Art of Anatomy of the Lungs

Ashley Davidoff MD Copyright 2015

In this first part of the series on the anatomy of lungs we emphasize principles, and outline how structure is integrated with function, disease and diagnosis. The lungs are two huffing and puffing sponge-like organs that dominate the chest cavity, essential in their function as the principal structures of respiration.

“A Breath of Fresh Air in the Lungs and Airways”

shows a 3D image of the lungs created using CT scan technology

“The Lungs Breathing in the Rib Jungle CT-Scan”

show phases of respiration surrounded by the rib cage which has intimate involvement in the movement of the chest and lungs

In this first part of the series on the anatomy of lungs we emphasize principles, and outline how structure is integrated with function, disease and diagnosis.

The unique structural characteristics of the lungs include their:

1. dominance in the chest cavity
2. ability to accommodate the entire cardiac output with every heartbeat
3. asymmetric nature
4. irregular and dichotomous branch pattern of the bronchovascular bundle
5. tubular transport system, with a single system functioning for both delivery and removal
6. spongy air-filled character
7. pyramidal or cone shape
8. dual blood supply

The unique functional aspects include

1. ability to move air efficiently
2. ability to exchange gases efficiently

The Common diseases that affect the lung include

1. Infections such as pneumonia and bronchitis
2. Neoplasms such as malignant carcinoma
3. Mechanical disorders such as emphysema
4. Circulatory disorders such as pulmonary embolism, pulmonary hypertension, and cor pulmonale
5. Immune disorders such as allergic asthma

The tools used for diagnosis include

1. Clinical history taking and clinical examination
2. Lab investigation including blood gases and lung function tests
3. Imaging studies including chest X-ray and CT scan

Treatment options in the pharmacological armamentarium include

1. Antibiotics for infections
2. Chemotherapeutic agents for malignancies
3. Smooth muscle relaxants for diseases that cause muscle spasm
4. Anticoagulants for pulmonary embolism and antifailure therapy for cor pulmonale
5. Surgical options are widely used for diseases such as bronchiectasis, malignancy, and pleural disease
6. Minimally invasive options are used to plug and cement emphysematous lungs, coil arteriovenous malformations, drain pleural effusions and pneumothoraces.

An understanding of the unique anatomy and physiology of the lungs brings comprehension  of how diseases will affect the lungs, and how these changes will be manifest clinically, in the lab, and on imaging studies.  Consequently understanding extends to the diagnosis and then treatment of disorder in the lungs.

Structural features

A Page from the Story of the Lungs

The AiA collage shows the lung in multiple facets including the rhythmic motion of inspiration and expiration (first and second images top row) an anatomical specimen, (top right) a 3D view (first left middle row) an artistic rendering of the secondary lobule (middle of the middle row) an artistic rendering of the small airways (middle row right and bottom row left) and the alveolus (last row middle and right image).

Dominance in the chest cavity

 

“Chest of Fruit” – dominated by the lungs

 This AiA rendition of the heart and lungs uses the shape of fruit and vegetables to create an image of the chest. The lungs are made of grapes, the pulmonary arteries of carrots, the ribs of banana peel and the heart is made of a red pepper. This image reflects the concept of the parts making up the whole.

 

Ability to accommodate the entire cardiac output with every heartbeat

One Beat – An Entire Cardiac Output in the Lungs 

The AiA rendering uses the implied microscopic capillary connections in the pulmonary circulation and gives the intimacy a human context.  They transport a whole cardiac output within one beat of the heart. The pulmonary circulation consists of a pulmonary arterial system that receives deoxygenated (“blue”)  blood from the right side of the heart  and transports the blood to the lungs where it is oxygenated at the capillary level.  The pulmonary veins transport the oxygenated (“red”) blood back to the left atrium.  The artistic rendering  shows the delicate connections between the two circulations.

