Gray's Anatomy Puzzle Book: Think you know your cranium from your clavicle? Tibia from your trachea? Think again ... [1 ed.] 9780711254411, 9780711254428, 0711254427, 0711254419

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G R AY ’ S A N AT O M Y PUZZLE BOOK

First published in 2020 by White Lion Publishing, an imprint of The Quarto Group, The Old Brewery, 6 Blundell Street, London, N7 9BH, United Kingdom www.QuartoKnows.com © 2020 Quarto Publishing plc. Text by Gabrielle M Finn Puzzles by Gareth Moore All rights reserved. No part of this book may be reproduced or utilised in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without permission in writing from White Lion Publishing. Every effort has been made to trace the copyright holders of material quoted in this book. If application is made in writing to the publisher, any omissions will be included in future editions. A catalogue record for this book is available from the British Library. ISBN 978 0 7112 5441 1 eISBN 978 0 7112 5442 8 10 9 8 7 6 5 4 3 2 1 Comissionning Editor Nicki Davis Project Editor

Joe Hallsworth

Proofreader

Caroline Curtis

Designer

Isabel Eeles

Typeset in Century Expanded Printed in China

G R AY ’ S A N AT O M Y PUZZLE BOOK GARETH MOORE GABRIELLE M FINN

Contents PUZZLES   7 SKELETON AND LIMBS

HEAD AND NECK

01  The ribs and rib cage  9

12  The brain  53

02  The hand and wrist  13

13  Cranial nerves  57

03  The foot  17

14  The spinal cord  61

04  The skull  21

15  The eye  65

05  The skeleton  25

16  The ear  69

06 Vertebrae 29

17  The nose  73

07  The shoulder  33

18  Oral cavity  77

08  The pelvis  37

19  Pharynx and larynx  81

09  The upper limb  41 10  The lower limb  45

THORAX

11  Facial muscles  49

20  The heart  85 21  The lungs  89

ABDOMEN

PELVIS

22  The liver  93

29 Uterus 121

23  The spleen  97

30  Penis and urethra  125

24  The pancreas  101

31 Bladder 129

25  The stomach  105

32  Pelvic floor and perineum  133

26  The kidney  109 27  Small intestine  113

BODY SYSTEMS

28 Large intestine (colon)  117

33  Nervous system  137 34  Lymphatic system  141 35 Skin (integumentary system)  145 36  Circulatory system  149

SOLUTIONS  152 INDEX   190 CREDITS  192

Puzzles

7

T

he study of the human body is fascinating and complex, with its own technical language, which can seem inaccessible or difficult to navigate. This book doesn’t try to explain or name everything but provides you with an easy-to-follow introduction describing how the body is built and how it works. As you travel from one part of the body to the next, read the introductions to learn more, looking for clues in the text along the way. You’ll then encounter a related set of puzzles with illustrations from the iconic medical reference text Gray’s Anatomy, each designed to encourage you to think more carefully about our anatomy and physiology. Entertaining, and all different, the puzzles will test your powers of observation and general knowledge, challenging you to unravel anagrams, crack codes, find missing pieces, link up matching parts and decipher cryptic clues. Tackle the puzzles on your own or with friends, and in any order you like. Some are straightforward, but others will require more thought and closer scrutiny – so that you’ll want to turn back the pages and discover things you may have missed.

9

01

TH E RIBS AND RIB CAG E The thoracic cage (rib cage) is part of the axial skeleton. The role of the thoracic cage is to protect the heart and lungs. It is formed of twelve pairs of ribs with their costal cartilages and the sternum. The ribs are anchored at the back (‘posteriorly’) to the 12 thoracic vertebrae known as T1 to T12. The ribs are curved and flattened bones. Each rib, also numbered 1–12, articulates posteriorly with its respective thoracic vertebrae. For the most part, ribs attach at the front (‘anteriorly’) to the sternum via cartilage, known as costal cartilage. The ribs are classified as true, false or floating. Ribs one to seven are true ribs, as their costal cartilage attaches directly to the sternum. Ribs 8–12 are false ribs, as their costal cartilages does not attach directly to the sternum. Ribs 11 and 12 are also called floating ribs, as they do not attach to the sternum at all. The costal cartilages of ribs 11 and 12 terminate within the muscles of the anterior abdominal wall. The sternum is an elongated bony structure that has the appearance of a necktie. It is composed of three parts: the manubrium, body and xiphoid process.

10

SKELETON AND LIMBS

RIB MATCH Ribs are called either true or false, depending on whether or not they attach to the sternum. Using the information in the text, can you complete the empty labels in this diagram by marking each of the labelled ribs as either a true or a false rib?

trachea

One of these labelled ribs is also known as a floating rib. Which one? sternum

The ribs and rib cage

LOST LETTERS Can you answer the following questions about the rib cage? In each case the answer is actually given to you, but it has been altered by removing any letter also found in the word ‘ANATO M Y’. Use a combination of your general knowledge and word skills to identify the underlying words.

1.

What is the name of the flat bone at the front of the rib cage? SERU

2.

How many ribs are there, counting each pair as two ribs? WE -FUR

3.

Muscles attached to the rib cage assist in what process? BR E HI G

4.

What are the names of the three sections of the sternum? UBR I U a) b) BD c) X I PHI D PR CE S S

5.

A true rib articulates (i.e. forms a joint) with two bones. One of them is the bone given in answer 1, but which is the other? One of the V E R E BR

CRYPTIC CLUES These cryptic-crossword clues all describe anatomical words or phrases which can be found in this chapter. Can you solve them?

1.

Price precedes Alabama relating to ribs (6)

2.

Disarrayed chaotic grace reveals bony frame (8, 4)

3.

Severe hesitation for breastbone (7)

11

13

02 TH E H AN D AND WRIST Positioned at the end of the upper limb (arm), the hand is an appendage that has evolved to grip and hold. The hands have a high density of nerves, especially in the fingertips, meaning the fingers have more touch sensitivity than other parts of the body. The hand has five digits: four fingers plus one thumb. It is composed of many different bones, muscles and ligaments, thus allowing a large range of movement. There are three major types of bones in the hand: carpal, metacarpals and phalanges. The carpal bones are a set of eight irregularly shaped bones, located in the wrist area. These are the most proximal bones of the hand, meaning closest to the body. Next are five metacarpals – each one related to a digit. Finally, the phalanges which are the most distal (furthest from the body) – these are the bones of the fingers. Each finger has three phalanges, except for the thumb, which has two. The thumb is termed opposable because it can move to touch the other fingers, providing the ability to grip. The wrist, a complex joint bridging the hand and forearm, is formed by the carpal bones plus the two long bones of the forearm – the radius and the ulna. Some carpal bones are named after structures that they resemble, such as, the lunate – so called because it is halfmoon shaped. Or the pisiform, the smallest carpal bone, located on the side of the little finger, so called because it is pea-shaped.

14

SKELETON AND LIMBS

Hand: Anterior

scaphoid tubercle

lunate capitate

triquetral

C A R PA L BONES

trapezium

A

trapezoid 1st metacarpal sesamoid bones

M E TA C A R PA L BONES

head

sesamoid bones

base head proximal phalanx PHALANGES

middle phalanx

distal phalanx tuberosity

A

R

WORD CIRCLE

T

E

I N

O R

Can you rearrange the eight letters in this word circle in order to reveal a word that appears in the diagram above? Then, can you find three other anatomical terms (unrelated to the hand), one with six letters and two each with three letters? Each of these three further words must include the centre letter, and cannot use any letter more than once.

The hand and wrist

DECODING DIGITS The answers to the following questions are given but have been encoded with a system you may once have used while contacting friends and family. Work out what this is in order to reveal the answers – or simply use your knowledge of the bones of the hand.

1.

Which set of bones in the hand are furthest from the centre of the body? 7 44 2 555 2 66 4 33 7777

2.

What is the name of the small, spherical carpal bone labelled A on the diagram opposite? 7 444 7777 444 333 666 777 6

3.

4.

Which bones make up the wrist? a)

222 2 777 7 2 555 0 22 666 66 33 7777

b)

777 2 3 444 88 7777

c)

88 555 66 2

Which part of the hand is most often injured? 555 444 8 8 555 33 0 333 444 66 4 33 777

CRYPTIC CLUES Can you solve these cryptic-crossword clues in order to reveal three words related to the hand or wrist?

1.

Request free ride with digit (5)

2.

Came across a vehicle friend’s hand bone (10)

3.

California hole consumed bone at the base of the palm (8)

15

17

03 T H E FO O T The feet are flexible structures consisting of bones, joints, muscles and soft tissues which enable people to stand and perform activities including walking, running and jumping. The feet attach to the leg via the ankle joint (or talocrural joint). It is a synovial joint formed by the bones of the leg (tibia and fibula) and the foot (talus). Almost a quarter of the bones in the body are in the feet. The feet are divided into three sections. The forefoot contains the five digits (toes) – which are made of phalanges – and the five longer bones, metatarsals. There are 14 phalanges in each foot: 2 in the hallux (big toe) and 3 in each of the remaining digits. The midfoot is a collection of bones – the cuboid, the navicular (named due its boatlike appearance) and 3 cuneiform bones – forming the arch of the foot. The hindfoot forms the heel and ankle. The talus bone supports the tibia and fibula (bones of the leg), forming the ankle. The calcaneus (heel bone) is the largest bone in the foot. The calcaneal tendon (Achilles tendon) connects the heel to the calf muscle and is essential for running, jumping and standing on the toes. The old phrase the ‘Achilles heel’ refers to this structure. Movement in the feet is achieved via the complex anatomy of 26 bones, 33 joints, 19 muscles, 10 tendons and 107 ligaments in each foot.

18

SKELETON AND LIMBS

MATCHING UP

Bones / Tendons:

The original inspirations for naming bones have come from various sources, such as their physical resemblance to various objects, or to mythological stories. See if you can pair the following four bones with the four derivations of their names:

1.

Navicular

2.

Achilles tendon

3.

Cuneiform

4.

Cuboid

Derivations: a. Resembling a boat b. Shares its name with a 3D shape c. Named after a Greek warrior d. Wedge-shaped

calcaneus

talus TA R S A L BONES

talus

cuboid

navicular

tubercle of navicular cuneiform bones M E TATA R S A L BONES

sesamoid bones

PHALANGES

The foot

19

6

12 Bones

Joints

27

9

Muscles

14 Tendons 10

7

68 3 Ligaments

39

MEDICAL INCISIONS The foot consists of various bones, joints, muscles, tendons and ligaments, but do you know how many there are of each? Find out by drawing three straight lines inside this square, to divide it up into five separate regions. Each region should contain one word, one bold number and one non-bold number. The sum of the two numbers in each region will reveal the total count of the body part described by the word.

CRYPTIC CLUES These cryptic-crossword clues all solve to parts of the foot, or something you will find inside the foot. Can you crack them? 1.

Female deer takes distance with heel and ankle (8)

2.

Pulls vehicle, so we hear, with big digits (4)

3.

Cloth fibres cover sport tissue holding two bones together (8)

21

04 TH E SKUL L The skull is a bony structure that supports the face and forms a protective cavity for the brain. An adult skull consists of 22 bones, divided into two parts deriving from their differing embryological origin, the neurocranium (the cranium) and the viscerocranium (the face). The cranium forms the cranial cavity which surrounds and protects the brain, brainstem and associated structures. The bones of the cranium are joined together by fibrous joints known as sutures. The joints do not fuse until adolescence in order to allow for brain growth during earlier years. The cranium is subdivided into a roof (known as the calvarium) and a base. The calvarium is comprised of the frontal, occipital and two parietal bones. The base is comprised of six bones – the frontal, sphenoid, ethmoid, occipital, parietal and temporal bones. These bones in the base are important because they are the point at which the vertebra, facial and jaw bones articulate to form joints. The viscerocranium is the facial skeleton and thus supports the muscles and tissues of the face. The structure of these bones determines features and shapes of the face – for example, the cheekbone from the zygomatic arch. It is comprised of 14 bones: the vomer, 2 inferior nasal conchae, 2 nasal bones, maxilla, mandible, palatine, 2 zygomatic bones and 2 lacrimal bones. The human skull has numerous holes within the base, known as foramina, through which cranial nerves, arteries, veins and other structures pass. The mandible bone articulates with the base of the cranium to form the jaw.

22

SKELETON AND LIMBS

lacrimal bone

vomer

maxilla

mandible

SKULL SUDOKU The skull is divided into several sections, each containing a number of bones. Solve this sudoku puzzle to reveal how many bones there are in each region, by copying the numbers from the coloured squares into the corresponding box in the table below.

4 2

3 6 1

To solve the sudoku itself, place 1 to 6 once each into every row, column and bold-lined 3 × 2 box.

NAME Bones in the calvarium Bones in the base of the cranium

1

Inferior nasal conchae Zygomatic bones

4 6

Lacrimal bones Mandible bones Vomer bones

NUMBER

The skull

23

frontal bone

parietal bone

sphenoid bone

ethmoid bone

A

zygomatic bone

occipital bone

zygomatic arch temporal bone

temporal styloid process

MISSING LETTERS Can you answer these questions about the skull? The solutions are given but have had every alternate letter removed, which have then been collected alongside each incomplete word. Can you use your general knowledge and decoding skills to fill in the blanks? 1.

What type of bone is labelled as A on the diagram? _A_A_

2.

The outline of the jaw is created by which bone? M_N_I_L_

3.

Letters to add: A C C I I M R

What is the name given to the fibrous joints of the skull? _U_U_E_

6.

Letters to add: A I O Y

The vomer belongs to which division of the skull? V_S_E_O_R_N_U_

5.

Letters to add: A B D E

If someone applied blusher to their cheeks, which bone would they sweep across? Z_G_M_T_C

4.

Letters to add: L N S

Letters to add: R S S T

Cranial nerves exit the skull through which structures? F_R_M_N_

Letters to add: A A I O

25

05 TH E SKEL ET O N The skeleton can be divided into two parts: the axial and appendicular skeleton. The axial skeleton makes up the central axis and consists of the skull, vertebrae, ribs and sternum. The appendicular skeleton is composed of the bones of the upper limbs, the lower limbs, the pectoral girdle and the pelvic girdle. The girdles are the points of attachment for the upper and lower limbs. The vertebral column is commonly known as the backbone or spine. There are normally 33 vertebrae in the spine. The upper 24 are articulating, meaning that they form joints and are separated from each other by intervertebral discs. The lower nine are fused in adults: five make up the sacrum and four make up the coccyx or tailbone. The coccyx can vary with between three and five fused bones. The articulating vertebrae are named in accordance with their location: seven cervical C1–C7 (neck), 12 thoracic T1–T12 (chest) and five lumbar L1–5 (lower back). The fused sacral bones are also named accordingly, S1–S5. The spine’s typical s-shape has three curves, maintained by the muscles of the back and abdomen. The first concave c-curve is the cervical curve. Next is the thoracic curve which is less pronounced. The final c-curve is the lumbar curve. The curves are also categorized as either lordotic or kyphotic. Lordosis is a normal inward curvature of the spine, seen in the cervical and lumbar regions. Kyphosis is a normal outward curvature, found in the thoracic region. Scoliosis refers to sideways curves of the spine and is always abnormal.

26

SKELETON AND LIMBS

DELETED LETTERS Delete one letter from each of the capitalized pairs in order to reveal the answers to the following questions about the skeleton. For example, CB AO NT LE could lose one letter from each pair to reveal ‘BONE’: CB AO NT LE 1.

The skeleton can be divided into two parts. The skull and vertebral column are part of which of these? AE PX IC IA DL

2.

How many vertebrae typically make up the spine? ET IH RI RG TM RY - FT HU OR L E E Y

3.

A spine with scoliosis would be abnormally bent in which direction? FS OI DL ER AW AR NY ST

4.

Can you name the regions of the spine, in order from top to bottom? a. CH AE RP LV RI EC AL SL b. ST CH OA IR AE HC PI AC c. LF EU LM BO NA RI d. RS AI MC RT UA LC e. MC NO CE CL IY FG SE AL I L

5.

What is the name of the structure labelled A on the opposite page? It occurs between the vertebrae. TI NH AT LE RO XV EL AR TR E A N B PR A L I L LD OI ES DC

CODED WORDS Each of the following rows of squares represents a different anatomical term relating to the skeleton. Every letter has been replaced by a number, and each place the same letter appears the same number is used. No number is used for more than one letter. Can you use your code-cracking skills and anatomical knowledge to write the correct letter in each square, to reveal these terms? Two letters have been filled in already to help you, and you can use the table beneath to keep track of your deductions.

The skeleton

27 1st cervical or atlas

1

4

1

1

12

9

16 L

4

10

6

4

3

5

3

11

12

18

8

4

3

5

3

2nd cervical or axis

1st thoracic

3

1

4

16 L

5

4

3

5

18

13

1

15

4

10

7

16 L

19

5

10

6

16 L

13

17

13

10

15

13

21

10

7

1

4

16 L

14

20

2

3

16 L 1st lumbar

N

1

13

10

17

5

1

14

10

17

13

16 L

14

20

21

7

1

14

10

17

13

1

7

16 L A

10 sacrum coccyx

Use this table to keep track of your deductions:

1

2

3

4

5

N

6

7

8

9 10 11 12 13 14 15 16 17 18 19 20 21 L

Bonus question: Which is the only one of the above terms not to refer to the spine?

