INTRODUCTION TO HUMAN MORPHOPHYSIOLOGY

FOR INTEGRAL MEDICINE STUDENTS

COMMUNITY.

AUTHORS:
Dr. C. Oscar Cañizares Luna.
Dr. C. Nélida Sarasa Muñoz.
Dr. Carmen Labrada Salvat.

COLLABORATORS:
Dr. Carlos E. Hernández Borroto.
Dr. Armando Rodríguez González.
Dr. Silvio Niño Escofet.
Dr. Pedro Monteagudo Valdivia.

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TABLE OF CONTENTS.
Generalities of human morphophysiology/3
Methods of study of human morphophysiology/4
Relationships of human morphophysiology with other sciences/12
Human organism/12
Levels of organization of living matter/13
Levels of organization of the human organism/16
Chemical composition of the organism/19
Inorganic substances/20
Organic substances/21
Place of man in nature/29
Ontogeny of the human organism/31
Growth and development/32
Constitutional types/33
Norms and anomalies/35
Morphofunctional nomenclature/36
Main anatomical planes/38
Main anatomical axes/40
Literature consulted/45

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GENERALITIES OF HUMAN MORPHOLOGY AND PHYSIOLOGY.

Human morphophysiology is a curricular discipline that studies the form,

structure and function of the human organism; as well as the laws and principles that
organizes its structure, development, and relationships with the external environment. It itself

includes a set of essential contents provided by specific sciences

like anatomy, histology, embryology, biochemistry, genetics, and physiology, but
in an integrated way, based on a conception of systemic integration according to the
human organism and systematic process in the development of teaching
learning that promotes the simultaneous and interrelated approach of the
content provided by the students and the teacher who guides this process, to
the time that guarantees your constant connection with professional practice; for
this discipline constitutes a basic guiding axis in scientific training and
humanist of the comprehensive community physician.

The knowledge of human morphophysiology provides the morphological basis and

theoretical and scientific skills necessary to successfully perform
professional in situations as diverse as:
a) The scientific interpretation of the relationship between the organism and its
parts and of this as a whole with the environment favoring the
biopsychosocial conception of man.
b) The systematized understanding of the organization and functioning of
human organism at different times in its life cycle and in different
situations of the environment in health conditions.
c) The scientific basis of the actions that are carried out to promote
health and prevent diseases in the individual, the family, the community and the
community; as well as medical actions and procedures for purposes
diagnostics, therapeutic or rehabilitation.
d) Correctly evaluate the process of individual growth and development
according to sex, age, constitutional types, race, and socioeconomic conditions.
e) Explain the emergence of different developmental defects of the organism that
affect the quality of life or can become incompatible with it, and

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 even projecting actions for the promotion and prevention of risk factors in
the pregnant woman.

f) Correct interpretation of the different images provided by the methods

current diagnostics, today available to the community on a large scale and
free at the Comprehensive Diagnostic Centers and High Technology Centers;
from simple radiographs, ultrasounds, CT scans, MRI
nuclear magnetic, up to endoscopies of different organic systems.
g) Interpret the results of different functional tests conducted with
diagnostic or evolution and prognosis fines; whether it is an electrocardiogram,
a bile drainage, a semen analysis, an electromyography or the potentials
brainstem evoked, among others.
h) Describe the ways in which biological agents can invade
the organism and alter the health status of the individual, in such a way that it can
establish your relationship with the observation of hygiene measures more
appropriate or with other actions such as the vaccination of the population, etc.
i) Describe the possible pathways through which a drug can reach
to cells and tissues, achieving the desired effect to restore health.
j) Carrying out topographic diagnoses based on alterations
morphofunctional identified through the clinic.

METHODS OF STUDY OF HUMAN MORPHOLOGY AND PHYSIOLOGY.

Given the diversity of structures and functions that are of interest to the
Human Morpho-physiology and its integrative character based on basic sciences
private biomedical; for a more educational characterization of the methods
from the study of it, we consider it more effective to make a generalization that
express the systemic nature of them with the name Observation
Morphofunctional. It would then be a methodology that has its origin
associated with humanity itself; used in one way or another by all
sciences have contributed large volumes of knowledge about the form,
structure, development and functioning of the human organism through the
centuries.

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When applied to the study of cells and tissues of different types and
characteristics, alive or dead, require instruments that enhance
artificially the size of the object to be observed (magnifying glasses and microscopes of different

type) and very often a prior preparation of it is necessary that

allow manipulation, staining, and cuts in different planes; therefore, it becomes
necessary, when starting in microscopic observations, to acquire a
basic knowledge and skills about the characteristics and management of
microscope and sample preparation techniques.
Essentially, the microscope is an instrument that integrates into a unique whole the
optical, luminous and mechanical systems to allow their visualization by the eye
Human with a high degree of resolution. The utility of any microscope.
it depends on its image magnification capacity and resolution
Details. The useful magnification of a common microscope is 1500 times.
The resolution capacity of a microscope means the ability to distinguish.
with clarity two adjacent points; beyond that resolution capability the
images of two points merge into one. The resolution capacity of
A good quality ordinary microscope has a resolution of 0.2 microns; that is to say, the possibility

to see clearly two objects separated by 0.2 microns from each other.

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 Figure 1. PARTS OF A LIGHT MICROSCOPE

Component systems of the microscope.

• Lighting system. It has a light source (natural or artificial),
a mirror, a diaphragm to regulate the amount of light, and a condenser.
• Optical system. Composed of objective and eyepiece lenses.
• Mechanical system. Comprised of a base, an arm, a plate, clamps,
objective holder (revolver), pinion and rack, focusing screw
micrometric and macrometric focusing screw.

Microscopes can be classified into two main groups:

Optical or Photonic. It uses light in different forms, acting as a.
two-stage amplification system: an objective lens provides the
initial amplification and an eyepiece lens placed conveniently so that
amplify the primary image again. A proper one is necessary.
illumination of the object to be observed. There are different varieties of microscopes
within this group:

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a) Polarizing microscope. It is a regular microscope that has a prism.
of Nicol interposed underneath the condenser in such a way that it polarizes the
light that passes through it. It is based on the birefringence that is presented.

different biological structures such as muscle fibers, tissue fibers

connective, fat droplets and the cones and rods in the retina.
b) Phase contrast microscope. It is used to study structures with
very similar refractive indices such as cellular cytoplasm and its
inclusions. It is very useful for studying living cells and unstained tissues.
c) Interference microscope. It depends on an object that produces a delay.
of the light in such a way that two beams of light can affect the sample
separated. This type of microscope is useful for measuring the refractive index of
object that is desired to be studied.

d) Dark field microscope. It uses an intense light beam at an oblique angle.

that does not manage to penetrate the object, giving an impression of a dark field with

bright spots similar to the effect of dust particles that 'float' in

the path of a light ray in a dark space. It is useful for observing
small transparent objects.
e) Ultraviolet ray microscope. It uses quartz lenses and its power of
Resolution is approximately double that of a regular microscope (0.1 micra).
Many substances have the ability to emit visible rays when they are
irradiated with invisible rays like ultraviolet light. The sample subjected to
Ultraviolet light then produces fluorescence either naturally or from
of fluorescent dyes.
f) X-ray microscope. X-rays have a much shorter wavelength
that visible light and ultraviolet light have greater power of
penetration. The radiations that pass through the object are made to strike against
a photographic film or a fluorescent screen and then it is amplified the
image obtained.
In general terms, microscopes that use radiation of wavelength
Waves below visible light have greater resolving power and the image does not
observe directly, but through properly sensitized films.

