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Figure Getting a Foot Examined, Khajuraho

Figure Getting a Foot Examined, Khajuraho


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33 Funny Exam Answers

We have had a lot of very serious lists on the site lately so I am posting a totally silly list. I can not vouch for whether these are authentic answers to the English GCSE exam, but regardless, they are funny.

1. Ancient Egypt was inhabited by mummies and they all wrote in hydraulics.They lived in the Sarah Dessert and traveled by Camelot. The climate of the Sarah is such that the inhabitants have to live elsewhere.

2. The Bible is full of interesting caricatures. In the first book of the Bible,Guinessis, Adam and Eve were created from an apple tree. One of their children,Cain, asked, &ldquoAm I my brother&rsquos son?&rdquo

3. Moses led the Hebrew slaves to the Red Sea, where they made unleavened bread which is bread made without any ingredients. Moses went up on Mount Cyanide to get the ten commandments. He died before he ever reached Canada.

4. Solomom had three hundred wives and seven hundred porcupines.

5. The Greeks were a highly sculptured people, and without them we wouldn&rsquot have history. The Greeks also had myths. A myth is a female moth.

6. Actually, Homer was not written by Homer but by another man of that name.

7. Socrates was a famous Greek teacher who went around giving people advice. They killed him. Socrates died from an overdose of wedlock. After his death, his career suffered a dramatic decline.

8. In the Olympic games, Greeks ran races, jumped, hurled the biscuits, and threw the java.

9. Eventually, the Romans conquered the Greeks. History calls people Romans because they never stayed in one place for very long.

10. Julius Caesar extinguished himself on the battlefields of Gaul. The Ides of March murdered him because they thought he was going to be made king. Dying, he gasped out: &ldquoTee hee, Brutus.&rdquo

11. Nero was a cruel tyranny who would torture his subjects by playing the fiddle to them.

12. Joan of Arc was burnt to a steak and was cannonized by Bernard Shaw. Finally Magna Carta provided that no man should be hanged twice for the same offense.

13. In midevil times most people were alliterate. The greatest writer of the futile ages was Chaucer, who wrote many poems and verses and also wrote literature.

14. Another story was William Tell, who shot an arrow through an apple while standing on his son&rsquos head.

15. Queen Elizabeth was the &ldquoVirgin Queen.&rdquo As a queen she was a success. When she exposed herself before her troops they all shouted &ldquohurrah.&rdquo

16. It was an age of great inventions and discoveries. Gutenberg invented removable type and the Bible. Another important invention was the circulation of blood. Sir Walter Raleigh is a historical figure because he invented cigarettes and started smoking. And Sir Francis Drake circumcised the world with a 100 foot clipper.

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17. The greatest writer of the Renaissance was William Shakespeare. He was born in the year 1564, supposedly on his birthday. He never made much money and is famous only because of his plays. He wrote tragedies,comedies, and hysterectomies, all in Islamic pentameter. Romeo and Juliet are an example of a heroic couplet. Romeo&rsquos last wish was to be laid by Juliet.

18. Writing at the same time as Shakespeare was Miguel Cervantes. He wrote Donkey Hote. The next great author was John Milton. Milton wrote Paradise Lost. Then his wife died and he wrote Paradise Regained.

19. During the Renaissance America began. Christopher Columbus was a great navigator who discovered America while cursing about the Atlantic. His ships were called the Nina, the Pinta, and the Santa Fe.

20. Later, the Pilgrims crossed the ocean, and this was called Pilgrim&rsquos Progress. The winter of 1620 was a hard one for the settlers. Many people died and many babies were born. Captain John Smith was responsible for all this.

21. One of the causes of the Revolutionary War was the English put tacks in their tea. Also, the colonists would send their parcels through the post without stamps. Finally the colonists won the War and no longer had to pay for taxis. Delegates from the original 13 states formed the Contented Congress. Thomas Jefferson, a Virgin, and Benjamin Franklin were two singers of the Declaration of Independence. Franklin discovered electricity by rubbing two cats backwards and declared, &ldquoA horse divided against itself cannot stand.&rdquo. Franklin died in 1790 and is still dead.

22. Soon the Constitution of the United States was adopted to secure domestic hostility. Under the constitution the people enjoyed the right to keep bare arms.

23. Abraham Lincoln became America&rsquos greatest Precedent. Lincoln&rsquos mother died in infancy, and he was born in a log cabin which he built with his own hands. Abraham Lincoln freed the slaves by signing the Emasculation Proclamation. On the night of April 14, 1865, Lincoln went to the theater and got shot in his seat by one of the actors in a moving picture show. The believed assinator was John Wilkes Booth, a supposedly insane actor. This ruined Booth&rsquos career.

24. Meanwhile in Europe, the enlightenment was a reasonable time. Voltaire invented electricity and also wrote a book called Candy.

25. Gravity was invented by Issac Walton. It is chiefly noticeable in the autumn when the apples are falling off the trees.

26. Johann Bach wrote a great many musical compositions and had a large number of children. In between he practiced on an old spinster which he kept up in his attic. Bach died from 1750 to the present. Bach was the most famous composer in the world and so was Handel. Handel was half German half Italian and half English. He was very large.

27. Beethoven wrote music even though he was deaf. He was so deaf he wrote loud music. He took long walks in the forest even when everyone was calling for him. Beethoven expired in 1827 and later died for this.

28. The French Revolution was accomplished before it happened and catapulted into Napoleon. Napoleon wanted an heir to inherit his power, but since Josephine was a baroness, she couldn&rsquot have any children.

29. The sun never set on the British Empire because the British Empire is In the East and the sun sets in the West.

30. Queen Victoria was the longest queen. She sat on a thorn for 63 years. She was a moral woman who practiced virtue. Her death was the final event which ended her reign.

31. The nineteenth century was a time of a great many thoughts and inventions. People stopped reproducing by hand and started reproducing by machine. The invention of the steamboat caused a network of river to spring up. Cyrus McCormick invented the McCormick raper, which did the work of a hundred men.

