The versatile pharynx

Pharynx depicted with legs, eyes, and nose.

Here’s a body part you’ve probably never seen in isolation — and almost certainly not with legs, and a face of its own!  But these embellishments serve to emphasize that the pharynx is a middle-man, straddling two different organ systems and negotiating the competing demands of each.

Ideally, air travels in through the nasal cavity, all three parts of the pharynx (nasopharynx, oropharynx, laryngopharynx), and then the larynx, on its way to the lungs.  While eating, breathing is paused while food travels through the oral cavity (mouth), the lower parts of the pharynx (oropharynx, laryngopharynx), and the esophagus on its way to the stomach.  But as you can see, these two pathways overlap in the pharynx.  As a result, the pharynx, along with associated structures, plays a vital role in regulating the passage of air and food.

There are four ways that food and air movement can differ from the ideal situation depicted above, and these “mistakes” vary all the way from innocuous (and perhaps entertaining) to life-threatening.

First, food could move through the upper pharynx (nasopharynx).  Sometimes food is expelled this way if you sneeze or laugh while food is in your mouth.  But most of the time, the soft palate, a muscular structure, closes against the back of the pharynx to prevent this.  If you want to “get in touch” with your soft palate, try snorting – you just closed your soft palate and then opened it while inhaling.  A word to the wise: Restrict your snorting to air and mucus!  But unfortunately, if you can think of it, somebody will try it — the FDA had to issue a warning not to snort chocolate powder.

Second, air can move between the middle pharynx (oropharynx) and the mouth.  Wait, you may say, isn’t this exactly how we breathe?  If that’s your impression, then you probably have a congested nasal cavity, and it’s true we can breathe through the mouth, although it’s less than ideal.  The reason is that the nasal cavity has complex folds that help to trap debris and pathogens and do an optimal job of “conditioning” the air before it reaches the lungs.  So if, as I often do, you find yourself walking behind a group of sneezing and coughing students, it may help to close your mouth and breathe through your nose.

Like the rest of your respiratory and digestive tracts, the pharynx is a moist habitat suitable for invading microbes, and being near the entrance to both tracts, it is a common place for infections to begin.  What’s known as a “sore throat” is generally a viral infection of the pharynx.  That’s likely why we have several immune structures — the tonsils — in the walls of the pharynx.

Third, air can move between the lower pharynx (laryngopharynx) and the esophagus – the food tube leading to the stomach.  According to healthline, in most of us about two quarts of air move into the stomach this way, each day, from the small amounts of air trapped in our food or drink.  And of course, when air leaves the body through this route it is called burping — technically known as eructation.

The fourth, and by far the most serious problem, is food traveling from the laryngopharynx into the larynx.  The larynx, or voicebox, sits in front of the esophagus and is the gateway for the lower respiratory tract.  “Inhaling” your food is dangerous — in the US, over 5,000 people die from choking each year. Our main protection from choking is the epiglottis — a laryngeal cartilage between the oropharynx and nasopharynx, which folds down to close off the entrance to the larynx, every time you swallow.

Your pharynx handles a lot of traffic through the body, and deserves some respect – definitely nothing to snort at!


How a long bone grows longer

How a long bone gets longer

The process by which your bones lengthen (during childhood and adolescence) is known as longitudinal bone growth.  It’s more complicated than you might think, so I’ve simplified it here.  There’s a strip of cartilage (the epiphyseal plate, or growth plate) embedded in each end of the bone, and that’s where all the lengthening growth occurs.

Within that plate, a remarkable process occurs.  First, as you might expect, the cartilage cells grow and divide, and this is what actually lengthens the bone.  But next, the cartilage cells essentially commit mass suicide, by creating a chemical “prison” that blocks the entry of nutrients and oxygen.  As the tissue dies it leaves a space behind, where bone cells can come in and add hard bone matrix.  Ultimately, this means the bone lengthens, and the whole “construction team” of cells follows the growth region as it extends further out.  It’s analogous to a road construction crew, where you have workers engaged in all steps of construction, but positioned at different points along the road.

But instead of painting a “center line,” the final step for our bone construction team is to lengthen the internal space of the bone.  This is known as the medullary cavity, and it’s there to make the bone lighter, and to house other important tissues (like bone marrow).  A group of “demolition” cells called osteoclasts lives near the end of the medullary cavity and continually eats away at the bone matrix.  This lengthens the medullary cavity, keeping its size in correct proportion, as the bone grows longer.

Why start with cartilage at all?  Unlike bone, cartilage is mostly water so it’s an easy tissue to rapidly assemble during early development.  Later in development, most of this cartilage is replaced by bone, but an important remnant of that early cartilage is the growth plate discussed here, which persists until adult height is reached.