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2. Electron microscope. It emerged in the 1950s. It uses
you create electrons with high speeds that penetrate the object of study;
they have a high resolution power that allows observing cellular structures and
tissues that cannot be observed under a light microscope. There are two
varieties:
a) Transmission electron microscope.
b) Scanning electron microscope.
The units of measurement used in microscopy are as follows:
Micron or micrometer. It equals one thousandth of a millimeter.
Millimicra or Nanometer. It is equivalent to one thousandth of a micrometer.

Angstrom unit. It is equivalent to one-tenth of a nanometer.

The quintessential method for preparing the material to be observed in the

Microscopic studies is the histological method that basically consists of
four fundamental steps: fixation, inclusion, slicing and staining.
1. The fixation of the material with appropriate solutions to prevent autolysis or
destruction of it.
2. The inclusion of the material previously fixed in paraffin block, such as
need for the next step.
3. The making of cuts with a special equipment called a microtome. The block
the paraffin that includes the biological material to be studied is subjected to
cuts in different planes, establishing their thickness according to the
study needs. The sections are mounted on small glass slides.
slides.
4. Staining. The biological material is subjected to the action of different substances.
Dyes to establish contrasts and facilitate observation. There are
acid dyes such as Eosin, useful for the staining of elements of
cellular cytoplasm and basic stains such as Hematoxylin, useful for
coloration of elements in the cell nucleus. This staining technique is very
used (H/E). There are other dyes such as Toluidine Blue, Blue A, Blue

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 Methylene, Brilliant Blue, Neutral Red, and the silver salts that are used
according to the characteristics of the structures to be studied under the microscope.

Other more specific techniques for sample preparation are:

a) Freezing fracture.
b) Cytochemistry.
c) Autoradiographic.
d) Immunocytochemistry.
Cellular fractionation.
f) Tissue culture.
When it comes to preparing material for observation through the
electron microscope, so the technique is different given the characteristics
of the electron beam that traverses the cells and tissues under study.
The choice of technique and the dyes to be used depends on the characteristics.
of the object of study and the objectives pursued by the observer.

When applying to study organs, organ systems, and regions of the

human body at first glance, some authors describe it as methods
systematic and topographic respectively in anatomical studies; but what
It is correct to also include the functional observation and that of an experimental type.
carried out in the laboratories both for research purposes and to achieve
teaching demonstrations. It does not require magnifying instruments, although it does require

equipment and tools to carry out the preliminary preparations of the material to
study: whether through anatomical dissection, injection of substances
colored solidifiable materials, cuts of bone parts, vivisection, the injection of
chemical substances, electrical stimulation, etc. As understood these
observations are made in some cases on experimental animals, in
others using deceased human anatomical material; and in other cases in individuals
lives as appropriate, always under rigorous ethical demands.
If it is about observations on living humans, then the most extensive methods
utility are:

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1. Physical examination. It is a fundamental method for the morphofunctional study in the
a living man and widely used in daily medical practice as one of the
components of the clinical method. It consists of obtaining information
about certain morphological and functional characteristics of the body
human through physical exploration. The main procedures for
The following are: observation, palpation, percussion, auscultation and the
Anthropometric measurements. This method is based on observations
surface anatomy and provides extensive information about the
características de la piel (color, temperatura, grosor, humedad, cicatrices,
distribution of body hair, etc.), the presence of bodily deformities,
increases in volume, absence or deformation of any part of the body,
presence of wounds, fractures, asymmetries, disproportion, atrophies, points
painful, abnormal noises produced by sick organs or absence
normal sounds in the functioning of an organ, the state of
body growth, among others. All this information is interpreted according to the
age, sex, race, profession, living conditions, etc.
2. Imaging method. It involves the study of the living human organism.
through images obtained by subjecting different parts of the body to
the action of waves and radiations produced by equipment built for
these purposes under the strictest technical scientific rigor and protection and safety
for the person. This method currently has support
highly developed technology that allows for simple X-rays and
contrasted up to helical tomography, ultrasound, and magnetic resonance imaging
nuclear. Currently available to the entire population free of charge.
3. Endoscopic method. It consists of the direct visualization in the living human of
the inner surface of different structures (such as the larynx, trachea,
bronchi, esophagus, stomach, duodenum, urinary bladder, sigmoid colon
rectum, vagina, etc.) by the introduction of appropriate instruments that
they carry a light source and in many cases lens systems to achieve a
useful visualization for diagnosis. The images obtained present
the characteristics of coloration, brightness, smoothness, roughness, etc. characteristic of the

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 structure in study whether in a healthy state or with abnormal characteristics
that suggest a specific pathological alteration.
4. Electrophysiological studies. Different organs of the human body are
they are characterized by an intense electrical activity that can be recorded
through the placement of appropriate electrodes coupled to equipment
designed for these purposes. Such is the case of electromyography through the
which one can study the proper functioning of striated muscle, the
electroencephalography to study the electrical activity of the brain, the
electrocardiography for the electrical activity of the heart, the study of
electrical potentials of the brainstem, etc.
5. Protein electrophoresis. It allows for an analysis of different proteins
contained in the blood based on their electrical properties.
6. Hemochemical studies. Quantification of different chemical substances
(glucose, creatinine, uric acid, enzymes released by damaged cells, lipids,
proteins, etc.), contained in the blood and that are an expression of
functioning of different organs and therefore the state of health or
disease of the individual.
7. Gasometry. Quantification in arterial or venous blood of gases such as
oxygen and carbon dioxide among others as an expression of the state
cellular metabolic. It is of great importance in the assessment of acid-base balance
basic of the organism.
8. Studies of body fluids. It is about the study of the characteristics
physical, cellular, biological, and chemical of different secretions and
secretions from various organs such as: bile, semen, saliva, the
vaginal secretions, gastric juice, bronchial secretions, the
cerebrospinal, pleural, peritoneal, pericardial fluids, etc.
Other studies allow for specific profiling of organs such as the
respiratory functional tests, renal functional tests, tests
liver functions, etc.
All these methods and techniques complement each other to allow us
the best knowledge of the form, structure, development, and function of different

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parts of the human body, and of it as a whole; which is extraordinary
value to assess the overall state of health. In this regard, it should be emphasized that the
meaning and usefulness of the physical examination and the clinical method in general regarding
other methods, which as a current trend are underestimated and relied upon the
technology for any study, even if it is not necessary.

RELATIONS OF HUMAN MORPHOPHYSIOLOGY WITH OTHER SCIENCES.

Human morphophysiology is related to other branches of science.
biological (anatomy, histology, embryology, biochemistry, physiology, genetics)
ontogeny, phylogeny, anthropogeny, etc.) from which it has selected its body
theoretical, with medical sciences (pathological anatomy, imaging, etc.) to the
which serves as a scientific foundation; and especially with the sciences
social sciences (sociology, psychology, demography, etc.) given the social nature of
man. In this sense, it is widely recognized that the modes and styles of
life, determined by factors economic, environmental, and sociocultural,
often cause alterations in health status that can only
change by acting in a systematic, scientific, and conscious manner through
promotion and prevention actions and raising individual responsibility and
collective regarding health.

HUMAN ORGANISM.
The human organism is the superior unit of albuminoid bodies with
metabolic capacity, growth, development, and self-direction. It is given
recognizes itself as a historically formed, integral system in continuous
variation, with particular structure and development. Lives in certain
environmental conditions to which it adapts or transforms for its benefit
and outside of which it cannot survive. The essential trait of the living organism is
its metabolic activity both internal and external without which it cannot exist. If
if the metabolism is affected, life is put in danger, and if it stops, it results in
death.