29

06 VERTEB RAE The spine consists of 33 vertebrae. Vertebrae in the cervical and thoracic spine are separated and cushioned by an intervertebral disc, preventing them from rubbing together. Vertebrae share a fairly common structure – an anterior vertebral body, and a posterior vertebral arch. The body is weightbearing and lower vertebrae have larger bodies than those in the upper spine in order to support more weight. The vertebral arch forms the side (lateral) and back (posterior) parts of each vertebrae. Together the body and arch form an enclosed hole – the vertebral foramen. The foramina of all the vertebrae line up to form the vertebral canal, which encloses the spinal cord. Vertebra structures differ slightly between spinal regions. For example, thoracic vertebrae have depressions called demifacets which articulate with the ribs. Typically, vertebral arches have several bony prominences – these are the sites at which muscles and ligaments attach. Each vertebra has a single spinous process, centred at the back, although in cervical vertebrae this is split into two at the end (bifid spinous process). There are two transverse processes, which extend sideways (laterally) and posteriorly from the vertebral body. Pedicles connect the vertebral body to the transverse processes. The lamina connect the transverse and spinous processes. Finally, articular processes enable joints to form between one vertebra and the vertebra above and below it. These articular processes are located at the intersection of the laminae and pedicles. C1 and C2 cervical vertebrae (called the atlas and axis respectively) are unique in structure to allow for the movement of the head. The coccyx has no vertebral arches and thus no vertebral canal.

30

SKELETON AND LIMBS

Lumbar verterbra spinous process vertebral foramen lamina

transverse process

superior articular facet transverse costal facet

body

Cervical verterbra

body

foramen for vertebral artery transverse process

pedicle spinal canal

articular process

lamina

spine

Vertebrae

A S

V

31

E R

E

T

S N

R

WORD CIRCLE Can you rearrange the ten letters in this word circle in order to reveal a word which appears on the diagrams of the vertebrae? Then, can you find some further words that can be related to the body and its functions (not specifically related to the vertebrae), including a six-letter and a five-letter word? Each word must include the centre letter, and cannot use any letter more times than it appears in the circle.

CRYPTIC CLUES Can you solve these cryptic-crossword clues in order to find three anatomical terms relating to the vertebrae? The solutions can be found either labelled on the diagrams or mentioned in the introductory text to this chapter.

1.

Bone opening in support of prayer ending (7)

2.

Spilled char to form symmetrical curve (4)

3.

Unable to walk around in a set of thin tissue layers (7)

33

07

T H E SH O UL DER Three bones make up the human shoulder: the clavicle (collarbone), the scapula (shoulder blade) and the humerus (long upper arm bone) and the associated muscles, ligaments and tendons. Within the shoulder is the shoulder joint, also known as the glenohumeral joint, a ball and socket joint. It lies between the shoulder blade and the humerus, which is the long bone in the upper arm. The shoulder is a major joint connecting the upper limb to the thorax. It is one of the most mobile joints in the human body, but it is not overly stable and thus is prone to dislocation (subluxation). The scapula connects the humerus with the clavicle. The shoulder joint is surrounded by a group of muscles known as the rotator cuff – they function to keep the humerus within the socket of the shoulder, which is very shallow. The humerus sits within a depression in the scapula, known as the glenoid fossa. Four muscles make up the rotator cuff: supraspinatus, infraspinatus, teres minor and subscapularis. The well-defined triangular muscle, seen at the top of the arm is the deltoid. This is a large muscle responsible for lifting each arm and providing the shoulder with its range of motion. The deltoid is named after the Greek letter delta, which is shaped like an equilateral triangle.

34

SKELETON AND LIMBS

PATHFINDER In the diagram of the shoulder opposite, only the first letter of most words is given. Can you restore all of the missing words by solving the puzzle below? Trace a single continuous path through the grid which visits every square exactly once, tracing out a series of nonoverlapping words so that each letter appears in exactly one word. The path can travel in any direction from square to square, except diagonally. The first word has already been found for you. As you find the words, copy them to the corresponding slot in the diagram. For example, the first word, ‘shoulder’, should be copied to the ‘1’ slot.

S

H

O

U

L

D

E

R

L

N

O

I

M

T

N

E

M

I

C

O

R

O

S

C

A

A

G

O

C

A

R

C

A

P

U

L

I

D

P

R

I

D

O

C

A

M

U

H

O

O

Z

N

E

C

E

R

S

C

P

E

O

L

L

S

U

S

E

A

R

I

C

A

J

O

I

N

T

T

D

I

V

The shoulder

35

1. S_____ (8)  10. j_____ (5) coracoclavicular 2. l_______(8)

6. t_____________(9)

5. c_______(6)

7. a__________(8)

4. c_____________(8) coracoacromial 2. l__________(8)

8. c__________(8) p_________(7)

3. s_________(7)

9. h_________(7)

LETTERMORPHOSIS Can you find words that fit the descriptions to the right by picking an anatomical word from the introduction to this chapter and adding or removing a single letter? For example, the word ‘toe’ (were it to occur in the introduction) could be changed into ‘tone’ by adding an ‘n’, or ‘skin’ could be changed into ‘kin’ by removing an ‘s’. The numbers after each clue specify the number of letters in each solution, to help you.

1.  Scrape (5) 2.  Having moderate heat (4) 3.  A single (3) 4.  Ascend (5)

37

08 T H E PE LVI S The pelvis is a basin-shaped collection of bones that function to connect the thorax and the lower limbs (legs). It supports the thorax, bladder and the internal sex organs. The bones can be divided into the pelvic girdle and the pelvic spine. The pelvic girdle, also known as the ‘hip bone’, is composed of three fused bones: the ilium, ischium and pubis (the pubic bone). These bones begin to fuse at puberty, before which triradiate cartilage separates the parts. Together, the ilium, pubis and ischium form a cup-shaped socket known as the acetabulum – the head of the femur (the long bone found in the thigh) articulates with the acetabulum to form the hip joint. The pelvic spine is the posterior portion of the pelvis below the lumbar spine, composed of the sacrum and coccyx. The bony pelvis consists of paired hip bones (innominate bones) – connected at the front by the pubic symphysis (slightly moveable joint) and behind by the sacrum. The pelvis opens superiorly toward the abdomen via a wide bony opening, the pelvic inlet, or pelvic brim. The greater pelvis (false pelvis) is located superiorly and provides support organs of the lower abdomen. The lesser pelvis (true pelvis), located inferiorly, is where the pelvic cavity and pelvic viscera are found. The junction between the greater and lesser pelvis is known as the pelvic inlet. Female pelvises have differences in their structure to facilitate childbirth. The male pelvis is narrower, taller and heart-shaped, whereas the female is more oval-like with a straighter coccyx and wider angle anteriorly to create a greater pelvic outlet for childbirth.

38

SKELETON AND LIMBS

brim of pelvis

let

pel sacrum

le c in t vi

p el vi c i n

ilium

coccyx

pu

bic arch

ischium

WORD FRAGMENTS The answers to the three questions on the opposite page about the pelvis have been split into fragments, listed below. Can you use your word skills and anatomical knowledge to reassemble the fragments and reveal the correct answer or answers to each question? The number of words and characters in each solution is provided to help you. BIS ER HA HEA HIUM ILI IN ISC LER LET NAR PED PEL PU ROW RT-S TAL UM VIC

The pelvis

1.

What is the name of the junction between the greater and lesser pelvis? _______________

2.

___________ (6, 5)

Which bones make up the hip bones (innominate bones)? a)  ___________ (5) b)  ___________ (5) c)  ______________ (7)

3.

How does the male pelvis differ to the female pelvis? It is _____________ (8), __________ (6), and ________-_________ (5-6)

LETTERMORPHOSIS Can you find words that fit the descriptions below by picking a word from the diagram of the pelvis opposite and adding or removing a single letter? For example, the word ‘toe’ (were it to appear on the diagram) could be changed into ‘tone’ by adding an ‘n’, or ‘skin’ could be changed into ‘kin’ by removing an ‘s’. The numbers after each clue specify the number of letters in each solution, to help you. The same word is permitted to be used more than once. 1.

Open to all (6)

2.

First name of a singer famously known as The King (5)

3.

Type of coniferous tree (5)

4.

Part of a curve (3)

CRYPTIC CLUES Can you use your anatomical knowledge and wordplay skills to solve these cryptic-crossword clues about the pelvis? The solution words can both be found in the introductory text to this chapter. 1.

Washing vessel as found in waste-paper basket (5)

2.

Pelvic projection regularly in shrimp (3)

39

41

09 T H E U P P ER L IM B The upper limb consists of four major parts: a girdle formed by the clavicles (collar bones) and scapulae (shoulder blade), the arm, the forearm and the hand. The upper limb is extremely mobile but is stabilized and supported by muscles connected to the ribs and vertebrae. Each upper limb comprises a clavicle, scapula, humerus, radius and ulna. The humerus is the major bone at the top of the arm. The forearm is made of the ulna and radius – together with the humerus they form the elbow joint. The elbow is a complex hinge joint that allows flexion and extension of the forearm. The foream is moved by muscles located along the humerus, including the triceps brachii, biceps brachii, brachialis and brachioradialis. The biceps brachii, translated as ‘two-headed muscle of the arm’, sits on the front of the upper arm and aids the forearm in lifting. It is a bi-articular muscle, meaning that it helps control the motion of both the shoulder and elbow joints. Its antagonist is the triceps brachii, which extends the forearm at the elbow joint to straighten the arm. The forearm is divided into two compartments: anterior and posterior. Generally, the anterior compartment contains the flexors, and the posterior contains the extensors. The flexor muscles are larger than the extensors as they must act against gravity. There are over 20 muscles that cause movement of the wrist, hand and finger – mostly located within the forearm. The upper limb is served by the network of nerves known as the brachial plexus.

42

SKELETON AND LIMBS

ENCODED PAIRS These questions about the upper limb have been organized into pairs, labelled ‘a’ and ‘b’, where the answer to each ‘a’ question is a number that will then help you decode the answer to the corresponding ‘b’ question, or vice versa. Each ‘b’ answer is a word or phrase which is given, but has been encoded. Each coded answer uses an alphabet shift cipher, where each letter has been shifted a fixed number of positions forward in the alphabet.

biceps brachii

brachialis

For example, ‘FIN’ with a shift of 4 would have become ‘JMR’. The solution to each ‘a’ question reveals the size of the shift that has been applied to the corresponding encoded ‘b’ answer.

brachioradialis

1.

a)  How many bones form the elbow joint? b)  Which muscle opposes the actions of biceps brachii?   W ULFHSV EUDFKLL

2.

a)  How many major parts form the upper limb? b)  The anterior forearm brings about what movement?   JPIBMS R

3.

a)  How many compartments is the forearm divided into? b)  What is the name of the network of nerves that supplies the upper limb?   DTCEJK CN RNGZWU

The upper limb

43

deltoid pectoralis major

biceps brachii

brachialis

MISSING LETTERS Every alternate letter has been removed in the answers to these questions about the upper limb. Can you use your general knowledge and decoding skills to fill in the blanks? 1.

What is the name of the main bone in the upper arm? _U_E_U_

2.

The elbow joint is formed by the answer to Question 1 and which two other bones? a)  _A_I_S b)   _L_A

3.

What type of joint is the elbow? H_N_E

4.

What are the four major parts of the upper limb? The letters required to complete these four answers are: AEGHLMNORR a)  _I_D_E b)  _R_ c)  F_R_A_M d)  _A_D

brachioradialis

45

10 TH E L O WE R L I M B The lower limb consists of the thigh (upper leg), leg (lower leg) and foot. The thigh contains a single long bone – the femur. The leg consists of two bones, the tibia and fibula, as well as the patella (knee cap). The kneecap is a sesamoid bone, meaning that it is embedded within a tendon. Babies are born without kneecaps; instead they have cartilage which turns into bone by the age of four. The knee joint is a hinge type synovial joint – it allows for flexion and extension, as well as some medial (internal) and lateral (external) rotation. It is formed by the patella, femur and tibia. The hip flexors connect to the top of the femur, running to the lower back and pelvis. The thigh contains large muscle groups including the quadriceps and hamstrings. The muscles in the anterior compartment of the thigh, including the quadriceps femoris (quads), act to extend the leg at the knee joint. The hamstrings are found in the posterior thigh and act to flex the knee joint and extend the thigh to the back of the body. The lower leg has numerous muscles, including those vital for movement of the ankle, foot and toes. The posterior calf contains two muscles: gastrocnemius and soleus. Gastrocnemius provides the recognizable shape of the calf. The buttocks are responsible for the movement of the hip and thigh and for stabilizing the body during walking. The gluteus maximus muscle is the biggest muscle in the human body. Many muscles, tendons and veins from the lower limb can be used for grafting to repair body parts – like the great saphenous vein in a triple heart bypass.

46

SKELETON AND LIMBS

last rib spine quadratus lumborum

crest o f

psoas minor

um ili

iliacus

psoas major

tensor fascia latae pectineus gracilis sartorius adductor longus rectus femoris

adductor magnus

vastus lateralis

vastus medialis

combined tendon of quadriceps femoris patella

tibia

The lower limb

MATCHING PARTS Can you place each of the bones and muscles from the given list into the correct category on the left?

UPPER-LEG BONES (ABOVE THE KNEE) KNEE BONE LOWER-LEG BONES (BELOW THE KNEE)

BONES AND MUSCLES TO PLACE:

• Adductors • Femur • Fibula • Gastrocnemius • Hamstrings • Patella

THIGH MUSCLES CALF MUSCLES

• Quadriceps • Soleus • Tibia

ANATOMICAL Use the diagram of the lower limb and your word knowledge to answer the following questions: 1.

How many separate muscles are labelled on the diagram? The muscles are the coloured parts.

2.

Which muscle shares part of its name with a sad-sounding type of musical scale?

3.

Which bone, labelled on the diagram, shares part of its name with a word referring to the top of a wave?

4.

Which labelled muscle’s name derives from the Latin for ‘tailor’?

5.

Which muscle’s name starts with the name of a setting agent for jam?

47

49

11 FAC IAL MU SC L ES The muscles used when making facial expressions originate from bones of the face (viscerocranium) or fascia and insert onto the skin. They are located within the subcutaneous tissue. They function by contracting to pull on the skin and bring about movement. They are the only group of muscles that insert into skin. There are 43 muscles in the face: they are controlled (stimulated) by the facial nerve. The facial muscles are mostly grouped around the facial orifices (eyes, nose, mouth) – functioning to close or widen the orifices. The facial muscles around the orbital opening include the corrugator supercilia and orbicularis oculi. These muscles control eyelid movement, protecting the cornea of the eye from damage. The nasal muscles, which move the nose and skin around it, are the compressor narium minor, dilator naris anterior, levator labii superioris alaeque nasi, nasalis and procerus. Nasalis is the largest of the group. The muscles that surround the oral opening are: buccinator, depressor anguli oris, depressor labii inferioris, levator anguli oris, levator labii superioris, mentalis, orbicularis oris, risorius, zygomaticus minor and zygomaticus major. These muscles are responsible for the movement of the mouth and lips, which are required during actions such as singing and whistling. Other facial muscles include the occipitofrontalis muscle which covers parts of the skull. Its name is derived from its two parts – the occipital belly, near the occipital bone, and the frontal belly, near the frontal bone.

50

SKELETON AND LIMBS

MATHEMATICAL PUZZLES Which of these equations are correct? Each consists of a number of categories relating to the facial muscles, which should be replaced with the correct count for that category. For example, there are five nasal muscles, so ‘nasal muscles’ should be replaced with the number ‘5’ in the equations. A table is included for you to keep track of the counts. 1.

Types of facial orifice + parts of occipitofrontalis muscle = nasal muscles

2.

Muscles around the oral opening ÷ parts of occipitofrontalis muscle = nasal muscles

3.

(Muscles around oral opening - nasal muscles) + muscle groups in the body which insert into the skin = types of facial orifice

4.

(Types of facial orifice + muscle groups in the body which insert into the skin) × muscles around oral opening + parts of occipitofrontalis muscle = facial muscles

5.

(Facial muscles + nasal muscles + parts of occipitofrontalis muscle) ÷ muscles around the oral opening = nasal muscles

CATEGORY

Nasal muscles Facial muscles Muscles around the oral opening Parts of the occipitofrontalis muscle Types of facial orifice Muscle groups in the body which insert into the skin

NUMBER

5

Facial muscles frontalis

51

temporoparietalis muscle

corrugator supercilii superior aricular muscle

orbicularis oculi procerus

anterior aricular muscle

nasalis dilatator naris ant.

occipitalis

dilatator naris post. depressor septi

posterior aricular muscle

levator labii superioris orbicularis oris

trapezius

platysma

mentalis masseter

external jugular vein

CRYPTIC CLUES Can you solve these cryptic-crossword clues? The solution words can be found either in the introductory text or labelled on the diagram of the facial muscles. 1. Has good command of a subject, so we hear and smell with this (4) 2.