Asymmetric nature of the lungs and irregular and dichotomous branch pattern of the bronchovascular bundle

 

Asymmetric Branching and the Ginkgo Tree

The AiA rendering is from a coronal 3D reformat of a chest CT shows normal lungs and airways.  The right lung has 3 lobes while the left lung has two lobes.  The top left image shows the  irregular and dichotomous branch pattern.  At the first branch point, the right bronchus is short and fat and the left long and thin.  The CT scan is then turned upside down in the top right image so that tracheobronchial system looks like a tree stripped of leaves in the winter. With  digital rendering the image is shaped so the lungs reflect the character of the ginkgo leaves as part of the Gingko tree.

Function Exchange of Gases

“Alveolus Cells and Capillaries of the Lung” 

shows an alveolus with single cell lining and associated arteriole, capillary and venous circulation.  The cool fresh air flows into the alveolus, and oxygen flows into the blue blooded arteriole converting into a red blooded venule.  A breeze of carbon dioxide flows through the single celled alveolus and into the airways for expiration

The Common Diseases of the Lungs

“The Big and Black Lungs of Emphysema”

shows  the normal sized pink lungs surrounded by the progressively enlarging gray and then black lungs of smoking related emphysema. If only they could go back to they they were!

“Emphysema” 

shows normal structure of terminal airways and alveoli on the left and emphysema with dilated respiratory bronchioles and alveoli.  The left sided image is an artistic rendering of the normal terminal bronchioles and alveoli and shows normal lung  architecture.  The right image is an artistic rendering showing the ravages of the disease called emphysema caused by smoking. In this disease the small airways and alveoli lose their elasticity and get stretched evolving into larger and larger structures.  These small airways look like big berries on a dilated stalk (respiratory bronchiole)

“Emphysema; Lungs and Small Airways too Big” 

shows the principle of structures that are too big and therefore they cannot perform their function optimally.  The left sided image is a CT scan that shows normal lung  architecture.  The right image is a CT scan showing the ravages of the disease called emphysema caused by smoking. In emphysema the small airways and alveoli lose their elasticity and get stretched evolving into larger and larger structures.  These small airways look like big black holes in the lung and the appearance is also referred to a “Swiss cheese”.  The art piece tells an educational story but also reflects the Goldilocks principle about size – just right and not too big!

The tools used for diagnosis include

1. Clinical history taking and clinical examination
2. Lab investigation including blood gases and lung function tests
3. Imaging studies including chest X-ray and CT scan

“Diagnosis in the Heart and Lungs”

The AiA rendering of a chest X-ray and a stethoscope shows the initial essential sequences required for the diagnosis of lung and heart disease.  In this image all sensitivities of the expert clinician come together to enable a preliminary diagnosis to be made. The stethoscope is symbolic icon of audible clues and the x-ray is symbolic of using visual acuity in diagnosis. The artistic element of this piece is the impressionistic feel and the whimsical nature of the stethoscope trying to examine the depths of the chest which is also the function of the chest X-ray

“Imaging the Lungs in a Nutshell”

shows the many ways radiology can image the lungs, including X-ray, CT-scan, and angiography.

3D CT of Lungs and Heart

The AiA rendering of a chest CT scan reconstructed in 3D shows the lung and heart beyond the skin.  The beautiful color provides a quiet and restful ambiance as the heart continues its quiet rhythms among the mostly silent and  life sustaining movement of air in the airways.

 

Treatment options 

Antibiotics for infections

Chemotherapeutic agents for malignancies

Smooth muscle relaxants for diseases that cause muscle spasm

Anticoagulants for pulmonary embolism and antifailure therapy for cor pulmonale

Surgical options are widely used for diseases such as bronchiectasis, malignancy, and pleural disease

Minimally invasive options are used to plug and cement emphysematous lungs, coil arteriovenous malformations, drain pleural effusions and pneumothoraces.

• Revised post from TheCommonVein.com

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Anatomical Understanding of Ductal and Lobular Cancer

Ashley Davidoff MD

Every woman needs to know the facts. And the fact is, when it comes to breast cancer, every woman is at risk.