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To better understand the structure and functioning of the organism it is necessary
to refer to its origin as an organized form of living matter to which
we generically call it Protoplasm.
Protoplasm constitutes the content of cells and has been considered as
the physical basis of life. It is a dispersed system, heterogeneous in colloidal state
where macromolecules and minerals are dispersed in an aqueous medium.
Protoplasm followed two directions in its organization and development:
1. The prokaryotic cell whose genetic material is dispersed because it lacks
nuclear envelope. Example: bacteria.
2. The eukaryotic cell in which the nuclear and cytoplasmic material are
organized and separated from each other by a membrane. It is characteristic of
plant and animal organisms.
Among the functional properties of protoplasm we find:
a) Irritability. Ability to respond to stimuli.
b) Conductivity. Ability to conduct the wave of excitation (impulse
electric) from the point of action of the stimulus to distant places.
c) Respiration. Release of chemical energy contained in complex molecules.
through metabolic processes.
d) Absorption. Ability to capture liquids and dissolved substances through the
membrane.
e) Secretion. Ability to produce and release certain useful materials to the outside.
f) Excretion. Ability to discharge waste materials to the outside.
g) Growth. Increase in cell volume due to an increase in quantity
total cytoplasm.
h) Reproduction. The ability to perpetuate oneself through cell division.

LEVELS OF ORGANIZATION OF LIVING MATTER.

In the historical process of organizing living matter (evolution of
Protoplasm) it is possible to propose a sequence of stages through which one transits.
from the simplest forms to the most complex ones:

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 FORMS IN NON-CELLULAR OR ABIOTIC LEVEL
(Protein moieties, viruses, etc.).
CELLULAR FORMS OR BIOTIC LEVEL
(Prokaryotic and eukaryotic cells).
TISSUES AND ORGANS
(Grouping and functional specialization of cells).
SYSTEMS AND DEVICES
(Set of organs grouped for common functions)
ORGANISM
Systems and devices integrated into a single whole
POPULATIONS
(Set of organisms)
COMMUNITY
(Coexistence in time and space of populations of different species)
ECOSYSTEM
Interaction between the population and the environment

BIOSPHERE
(Set of all the Communities that live on the planet)
UNIVERSE

Considering the organization that living matter has acquired, among

the levels of organism and population can locate the level of Family as
fundamental cell of society, as it is the microcosm where man
develops its fundamental activities of growth, development, learning and
formation of moral values; whose stability is essential for development
human and the preservation of health.

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Figure 2. LEVELS OF ORGANIZATION OF LIVING MATTER.

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LEVELS OF ORGANIZATION OF THE HUMAN BODY.
The human organism reflecting this evolutionary process is organized
by levels of increasing complexity:
Cell. The cell constitutes the basic structural and functional unit of
organism.
Tissue. Tissues as historically formed systems with properties
specific morphophysiological characteristics from cellular groupings; where they
they distinguish four basic types of tissues: epithelial, connective, muscular and
nervous.
Organic. Organs are the result of a long process of selection.
useful adaptations to the organism (according to feeding conditions,
reproduction and defense) through reinforcement and elimination. The organ is
the natural instrument of the body; it is a formation of relative integrity, with a
shape, structure, function, development, and position in the organism that are
inherent and specific to each one. The organs are made up of various
tissues of which the predominant ones determine their function and structure
specific. The organ is a fraction of the whole and cannot exist isolated from
organism; its vital activity is regulated by the nervous and endocrine systems. Since
From the ontogenetic point of view, the organs can be permanent or definitive and
temporary or provisional.
Devices and organ systems. There are numerous and very diverse functions
for which the organs separately are insufficient, so that it is
it is necessary for them to be grouped into complexes called systems or
devices according to their characteristics:
Organ system: it is a morphological and functional grouping of organs
under a plan of common structure and origin; where it is also established
mutual anatomotopographic relationships. E.g. muscular system, skeletal system,
vascular system, digestive system, respiratory system, nervous system and
urinary system.

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Devices. Set of isolated organs or organ systems with structure
and unequal developments, but with a common function. e.g. endocrine system,
locomotor apparatus or osteomuscular system.
Currently, this distinction has lost interest and is used interchangeably.
Organ systems can be grouped according to their functions in the following way
next:
a) For assimilation and disassimilation (digestive, respiratory and
urinary
b) For the conservation of the species (genital system).
c) For the circulation of liquids and the transportation of substances (system
cardiovascular and lymphatic.
d) For the chemical bond and the regulation of different biological processes
(endocrine system).
e) For the adaptation of the organism with the help of movement (apparatus
locomotor).
f) For the reception of stimuli from the outside world (the organs of the
senses).
g) For the linkage and association of all the organs with each other and the organism
as a unique whole with the environment (nervous system).
In the process of development of the animal world, the nervous system became
in the direction system ensuring the integrity of the organism and its unity
with living conditions. Through it, metabolism is carried out.
with the natural environment.
The organs associated with functions a, b, c, and d are called organs of the
vegetative life and those related to the functions e, f, and g are
They are called organs of animal life or of relation. This division of the
organs associated with vegetative and relational life have their
ontogenetic foundation in the formation of the digestive and neural tubes
in the early stages of embryonic life, but it will only be useful to us from the
didactic point of view, as there is an indissoluble relationship between the two
parts given the integrity of the organism as a unique whole.

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 Organism. It is the highest level of organization of living matter, it is the
integration of the preceding levels into a unique whole, as in a synthesis
of those. In the organism, its INTEGRITY is fundamental and is given through
de:
1. The structural association of all its parts (cells, tissues, organs,
systems and devices) through liquids that circulate through the vessels or that are
they are found in different spaces and cavities (humoral link), or through
different forms of connective tissue and through the nervous system (link
nervous).
2. The unity between vegetative and animal processes.
3. The unity between the psychic and the somatic.
A whole is a complex system of reciprocal relationships between elements and
processes with a special quality that distinguishes it from other systems.
A part is an element of the system subjected to the whole. The organism is a whole,
It is something more than a simple sum of its parts, given their reciprocal relationships.

established through the processes of phylogenesis and ontogenesis. The quality

special of the organism as a whole is its ability to exist in a way
independent in a given medium; this distinguishes it from any other structure.
This quality lies in its organic nature. E.g. A unicellular organism like the
ameba lives independently; on the contrary, a cell that is part of
of an organism (such as the leukocyte) cannot exist outside of it and dies upon
to be extracted from the blood.

The organism as a whole plays a guiding role in relation to its parts,

being an expression of it the subordination of the activity of all the organs
to neurohumoral regulation; that is why isolated organs cannot perform
those functions that are inherent to it within the framework of the organism in its

totality. The organism, for its part, can continue to exist as a whole,
even after having lost some of its parts (surgical practice where
organs are removed or parts of the body are amputated). The subordination of the part
the whole is not absolute, the parts have a relative autonomy, since
certain cells can live and reproduce outside the organism (culture of

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tissues, in vitro embryos and others); although the functions of these isolated cells
they are not identical to the functions of the cells in the whole organism because
to find themselves excluded from the common metabolism with other tissues. By possessing a

relative independence the part can influence the whole as when it

produce the disease of an organ in isolation (liver, heart, stomach,
etc.) to some extent affecting the health status of the organism in its
set. This aspect must be taken into account in the performance of the
health professionals, for when attending to the individual; one should not address the
attention only to the sick organs or to the diseases, but
integrally to man as a whole taking into account also the
the somatic-psychic and psychosomatic interrelation existing in the organism
human, as well as their social character.