Donkey within distance is chewing muscle (8)

3.

Smiling muscle confused sour Iris (8)

53

12 TH E B RAI N The brain is a jelly-like mass of tissues and nerves connected to the spinal cord. The brain controls your ability to think, see, feel, talk and hear. It is also responsible for your memory and ability to move. It even controls your breathing. The brain has three main parts: the cerebrum, the cerebellum and the brainstem. The cerebrum is the principal, anterior part of the brain, located in the front of the skull. It has left and right hemispheres (halves), separated by a fissure. Each hemisphere controls the opposite side of the body. The cerebrum has many functions including control of vision, hearing, emotion, speech and walking. Each hemisphere has four sections, known as lobes: frontal, parietal, temporal and occipital. Each lobe controls specific functions. For example, the frontal lobe controls personality, decision-making and reasoning, while the temporal lobe controls memory and sense of smell. The cerebellum, which translates to ‘little brain’ in Latin, sits at the back of the brain. It controls voluntary movements such as posture, balance, coordination and speech. Finally, the brainstem, at the bottom of the brain, connects the cerebrum with the spinal cord. Its parts include the midbrain, the pons and the medulla. It controls the body’s pivotal functions such as breathing, heartbeat, blood pressure and swallowing.

54

HEAD AND NECK

ANAGRAMMATIC The letters in some of the labels or part labels on the diagram of the brain have been rearranged to form the following phrases. Can you identify each original label? To make it trickier, abbreviations used on the diagram have been expanded first. The spaces and punctuation do not necessarily correspond with the original labels. 1.

Elaborate lip

2.

Virus of fussy lies

3.

Odd molten fireball

4.

Artificial, precious poets

5.

Promote label

6.

Reliable or in front of

7.

Respectful arsonist

DIAGRAM DETAIL By looking closely at the diagram can you answer the following questions? You will need to expand abbreviations to reach the correct answers. 1.

How many superior lobes are labelled?

2.

How many fissures are labelled?

The brain

central sulcus (fissure of Rolando)

55

intraparietal fissure post central fissure

precentral fissure end of calloso-marginal fissure

R

O

N

T

AL

su

F

PA

B LO

p

ro .f

E

a nt

RI

ET

AL

be l lo

LO

B

E

parietooccipital fissure

PI B E TA L

mid. frontal lobe

OCC

L

inf. frontal lobe

I LO

A R TEMPO E B LO

ascending lateral sulcus (fissure of Sylvius)

horizontal lateral sulcus (fissure of Sylvius)

cerebellum sup. temporal fissure

lateral sulcus (fissure of Sylvius)

brainstem inf. temporal fissure

CRYPTIC CLUES Can you solve these brain-related cryptic-crossword clues? The solutions can be found either labelled on the diagram or mentioned in the introductory text. 1.

Nervous organ located in cobra infestation (5)

2. Aluminium added to back of façade relating to the forehead (7) 3. Chaotic tribesman found at the bottom of the brain (9)

57

13 C RAN IAL N ERVES The cranial nerves are a set of 12 paired nerves that arise directly from the brain. Each pair has a different function for sense, movement or both. Sensory cranial nerves aid vision, smell and hearing. Motor cranial nerves help control muscle movements. Cranial nerves are named relative to their function; each is also identified numerically using roman numerals (I-XII). The olfactory and optic nerves arise from the cerebrum, but the remaining 10 emerge directly from the brainstem. The cranial nerves, in numerical order, are: olfactory nerve, optic nerve, oculomotor nerve, trochlear nerve, trigeminal nerve, abducens nerve, facial nerve, vestibulocochlear nerve, glossopharyngeal nerve, vagus nerve, accessory nerve, hypoglossal nerve. The vagus nerve (X) is the longest cranial nerve and is named because it is said to wander like a vagabond, sending out sensory fibres from the brainstem to the organs. It regulates a vast range of crucial functions, communicating motor and sensory impulses to every organ in your body, including the heart. Conversely, the olfactory nerve (I) is the shortest cranial nerve. It exits the skull through a structure known as the cribriform plate, due to its sievelike structure, to convey special sensory information related to smell. The facial nerve (VII) is another cranial nerve of interest. It emerges from the pons (of the brainstem) to control the muscles of facial expression. It also functions in the conveyance of taste sensations from the anterior two-thirds of the tongue. Bell’s palsy is a well-known condition where one side of the face droops due to paralysis of the facial nerve of unknown cause. The accessory nerve (XI) and hypoglossal nerve (XII) are both motor in function. The former causes muscles in the neck (sternocleidomastoid) and back (trapezius) to move, the latter innervates the muscles of the tongue.

58

HEAD AND NECK IV trochlear III oculomotor

X vagus

II optic I olfactory XI accessory

XII hypoglossal

IX glossopharyngeal

VIII vestibulocochlear

VII facial VI abducens

V trigeminal

MATCHING PARTS Can you draw lines to match each of the cranial nerves on the left with its corresponding function on the right? CR A N I A L N ERVE

F U N C T IO N

Olfactory (I)

Enables us to tilt our heads and shrug our shoulders

Optic (II) Oculomotor (III) Facial (VII) Vestibulocochlear (VIII) Vagus (X)

Conveys sensory information related to smell The longest cranial nerve, with a name that stems from the Latin for ‘wander’ Supplies muscles in the tongue, apart from the palatoglossus Facilitates most of our eye movements Conveys visual information

Accessory (XI)

Conveys auditory information and helps us to balance

Hypoglossal (XII)

Operates muscles that facilitate facial expressions

Cranial nerves

ENCODED PAIRS These questions about the cranial nerves have been organized into pairs, labelled ‘a’ and ‘b’, where the answer to each ‘a’ question is a number that will then help you decode the answer to the corresponding ‘b’ question, or vice versa. Each ‘b’ answer is a word or phrase which is given, but has been encoded. Each coded answer uses an alphabet shift cipher, where each letter has been shifted a fixed number of positions forward in the alphabet. For example, ‘FIN’ with a shift of 4 would have become ‘JMR’. The solution to each ‘a’ question reveals the size of the shift that has been applied to the corresponding encoded ‘b’ answer.

1.

a)  How many cranial nerves arise from the cerebrum? b)  The olfactory nerve fibres pierce through fine holes in which structure of the ethmoid bone?

E TK D TK HQTO R NC VG

2.

a)  How many cranial nerves are there?



b)  Bell’s palsy results from paralysis of which nerve?

R MOUMX

3.

a)  What number (converted from Roman numerals) is assigned to the longest cranial nerve?



b)  Which cranial nerve innervates the lungs?

FK QE C

59

61

14 TH E SPIN AL C O RD The spinal cord is a greyish tubular bundle of nervous tissue and supporting cells. It extends from the brainstem to the lumbar vertebrae at the base of the spine. Together, the brain and spinal cord form the central nervous system. The spinal cord arises from the cranium (skull) as a continuation of the part of the brainstem known as the medulla oblongata. It follows a simple, downward course as it travels through the vertebral canal, which is a cavity within the vertebral column, formed by the vertebrae. Within the vertebral canal, the spinal cord is surrounded by spinal meninges which contain cerebrospinal fluid (CSF). Meninges are the connective tissue coverings of the brain and spinal cord. There are three layers: dura mater, arachnoid mater and pia mater, from outermost to innermost. CSF occupies the subarachnoid space, found between the arachnoid mater and the pia mater. At the L2 vertebral level the spinal cord tapers off, forming the conus medullaris. Because the spinal cord terminates at veterbral level L2, it occupies only around two-thirds of the vertebral canal. The spinal nerves that arise from the end of the spinal cord are bundled together, forming a structure known as the cauda equina, so named due to its resemblance to a horse tail. The cord has two prominent enlargements: the cervical and the lumbar. These enlargements correspond to the origins of large nerve plexi that supply the limbs. The spinal cord is anchored by the filum terminale, a thread of connective tissue, to the first segment of coccyx.

62

HEAD AND NECK

MISSING LETTERS The answers to these questions about the spinal cord are all given, but are missing any letters found in ‘NERVOUS SYSTEM’. Can you identify the solutions based on the information in this chapter and your word skills? 1. Which structure is labelled ‘A’ on the diagram?

4.

C ADA QI A

What other structure joins with the spinal cord to form the central nervous system? B AI

2.

Which structure is labelled ‘B’ on the diagram?

5.

F I L I AL

Which layer of the meninges is innermost? PIA A

3.

What are the names of the two enlargements of the spinal cord?

6.

C I C AL and LBA

Cerebrospinal fluid (CSF) is sampled from the spinal column during a spinal tap (lumbar puncture). In which space is CSF found? B AAC HID

LETTERMORPHOSIS Can you find words that fit the description below by adding or removing one letter from an anatomical word which can be found somewhere in the diagrams of the spinal cord? For example, the word ‘toe’ (were it to occur) could be changed into ‘tone’ by adding an ‘n’, or ‘skin’ could be changed into ‘kin’ by removing an ‘s’. The numbers after each clue specify the number of letters in each solution, to help you.

Since there are relatively few words on the diagrams, the same word is permitted to be used more than once. 1.

Spider (8)

2.

Friend, informally (4)

3. Italian city in the Tuscany region (4) 4. Someone skilled at their art (6)

The spinal cord

63

conus medullaris dura mater

A

arachnoid mater

pia mater

B

posterior nerve root

65

15 T H E E YE The eyes are organs housed by the bony orbits (eye sockets) of the skull which are bilateral, symmetrical cavities in the head. Each orbit houses the blood vessels and nerves, as well as the six extraocular muscles which are separate from the eye yet are responsible for the movement of the eyeball and superior eyelid. Eyelids cover the orbits anteriorly – these thin folds of skin cover and protect the eye, also maintaining moisture. The eyeball itself can be divided into three layers: fibrous, vascular and inner. Outermost is the fibrous layer which consists of the sclera and cornea. Continuous with each other, they provide shape to the eye. The vascular layer consists of the choroid, ciliary body and iris. The choroid is a layer of connective tissue and blood vessels which nourish the outer layers of the retina. The retina is a thin layer of tissue lining the back of the eye which receives light, converting it into neural signals that are sent to the brain. The two-part ciliary body (ciliary muscle and processes) controls the shape of the lens and contributes to the formation of aqueous humour (fluid filing the chamber of the eye that maintains pressure). The iris is circular with a central aperture (the pupil) – the diameter of which is altered by smooth muscle fibres within the iris. It is the coloured part of the eye that helps regulate the amount of light that enters. The lens of the eye is located anteriorly, between the aqueous humour and the pupil. The shape of the lens is altered by the ciliary body.

66

HEAD AND NECK

SECRET CODE The answers to these questions have all been encoded using the same system, where the numbers clue a series of letters in the alphabet in some way. Can you figure out what the system is and reveal the answers to all of these ocular questions? Spaces between words are shown. 1.

A person’s eye colour is visible in which structure? 918919

2.

Which layer of the eye receives light? 185209141

3.

The extraocular muscles control the movements of which two structures? a. 1 9 2 1 1 6 5 1 8 9 1 5 1 8

52551294

b. 5 2 5 5 2 1 1 2 1 2 4.

What are the two constituent parts of the outermost layer of the eye? a. 1 9 3 1 2 5 1 8 1 b. 3 1 5 1 8 1 4 5 1

5.

How many bones make up each orbit? 19522514

6.

What is the central aperture also known as? 2085 162116912

LETTERMORPHOSIS Can you find words that fit the description below by adding or removing one letter from an anatomical word which can be found somewhere in the diagram of the eye? For example, the word ‘toe’ (were it to occur) could be changed into ‘tone’ by adding an ‘n’, or ‘skin’ could be changed into ‘kin’ by removing an ‘s’. The numbers after each clue specify the number of letters in each solution, to help you.

1.

Temporarily provides money to someone (5)

2.

Relating to sexual appetites (6)

3.

The convex shape of a road (6)

4.

Open, uncultivated area (5)

5.

From Galway, perhaps (5)

6.

Flavoured Greek white or rosé wine (7)

The eye

67

sulcus circularis cornea ciliary body posterior chamber

cornea

iris

aqueous humor

iris

zonular spaces

conjunctiva lens

vitreous

body

rectus lateralis rectus medialis

retina hyaloid canal

choroid coat

sclera optic nerve

fovea centralis

nerve sheath

69

16 T H E E AR The ear, an organ of hearing and balance, is divided into three parts: external, middle and inner. The external ear includes the auricle (or pinna) and the external acoustic meatus (ear canal) – ending at the tympanic membrane (eardrum). The auricles are paired structures found on either side of the head – they are typically what people consider to be their ears. Their role is to direct sound waves towards the external acoustic meatus. The auricle is a mostly cartilaginous structure creating an outer curve, known as the helix. The lobule at the bottom is not supported by cartilage – this is the part usually pierced through by earrings. The middle ear lies within the temporal bone and transmits vibrations from the tympanic membrane to the inner ear via the auditory ossicles – three small bones named malleus, incus and stapes. They are also referred to as the hammer, anvil and stirrup due to their shape. The Eustachian tube, also in the middle ear, connects the ear with part of the palate, functioning to equalize the air pressure on both sides of the eardrum, thus preventing pressure build up in the ear. The inner ear consists of a bony and a membranous labyrinth, and contains the organs of hearing and equilibrium. This bony cavity is divided into three sections: the vestibule, the semi-circular canals and the cochlea. The vestibule’s structures help sense gravity. The three fluid-filled, semi-circular canals help maintain balance. The cochlear transforms vibrations into neural signals.

70

HEAD AND NECK

CROSSWORD Can you solve this crossword, where almost all of the clues are about the ear? 1

2

3

4

5 6

7

8

9

10

11

12 13

14

15 16 17

AC RO SS

D OW N

3 6 8 9 13

1 Latin name for 5 down (7) 2 Hollow cylinder (4) 4 One of a group of bones which protect the lungs (3) 5 Tool; small bone in the middle ear (6) 6 Passage leading into the body, such as 10 down (6) 7 Ornament worn on a dangling lobe (7) 10 Passage leading into the ear – also known as 6 down (3, 5) 11 Ossicle, for example (4) 12 Stirrup-shaped bone in the ear (6) 13 Outer edge of the ear (5) 14 Bone shaped like 17 across (5)

Relating to the ear (5) Barrier, e.g. the eardrum (8) Small lobe (6) Lobby; cavity of the inner ear (9) Sense through which sounds can be perceived (7) 15 Sense that stops you falling (7) 16 Dull pain, e.g. in the ear (4) 17 Flat-topped iron block; part of the ear (5)

The ear

71

LETTERMORPHOSIS Can you find words that fit the description below by adding or removing one letter from an anatomical word that can be found somewhere on the diagrams of the ear?

1.

Droplet (7 )

2.

Rip (4 )

3.

Container (3 )

For example, the word ‘toe’ (were it to occur) could be changed into ‘tone’ by adding an ‘n’, or ‘skin’ could be changed into ‘kin’ by removing an ‘s’. The numbers after each clue specify the number of letters in each solution, to help you.

4.

Religious wrongdoer (6 )

attic incus malleus tympanic cavity tensor

auricula

ear canal/ eustachian tube

tympani

styloid process lobule

tympanic membrane

semi-circular canals

cochlea

vestibule

The inner ear

73

17 T H E N O SE The nose is the entrance to the respiratory tract and contains the olfactory organ. It’s the external protuberance of the nasal cavity. Externally it has a bony component made from the nasal bones, maxillae and frontal bone. Its cartilaginous component is inferiorly positioned. It is subdivided into a left and right chamber by a thin wall, the nasal septum. Anteriorly, the nostrils open the canals externally. The floor of the nasal cavity is formed by the palate. The nasal cavity is the most superior part of the respiratory tract and has three divisions: the vestibule, the respiratory region and the olfactory region. Nasal hairs protect the vestibule by capturing foreign bodies, such as dust particles. Incoming air is warmed up and moistened by flowing through narrow passageways called meati (singular meatus) that contain several blood vessels and run between three shell-like projections of the nasal cavity’s lateral wall (the superior, middle and inferior conchae). These conchae, also called turbinates, are bone shelves covered with a mucous membrane. Mucus also drains from four paranasal air sinuses (frontal, maxillary, ethmoidal and sphenoidal) into the nasal cavity – it is passed back to the throat, where it is swallowed. Paired olfactory organs in the upper part of the nasal cavity contain receptors stimulated when airborne compounds dissolve. The olfactory cranial nerve carries this information to the brain’s olfactory bulb, which processes the nerve impulses as smells.

74

HEAD AND NECK

HIDDEN WORDS Can you find the answers to these four questions about the nose concealed in the diary entry below? The answers are hidden in order, with one in each paragraph. Answers may be concealed across words – for example, the word ‘red’ can be found in ‘higher education’. The number of letters in each solution is provided.

1.

Which structure forms the floor of the nasal cavity? ____________ (6)

2.

Which nerve transmits nerve impulses to provide smell? ________________ (9)

3.

Frontal, maxillary, ethmoidal and sphenoidal are names given to what? Paranasal ____________ (7)

4.

