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Anatomy & Physiology 2e: 1.5 Medical Imaging

Anatomy & Physiology 2e
1.5 Medical Imaging
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table of contents
  1. Cover
  2. Title Page
  3. Copyright
  4. Table Of Contents
  5. Chapter 1. An Introduction to the Human Body
    1. 1.0 Introduction
    2. 1.1 How Structure Determines Function
    3. 1.2 Structural Organization of the Human Body
    4. 1.3 Homeostasis
    5. 1.4 Anatomical Terminology
    6. 1.5 Medical Imaging
  6. Chapter 2. The Chemical Level of Organization
    1. 2.0 Introduction
    2. 2.1 Elements and Atoms: The Building Blocks of Matter
    3. 2.2 Chemical Bonds
    4. 2.3 Chemical Reactions
    5. 2.4 Inorganic Compounds Essential to Human Functioning
    6. 2.5 Organic Compounds Essential to Human Functioning
  7. Chapter 3. The Cellular Level of Organization
    1. 3.0 Introduction
    2. 3.1 The Cell Membrane
    3. 3.2 The Cytoplasm and Cellular Organelles
    4. 3.3 The Nucleus and DNA Replication
    5. 3.4 Protein Synthesis
    6. 3.5 Cell Growth and Division
    7. 3.6 Cellular Differentiation
  8. Chapter 4. The Tissue Level of Organization
    1. 4.0 Introduction
    2. 4.1 Types of Tissues
    3. 4.2 Epithelial Tissue
    4. 4.3 Connective Tissue Supports and Protects
    5. 4.4 Muscle Tissue
    6. 4.5 Nervous Tissue
    7. 4.6 Tissue Injury and Aging
  9. Chapter 5. The Integumentary System
    1. 5.0 Introduction
    2. 5.1 Layers of the Skin
    3. 5.2 Accessory Structures of the Skin
    4. 5.3 Functions of the Integumentary System
    5. 5.4 Diseases, Disorders, and Injuries of the Integumentary System
  10. Chapter 6. Bone Tissue and the Skeletal System
    1. 6.0 Introduction
    2. 6.1 The Functions of the Skeletal System
    3. 6.2 Bone Classification
    4. 6.3 Bone Structure
    5. 6.4 Bone Formation and Development
    6. 6.5 Fractures: Bone Repair
    7. 6.6 Exercise, Nutrition, Hormones, and Bone Tissue
    8. 6.7 Calcium Homeostasis: Interactions of the Skeletal System and Other Organ Systems
  11. Chapter 7. Axial Skeleton
    1. 7.0 Introduction
    2. 7.1 Divisions of the Skeletal System
    3. 7.2 Bone Markings
    4. 7.3 The Skull
    5. 7.4 The Vertebral Column
    6. 7.5 The Thoracic Cage
    7. 7.6 Embryonic Development of the Axial Skeleton
  12. Chapter 8. The Appendicular Skeleton
    1. 8.0 Introduction
    2. 8.1 The Pectoral Girdle
    3. 8.2 Bones of the Upper Limb
    4. 8.3 The Pelvic Girdle and Pelvis
    5. 8.4 Bones of the Lower Limb
    6. 8.5 Development of the Appendicular Skeleton
  13. Chapter 9. Joints
    1. 9.0 Introduction
    2. 9.1 Classification of Joints
    3. 9.2 Fibrous Joints
    4. 9.3 Cartilaginous Joints
    5. 9.4 Synovial Joints
    6. 9.5 Types of Body Movements
    7. 9.6 Anatomy of Selected Synovial Joints
    8. 9.7 Development of Joints
  14. Chapter 10. Muscle Tissue
    1. 10.0 Introduction
    2. 10.1 Overview of Muscle Tissues
    3. 10.2 Skeletal Muscle
    4. 10.3 Muscle Fiber Excitation, Contraction, and Relaxation
    5. 10.4 Nervous System Control of Muscle Tension
    6. 10.5 Types of Muscle Fibers
    7. 10.6 Exercise and Muscle Performance
    8. 10.7 Smooth Muscle Tissue
    9. 10.8 Development and Regeneration of Muscle Tissue
