The People's Common Sense Medical Adviser in Plain English Part 5

CHAPTER VII.

PHYSIOLOGICAL ANATOMY.

CIRCULATORY ORGANS.

Having considered the formation of chyle, traced it through the digestive process, seen its transmission into the _vena cava_, and, finally, its conversion into blood, we shall now describe how it is distributed to every part of the system. This is accomplished through organs which, from the round of duties they perform, are called _circulatory_. These are the Heart, Arteries, Veins, and Capillaries, which const.i.tute the _vascular system_.

Within the thorax or chest of the human body, and enclosed within a membranous sac, called the _pericardium_, is the great force-pump of the system, the heart. This organ, to which all the arteries and veins of the body may be either directly or indirectly traced, is roughly estimated to be equal in size to the closed fist of the individual to whom it belongs.

It has a broad end turned upwards, and a little to the right side, termed its _base_; and a pointed end called its _apex_, turned downwards, forwards, and to the left side, and lying beneath a point about an inch to the right of, and below, the left nipple, or just below the fifth rib. Attached to the rest of the body only by the great blood-vessels which issue from and enter it at its base, the heart is the most mobile organ in the economy, being free to move in different directions.

The heart is divided into two great cavities by a fixed part.i.tion, which extends from the base to the apex of the organ, and which prevents any direct communication between them. Each of these great cavities is further subdivided transversely by a movable part.i.tion, the cavity above each transverse part.i.tion being called the _auricle_, and the cavity below, the _ventricle_, right or left, as the case may be.

[Ill.u.s.tration: Fig. 40.

General view of the heart and lungs, _t_. Trachea, or windpipe, _a_. Aorta, _p_. Pulmonary artery, 1, 2.

Branches of the pulmonary artery, one going to the right, the other to the left lung. _h._ The heart.]

The walls of the auricles are much thinner than those of the ventricles, and the wall of the right ventricle is much thinner than that of the left, from the fact that the ventricles have more work to perform than the auricles, and the left ventricle more than the right.

In structure, the heart is composed almost entirely of muscular fibers, which are arranged in a very complex and wonderful manner. The outer surface of the heart is covered with the pericardium, which closely adheres to the muscular substance. Inside, the cavities are lined with a thin membrane, called the _endocardium_. At the junction between the auricles and ventricles, the apertures of communication between their cavities are strengthened by _fibrous rings_. Attached to these fibrous rings are the movable part.i.tions or valves, between the auricles and the ventricles, the one on the right side of the heart being called the _tricuspid valve_, and the one on the left side the _mitral valve._ A number of fine, but strong, tendinous chords, called _chordae tendineae_, connect the edges and apices of these valves with column-like elevations of the fleshy substance of the walls of the ventricles, called _columnae carneae_.

[Ill.u.s.tration: Fig. 41.

1. The descending vena cava. 2.

The ascending vena cava. 3. The right auricle. 4. The opening between the right auricle and the right ventricle. 5. The right ventricle. 6.

The tricuspid valves. 7. The pulmonary artery. 8, 8. The branches of the pulmonary artery which pa.s.s to the right and the left lung. 9. The semilunar valves of the pulmonary artery. 10. The septum between the two ventricles of the heart. 11, 11.

The pulmonary veins. 12. The left auricle. 13. The opening between the left auricle and ventricle. 14.

The left ventricle. 15. The mitral valves. 16, 16. The aorta. 17. The semilunar valves of the aorta.]

The valves are so arranged that they present no obstacle to the free flow of blood from the auricles into the ventricles, but if any is forced the other way, it gets between the valve and the wall of the heart, and drives the valve backwards and upwards, thus forming a transverse part.i.tion between the auricle and ventricle, through which no fluid can pa.s.s.

At the base of the heart are given off two large arteries, one on the right side, which conveys the blood to the lungs, called the _pulmonary artery_, and one on the left side, which conveys the blood to the system in general, called the _aorta_. At the junction of each of these great vessels with its corresponding ventricle, is another valvular apparatus, consisting of three pouch-like valves, called the _semilunar valves_, from their resemblance, in shape, to a half-moon. Being placed on a level and meeting in the middle line, they entirely prevent the pa.s.sage of any fluid which may be forced along the artery towards the heart, but, flapping back, they offer no obstruction to the free flow of blood from the ventricles into the arteries.

[Ill.u.s.tration: Fig. 42.

A representation of the venous and arterial circulation of the blood.]