32. Louis Pasteur discovered a cure for rabbis. Charles Darwin was a naturalist who wrote the Organ of the Species. Madman Curie discovered radio. And Karl Marx became one of the Marx brothers.

33. The First World War, caused by the assignation of the Arch-Duck by an anahist, ushered in a new error in the anals of human history.


The Cottingley Fairies

“There are fairies at the bottom of our garden,” announces the opening line of a poem by Rose Fyleman first published in 1917. Coincidentally, that was also the year that two intelligent and talented young conspirators managed to convince the world that there were fairies living near Cottingley Beck, the stream that ran past the foot of their garden.

The curious tale of the Cottingley Fairies began in the summer of that year, when nine-year-old Frances Griffiths and her mother returned to England from South Africa to stay with the Wright family in Cottingley, West Yorkshire. Next to the house where Polly and Arthur Wright and their sixteen-year-old daughter Elsie lived was the small wooded valley through which Cottingley Beck flowed. Elsie and Frances were cousins.

Cottingley Beck still flows picturesquely over rocky outcrops overshadowed by trees, just the type of pretty location that children love to explore. It quickly became the favourite spot of the two cousins, who regularly got into trouble for returning home wet and untidy after playing in and around the beck.

When told off for getting wet, they said they went there “to see the fairies”. Their families undoubtedly scoffed at an excuse that was as thin as “the dog ate my homework”, and so Elsie borrowed her father’s Midg quarterplate camera and went in search of proof. The girls were back within the hour.

Elsie’s father Arthur was a keen amateur photographer with his own darkroom and all the equipment required to develop the plate the girls had taken. The image, now a very famous one, shows Frances, head slightly tilted, gazing off just to the right of the photographer. In front of her several winged fairy figures dressed in diaphanous clothing are dancing. Frances looks as though she is trying hard not to laugh.

Elsie had an interest in photography herself, a talent for art and experience in retouching photographs. Arthur Wright was immediately suspicious. Even when the girls came back in September with an impressive plate showing Elsie holding out her hand to a gnome-like winged figure, Arthur was unconvinced. He knew the girls had been up to something, he just wasn’t sure how they’d done it. The most likely explanation seemed to be that they’d used cut-out figures. Arthur’s instincts were right, though it would be decades before that was confirmed.

Above: Elsie Wright with a friendly neighbourhood gnome

Elsie’s mother Polly, who was interested in the Theosophical movement, took the photographs along to a meeting of the Theosophical Society in nearby Bradford. Appropriately, the subject of the evening lecture was “fairy life”, and the images appear to have caught the imagination and the enthusiasm of the society’s supporters, and of one of its leading members, Edward Gardner.

Seizing on an opportunity to promote the most important spiritual message of the Theosophists – that humankind was undergoing a process of transformation that would lead eventually to the perfection of the species – Gardner claimed the two images were supernatural proof that great metaphysical changes were happening.

Above: Elsie Wright and a Cottingley Fairy

The photographs were examined by photographic expert Harold Snelling, who confirmed them as authentic images of “what was in front of the camera”, thus avoiding having to validate them as images of fairies. Gardner used the images in his lectures and also had prints created to sell afterwards. The images appeared in a spiritualist magazine where they caught the eye of Sir Arthur Conan-Doyle, a believer in spiritualism himself. He was about to write a piece on fairies for the Christmas edition of the Strand magazine, and asked Arthur and Elsie for permission to use the images.

Conan-Doyle’s credulity in this and other matters still remains a mystery. He had been apparently fully taken in by the Piltdown Man fake, and since neither Piltdown Man nor the Cottingley fairies would be revealed as fakes until after his death, he presumably went on believing in the truth of them until the day he died.

Above: The Pildown Man, another famous fake!

For the Cottingley fairies were fakes, beautifully drawn images of fairies probably created by Elsie and staged and photographed by both girls. They had been copied from images in “Princess Mary’s Gift Book”, published in 1914, and then had wings added to them. Held upright with hatpins, they were sufficiently plausible to be accepted by Conan-Doyle and many others. Three more fairy images were taken, the final one, “Fairies and their Sunbath”, in 1920.

Perhaps the timing had something to do with the way the images were so readily accepted. The horrific reality of the 1914-1918 war would leave people desperate for a different world, a world in which there might still be the possibility of magic. Conan Doyle’s own son was a victim of the war.

During the 1920s and 30s, fairies, gnomes and other supernatural creatures would be popular subjects for mass-market prints, pottery and ornaments. As cinematography advanced, the fairy-tale cartoons of Walt Disney captured the imagination of children and adults alike. People continued to believe in the fairies because they wanted to believe in them. They wanted to have faith in the girls and the story they told. Somewhere in a forgotten corner of the green and pleasant isle, supernatural beings still lived their secret lives, revealed only to a select few.

Hard though it is to believe now, debate on the authenticity of the Cottingley fairies continued until well into the 1960s. Television opened up even greater opportunities for investigative journalism in the following decade, and the images came under greater scrutiny. However, they were not entirely debunked until the 1980s, when Geoffrey Crawley, the editor of the “British Journal of Photography”, undertook a major investigation, concluding they were fakes.

The cousins were both still alive in the 1980s, and finally Elsie confessed to the hoax, probably with some relief, in 1983. What had undoubtedly started out as a cleverly stage-managed bit of fun, suggested by Frances, had got seriously out of hand. The cousins themselves were astonished at how readily people of the calibre of Conan-Doyle had accepted the images. Perhaps not wholly wanting to relinquish the story, Frances maintained all her life that “Fairies and their Sunbath”, the fifth and last image, showed real fairies, not fakes.

Miriam Bibby BA MPhil FSA Scot is a historian, Egyptologist and archaeologist with a special interest in equine history. Miriam has worked as a museum curator, university academic, editor and heritage management consultant. She is currently completing her PhD at the University of Glasgow.