Which structure separates the nose into two chambers? __________ septum (5) It was good to catch up with family at dinner today. My grandpa, late as always because of his hip, still goes for a walk every day to his favourite bench. My aunt is always tired from working in the Lysol factory, but somehow still has enough energy to play with the children. My cousin uses a huge number of tissues because of his dog allergy – I always feel sorry for him, as our golden retriever does shed a lot of hair. My sister-in-law brought a beautiful china salt cellar with her – very thoughtful, as ours broke last week.

The nose

75

frontal sinus

superior concha middle concha

sphenoidal sinus

atrium

vestibule

meati (passageways) nasal hairs

palate

inferior concha

CRYPTIC CLUES Can you solve these cryptic-crossword clues about the nose? The solutions can be found labelled either on the diagram or in the introductory text. 1.

Spiral-shaped depression is deception preceding half of Latin dance (6)

2.

Central court for nasal cavity (6)

3.

North oil spread around short street opening (7)

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18 ORAL CAVI T Y Anatomically, the oral cavity refers to the mouth. It includes the lips, the lining inside the cheeks and lips, the front two-thirds of the tongue, the upper and lower gums, the floor of the mouth, the bony roof of the mouth, and a small area behind the wisdom teeth. It has three functions: digestion, communication and breathing. Many bones contribute to the bony structure of the oral cavity: paired maxillae, palatine and temporal bones, and the unpaired mandible, sphenoid and hyoid bones. The cheeks form the lateral walls of the oral cavity. The buccinator muscle provides the main structural and functional component of the cheek. The buccal fat pad is superficial and gives the cheeks a rounded contoured shape. The buccinator muscle contracts to keep food between the teeth when chewing. The palate (roof of the mouth) is the division between the nasal and oral cavities. The oral cavity is separated into the hard and soft palate. The hard palate is immobile and comprised of bone. The soft palate is comprised of muscle fibres covered by a mucous membrane – it can be elevated during swallowing to prevent the food bolus from entering the nasopharynx. The oral cavity houses two sets of teeth during a lifetime – primary and permanent. The teeth are set into two opposing arches – maxillary (upper) and mandibular (lower). Teeth are positioned in alveolar sockets and connected to the bone by a suspensory periodontal ligament.

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HEAD AND NECK

uvula

palate

pharynx buccinator muscle

palatine tonsil

ALPHABETICAL ANAGRAMS The answers to these questions about the oral cavity have been anagrammed, with all of the letters within each word rearranged into alphabetical order. Can you solve the anagrams to reveal the answers? Where the answer has more than one word, each word is given separately. 1.

How many teeth does an adult typically have?

3.

H I RT T Y-OTW 2.

What are the three functions of the oral cavity? a)  DEG I I NOS T b)  AC CI I MMNNOOTU c)  AB E GHI NRT

Which muscle constitutes the cheek? AB C C INO RTU

4.

What connects the teeth to the bone? ENO PRSSSUY ADEIL NO O PRT AEG IL M NT

Oral cavity

S

T H K

L

I P U

I N M

O C N

U C S

D I

M O B

E T B

W I

79

T O E S

S

L E

M A

A T E

C D O

T H

LETTER TRIANGLES Place the triangular tiles within the larger shape in order to spell out six anatomical terms relating to the oral cavity, so one term reads across each row. Each small triangle is used only once and may not be rotated or reflected. Each solution can be found in the introductory text to this chapter or is labelled on the diagram. The final row will consist of two words.

R

81

19 P H ARYN X AND L ARY NX The word ‘throat’ is commonly used for the parts of the neck that lie anterior to the vertebral column, including the pharynx and the larynx. The pharynx is a muscular passage that runs from the oral and nasal cavities down to the larynx and oesophagus. The pharynx serves both respiratory and digestive functions. The pharynx contains both circular and longitudinal muscles. Circular muscles form constrictions that help push food to the oesophagus and prevent air from being swallowed. Longitudinal fibres lift the walls of the pharynx during swallowing. The pharynx is comprised of three sections: the nasopharynx, oropharynx and the hypopharynx. The nasopharynx is found at the back of the nasal cavity. The nasopharynx and oropharynx are connected by an isthmus (a narrow passage connecting two parts). The oropharynx begins at the back of the oral cavity and continues to the epiglottis, a flap of tissue that covers the air passage to the lungs and that directs food to the oesophagus. The hypopharynx begins at the epiglottis and leads down to the oesophagus. Its function is to regulate the passage of air to the lungs and food to the oesophagus. The larynx itself is referred to as the voice box. It is an organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration. The larynx houses the vocal folds, and manipulates pitch and volume, which is essential for phonation (the ability to produce sound).

82

HEAD AND NECK

1. n_____ c_____ (5, 6)

2. n_____ (11)

3. o_____ c_____ (4, 6)

tongue 4. o_____ (10)

5. h_____ (11)

epiglottis

6. l_____ (6)

thyroid cartilage (Adam’s apple)

8. t_____ (7)

7. o_____ (10)

Pharynx and larynx

83

WORD FRAGMENTS The labels for this diagram of the pharynx and larynx have been split into fragments. These are listed in alphabetical order below. Can you reassemble the fragments in order to restore the labels? The first letter of each word and the number of words and characters for each solution are provided on the diagram to help you.

AL

AL

CHEA

CAV

CAV OES GUS HYP ITY ITY LAR NAS NAS OPHA OPHA OPHA OR ORO PHA RYNX RYNX RYNX TRA YNX

CRYPTIC CLUES Use your knowledge of the throat to help you solve these pig-themed cryptic-crossword clues that reveal words related to the pharynx and larynx. 1.

Pass down the throat to female pig holding brick structure (7)

2.

Pig’s toilet disarrayed flap of cartilage covering the windpipe (10)

85

20 TH E H E ART The human heart is an organ responsible for pumping blood throughout the body, supplying oxygen and nutrients to tissues and removing carbon dioxide and other waste products. The heart has four chambers: two atria (upper) and two ventricles (lower).The right atrium receives oxygen-poor (deoxygenated) blood from the body and pumps it to the right ventricle. The right ventricle pumps the deoxygenated blood to the lungs. The left atrium receives oxygen-rich (oxygentated) blood from the lungs and pumps it to the left ventricle. The left ventricle then pumps the oxygenated blood to the rest of the body. Of course, the heart needs connecting to the lungs and body – this is the role of the great vessels. These are the ascending aorta, the pulmonary trunk, the pulmonary veins, the superior vena cava and the inferior vena cava. The aorta is the most important artery of the body, responsible for supplying the body with oxygenated blood. The aorta, which arches as it exits the heart, changes name (ascending and descending, thoracic and abdominal) as it traverses the body, gives off branches to all the bodily regions, above the waist, before terminating as the common iliac arteries to then supply the lower parts of the body. The superior vena cava receives deoxygenated blood from all parts of the upper body, while the inferior vena cava receives the venous return from the lower body and abdomen. These two large veins both drain into the right atrium of the heart.

86

THORAX

HEARTY SUDOKU The heart is divided into several parts. Solve this sudoku puzzle to reveal how many of each type of part are contained within the heart, by copying the numbers from the coloured squares into the corresponding box in the table below. To solve the sudoku itself, place 1 to 6 once each into every row, column and bold-lined 3 × 2 box.

1 4 3 2

3 4

NAME

NUMBER

Apex

1

Ventricles Layers of the heart wall Valves

6

Chambers Atria

aortic arch

superior vena cava

pulmonary artery

right chamber left chamber

The heart

superior vena cava

87

aorta

inferior vena cava

aortic valve

left atrium right atrium

mitral valve

tricuspid valve

left ventricle

ventricular septum

right ventricle

CRYPTIC CLUES Can you solve these cryptic crossword clues relating to the heart? The solutions can all be found labelled on the diagram or in the introductory text to this chapter. 1.

Roman court reconstructed Timaru (6)

2. Switzerland fossilized resin in judge’s office (7) 3.

Dive into smuggling blood vessel (4)

89

21

TH E L UNG S The respiratory system is made up of the airway, the lungs and the muscles of respiration. The lungs sit in the thorax (chest), beneath the rib cage. The main function of the lungs is to enable the body to receive oxygen from the air and expel carbon dioxide to the atmosphere. Each lung is made up of lobes, separated by cracks, known as fissures. The right lung has an upper (horizontal) and a lower (oblique) fissure. The left lung has only an oblique fissure. The lungs sit above the diaphragm, a thin sheet of muscle that separates the thorax from the abdomen. The trachea (windpipe) is a tube constructed of cartilage rings that conducts inhaled air into the lungs through its tubular branches, called bronchi, which then divide into smaller branches known as bronchioles, eventually becoming microscopic. The lungs are like bellows. When the lungs expand, air is drawn into the body. The lungs expel carbon dioxide, the body’s waste gas, as they compress. The lungs are not made of muscle tissue, so it is the diaphragm and the muscles associated with the ribs that pump air in and out of the lungs.

90

THORAX

E

D

F

A

B

C

LABEL MATCH The letters on this diagram label various parts of the lungs. Can you match up the letters on the left with their descriptions on the right?

A

Superior lobe

B

Left Lung

C Trachea D

Right Lung

E

Middle lobe

F

Oblique fissure

The lungs

MISSING VOWELS All of the vowels have been removed from the answers to these questions about the lungs. Can you use your pulmonary general knowledge and word skills to restore them? The spaces are placed randomly to help disguise the words. 1.

What is the name of the tube that enables air to enter the lungs? T RC H

2.

The right lung has three lobes but the left has only two to make room for which structure? H RT

3.

Which structures branch from the trachea? BR N CH

4.

D-shaped rings of what type of tissue support the trachea, keeping it open? C RTL G

5.

What structure sits beneath the lungs? D P HR G M

CRYPTIC CLUES Can you solve these cryptic-crossword clues about the lungs? The solutions can be found either labelled on the diagram or mentioned in the introductory text to the chapter. 1.

Rush of air with smoking device is a passage for breath (8)

2.

Thunderous god takes US chopping tool found between the neck and the abdomen (6)

3.

Short lunge sac into which air is drawn (4)

91

93

22 TH E L I VER The liver is the body’s second largest organ, superseded only by the skin, which is significantly larger and heavier. It has a triangular shape that extends across the entire abdominal cavity just below the diaphragm. The majority of the liver is located on the right side of the body. The liver consists of four lobes: the left, right, caudate and quadrate. The left and right lobes are the largest lobes; they are separated by the falciform ligament. The right lobe is about five times larger than the left lobe. The left lobe has a more pointy, tapered appearance. The caudate lobe is small and extends from the back (posterior) side of the right lobe and wraps around a large vein, the inferior vena cava. Also small, is the quadrate lobe which is inferior to the caudate lobe and also extends from the posterior side of the right lobe, wrapping around the gall bladder. The gall bladder sits under the liver, in addition to parts of the pancreas and intestines. The liver’s main function is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The tubes that carry bile through the liver and gall bladder are known as bile ducts and form a branched structure, the biliary tree. The liver has a key role in detoxifying chemicals and breaking down (metabolizing) drugs. As it does so, the liver secretes bile that ends up in the intestines. The liver also makes proteins important for blood clotting.

94

ABDOMEN

ENCODED PAIRS These questions about the liver have been organized into pairs, labelled ‘a’ and ‘b’, where the answer to each ‘a’ question is a number that will then help you decode the answer to the corresponding ‘b’ question, or vice versa. Each ‘b’ answer is a word or phrase which is given, but has been encoded. Each coded answer uses an alphabet shift cipher, where each letter has been shifted a fixed number of positions forward in the alphabet. For example, ‘FIN’ with a shift of 4 would have become ‘JMR’. The solution to each ‘a’ question reveals the size of the shift that has been applied to the corresponding encoded ‘b’ answer. 1.

a)  How many large veins does the liver wrap around?



b)  The right and left lobes of the liver are separated by which structure?

GBMD JGPS N MJHBNFO U

2.

a)  How many lobes make up the liver?



b)  Which structure (muscle) is located above the liver?

HME TLV E K Q

3.

a) If all the organs in the human body were ordered by size (largest to smallest), at which position would the liver be in the list?



b)  Which word means ‘relating to the liver’?

JGR CV K E

CRYPTIC CLUES Can you solve these cryptic-crossword clues about the liver? The solutions can be found labelled on the diagrams. 1.

At first, large organ becomes enlarged, flattish hanging part (4)

2.

Bile store in inflatable bag after cheek (4, 7)

3.

Potato, e.g., joins portent and legend with eminence (5, 8)

The liver

95

gall bladder RI

G

H

falciform ligament

T

LO

LE

FT

L

O

B

BE

E

caudate lobe

inferior vena cava

suprarenal impression

nonperitoneal surface

RI

caudate lobe

GH

T

L O B

E

B

renal impression

E

LEFT

L

O

gastric impression

tuber omentale caudate process

duodenal impression

quadrate lobe gall bladder

colic impression

97

23

TH E SP L EEN The spleen is an organ, about the size of a fist, which is found in the left upper part of the abdomen just under the diaphragm, between the stomach and the left kidney. It is protected by the 9th to 11th ribs, meaning that it is not readily felt unless abnormally enlarged. The spleen is the largest organ of the lymphatic system, which is the body’s drainage network. The spleen has multiple roles in the body. It acts as a filter for blood as part of the immune system. Old red blood cells are recycled in the spleen. The body also stores platelets and white blood cells in the spleen. The spleen also helps fight certain kinds of bacteria that cause pneumonia and meningitis. The spleen is divided into two main tissues, red pulp and white pulp. It is surrounded by a dense fibrous covering called the splenic capsule. The sinuses in the spleen are a reservoir for blood. The spleen has a central fissure called the hilum, at which the splenic artery and spleen vein enter and exit the spleen, respectively. It is possible to live if the spleen is not functioning correctly or even without a spleen (asplenia), if, for example, it has been removed (splenectomy) due to damage or for congenital reasons. However, people without a spleen are more prone to infections.

98

ABDOMEN

liver

portal vein

stom a ch

bile duct

pancreas

spleen duodenum

jejunum

superior mesenteric

descending colon

ascending colon

ileum

rectum

ilio-pelvic colon

DIAGRAM DETAIL Use the diagram and your general knowledge to answer these questions: 1.

How many times does the word ‘colon’ appear on the diagram?

2.

If you start at the liver and travel down along the portal vein to the end of the superior mesenteric, which organ do you pass directly behind?

3.

Which part of the anatomy labelled on the diagram shares the first part of its name with an imposing entrance?

4.

Which London railway station shares part of its name with an organ on this diagram, with one letter removed?

5.

Can you find the part of the abdomen which is an anagram of ‘lucid bet’?

The spleen

99

LETTER TRIANGLES Place the triangular tiles within the larger shape in order to spell out six anatomical terms relating to the spleen, so one term reads across each row. Each small triangle is used only once and may not be rotated or reflected. Each solution can be found in the introductory text to this chapter or is labelled on the diagram. The penultimate row will consist of two words.

M

C R V

N

E I O

E N E

T O N

U L V

C T

M Y H

A S

P L L

A C E E E N

S

P A

P

L I

S S P

P

E R

CRYPTIC CLUES Can you solve these cryptic-crossword clues that relate to the spleen? The solutions can be found labelled on the diagram. 1.

A pair join hideout with brief hesitation for a part of the small intestine (8)

2.

List punctuation on the rise in large intestine (9, 5)

3.

Small intestine part announced as Greek Troy (5)

101

24 TH E PAN CREAS The pancreas is a long and tapered organ located across the back of the abdomen. It sits behind the stomach, on the posterior abdominal wall, extending from the duodenum to the spleen. The pancreas is divided into five parts: the head, uncinate process, neck, body and tail. The right side of the organ is the widest part and is called the head. The head lies within the C-shaped curve of the duodenum. When a pancreatic tumour is present, it is typically the head that is affected. The left-side is more tapered, extending slightly upward – this is the body of the pancreas. It ends near the spleen, called the tail. The pancreas plays an essential role in converting food into fuel. It has two main functions: a digestive (exocrine) function and a hormone (endocrine) function that regulates blood sugar. The greek pancreas translates to ‘all flesh’, so named due to its lack of bone or cartilaginous tissue. The pancreas has a central duct, the pancreatic duct, which starts at the tail. The duct joins the pancreas to the common bile duct, forming the hepatopancreatic ampulla which enters the duodenum in order to supply pancreatic juice to aid digestion. There is also an accessory pancreatic duct which empties into the duodenum. The exocrine pancreas is a lobulated, serous gland. It is composed of around one million clusters of cells known as acini. The endocrine portion of the pancreas is formed of clusters of cells called islets of Langerhans, of which there are approximately one million.

102

ABDOMEN

DELETED LETTERS Delete one letter from each pair to reveal the answers to these questions about the pancreas. 1.

What is the name of the structure labelled A? PT E A LN CR R I E M E A T S IL C A

2.

DL UA C I TN

Which C-shaped organ sits around the pancreas? D P A U OI D P E A GN R U M A

3.

Islets make up which part of the pancreas? R E NI I D OC CA I R PI E N DE

4.

The pancreas terminates near which organ? E S PO LT R E I E MN

5.