The blind spot in the human eye

The blind spot in the human eye

Normally, the blind spot goes unnoticed, for two reasons.  First, each eye fills in the gap in what the other eye is seeing.  So, if a mosquito is hidden in the blind spot of your right eye, you can still detect it with your left.  Each eye plays “backup” to the other.

So, does that mean that if you close one eye, you’ll see a blank “hole” in your vision, everywhere you look? While there really is a “hole” in your perception, it’s not that easy to detect. The reason is that the brain’s visual processing center fills in the “hole” by extrapolating from the surrounding area. So, if you look at a blue sky with one eye, the blind spot “sees” blue as well.

The way to “see” the blind spot is to both close one eye, and prevent your brain from extrapolating the surroundings. The way to do that is using an object that contrasts sharply with its surroundings but is small enough to “hide” inside the blind spot. In the example above, a round black spot is used.

The blind spot is one of my favorite topics for a classroom demonstration.  Using a document camera, I project an “X” on the left side of the screen, and a “dot” a short distance to the right.  I tell the entire class to close their left eye, focus their right eye on an “X” projected on the screen, and to raise their hand if the dot disappears.  I then slide the dot slowly to the right (on the document camera, this is easy to do if the “X” and the “dot” are on separate pieces of paper).  At first, only students in the front rows raise their hand, but as the visual angle between the shapes increases, hands go down in the front and start to go up further and further back in the room.

There’s a vas deferens between your epididymis and your ejaculatory duct

vas deferens mnemonic with Prof. Sperm at the chalkboard

You’ve almost made it through a semester of anatomy.  Like a sperm cell, you sometimes feel like just another face in the crowd, but you know there’s light at the end of the tunnel!

But first, you need to make sense of that tangle of tubes known as the male reproductive system.

The epididymis – which rhymes suggestively with “did he miss” – is the site of final sperm maturation.  Twenty feet of tiny tubing is coiled so tightly it fits in a structure less than two inches long, that hangs like a comma over the testis.  The epididymis is also where the sperm bide their time until ejaculation occurs.

But most of the semen is not sperm, and is instead produced by glands, found further down the assembly line.  The seminal vesicle, in particular, plays a seminal role, producing 60% of the semen, a concoction of nutrients, signals and other molecules.

On Professor Sperm’s chalkboard diagram, the ejaculatory duct represents the confluence where the wriggling sperm are doused with this sticky cocktail.  Other glands down the pipeline (prostate and bulbourethral glands) complete the mix, as it travels through the urethra on its way to the exit.

If all those tubes are starting to sound alike, take heart!  Between the epididymis and the ejaculatory duct, there’s truly a vast difference, and also, a vas deferens.  This longest of the male tubes (18 inches or so) is called into play only at the time of ejaculation, transporting the sperm all the way up the scrotum, along the inguinal canal and finally hurtling them into the ejaculatory duct.

In place of “vas deferens”, many books now use the term “ductus deferens”.  To that, I say, “same difference!”

Gray and white matter – the cities and highways of the brain

gray and white matter is city and highway

Your brain has around a hundred billion signaling cells called neurons, forming an astronomical number of connections (synapses).  The “wiring” is incredibly complex — an electrician’s nightmare!  Hundreds of functional brain regions and circuits have been identified, but to a large extent the brain is still a “black box”.

One thing that’s plain, though, as you look at a slice of brain, is that it’s divided into two general types of tissue.  Gray matter is where information is processed.  Here you’ll find dendrites, the “input cables” that a neuron uses to take in information.  These are all attached to the cell body, which therefore, in effect represents an “integration zone” for all the signals coming in.   If the neuron decides it has something to say about the matter, it fires off a signal through the axon, the single “output cable” of the cell.

You’ll also find white matter, distinguished by the presence of myelin, a wrapping provided by other cells (here, oligodendrocytes, seen hanging under the “freeway”).   Myelin is a fatty material so the white color is not surprising — think of the pale crust of grease on a refrigerated pot of chicken soup.

Unlike the water that fills and surrounds each cell (remember: keep that hair dryer out of the bathtub!), fat is a poor conductor of electricity, so myelin serves as an insulating covering for axons.  It prevents an axon from being “short-circuited” when two axons lie side by side, and it also greatly speeds up the signal transmission along an axon.  So, a group of myelinated axons (which can be up to several feet long!) is a good way to carry a large body of information from one place to another, quickly and uncorrupted.

What we have, then, is a sprawling “metropolitan area” consisting of “commercial city centers” joined together by high-speed, multi-lane “highways”.  Gray matter tends to have highly branched neurons with many connections, allowing intricate exchange of information.  The flow of “traffic” is complex, and stops are frequent.  White matter is all about rapid, long-distance signaling from one “city center” to another, very much like an expressway.  These axons are insulated against nervous input, but at intervals some will branch off to make a connection.