CHEMICAL COMPOSITION OF THE ORGANISM.

The chemical structure of the human organism is based on the
carbon atoms. The chemical structures that are formed by the union of
Carbon atoms through chemical bonds are called molecules.
organic compounds, of which hydrocarbons are the most representative type.
In living organisms, the hydrogen atoms of hydrocarbons are
replaced by different types of functional groups (hydroxyl, carboxyl, methyl,
ester, etc.) and form very reactive organic molecules, the biomolecules.
In living matter, there are also chemical elements that are essential to the
what is called bioelements, represented in different proportions to each other
others. Among the most abundant bioelements, hydrogen (H) stands out.
oxygen (O), nitrogen (N), and carbon (C). All with great capacity to
forming chemical (covalent) bonds in which one, two, or three are shared
pairs of electrons; allowing molecules such as H to form2O, NH3, CO2e
H2which are precursors of simple biomolecules that constitute the foundation
of the macromolecules common to all living organisms: amino acids,
nucleotides, monosaccharides, fatty acids, phosphoric acid, choline, glycerol, etc.
from simple biomolecules an unlimited number of

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macromolecules or large biomolecules: proteins, nucleic acids,
polysaccharides and lipids.
Bioelements in general can be classified into fundamental (O, C,
H, P and S), important (Ca, K, Na, Cl, Mg and Fe) and trace (Zn, Co, Mn, F and I). The
traces or trace elements although their participation in the constitution of the organism
They are very small, essential for life, fundamentally due to their
important function in the action of enzymes.
The chemical substances that are involved in metabolic reactions are
produced by them can be divided into two large groups: substances
inorganic (which very exceptionally contain carbon) and substances
organic compounds that contain carbon and hydrogen atoms.
Inorganic substances generally react or dissolve in water and
they release ions, called electrolytes, while organic compounds;
some dissolve in water, but others require organic solvents such as
ether or alcohol.
Inorganic substances.
The most abundant chemical substance in the organism is water (H2O), the one that

represents two-thirds of an adult's weight. She is the largest.

component of blood and other body fluids including those that are
they are found inside the cell. Thanks to their polarity and high constant
Dielectric water weakens the electrostatic forces that exist between the ions and
among polar molecules, with which new bonds are established between the
water and these water-soluble molecules; it also has the ability to dissolve the
majority of substances (universal solvent) and allows acids, bases
and salts separate into electrically charged particles that can, from this
way, participate in many more chemical reactions of the organism than when
They are in their original form. Water can absorb more heat per unit of weight.
with less change in body temperature than any other substance, because
among its properties is the requirement for more heat per unit of weight to
increase its temperature by one degree (specific heat), therefore it plays a
main role in essential biological processes. As a main component of

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body fluids carry different substances to the tissues and
enables the processes of exchange, excretion, absorption, and secretion. Water
it can also absorb and transport heat, thanks to its high conductivity
thermal, from the deep areas of the body to the surface where it is
dissipated, which makes it a basic element for thermoregulation. This
property is of relevant significance in practice in the management of the states
febrile, mainly in the pediatric age group.
Another inorganic substance in the body is oxygen (O2), the one that
it incorporates into it through pulmonary ventilation and is transported to the
tissues by the blood through specialized cells called erythrocytes. Once
In the tissues, oxygen is used by the cell in oxidation processes for the
obtaining chemical and thermal energy from glucose and other molecules. The
The released energy is used to ensure the metabolic functions of the cell.
On the other hand, carbon dioxide (CO2It is a compound that is obtained as
waste substance when energy is released from certain metabolic processes and
it is released into the air within the lungs and from here to the outside.

Inorganic salts are not present in the body in molecular form.

but in the form of positive ions (cations) and negative ions (anions) constituting the
source of many necessary ions including sodium ions (Na+Chlorine
(Cl-Potassium (K+) Calcio (Ca+2Magnesium (Mg)+2Phosphate (PO4-2Carbonate
(CO3-2), Bicarbonate (HCO3-and Sulfate (SO4-2An example is chloride.
of sodium (NaCl) that is present in body fluids in the form of cations of
sodium and chloride anions. Inorganic salts serve important functions in
the organism such as the maintenance of osmotic pressure, the transport of
oxygen and carbon dioxide, the maintenance of alkalinity reactions
from the blood, the formation of bones, from the blood and from tissue fluids, thus
such as irritability and muscle contractility and blood coagulation.
Organic substances.
In the organism, important organic substances are found that constitute
from 10 to 30% of the cellular protoplasm and include proteins, carbohydrates,
lipids and nucleic acids.

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Carbohydrates. They are also known as sugars, glycosides or hydrates of
carbon. They are chains of carbon atoms with various hydroxyl groups and with
an aldehyde group (aldoses) or with a ketone group (ketoses) so they are
also known as polyalcohols and constitute the majority of the material
organic matter of the earth. They are the substances that provide most of the energy
what the organism requires, they provide materials for the construction of certain
cellular structures and are often reservoirs of energy supply. Their
molecules contain atoms of carbon, hydrogen, and oxygen, presenting
frequently two or more hydrogen atoms per oxygen atom (just like
the water), which is easily demonstrable in the formula of carbohydrates such as the
glucose C6H12O6.
The carbohydrates unable to hydrolyze into simpler compounds are
they are called monosaccharides or simple sugars and participate in the formation of

more complex molecules. Simple sugars include glucose, fructose and

galactose which are the most common monosaccharides; due to the importance of their
biological functions are highlighted by glyceraldehyde (trioses), ribose and
deoxyribose (pentoses) and glucose, galactose, and mannose (hexoses). In the
complex carbohydrates are formed when simple sugar molecules come together
molecules of varied size; some like sucrose, maltose, and lactose
simple sugars or disaccharides. Others consist of several units of
simple sugars and are called polysaccharides, such is the case of starch as
reserve of glucose units in plant cells, forming cellulose
part of the walls of these cells, of glycogen as a reserve of glucose in
the animal cell and glycosaminoglycans, very abundant in the tissue
conjunctive where they form, together with proteins, the so-called proteoglycans.
Among the main functions of carbohydrates are the following:
They are sources and reserves of energy.
b) They are structural components of the molecules of inheritance (ribose and
deoxyribose.
c) They are involved in the recognition between molecules and between cells
(glycoproteins and glycolipids).

22
 d) They are structural and protective elements (connective tissue, lubricants,
bone joints, covered with insects, cell walls of plants
and fungi) such as cellulose, chitin, glycosaminoglycans, etc.
Lipids. They represent a group of organic substances insoluble in water.
but soluble in certain organic solvents such as ether and chloroform. They include a
variety of compounds such as fats, phospholipids, and steroids that have
vital functions in the cell. The most common member of this group is the
fats. These are used to form parts of the cell and to provide energy.
cellular activities. In reality, they can provide more energy per gram
I believe that carbohydrate molecules, but like those the molecules of
fats are composed of atoms of carbon, hydrogen, and oxygen, although in
smaller amount of these last ones than in carbohydrates, constitute a form
more concentrated fuel. The molecules of fatty acids differ in the
length of their carbon atom chains, as well as in the way in which
these combine: in some cases the carbon atom is completely
joined by simple carbon-carbon links, this type of fatty acid is
saturated and it is one in which each carbon atom is surrounded by as many
hydrogen atoms as it is possible; that is, it is saturated with atoms of
hydrogen. Others that have a double bond between carbon atoms are
called unsaturated and those that have several double bonds between
Carbon atoms are called polysaturated.
The structural units of fats are the molecules of fatty acids and
glycerol, these small molecules bond in such a way that each molecule of
glycerol combines with three molecules of fatty acids, resulting in a
triglyceride molecule. Although the glycerol portion is always the same, there are
different types of fatty acids and consequently there are several types of
triglycerides. The melting point of fatty acids increases with length
from the chain and when the number of double bonds decreases. At the temperature
at 25 degrees Celsius, unsaturated fatty acids are liquids and the
Saturated are solids. The fat molecules that contain only fatty acids.

