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Introduction to Anatomy and Physiology (HK24CY005)

Anatomy is about discovering how we are made, and where the different organs and

parts of our body are located.

Physiology is about understanding what the different organs do and how they inter-

relate with other parts of the body.

We are all made up of the same materials, yet each one of us is truly unique. This is one

of the miracles of life – how there can be so many variants, even though we all (well,

most of us) have two eyes, a nose a mouth and two ears. So what is it that makes our

bodies how they are? Let’s start with the basic building blocks:

Cells are the basis of all our bodies. They knit together to form all the

different structures, tissues and organs that we need to function. The

structure of a cell includes a nucleus, surrounded by protoplasm,

encased by a cell membrane. Different cells have specialist functions,

depending on the job they are required to do, and as a result, may also

have different shapes, and may be referred to as specialised cells.

Tissue is the collective term for a mass of cells specialised to perform a

particular function. Most people think of tissue as soft, like skin or

muscle, but tissue can be any part of the body. Different types of tissue

are bone, cardiac, muscular, nervous, blood, connective or subcutaneous

(tissue that lies under the skin). Different types of tissue are needed for

the different jobs they have to do.

Organs are complex structures that have a specific function. They are

composed of more than one type of tissue. Better known organs

include: the heart, lungs, eyes, kidneys and brain. Without organs, life

would either be very difficult, or impossible. This is why in many cases

organs come in pairs, so that if one fails, the other can take over the

whole job.

Systems encompass a group of organs and tissues, all functioning

together to accomplish their task. So the circulatory system

would include the heart (organ) and all the arteries, veins and

blood (tissues). The respiratory system would include the lungs

(organ), bronchial tubes and trachea (tissues). The nervous

system would include the brain (organ) the spinal cord and all the

nerves that branch off it (tissues).

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All the body’s systems are connected to each other via the Central Nervous System

(CNS). This enables each independent system to react to the needs of the body and

keep it in optimum condition.

Anatomical Terms of Reference

To make things easier when describing positions of the body, clinical terms of

reference have been devised that are used by all health professionals. All descriptions

of the body assume that the person is standing in the anatomical position. This is

standing erect, head, eyes and toes directed forward, the heels and toes together. The

upper limbs are hanging by the sides with the palms of the hands facing forward.

Median Plane: this is when the body, positioned in the anatomical position, has been

divided longitudinally down through the midline, separating the body into right and left

halves.

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In addition to the diagram, and particularly for Reflexologists:

Plantar – is the sole of the foot

Dorsal – is the upper area of the foot and hand

Palmar – is the palm area of the hand

Terms of Movement

Flexion: bend or flex a limb forward Extension: increase the angle of a joint

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Abduction: move away from the midline Adduction: move closer to the midline

Plantar flexion: flexing foot toward the

ground

Dorsiflexion: bending foot up

Supination: to turn the palm up Pronation: to turn the palm down

Inversion: turning towards the centre Eversion: turning outwards away from

centre

Rotation: to move a bone around its

longitudinal axis

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Cavities of the Body

The body is divided into four main areas: the cranial, thoracic, abdominal and pelvic

cavities.

Cranial Cavity – this is bordered by the

skull and contains the brain.

Thoracic Cavity - this is the upper part of the

trunk. It is bordered by the sternum (anteriorly),

the ribs with associated intercostal muscles and

costal cartilages, the thoracic vertebrae

(posteriorly), the root of the neck (superiorly),

and the diaphragm (inferiorly).

The main organs located in the thoracic cavity are

the lungs and heart.

Abdominal Cavity – this cavity forms the main part of the trunk and is the largest body

cavity. It is bordered by the diaphragm (superiorly), the muscles of the anterior

abdominal wall (anteriorly), the lumbar vertebrae and muscles of the posterior

abdominal wall (posteriorly), the lower ribs and muscles of the abdominal wall (laterally),

and inferiorly it is continuous with the pelvic cavity. The main organs and associated

structures found in the abdominal cavity are: the stomach, small intestine and most of

the large intestine, the liver, gall bladder, bile ducts, pancreas, spleen, the kidneys, and

the adrenal glands.