The _Arteries_, being always found empty after death, were supposed by the ancients, who were ignorant of the circulation of the blood, to be tubes containing air; hence their name, which is derived from a Greek word and signifies an _air-tube._ Arteries are the cylindrical tubes which carry blood to every part of the system. All the arteries, except the coronary which supply the substance of the heart, arise from the two main trunks, the pulmonary artery and the aorta. They are of a yellowish-white color, and their inner surface is smooth. The arteries have three coats. (1.) The external coat, which is dest.i.tute of fat, and composed chiefly of cellular tissue, is very firm and elastic, and can readily be dissected from the middle coat. (2.) The middle, or fibrous coat, is thicker than the external, and composed of yellowish fibers, its chief property is contractility. (3.) The internal coat consists of a colorless, thin, transparent membrane, yet so strong that it can, it is thought, better resist a powerful pressure than either of the others.

Arteries are very elastic as well as extensible, and their chief extensibility is in length. If an artery of a dead body be divided, although empty, its cylindrical form will be preserved.

The _Veins_ are the vessels through which the venous blood returns to the auricles of the heart. They are more numerous than the arteries, and originate from numerous capillary tubes, while the arteries are given off from main trunks. In some parts of the body, the veins correspond in number to the arteries; while in others, there are two veins to every artery. The veins commence by minute roots in the capillaries, which are everywhere distributed through the body, and gradually increase in size, until they unite and become large trunks, conveying the dark blood to the heart. The veins, like the arteries, have three coats. The external, or cellular coat, resembles that of the arteries; the middle is fibrous, but thinner than the corresponding one of the arteries; and the internal coat is serous, and a.n.a.logous to that of those vessels. The veins belong to the three following cla.s.ses: (1.) The systemic veins, which bring the blood from different parts of the body and discharge it into the vena cava, by means of which it is conveyed to the heart; (2), the pulmonary veins, which bring the arterial, or bright red blood from the lungs and carry it to the left auricle; (3), the veins of the portal system, which originate in the capillaries of the abdominal organs, then converge into trunks and enter the liver, to branch off again into divisions and subdivisions of the minutest character.

The _Capillaries_ form an extremely fine net-work, and are distributed to every part of the body. They vary in diameter from 1/3500 to 1/2000 of an inch. They are so universally prevalent throughout the skin, that the puncture of a needle would wound a large number of them. These vessels receive the blood and bring it into intimate contact with the tissues, which take from it the princ.i.p.al part of its oxygen and other elements, and give up to it carbonic acid and the other waste products resulting from the transformation of the tissues, which are transmitted through the veins to the heart, and thence by the arteries to the lungs and various excretory organs.

The blood from the system in general, except the lungs, is poured into the right auricle by two large veins, called the superior and the inferior _vena cava_,' and that returning from the lungs is poured into the left auricle by the _pulmonary veins._

During life the heart contracts rhythmically, the contractions commencing at the base, in each auricle, and extending towards the apex.

Now it follows, from the anatomical arrangement of this organ, that when the auricles contract, the blood contained in them is forced through the auriculo-ventricular openings into the ventricles; the contractions then extending to the ventricles, in a wave-like manner, the great proportion of the blood, being prevented from re-entering the auricles by the tricuspid and mitral valves, is forced onward into the pulmonary artery from the right ventricle, and into the aorta from the left ventricle.

When the contents of the ventricles are suddenly forced into these great blood-vessels, a shock is given to the entire ma.s.s of fluid which they contain, and this shock is speedily propagated along their branches, being known at the wrist as the _pulse_.

On inspection, between the fifth and sixth ribs on the left side of the chest, a movement is perceptible, and, if the hand be applied, the impulse may be felt. This is known as the throbbing, or beating of the heart.

If the ear is placed over the region of the heart, certain sounds are heard, which recur with great regularity. First is heard a comparatively long, dull sound, then a short, sharp sound, then a pause, and then the long, dull sound again. The first sound is caused mainly by the tricuspid and mitral valves, and the second is the result of sudden closure of the semilunar valves.

No language can adequately describe the beauty of the circulatory system. The constant vital flow through the larger vessels, and the incessant activity of those so minute that they are almost imperceptible, fully ill.u.s.trate the perfectness of the mechanism of the human body, and the wisdom and goodness of Him who is its author.

Experiments have shown that the small arteries may be directly influenced through the nervous system, which regulates their caliber by controlling the state of contraction of their muscular walls. The effect of this influence of the nervous system enables it to control the circulation over certain areas; and, notwithstanding the force of the heart and the state of the blood-vessels in general, to materially modify the circulation in different spots. Blushing, which is simply a local modification of the circulation, is effected in this way. Some emotion takes possession of the mind, and the action of the nerves, which ordinarily keep up a moderate contraction of the muscular coats of the arteries, is lost, and the vessels relax and become distended with arterial blood, which is a warm and bright red fluid; thereupon a burning sensation is felt, and the skin grows red, the degree of the blush depending upon the intensity of the emotion.