Pat Garrett&aposs Account of Billy the Kid&aposs Death

The 1882 biography The Authentic Life of Billy the Kid, Noted Desperado of the Southwest, Whose Deeds of Daring and Blood Made His Name a Terror in New Mexico, Arizona and Northern Mexico, which was written by Garrett, his killer, contains what seems to be the most credible account of the fatal confrontation, according to Motavalli. Instead of depicting an epic gunfight out of a dime novel, Garrett makes his shooting of the outlaw seem like an incredibly lucky break.

That night, Garrett wrote, he and two deputies, John W. Poe and Thomas McKinney, went to the ranch where Maxwell lived. A short distance from the property, Poe spotted an acquaintance who was camped out, and the lawmen dismounted and stopped to have coffee with him before heading on foot through an orchard to the house. Then they heard voices in Spanish𠅊 language that Billy the Kid spoke as well as English and the Gaelic of his parents’ native country, Ireland. 

The three men concealed themselves, as a man in a broad-brimmed hat, a dark vest, shirt and pants walked past them. Though they didn’t realize it, the man was Billy the Kid, who was headed for the house with the intention of carving for himself a piece of beef.

Leaving the two deputies on the porch, Garrett slipped into the darkened house and quickly found the room where Maxwell was in bed. Garrett began questioning him, and Maxwellꂭmitted that the outlaw had been around, though he wasn’t sure where he was at the moment. Just then, a figure appeared in the door, carrying a gun and a butcher knife, and asked in Spanish who was there.

Pat F. Garrett, the famous sheriff of Lincoln County, New Mexico who shot Billy the Kid.

Bettmann Archive/Getty Images

“Who is it, Pete?” Garrett whispered to Maxwell.

Billy the Kid realized that someone besides Maxwell was there in the darkness, and raised his pistol within a foot of Garrett’s chest. “Who’s that?” he asked, in Spanish.

Garrett quickly drew his revolver and fired two shots. The first shot hit Kid in the chest. “He never spoke,” Garrett recalled. 𠇊 struggle or two, a little strangling sound as he gasped for breath, and The Kid was with his many victims.”

When Garrett and the deputies examined Billy the Kid’s gun, they found that he had five cartridges and one shell in the chamber, with the hammer resting on it. If he hadn’t hesitated, Garrett might have been the one lying dead on the floor.

“It was the first time, during all his life of peril, that he ever lost his presence of mind, or failed to shoot first,” Garrett wrote.

The next day, according to Garrett, a Coroner’s Jury held an inquest, determined that the dead man was Billy the Kid, and ruled that Garrett’s killing of him had been a justifiable homicide. The outlaw’s body was buried that same day. Garrett noted that the corpse went into the grave fully intact, in order to discredit opportunists who were exhibiting skulls, fingers and other body parts that they claimed had belonged to Billy the Kid. “One medical gentleman has persuaded credulous idiots that he has all the bones strung upon wires,” Garrett wrote with distain.


Mercy Brown

Mercy Brown may rival Count Dracula as the most notorious vampire. Unlike Count Dracula, however, Mercy was a real person. She lived in Exeter, Rhode Island and was the daughter of George Brown, a farmer.

After George lost many family members, including Mercy, in the late 1800s to tuberculosis, his community used Mercy as a scapegoat to explain their deaths. It was common at that time to blame several deaths in one family on the “undead.” The bodies of each dead family member were often exhumed and searched for signs of vampirism.

When Mercy’s body was exhumed and didn’t display severe decay (not surprising, since her body was placed in an above-ground vault during a New England winter), the townspeople accused her of being a vampire and making her family sick from her icy grave. They cut out her heart, burned it, then fed the ashes to her sick brother. Perhaps not surprisingly, he died shortly thereafter.


Superficial Reflexes

  1. Biceps and Brachioradialis C5/C6
  2. Triceps C7 (Note: Some references include C6 OR C8, however C7 is predominantly involved.)
  3. Patellar L2-L4
  4. Ankle S1

Superficial Reflexes

Corneal reflex (blink reflex)

  1. Involuntary blinking in response to corneal stimulation
  2. Afferent: nasociliary branch of ophthalmic branch (V1) of trigeminal nerve (5th nerve)
  3. Efferent: facial nerve (7th nerve)
  1. Contraction of superficial abdominal muscles when stroking abdomen lightly
  2. Significant if asymmetric–usually signifies a UMN lesion on the absent side.
  1. Contraction of cremaster muscle (that will pull up the scrotum/testis) after stroking the same side of superior/inner thigh
  2. Absent with:
  3. testicular torsion
  4. upper/lower motor neuron lesions
  5. L1/L2 spinal cord injury
  6. ilioinguinal nerve injury (during hernia repair)
  1. The plantar reflex can be:
  2. Normal (Toes down-going)
  3. Absent
  4. Abnormal or "Babinski Present"
  5. Note: It is incorrect to say ‘negative Babinski '

Visceral Reflexes

Anal reflex (anal wink)

  1. Reflexive contraction of the external anal sphincter upon stroking the skin around the anus (afferent: pudendal nerve efferent: S2-S4)

Bulbocavernosus reflex

  1. Anal sphincter contraction in response to squeezing the glans penis or tugging on an indwelling Foley catheter
  2. Reflex mediated by S2-4 and used in patients with spinal cord injury

DTR Scale

We are not big believers in grading reflexes (grading muscle power is much more useful). Nevertheless, if you need something beyond “absent,” “present,” “brisk,” or “hyperactive” then use below. If you have a hyperactive reflex don’t forget to look for clonus.


5. Presbyterians believe they are protestant and meant to share God’s word with others.

Presbyterians believe in a sovereign God and in worshipping him. They also believe in the Bible and in using its word to serve as an “authoritative guide” for what to believe, according to the Central Presbyterian Church in Athens, Georgia.

According to the Presbyterian Church USA, salvation comes through grace and “no one is good enough” for salvation. “Despite our failure, God decided to save us through the incarnation, death and resurrection of Jesus,” James Ayers wrote for Presbyterians Today.

Also, the Presbyterian church believes evangelism is part of God’s mission. Sharing God’s message is the responsibility of the church. This includes living a life that “speaks louder than words,” according to the Presbyterian Church USA.