The anterior abdominal cavity The posterior abdominal and pelvic cavities

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Pelvic Cavity - this cavity is situated

below the abdominal cavity. It borders

with the pubic bones (anteriorly), the

abdominal cavity (superiorly), the

sacrum and coccyx (posteriorly), the

innominate bones (laterally) and the

muscles of the pelvic floor (inferiorly).

It contains the sigmoid colon, rectum,

anus, some loops of the small intestine,

the urinary bladder, and the lower

parts of the ureters and the urethra. The pelvic cavity also contains part of the

reproductive system, so varies in the male and female. The female pelvic cavity also

contains the uterus, uterine tubes, ovaries and vagina.

The male pelvic cavity also contains the prostate

gland, seminal vesicles, spermatic cords, deferent

ducts (vas deferens), ejaculatory ducts and the

urethra.

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Homeostasis (3.1)

You will frequently hear therapists say that the goal of their treatment is to bring

about homeostasis. But what do they mean? In simplistic terms they want to bring

about a state of balance and harmony to the body. Homeostasis is a physiological

process by which the internal systems of the body (e.g. blood pressure, body

temperature, and acid-base balance) are maintained at equilibrium, despite variations in

the external conditions. In other words, the internal environment (i.e. what is going on

inside the body) needs to be kept within certain parameters for the body to remain

healthy. Lots of factors outside the body (the external environment) may influence

how the body functions, and the body may need to overcome these factors to work

efficiently.

Example:

The body wants to maintain a constant temperature of approximately 36.8°C.

On a very hot day, the body needs to cool itself, to prevent

the core temperature from rising. It can do this by sweating

and re-directing blood flow to just under the skin, to try and

lose heat from the blood.

Conversely on a very cold day, the blood flow is directed away from the

skin to the vital organs in order to conserve heat, and shivering may occur

which helps to generate heat. These mechanisms are homeostatic

processes to try to keep the internal environment stable when the

external environment varies.

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ORGANISATION OF THE BODY

Cells

Every living organism is made from a collection of cells, each evolving to carry out

specific functions and becoming a specialised cell. When cells group together, they

form specialised tissues. The cell is the smallest living organism in the body and,

depending on its structure, will have a specific job to do. The proper term for the study

of cells is “cytology”.

Below is a generalised picture of a cell to show the different possible organelles that

could be present.

Organelles of a Cell

Each cell consists of an outer membrane and inside this is a gel-like fluid called

cytoplasm in which float many different organelles. The organelles are like ‘little

organs’, each having a specific job to do in order for the cell to function. The largest

of all the organelles is the nucleus, and the nucleus contains the cells genetic material,

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the DNA. The nucleus is the control centre directing the functions of the cell. The

membrane of a cell is semi-permeable - it will allow certain substances to pass through,

so that it can obtain the substances it requires from its environment (and expel waste

products). However, the membrane is impermeable to some substances, in order to

protect the cell.

The amount of organelles in a cell will vary, depending upon the cell’s functions. All

body cells contain a nucleus, with the exception of red blood cells (erythrocytes).

Skeletal muscle cells may have several nuclei, and very active cells such as liver, muscle

and spermatozoa will contain large numbers of mitochondria (which are required for

energy production). Certain body cells may have projections on their plasma membrane,

called cilia to help them expel foreign particles, such as those found in the respiratory

tract. The cells of the body can adapt in shape, function and content, to better enable

them to perform the specific tasks which they are required to do.

Cell Reproduction

All cells grow and die, so for the body to remain healthy, cells need to renew

themselves.

All body cells, with the exception of the reproductive cells, have diploid (or two

complete sets) of chromosomes, called somatic cells. Human cells contain 46

chromosomes in each. However, the reproductive cells (spermatozoa and ova) contain

only 23 chromosomes in each.

The way a somatic cell reproduces is by splitting into two, thereby ending up with a

perfect copy of itself. This process is called mitosis and it takes about two hours from

start to finish.

A different process called meiosis creates the reproductive cells (spermatozoa and

ova). Rather than an exact copy of the original cell being produced by splitting, a more

complicated procedure occurs where the DNA strands swap some of their genetic

material, creating new combinations, so that all the spermatozoa and ova have a

different combination of DNA, which enables new individuals to be born following

sexual reproduction.

How Does a Cell Get its Energy?

A cell cannot eat, as we would define eating. The materials/substances a cell needs have

to pass through the cell membrane and, depending on the substance, this is done in

various ways. These processes are also used to enable the cell to get rid of waste

products.