Which two structures form the hepatopancreatic ampulla? a)  CH OA OM PM R O A N A D OU LC BT

IB NI PL RE

b)  HP I A LN A C R C E R I A ST IL C A I D UM CE HT

PANCREATIC PAIRS The pancreas has five sections: the head, neck, body, uncinate process and tail. Looking at the illustration and the list below, which pair is the odd one out? 1.

Tail and Neck

2.

Head and Body

3.

Head and Uncinate Process

4.

Tail and Uncinate Process

The pancreas

bile duct

103

portal vein

opening of pancreatic duct and bile duct

hepatic artery

A

tail body neck head

duodenum

uncinate process

CRYPTIC CLUES See if you can solve these cryptic-crossword clues to reveal two parts of the pancreas: 1.

Secretly follow hindmost part (4)

2. Diet club cooked component of hepatopancreatic ampulla (4, 4)

105

25 TH E STOM AC H The stomach is a muscular, saclike organ located on the left side of the upper abdomen. It has two curves, the lesser curvature (innermost) and the greater curvature (outermost). Stomach size varies between individuals, and between meals. The stomach receives food from the oesophagus and passes food to the duodenum (small intestine). The lower part of the oesophagus that connects to the first part of the stomach (cardia) is called the gastroesophageal (GE) junction. This junction is surrounded by a thickened muscular ring known as the cardiac sphincter. The stomach produces and secretes several important substances to control the digestion of food and is divided into five regions. The cardia is the first part of the stomach below the oesophagus. It contains the oesophageal sphincter, a thin ring of muscle that prevents contents from going back up. The fundus is the rounded area that lies to the left of the cardia and below the diaphragm – it the dilated portion and often contains gas. Next, the body is the largest and main part of the stomach responsible for mixing and starting to break down food. The antrum is the lower part of the stomach. The antrum holds the broken-down food ready for release into the small intestine. Finally, the pylorus is the part of the stomach that connects to the duodenum, the first part of the intestine. It includes the pyloric sphincter, which is a thicker ring of muscle that acts as a valve to control the emptying of stomach contents (chyme) into the duodenum, and vice versa. Internally, the stomach is full of folds known as rugae. Rugae function to allow the stomach to stretch, accommodating larger volumes of food and help to move food during digestion.

106

ABDOMEN

CROSS SECTION THROUGH THE STOMACH

2. c_____ n_____ (8, 5)

fundus

1. c_____ (6)

6. d_____ (8)

lesser curvature

, 9)

9. b_____ (4)

c__ ___ (7

5. p_____ s_____ (7, 9)

__ __ _

8. p_____ (7)

g 3.

pyloric canal 7. a_____ (6)

4. r_____ (5)

EXTRA ANAGRAMMATIC The five regions of the stomach have been scrambled into anagrams below, with one extra letter added to each, plus some extra spaces. For example, ‘cram’ is an anagram of ‘arm’, with the letter ‘c’ added. Can you solve all of the anagrams, revealing the extra letters in the process? When read in order from 1 to 5, the extra letters spell an anatomical word. 1.

Poorly Su

2.

Arm Turn

3.

By God

4. Arcadia 5.

Sun Fund

The stomach

107

PATHFINDER In this diagram of the stomach, only the first letter of most words is given. Can you restore all of the missing words by solving the puzzle below? Trace a single continuous path through the grid which visits every square exactly once, tracing out a series of non-overlapping words so that each letter appears in exactly one word. The path can travel in any direction from square to square, except diagonally. The first word has already been found for you. As you find the words, copy them to the corresponding slot in the diagram. For example, the first word, ‘cardia’, should be copied to the ‘1’ slot.

C

A

R

H

I

T

E

N

U

A

C

D

P

N

C

R

E

M

R

A

I

S

C

I

D

D

A

D

I

N

L

O

R

U

O

N

N

L

A

Y

P

E

U

R

T

O

T

C

H

G

A

M

P

Y

C

R

A

E

R

G

O

B

L

U

E

T

U

R

U

D

S

O

R

V

A

T

E

R

Y

U

R

CRYPTIC CLUES Can you solve these cryptic-crossword clues related to the stomach? The solutions can be found labelled on the diagram. 1.

Insect spirit in lower part of stomach (6)

2.

Group requests sum of money, perhaps, for area below diaphragm (6)

109

26 TH E KID NEY The kidneys are a pair of bean-shaped organs on either side of the spine and below the rib cage. Due to their presence on each side of the body, they are known as bilateral. Structures and functions related to the kidneys are known as renal. The right kidney is often situated slightly lower due to the presence of the liver. Kidneys function to filter blood, removing waste and controlling the body’s fluid balance. Internally, the renal functional tissue (parenchyma) is divided into two – the outer cortex and inner medulla. The cortex extends into the medulla, dividing it into triangular shapes known as renal pyramids. The tip (apex) of a renal pyramid is called a renal papilla. Each renal papilla is associated with a structure known as the minor calyx, which collects urine from the pyramids. Several minor calices merge to form a major calyx, so named after a goblet (calix). Urine passes through the major calices into the renal pelvis (pelvis meaning wide vessel), a flattened and funnel-shaped structure. From the renal pelvis, each kidney is drained at the duct, known as the ureter, through which urine passes from the kidney to the bladder for storage. The inner margin of each kidney has a deep fissure (cleft), known as the renal hilum. The hilum is the entry and exit point for the renal vessels and ureter. The adrenal glands sit above the kidneys. Uraemia is the term for a raised level of urea and other waste compounds in the blood which are normally eliminated by the kidneys.

110

ABDOMEN

CROSSWORD/ANAGRAM This crossword puzzle is themed around the kidneys, with a few clues about the rest of the human anatomy. Use the introductory text to this chapter, the diagram and your general knowledge to help solve the clues. 1 2

3

4

5 6

7

8

Once you are finished, the shaded squares will reveal an anagram of a word that relates to the kidneys. What is that word?

9 10 11

12 13

14

15 16

17

18

19

ACROSS

DOWN

1 Gestation organ (4) 2 A raised level of urea in the blood (7) 7 Deep division between two parts of the body (5) 8 Kidney-shaped edible seed (4) 10 A bone of the finger or toe (7) 11 Name of the part labelled ‘A’ on the diagram (5) 14 Arm or leg (4) 15 Funnel-shaped renal structure (6) 16 Experimental room (3) 18 Functional tissue of an organ (10) 19 Series of vertebrae (5)

1 2 3 4 5 6 9 11 12 13 17

It’s removed by the kidneys (5) Liquid that passes through the ureter (5) ‘______’ gland, found above the kidneys (7) Substance secreted in various parts of the body for lubrication (5) The pinnacle of a pyramid-shaped structure in, e.g., the heart (4) Kidney part named after a goblet (5) The tip of a renal pyramid (7) U-shaped bend in a road that’s also the shape of the loop of Henle, found inside the kidney (7) Structure transporting urine to the bladder (6) Side of the body where the lower kidney is found (5) Bitter fluid that aids digestion (4)

The kidney

111

suprarenal gland cortex

major calyx minor calyx medial

medulla

A renal pelvis

border

renal pyramid in medulla

ureter

CRYPTIC CLUES Can you solve these cryptic-crossword clues, each of which clues a part of the kidney labelled on the diagram? 1.

Maine clock face found in the centre (6)

2.

Start of ground area above water, source of chemical secretion (5)

3.

Be next to type of collie (6)

113

27 SMAL L IN T ESTI NE The small intestine is an organ located within the gastrointestinal (digestive) tract, approximately 6 metres (20 feet) in length but this can vary considerably. It functions to absorb nutrients from food. It traverses from the pylorus of the stomach to the ileocaecal junction, a point at which the small and large intestines meet. The small intestine is divided into three parts: the duodenum, jejunum and ileum. The duodenum – named after ‘duodenum digitorum’, meaning twelve fingers’ breadths, equating to its approximate length – runs from the pylorus of the stomach to the duodenojejunal junction, a junction with the jejunum. It receives partially digested food from the stomach. The jejunum begins at a bend known as the duodenojejunal flexure. The next part of the small intestine is the ileum; there is no clear external demarcation between the jejunum and ileum, although the two are structurally different. The ileum ends at the ileocaecal junction, a sphincter muscle situated at the junction of the ileum and the colon (large intestine). The ileum has a greater abundance of fat compared to the jejunum, it also has a thinner wall and smaller diameter. Internally, the ileum differs to the duodenum and jejunum because it has significantly fewer plicae circulares, the folds of mucous membrane. The folds are dense within the first early parts of the small intestine. Conversely, the ileum has a greater amount of Peyer’s patches – small masses of lymphatic tissue. The blood vessels differentiate the jejunum and ileum, typically vasa recta (meaning straight vessels), which among other features are longer in jejunum.

114

ABDOMEN

SECRET CODE The answers to these questions have all been encoded using the same system, where the numbers clue a series of letters in the alphabet in some way. Can you figure out what the system is and reveal the answers to all of these intestinal questions? Spaces between words are shown, as are the lengths of each answer. The same code has already been used once previously in the book, so you will have a head start if you have already solved the relevant puzzle. 1.

2.

What are the three constituent parts of the small intestine? a)

4211545142113 (8)

b)

1051021142113 (7)

c)

91252113 (5)

What is another name for straight blood vessels? 221191 1853201 (4, 5)

3.

4.

Which structures unite at the ileocaecal junction? a)

91252113 (5)

b)

315121514 (5)

Which structure is labelled A? 42115451415105102114112

61252421185 (14, 7)

DIAGRAM DETAIL Use the diagram and your general knowledge to answer these questions. 1.

When combined, which two labels from the diagram are an anagram of ‘violet charms’?

2.

Which anatomical part, with a name which stems from the Latin word for ‘blind’, is a pouch located at the start of the large intestine?

3.

Which label on the diagram, whose name includes the fifth sign of the zodiac, refers to a part of the body where two sections of the gastrointestinal system join together?

Small intestine

115

gall bladder stomach

liver

spleen

duodenum pancreas

A

large intestine (colon)

ileocaecal junction jejunum

caecum

ileum

CRYPTIC CLUES Can you solve these cryptic-crossword clues? The solutions can both be found on the diagram. 1.

Large organ found in stripped shavings (5)

2.

Start of building climbing equipment bag (7)

117

28 LARGE IN TEST I NE (CO L O N) The colon (large intestine), the distal part of the gastrointestinal tract, is about 1.5 metres (5 feet) long. It commences at the caecum, a pouch that connects the small intestine to the colon, also home to the appendix. It terminates at the rectum. It receives digested food from the small intestine, from which it absorbs water and minerals (electrolytes) to form faeces. The colon can be divided into four parts – ascending, transverse, descending and sigmoid (meaning s-shaped). The colon is shaped like the letter ‘n’, arching over the small intestine. Each part does what it says on the tin, running in the direction of its name. The ascending colon ascends up towards the liver where it then turns 90 degrees, creating the right colic flexure (or hepatic flexure); this flexure is the start of the transverse colon. The transverse colon extends towards the spleen, where it, too, turns 90 degrees to point downward; this turn is the left colic flexure (or splenic flexure). The transverse colon varies in position, it can be as low as the pelvis in some cases. The colon then descends towards the pelvis and is thus called the descending colon. Finally, it begins to turn towards the midline, becoming the sigmoid colon. The rectum is the last part of the colon complete with sphincter muscles to prevent accidental emptying. The colon has characteristic features, including a wide diameter. Omental appendices, small pouches filled with fat, attach to its surface. Strips of muscle, known as teniae coli, run longitudinally, creating segmentations (sacculations) known as haustra, which contract as they pass on the chyme between one section to another.

118

ABDOMEN

ANAGRAMMATIC Some of the parts of the large intestine labelled in the diagram have been scrambled into anagrams. Can you solve the anagrams in order to reveal the original labels? The spaces may not correspond with the original terms. 1.

Index app

4.

Sixpence fuller

2.

Pilfer exact hue

5.

Gloom in disco

3.

Long and concise

MATHEMATICAL PUZZLES Which of these equations are correct? Each consists of a number of categories relating to the colon, which should be replaced with the correct number for that category. For example, there are four sections of the colon, so ‘sections of the colon’ should be replaced with the number ‘4’ in the equations. A table is included for you to keep track of the counts. 1.

Sections of the colon + number labelling the ascending colon on the diagram = number labelling the descending colon on the diagram

2.

(Degrees of turn in the hepatic flexure + length of the colon in metres) × 2 = 180

3.

Sections of the colon × length of the colon in metres = number labelling the ascending colon on the diagram

4.

Degrees of turn in the hepatic flexure ÷ number labelling the descending colon on the diagram = sections of the colon

CATEGORY

Number of sections of the colon Number labelling the ascending colon on the diagram Number labelling the descending colon on the diagram Degrees of turn in the hepatic flexure Length of the colon in metres

NUMBER

4

Large Intestine (colon)

119

1. duodenum

8. transverse colon

9. splenic flexure

7. hepatic flexure

2. jejunum

10. descending colon

6. ascending colon

11. sigmoid colon

3. ileum

4. caecum

5. appendix

12. rectum

121

29 U TERUS The uterus is a thick-walled muscular organ which expands in order to accommodate a growing foetus. It is a secondary sex organ, meaning it matures during puberty under the influence of sex hormones produced from primary sex organs (ovaries in females). The uterus has an inverted pear-shape. It is located between the bladder and the rectum, but its exact position differs depending on the fulness of the bladder. Its function is to house and grow a fertilized egg until it becomes a developed foetus and is ready to be delivered. It is connected distally (lower end) to the vagina, and sideways (laterally) to the uterine tubes. The uterus has three parts: the fundus, body and cervix. The fundus is the top of the uterus, just above the entry point of the uterine tubes. The uterine tubes are also known as oviducts or fallopian tubes. They function to transport the egg (ovum) from the ovary to the uterus each month. Fimbriae tubae (meaning resembling a fringe) are small, finger-like projections at the end of the tubes that connect to the ovary to enable transit of the egg. The body is the main part of the uterus and is the site for implantation of the fertilized egg. The cervix is the lower part of the uterus which links it to the vagina. The cervix is a cylinder of tissue which dilates to around 10 centimetres (4 inches) to allow passage of the baby during childbirth. During menstruation, the cervix opens only enough to permit menstrual flow.

122

PELVIS

PE R I OD I C TA BLE OF EL EM ENTS

ELEMENTS OF THE BODY Below are three questions about the uterus. The answers are given, but they have all been concealed using a coding system relating to the periodic table. Use your knowledge of the female reproductive system – along with your puzzling talents and a copy of the periodic table – to work out the answers. (In the final answer, some letters are also given directly) 1.

What is the name of the structure labelled ‘A’ on the diagram? 8 23 18 39

2.

Into which part of the uterus does a fertilised egg implant? 5 8 66

3.

Which word means ‘relating to the muscular tube between the cervix and external genitals’? 2 3 47 49 13

4.

What is the name of an operation to remove all or part of the uterus? 1 39 16 52 75 6 T 8 M 39

Uterus

123

fallopian tube

A

uterus

ovarian artery

uterine artery

vagina

vaginal arteries

CRYPTIC CLUES Can you solve these uterus-themed cryptic-crossword clues? All of the answers can be found somewhere in this chapter. 1.

Sweet fruit sounds like a duo (4)

2.

Regularly engage female reproductive cell (3)

125

30 P EN IS AND U RETH RA The penis and the urethra are part of the urinary and reproductive systems. The penis is the male sex organ and reaches full size following puberty. The penis has a sexual function, as well as being the conduit for urine to leave the body. The urethra passes from the internal urethral orifice of the bladder, through the prostate, perineal membrane and muscles to the external urethral orifice located at the tip of the glans penis (the bulbous structure at the distal end). Its role is to convey urine or semen out of the body as required. The urethra is divided into four parts. The preprostatic part is surrounded by the internal urethral sphincter, which prevents semen from entering the bladder during ejaculation. The prostatic part runs through the prostate gland. Next, the intermediate membranous part is surrounded by the external urethral sphincter. Finally, the penile (spongy) part runs through the penis. The penis consists of three parts: the root, the body and the glans. The root contains erectile tissue, constituting three groups – the bulb and the left and right crura. The bulb and crura are covered in muscles. The body of the penis extends from the root to the ends of the corpora cavernosa, a pair of spongy regions of erectile tissue, which contain the largest volume of the blood in the penis during an erection. The glans is the rounded tip of the penis, translated from the Latin word for ‘acorn’. It has a double layer of skin called the prepuce (foreskin). Located in the middle of the glans penis is the opening of the urethra. The frenulum is a fold of skin that runs from the prepuce to the urethral surface of the glans.

126

PELVIS

ALPHABETICAL ANAGRAMS The answers to these questions about the penis have been anagrammed, with all of the letters arranged in alphabetical order. Can you solve the anagrams to reveal the answers? Where an answer has more than one word, each word is anagrammed separately. 1.

2.

What are the names of the three parts of the penis? a)

OORT

b)

BD OY

c)

A GLNS

The tip of the penis, part of the name of which translates from the Latin for ‘acorn’, is known by what name? AGLNS E I NPS

3.