  15. Chapter 11. The Muscular System
    1. 11.0 Introduction
    2. 11.1 Describe the roles of agonists, antagonists and synergists
    3. 11.2 Explain the organization of muscle fascicles and their role in generating force
    4. 11.3 Explain the criteria used to name skeletal muscles
    5. 11.4 Axial Muscles of the Head Neck and Back
    6. 11.5 Axial muscles of the abdominal wall and thorax
    7. 11.6 Muscles of the Pectoral Girdle and Upper Limbs
    8. 11.7 Appendicular Muscles of the Pelvic Girdle and Lower Limbs
  16. Chapter 12. The Nervous System and Nervous Tissue
    1. 12.0 Introduction
    2. 12.1 Structure and Function of the Nervous System
    3. 12.2 Nervous Tissue
    4. 12.3 The Function of Nervous Tissue
    5. 12.4 Communication Between Neurons
    6. 12.5 The Action Potential
  17. Chapter 13. The Peripheral Nervous System
    1. 13.0 Introduction
    2. 13.1 Sensory Receptors
    3. 13.2 Ganglia and Nerves
    4. 13.3 Spinal and Cranial Nerves
    5. 13.4 Relationship of the PNS to the Spinal Cord of the CNS
    6. 13.5 Ventral Horn Output and Reflexes
    7. 13.6 Testing the Spinal Nerves (Sensory and Motor Exams)
    8. 13.7 The Cranial Nerve Exam
  18. Chapter 14. The Central Nervous System
    1. 14.0 Introduction
    2. 14.1 Embryonic Development
    3. 14.2 Blood Flow the meninges and Cerebrospinal Fluid Production and Circulation
    4. 14.3 The Brain and Spinal Cord
    5. 14.4 The Spinal Cord
    6. 14.5 Sensory and Motor Pathways
  19. Chapter 15. The Special Senses
    1. 15.0 Introduction
    2. 15.1 Taste
    3. 15.2 Smell
    4. 15.3 Hearing
    5. 15.4 Equilibrium
    6. 15.5 Vision
  20. Chapter 16. The Autonomic Nervous System
    1. 16.0 Introduction
    2. 16.1 Divisions of the Autonomic Nervous System
    3. 16.2 Autonomic Reflexes and Homeostasis
    4. 16.3 Central Control
    5. 16.4 Drugs that Affect the Autonomic System
  21. Chapter 17. The Endocrine System
    1. 17.0 Introduction
    2. 17.1 An Overview of the Endocrine System
    3. 17.2 Hormones
    4. 17.3 The Pituitary Gland and Hypothalamus
    5. 17.4 The Thyroid Gland
    6. 17.5 The Parathyroid Glands
    7. 17.6 The Adrenal Glands
    8. 17.7 The Pineal Gland
    9. 17.8 Gonadal and Placental Hormones
    10. 17.9 The Pancreas
    11. 17.10 Organs with Secondary Endocrine Functions
    12. 17.11 Development and Aging of the Endocrine System
  22. Chapter 18. The Cardiovascular System: Blood
    1. 18.0 Introduction
    2. 18.1 Functions of Blood
    3. 18.2 Production of the Formed Elements
    4. 18.3 Erythrocytes
    5. 18.4 Leukocytes and Platelets
    6. 18.5 Hemostasis
    7. 18.6 Blood Typing
  23. Chapter 19. The Cardiovascular System: The Heart
    1. 19.0 Introduction
    2. 19.1 Heart Anatomy
    3. 19.2 Cardiac Muscle and Electrical Activity
    4. 19.3 Cardiac Cycle
    5. 19.4 Cardiac Physiology
    6. 19.5 Development of the Heart
  24. Chapter 20. The Cardiovascular System: Blood Vessels and Circulation
    1. 20.0 Introduction
    2. 20.1 Structure and Function of Blood Vessels
    3. 20.2 Blood Flow, Blood Pressure, and Resistance
    4. 20.3 Capillary Exchange
    5. 20.4 Homeostatic Regulation of the Vascular System
    6. 20.5 Circulatory Pathways