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Transportation of Substances Across Cell Membranes

It is in the nature of all gaseous or liquid substances to want to spread out and fill the

space they are in. If there is a high concentration of a substance in an area, but a low

concentration of that same substance in an adjoining area, it will move down its

concentration gradient (like going downhill) until there is an equal concentration of it in

both areas (this is called equilibrium). This ability of substances to move forms the

basis of how substances can transfer across the cell membranes.

The simplest way for a substance to cross the membrane is by diffusion. This is the

movement of a substance down its concentration gradient, provided the membrane is

permeable to the substance. The movement of water is known as osmosis, which is a

type of diffusion.

Sometimes a cell requires substances to pass through their membrane, against their

concentration gradient. This cannot occur passively, therefore it requires energy to

move the substances, and this type of movement is called active transport. One major

type of active transport used by the body is the sodium-potassium pump. Active

transport is particularly important in maintaining a charge on the cell membrane,

required for nerve impulse transmission.

Some particles are too large to pass across a cell membrane, so instead the cell has to

engulf the particle; this is called endocytosis, of which there are two types: pinocytosis

for small particles; or phagocytosis for larger particles (such as cell fragments, foreign

materials or microbes). Particles may be brought into the cell for digestion, or

destruction. The reverse of this, to expel particles from the cell is called exocytosis.

Body Fluids

The human body is largely made up of fluids, 60% of the average weight of an adult

being water. Children, babies and underweight adults have a higher proportion of

water, whereas obese people and the elderly have a lower proportion of water. About

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22% of this water is extracellular (i.e. outside the cells) and 38% of it is intracellular

(i.e. inside the cells). Many functions of the body take place in a fluid environment. It

is important; therefore, that we take in sufficient water for our bodies to function

properly, and that the concentrations of body fluids remain at the correct levels for

these bodily functions to work properly.

Extracellular Fluid (ECF)

The main extracellular fluids of the body are: blood, plasma, lymph, cerebrospinal fluid

and interstitial/intercellular fluid (this is the tissue fluid that bathes all cells of the

body, with the exception of the outer layers of the skin). Other extracellular fluids

found in lesser amounts are: synovial fluid (joint fluid), pericardial fluid (around the

heart) and pleural fluid (around the lungs). The interstitial fluid delivers nutrients to

the individual cells of the body, and all other fluids have equally important rolls. The

composition of each of the different fluids vary, however, the exact composition of

each is essential to the job that fluid performs. The body, therefore, has many

homeostatic mechanisms in place to keep body fluids at the correct composition.

Intracellular Fluid (ICF)

The composition of the fluids inside the cells is quite different from the fluids outside

the cells. This difference is maintained largely by the sodium-potassium pump and this

is needed for the correct functioning of the cells (especially muscle and nerve cells).

The cell membrane is also selectively permeable, i.e. it only allows certain substances to

pass through it, which also helps maintain the differences. Inside the cells the

potassium, ATP (energy source), and protein is higher than outside, whereas the sodium

levels are higher outside the cells.

These three pictures show how body cells can be affected if the extracellular fluid

concentrations are not correct.

A – The fluid is at the right concentration so the cell can function

properly.

B – The fluid is too dilute and water goes into the cell. There is a risk

that the cell may burst.

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C – The fluid is too concentrated and fluid leaves the cell. The

intercellular fluid would no longer contain sufficient water to enable cell

functions to occur and the cell would die.

pH of Body Fluids

pH is measured on a scale of 0 to 14. The pH of a fluid is 7 if the fluid is neutral, e.g.

water, below 7 if it is acidic, e.g. hydrochloric acid, or above 7 if it is an alkali (also

called a base), e.g. ammonia solution.

Chemical reactions occur at specific pH values, but if the pH is wrong, then these

reactions either don’t happen, or are less efficient. Our bodies function as a result of

lots of chemical reactions, which means that the pH of fluid must be within a specific

range for particular reactions to occur. Therefore, different body fluids are

maintained within certain ranges to enable reactions to occur within those tissues.

Below is a table containing the pH values of some of the more common body fluids. Note

that gastric juice found in the stomach is highly acidic (i.e. a low pH value). This is

important for activation of certain enzyme reactions in the stomach and it is also good

at killing invading micro-organisms (bacteria/viruses/fungi) which may have been

ingested in our food, helping to keep our bodies safe from infection.