What is the name of the paired erectile tissue found within the penis? ACOOPR R A A CE NOR S V EINPS

The answers to these questions are alphabetical anagrams of parts of the penis labelled by letters on the diagram. Solve the anagrams to reveal their names. 4.

What is the name of the covering labelled ‘A’? C E E PPR U (E FI K NOR S )

5.

What is the name of the gland labelled ‘B’? AE OPR S TT

6.

What is the name of the specific part of the urethra labelled ‘C’? EE I LNP GNOPS Y A E HR RTU

Penis and urethra

127

inte rens efe sd

ves

symphysis pubis

dorsal vein of penis

va

seminali icula s

gum e

nt

bladder

corpus cavernosa penis

prostate gland

urethra

C

prostatic portion of urethra crus penis ejaculatory duct

glans penis

B

scrotum A

LETTERMORPHOSIS Can you find words that fit the description below by adding or removing one letter from an anatomical word which can be found somewhere on the diagram of the penis? For example, the word ‘toe’ (were it to occur) could be changed into ‘tone’ by adding an ‘n’, or ‘skin’ could be changed into ‘kin’ by removing an ‘s’. The numbers after each clue specify the number of letters in each solution, to help you.

1.  Drinking establishments (4) 2.  Outer part of a loaf (5) 3.  Magical elixir (6) 4.  Decorative vessel (4)

129

31 BL ADDER The bladder is an organ within the urinary system. It has two key roles: temporary storage of urine and assistance in the expulsion of urine. The size and position of the bladder differs according to how the volume of urine it contains – typically up to 400ml (14 fl oz) in a normal adult. It is flat and lies over the bowel when empty. It assumes an oval shape when full. Externally, the bladder has an apex that is located at the top, pointing towards the pubic symphysis. It connects to the tummy button (umbilicus) via the median umbilical ligament. The main part of the bladder is the body. The fundus (base) is located posteriorly and is triangular in shape. The neck is formed by the convergence of the fundus with two inferolateral surfaces and is continuous with the urethra. Urine enters the bladder through the left and right ureters and exits via the urethra. Internally, these orifices are marked by the trigone, a triangular area located within the fundus with smooth walls. Emptying of the bladder is known as micturition and is facilitated by the musculature. The bladder wall contains detrusor muscle which has specialized fibres orientated in multiple directions to allow for stretch and maintenance of integrity. Sphincters control flow, namely the internal urethral sphincter and external urethral sphincter. The internal has a functional and structural difference between sexes. In the male it also functions to prevent regurgitation of semen during ejaculation. In both sexes, the external urethral sphincter is under voluntary control.

130

PELVIS

MISSING VOWELS All of the vowels have been removed from the answers to these questions about the bladder. Can you use your anatomical general knowledge and word skills to restore them? The spaces are placed randomly to help disguise the words. Where an answer has more than one word, the number of letters in each word is provided.

1.

What shape does the bladder assume when full? VL

2.

The median umbilical ligament attaches the apex of the bladder to which structure? M BL CS (T MM Y BT TN) (9, 5, 6)

3.

4.

5.

Which structures join the bladder at orifices associated with the trigone? a)

R G H TR TR (5, 6)

b)

L FTR TR (4, 6)

What are the two roles of the bladder? a)

TM PR RYR NS TR G (9, 5, 7)

b)

R NX PL S N (5, 9)

The specialized fibres of which muscle allow for stretch of the bladder wall? DT RSR

Bladder

131

1. u______ (6)

1. u______ (6)

bladder 2. o______ o___ u______ (7, 2, 6)

3. t_______ (7)

4. i______ u_______ o_______ (8, 8, 7)

5. u_______ (7)

WORD FRAGMENTS The labels in this diagram have been split into fragments and arranged into alphabetical order, below. Can you work out which fragments fit together and then restore the bladder labels? The first letter of each word is provided to help you. AL CE EN ER ET ET ETH FI GO HRA IN ING NE OF OP ORI RAL RN TE TER TRI UR UR UR URE

133

32 PELVIC FL O O R AN D PERI NEUM The pelvic floor is a muscle sling that supports the pelvic organs – it spans the bottom of the pelvis. The pelvic floor supports the bladder and bowel in men, and the bladder, bowel and uterus in women. It is also known as the pelvic diaphragm. The pelvic floor is composed of the muscles levator ani and coccygeus, along with the associated connective tissue that spans the lower portion of the pelvis. The pelvic floor separates the pelvic cavity above from the perineal region, including the perineum which is found below. Males and females have pelvic floors, but the female pelvis is larger. The perineum is defined as the surface between the pubic symphysis and the coccyx and is found in males and females. The perineum sits below the pelvic floor and between the legs. This diamond-shaped area includes the anus and, in females, the vagina. It also corresponds to the pelvic outlet. A structure of utmost importance is the perineal body – this fibromuscular mass sits in the middle line of the perineum. It is the junction between two triangles – the urogenital triangle and the anal triangle. It is found in both males and females. In females, it is found between the vagina and anus. In males, it is found between the bulb of the penis and the anus. It is essential for the integrity of the pelvic floor, particularly in females. Rupture during childbirth leaves a gap between the muscles and therefore can lead to prolapse of pelvic content such as the uterus or rectum.

134

PELVIS

urethral opening

vaginal opening

perineal body

transverse perineal muscles

levator ani anus gluteus maximus

DELETED LETTERS Delete one letter from each of the capitalized pairs in order to reveal the answers to the following questions about the pelvic floor. For example, CB AO NT LE could lose one letter from each pair to reveal ‘BONE’: CB AO NT LE 1.

2.

Which two muscles make up the pelvic floor? a)

G L I E NV A U NT LO R E

b)

SC A O PC CR E Y GR E L AU RS

Which structure maintains the integrity of the pelvic floor? SP EI NR A I LN E R A E S L

3.

HB EO DR YL

What is the alternative name for the pelvic floor? P O C E L R AV I R E C

4.

FA NI NI

S D I L E A PL RH O R AI G N PM

Which structure passes through the rectal hiatus in the pelvic floor? RS P E C H E T UI BM

Pelvic floor and perineum

135

CODED WORDS Each of the following rows of squares represents a different anatomical term relating to the pelvic floor. Every letter has been replaced by a number, but every place the same letter appears the same number is used. No number is used for more than one letter. Can you use your code-cracking skills and anatomical knowledge to write the correct letter in each square, to reveal these terms? Three letters have been filled in already to help you, and you can use the table beneath to keep track of your deductions. 16

1 N

10

4

14

16

7

15

1 N

16

4

5

6

15

1

3

17

13

18

N

H 16

1 N

16

2 L

5

13

2

14

15

3

10

17

18

15

3

16

16

1 N 14

7

15

2 L 17

13

9

L 7

2 L

10

17

13

5

10

8

15

3

4

4

9

11

16

12

15

11

10

4

11

5

6 H

9

4

15

4

Use this table to keep track of your deductions:

1

2

N L

3

4

5

6 H

7

8

9 10 11 12 13 14 15 16 17 18

137

33 NERVOU S SYST EM The nervous system is defined as a complex collection of nerves and specialized cells known as neurons that transmit signals between different parts of the body. The nervous system can be divided into two divisions: the central and peripheral nervous systems. The central nervous system (CNS) is the brain and spinal cord. The CNS is named due to its function to integrate received information and coordinate the activity of all parts of the body. Everything else belongs to the peripheral nervous system (PNS). In other words, the PNS refers to the portion of the nervous system that is outside the brain and spinal cord. The nerves in the PNS connect the CNS to sensory organs (e.g. the ear and eye), other organs of the body, muscles, blood vessels and glands. The PNS nerves include the 12 cranial nerves, the spinal nerves and roots, and the autonomic nerves. The autonomic nervous system (ANS) is a division of the peripheral nervous system which supplies smooth muscle and glands, and thus controls the function of internal organs. The ANS acts largely unconsciously and regulates bodily functions such as the heart rate, digestion, respiratory rate, pupillary response, urination and sexual arousal, as well as certain reflex actions such as coughing, sneezing, swallowing and vomiting. The ANS is the primary mechanism in control of the fight-or-flight response. It has two divisions: the sympathetic nervous system and the parasympathetic nervous system. The hypothalamus regulates the autonomic nervous system.

138

BODY SYSTEMS

brain

spinal cord brachial plexus spinal ganglion

intercostal nerve

sciatic nerve

nerves

LETTERMORPHOSIS Can you find words that fit the description below by adding or removing one letter from an anatomical word which can be found somewhere in the introductory text to this section? For example, the word ‘toe’ (were it to occur) could be changed into ‘tone’ by adding an ‘n’, or ‘skin’ could be changed into ‘kin’ by removing an ‘s’. The numbers after each clue specify the number of letters in each solution, to help you. 1.

Stringed instruments (6)

2.

Perches for the night (6)

3.

Nobleman (4)

Nervous system

139

CROSSWORD Use the diagram, the introductory text to this chapter and your general knowledge of human anatomy to help solve the clues and complete this crossword puzzle. 1 4

2

3

5 6

7

8

9

11

10

12

13

14 15

16

ACROSS

DOWN

1 Part of the nervous system that controls your heart rate: the ______ nervous system (9) 6 Act of expelling air from the lungs with a sudden, sharp action (8) 7 Bundle of nerves contained within the vertebrae (6,4) 10 ______ bladder, place where bile is stored (4) 11 Fibres which transmit impulses around the body (6) 13 Flexible, baglike structure (3) 15 Instinctive physiological response to a threat (5, 2, 6) 16 Reflex act of passing something down your throat (10)

2 Cells which transmit nerve impulses (7) 3 Part of the nervous system with overall control: the _______ nervous system (7) 4 Relating to e.g. taste or sight (7) 5 Organ that coordinates nervous activity (5) 6 Smallest unit of an organism (4) 8 The process of food being broken down by the body (9) 9 Organ where the cornea is located (3) 12 Organ where the smallest named bone in the human body can be found (3) 14 Body parts used for speech (4)

141

34 LY MP H AT IC SYST EM The lymphatic system is defined as a network of organs and tissues that help the body get rid of toxins, waste and other unwanted materials. The lymph system is an important part of the immune system. It plays a role in fighting bacteria and other infections, as well as destroying old or abnormal cells, such as cancer cells. The primary function of the lymphatic system is to transport lymph around the body. Lymph translates from the Latin lympha meaning ‘water’. Lymph is a fluid containing infection-fighting white blood cells called lymphocytes. The lymphatic system primarily consists of lymphatic vessels which are are larger than capillaries (the smallest blood vessels) but smaller than the smallest veins.. The lymphatic vessels are connected to lymph nodes (or lymph glands), where the lymph is filtered. From the lymph glands, the lymph moves into larger lymphatic vessels that join up. These eventually reach a very large lymph vessel at the base of the neck called the thoracic duct. The thoracic duct then empties the lymph back into the blood circulation. Lymphadenopathy is the name given to swollen lymph nodes – the most common cause for which is infection. However, lymph nodes can also become swollen because of cancer. The tonsils, adenoids, spleen and thymus are all part of the lymphatic system. The thymus is a small gland under the sternum (breast bone) which helps to produce white blood cells to fight infection – it is typically most active in teenagers and shrinks in adulthood. The tonsils and adenoids help to protect the entrance to the digestive system and the lungs from bacteria and viruses.

142

BODY SYSTEMS

S D S L

C G L

H O S

O D X

O N E

I L I

T H N

Y M Y

T O P M U

Y T A S N O

T A D

E

I N E

N D

LETTER TRIANGLES Place the triangular tiles within the larger shape in order to spell out six anatomical terms relating to the lymphatic system, so one term reads across each row. Each small triangle is used only once and may not be rotated or reflected. Each solution can be found in the introductory text to this chapter or is labelled on the diagram. The final row will consist of two words.

Lymphatic system

right lymphatic duct

143

internal jugular vein

MISSING LETTERS

subclavian vein

oesophagus

Can you answer these questions about the lymphatic system? The solutions are given but have had every alternate letter removed. Fill in the blanks to reveal the answers. 1. Which bone is the thymus gland found beneath? S_E_N_M

intercostal glands

2. Which glands protect the digestive system? a) _O_S_L_ b) _D_N_I_S

thoracic duct

3. What is another name for a lymph gland? _Y_P_ cisterna chyli

lumbar glands

psoas major

N_D_

4. Can you identify these two other structures that are part of the lymphatic system? a) _P_E_N b) _H_M_S 5. Which structure returns lymph back to the circulatory system? T_O_A_I_

D_C_

145

35 SKIN (INT E GU ME N TA RY S YS TEM ) The skin, the body’s largest organ, covers the entire outside of the body. The skin and its accessory structures make up the integumentary system. Its many roles include protecting body against heat, light, injury and infection. It also regulates body temperature; gathers sensory information from the environment; stores water, fat and vitamin D; and plays a role in the immune system protecting from disease. There are two general types of skin: thin and hairy, and thick and hairless. Hairy skin is more prevalent. Thick and hairless is found on parts of the body that are most used, enduring significant friction, such as the palms of the hands or the soles of the feet. The skin is made of multiple layers of cells and tissues, which are held to underlying structures by connective tissue. The skin has three layers that differ in function, thickness and strength. The epidermis is the tough protective outer layer that contains the melanin-producing melanocytes which have a role in skin pigmentation. The second layer is the dermis, containing nerve endings, sweat glands, oil glands and hair follicles. Finally, a fatty layer of subcutaneous tissue, known as the subcutis or hypodermis, provides insulation and cushioning to act like a shock absorber for vital organs. The epidermis does not contain blood vessels, meaning it is avascular. The dermis contains blood vessels and so is vascular. Cells in the skin’s deepest layers are nourished by diffusion from blood capillaries that are present in the upper layers of the dermis. Diffusion provides nourishment and waste removal from the cells of the dermis, as well as for the cells of the epidermis.

146

BODY SYSTEMS

ANAGRAM DIAGRAM On the diagram shown, some of the labels have been replaced with numbers. The correct text for each label is shown below, but in each case it has been anagrammed into other words. Altering the spacing as required, can you unscramble each set of letters and reveal the original labels? Some labels contains terms consisting of more than one word. 1. Never 2. Dimers 3. Piteous asides Useful, sordid organ 4. 5. Up electrical cost 6. Golden abacuses 7. I simpered Prim, social lecturer 8.

All of the words you need to solve the anagrams are provided in the list below. Some of these words may be used more than once, others not at all.

• Melanin • Muscle • Nerve • Papillae • Pili • Sebaceous • Sudoriferous • Sweat • Tactile • Tissue

• Adipose • Arrector • Corneum • Corpuscle • Dermal • Dermis • Epidermis • Follicle • Gland • Hair

5.

7. 8.

2. 6. 1.

hair follicle

4.

3.

Skin (integumentary system)

147

PATHFINDER

E

P

I

D

A

N

S

I

M

R

E

L

O

H

S

H

A M

E

C

Y

I

R

I

N

O

Y

P

M

L

E

T

I

T

O

R

S

S

A

L

E

D

E

I

N

S

U

S

1.

What is the name of the top layer of the skin?

The answers to the following questions about the skin are concealed in this pathfinder, in order. Can you reveal them by tracing a single continuous path through the grid which visits every square exactly once, tracing out a series of non-overlapping words so that each letter appears in exactly one word? Starting at the arrow, the path can travel in any direction from square to square, except diagonally.

E______________(9) 2.

What is one of the names for the bottom layer of the skin? __________________(10)

3.

What type of skin is the thickest? ____________(8)

4.

What is one of the functions of subcutaneous fat? _________________(10)

5.

What are the cells that control skin pigmentation called? _____________________(11)

149

36 C IRCU LAT O RY SYST EM The circulatory system is a network consisting of blood, blood vessels and the heart. It supplies tissues in the body with oxygen and other nutrients, transports hormones and removes unnecessary waste products. The body has different circulatory systems: pulmonary, coronary (cardiovascular) and systemic (including portal). The pulmonary system is between the heart and the lungs. The systemic is for the rest of the body. The main function of a blood vessel is to transport blood around the body. They also play a key role in controlling blood pressure. There are five main types of blood vessel: arteries, arterioles, capillaries, venules and veins. Arteries carry blood away from the heart to other organs. Varying in size, the largest arteries have special elastic fibres in their walls. The aorta is the body’s largest artery – it carries blood away from the heart to the rest of the body. Arterioles are the smallest arteries in the body. They deliver blood to capillaries. Capillaries are tiny vessels that connect arterioles to venules and are known as exchange vessels. They have very thin walls that allow nutrients from the blood to pass into the body tissues. Waste products from body tissues can also pass into the capillaries. Capillaries within a tissue reunite in groups to form small veins called venules. Venules collect blood from capillaries and drain into veins. Veins are the blood vessels that carry blood back to the heart and may contain valves which stop blood flowing backwards. The largest vein in the human body is the inferior vena cava, which carries deoxygenated blood from the lower body back up to the heart.