Proceeding with this fantasy, we see an exit approaching for “Las Vagus” – that’s a reference to the vagus nerve, a major nerve that extends from the brain to many of your internal organs.  You may also have noticed that on white matter, the ride is a bumpy one – That’s because there are gaps in the myelin (nodes of Ranvier).  Paradoxically, though, in real life these gaps actually speed up the signal!

Capillaries do all their work in bed – they’re not lazy, but they’re leaky!

Capillaries do all their work in bed – they’re not lazy, but they’re leaky!

Capillaries leaking in bed

Our tiny capillaries are the most important blood vessels in the body, responsible for supplying virtually all the oxygen and nutrients that our organs depend on.  So how do they behave, under the immense burden of this great responsibility?  They never even climb out of bed!

A capillary bed is the name for a group of capillaries that all receive blood from the same source.  The source vessel is called a metarteriole, and from there, a branching network of capillaries originates.  The large number of branches provides a huge surface area across which diffusion can rapidly deliver the materials demanded by the surrounding tissues.

But there’s something else going on in most capillary beds – they’re leaky.  But don’t worry, it’s perfectly normal!  There are holes in the capillary walls, allowing the fluid component of blood (plasma) to leak out, and this is how the body’s interstitial fluid is produced.  The bulk flow of fluid across the capillary wall, back and forth between the blood and surrounding tissues, permits more rapid exchange than diffusion alone can provide.

Capillary leakiness varies greatly from one organ to the next, depending on the need for exchange.  The liver is the “water purification plant” of the body, and requires tremendous amounts of exchange to do its job – it therefore has among the leakiest capillaries.  At the other extreme, the brain is like a “cleanroom” where contaminants are excluded to prevent “misfires” of the delicate neural machinery – so its capillaries are almost watertight (the blood-brain barrier).

Given that most capillaries are leaky, what happens to all that water?  Does the bedroom flood completely, until a plumber is called to the scene?  Well, not quite.  The answer to this problem is the lymphatic system – it’s the storm drain of the body, which collects all the excess interstitial fluid of the body, and carries it right back to the blood…to be leaked out, all over again, by our hard-working capillaries.

Don’t have a heart attack!

Don’t have a heart attack!

heart with obstructed coronary artery

This week’s image may seem melodramatic, but I’m sure if you were a heart undergoing a heart attack, you’d feel something like this.

Heart attacks teach us that the heart is like any other organ – it consists of cells that require oxygen and nutrients to survive.  The other thing we learn is that, despite the large amount of blood in the heart, almost none of its contents are directly available to the heart’s cells.  That’s because diffusion is only effective across short distances, so the thickness of the heart’s walls prevents all but the inner surface cells (endothelium) from acquiring their vital resources in this way.

The solution is for the heart to have its own network of blood vessels, the coronary arteries, penetrating deep into the heart walls to supply its own tissues with blood.  The suffering heart depicted here is actually anatomically correct (minus the face and heads), allowing us to see all the major blood vessels that deliver blood to and from the body.

Oxygenated blood, from the lungs, reaches the heart through the four pulmonary veins, entering horizontally from the sides.  It enters the left side of the heart, which ejects this oxygen-rich blood (shown in red) into the aorta, the largest artery in the body.  The aorta emerges diagonally from the left side and arches over the top of the heart, branching many times to provide oxygen to the entire body.

From the aorta, the right coronary artery curves around the heart’s right side (on the left side of the page), and the left coronary artery curves toward the heart’s left side, each providing many branches of their own.  If one of these becomes blocked by a blood clot or fatty deposits in the artery walls, then a heart attack results – meaning the heart tissue dies due to the obstructed blood supply, and the resulting lack of oxygen to that region.  This is different from cardiac arrest, in which the heart stops beating – a problem with the electrical conducting system of the heart.  (However, the two problems can be related, if a heart attack damages part of the conducting system.)

Let’s look at the rest of the blood flow, in a healthy heart.  From a coronary artery, tiny branches (capillaries) supply oxygen to the heart’s tissues by diffusion, and drain into cardiac veins (not shown) which drain into the right side of the heart.  This is also where oxygen-depleted blood enters from the rest of the body, through the superior and inferior vena cava (vertical vessels on the left side of the page).  From there, it is pumped through the pulmonary trunk (large vessel crossing in front of the aorta) back to the lungs.

Which tissue do we need the most?

Which tissue do we need the most?

The entire body is composed of only four basic tissue types.  Muscle tissue, of course, allows you to move around.  But it’s also what moves your internal organs – the beating of the heart, the rumbling of the stomach.  Even your blood vessels have muscle tissue, which controls the distribution of blood in the body.  It’s hard to argue we could live without muscle.

But most of our muscles wouldn’t be much good without nervous tissue, which responds to stimuli and coordinates the activity of your organs.  It’s true that many of the slower, internal processes do not depend on nervous input – they may instead involve hormones, for example.  But what good is a body without a brain to give it meaning?