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Tissues

There are various types of tissue found in the body, each

having specialised functions. The proper term for the

study of tissues is histology.

Epithelial Tissue (Soft Tissue)

Epithelial tissue covers the body surfaces (internal and

external), lines hollow organs, cavities and ducts, and it

forms glands. Its functions therefore include protection,

absorption, filtration and secretion, depending upon its

location. Epithelial tissue may be either wet (such as that

which lines our mouths) or dry (waterproof and found on

the top layer of skin).

A variety of different epithelial cell shapes can be found:

squamous, cuboidal, columnar and transitional. Epithelium

varies depending on its function, and is sometimes only a

single cell layer thick (simple) e.g., found in the alveoli; or

may be several layers thick (stratified), e.g. in the skin.

Some epithelium may be specialised to change shape

(transitional), e.g. found in the bladder; or have projections

on to help move particles (ciliated), e.g. found in the

fallopian tubes.

Connective Tissue

Connective tissues are the supporting tissues of the body. They provide protection,

transport, binding, structural support or insulation. The cells in connective tissue are

surrounded by a matrix made up of protein fibres and a fluid, gel or solid ground

substance, which determines whether the tissue is a liquid, semi-solid or liquid. There

are many types of connective tissue:

Areolar (or loose) connective tissue

Adipose tissue

Lymphoid tissue (reticular tissue)

Yellow elastic tissue (elastic connective tissue)

White fibrous tissue (dense regular connective tissue)

Bone

Blood

Hyaline Cartilage

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Yellow elastic cartilage (elastic fibrocartilage)

White fibrocartilage

Nervous Tissue (Soft Tissue)

Nerve tissue is arranged in bundles of fibres composed of nerve cells. These fibres run

throughout the body like an electrical wiring system, and send the brain information

about the state of the body and its environment. Further information is found in the

session on the ‘Nervous System’.

Muscular Tissue (Soft Tissue)

There are three types of muscular tissue:

Striated

Smooth

Cardiac

Further information is found in the session on the ‘Muscular System’.

Tissue Regeneration

Some body tissues get worn out and need to regenerate. This requires new cells to be

produced. The actual function of the tissue will determine whether or not they can

regenerate.

Some tissues have a high turnover of cells, so they need to replicate continuously in

order to replace the cells that are dying, e.g. skin and mucous membranes. Some cells

of the body although they can still replicate, they do so more slowly, e.g. the liver,

kidney and smooth muscles. Certain types of tissue cannot regenerate, e.g. nerve cells,

skeletal and cardiac muscles cells. In situations where these tissues are damaged, and

the normal tissue cells cannot be replicated, cellular replacement is usually by fibrous

tissue. This reduces the functionality of the particular tissue.

Types of Membrane

Membranes are thin sheets that line cavities, cover surfaces and provide protective

layers around organs. They can either be epithelial membranes or connective tissue

(synovial) membranes.

Mucous membrane (mucosa) – this is a moist

epithelial membrane. Goblet cells in the

epithelial layer secrete a fluid called mucous.

This fluid prevents the membrane from drying

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out and also acts as lubrication, protecting against mechanical and chemical injury to

the underlying cells. In the respiratory tract, mucous helps trap foreign particles so

that they can be expelled. Mucous membranes line body cavities that open to the

exterior, so they are found in the digestive, respiratory, urinary and reproductive

systems.

Serous membrane (serosa) – this is also an

epithelial membrane. With serous membranes

there are two layers of areolar connective

tissue lined by a simple squamous epithelium.

Between the two layers a serous watery fluid is

secreted. The two layers are called the parietal

layer (lines a cavity) and the visceral layer

(surrounds the organs). The fluid between the

layers enables an organ to glide freely within a

cavity without being damaged by friction, so

these membranes are found around organs which need to change shape, such as around

the heart (the pericardium), the lungs (the pleura) or the abdominal cavity (the

peritoneum).

Synovial membrane – is a connective tissue membrane. It is

made up of areolar connective tissue, elastic fibres and fat.

Synovial fluid (a clear, sticky, oily fluid) is secreted into the

cavity that the membrane is lining and acts as lubrication for

movement or cushioning. Synovial membranes are found

lining the cavities of freely moveable joints and surrounding

the tendons, preventing damage from rubbing.