The pallor produced by fright and by extreme anxiety, is purely the result of a local modification of the circulation, brought about by an over-stimulation of the nerves which supply the small arteries, causing them to contract, and to thus cut off more or less completely the supply of blood.

CHAPTER VIII.

PHYSIOLOGICAL ANATOMY.

THE ORGANS OF RESPIRATION.

THE ORGANS OF RESPIRATION are the Trachea, or windpipe, the Bronchia, formed by the subdivision of the trachea, and the Lungs, with their air-cells. The _Trachea_ is a vertical tube situated between the lungs below, and a short quadrangular cavity above, called the _larynx_, which is part of the windpipe, and used for the purpose of modulating the voice in speaking or singing. In the adult, the trachea, in its unextended state, is from four and one-half to five inches in length, about one inch in diameter, and, like the larynx, is more fully developed in the male than in the female. It is a fibro-cartilaginous structure, and is composed of flattened rings, or segments of circles.

It permits the free pa.s.sage of air to and from the lungs.

The _Bronchia_ are two tubes, or branches, one proceeding from the windpipe to each lung. Upon entering the lungs, they divide and subdivide until, finally, they terminate in small cells, called the _bronchial or air-cells,_ which are of a membranous character.

[Ill.u.s.tration: Fig. 43.

An ideal representation of the respiratory organs. _3._ The larynx. _4._ The trachea. _5, 6._ The bronchia. _9, 9, 9, 9._ Air-cells.

_1, 1, 1, 2, 2, 2._ Outlines of the lungs.]

The _Lungs_ are irregular conical organs rounded at the apex, situated within the chest, and filling the greater part of it, since the heart is the only other organ which occupies much s.p.a.ce in the thoracic cavity.

The lungs are convex externally, and conform to the cavity of the chest, while the internal surface is concave for the accommodation of the heart. The size of the lungs depends upon the capacity of the chest.

Their color varies, being of a pinkish hue in childhood but of a gray, mottled appearance in the adult. They are termed the _right_ and _left_ lung. Each lung resembles a cone with its base resting upon the diaphragm, and its apex behind the collar-bone. The right lung is larger though shorter, than the left, not extending so low, and has three _lobes_, formed by deep fissures, or longitudinal divisions, while the left has but two lobes. Each lobe is also made up of numerous _lobules_, or small lobes, connected by cellular tissue, and these contain great numbers of cells. The lungs are abundantly supplied with blood-vessels, lymphatics, and nerves. The density of a lung depends upon the amount of air which it contains. Thus, experiment has shown that in a _foetus_ which has never breathed, the lungs are compact and will sink in water; but as soon as they become inflated with air, they spread over a larger surface, and are therefore more buoyant. Each lung is invested, as far as its root, with a membrane, called the _pleura_, which is then continuously extended to the cavity of the chest, thus performing the double office of lining it, and const.i.tuting a part.i.tion between the lungs. The part of the membrane which forms this part.i.tion is termed the _mediastinum_. Inflammation of this membrane is called _pleurisy_. The lungs are held in position by the root, which is formed by the pulmonary arteries, veins, nerves, and the bronchial tubes. Respiration is the function by which the venous blood, conveyed to the lungs by the pulmonary artery, is converted into arterial blood. This is effected by the elimination of carbonic acid, which is expired or exhaled from the lungs, and by the absorption of oxygen from the air which is taken into the lungs, by the act of inspiration or inhalation. The act of expiration is performed chiefly by the elevation of the diaphragm and the descent of the ribs, and inspiration is princ.i.p.ally effected by the descent of the diaphragm and the elevation of the ribs.

[Ill.u.s.tration: Fig. 44.

A representation of the heart and lungs. 4. The heart. 5. The pulmonary artery. 8. Aorta. 9, 11.

Upper lobes of the lungs. 10, 13. Lower lobes. 12.

Middle lobe of the right lung. 2. Superior vena cava. 3. Inferior vena cava.]

When the muscles of some portions of the air-pa.s.sages are relaxed, a peculiar vibration follows, known as snoring. Coughing and sneezing are sudden and spasmodic expiratory efforts, and generally involuntary.

Sighing is a prolonged deep inspiration, followed by a rapid, and generally audible expiration. It is remarkable that laughing and sobbing, although indicating opposite states of the mind, are produced in very nearly the same manner. In hiccough, the contraction is more sudden and spasmodic than in laughing or sobbing. The quant.i.ty of oxygen consumed during sleep is estimated to be considerably less than that consumed during wakefulness.

[Ill.u.s.tration: Fig. 45.

View of the pulmonary circulation.]