Photo courtesy: ©Thinkstockphotos.com


Contents

Elements of the human body by mass. Trace elements are less than 1% combined (and each less than 0.1%).
Element Symbol percent mass percent atoms
Oxygen O 65.0 24.0
Carbon C 18.5 12.0
Hydrogen H 9.5 62.0
Nitrogen N 3.2 1.1
Calcium Ca 1.5 0.22
Phosphorus P 1.0 0.22
Potassium K 0.4 0.03
Sulfur S 0.3 0.038
Sodium Na 0.2 0.037
Chlorine Cl 0.2 0.024
Magnesium Mg 0.1 0.015
Trace elements < 0.1 < 0.3

The human body is composed of elements including hydrogen, oxygen, carbon, calcium and phosphorus. [1] These elements reside in trillions of cells and non-cellular components of the body.

The adult male body is about 60% water for a total water content of some 42 litres (9.2 imp gal 11 US gal). This is made up of about 19 litres (4.2 imp gal 5.0 US gal) of extracellular fluid including about 3.2 litres (0.70 imp gal 0.85 US gal) of blood plasma and about 8.4 litres (1.8 imp gal 2.2 US gal) of interstitial fluid, and about 23 litres (5.1 imp gal 6.1 US gal) of fluid inside cells. [2] The content, acidity and composition of the water inside and outside cells is carefully maintained. The main electrolytes in body water outside cells are sodium and chloride, whereas within cells it is potassium and other phosphates. [3]

Cells Edit

The body contains trillions of cells, the fundamental unit of life. [4] At maturity, there are roughly 30 [5] –37 [6] trillion cells in the body, an estimate arrived at by totaling the cell numbers of all the organs of the body and cell types. The body is also host to about the same number of non-human cells [5] as well as multicellular organisms which reside in the gastrointestinal tract and on the skin. [7] Not all parts of the body are made from cells. Cells sit in an extracellular matrix that consists of proteins such as collagen, surrounded by extracellular fluids. Of the 70 kg (150 lb) weight of an average human body, nearly 25 kg (55 lb) is non-human cells or non-cellular material such as bone and connective tissue.

Genome Edit

Cells in the body function because of DNA. DNA sits within the nucleus of a cell. Here, parts of DNA are copied and sent to the body of the cell via RNA. [8] The RNA is then used to create proteins which form the basis for cells, their activity, and their products. Proteins dictate cell function and gene expression, a cell is able to self-regulate by the amount of proteins produced. [9] However, not all cells have DNA some cells such as mature red blood cells lose their nucleus as they mature.

Tissues Edit

The body consists of many different types of tissue, defined as cells that act with a specialised function. [10] The study of tissues is called histology and often occurs with a microscope. The body consists of four main types of tissues. These are lining cells (epithelia), connective tissue, nerve tissue and muscle tissue. [11]

Cells that lie on surfaces exposed to the outside world or gastrointestinal tract (epithelia) or internal cavities (endothelium) come in numerous shapes and forms – from single layers of flat cells, to cells with small beating hair-like cilia in the lungs, to column-like cells that line the stomach. Endothelial cells are cells that line internal cavities including blood vessels and glands. Lining cells regulate what can and can't pass through them, protect internal structures, and function as sensory surfaces. [11]

Organs Edit

Organs, structured collections of cells with a specific function, [12] mostly sit within the body, with the exception of skin. Examples include the heart, lungs and liver. Many organs reside within cavities within the body. These cavities include the abdomen (which contains the stomach, for example) and pleura, which contains the lungs.

Systems Edit

Circulatory system Edit

The circulatory system consists of the heart and blood vessels (arteries, veins and capillaries). The heart propels the circulation of the blood, which serves as a "transportation system" to transfer oxygen, fuel, nutrients, waste products, immune cells and signalling molecules (i.e. hormones) from one part of the body to another. Paths of blood circulation within the human body can be divided into two circuits: the pulmonary circuit, which pumps blood to the lungs to receive oxygen and leave carbon dioxide, and the systemic circuit, which carries blood from the heart off to the rest of the body. The blood consists of fluid that carries cells in the circulation, including some that move from tissue to blood vessels and back, as well as the spleen and bone marrow. [13] [14] [15] [16]

Digestive system Edit

The digestive system consists of the mouth including the tongue and teeth, esophagus, stomach, (gastrointestinal tract, small and large intestines, and rectum), as well as the liver, pancreas, gallbladder, and salivary glands. It converts food into small, nutritional, non-toxic molecules for distribution and absorption into the body. These molecules take the form of proteins (which are broken down into amino acids), fats, vitamins and minerals (the last of which are mainly ionic rather than molecular). After being swallowed, food moves through the gastrointestinal tract by means of peristalsis: the systematic expansion and contraction of muscles to push food from one area to the next. [17] [18]

Digestion begins in the mouth, which chews food into smaller pieces for easier digestion. Then it is swallowed, and moves through the esophagus to the stomach. In the stomach, food is mixed with gastric acids to allow the extraction of nutrients. What is left is called chyme this then moves into the small intestine, which absorbs the nutrients and water from the chyme. What remains passes on to the large intestine, where it is dried to form feces these are then stored in the rectum until they are expelled through the anus. [18]

Endocrine system Edit

The endocrine system consists of the principal endocrine glands: the pituitary, thyroid, adrenals, pancreas, parathyroids, and gonads, but nearly all organs and tissues produce specific endocrine hormones as well. The endocrine hormones serve as signals from one body system to another regarding an enormous array of conditions, and resulting in variety of changes of function. [19]

Immune system Edit

The immune system consists of the white blood cells, the thymus, lymph nodes and lymph channels, which are also part of the lymphatic system. The immune system provides a mechanism for the body to distinguish its own cells and tissues from outside cells and substances and to neutralize or destroy the latter by using specialized proteins such as antibodies, cytokines, and toll-like receptors, among many others. [20]