Glands

Glands are a group of epithelial cells secreting specialised substances. They are divided

into two specific types:

Endocrine glands – secrete their substances (hormones) directly into the blood or

lymph. Further information is found in the session on the ‘Endocrine system’.

Exocrine glands – discharge their secretions via a duct, or directly onto the epithelial

surface of a hollow organ. Secretions of exocrine glands include: mucus, digestive

juices, saliva and earwax.

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Systems of the Body

The body is split into several systems according to the type of function they do. We

will be studying the following systems:

Digestive

Exocrine

Endocrine

Nervous

Skeletal

Muscular

Cardio-vascular and circulatory

Respiratory

Sensory

Integumentary

Immune

Lymphatic

Urinary

Reproductive

Although each system is studied separately, all the systems interact and are

interdependent on each other in order to allow the body to function. Below are some of

the ways the different systems interact.

The digestive system absorbs and processes food, and removes waste products. Every

cell of the body requires nutrients and energy, which are derived from food, and

removal of its waste, therefore the whole body is dependent (i.e. all other body

systems) on the digestive system functioning properly.

The respiratory system brings oxygen into the body, which all cells require to function,

and it removes carbon dioxide (waste gas) from the body, so again, every cell and

therefore body system is reliant on the respiratory system.

The cardiovascular/circulatory system is the body’s main transport system. It

transports nutrients, oxygen and waste products to all the cells, therefore enabling all

the cells to work efficiently. The digestive and respiratory systems could not get their

products to and from the cells without the circulatory system. It also transports white

blood cells and platelets, which are important for the body’s immunity. It also

transports chemicals and hormones, so aids the endocrine system.

The nervous system sends messages from the brain to control the body, so affects all

other systems.

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The endocrine system is another type of control system which sends hormones

(chemical messengers) around the body. All other body systems have some element of

hormonal control.

The exocrine system releases chemicals into organs or onto surfaces. Some of these

help with digestion, excretion, immunity, lubrication, so again, many parts of the body

have an exocrine function.

The skeletal and muscular systems closely interact for the movement of the body.

However, they both also offer some protection to the organs underneath. Smooth

muscles make up parts of the circulatory, respiratory, urinary, digestive and

reproductive systems. The heart is also a muscle, and there are even small muscles

found in the skin.

The integumentary system is mainly composed of the skin, which acts to protect the

rest of the body, as one of its many functions.

The sensory system informs the brain of what is going on in the external environment,

so allows the nervous and endocrine systems to exert their effects on all other body

systems in order for the body to adapt to its environment.

The urinary system functions to eliminate waste from the body. It therefore enables

the cells to function properly, as cells cannot function if there is a build-up of waste.

It also controls the water balance in the body, so assists the cardiovascular system.

The reproductive system brings about new life. It also is involved in the growth and

development and ageing processes that affect many parts of the body.

The immune and lymphatic systems act to protect the body from illness, so help to

keep the body working efficiently. The lymphatic system also works as a secondary

circulatory system, so transports substances from the tissues, fats from the digestive

system and immune cells back to the blood.

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HANDS AND FEET HK24CY005 1.1

The main structures found in the hands and feet are bones, muscles, tendons and

ligaments. There is also a nerve supply, blood supply, and lymphatic drainage. The outer

surface that is seen is covered in skin, which also has a covering of fine hairs, with the

exception of on the palms and soles. Therefore, as you can see there is an interaction

of many body systems in order for the hands and feet to function. For today, we shall

look at the bones, muscles, tendons and ligaments of the hands and feet, but more

detail of muscles and bones can be found in the lessons on those systems.

The muscles that can be found in the hands and feet are skeletal (or voluntary)

muscles, which move as a result of conscious nerve stimulus, received, from the brain.

The muscles attach to the bones via a tendon, which is made of connective tissue that

runs throughout the muscle and is an

extension of the muscular fascia and (see

muscular lesson), this allows the muscles

to be able to exert a force on the bones,

and thus the bones can move. The

muscles need to attach across a joint,

between two bones, in order that one

bone can move in relation to another bone.

Ligaments are also required, which are a

tough fibrous connective tissue. The

ligaments join bones to bones, and prevent

over movement at a joint.

