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Academic decathlon 2005

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Anatomy (Ana- apart; tomy- to cut)
and Physiology (Physio – nature;
ology- the study of)
Man’s measure of man; advances in medicine through
the Renaissance
Academic decathlon, 2005
Schools of thought in medicine
• Homeric and mythical (pre-460 BC)
– Apollo (Greek god of medicine); Ascelpius’ cult
– First medical schools: Cyrene, Crotona, Cnidus, & Cos
• Hippocratic (BC 460 – 50)
– Corpus Hippocraticum, significant speculation concerning
causes, Humoral pathology (blood, mucus, black and yellow
gall)
• Dogmatic (BC 460 – 50)
– Connection of symptom and disease; teleological arguments
(objects have properties by design)
• Alexandrian (BC ~300)
– Clinical experience by exact methods, opposed four
fundamental humors, as disease in solid parts
• Methodizers (~BC 120 – 700 AD)
– Disease is caused by a blockage of pores in the body, that
permeate all regions and produce sensation and function
Academic decathlon, 2005
The Early Anatomists
• Hippocrates (actually 7 people, the 2nd is famous)
– “Father” of western medicine (Born at Cos)
– Illness had a natural cause
– First to use observation of symptoms for
clinical diagnosis; “observe patients”
– No dissection
– Used diet to counteract disease
• Aristotle (dogmatic)
–
–
–
–
“Father” of comparative anatomy
“Father” of embryology
Distinguished nerves from tendons
Pre-formation theory
• Herophilus (BC ~ 300, Alexandrian)
– Structure and function of organs
– “Father” of neuroscience
• Erasistratus (BC 330 – 240, Alexandrian)
– First to map cardiovascular system
– Extensive mapping of the brain
• Differentiated cerebrum from cerebellum
Academic decathlon, 2005
Methodizers: Ancient Roman medicine
•Disease is a contraction or
relaxation of pores which
allowed fine atoms to pass
sensation to parts of the body
•Galen (c. AD 129 - 201)
•De usu partium (On the usefulness
of the body parts)
•Doctor to gladiators
•Dissected animals, not humans
•Laid groundwork for physiological
connections to anatomical design
–Diaphragm in respiration
•Clinical observation was key to
diagnosis
•His texts were the basis of western
medicine for 1500 years
•Not challenged until Vesalius,
Paracelsus, and Harvey (15501630’s)
Academic decathlon, 2005
Medicine in the Middle Ages
• Ibn Sina
(a.k.a. Avicenna,
980-1037 AD)
• The cannon of medicine
• Medical standard text until
the mid-1600’s
Significant advances in
pharmacology
• Compilation of Greek, Roman, & Persian medical knowledge;
information critical to survival of knowledge through the Dark ages
in Europe
Academic decathlon, 2005
Development of Medical knowledge
• Byzantine
– No advances, but saved ancient Greek texts of historical
value
• Arabian (AD 431 - ~750 - 1200)
– Significant increases in pharmacology, saved Greek and
Alexandrian anatomy
– Establishment of western medical schools by Charlemagne
(768-814)
• Scholastic (1200 – present)
– Establishment of School of Salerno (600 – 1100), Fall of
Moors in Spain (1085) allowed rise of Univ. Bologna
(~1200), Univ. Padua (1222), Univ. Montpellier (~1200).
Rise of surgery and dissection of cadavers. First since
Greece (Cos) and Alexandrian school.