Integumentary system Edit

The integumentary system consists of the covering of the body (the skin), including hair and nails as well as other functionally important structures such as the sweat glands and sebaceous glands. The skin provides containment, structure, and protection for other organs, and serves as a major sensory interface with the outside world. [21] [22]

Lymphatic system Edit

The lymphatic system extracts, transports and metabolizes lymph, the fluid found in between cells. The lymphatic system is similar to the circulatory system in terms of both its structure and its most basic function, to carry a body fluid. [23]

Musculoskeletal system Edit

The musculoskeletal system consists of the human skeleton (which includes bones, ligaments, tendons, and cartilage) and attached muscles. It gives the body basic structure and the ability for movement. In addition to their structural role, the larger bones in the body contain bone marrow, the site of production of blood cells. Also, all bones are major storage sites for calcium and phosphate. This system can be split up into the muscular system and the skeletal system. [24]

Nervous system Edit

The nervous system consists of the body's neurons and glial cells, which together form the nerves, ganglia and gray matter which in turn form the brain and related structures. The brain is the organ of thought, emotion, memory, and sensory processing it serves many aspects of communication and controls various systems and functions. The special senses consist of vision, hearing, taste, and smell. The eyes, ears, tongue, and nose gather information about the body's environment. [25]

From a structural perspective, the nervous system is typically subdivided into two component parts: the central nervous system (CNS), composed of the brain and the spinal cord and the peripheral nervous system (PNS), composed of the nerves and ganglia outside the brain and spinal cord. The CNS is mostly responsible for organizing motion, processing sensory information, thought, memory, cognition and other such functions. [26] It remains a matter of some debate whether the CNS directly gives rise to consciousness. [27] The peripheral nervous system (PNS) is mostly responsible for gathering information with sensory neurons and directing body movements with motor neurons. [26]

From a functional perspective, the nervous system is again typically divided into two component parts: the somatic nervous system (SNS) and the autonomic nervous system (ANS). The SNS is involved in voluntary functions like speaking and sensory processes. The ANS is involved in involuntary processes, such as digestion and regulating blood pressure. [28]

The nervous system is subject to many different diseases. In epilepsy, abnormal electrical activity in the brain can cause seizures. In multiple sclerosis, the immune system attacks the nerve linings, damaging the nerves' ability to transmit signals. Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a motor neuron disease which gradually reduces movement in patients. There are also many other diseases of the nervous system. [26]

Reproductive system Edit

The reproductive system consists of the gonads and the internal and external sex organs. The reproductive system produces gametes in each sex, a mechanism for their combination, and in the female a nurturing environment for the first 9 months of development of the infant. [29]

Respiratory system Edit

The respiratory system consists of the nose, nasopharynx, trachea, and lungs. It brings oxygen from the air and excretes carbon dioxide and water back into the air. First, air is pulled through the trachea into the lungs by the diaphragm pushing down, which creates a vacuum. Air is briefly stored inside small sacs known as alveoli (sing.: alveolus) before being expelled from the lungs when the diaphragm contracts again. Each alveolus is surrounded by capillaries carrying deoxygenated blood, which absorbs oxygen out of the air and into the bloodstream. [30] [31]

For the respiratory system to function properly, there need to be as few impediments as possible to the movement of air within the lungs. Inflammation of the lungs and excess mucus are common sources of breathing difficulties. [31] In asthma, the respiratory system is persistently inflamed, causing wheezing and/or shortness of breath. Pneumonia occurs through infection of the alveoli, and may be caused by tuberculosis. Emphysema, commonly a result of smoking, is caused by damage to connections between the alveoli. [32]

Urinary system Edit

The urinary system consists of the kidneys, ureters, bladder, and urethra. It removes toxic materials from the blood to produce urine, which carries a variety of waste molecules and excess ions and water out of the body. [33]

Human anatomy is the study of the shape and form of the human body. The human body has four limbs (two arms and two legs), a head and a neck which connect to the torso. The body's shape is determined by a strong skeleton made of bone and cartilage, surrounded by fat, muscle, connective tissue, organs, and other structures. The spine at the back of the skeleton contains the flexible vertebral column which surrounds the spinal cord, which is a collection of nerve fibres connecting the brain to the rest of the body. Nerves connect the spinal cord and brain to the rest of the body. All major bones, muscles, and nerves in the body are named, with the exception of anatomical variations such as sesamoid bones and accessory muscles.

Blood vessels carry blood throughout the body, which moves because of the beating of the heart. Venules and veins collect blood low in oxygen from tissues throughout the body. These collect in progressively larger veins until they reach the body's two largest veins, the superior and inferior vena cava, which drain blood into the right side of the heart. From here, the blood is pumped into the lungs where it receives oxygen and drains back into the left side of the heart. From here, it is pumped into the body's largest artery, the aorta, and then progressively smaller arteries and arterioles until it reaches tissue. Here blood passes from small arteries into capillaries, then small veins and the process begins again. Blood carries oxygen, waste products, and hormones from one place in the body to another. Blood is filtered at the kidneys and liver.

The body consists of a number of body cavities, separated areas which house different organ systems. The brain and central nervous system reside in an area protected from the rest of the body by the blood brain barrier. The lungs sit in the pleural cavity. The intestines, liver, and spleen sit in the abdominal cavity.

Height, weight, shape and other body proportions vary individually and with age and sex. Body shape is influenced by the distribution of bones , muscle and fat tissue. [34]

Human physiology is the study of how the human body functions. This includes the mechanical, physical, bioelectrical, and biochemical functions of humans in good health, from organs to the cells of which they are composed. The human body consists of many interacting systems of organs. These interact to maintain homeostasis, keeping the body in a stable state with safe levels of substances such as sugar and oxygen in the blood. [35]

Each system contributes to homeostasis, of itself, other systems, and the entire body. Some combined systems are referred to by joint names. For example, the nervous system and the endocrine system operate together as the neuroendocrine system. The nervous system receives information from the body, and transmits this to the brain via nerve impulses and neurotransmitters. At the same time, the endocrine system releases hormones, such as to help regulate blood pressure and volume. Together, these systems regulate the internal environment of the body, maintaining blood flow, posture, energy supply, temperature, and acid balance (pH). [35]

Development of the human body is the process of growth to maturity. The process begins with fertilisation, where an egg released from the ovary of a female is penetrated by sperm. The egg then lodges in the uterus, where an embryo and later fetus develop until birth. Growth and development occur after birth, and include both physical and psychological development, influenced by genetic, hormonal, environmental and other factors. Development and growth continue throughout life, through childhood, adolescence, and through adulthood to old age, and are referred to as the process of aging.