There are many types of joints found in the human body

(see skeletal lesson), but those found in the hands and

feet are called synovial joints, which are freely movable

joints. In this type of joint, the ends of the opposing

bones are covered with hyaline cartilage, and they are

separated by a space called the joint cavity. The

components of the joints are enclosed in a dense fibrous

joint capsule. The outer layer of the capsule consists of

the ligaments that hold the bones together. The inner

layer is the synovial membrane that secretes synovial

fluid into the joint cavity for lubrication. There is more

than one type of synovial joint that can be found in the arms, hands, legs and feet:

Ball and Socket joints allow for very varied movement and are most

well known in the hip and shoulder. This kind of joint allows flexion,

extension, adduction, abduction, rotation and circumduction.

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Ellipsoid joints are like a ‘cut down’ version of a ball and socket

joint. This kind of joint is found in the wrist, but the amount of

movement is not so great as a ball and socket joint.

Hinge Joints allow movement in only two directions (flexion

and extension). Think of a door hinge and you will get the

idea! A good example of a hinge joint is in the elbow or knee.

These are also found in the fingers and toes.

Saddle Joints allow all movement, except rotation. Saddle joints

are so called, because both surfaces look like a saddle (one

inverted and rotated 90º on top of the other). A good example of

a saddle joint would be found in the base of the thumb.

Gliding joints are so called because they allow bones

to glide at their joints and they have flat articulating surfaces –

where small amounts of flexibility are needed. Reflexologists and

podiatrists are most familiar with the metatarsal joints found in the

feet.

The Hands

According to Smith (2006), “Our hands do so much for us. They are capable of a wide

variety of functions: touching, grasping, feeling, holding, manipulating, caressing, and

more. They are a vitally important part of who we are and how we see ourselves.”

Our hands require a large portion of the

functioning of our brain, in relation to their size,

because they are so important to us.

On the right, from Life’s Journey in Words (2011)

is a “homunculus, a representation of how our brain

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views our body. Tongue, face, fingers appear so huge because a bigger part of your

brain is devoted to their function and there are a huge number of sense receptors,

muscles, and nerves.”

Without the ability to hold objects and tools, the human race would not have developed

as it has done. Our hands can do both gentle actions and heavier labour. They also

contain many nerve endings so we can detect sensations. Without our hands, we would

not be able to perform a reflexology treatment. In addition, not only can the hands be

used to perform reflexology, but they also contain reflex points themselves, so

reflexology treatments can be done on the hands.

Structure of the Hand

Within the hands are many small bones, to allow for fine movements. Although there

are some muscles in the hands, much of the movement is created by muscles in the

arms, the tendons of which attach to the bones of the hands. This allows the hands to

be less bulky, and be able to grasp objects.

A mnemonic to help you remember the

bones:

Some Lovers Try Positions They Can’t

Handle

Or

Touching Toes Causes Happiness So

Let’s Touch Plenty

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Muscles which move the

forearm and wrist and their

action:

Biceps brachii - Flexes

and supinates forearm.

Flexes arm

Brachialis - Flexes the

forearm

Brachoradialis - Flexes,

semi-supinates and semi-

pronates the forearm

Triceps brachii - Extends

forearm. Extends arm

Pronator teres - Pronates

and flexes forearm

Pronator quadratus -

Pronates the forearm and

hand

Supinator - Supinates

forearm and hand

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In addition to the muscles shown in the above diagrams, it can be seen how the tendons

(shown as white) extend down into the hands and there is actually little muscle within

the hand. The flexor retinaculum is a band of ligaments around the wrist. The tendons

go beneath this band of ligament, so the ligaments hold the bones, muscles and tendons

in place during the movement of the wrist, hand and fingers.

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The Feet

The feet’s main function is to support the body and allow us to walk and run. Within

reflexology, we regard the feet as a very important area for treatment, since the

whole body can be mapped onto the foot - so just by working on the feet, the whole

person can be affected.

Structure of the Feet

The bones of the feet do not go flat to the floor - they have arches. The arches allow

an element of springiness to aid in walking and running. Like the hands, the feet also

have many small bones to allow flexibility, yet they are generally less flexible than the

hands, so less able to manipulate objects. Also, similar to the hands, only some of the

movement comes from muscles in the foot, as muscles in the legs (attached by tendons)

control many of the bones.