150

BODY SYSTEMS

right vagus nerve

carotid artery

trachea

left vagus nerve

subclavian artery

thoracic duct

right subclavian vein left subclavian vein pl

ra

eu

pl

eu

ra

left brachiocephalic (or innominate) vein aorta

superior vena cava

pulmonary artery

right auricula

left auricula

aorta

coronary artery

right ventricle

inferior vena cava

thoracic aorta

Circulatory system

SECRET CODE The answers to the following questions have all been encoded using the same system, where the numbers clue a series of letters in the alphabet in some way. Can you figure out what the system is and reveal the answers to all of these circulatory questions? Spaces between words are shown. 1.

What is the aorta? 7 1922

2.

15269202287

26972292

How many main types of blood vessel are there? 2 118522

3.

4.

What are four types of circulatory system? a)

116151412132692

b)

828722141824

c)

24269231812526824615269

d)

1112972615

What connects arterioles to venules? 2 4261118151526918228

5.

Which is the largest vein in the body? 1 8132122918129

5221326

2426526

LETTERMORPHOSIS Can you find words that fit the description below by changing one letter in an anatomical word which can be found somewhere on the diagram of the circulatory system? For example, the word ‘toe’ (were it to occur) could be changed into ‘top’ by changing the ‘e’ to a ‘p’. The numbers after each clue specify the number of letters in each solution, to help you. 1.

Underground chamber (4)

2.

Performance by two singers (4)

3.

Horse guide (4)

4.

Present food, as a waiter (5)

151

Solutions

154

Solutions

01 TH E RIBS AND RIB CAG E RIB MATCH 2 – true 3 – true 5 – true 9 – false 10 – false 12 – false; this rib is also known as a floating rib

LOST LETTERS 1. STERNUM 2. TWENTY-FOUR 3. BREATHING 4. a) MANUBRIUM  b) BODY  c)  XIPHOID PROCESS 5. VERTEBRA

CRYPTIC CLUES 1. Costal. ‘price’ = cost, ‘Alabama’ = AL, ‘relates to ribs’ = costal. 2.  Thoracic Cage. ‘Chaotic grace’ is an anagram (‘disarrayed’) of thoracic cage. ‘Bony frame’ = thoracic cage. 3. Sternum. ‘Severe’ = stern, ‘hesitation’ = um, ‘breastbone’ = sternum.

Solutions

02 TH E H A ND AN D WR I ST WORD CIRCLE Anterior. The three other words are retina, ear and toe.

DECODING DIGITS The code uses the digit-to-letter correspondence on a regular phone keypad, where multiple presses of a key are represented by repeated digits. For example, 2 = A, 22 = B, 222 = C, 3 = D and so on. A ‘0’ represents a space. 1. Phalanges 2. Pisiform 3.  a) Carpal bones (of which there are eight)  b) Radius  c) Ulna 4.  Little finger

CRYPTIC CLUES 1. Thumb. ‘Request free ride’ = thumb (as you might thumb a lift); ‘digit’ = thumb 2. Metacarpal. ‘Came across’ = met, ‘a’ = a, ‘vehicle’ = car, ‘friend’ = pal, which is ‘hand bone’ = metacarpal. 3. Capitate. ‘California’ = CA, ‘hole’ = pit, ‘consumed’ = ate, ‘bone at the base of the palm’ = capitate.

155

156

Solutions

03 T H E FO O T MATCHING UP 1 – a   2 – c   3 – d   4 – b

MEDICAL INCISIONS 6

12 Bones

Joints

27

9

Muscles

14

Bones = 26 Tendons

Joints = 33

10

7

Tendons = 10

68 3 Ligaments

39

Muscles = 19 Ligaments = 107

CRYPTIC CLUES 1.  Hindfoot. ‘Female deer’ = hind, taking ‘distance’ = ‘foot’, with ‘heel and ankle’ = hindfoot (see opening text) 2.  Toes. ‘Pulls vehicle, so we hear’ = tows, being a homophone of ‘toes’, which in turn are ‘big digits’. 3.  Ligament. ‘Cloth fibres’ = lint, ‘cover’ (enclose the letters of) ‘sport’ = game, i.e. ‘game’ is inserted into the middle of ‘li’ and ‘nt’ to make ‘ligament’, which is a ‘tissue holding two bones together’

Solutions

157

04 T H E SK UL L SKULL SUDOKU Bones in the calvarium  4 Bones in the base of the cranium  6 Inferior nasal conchae  2 Zygomatic bones  2 Lacrimal bones  2 Mandible bones  1 Vomer bones  1

4 2 3 1 6 5

5 3 4 6 2 1

6 1 5 2 3 4

2 4 6 5 1 3

3 6 1 4 5 2

1 5 2 3 4 6

MISSING LETTERS 1. NASAL  2. MANDIBLE   3. ZYGOMATIC 4. VISCEROCRANIUM   5. SUTURES  6. FORAMINA

158

Solutions

05 TH E SKELET O N

DELETED LETTERS 1. AXIAL 2. THIRTY-THREE 3. SIDEWAYS 4.  a. CERVICAL  b. THORACIC c. LUMBAR  d. SACRAL e. COCCYGEAL 5.  INTERVERTEBRAL DISC

CODED WORDS COCCYX, LORDOSIS, KYPHOSIS, SCOLIOSIS, PECTORAL GIRDLE,  VERTEBRAL COLUMN, CERVICAL CURVE,  LUMBAR CURVE. 1

2

3

C N S

4

5

O I

6

7

8

9 10 11 12 13 14 15 16 17 18 19 20 21

D A H X R K Y E U T

L V P

BONUS QUESTION The pectoral girdle is not part of the spine.

G M B

Solutions

06 TH E VERTEB RAE

WORD CIRCLE Transverse. Other words include nerves, sterna, sense, ear(s), tear(s), see(s) and eat(s).

CRYPTIC CLUES 1. Foramen. ‘Bone opening’ = foramen; ‘in support of’ = for, ‘prayer ending’ = amen. 2. Arch. ‘Spilled’ = anagram of ‘char’ = arch; ‘symmetrical curve’ = arch. 3. Laminae. ‘Unable to walk’ = lame; written around ‘in a’; ‘set of thin tissue layers’ = laminae.

159

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Solutions

07 TH E SH OUL DER S

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LETTERMORPHOSIS

PATHFINDER:

1. Scuff

1.  Shoulder (already given)

(add an ‘s’ to ‘cuff’)

2. Ligament

2. Warm

3. Scapula

(add a ‘w’ to ‘arm’)

4. Clavicle

3. One

5. Conoid

(remove ‘b’ from ‘bone’)

6. Trapezoid

4. Climb

7. Acromion

(add ‘c’ to ‘limb’)

8.  Coracoid process 9. Humerus 10. Joint

Solutions

08 T H E PE LVI S

WORD FRAGMENTS 1.  PELVIC INLET 2.  a) ILIUM  b) PUBIS  c) ISCHIUM 3.  NARROWER, TALLER, HEART-SHAPED

LETTERMORPHOSIS 1. Public (add an ‘l’ to ‘pubic’) 2. Elvis (remove the ‘p’ from ‘pelvis’) 3. Larch (add an ‘l’ to ‘arch’) 4. Arc (remove the ‘h’ from ‘arch’).

CRYPTIC CLUES 1. Basin. ‘Washing vessel’ = basin; with ‘as’ inside (‘found in’) a ‘waste-paper basket’ = ‘bin’. 2. Hip. ‘Pelvic projection’ = hip; the word can be found ‘regularly’ (by taking every nth letter) in ‘shrimp’.

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Solutions

09 T H E U PPER L I M B ENCODED PAIRS 1.  a) 3  b) TRICEPS BRACHII

2.  a) 4  b) FLEXION

3.  a) 2  b) BRACHIAL PLEXUS

MISSING LETTERS 1. HUMERUS

2. a)  RADIUS b)  ULNA

3. HINGE

  4.  a)  GIRDLE b)  ARM c)  FOREARM d)  HAND

Solutions

10 TH E L O WE R L I M B MATCHING PARTS UP P E R - LE G BONE S ( A B O VE T H E KN EE) Femur K NE E BON ES Patella LOW E R - LE G BONE S ( BE L O W T H E KN EE) Tibia Fibula T HI GH M USC L ES Quadriceps Hamstrings Adductors CA LF M USC L ES Gastrocnemius Soleus

ANATOMICAL 1.  13 – Quadratus lumborum, psoas minor, psoas major, iliacus, tensor fasciae latae, sartorius, pectineus, adductor longus, gracilis, adductor magnus, rectus femoris, vastus lateralis and vastus medialis. 2.  Psoas minor – ‘minor’ scales contain a flattened third, producing a more melancholy effect. 3.  Crest of Ilium – ‘crest’ refers to the top of a wave. 4.  Sartorius – ‘sartor’ is the Latin for ‘tailor’ and is also the etymological base of the word ‘sartorial’. 5.  Pectineus – ‘pectin’ can be found in ripe fruit and can be used to set jam.

163

164

Solutions

11 THE FACIAL MUSCLES MATHEMATICAL PUZZLES Equations 1, 2 and 5 are correct; equations 3 and 4 are incorrect: 1.  3 + 2 = 5 2.  10 ÷ 2 = 5 3.  (10 – 5) + 1 ≠ 3 4.  (3 + 1) × 10 + 2 ≠ 43 5.  (43 + 5 + 2) ÷ 10 = 5 N U M B ER

CAT E GORY Nasal muscles Facial muscles Muscles around the oral opening Parts of the occipitofrontalis muscle Types of facial orifice Muscle groups in the body which insert into the skin

5 43 10 2 3 1

CRYPTIC CLUES 1. Nose: a homophone (‘so we hear’) of ‘knows’; and ‘we smell with this’ is a description of the nose. 2. Masseter: ‘donkey’ = ass, written ‘within’ a ‘distance’ = meter; the answer is a ‘chewing muscle’. 3. Risorius: ‘smiling muscle’ is a definition; it is an anagram (‘confused’) of ‘sour Iris’.

Solutions

12 TH E B RAI N ANAGRAMMATIC 1.  Parietal lobe 2.  Fissure of Sylvius 3.  Middle frontal lobe  (‘mid’ = middle) 4.  Parieto-occipital fissure 5.  Temporal lobe 6.  Inferior frontal lobe  (‘inf’ = inferior) 7.  Post central fissure

DIAGRAM DETAIL 1.  1 – Superior frontal lobe – in the label, ‘superior’ is abbreviated to ‘sup’ 2.  9 – fissure of Sylvius, sup. temporal fissure, inf. temporal fissure, parieto-occipital fissure, calloso-marginal fissure, intraparietal fissure, post central fissure, fissure of Rolando, precentral fissure

CRYPTIC CLUES 1. Brain. ‘Nervous organ’ describes the brain (since it consists of nervous tissue); the solution is located in ‘cobra infestation’. 2. Frontal: ‘Aluminium’ = Al, ‘façade’ = front, ‘relating to the forehead’ = frontal. 3. Brainstem: ‘Tribesman’ is an anagram (‘chaotic’) of brainstem; ‘found at the bottom of the brain’ describes the brainstem.

165

166

Solutions

13 TH E C RANI AL N ERVES

MATCHING PARTS NAME OF NE RV E Olfactory (I) Optic (II) Oculomotor (III) Facial (VII) Vestibulocochlear (VIII) Vagus (X) Accessory (XI) Hypoglossal (XII)

FUNCT I ON Conveys sensory information related to smell Conveys visual information Facilitates most of our eye movements Operates muscles that facilitate facial expressions Conveys auditory information and helps us to balance The longest cranial nerve, with a name that stems from the Latin for ‘wander’ Enables us to tilt our heads and shrug our shoulders Supplies muscles in the tongue, apart from the palatoglossus.

ENCODED PAIRS 1.  a) 2 1.  b)  CRIBRIFORM PLATE 2.  a) 12 2.  b) FACIAL 3.  a)  10 (X in Roman numerals) 3.  b) VAGUS

Solutions

14 TH E SPIN AL C O RD

MISSING LETTERS 1.  CAUDA EQUINA 2.  FILUM TERMINALE 3.  CERVICAL and LUMBAR 4. BRAIN 5.  PIA MATER 6. SUBARACHNOID

LETTERMORPHOSIS 1.  Arachnid  (remove the ‘o’ from ‘arachnoid’) 2.  Mate  (remove the ‘r’ from ‘mater’) 3.  Pisa  (add an ‘s’ to ‘pia’) 4.  Master  (add an ‘s’ to ‘mater’)

167

168

Solutions

15 T H E EYE

SECRET CODE The coding system is a letter-to-number cipher, where each letter of the alphabet is assigned a consecutive number, so that A = 1, B = 2, C = 3 and so on up until Y = 25, Z = 26. It is up to you to break the digits into their component numbers. 1.  9-18-9-19: Iris 2.  18-5-20-9-14-1: Retina 3.  a)  19-21-16-5-18-9-15-18

5-25-5-12-9-4: Superior eyelid

3.  b)  5-25-5-2-1-12-12: Eyeball 4.  a)  19-3-12-5-18-1: Sclera 4.  b)  3-15-18-14-5-1: Cornea 5.  19-5-22-5-14: Seven 6.  20-8-5

16-21-16-9-12: The pupil

LETTERMORPHOSIS 1.  Lends (add ‘d’ to ‘lens’) 2.  Carnal (add ‘r’ to ‘canal’) 3.  Camber (remove ‘h’ from ‘chamber’) 4.  Heath (remove ‘s’ from ‘sheath’) 5.  Irish (add ‘h’ to ‘iris’) 6.  Retsina (add ‘s’ to ‘retina’)

Solutions

16 TH E EAR

CROSSWORD M A U R A L L I M L O B U L E A E V E S T U A U S S R S T C B A L A N C P N E A N V S L

E

I

H E L I X

T U H M B R A N E E M A M R B U L E R O R I N N E A R I N G N A C H E L U S

LETTERMORPHOSIS 1.  Globule (add a ‘g’ to ‘lobule’)  2.  Tear (add a ‘t’ to ‘ear’) 3.  Tub (remove the ‘e’ from ‘tube’)  4.  Sinner (add an ‘s’ to ‘inner’)

169

170

Solutions

17 T H E N O SE

HIDDEN WORDS 1. Palate (my grandpa, late as always) 2. Olfactory (working in the Lysol factory) 3. Sinuses (My cousin uses) 4. Nasal (beautiful china salt cellar)

CRYPTIC CLUES 1. Concha: ‘Spiral-shaped depression’ = concha; ‘deception’ = con; ‘Latin dance’ = cha-cha, so half of it is ‘cha’. 2. Atrium: ‘central court’ = atrium; ‘nasal cavity’ = atrium. 3. Nostril: ‘n’ = north, with ‘oil’ around (‘spread around’) ‘short street’ = str, to form ‘nostril’; and ‘nostril’ = opening.

Solutions

18 TH E O RAL C AVI T Y

ALPHABETICAL ANAGRAMS 1. THIRTY-TWO 2.  a) DIGESTION b) COMMUNICATION c) BREATHING 3. BUCCINATOR 4.  SUSPENSORY PERIODONTAL LIGAMENT

LETTER TRIANGLES

I P L U S M O T H O C E T S N K B S M A D I L E U C I N T O B S C M A E R W I D O T E T H

171

172

Solutions

19 TH E P H ARYNX AN D LARYNX WORD FRAGMENTS 1.  NASAL CAVITY 2. NASOPHARYNX 3.  ORAL CAVITY 4. OROPHARYNX 5. HYPOPHARYNX 6. LARYNX 7. OESOPHAGUS 8. TRACHEA

CRYPTIC CLUES 1. Swallow: ‘Female pig’ = sow, which contains (is ‘holding’) a ‘brick structure’ = wall. ‘Pass down the throat’ = swallow. 2. Epiglottis: ‘Pig’s toilet’ is an anagram (‘disarrayed’) of epiglottis; ‘flap of cartilage covering the windpipe’ = epiglottis.

Solutions

173

20 T H E H EART

HEARTY SUDOKU

1 4 2 6 3

3 2 6 1 4 3 6 2 1 4

6 2 4 3 1 4 6 3 1 2 1 4 2 3 6

N A ME

N U MB E R

Apex

1

Ventricles

2

Layers of the heart wall

3

Valves

4

Chambers

4

Atria

2

CRYPTIC CLUES 1. Atrium: ‘Roman court’ = atrium, ‘Timaru’ is an anagram (‘reconstructed’) of atrium. 2. Chamber: ‘Switzerland’ = CH (international vehicle registration); ‘fossilized resin’ = amber; ‘judge’s office’ = chamber. 3. Vein: The solution can be found in ‘dive into’ (it is ‘smuggling’ the letters); ‘blood vessel’ = vein.

174

Solutions

21 TH E L UNG S LABEL MATCH A.  Left lung B.  Right lung C.  Oblique fissure D.  Superior lobe E. Trachea F.  Middle lobe

MISSING VOWELS 1. TRACHEA 2. HEART 3. BRONCHI 4. CARTILAGE 5. DIAPHRAGM

CRYPTIC CLUES 1. Windpipe. ‘Rush of air’ = wind, ‘smoking device’ = pipe, ‘passage for breath’ = windpipe. 2. Thorax. ‘Thunderous god’ = Thor, ‘US chopping tool’ = ax, ‘found between the neck and the abdomen’ = thorax. 3. Lung. ‘Lunge’ is short, i.e. loses the last letter to become ‘lung’. ‘Sac into which air is drawn’ = lung.