    7. 20.6 Development of Blood Vessels and Fetal Circulation
  25. Chapter 21. The Lymphatic and Immune System
    1. 21.0 Introduction
    2. 21.1 Anatomy of the Lymphatic and Immune Systems
    3. 21.2 Barrier Defenses and the Innate Immune Response
    4. 21.3 The Adaptive Immune Response: T lymphocytes and Their Functional Types
    5. 21.4 The Adaptive Immune Response: B-lymphocytes and Antibodies
    6. 21.5 The Immune Response against Pathogens
    7. 21.6 Diseases Associated with Depressed or Overactive Immune Responses
    8. 21.7 Transplantation and Cancer Immunology
  26. Chapter 22. The Respiratory System
    1. 22.0 Introduction
    2. 22.1 Organs and Structures of the Respiratory System
    3. 22.2 The Lungs
    4. 22.3 The Process of Breathing
    5. 22.4 Gas Exchange
    6. 22.5 Transport of Gases
    7. 22.6 Modifications in Respiratory Functions
    8. 22.7 Embryonic Development of the Respiratory System
  27. Chapter 23. The Digestive System
    1. 23.0 Introduction
    2. 23.1 Overview of the Digestive System
    3. 23.2 Digestive System Processes and Regulation
    4. 23.3 The Mouth, Pharynx, and Esophagus
    5. 23.4 The Stomach
    6. 23.5 Accessory Organs in Digestion: The Liver, Pancreas, and Gallbladder
    7. 23.6 The Small and Large Intestines
    8. 23.7 Chemical Digestion and Absorption: A Closer Look
  28. Chapter 24. Metabolism and Nutrition
    1. 24.0 Introduction
    2. 24.1 Overview of Metabolic Reactions
    3. 24.2 Carbohydrate Metabolism
    4. 24.3 Lipid Metabolism
    5. 24.4 Protein Metabolism
    6. 24.5 Metabolic States of the Body
    7. 24.6 Energy and Heat Balance
    8. 24.7 Nutrition and Diet
  29. Chapter 25. The Urinary System
    1. 25.0 Introduction
    2. 25.1 Internal and External Anatomy of the Kidney
    3. 25.2 Microscopic Anatomy of the Kidney: Anatomy of the Nephron
    4. 25.3 Physiology of Urine Formation: Overview
    5. 25.4 Physiology of Urine Formation: Glomerular Filtration
    6. 25.5 Physiology of Urine Formation: Tubular Reabsorption and Secretion
    7. 25.6 Physiology of Urine Formation: Medullary Concentration Gradient
    8. 25.7 Physiology of Urine Formation: Regulation of Fluid Volume and Composition
    9. 25.8 Urine Transport and Elimination
    10. 25.9 The Urinary System and Homeostasis
  30. Chapter 26. Fluid, Electrolyte, and Acid-Base Balance
    1. 26.0 Introduction
    2. 26.1 Body Fluids and Fluid Compartments
    3. 26.2 Water Balance
    4. 26.3 Electrolyte Balance
    5. 26.4 Acid-Base Balance
    6. 26.5 Disorders of Acid-Base Balance
  31. Chapter 27. The Sexual Systems
    1. 27.0 Introduction
    2. 27.1 Anatomy of Sexual Systems
    3. 27.2 Development of Sexual Anatomy
    4. 27.3 Physiology of the Female Sexual System
    5. 27.4 Physiology of the Male Sexual System
    6. 27.5 Physiology of Arousal and Orgasm
  32. Chapter 28. Development and Inheritance
    1. 28.0 Introduction
    2. 28.1 Fertilization
    3. 28.2 Embryonic Development
    4. 28.3 Fetal Development
    5. 28.4 Maternal Changes During Pregnancy, Labor, and Birth
    6. 28.5 Adjustments of the Infant at Birth and Postnatal Stages
    7. 28.6 Lactation
    8. 28.7 Patterns of Inheritance
  33. Creative Commons License
  34. Recommended Citations
  35. Versioning