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Arches of the Feet

The reason our feet are arched is to better support the weight of the body whilst

standing, and also to add a degree of ‘springiness’ to better aid walking and running. The

arches are:

Medial Longitudinal Arch - which is found along the first three metatarsals, all three

cuneiforms, navicular, talus, and calcaneum.

Lateral Longitudinal Arch – which is found along the fourth and fifth metatarsals,

cuboid and calcaneum.

Transverse Tarsal Arch – which is found across the cuboid and all three cuneiforms.

Anterior Metatarsal Arch – which is found across all five metatarsal/phalangeal joints.

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Muscles which move the

foot and their action:

Tibialis anterior -

Dorsiflexes and

inverts foot

Peroneus tertius -

Dorsiflexes and

everts foot

Gastrocnemius -

Plantar flexes foot

and flexes knee

Soleus - Plantar

flexes foot

Plantaris - Plantar

flexes foot

Tibialis posterior -

Plantar flexes and

inverts the foot

Peroneus longus -

Plantar flexes and

everts the foot

Peroneus brevis -

Plantar flexes and

everts the foot

Diagram showing tendons and

bursae of the ankles.

Bursae

Bursae (singular form is bursa) are

found at points of friction in the

body. They are made of a synovial

membrane filled with a small

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amount of synovial fluid (so similar to a synovial joint). they can be found between bone

and another surface to such as tendons, ligaments or muscles. Bursae form a cushioning

to protect the bone and there are about 160 within an adult human body, some are

present at birth, but some develop later in life due to friction. In the above diagram,

the subcataneous calcaneal bursa and retrocalcaneal bursa can be seen which protect

the Achilles tendon where it attaches to the calcaneal bone. In addition to the bursae

shown above, bursae may form at any joints where there is too much friction, with a

common place in the foot for a bursa to be found being at the joint of the first

metatarsal with the distal phalanx of the large toe, and this bursa is commonly

referred to as a bunion.

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Macro Skeleton on Micro bones of Foot HK24CY005 2.2

Spine Arm

Ribs & arm Scapula, arm & pelvis

Head & jaw

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PRACTICAL REFLEXOLOGY – SESSION 2 (HK25CY008

The Reflexologist - Playing Detective!

As a Reflexologist, you begin to form an idea of a client’s state of health before they

even begin to answer questions on your Client Medical Form.

FIRST IMPRESSIONS

How do they walk towards you - are they limping, staggering, hesitant, confident,

twisted to one side?

The first glimpse of your new client may be when they are seated in the waiting room -

how do they rise?

Mentally note down everything you see and feel, intuitively, in that first meeting and

make notes later, so you have a comparison when they leave you, and on subsequent

visits.

FOOTWEAR

What sort of shoes are they wearing, if well worn, is one side worse than the other?

When they take their shoes off are they struggling? Do they fit properly? Look at the

dorsal aspect of the foot while they are standing, is it marked by the shoes, is it

veined, what colour is it?

HOW DO THE FEET LOOK?

Note:

The colour and pigmentation

The texture (dry, sweaty)

Any injuries (bruises, cuts)

Any foot conditions: ie bunions, verrucas, athletes foot, corns etc.

Any moles

Chilblains

Birthmarks

Cracks on heels or between toes

Dry flakes of skin

Oedema (swelling due to fluid)

Puffiness

Deformities

Amputations

Toenail conditions (fungal, thickened, discoloured)

Prominent veins/broken veins

Shape (broad/narrow/short or long toes – webbed toes)

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Arches (raised, dropped/fallen)

When looking at the feet, there are conditions that may be commonly seen during a

treatment session. The following conditions can indicate further problems that the

client may be experiencing:

Ingrown toenails can also be a sign of headaches

Fallen longitudinal arch can signal back problems

Foot odour can be a sign of poor toxin elimination

A bunion at the end of a big toe can signal neck problems (stiff)

Calluses on the four toes can be a sign of sinus congestion.

When viewing the spine reflex on the foot, it can give clues as to the condition of the

client’s spine:

A high medial longitudinal arch can represent lordosis

A large bunion can represent kyphosis

Deep lines across a reflex can represent previous injury/problems

When next looking at a client’s or classmate’s feet, see if you can observe something

unusual. Then, by looking at the foot chart, try to work out what area of the body you

are looking at, and what it could possibly represent.