23
Saturated fats are called saturated fats and those that include fatty acids.
unsaturated fats are called unsaturated fats.
Phospholipids are very similar in their structure to fats since they also
they consist of a glycerol molecule, but they have only two chains of
fatty acids and in the third position, they have a phosphate group recognized in
the same one a head constituted by the phosphated portion that is soluble in
water and a tail formed by fatty acids and is insoluble in water.
Steroids are complex structured molecules that include rings of
interconnected carbon atoms. Participating in the formation of the most
Important steroid molecules include cholesterol, which is used in
the synthesis of sex hormones such as estrogens, progesterone, testosterone, and
other hormones from the adrenal glands.
Among the main functions of lipids are highlighted:
a) Structural function as part of biological membranes such as the
phospholipids, cholesterol, and sphingoglycolipids.
b) Energy function when transporting and storing energy like the
triglycerides.
c) Protective function in bacteria and plants such as lipopolysaccharides and the
wax.
d) Regulatory function of processes such as hormones
steroids (estrogens, progesterone, testosterone), prostaglandins,
lip soluble vitamins and intracellular mediators (inositol trisphosphate and
diacylglycerol.
When a diet rich in saturated fats is consumed, there is a risk of
to develop significant alterations in the walls of the arteries
(arteriosclerosis), a state in which their lumen is decreasing,
which causes multiple damage to different organs and tissues; that's why
it is recommended that unsaturated fats predominate in the daily diet.
they are present in vegetable oils, and avoid fat as much as possible
of animal origin.

24
Proteins. They constitute the most complex and abundant organic substance.
in the organism; in most cells it makes up between 10 and 20% of the
cell mass. Carbon is always present in its chemical structure,
hydrogen, oxygen, and nitrogen; but sometimes they contain sulfur, phosphorus or
iron. The presence of nitrogen distinguishes them from other substances
organic. They are made up of simpler units called amino acids that
they are characterized by the presence of an amino group that replaces an atom
of hydrogen in the molecule of an organic acid. Although there have been
about 300 amino acids have been identified in nature and have been synthesized a
A large number of them, only around 20 are involved in the formation of
proteins even though none of them contains all of them. Among the
The foods richest in amino acids include casein from milk, which is
formed by 17 or more of them. This justifies the importance of ensuring the
daily consumption of milk in children as a reliable source of protein,
vitamin and calcium necessary for their intense process of growth and development. The
the composition of amino acids in proteins differs from one animal to another and even
from one tissue to another of the same animal, which is why it is important to consume a diet

varied in its protein composition. Among vegetables, they are especially rich
in proteins, beans (black beans), lentils, peas, and peanuts. Since the
from a functional point of view, proteins act:
a) As structural material; like those that form the extracellular component
of bones and cartilage.
b) As constituents of the skin, cell membranes, etc.
c) As transport and storage of molecules: Example: transport of oxygen
by hemoglobin and myoglobin, iron by transferrin, the
ferritin, etc., of lipids by apolipoproteins, albumin, and others.
d) As controllers of genetic function forming part of the
chromosomes.
e) As nerve growth and epidermal growth factors.
f) As regulators of metabolism: thyroid-stimulating hormone and prolactin.
g) In the regulation of hydroelectrolytic balance: antidiuretic hormone.

25
 h) As receptors of cell surfaces where they specialize in
recognize and capture particular types of molecules.
i) As antibodies that act against foreign agents or substances that
they enter the body.
j) Others act as enzymes or regulate the coordinated movement of
cells and cellular components such as actin and myosin in muscle
or the tubulin in the chromosomes.
Each type of protein molecule contains a specific number and type of
amino acids organized in a particular linear sequence. The chain of
amino acids generate a unique three-dimensional structure. Consequently
different types of protein molecules have different shapes, which is
related to its specific function. That shape of the protein molecule
fundamentally maintained through weak interactions by means of the
which parts of the molecule bind to other parts of itself.
Nucleic acids: They constitute the fundamental element of most of the
cells. They are generally large and complex molecules that contain atoms
of carbon, hydrogen, oxygen, nitrogen, and phosphorus that are organized in a
structure called nucleotide. Each nucleotide contains a five sugar
carbon atoms (ribose or deoxyribose), a phosphate group, and one or more bases
organic. There are two main types of nucleic acids; the one that contains as
ribose sugar called ribonucleic acid (RNA) and the one that contains sugar
deoxyribose, known as deoxyribonucleic acid (DNA), molecules that
carry all the genetic information of living beings. These molecules and their
derivatives have very important functions in the metabolism of living beings;
such is the case of adenosine triphosphate or ATP, (universal energy unit
chemistry that is involved in most metabolic reactions of
living beings), uracil triphosphate (UTP), guanosine triphosphate (GTP), and cytosine
triphosphate or CTP (which are involved in the biosynthesis of glycogen and phospholipids,
among others); cyclic AMP and cyclic GMP (which act as intermediaries in the
transmission of information from membrane receptors to enzymes

26
intracellular) and uric acid (plasma antioxidant that results from the
degradation of purine bases.
The internal environment of the organism is made up of blood, lymph, and fluid.
tissue. Unlike the external environment whose conditions can vary
considerably, the internal environment is distinguished by the relative constancy of the
composition and physical-chemical properties, a state referred to as
Homeostasis is characterized by a relatively constant concentration.
of proteins, glucose, sodium ions, potassium, calcium, and many other substances.
At the same time, the organism without an external medium that sustains its existence.
it would not be possible, for always and everywhere life is made up of two types
of factors: those linked to a specific biological organization and others
associated with external influences that induce multiple variations. The
The organism is inextricably linked to living conditions.
environmental; the boundary between the organism and the means of subsistence is relative,
because a constant variation and transformation of the exterior occurs in it
interior and vice versa. The assimilation of food constitutes an example of
transformation of the exterior into the interior. The unity of the organism with the
the conditions of their existence are realized through metabolism with nature
environment, if that metabolism stops, life also stops. The unit
the organism's interaction with the external environment constitutes the evolutionary basis of forms

organic. In the evolutionary process, the variability of structure is observed in the

organisms as a morphological expression of their adaptation to changes in the
conditions of existence. Adaptation is conditioned both by influence
from the environment as well as from the hereditary and other properties of the organism in

evolution. Variations in the environment lead to alterations of

an organism that constantly adapts to changes in conditions
medium, and inversely, the influence of the developing organism varies
also, to a certain extent, the environment that surrounds it.