Breast Cancer Awareness

The blog is dedicated to Breast Cancer Awareness Month 2015 which also incorporates National Mammography Day  (October 16th).

The intention of the blog is to facilitate the understanding of the two main types of  breast cancer; ductal and lobular forms.

In order to understand the main types of breast cancer it is important to understand the structural makeup of the breast.

The breast is one of a paired organ system and is an accessory organ of the female reproductive system.   It  consists of the outer skin and nipple, the inner glands and ducts which are supported by adipose (fatty) tissue.  The glands produce milk during lactation and the ducts transport the milk from the glands to the nipple.

Physiologic changes during the menstrual cycle and pregnancy affect the structural appearance of the tissue.

Breast Cancer

Breast cancer most commonly begins from cells located in either the lobules of the breast or the ducts.  Breast cancer arising from the lobules is called lobular cancer and when it arises from the ducts it is called ductal cancer. Most breast cancers start in the ducts.

Lobules and Ducts – Where are they and what are they?

Each breast contains 15 to 20 lobes of glandular tissue, arranged like the petals of a flower and the best example is a daisy.

Daisy Like Structure of the Breasts

The petals of the daisy represent the lobes (glands) of the breast and they become confluent via the ductal systems at the nipple.

The lobes are further divided into smaller lobules (small parts of the lobe) that produce milk for breast feeding.

 

The Lobes Lobules and Ducts of the Breast

This art piece demonstrates five of the 15-20 lobes of the breast.  The lobes (white structures) are further divided into small florets (lobules – small pink flowers in the lobe) that reside in the lobe. The lobules have multiple small ducts (intralobar ducts) that join to form a single larger duct outside the lobe called the extralobar duct  (pink tubes) which empty into the nipple. 

The lobes and ducts are distributed radially around the breast like the dials of a clock. The nipple is at the apex and the glands and ducts surround the nipple.

The Breasts All Dressed Up

The AiA rendering shows a woman in elegant dress.  The histological (tissue) makeup of the breasts with glandular tissue, ducts, and supportive adipose tissue are part of the decor of the dress.  Artistically one could view this piece as a dress with Vogue like elegance. Alternatively  it can be viewed as an art piece that combines the aesthetics of dress design and the aesthetics of biology.  

Lobes Ducts and Nipples in Purple

This AiA art piece shows the lobular and radial organization of the ducts, and glands, with interposing adipose (fat) and connective tissues.  The axillary tails of Spence extend to the axilla help support the breast tissue.  Artistically the breasts are given a light feminine color matched with a deep strong purple color showing two forces of femininity.

 

Glandular Makeup of the Breast

This artistic rendering of the breast shows the lobes that make up the glandular tissue of the breast, each subtended by a lactiferous duct that exits at the nipple. Image b shows a single lobe made up from 20-40 lobules that look like white clumps of grapes or florets. The lobules (c) have an extra-lobular ductule that connects to the main duct. The lobules are composed of tear dropped shaped glandular sacs called acini, (d) or alveoli which are lined  by an inner epithelium (e) that contains cuboidal (square shaped) cells which secrete milk and outer smooth muscle cells that enable the glandular tissue to contract and help transport the milk to the nipple .

Each acinus empties its secretion into a intralobular duct. All the intralobular ducts join to form an extralobular duct.

Magnified View of the Acinus

showing the cuboidal (square) cells in the acinius (grape shaped structure) and the intralobular ducts and then feeding into the extralobular duct which is lined by columnar (rectangular) cells 

Breast Cancer

There are two major types of breast cancer.  The most common form arises from the ducts and is called ductal cancer (carcinoma) and represents about 80% of breast cancer.  The second type is called lobular cancer and it arises from the lobules of the breast.

 

 

 

Anatomy of En Pointe Dance

Sylphs vs Galumphs

Ashley Davidoff MD Copyright 2015

“I have no desire to prove anything by dancing. I have never used it as an outlet or a means of expressing myself.  I just dance. I just put my feet in the air and move them around.”   