1.5 Medical Imaging

Learning Objectives

By the end of this section, you will be able to:

  • Compare and contrast medical imaging techniques in terms of their function and use in studying the human body

For thousands of years, fear of the dead and legal sanctions limited the ability of anatomists and physicians to study the internal structures of the human body. An inability to control bleeding, infection, and pain made surgeries infrequent, and those that were performed—such as wound suturing, amputations, tooth and tumor removals, skull drilling, and cesarean births—did not greatly advance knowledge about internal anatomy. Theories about the function of the body and about disease were therefore largely based on external observations and imagination. During the fourteenth and fifteenth centuries, however, the detailed anatomical drawings of Italian artist and anatomist Leonardo da Vinci and Flemish anatomist Andreas Vesalius were published, and interest in human anatomy began to increase. Medical schools began to teach anatomy using human dissection; some resorted to grave robbing to obtain corpses. Laws were eventually passed that enabled students to dissect the corpses of criminals and those who donated their bodies for research. Still, it was not until the late nineteenth century that medical researchers discovered non-surgical methods to look inside the living body.

X-Rays

German physicist Wilhelm Röntgen (1845–1923) was experimenting with electrical current when he discovered that a mysterious and invisible “ray” would pass through his flesh but leave an outline of his bones on a screen coated with a metal compound. In 1895, Röntgen made the first durable record of the internal parts of a living human: an “X-ray” image (as it came to be called) of his wife’s hand. Scientists around the world quickly began their own experiments with X-rays, and by 1900, X-rays were widely used to detect a variety of injuries and diseases. In 1901, Röntgen was awarded the first Nobel Prize for physics for his work in this field.

The X-ray is a form of high energy electromagnetic radiation with a short wavelength capable of penetrating solids and ionizing gases. As they are used in medicine, X-rays are emitted from an X-ray machine and directed toward a specially treated metallic plate placed behind the patient’s body. The beam of radiation results in darkening of the X-ray plate. X-rays are slightly impeded by soft tissues, which show up as gray on the X-ray plate, whereas hard tissues, such as bone, largely block the rays, producing a light-toned “shadow.” Thus, X-rays are best used to visualize hard body structures such as teeth and bones (Figure 1.5.1). Like many forms of high energy radiation, however, X-rays are capable of damaging cells and initiating changes that can lead to cancer. This danger of excessive exposure to X-rays was not fully appreciated for many years after their widespread use.

This photo shows an X ray image of the palmar surface of the left hand. The bones appear bright white against a gray outline of the skin of the hand. The four segments of the finger bones are clearly visible, as well as the collection of round bones that compose the wrist and connect the hand to the two bones of the forearm.
Figure 1.5.1 – X-Ray of a Hand: High energy electromagnetic radiation allows the internal structures of the body, such as bones, to be seen in X-rays like these. (credit: Trace Meek/flickr)

Refinements and enhancements of X-ray techniques have continued throughout the twentieth and twenty-first centuries. Although often supplanted by more sophisticated imaging techniques, the X-ray remains a “workhorse” in medical imaging, especially for viewing fractures and for dentistry. The disadvantage of irradiation to the patient and the operator is now attenuated by proper shielding and by limiting exposure.

Modern Medical Imaging

X-rays can depict a two-dimensional image of a body region, and only from a single angle. In contrast, more recent medical imaging technologies produce data that is integrated and analyzed by computers to produce three-dimensional images or images that reveal aspects of the body functioning.

Computed Tomography

Tomography refers to imaging by sections. Computed tomography (CT) is a noninvasive imaging technique that uses computers to analyze several cross-sectional X-rays in order to reveal minute details about structures in the body (Figure 1.5.2a). The technique was invented in the 1970s and is based on the principle that, as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates 360 degrees around the patient, taking X-ray images. A computer combines these images into a two-dimensional view of the scanned area, or “slice.”

