaning of the word. A shortened form of a word or phrase is an abbreviation.


• A chart is a written record of professional interactions representing a clinical reasoning method that emphasizes a problem-solving approach. The POMR is a problem-oriented medical record, and SOAP is the acronym (subjective, objective, assessment/analysis, and plan) for the four parts of the written account of the health assessment.


• Tao is an ancient philosophic concept and orientation that sees the universe and each individual as one and the same. By definition, kinesiology is the study of movement. Mechanical principles that relate directly to the human body are used in the study of biomechanics. Yin/yang is the dynamic balance between opposing forces and the continual process of creation and destruction within the natural order of the universe and of each person’s inner being.


• Acupuncture is the art and science of manipulating the flow of Qi, the basic life force. The centuries-old patterns that acupuncture points make on the surface of the body are grouped together in lines called channels or meridians. In traditional Chinese medicine, this system of points and meridians is known as Jing Luo. Essential substances are the fluids, essences, and energies that keep the mind, body, and spirit in balance. Shen is the spirit. Moxibustion uses burning herbs placed on or near the body to stimulate specific acupuncture points. Unlike the Western concept of organs, Chinese medicine thinks in terms of an organ system, which comprises an organ, essences, and fluids as they interact with the meridians.


• Qigong is an ancient Chinese art of exercise and meditation that supports homeostasis. The Seven Emotions are joy, anger, fear, fright, sadness, worry, and grief. Heat, cold, wind, dampness, dryness, and summer heat are known as the Six Pernicious Influences. The Seven Emotions and the Six Pernicious Influences are internal triggers of disharmony in mind/body/spirit.


• The five elements are five basic processes or phases of a cycle that represent inherent capabilities of change. The five elements are water, wood, fire, metal, and earth.


• A cun is a method of measurement that uses a relative standard of size and spacing on an individual, regardless of size or shape.


• Combine word elements into medical terms. Examples of word elements combined into medical terms are shown in Table 8-1.


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Jun 22, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Anatomy, physiology, and pathology

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