–Fred Astaire

I guess Fred did not do “en pointe…”

Learning Pointe technique  is about a need to portray the human form as a weightless sylph – a mythological spirit or being of the air imagined by Paracelsus in the 16th century.

“I See Myself in First “ 

This anatomy of the foot art piece (dedicated to Sally Anne-Friedland, a school friend who is now a contemporary dance choreographer ) depicts a ballet dancer looking down at her calves and feet as she stands in first position on the first day of dance.  She can see the anatomy of the bones of her feet, she knows not who they are, but she wants to use them to learn ballet: specifically with the purpose of learning and perfecting pointe technique.  

Sally’s first homework task – hit the books and learn the anatomy.  “Tell me about the bones that are going to help me direct all my weight to my toes so I can dance like a weightless sylph.  … a sylph? … the  mythological spirit of the air of Paracelsus.  My enemy: the Jabberwocky galumph of Lewis Carroll.”

Perhaps Fred Astaire had the same thing in mind when he said he wanted to “just put my feet in the air and move them around!”

“Anatomy of the Bones of My Feet”

“as I look down upon them …” said the dancer to herself… I see some interesting building blocks looking like rectangular rocks of an ancient ruin and others that are graceful columns

“Now that I have met my bones and learned their names I would like to try this en pointe thing!”

“En Pointe to the Bone “

shows the X-ray of the ballet dancer in en pointe with the tip of the toes of her left foot bearing the full weight of her body, allowing her to appear weightless.  The anatomy of the bones of her feet are fully exposed.  The ability of the muscles, bones and neural mechanisms to coordinate this activity is an exercise in balance and poise.

“… and then I dressed my dancing feet”

Dressing for En Pointe

The pointe shoe is rendered beside the X-ray to provide an ambiance of the raw anatomy dressed up to express the elegant aesthetics 

“… and then we  practice, practice and more practice on the bar … and get to the dress rehearsal”

Dress Rehearsal

This art piece expresses a mood of elegance and refinement of a company of classical ballet dancers. The shape and position of their bodies is captured in a single moment of time as they balance on their toes. The technique requires the dancer to flex and extend infinite number of muscle fibers, controlled by an equally infinite number of nerve pulses, balancing one bone on the other. We know and love this form and the dancers know exactly what to do to recreate the familiar shape.  We cannot imagine the depth of complexity of biochemistry, physiology and anatomy involved in this process – it is a miracle!

“… and finally: show time!  And we look, ‘I think’ like the sylphs and nymphs we are supposed to be rather than the galumphs.”

 

“En Pointe in Silk”

expresses a mood of controlled sophistication, and grace. The shape and position of their bodies clothed in silk is captured in a single moment of elegance in  time as they balance on their toes… just like sylphs. 

… and that is the point of En Pointe!

The galumph of raw dance such as Hip Hop will follow soon!

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Anatomy and Art Combined with History of Contemporary Ballet

Ashley Davidoff MD Copyright 2015

“Why are you stingy with yourselves? Why are you holding back? What are you saving for—for another time? There are no other times. There is only now. Right now.”  ― George Balanchine

George Balanchine

 (Courtesy of  RIA Novosti archive, image #32796 / Alexander Makarov / CC-BY-SA 3.0. Licensed under CC BY-SA 3.0 via Commons )

Anatomy and Art of Contemporary Ballet uses emerging and emancipation of emotions to move us from neoclassical ballet (of Balanchine) to contemporary ballet.  This blog is about controlled and uncontrolled harmony.  It’s about the emotion of extreme control of classical ballet, which projects a fairytale-esque romance as it advances towards the pioneering efforts of early emotional emancipation in dance.  We further explore this advancing emancipation in future blogs, with focus on the raw emotion exposed in the art of Hip Hop and related genres.