These photos shows four types of imaging equipment. Photo A, the results of a CT scan, shows 17 different transverse views of the skull, each taken at a different depth along the superior-inferior axis. The images are translucent, similar to an X ray, and are viewed on a light board. Photo B shows an MRI machine, which is a large drum into which lying patients enter via a conveyor belt. Photo C shows computer images of the body taken with PET scans. This produces anterior, lateral, posterior, and transverse views of the body that reveal the structure of the internal organs. Photo D shows an ultrasound readout, which is black and white. The image depicts solid tissues as light areas and empty space as dark areas. Some of the features of a young fetus can be seen in the empty space at the center of the image. The space containing the fetus is surrounded by the solid tissue of the uterus.
Figure 1.5.2 – Medical Imaging Techniques: (a) The results of a CT scan of the head are shown as successive transverse sections. (b) An MRI machine generates a magnetic field around a patient. (c) PET scans use radiopharmaceuticals to create images of active blood flow and physiologic activity of the organ or organs being targeted. (d) Ultrasound technology is used to monitor pregnancies because it is the least invasive of imaging techniques and uses no electromagnetic radiation. (credit a: Akira Ohgaki/flickr; credit b: “Digital Cate”/flickr; credit c: “Raziel”/Wikimedia Commons; credit d: “Isis”/Wikimedia Commons)

Since 1970, the development of more powerful computers and more sophisticated software has made CT scanning routine for many types of diagnostic evaluations. It is especially useful for soft tissue scanning, such as of the brain and the thoracic and abdominal viscera. Its level of detail is so precise that it can allow physicians to measure the size of a mass down to a millimeter. The main disadvantage of CT scanning is that it exposes patients to a dose of radiation many times higher than that of X-rays. In fact, children who undergo CT scans are at increased risk of developing cancer, as are adults who have multiple CT scans.

External Website

catscan

A CT or CAT scan relies on a circling scanner that revolves around the patient’s body. Watch this video to learn more about CT and CAT scans. What type of radiation does a CT scanner use?

Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is a noninvasive medical imaging technique based on a phenomenon of nuclear physics discovered in the 1930s, in which matter exposed to magnetic fields and radio waves was found to emit radio signals. In 1970, a physician and researcher named Raymond Damadian noticed that malignant (cancerous) tissue gave off different signals than normal body tissue. He applied for a patent for the first MRI scanning device, which was in use clinically by the early 1980s. The early MRI scanners were crude, but advances in digital computing and electronics led to their advancement over any other technique for precise imaging, especially to discover tumors. MRI also has the major advantage of not exposing patients to radiation.

Drawbacks of MRI scans include their much higher cost, and patient discomfort with the procedure. The MRI scanner subjects the patient to such powerful electromagnets that the scan room must be shielded. The patient must be enclosed in a metal tube-like device for the duration of the scan (see Figure 1.5.2b), sometimes as long as thirty minutes, which can be uncomfortable and impractical for ill patients. The device is also so noisy that, even with earplugs, patients can become anxious or even fearful. These problems have been overcome somewhat with the development of “open” MRI scanning, which does not require the patient to be entirely enclosed in the metal tube. Patients with iron-containing metallic implants (internal sutures, some prosthetic devices, and so on) cannot undergo MRI scanning because it can dislodge these implants.

Functional MRIs (fMRIs), which detect the concentration of blood flow in certain parts of the body, are increasingly being used to study the activity in parts of the brain during various body activities. This has helped scientists learn more about the locations of different brain functions, abnormalities, and diseases.

External Website

mri

A patient undergoing an MRI is surrounded by a tube-shaped scanner. Watch this video to learn more about MRIs. What is the function of magnets in an MRI?

Positron Emission Tomography

Positron emission tomography (PET) is a medical imaging technique involving the use of so-called radiopharmaceuticals, substances that emit radiation that is short-lived and therefore relatively safe to administer to the body. Although the first PET scanner was introduced in 1961, it took 15 more years before radiopharmaceuticals were combined with the technique and revolutionized its potential. The main advantage is that PET (see Figure 1.5.2c) can illustrate physiologic activity—including nutrient metabolism and blood flow—of the organ or organs being targeted, whereas CT and MRI scans can only show static images. PET is widely used to diagnose a multitude of conditions, such as heart disease, the spread of cancer, certain forms of infection, brain abnormalities, bone disease, and thyroid disease.