Professional study Edit

Health professionals learn about the human body from illustrations, models, and demonstrations. Medical and dental students in addition gain practical experience, for example by dissection of cadavers. Human anatomy, physiology, and biochemistry are basic medical sciences, generally taught to medical students in their first year at medical school. [36] [37] [38]

Depiction Edit

Anatomy has served the visual arts since Ancient Greek times, when the 5th century BC sculptor Polykleitos wrote his Canon on the ideal proportions of the male nude. [39] In the Italian Renaissance, artists from Piero della Francesca (c. 1415–1492) onwards, including Leonardo da Vinci (1452–1519) and his collaborator Luca Pacioli (c. 1447–1517), learnt and wrote about the rules of art, including visual perspective and the proportions of the human body. [40]

History of anatomy Edit

In Ancient Greece, the Hippocratic Corpus described the anatomy of the skeleton and muscles. [41] The 2nd century physician Galen of Pergamum compiled classical knowledge of anatomy into a text that was used throughout the Middle Ages. [42] In the Renaissance, Andreas Vesalius (1514–1564) pioneered the modern study of human anatomy by dissection, writing the influential book De humani corporis fabrica. [43] [44] Anatomy advanced further with the invention of the microscope and the study of the cellular structure of tissues and organs. [45] Modern anatomy uses techniques such as magnetic resonance imaging, computed tomography, fluoroscopy and ultrasound imaging to study the body in unprecedented detail. [46]

History of physiology Edit

The study of human physiology began with Hippocrates in Ancient Greece, around 420 BCE, and with Aristotle (384–322 BCE) who applied critical thinking and emphasis on the relationship between structure and function. Galen (ca. 126–199) was the first to use experiments to probe the body's functions. [47] The term physiology was introduced by the French physician Jean Fernel (1497–1558). [48] In the 17th century, William Harvey (1578–1657) described the circulatory system, pioneering the combination of close observation with careful experiment. [49] In the 19th century, physiological knowledge began to accumulate at a rapid rate with the cell theory of Matthias Schleiden and Theodor Schwann in 1838, that organisms are made up of cells. [48] Claude Bernard (1813–1878) created the concept of the milieu interieur (internal environment), which Walter Cannon (1871–1945) later said was regulated to a steady state in homeostasis. In the 20th century, the physiologists Knut Schmidt-Nielsen and George Bartholomew extended their studies to comparative physiology and ecophysiology. [50] Most recently, evolutionary physiology has become a distinct subdiscipline. [51]


LATERAL ANKLE-LIGAMENT SPRAINS AND INSTABILITY

The main lateral soft tissue stabilizers of the ankle are the ligaments of the lateral ligamentous complex: the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). In the neutral position, especially when coupled with compressive loads during weight bearing, the bony architecture of the ankle joint greatly assists with stability. 15 As the foot goes into plantar flexion, thereby dissociating the bony talar contribution to talocrural stability, the ligamentous structures assume a greater role in providing stability and are more susceptible to injury.

The ATFL is a small thickening of the tibiotalar capsule. When the foot is in plantar flexion, the ligament courses parallel to the axis of the leg. 16 , 17 Because most sprains occur when the foot is in plantar flexion, this ligament is most frequently injured in inversion sprains. The CFL and PTFL are less commonly injured. 18 , 19 Rupture of these ligaments typically occurs in more severe injuries, as the inversion force continues posteriorly around the ankle after the ATFL is sprained. Isolated injuries of the CFL can occur when the ligament is under maximum strain with the foot in dorsiflexion but are infrequent. Isolated injuries of the PTFL are extremely rare. Most injuries to the PTFL occur with very severe ankle sprains in which both the ATFL and CFL have been torn, and the forces continue around the lateral aspect of the ankle. Broström 18 found that isolated, complete rupture of the ATFL was present in 65% of all ankle sprains. A combined injury involving the ATFL and the CFL occurred in 20% of his patients.

The extent of tissue damage that occurs during an injury depends on the direction and magnitude of the forces and the position of the foot and ankle during the trauma. Ankle sprains occur significantly more often in athletes who have had previous ankle sprains. 20 Pes cavus, rearfoot varus, tibial varus, and previous trauma are factors that may contribute to ankle-inversion injury, although none of these have been scientifically verified as contributing factors.

Evaluation

The most common mechanism of injury is an athlete who “rolled” over the outside of his or her ankle (Figure ​ (Figure1). 1 ). This usually occurs as either a noncontact injury or when the athlete lands from a step or jumps onto an opponent's foot with an inverted foot. The foot is usually plantar flexed at the time of the injury. Many patients state that they have heard something “snap” during the trauma however, feeling a tearing sensation or hearing a snap does not appear to correlate with the severity of the injury. 8 The main site of pain and swelling is usually localized to the lateral side of the ankle over the ATFL. Several hours after the injury, generalized swelling and pain can make the evaluation more difficult and less reliable. Most patients have pain and discomfort when trying to ambulate on the injured extremity. Ecchymosis can occur 24 to 48 hours after the injury. The discoloration is usually worst along the lateral side but can also occur in the retrocalcaneal bursal area and along the heel because of the potential space available for swelling and the pooling effect of gravity. It is important that the entire leg, ankle, and foot be examined to ensure that no other injuries have occurred. With tenderness over the midshaft of the fibula or medial-side tenderness and swelling, the examiner should be suspicious of fracture or more significant injury.