The living conditions of animals constitute their biological environment;

For man, in addition to the biological environment, the social environment is of great importance.

and in it, as a fundamental condition of existence, work. The labor activity

27
it is the most important factor of the human environment, the achievement of
A harmony within it is essential to maintain a state of health.
Work processes are especially related to the muscular and systems.
nervous according to the character of the profession. Professional specialization leads
a greater development of those parts of the organism with whose functions it is
linked to that specialty. In such a way, the profession leaves an impression
determined by the structure of the human body. "The organism creates its own
shape in the work.
In addition to work, other conditions influence the human body.
existence such as food, housing, clothing, etc. It is also
The psychological state of the individual is influenced by their social position.
The working and living conditions are referred to as the social environment, which
exerts great and varied influences, both negative and positive, on
the man. In this sense, the structure of society plays a decisive role in
the development of the organism. The lifespan of individuals belonging
to the exploited classes and entire towns subjected to conditions of
exploitation is lower than that of the representatives of the dominant classes. To live
under conditions of moral oppression, poverty, and exhausting work affects
negatively the well-being and full development of man. The classes
the exploited are poorly nourished and become ill more often, a situation that does not

it only affects them directly but also influences their descendants. In India
during English colonialism, the average lifespan did not exceed 30 years and
after its independence began to rise progressively; in Cuba in
In the 1950s, life expectancy at birth was less than 50 years.
and is currently over 77 years old; in Venezuela in the last four
In recent years, an increase in life expectancy at birth has been observed from 73.3 to
76.2 years; with a contrast between 73.5 in the Capital District and 64.9 in Delta
Amacuro, what constitutes a reflection of the social inequalities still existing.
and its influence on the human body. This increase in hope for
life is accompanied by an increase in its quality, which is
achieves, among other things, by changing the lifestyles of the population, such as

28
eliminate toxic habits, establish the practice of physical exercise, healthy recreation
and the consumption of balanced food in quantity and quality, etc. Taking into account
Taking into account the aforementioned aspects, it becomes evident that the conditions

social factors strongly influence the development of the human organism and its
health status.
The maintenance of homeostasis of the internal environment of the organism and its relationship with

the external environment is decisive in the state of health. This belief underpins
the need to implement health promotion and prevention actions
of diseases in the individual, the family, and the community.

PLACE OF MAN IN NATURE.

The origin of man and the place he occupies in living nature since the
antiquity has been the object of struggle between materialism and idealism. For
to understand man's place among animals is essential to have
present the outline of your family tree based on the classification of the
animal world from the simplest forms to the highest ones. A
The synopsis of the family tree provides a general orientation of the place of
man in nature.

Type Curved

Subtype Vertebrate

Class Mammal

Order (subclass) Primate (placental)

Family (suborder) Pitecoides or Anthropoids (platyrrhines and catarrhines)

Gender Monkey Man.

29
 Heidelberg Man
Species Neanderthal primitive man
Reasonable man

Fossil Man
Subspecies (variety)
Contemporary Man

The credit for having presented a

theory that aimed to solve the problem of anthropogenesis by demonstrating the
unit of origin of man and animals, the origin of the human being from such
or which species of extinct anthropomorphic monkeys. This demonstration was
unilateral based solely on biological data and not taking into account the
determinant factors in the transformation of the monkey into man (this theory is
object of profound studies and questioning today.
The typical traits that differentiate humans from anthropoid monkeys are
following:
1. Upright march.
2. The use of the hand as a working organ.
3. Articulated language.
Greater elevated development of the brain and the skull.
5. Localization of the viscera as a consequence of the upright position.
6. Skin with a marked absence of hair.
Laws or principles that govern the structure of the human body.
In the structure of the human body, laws or principles manifest themselves.
fundamentals such as the following:
a) Polarity. Existence of two extremes or poles, cephalic and caudal, which...
expresses both in the entirety of the body and in many of its components.
b) Bilateral symmetry. Presence of similar organs and structures on both sides.
sides of the body and of two similar halves in the case of the located structures
in the middle line.

30
c) Segmentation or metameric formation of most of the body.
Persistence as a vestige of somatic segmentation from the embryonic period of
structures in the form of overlapping segments in certain regions of the
body.
d) Correlation of different types between the parts of the body:
• Physiological due to functional conditioning.
• Topographical by proximity between the organs.
• Genetics by distribution of genes on chromosomes.

ONTOGENY OF THE HUMAN ORGANISM.

Ontogenesis. Individual development of the human organism from fertilization
until death; depending on the environment in which it develops
divided into two main periods:
I – Intrauterine or Prenatal. Extended from fertilization to birth.
Divided into three smaller periods: pre-embryonic, embryonic, and fetal.
II - Extrauterine or Postnatal. Extended from birth to death. The
the organism continues its development outside the maternal womb, but at a pace
different.
Birth can be considered a qualitative leap in development.
individual in which one passes from a medium with permanent conditions characteristic of
mother's womb, to another of constantly changing conditions of the outside world;
the quality of metabolism and the organs responsible for carrying it out also vary,
for example, during the intrauterine period, nutrition and respiration have
place through the maternal blood and the placenta (blood circulation
placentaria). In the postnatal period, these processes are carried out with the help of the
organs of digestion and respiration of the newborn. The placental circulation
is replaced by the pulmonary circulation.
In postnatal life, different age periods are distinguished:
a) Newborn or neonate. It extends during the first 4 weeks of life
extrauterine, period in which the organism has to adapt to the new
living conditions. The body of the newborn differs greatly from the body of

31
 adult in its shape and dimensions. The head is very voluminous and represents
a quarter of the body length, which averages 50
centimeters and weighing 3250 – 3500 grams. The abdomen has larger
dimensions in which the thorax and legs are short. The length of the
upper and lower extremities are similar.
b) Infant. From the first month of life until the year.
c) Early childhood from one year to 2 ½ years.
d) Preschool. From 2 ½ years to 6 years.
e) School or early childhood. From 6 years old to puberty.
f) Adolescence. From puberty to approximately 16 years old.
g) Youth. From 16 to 20 years old.
h) Adulthood. From 20 to 45 years old.
Middle Age. From 45 to 60 years old.
j) Advanced age. From 60 to 75 years.
k) Senile age. Over 75 years.
In each of these periods, the organism presents characteristics.
morphofunctional characteristics that distinguish it as an expression of the process of

individual growth and development.

It is important to keep in mind that both in the prenatal period and in the
postnatal, in its different minor stages, there are levels of susceptibility and
vulnerability either due to internal reasons of the organism or due to factors
environmental factors that can affect the health status of the organism and which there are

that due attention should be paid both to take preventive actions as

therapeutic and rehabilitation.

GROWTH AND DEVELOPMENT.