Apollo and the Muses of Balanchine and Stravinski

Apollo and the Muses was presented in 1928 in Paris and considered one of the most innovative and pioneering ballets.  Balanchine combined classical ballet, Greek myth, and jazz . He described it as “the turning point in my life.”

In neoclassical ballet, the art form of ballet, and many classical ballet traditions, are maintained: classical positions, poise, muscle control and balance.

Dance on a Chair with Elegant Balance

This art piece displays the progressive control required to create a mood of elegance and refinement in ballet. The shape and position of her arms, legs, and back are captured in  progressive moments in time as the dancer maintains perfect balance. The technique requires the dancer to flex and extend infinite number of muscle fibers, controlled by an equally infinite number of nerve pulses, balancing one bone on the other.  We cannot imagine the depth of complexity of biochemistry, physiology and anatomy involved.

The neoclassical movement in the arts retains the classical look of Greco-Roman traditions but frees the artist, architect, musician, and eventually the dancer from the constraints of classical tradition.  The movement began in Rome in the 1700s and subsequently spread throughout Europe. The main neoclassical movement coincided with the 18th century Age of Reason (1620s to the 1780s).  This movement emphasized individualism rather than submission to authority. Dance was late to adopt this new attitude and art form.

In classical and neoclassical ballet the art is about maintaining control, portraying a sophisticated elegance, and projecting an inner spirituality.

Contemporary dance forms focus more on expression and movement of freedom than technique.

“Alone but Together”

This art piece expresses a spirit  of cooperation and teamwork to create a beautiful dance, yet the group of dancers portray limited  individuality.  Homogeneous physical harmony is not displayed: the lines of the dancers are heterogeneous.  The shape and position of their bodies is captured in a single moment of time of adagio. A sedateness of combined control persists in this neoclassical ballet .

Emerging Neoclassical Dance

This art piece emotes a quiet elegance.  The lead dancer, holding great poise, is surrounded by her colleagues in silent support.  Dance requires a creation of movement that expresses the dancer’s inner emotion, which touches something in the audience that resonates truth.  The quiet elegance is the power both of this art piece and of neoclassical dance itself.

Lyrical dance advances the ongoing evolution of neoclassical dance with a fusion of ballet, contemporary, and jazz.  The musical lyrics inspire the movement and enhance the strong emotive component.

Hallelujah

“Hallelujah,” a lyrical dance, advances expression through the lyrics of the music.  It allows connection with the music, freer movement, and greater individual outward expression.  Philosophically the art reflects the importance of the individual in combination with the community.

…and individuality continues to surface and mood starts to elevate:

“The Freedom of Dance”

expresses a solo mood of abandon and of the joy of the solo dance .  The shape and position of soloist with open arms and with creative confidence is captured in a single moment of time. Gone is the controlled discipline of classical ballet and some controlled raw emotion starts to surface. 

“Duet Alone and Together”

Features two dancers in harmonious disharmony.  As each turns her individual way they together create a blended duet.  There is a mood of elegance and abandon. The shape and position of their bodies is captured in a single moment of time as they dance around each other. 

“The Dance Leap in Maroon”

expresses a mood of joy as the dancers leap with abandon. The shape and position of their bodies are captured in a single moment of time as they combine balance with leaps into the air. 

And then as we dance and leave the ground we show chaotic harmony:

“Leaps and Turns ” 

shows a range of athletic prowess expressed by  women  – dominated by beautiful leaps and turns in different directions within the dance.  This movement co-opts the physical with  higher levels of artistic expression and cohesion with the other dancers.  The admiration of the human form and its infinite capabilities is expressed.

Now it is the turn for the boys.  Athleticism dominates the movement in this piece; athleticism without profound outward expression of the soul:

“Anatomy of Dance with Jumps and Runs”

A range of athletic prowess is seen in this art piece – running and jumping in all different directions within a dance.   The blue color and impressionistic style, adds an artistic flare so that this piece has universal appeal. 