Typical ankle-inversion injury. Note the plantar-flexed ankle.

Clinical stability tests for ligamentous disruption are best performed between 4 and 7 days after the injury, when the acute pain and swelling are diminished and the patient is able to relax during the examination. 21 The anterior drawer test is more specific for assessing the integrity of the ATFL, and the talar tilt test is more specific for detecting injury to the CFL. These findings are best recorded as differences between the ankles (assuming the opposite ankle is uninjured), but the tests can still be difficult to interpret, and the results often vary greatly among examiners. 22 , 23 Caution must be exercised in interpreting these tests, but a positive test can help to confirm the diagnosis in a patient with a suspicious history. 18 , 24 , 25

The anterior drawer test evaluates ATFL integrity by the amount of anterior-talar displacement that can be produced in the sagittal plane. To perform this test, the patient should be sitting with the knee flexed to relax the calf muscles and prevent the patient from actively guarding against the examiner. The examiner grasps the heel firmly in one hand and pulls forward while holding the anterior aspect of the distal tibia stable with the other hand (Figure ​ (Figure2). 2 ). The sensitivity of the test can be improved by placing the ankle in 10° of plantar flexion. 26 Increased anterior translation of the talus with respect to the tibia is a positive sign and indicates a tear of the ATFL, particularly if the translation is significantly different from the opposite side. However, how much translation is physiologically normal is the subject of disagreement: it has been reported to be anywhere from 2 mm to 9 mm. 27 , 28 Therefore, it is better to compare the amount of pathologic anterior laxity with the normal side. This analysis by the examiner is subjective, and agreement among observers varies.

Anterior drawer test. The ankle is held between neutral and 10° of plantar flexion, and the calcaneus is pulled anteriorly while the tibia is held stable.

The talar tilt test is defined as the angle produced by the tibial plafond and the dome of the talus in response to forceful inversion of the hindfoot. The talar tilt test is performed with the ankle in the neutral position. The examiner holds the heel stable while trying to invert the heel with respect to the tibia (Figure ​ (Figure3). 3 ). It is important to try to grasp the talus and calcaneus as a unit to limit subtalar motion during the test. As in the anterior drawer examination, the results from the talar tilt test are difficult to interpret, with reports indicating normal values between 5° and 23°, 29 , 30 but as a general rule, more than 10° difference from the normal side is considered abnormal. 31

Talar tilt test. The calcaneus and talus are grasped as a unit and tilted into inversion. The tibia is held stable with the ankle in neutral dorsiflexion.

A new testing device developed by Kirk et al 32 applies standardized loads for both the anterior drawer and talar tilt tests. At an anterior force of 111 N (25 lbs) and a torque of 16 Nm, the mean anterior-drawer translation was 5.9 mm, and the mean talar-tilt translation was 51°. The device has not yet been adopted into widespread use.

Radiographic Analysis

Clinical guidelines for determining the necessity of radiographs have been developed to limit the number of radiographs. These guidelines carry tremendous potential for cost savings. The Ottawa Ankle Rules (OAR) are the commonly used criteria for predicting which patients require radiographic images. 33 Radiographs are only required for those patients with (1) tenderness at the posterior edge or tip of the medial or lateral malleolus (2) inability to bear weight (4 steps) either immediately after the injury or in the emergency room or (3) pain at the base of the fifth metatarsal. Following these rules provided nearly 100% sensitivity for detecting fractures while significantly reducing the number of unnecessary radiographs. 33 Standard radiographs, if necessary, should include anteroposterior (AP), lateral, and mortise views. The mortise view is an AP view with the tibia internally rotated by 15° to 20°. This position allows evaluation of the syndesmosis and assessment of mortise disruption. In the mortise view, the talus should be equidistant from both malleoli.

Stress radiography for acute injuries will not change the treatment protocol and is generally not indicated. These techniques are more often used for research purposes or to differentiate between mechanical instability and functional instability in patients with chronic ankle problems. Specialized instruments have been developed to apply standardized loads during the stress radiographs. The anterior-drawer stress radiograph is more sensitive for ATFL insufficiency, and the talar-tilt stress radiograph is more sensitive for CFL integrity. However, the amount of displacement that represents a pathologic condition is variable. The most commonly used criteria for the anterior-drawer stress test are those of Karlsson, 31 who defined abnormal laxity as an absolute anterior displacement of 10 mm or a side-to-side difference of more than 3 mm (Figure ​ (Figure4). 4 ). Abnormal talar tilt is even more controversial due to the large variation in “normal” talar tilt, which is reported to be from 0° to 27°. 19 , 31 , 34 , 35 A talar tilt of 15° more than the normal side correlated with a complete double-ligament rupture (ATFL and CFL). 19 As a general rule, a finding of more than 10° greater than the normal side is considered abnormal (Figure ​ (Figure5 5 ). 28

Anterior-drawer stress test. A, schematic drawing, and B, radiograph. (Copyright 2002 by the Hughston Sports Medicine Foundation, Inc).

Talar-tilt stress radiograph. (Copyright 2002 by the Hughston Sports Medicine Foundation, Inc).

If the results of the 2 stress-radiographic images are combined, the sensitivity of the tests increases to 68%, but the specificity falls to 71% 21 therefore, it is difficult to recommend routine use of stress radiography.

Ankle-joint arthrography is a sensitive and specific diagnostic test for ligament ruptures, 36 , 37 as shown by Lahde et al, 22 who studied 7000 ankle arthrographies performed over a 15-year period. But they also found limitations of arthrography: it is reliable only within the first 24 to 48 hours, cannot quantify the severity of ligament damage, and is an invasive procedure. Proper interpretation of arthrographic images requires a full understanding of the variant and natural leakage of contrast. Arthrography is a valuable research tool, but it is rarely indicated for clinical use because it does not change the treatment protocol.