External Website

pet

PET relies on radioactive substances administered several minutes before the scan. Watch this video to learn more about PET. How is PET used in chemotherapy?

Ultrasonography

Ultrasonography is an imaging technique that uses the transmission of high-frequency sound waves into the body to generate an echo signal that is converted by a computer into a real-time image of anatomy and physiology (see Figure 1.5.2d). Ultrasonography is the least invasive of all imaging techniques, and it is therefore used more freely in sensitive situations such as pregnancy. The technology was first developed in the 1940s and 1950s. Ultrasonography is used to study heart function, blood flow in the neck or extremities, certain conditions such as gallbladder disease, and fetal growth and development. The main disadvantages of ultrasonography are that the image quality is heavily operator-dependent and that it is unable to penetrate bone and gas.

Microscopy

Microscopy is not an imaging technique, but rather a way to view a small sample of tissue removed from the human body. When there is a problem in a specific body tissue, a physician can remove a sample of the tissue from the body and prepare it as a microscope slide. The physician can then view structures not visible with the naked eye. Commonly used microscope techniques include light microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Tissue samples used in light microscopy are typically stained using colorful dyes to enhance contrast as various parts of the cells take up dye differently. Light microscopes typically magnify approximately 10x to 1000x. In contrast, SEM can magnify up to 500,000x and TEM can magnify up to 10,000,000x. Both SEM and TEM use electron waves rather than light to magnify a sample. SEM provides a 3D image of the sample surface, whereas TEM provides a high resolution image from an ultra-thin sample.

Chapter Review

Detailed anatomical drawings of the human body first became available in the fifteenth and sixteenth centuries; however, it was not until the end of the nineteenth century, and the discovery of X-rays, that anatomists and physicians discovered non-surgical methods to look inside a living body. Since then, many other techniques, including CT scans, MRI scans, PET scans, ultrasonography, and advanced microscopy techniques have been developed, providing more accurate and detailed views of the human body’s form and function.

Interactive Link Questions

1. A CT or CAT scan relies on a circling scanner that revolves around the patient’s body. Watch this video to learn more about CT and CAT scans. What type of radiation does a CT scanner use?

2. A patient undergoing an MRI is surrounded by a tube-shaped scanner. Watch this video to learn more about MRIs. What is the function of magnets in an MRI?

3. PET relies on radioactive substances administered several minutes before the scan. Watch this video to learn more about PET. How is PET used in chemotherapy?

Review Questions

An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://open.oregonstate.education/aandp/?p=45#h5p-12

An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://open.oregonstate.education/aandp/?p=45#h5p-13

An interactive H5P element has been excluded from this version of the text. You can view it online here:
https://open.oregonstate.education/aandp/?p=45#h5p-14

Critical Thinking Questions

Which medical imaging technique is most dangerous to use repeatedly, and why?

CT scanning exposes patients to much higher levels of radiation than X-rays, and should not be performed repeatedly.

Explain why ultrasound imaging is the technique of choice for studying fetal growth and development.

Ultrasonography does not expose a mother or fetus to radiation, radiopharmaceuticals, or to magnetic fields. At this time, there are no known medical risks of ultrasonography.

Solutions

Interactive Link Question 1:

  • X-rays.

Interactive Link Question 2:

  • The magnets induce tissue to emit radio signals that can show differences between different types of tissue.

Interactive Link Question 3:

  • PET scans can indicate how patients are responding to chemotherapy.

Annotate

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Chapter 2. The Chemical Level of Organization
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Anatomy and Physiology
Copyright © 2019 by Lindsay M. Biga, Sierra Dawson, Amy Harwell, Robin Hopkins, Joel Kaufmann, Mike LeMaster, Philip Matern, Katie Morrison-Graham, Devon Quick & Jon Runyeon

Anatomy & Physiology by Lindsay M. Biga, Sierra Dawson, Amy Harwell, Robin Hopkins, Joel Kaufmann, Mike LeMaster, Philip Matern, Katie Morrison-Graham, Devon Quick & Jon Runyeon is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License, except where otherwise noted.

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