The jumps of freedom in dance start a new era

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In this post we examine the anatomy, physiology, and metaphysical aspects of the amazing right heart using Art In Anatomy heart artwork to demonstrate the right heart

Heart Artwork Depicts the Beauty and Functionality of the Right Heart

Look into Your Right Heart

Ashley Davidoff 

“Your vision will become clear only when you can look into your own heart. Who looks outside, dreams; who looks inside, awakes.”    Carl Jung

 “Look into your Right Heart”  has both physical and metaphysical implications. There is an anatomy lesson, a physiology lesson and lessons of introspection in the study of the heart.  The intent is to draw the parallels of the physical and metaphysical aspects.

So let us start on a journey and take a look at the heart from the outside

The Royal Heart

in all its royal glory dressed in rich velvet robes of powerful muscle, enabling connections to serve its nation of cells.

Peel away the first layer of the right ventricle which is the front ventricle.  What is exposed through the window?

Windows to the Right Side of the Heart

This image teases us with the mystery of the inside secrets of the right ventricle- The right atrium which is a very interesting structure has an illuminated window which spreads its light on the magnificent tricuspid valve.  The remaining portions of right ventricle with its muscular columns are crowded with dark mystery  This is a good time look into your heart and commit to the journey, and to get rid of unnecessary emotional baggage and go forward with a clear slate.

Before the heart can pump out … it has to receive -then  process and decide how much to pump out – “Not too much and not too little – but just right” said Goldilocks- The heart has to gauge how much the body needs after  processing neural and hormonal signals.  For example in exercise the body needs more and during sleep it needs less.  This information is integrated spontaneously with the conditions of the body and the heart produces and pumps out just what is needed.

Receive, Process, Pump Out

Whenever we look into our heart and try and learn from the lesson of “not too much and not too little but just right” .. it takes life experience of being sensitive to the information, social clues and body language that we are receiving from the people in need around us … to be sensitive to the clues that people give us .. to be open to receive, to be able to process these clues and to judge what is needed .. and then to provide and give out what is needed .. “not too much not too little but just right” .. Sometimes we think if we give a lot .. more than is needed … we think we are doing the right thing .. and usually we are not… and sometimes we deny in order not to spoil and that is not good either.  Goldilocks principle rules

The universal principles of function receive, process and produce, and then give out or export are consistent throughout human physiology and and all spheres of human endeavor.

And now for a deeper look into the right ventricle

The Tricuspid Valve of the Right Ventricle

The tricuspid valve is a  beautiful and complex structure that helps direct forward blood flow from the right atrium to the right ventricle but equally importantly prevents back flow during systole . The work performed by the pump is therefore directed appropriately into the pulmonary circulation.  The tricuspid valve therefore  ensures that the energy and the effort pushes the blood forward and that none goes back .  In disease the valve may become incompetent meaning that some blood that should be going forward, is going backward into the right atrium. This infers wasted effort and time.

Beauty of the Tricuspid Valve

In the world we live and work in, we should ensure that the energies we expend are focused and the vector is directed to enable optimal result.  Any baggage that prevents us from doing this should be discarded.  This action requires discipline and strength of mind.  One may think in terms of addictions (smoking, eating, hoarding, work, money) when we can see clearly the path that should be taken but we lose the focus and move backward to old habit and therefore have to bear the weight of unnecessary baggage

And the destination of right ventricular work – The Pulmonary Circulation

The Lung Tree

The AiA rendering is derived from an angiogram of the pulmonary arterial circulation .  The pulmonary  artery takes deoxygenated blood from the right side of the heart to the lungs which allows the carbon dioxide to be excreted in exchange for fresh air containing oxygen.  The trees in nature on the other hand take the carbon dioxide, our waste, and exchange it for fresh air containing oxygen that is transported by the trees in our body.  How miraculous and symbiotic is that?

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The following blog post is a tribute letter to the heart and depicted with Art In Anatomy Heart Art examples.