Growth. It is a process characterized by the increase in dimensions.
spatial and weight, reflects an accumulation of quantitative changes; it does not have
uniform speed and is much faster during the prenatal period,
especially during the fetal stage, than during postnatal life. There are different
forms of growth according to which it is due to an increase in the number of cells,

32
in the size of the cells or in the amount of extracellular substance. This
The process is subject to a multitude of internal (genetic) and external factors.
(socioeconomic and cultural conditions) and is an indicator of health status
which should receive the greatest attention from the earliest stages of
prenatal period.
Development. It is a process of qualitative changes in the organism such as
consequence of the quantitative accumulations inherent to the process of
growth, in it structural characteristics and capabilities are expressed
functional characteristics of the species corresponding to each stage of the cycle
vital.
The processes of growth and development occur throughout life with
variable speeds and rhythms are genetically governed, they are susceptible to being
affected by different environmental factors and constitute components
essentials of health processes. Its scientific foundation is found
in five basic mechanisms that will be the subject of deeper study in the
next topics.
These processes mutually condition each other and should not be evaluated by
not separated in a static manner, these are dynamic processes that characterize
at each stage of life and in which the levels reached at each one
condition the following, so that the delay in any of them can
negative repercussions in the next or globally. It is essential
highlight that these processes, due to their nature, go beyond the biological framework to

include the psychosocial and humanistic dimension. The processes of growth and
development should be evaluated both by stages and globally; with
special emphasis on the embryonic, fetal, and infancy periods considered the
greater vulnerability; as a way to ensure greater biopsychosocial fullness
in the new generations. Among the factors that must be considered with
priority in this sense is teenage pregnancy as a
serious social problem in the country, the nutritional status of the pregnant woman,
drug consumption, as well as exposure to other chemical substances and
radiations during this period, the social exploitation of women, the

33
resurgence of infectious diseases in childhood, domestic violence
and social, access to education and health services and living conditions
in general sense.
CONSTITUTIONAL TYPES.
Constitution. It is the individual concrete expression of the general definition of the
organism. It is nothing more than that complex of particular physiological particularities and

morphological characteristics related to a given individual and due to natural conditions

certain social factors that are manifested by the reactions of the organism to
different influences (including pathological ones). It is accepted as a basic core of
this complex the hereditary properties received from the generations
previous. Each individual represents in itself a unit of internal factors
(hereditary) and external (environmental) factors that manifest in the formation
of its body, that is, in its constitution.
Constitutional types:
1. Hypersthenic. They exhibit a predominant growth in width, they are
massive and obese. The trunk is relatively elongated and the limbs are short,
with a bulky head, thorax, and abdomen; all linked to the intense
development of the corresponding cavities. There is a relative predominance of
the dimensions of the abdomen in relation to those of the chest and the dimensions.

transverse with respect to the longitudinal. It corresponds to the types

dolicocephalic and brachycephalic from other classifications.

2. Asthenics. They exhibit a preference for growth in length, slenderness and

lightness in the structure of the body, with a generally weak development and the
the dimensions of the limbs exceed those of the trunk, what is then
relatively short. The dimensions of the thorax exceed those of the abdomen and
the longitudinal ones to the cross-sectional ones. It corresponds to the types
brachymorphic and longilineal from other classifications.
3. Normosthenics or Normotypes. They occupy an intermediate position between the types.
previous. It corresponds to the mesomorphic and normolinear types of others
rankings.

34
The truly important thing about this classification based on characteristics
external, it corresponds to an internal characterization in terms of
dimensions, shape, and arrangement of organs and vessels are dealt with. Thus, in the
hypersthenic individuals have a relatively large heart and it is positioned
transversely over a very elevated diaphragm, the aorta is very wide and the
short lungs, the stomach is very voluminous, relatively short, of
elevated and transverse location. The intestinal loops are arranged
preferably in a horizontal direction. The liver, the pancreas, the kidneys and the
Bazo are very bulky.
In asthenic individuals, an inverse picture is observed: the majority of the
organs are located lower down, as if descended, with small
dimensions. The lungs are relatively long in correspondence with the
length of the thoracic box.
In the case of normosthenics, these traits have characteristics
intermediaries as appropriate.

NORM AND ANOMALIES.

Between the organism and the specific conditions of the outside world there exists a
determined balance that is achieved thanks to certain particularities
morphological and functional. This equilibrium is called NORMA and the set
of the corresponding morphofunctional particularities in the body are
it is called normal. The norm is not something immobile, unchangeable, on the contrary, it is

polymorphic and therefore presents a multitude of varieties that constitute variants of

the norm (individual variability). The norm is the harmonious set of variants
morphofunctional aspects of the organism that ensure the full development of functions
biological and social aspects of the individual.

There are differential traits in the organism associated with sex and age.
Regarding sex, the traits are divided into primary and secondary. In the
Primary organs include the reproductive organs and first and foremost the
gonads, the rest of the traits are considered secondary.

35
In general, women have a shorter stature, less weight, the torso is
shorter and longer legs, narrower shoulders and the pelvis more
wide. The chest is shorter and the abdomen is longer than in the male.
man has a greater total muscle mass (40%) than woman (32%); the
what explains the lesser physical strength of those. Adipose tissue in women is
more abundant than in men and have developed mammary glands.
The skin of man is thicker and hairier.

MORPHOFUNCTIONAL NOMENCLATURE.
Parts and cavities of the human body:

Sienes
Vertex
Head Front
Occiput
Cara
Neck
Thorax
Body Trunk Abdomen
Back

Upper and Lower Limbs.

Cranial cavity and vertebral canal (brain and spinal cord)

36
 spinal
Body cavities: Thoracic cavity (heart, lungs, thymus, and vessels)
Abdominal cavity (liver, intestines, pancreas, etc.)

Cranial cavity.

Thoracic cavity.
Vertebral canal.

Abdominal cavity.

Pelvic cavity.

Figure 3. BODY CAVITIES.

In morphofunctional studies, it is necessary as a working tool,

define a set of terms that allow for precise descriptions about
any structure or region of the body related to its functioning, and that to the
thus favor communication between professionals in both the morpho sciences
physiological as well as other related branches, regardless of the native language,
geographical location or national culture. This terminology is defined based on a
set of planes, axes, and lines that are conventionally drawn on the body to
starting from considering the latter in a fixed position called 'position
anatomical." Then our first step is to clearly define this concept: the
Anatomical position is the one that considers the human body in position

37
vertical, facing the observer, standing upright, with feet together, looking at
horizon, the upper limbs at the sides of the body with the palms
facing forward. It is an abstraction of the human body in the
space under certain conditions of agreement to carry out the
morphological descriptions. In any real position in which it is located the
human body (child, young person, or elderly) or any of its parts, for the purposes of
the morphological descriptions and their functional interpretation the observer will assume
that this one or that one is positioned in front of him in anatomical position. Any other

interpretation leads to descriptive and localization errors. When it comes to

descriptions in embryos or fetuses the given definition of 'anatomical position' is
inconsistent because of the state of development and the morphology of the new organism
they do not correspond to those terms. In this case, they must be taken into account
the relevant observations.

MAIN ANATOMICAL PLANES.

They are imaginary plans that are drawn on the body, which serve as a guide for
the realization of studies of different types and for the exact localization of different
structures in the organism.
a) Sagittal Plane. Arranged vertically, it is drawn on the body or on one of its
parts in an anteroposterior manner that divides it into two parts
left and right. If the plane is drawn through the middle, then the two
parts are equal (they are halves) and are called in this case flat
midsagittal.
b) Frontal Plane. Positioned vertically, but perpendicular to the sagittal plane
divide the body (organ or region) into an anterior part and a posterior part.
c) Horizontal Plane. Arranged horizontally and thus perpendicular to the
two previously indicated planes. It divides the body (organ or region) into a
upper part and lower part.
d) Oblique Plan. It is drawn with a determined angle of inclination with respect to
horizontally according to the observer's interests and the characteristics of the
organ or region that is studied.

38
 Sagittal Plane.
Plano Frontal

Plano Horizontal.

Figure 4. MAIN ANATOMICAL PLANES.

By making cuts according to these plans, surfaces in the sagittal plane are obtained.
frontal, transversal or oblique that provide a lot of information from the point of
morphological view of the body as a whole as well as of some of its parts
specific organs. Currently, this type of agreement is applied to the

39
implementation of diagnostic techniques such as computed axial tomography,
nuclear magnetic resonance, ultrasound and conventional X-rays. A
Through helical tomography, reconstructions can be made.
three-dimensional combining the cuts in the previously described planes, what
provides a greater insight into the anatomy of the living man.