There are many more noteworthy observations you can make, just be vigilant to any

changes from before the treatment, during the treatment and after the treatment.

HOW DO THE FEET FEEL?

Temperature - compare both feet

Are they damp, clammy? This can be a sign of toxin build-up in the client.

Are they cold? This could be a sign of poor circulation.

Are they rigid or relaxed? This can be a sign of the client’s personality.

HOW DO THE FEET SMELL?

Cheesy, vinegary, other?

Note any increase or change of odour as you work, this could indicate the release of

toxins or a hormonal imbalance.

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OTHER INTERPRETATIONS

Oriental Diagnosis, and various other schools of thought, put an interesting angle on

every visual aspect of the feet. They interpret every individual foot trait as an

emotional, hereditary or physical indicator as to that person's make up.

For example:

Dr Hirasawa from Japan reports a 90 per cent success rate using foot characteristics

as a diagnostic tool. The study of some 75,000 patients reveals that the toes are

particularly helpful in detecting illness and disease. He has found that a painful and

stiff big toe usually signifies liver trouble, in the second and third toe it signifies

stomach problems. Pain and stiffness in the fourth toe is related to spleen conditions

while the little toe suggests bladder problems. If one toe does not make contact with

the surface it can mean digestive or respiratory trouble. If all the small toes are

considerably shorter than the big toe there may be a problem with emotional

instability. Finally slippers which inhibit the use of heels can cause headaches!

There is more information on ‘reading feet’ which will be taught in session 5 - If this

aspect of foot observation fascinates you, then we also highly recommend a CPD course

with Jane Sheehan.

PRACTICAL TECHNIQUES HK25CY007/008

Breast / Intercostal reflexes

Working between the metatarsals is to work the

intercostal reflexes and the breast reflex. Finger walk

down, between the metatarsals, pushing against each

track of the metatarsal bones, two fingers at a time.

Start between the big and second toe, then work the next track and so on, until the full

width of the foot has been worked.

Next, snowplough down the entire length of the dorsal foot,

ensuring the fingers get right into the v-notch, which is the

groin/lymphatic reflex, then work across the v-notch with

both hands, simultaneously working under the medial and

lateral malleolus.

This ‘snowplough’ technique is excellent for lower lymphatic

drainage.

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When the right foot has been completed, do the same with the left foot.

Shoulder Reflex

The shoulder reflex is under the little toe (zone 5), and often

becomes disturbed, as this is where most people carry tension.

Start by thumb walking across the pad, under the little toe.

When you get under the pad, you are working the scapula.

When you have covered the area, work now in an upward

movement, so the whole of the shoulder reflex has been

worked in two directions.

Now work the same area, but on the dorsal aspect, and

work using the fingers. Remember that the area needs to

be worked first across, then from top to bottom. When

working top to bottom, use the middle finger and use a

rocking/hooking technique.

To finish the shoulder area, sweep with the edge of the

index finger, from the dorsal aspect, right round to the

plantar aspect. Start at the top and repeat these sweeps

until the diaphragm line is reached.

Once all this is done on the right foot, repeat on the left.

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Trapezius and Neck reflexes

These reflexes are worked by thumb walking over the top

pad of the foot, just underneath the toes. Thumb walk

from the lateral edge of the foot to the medial 3 times.

As you walk across, rock the foot onto the working thumb,

so the thumb pushes in easier.

Once you are thumb walking under the big toe, you are now

working the Thymus reflex, rather than the Trapezius.

The thyroid now needs working. This is found in the base of

the big toe, between the pad of the toe and the pad of the

foot. Work this area in a criss-cross pattern, so as to ensure

none of it is left out. Work using both thumbs in both

directions.

The neck is next, and we use a technique called ‘The Pinch

of Salt’. Finger hook-walk round the neck reflex, keeping

the thumb stationary. First work round the base of the big

toe, then in subsequent lines, work slightly higher each

time, until the 1st joint of the toe is reached.

Finally, it is time to work the ears and eye reflexes

of the right foot. Place the index finger over the

outer ear reflex first, rotate the finger as pressure

is applied. Then do the same for the inner ear reflex,

and then finish with the eye reflex.

With the right foot worked, it is now time to repeat

all this on the left foot.

33

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Mazzone, M. F. and McCue, T. Common Conditions of the Achilles Tendon. American

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