Solutions

22 TH E L I VER ENCODED PAIRS 1.  a)  1   b)  Falciform ligament, shift = 1

2.  a)  4   b)  Diaphragm, shift = 4

3.  a)  2   b)  Hepatic, shift = 2

CRYPTIC CLUES 1. Lobe: The solution can be spelt with the first letters of ‘large organ becomes enlarged’. ‘Flattish hanging part’ = lobe. 2.  Gall bladder: ‘bile store’ = gall bladder; ‘inflatable bag’ = bladder; after ‘cheek’ = gall 3.  Tuber omentale: ‘Potato, e.g.’ = tuber, ‘portent’ = omen, ‘tale’ = legend; the tuber omentale is an ‘eminence’, anatomically

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Solutions

23 TH E SPLEEN LETTER TRIANGLES DIAGRAM DETAIL 1. Three times  2. The pancreas 3. Portal vein  4. St Pancras  5. Bile duct

U L V P L I E R T O A C S N M E H P A C R A S P L E N E I S L E E V O N S P E N C T M Y P

CRYPTIC CLUES 1. Duodenum: ‘A pair’ = duo, ‘hideout’ = den, ‘brief hesitation’ = um, ‘part of the small intestine’ = duodenum. 2.  Ascending colon: ‘List punctuation’ = colon, ‘on the rise’ = ascending, thus ‘ascending colon’, which is ‘in [the] large intestine’. 3. Ileum: ‘Small intestine part’ = ileum; ‘Greek Troy’ = Ilium (alternate name for Troy, especially once Greek), which is a homophone (‘announced’) of Ileum.

Solutions

24 T H E PAN C REAS DELETED LETTERS 1.  PANCREATIC DUCT 2. DUODENUM 3. ENDOCRINE 4. SPLEEN 5.  a)  COMMON BILE DUCT   b)  PANCREATIC DUCT

PANCREATIC PAIRS Pair 3 is the odd one out – the head and uncinate process are adjacent to one another, while the other pairs are made up of sections of the pancreas which are not.

CRYPTIC CLUES 1. Tail: This is a double definition. ‘Secretly follow’ = tail; ‘hindmost part’ = tail. 2.  Bile duct: ‘Diet club’ is an anagram (‘cooked’) of bile duct; ‘component of hepatopancreatic ampulla’ = bile duct.

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Solutions

25 T H E STOM AC H EXTRA ANAGRAMMATIC 1. Pylorus, +O   2. Antrum, +R 3. Body, +G   4. Cardia, +A   5. Fundus, +N Hidden word: ORGAN

PATHFINDER 1. Cardia

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4. Rugae

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5. Pyloric sphincter

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6. Duodenum

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2. Cardinal notch 3. Greater curvature

7. Antrum 8. Pylorus 9. Body

CRYPTIC CLUES 1. Antrum: ‘Insect’ = ant, ‘spirit’ = rum, ‘lower part of stomach’ = antrum. 2. Fundus: ‘Group requests sum of money, perhaps’ = fund us, ‘area below diaphragm’ = fundus.

Solutions

179

26 T H E KIDNEYS CROSSWORD U R A R D I R N E B E A N A H I L A I P R P A R I N

E M I U C L U S P U M R E L V T E N C R

W O A A P S E F T X E P H A L A P R L I I S L G L H Y M A T S P I

M B C A L Y N X M B A B I L N E

Anagram solution: DIALYSIS

CRYPTIC CLUES 1. Medial: ‘Maine’ = ME (state abbreviation); ‘clock face’ = dial; ‘found in the centre’ = medial. 2. Gland: ‘Start of ground’ = G, ‘area above water’ = land, ‘source of chemical secretion’ = gland. 3. Border: Two straight definitions, of ‘be next to’ and ‘type of collie’.

180

Solutions

27 S MALL IN T EST I NES SECRET CODE The coding system is a letter-to-number cipher, where each letter of the alphabet is assigned a consecutive number, so that A = 1, B = 2, C = 3 and so on up until Y = 25, Z = 26. It is up to you to break the digits into their component numbers. 1.  a)  4-21-15-4-5-14-21-13: Duodenum b)  10-5-10-21-14-21-13: Jejunum   c) 9-12-5-21-13: Ileum 2.  22-1-19-1

18-5-3-20-1: Vasa recta

3. a) 9-12-5-21-13: Ileum  b)  3-15-12-15-14: Colon 4.  4-21-15-4-5-14-15-10-5-10-21-14-1-12

6-12-5-24-21-18-5: Duodenojejunal flexure

DIAGRAM DETAIL 1.  ‘Liver’ and ‘stomach’ 2. Caecum 3.  Ileocaecal junction – ‘leo’, found in ‘ileocaecal’ is the fifth sign of the zodiac.

CRYPTIC CLUES 1. Liver: ‘Large organ’ = liver; ‘shavings’ = ‘slivers’, which when ‘stripped’ of its first and last letters reveals ‘liver’. 2. Bladder: ‘Start of building’ = b; ‘climbing equipment’ = ladder; ‘bag’ = bladder.

Solutions

181

28 T H E LARG E I NTESTIN E (C O L O N) ANAGRAMMATIC 1. Appendix 2.  Hepatic flexure 3.  Ascending colon 4.  Splenic flexure 5.  Sigmoid colon

MATHEMATICAL PUZZLES CAT E GO RY

N U M B ER

Number of sections of the colon

4

Number labelling the ascending colon on the diagram

6

Number labelling the descending colon on the diagram

10

Degrees of turn in the hepatic flexure

90

Length of the colon (m)

1.5

Equations 1 and 3 are correct; equations 2 and 4 are incorrect. 1. 

4 + 6 = 10

2.  (90 + 1.5) × 2 ≠ 180 (should be 183) 3. 

4 × 1.5 = 6

4.   90 ÷ 10 ≠ 4 (should be 9)

182

Solutions

29 TH E U TE RUS

ELEMENTS OF THE BODY In this code, each number should be replaced by the symbol for the element of the corresponding atomic number, so for example 1 = H (for hydrogen). 1.  Ovary – O V Ar Y 2.  Body – B O Dy 3.  Vaginal – V Ag In Al 4.  Hysterectomy – H Y S Te Re C (T) O (M) Y

CRYPTIC CLUES 1. Pear: ‘a duo’ = pair, which is a homophone (‘sounds like’) of ‘pear’; ‘sweet fruit’ is a straight definition. The uterus is described as shaped like a pear in the text. 2. Egg: The word ‘egg’ can be made ‘regularly’ using every other letter of ‘engage’; ‘female reproductive cell’ = egg.

Solutions

30 TH E P EN I S AND U RET HRA

ALPHABETICAL ANAGRAMS 1. a) ROOT  b)  BODY  c)  GLANS 2.  GLANS PENIS 3.  CORPORA CAVERNOSA PENIS 4.  PREPUCE (FORESKIN) 5. PROSTATE 6.  PENILE SPONGY URETHRA

LETTERMORPHOSIS 1. Pubs (remove the ‘i’ from ‘pubis’) 2. Crust (add a ‘t’ to ‘crus’) 3. Potion (remove the ‘r’ from ‘portion’) 4. Vase (add an ‘e’ to ‘vas’)

183

184

Solutions

31 TH E B L AD DER

MISSING VOWELS 1. OVAL 2.  UMBILICUS (TUMMY BUTTON) 3.  a)  RIGHT URETER b)  LEFT URETER 4.  a)  TEMPORARY URINE STORAGE b)  URINE EXPULSION 5. DETRUSOR

WORD FRAGMENTS 1. URETER 2.  OPENING OF URETER 3. TRIGONE 4.  INTERNAL URETHRAL ORIFICE 5. URETHRA

Solutions

185

32 THE P ELVIC F L O O R

DELETED LETTERS 1. a) LEVATOR ANI  b)  COCCYGEUS 2. PERINEAL BODY 3. PELVIC DIAPHRAGM 4. RECTUM

CODED WORDS Anus; vagina; sphincter; anal triangle; pelvic cavity; gluteus maximus; pubic symphysis.

The number-to-letter code is as follows:

1

2

3

4

5

6

7

8

9 10 11 12 13 14 15 16 17 18

N L C S

P

H G B Y U M X E V I

A T

R

186

Solutions

33 TH E N ERVO US SYST EM LETTERMORPHOSIS 1. Cellos (add an ‘o’ to ‘cells’) 2. Roosts (add an ‘s’ to ‘roots’) 3. Earl (add an ‘l’ to ‘ear’)

CROSSWORD S B E R A N S P I O N R Y N L F I G P S W

A U T O N E C O U E R N A L C O L N E S Y E R V E S A H T O R F

O M I C E G H I N G T R D R I A G A L L E S A C T L I G H T O A L L O W I N G

Solutions

34 T H E LYMP HAT I C SYSTE M LETTER TRIANGLES

N OXD E T O I N O N I L T E S I S A D N O D S L YYM P HSO C YAT E T H M U G L N D MISSING LETTERS 1. STERNUM 2. a) TONSILS  b)  ADENOIDS 3.  LYMPH NODE 4. a)  SPLEEN  b)  THYMUS 5.  THORACIC DUCT

187

188

Solutions

35 SKIN (INTEGUMENTARY SYSTEM) ANAGRAM DIAGRAM 1. Nerve 2. Dermis 3.  Adipose tissue 4.  Sudoriferous gland 5.  Tactile corpuscle 6.  Sebaceous gland 7. Epidermis 8.  Arrector pili muscle

PATHFINDER E

P

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A

N

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1. Epidermis  2. Hypodermis  3. Hairless  4. Insulation  5. Melanocytes

Solutions

36 TH E CIRCUL AT O RY SYSTE M

SECRET CODE The coding system is a letter-to-number cipher, where each letter of the alphabet is assigned a consecutive number, working backwards through the alphabet, so that A = 26, B = 25, C = 24 and so on through until Y = 2, Z = 1. It is up to you to break the digits into their component numbers. 1.  7-19-22 15-26-9-20-22-8-7 26-9-7-22-9-2:  The largest artery 2.  21-18-5-22: Five 3.  a) 11-6-15-14-12-13-26-9-2: Pulmonary 3.  b) 8-2-8-7-22-14-18-24: Systemic 3.  c) 24-26-9-23-18-12-5-26-8-24-6-15-26-9: Cardiovascular 3.  d) 11-12-9-7-26-15: Portal 4.  24-26-11-18-15-15-26-9-18-22-8: Capillaries 5.  18-13-21-22-9-18-12-9 5-22-13-26 24-26-5-26:  Inferior vena cava

LETTERMORPHOSIS 1.  Cave (replace second ‘a’ with ‘e’ in ‘cava’) 2.  Duet (replace ‘c’ with ‘e’ in ‘duct’) 3.  Rein (replace ‘v’ with ‘r’ in ‘vein’) 4.  Serve (replace ‘n’ with ‘s’ in ‘nerve’)

189

Index A accessory nerve 57 acetabulum 37 Achilles tendon 17 adenoids 141 ankle 17, 45 antrum 105 aorta 85, 149 appendicular skeleton 25 appendix 117 arm 13, 33, 41 arteries 149 arterioles 149 articular processes 29 auricles 69 autonomic nervous system 137 axial skeleton 9, 25

B biceps brachii 41 bile duct 93, 101 bladder 37, 109, 121, 125, 128–31, 133, 184 blood 149 blood vessels 149 bowel 133 the brain 21, 52–5, 137, 165 brainstem 53, 61 buccinator muscle 49, 77 buttocks 45

C caecum 117 calcaneal tendon 17 calf 17, 45 calices 109 calvarium 21 capillaries 149

cardia 105 carpal bones 13 central nervous system 61, 137 cerebellum 53 cerebrum 53, 57 cervical spine 25, 29 cervix 121 cheeks 77 choroid 65 ciliary body 65 circulatory system 148–51, 189 clavicle 33, 41 coccyx 25, 29, 37, 61, 133 collar bone 33, 41 colon 116–19, 181 costal cartilage 9 cranial nerves 56–9, 166 cranium 21, 61

D deltoid muscle 33, 43 dermis 145 diaphragm 89, 97 duodenum 101, 105, 113

E

facial nerve 49, 57 feet 16–19 femur 37, 45 fibula 17, 45 fingers 13 foot 45, 156 forearm 41 fundus 105

G gall bladder 93 gastroesophageal junction 105 gastrointestinal tract 112–19 gluteus maximus 45

H hamstrings 45 hand 12–15, 41, 155 heart 9, 84–7, 149, 173 hepatopancreatic ampulla 101 hip 37, 45 hip flexors 45 humerus 33, 41 hypodermis 145 hypopharynx 81

ear 68–71, 169 elbow 41 epidermis 145 Eustachian tube 69 exocrine pancreas 101 eyelids 65 eyes 64–7, 168

I

F

J

face 21, 49 facial muscles 48–51, 164

jaw 21 jejunum 113

ileum 113 immune system 97, 141, 145 inferior vena cava 85, 149 integumentary system 144–7, 188 iris 65

K kidney 108–11, 179 knee joint 45

L large intestine 116–19, 181 larynx 80–3, 172 leg 17, 37, 45 lens 65 lips 49, 77 liver 92–5, 109, 175 lower limb 44–7, 163 lungs 9, 88–91, 174 lymph 141 lymph nodes 141 lymphatic system 97, 140–3, 187

pelvic inlet 37 pelvis 36–9, 133, 161 penis 124–7, 133, 183 perineal body 133 perineum 132–5 peripheral nervous system 137 phalanges 13, 17 pharynx 80–3, 172 pisiform 13 pubic symphysis 37, 129, 133 pulmonary system 149 pylorus 105, 113

Q quadriceps 45

M

R

meati 73 meninges 61 metacarpal bones 13 metatarsal bones 17 mouth 49, 77 mucus 73

radius 13, 41 rectum 117, 121, 133 renal functional tissue 109 renal papilla 109 reproductive system 120–7 respiratory system 89 retina 65 ribs and rib cage 8–11, 25, 41, 97, 154 rotator cuff 33 rugae 105

N nasal cavity 73 nasal muscles 49 nervous system 136–9, 186 nose 72–5, 170

O occipitofrontalis muscle 49 oesophagus 81, 105 olfactory nerve 57, 73 oral cavity 76–9, 171 oropharynx 81

P palate 73, 77 pancreas 100–3, 177 parasympathetic nervous system 137 patella 45 pelvic floor 132–5, 185 pelvic girdle 25, 37

S sacrum 25, 37 scapulae 33, 41 sesamoid bones 18, 45 sex organs 121, 125 shoulder 32–5, 160 shoulder blade 33, 41 the skeleton 24–7, 158 skin 93, 144–7, 188 the skull 20–3, 25, 61, 157 small intestine 101, 105, 112–15, 117, 180 spinal cord 60–3, 137, 167 spine 25 spleen 96–9, 176 sternum 9, 10, 25

stomach 104–7, 113, 178 subcutis 145 superior vena cava 85 sympathetic nervous system 137 synovial joints 17, 45 systemic system 149

T talus 17 teeth 77 thigh 45 thoracic spine 25, 29 thoracic vertebrae 9, 29 thorax 37, 89 throat 81 thumb 13 thymus 141 tibia 17, 45 toes 17, 45 tonsils 141 trachea 89 transverse processes 29 triceps brachii 41

U ulna 13, 41 upper limb 13, 40–3, 162 uraemia 109 urethra 124–7, 129, 183 urinary system 109, 125, 128–31 urine 109, 125, 129 uterine tubes 121 uterus 120–3, 133, 182

V vagina 121, 133 vagus nerve 57 venules 149 vertebrae 21, 25, 28–31, 41, 61, 159 vestibule 69, 73 viscerocranium 21, 49

W wrist 12–15, 155

Gareth would like to thank his assistant, Elizabeth Crowdy, for her enormous help with this book.

ABOUT THE AUTHORS Dr Gareth Moore is the author of more than 200 puzzle and brain-training titles for both children and adults, including The Ordnance Survey Puzzle Book, The Penguin Book of Puzzles and The Art Puzzle Book. He is also a director of the World Puzzle Federation, which oversees the World Puzzle Championships, and a director of the UK Puzzle Association. Find him online at www.DrGarethMoore.com. Professor Gabrielle M. Finn is Vice Dean for Teaching, Learning and Students in the Faculty of Biology, Medicine and Health at the University of Manchester and Professor of Medical Education. She has edited the books 30-second Anatomy and 30-second Medicine and is Associate Editor for the journals BMC Medical Education and Anatomical Sciences Education.

PICTURE CREDITS Illustrations sourced from Anatomy of the Human Body by Henry Gray, F.R.S (1918) and Anatomy Descriptive and Surgical by Henry Gray, F.R.S (1905), except pp.52, 60, 63 left, 86, 112, 115, 116, 119, 128, 131, 136, 138 Getty images / ilbusca; p.55 Stocktrek Images, Inc. / Alamy Stock Photo; p.122 Shutterstock / Peter Hermes Furia;  p.144, 146 Patrick Guenette / Alamy Stock Vector.