MAIN ANATOMICAL AXES.

An axis is nothing more than any straight line that is part of a plane.
determined. According to the previously defined plans, the axes will be
following:
a) Sagittal axis. One that crosses the body or one of its parts horizontally
and in the anteroposterior direction. Traced at the level of a joint, over the
the same involves movements of approaching and distancing (adduction and
abduction) with respect to the midline of the body or that part of it.
b) Frontal or transverse axis. The one that crosses the body or one of its parts.
horizontally from one side to the other. Drawn at the level of a joint over
angular movements of the limbs are performed (flexion and
extension).
c) Vertical axis. The one that extends vertically from one end to the other.
body or any of its parts. Traced at the level of a joint over the
Rotation movements are carried out in both directions.
Morphological terminology. It is a set of technical terms in use.
habitual in morphological studies:
a) Superior and Inferior. It refers to the position that a structure occupies.
determined in the body or one of its parts with respect to a plane
previously established horizontal layout; that is, depending on whether it is above or below

of said plan.
b) Cephalic and Caudal. It refers to the position occupied by a structure.
determined in the body or one of its parts depending on which is closer to one or
another of its ends (toward the brain or toward the tail). These terms are
are more frequently used in the descriptions of embryonic structures

40
 and fetal. Sometimes they are used as synonyms for superior and inferior,
but it is not always sufficiently rigorous.
c) Medial and Lateral. It refers to the position occupied by a certain structure.
in the body or one of its parts depending on whether it is closer or further from the

sagittal plane.
d) External and Internal. It refers to the position of an organ or structure as it relates to

located outside or inside a natural cavity of the organism. They are not
sinónimos de lateral y medial.
e) Superficial and Deep. Refers to the position occupied in the body or a
a structure determined by its parts according to whether it is closer or more
away from the surface of the body or a specific organ.
f) Anterior and Posterior. It refers to the position occupied in the body or one of
its parts an organ or structure depending on whether it is located in front of or behind
a previously drawn front plan.
g) Ventral and Dorsal. It refers to the position occupied in the body or one of its
parts an organ or structure according to its location in a similar form to the
surface of the belly or back of the same. These terms are of more common use
appropriate in the descriptions made in embryos and fetuses. They are
it is used interchangeably in the sense of anterior and posterior, but it is not always
it is correct to do so. The term ventral can be replaced by rostral when it
it deals with the cephalic part of the body.
h) Proximal and Distal. They are relative terms used in descriptions in the
extremities. They refer to the position occupied by a structure in relation to
to another having as a reference point the junction of said extremity
to the trunk. The same structure can be proximal or distal depending on the other.
structure with which it is compared.
i) Apical and Basal. It refers to the position of a structure depending on its location.
closer to the base or the vertex or apex of an organ. When it comes to
a cell or tissue refers to the free surface or the surface that is on
contact with deeper plans of one or the other.

41
They are also very useful for morphofunctional descriptions.
for the locations in the medical exercise, especially guiding in the
performance of the physical examination; a set of reference lines that are drawn in
the trunk:

TORAX
Anterior median. It coincides with the anterior midline of the thorax.
Laterals. Vertical lines extended on both sides of the midline.
Paraesternales. Vertical lines extended on both sides of the midline
coinciding with the lateral edges of the sternum.
Medioclavicular or mammary. Vertical lines drawn between the midpoint of the
clavicle and the nipple.
Auxiliary lines (anterior, middle, and posterior): vertical lines coinciding with the edge
inferior of the pectoralis major, with the lower edge of the latissimus dorsi and position

intermediate between both, respectively.

BACK
Scapulars. Vertical lines that pass through the lower angle of the scapulae.
ABDOMEN

Two horizontal lines drawn at the level of the anterior ends of

the tenth ribs above and at the level of the iliac crests
anterosuperiorly caudally.
Two vertical lines drawn by the lateral edges of the muscles
anterior rectus of the abdomen.
Other authors draw perpendicular lines that intersect at the level of
navel.

42
The lines drawn on the front wall of the abdomen divide it into
quadrants, which is very useful for clinical and surgical practice when
facilitate the projection of the abdominal organs onto this wall.

4
6
2
5

Figure 5. Main lines drawn on the body surface.

Vertical abdominal lines.
2. Midclavicular line.

43
3. Parasternalline.
4. Midsternal line.
5. Horizontal abdominal lines.
6. Scapular line

1 2 3

4 5 6

7 9
8

Figure 6. PROJECTION OF ABDOMINAL ORGANS

ON THE ANTERIOR WALL OF THE ABDOMEN
Right hypochondrium.
2. Epigastrium.
3. Left hypochondrium.
4. Right flank.

44
 5. Mesogastrium.
Left flank.
7. Inguinal region or right iliac fossa.
8. Hypogastrium.
9. Inguinal region or left iliac fossa.
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1. Martínez Pérez M. and Collaborators. Histology. C. Havana 1987.
2. Alfonso Zerquera C. and Collaborators. Human Embryology. C. Havana.
1985.
3. Sadler TW. Langman's Medical Embryology. 7th edition. Mexico 1999.
4. Leeson CR and Leeson TS. Histology. 3rd edition. Madrid 1978.
Basic Histology
6. Carrera JM and Kurjak A. Embryo Medicine. Barcelona 1997.
Tatarinov VG. Human Anatomy and Physiology. 3rd Edition. Publishing House
MIR.Moscow 1987.
8. King G.K, Showers M.J. Human Anatomy and Physiology. Fifth edition.
Philadelphia. 1963.
9. Jacob and Francone. Structure and Function in Man. Third edition.
Philadelphia 1973.
10. Rosell Puig W, Dovale Borjas C, Alvarez Torres I. Human Morphology I.
Generalities and Somatic Systems. Medical Sciences Publishing.
Havana City. 2001.
11. Hole J.W. Essentials of human anatomy & Physiology. United States of
America. 1995.
12. Álvarez Sintes R. and collaborators. Topics in Comprehensive General Medicine.
Volume I and II. Havana City. Ed. ECIMED 2001.
13. Borrota Cruz R, Lemus Lago ER, Aneiros Rivas R. Primary Care
Health, Family Medicine and Medical Care. La Paz - Bolivia: University
Mayor of San Andres. 1998: 190

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14. Cañizares Luna O, Sarasa Muñoz N, Vila Bormey A. Educational work
curricular in morphological sciences. Medicentro 2003:7(1) available URL
The provided text is a URL and cannot be translated.
15. Cañizares Luna O, Sarasa Muñoz N. The Cuban sociomedical paradigm: a
challenge for the teaching of Human Anatomy. Cuban Journal of Medical Education

Super 2000;14(2):148-54.
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Atlas of Human Embryology. Medical Sciences Publishing. Havana
2000 104 p.

17. Seeley R. Stephens T, Tate P. Anatomy and Physiology. 2and. ed. USA:
Mosby Year Book; 1992.

Alvarez Sintes R. Family Health. Promoter Manual. 2nd Edition

Maracay, Aragua 2005.

19. Álvarez Sintes R, Barcos Pina I. Interpretation of the BARRIO Mission

INSIDE from the perspective of a healthcare worker. Republic
Bolivarian Republic of Venezuela. Ministry of Health and Social Development. Caracas.
2004

20. Moore KL, Dalley AF. Clinically Oriented Anatomy. 4th Edition.
Panamerican Medical Editorial. Third reprint. USA. 2005.

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