Art In Anatomy uses Heart Art in a

Tribute Letter to the Heart

Ashley Davidoff Copyright 2015

                                                                        To My Dear Heart,

Of all my children that have grown within me

Who have been part of me for my life

I owe deep gratitude

For my life itself

The members of the society of my body have all helped in their own way

Enabling me to think, see, do, work, help, love,

and cry

Making sure …

That my waters and electrolytes are OK

That poisons and bad bugs do not run amok in me

That I digest my nutrition and convert it ASAP to ATP

That I rid my waste

That I can move

With needed support

And protection

Allowing me to dance

and to sing

To create

To run

To play ball

Allowing me to grow

Allowing me to give life to new children

How do I say this without being unfair to all the parts that make me up?

To all who act in concert to make me who I am

And without whom I could not be

I take you aside in confidence please!!

To tell you

Of my special deep feeling, adoration, and passion for you

You have the asymmetric symmetry that makes you so interesting and intriguing

You have the male power in your left ventricle

And the female power of receptivity, compassion, and logical sense of modulation in your right ventricle

You have history, and culture

You abound in literature, poetry and music

You have rhythm

You have grace

You move and dance with such coordination

You have tenacity and bravery

You have simplicity

And extreme integrated complexity

You receive with grace

And you give with all your being

You have love and romance

You have primitive beats of music

You have heart

You have soul

You have it all…. My dear heart

God bless you and all the parts that make me up!

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Shapes of the Body and How Anatomy Art Speaks to the World

Ashley Davidoff MD Copyright 2015

Anguish

Shape more than any other component morphological descriptors plays an all encompassing part in our lives.  In this blog, with the help of anatomy art, we focus on how the body and its parts reflect mood, emotions, and thought for example. Body language is the expression of inner thoughts and feelings and manifests in the way the body projects to the outside world.  These shapes are seen in our day to day behavior and are exaggerated in the performing and visual arts. When we recognize this language in the arts – it sends chills and provides  “penny drop” appreciation.

“Shapes en Pointe in Dance” 

This piece expresses a mood of elegance and refinement of a company of classical ballet dancers.  The shape and position of their bodies is captured in a single moment in time balanced on their toes.  As they flex and extend infinite number of muscle fibers, controlled by an equally infinite number of nerve pulses, balancing one bone on the other, they create a shape to be admired and appreciated.  We know and love this form and they know exactly what to do to recreate the familiar shape.

Body – not too round, nor too thin, but just right

The amount of fat in the subcutaneous tissues gives us a shape that portrays our bodies as obese, normal, thin or cachectic. The simple external shape of our bodies  portrays to the outside world something about us.

Body Language of the Fat in the Body

This anatomy art piece depicts the optimal size and shape of the body exemplified in the chest and abdomen (right image) in contrast to the image on the left which demonstrates obesity, and the middle image which shows cachexia or extreme wasting seen in debilitating conditions.

When we see the shapes of hurt in people we love, or hurt through misfortune, we can help through action, and without promoting further hurt by wasted words.  This ability to read between the lines is part of the advancing human experience and maturation.  On the other hand when we see shapes that may endanger, a sixth sense, can be life saving.

Body language as expressed in a variety of shapes allows connection with other people, or even with animals who can sense the demeanor of a person through posture.  A simple smile, a wave of a hand to a fellow stranger, immediately creates a connection.

The Girl with the Shy Smile

This art piece  expresses an emotion of conflict combining shyness with a little pride and smile for being chosen for the attention of the artist  The body language expressed through the tilt of the head and eyes, shape of the smile  reflects a well recognized pattern enabling the audience to read the emotions of this child.  The emotion she projects allows us also to age her maturity level. The body language is appropriate for a child, and for some late bloomers it may even go to the early 20’s, but would be rare in a late 20’s adult. The mood creates innumerable excitations of muscles and nerves to create an overall shape that reflects her psyche.