Similarly, magnetic resonance imaging (MRI) and computed tomography (CT) scanning are rarely necessary for typical acute ankle sprains because the results do not affect the treatment protocol. Gaebler et al 19 compared intraoperative findings with MRI results in 25 patients who had a talar tilt greater than 15° and found that MRI was reliable in diagnosing lateral-ligament injuries. Magnetic resonance imaging and CT scanning have been useful for identifying osteochondral injuries that may mimic, or occur in conjunction with, chronic lateral ankle instability. 38

Grading Lateral Ankle-Ligament Sprains

Several lateral ankle-ligament grading systems have been used. This makes comparison in the literature difficult, as many authors did not state which grading system they used. The traditional grading system for ligament injuries focuses on a single ligament, with a grade I injury representing a microscopic injury without stretching of the ligament on a macroscopic level. A grade II injury has macroscopic stretching, but the ligament remains intact. A grade III injury is a complete rupture of the ligament. 31 Applying this grading system to lateral ankle-ligament sprains addresses only the status of the ATFL and ignores injury to either the CFL or PTFL. Some authors have thus resorted to grading lateral ankle-ligament sprains by the number of ligaments injured. 18 , 19 , 24 The major drawback to this system is that, unless the injury is treated surgically, objective evidence of injury to each ligament is lacking. Finally, because of the problems of these grading systems, a classification based on clinical severity has been used. This system has 3 clinical grades: grade I (mild), grade II (moderate), and grade III (severe). 16 , 17 A grade I injury involves little swelling and tenderness, minimal or no functional loss, and no mechanical joint instability. A grade II injury has moderate pain, swelling, and tenderness over the involved structures some joint motion is lost, and joint instability is mild to moderate. A grade III injury is a complete ligament rupture with marked swelling, hemorrhage, and tenderness function is lost, and joint motion and instability are markedly abnormal. Grading of ankle sprains remains a largely subjective interpretation, and agreement among independent observers varies.

Differential Diagnosis

Other problems can mimic, or be coupled with, lateral ankle-ligament sprains. Fractures of the ankle are often associated with ankle-ligament injuries. 12 In particular, the examination should focus on potential fractures of the lateral, medial, and posterior malleolus proximal fibula lateral or posterior process of the talus anterior process of the calcaneus fifth metatarsal navicular or other midtarsal bones and children's epiphyseal separations.

Patients with stress fractures about the ankle joint may present with a different type of history but similar symptoms. In particular, a transverse, proximal diaphyseal fracture of the fifth metatarsal bone (Jones fracture) can mimic an acute lateral ankle sprain. 33 This is particularly true when an acute fracture occurs through an area of previous stress reaction that may have had minimal or no symptoms. The distal fibula, medial malleolus, calcaneus, navicular, and metatarsals are also prone to stress fracture.

Osteochondral fractures or osteochondritis dissecans of the talar dome or the tibial plafond can occur with lateral ankle-ligament sprains. 38 These fractures can become chronic problems, with continued pain and recurrent instability episodes. If plain radiographs are negative despite continued pain, a bone scan, CT scan, or MRI may be helpful to evaluate for this lesion. 38 Arthroscopy is the definitive test for the diagnosis and treatment of these fractures.

Athletes with sprains of the subtalar joint or midfoot ligaments can present with a similar history. 39 In particular, the dorsal calcaneocuboid ligament, bifurcate ligament, cervical ligament, and interosseous talocalcaneal ligament are prone to injury.

Subluxation or dislocation of the peroneal tendons can mimic an ankle sprain. 40 However, these injuries typically occur by a violent dorsiflexion and pronation moment of the ankle instead of the typical inversion injury of lateral-ligament injuries. 40


The First Telephone Book Had Fifty Listings and No Numbers

We know exactly when the now-defunct expression “I’m in the book” became a saying: 1878.

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Since the advent of the internet, the print phone book has largely become an artifact of a past age. At least one city has attempted to ban the phone book’s yellow pages on environmental grounds. But in February 1878, the phone book was cutting-edge technology.

First published on this day in 1878, the telephone directory widely considered to be the absolute first phone book was nothing but a sheet of cardboard with the names of both private people and businesses who had a telephone.

The fact that there were 50 people to call in New Haven, Connecticut in 1878 definitely had something to do with the fact that the telephone was invented near there less than two years previously and was first demonstrated by inventor Alexander Graham Bell in New Haven.   

George Coy, who founded the New Haven telephone network, saw a Graham Bell demonstration in April 1877.  Writing for the University of Connecticut’s archive blog, Laura Smith tells the story of how Coy, employed by a local telegraph company, turned that demonstration into the world’s first telephone exchange.

In November 1877 he was awarded a Bell telephone franchise for New Haven and Middlesex counties and spent the next two months getting partners and financial backing. On January 28, 1878, the New Haven District Telephone Company, in a rented storefront office in the Boardman Buiilding at the corner of Chapel and State Streets, opened for business with 21 subscribers, each of whom paid $1.50 per month for the service.

That number had ballooned by the time the directory came out. Coy’s network was made possible by the switchboard, which he invented to accommodate multiple call locations. Before that, Smith writes, the first telephones were privately used on direct lines.

The header of the first telephone directory ever. (Archives & Special Collections at the Thomas J. Dodd Research Center, University of Connecticut Libraries)

Telephones—and telephone books—quickly caught on, and the first New Haven telephone book that was more than just a sheet of cardboard was published in November 1878. In 2008 a copy of that book made headlines when it was  sold at auction for $170,500.

As author Ammon Shea  told Jason Zasky for Failure Magazine, early phone books looked a little different than the ones published today (although it’s not likely you have regular contact with one of those either.)  For one thing, they often had instructions explaining how a telephone was used. “When people first started using the telephone they would often yell into the wrong part,” Shea said. And when they did get on the phone, they had to figure out what to say to start a conversation: “Ahoy” was Alexander Graham Bell’s preferred option.

It’s not actually that strange that the first phone book had only the name of the person whose phone it was, Shea said. People resisted the idea of actually dialing a number themselves well into the twentieth century, preferring to speak to the switchboard operator and have that person direct their call.

About Kat Eschner

Kat Eschner is a freelance science and culture journalist based in Toronto.


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