Epithelium, though, really is essential at the most basic level.  This is the tissue that lines all your external surfaces and your internal spaces.  Every substance that enters the body (food, water, oxygen) must cross an epithelium to do so.  These tissues are therefore the “gatekeepers” to the body, in charge of exchange with the environment – although, under the command of nervous tissue.

So the tissues must work together, and there’s no better example of this than the fourth basic type, connective tissue.  As the name suggests, it is the “putty” that holds the body together, filling in all the spaces between epithelium, muscle and nervous tissue.  But it also provides pathways for the movement of materials within the body.  This is the most diverse tissue type, including blood, the essential medium of transport, but many other types such as bone and cartilage.  The key feature of connective tissue is the presence of a large amount of nonliving “stuff” in between the living cells – the extracellular matrix.  Water is often abundant here, and this interstitial fluid forms another major transport medium for substances to move among all the tissues.

So of course, it’s hard to say any one basic tissue is more important than another.  I don’t know about you, but this “exchange” about the “connections” has been a “moving” subject for me that touches a “nerve”.  Pass the box of tissues!

Who supports your support system? An unsung hero — connective tissue

Connective tissue, the inner part of the wall that conveys the body's infrastructure

If you’ve been reading this blog, by now you’ll know that the oxygen and nutrients your cells depend upon first enter the cell’s neighborhood by means of your crowded capillaries.  Molecules then diffuse outward across the interstitial fluid to reach most cells in your body.  The cardiovascular system is the most obvious “support system” in the body because it circulates the blood that keeps your cells alive.  It also works with the kidneys to remove wastes.  I’d also add the lymphatic system (see lymph nodes) which drains excess interstitial fluid and filter pathogens from it.  And, I’d include the nervous system which carries a crucial pipeline of information that many cells depend on to do their job.

But who supports the “support system”?  Do your blood vessels, lymph vessels and nerves simply meander through the body, or is there a structure – a scaffolding — that holds them in place?  Yes, there is – our unsung hero, the connective tissues of the body.

In a typical organ like your stomach, lungs, or skin, you’ll have one or more layers of epithelium at the surface (shown in yellow) to interact with your food, air, or the external environment.  Always behind that epithelium you’ll have connective tissue (shown in brown) which carries the blood vessels, lymph vessels, and nerves that serve that region of the body.  Even a muscle layer (for example in the stomach), as seen at far right, actually contains, between the muscle cells, a great deal of intervening connective tissue, which is where the vessels and nerves travel.  (This is the endomysium, the “first class seat” that supplies all the muscle cell’s needs.)

As you go about your business indoors, at work or home, think of the wall surfaces as an epithelium.  They provide electrical outlets, faucets, heating vents and other necessities for life.  But all of these things come to you through an infrastructure of electrical wires, water and sewage pipes, ventilation ducts, and internet cables that travel, unseen, through the walls.  Inside your body, that role of the “internal wall space”, which supports and conceals the “support system” of the body, is served by connective tissue.

Your crowded capillaries

Red blood cells in capillary

Your blood is crowded with red blood cells, or erythrocytes — they occupy around 45% of blood volume in most people (that number is the hematocrit).  This becomes more evident when you look at the capillaries, the tiniest blood vessels.  These vessels are literally what keeps you alive from one moment to the next — providing virtually all the oxygen and nutrients, and removal of wastes, that allows your organs to survive — brain, muscles, skin, bones, and so on… even the heart itself.

Red blood cells travel in single file down your capillaries.  This is no accident, because exchange here depends on the rate of diffusion, the passive drift of molecules from regions of high to low concentration.  Diffusion is a cheap, but slow, way for a cell to get its “groceries”, so the only way this can work is to minimize the diffusion distance those molecules have to travel.

Capillaries accomplish this in two ways.  The narrow vessel means that an oxygen molecule, for example, is never more than half a cell’s diameter away from the wall of the vessel.  But also, the wall itself is extremely thin (endothelium — a type of simple squamous epithelium), further minimizing the diffusion distance.

On top of this, your capillaries branch many times to permeate the tissues.  It’s been estimated that if all your capillaries were laid end-to-end, they would total 50,000 miles — enough to wrap twice around the Earth.  Packed into your tissues, this provides an enormous contact surface, across which exchange can occur.

Not only does this branching increase contact, it also decreases the velocity of blood flow — in the same way that a wide hose ejects water more slowly than one with a thumb placed partway over the end.  The speed of blood flow in the aorta (the largest artery) is about 1 ft./sec. but goes down to around 1/1000 that speed in the capillaries — about 3/10 of a millimeter (equivalent to around 30 cells) each second.

So, picture a long, but crowded buffet line that moves briskly along — each cell has a chance to exchange everything it needs to (albeit without much elbow room) before it shoots out the other end of the capillary, to head back toward the lungs.