• Pneumonic Plague (1346 – 1353)
– Epidemic: 25 million killed in Europe (100,000
Franciscan monks)
• Humanism (1500)
– Fall of Methodizer doctrine; challenge of Galen and Arabic
methodology and conclusions
– Use of empirical evidence and critical evaluation for
inductive reasoning for underlying causes of symptoms
Academic decathlon, 2005
Medical texts and information (700 – 1500)
• The information contained
within medical texts often lacked
a significant amount of detail
For example, diagrams within 15th century
medical texts, based on the works of Galen and
Ibn Sina, indicated a paucity of anatomical
understanding…
Academic decathlon, 2005
Galenic blood flow and the
cardiovascular system
• Three body centers:
– Liver (nutrition and growth)
– Heart (vitality)
– Brain (sensation and reason)
• Two types of blood
– Venous
• Nourishment from blood produced in the liver
– Arterial
• Vitality from blood produced in the heart
• Contained “pnuema” (spirituous air) that fed the body,
it does not return to the heart (no circulation)
• Heart does not drive blood: diastole (dilation)
sucked blood into the heart. Blood movement
by “pulsative faculty” within arteries
Academic decathlon, 2005
Galenic blood flow
•Blood from right to left side via invisible channels (pores) in
the interventricular septum
•Blood then “changed”
from venous to arterial
•Only enough blood to
nourish lungs leaves
right side of heart
•If air is necessary to make
arterial blood, how did air
get to the heart?
•Pulmonary vein conveyed air from the lung to the left side of
the heart.
–Mix of pneuma and blood in ventricle (bright versus dark red blood)
–By product “sooty vapors” that travel to the lungs via same
pulmonary vein, and are expelled
Academic decathlon, 2005
Anatomy in the Renaissance
• Leonardo da Vinci (1442 – 1519)
• Use of artists to display and
represent the human form
• Scale and perspective
Academic decathlon, 2005
da Vinci’s sketches of the human form
Academic decathlon, 2005
da Vinci’s sketches of the human form
Academic decathlon, 2005
da Vinci’s sketches of the human form
• Dramatic increases in accuracy
Academic decathlon, 2005
Sculpture and perfection in display of
the human form Michelangelo Buonarroti (1457 – 1564)
Sculpture added three
dimensionality to the
study of anatomy & muscle
sketches found in 1495 Academic decathlon, 2005
Influence of Renaissance artists
..
• Albrecht Durer (1471 – 1528)
There was a need for
perspective and scale
in the development of
accurate anatomical
plates
Academic decathlon, 2005
Andreas Vesalius (1514-1564)
• Founder of modern anatomy
• Significant advances in surgery
– Extensive diagrams & use of
technology (printing press)
1543: De Humani Corporis Fabrica
(On the Fabric of the Human Body)
Academic decathlon, 2005
Andreas Vesalius (1514-1564)
• De Humani Corporis Fabrica
• Second edition contained specific
corrections:
Septum of the heart for blood flow
Connections of the cardiovascular system
Dispelled venesection (blood-letting)
• The systemic, rational approach to solving
medical problems using careful observation
and critical thinking.
Academic decathlon, 2005
Role of institutions
• Students of Vesalius
• Michael Servetus (1511)
– Pulmonary circulation and
interventricular septum; burned at
the stake for heresy by John Calvin in
1553
• Realdo Columbus
– Coined “circulation” and linked
respiration to blood (1559),
pulmonary circulation
Academic decathlon, 2005
Anatomy in the 16th century
• Study of specific structures and systems
in the body & technology (microscopes)
– Hieronymus Fabricius (valves and circulation)
– Gabriello Fallopio (reproductive system, hearing)
– Bartolomeo Eustacius (sensory systems)
Academic decathlon, 2005
Advances in surgery
• Ambroise Pare (1510 – 1590)
• Field surgeon in Italy and France
• Gunshot wounds and arterial
hemorrhage
• Ended cauterization of wounds with oil
• Contused wounds were bandaged and ligature was used
to end hemorrhage
• Championed the use of artificial limbs
• Perfected lithotomy (kidney stone removal) and hernia
surgery
• Introduced podalic childbirth (feet first) and
manipulation of fetus in womb
Academic decathlon, 2005
Anatomy in the 17th Century
• Marcello Malpighi
• Father of cytology, histology, and
modern embryology
Academic decathlon, 2005
Circulation of blood
• William Harvey
– Essay on the Motion of the Heart and
Blood
Academic decathlon, 2005
Vessels and capillary beds
Academic decathlon, 2005
Anatomy in the 18th Century
• Henry Gray (1827-1861)
• Lecturer in Anatomy- St. George’s
• Published Gray’s Anatomy (1858)
– Diagrams by
Dr. H. VanDyke Carter
Academic decathlon, 2005
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