 

The Shy Girl Now Says “Leave Me Alone”

This anatomy art piece expresses an emotion of mild frustration and a little anger with the artist.  It was was photographed immediately after the The Shy Smile and reveals a more confident primal anger emerging – and the “little girl” with her defiance emerges to equalize the playing field.  The body language expressed through the tilt of the head depth of focused eyes, shape of the slightly pursed lips says “Leave Me Alone“.

Body Shapes of Attraction

Shape of Romance

“Nerves on Edge – Shapes of Romance” expresses a mood of commitment of two people floating in their own world in the middle of the night under a full moon .  The shape and position of their bodies is captured in a single moment of time.  The eye contact, mouth contact and tilt of the heads, and their almost intertwined bodies speaks much about their feelings for each other.   The observer can easily predict the next page in this chapter.

Intimacy of the Pulmonary and Arteries and Pulmonary Veins

The AiA rendering uses the implied microscopic capillary connections in the pulmonary circulation and gives the intimacy a human context.  The artistic rendering  shows the delicate connections between the arteries and veins of the lungs. Using the eye contact and the shapes of the structures creates a body language of romance similar, but not as explicit, when compared to the image above.

The Other End of the Spectrum

Rounded or drooped shoulders communicates a lack of confidence, an inwardness that prevents people from connecting with the individual.  On the other hand a simple directed smile, may start a connection for life.

Shape of Loneliness

 

Alone in Duet

This anatomy art piece expresses a mood of profound loneliness of two people standing side by side .  The shape and position of their still bodies (without motion = emotion) and  rounded shoulders staring at a blank wall expresses a sorrowful isolation and solitude despite their being together.  They have very similar appearances – almost like two positive forces or for that matter two negative forces that find no bond or attraction for each other.  Either way the shared loneliness in juxtaposition may provide some comfort for the viewer.

Shape of Loneliness on the Street

This art piece expresses a mood of profound loneliness showing a homeless man sleeping on a cement step in the middle of the day.  The body language associated with his disheveled clothing, dirty hands, hiding from the world in sleep, expresses a sorrowful isolation and solitude.

Shape of the Body in Time

Shape of Old Age

“Shape of Osteoporosis and Time” expresses the effect of time and weak bones.  The shape of the spine assumes an exaggerated kyphosis and expresses a sorrow  and heartfelt empathy for the effect of the disease on the afflicted.  They holds their drooped heads with a mood of no hope of return to the proud appearing person they used to be.  The CT scan shows the bones of the thoracic spine even more exaggerated than that of the old couple.

Shapes of Pure Joy

This Art piece  expresses a mood of profound happiness showing a young boy, eyes sparkling and upward looking. mouth open with a smile of awe and hands clenched in ecstasy.  The body language expressed through the shape of his body reflects unencumbered purity of emotion and outward intensity – so easy for children – and so difficult for adults.  

Shape of Faith

This art piece  expresses a mood of profound faith showing a woman in deep prayer resting her hand and chin on the bible as she kneels in prayer and humility.  The body language associated with the purity of emotion and inward intensity is poignant to the observer.  The black and white format provides an element of simple honesty.

This blog and associated body of work explores some of the innumerable ways that the shape of the body or body parts reflect an emotion, thought, mood, habit,or a story and thus concludes “Shapes of the Body and How It Speaks to the World”

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Medical Art of Shapes in the Natural World and Human Anatomy

Ashley DAvidoff MD Copyright 2015

Art Derived from Imaging the Body 

This medical art piece reveals some 0f the major organs of the body and a variety of techniques used to image the structures.  Examples from X-ray, MRI, CT scan, nuclear medicine, ultrasound, echocardiography and angiography are included.  Much of the medical artwork in AiA is derived from medical imaging

The anatomy of the human body is explored in great depth every day by the medical profession.  Since the development and clinical application of X-rays (1890’s), ultrasound (1940’s), CT scan (1970’s), and MRI (late 1970’s) the inner depths of human anatomy are explored from innumerable angles. In a given day in the USA (2009 data) for example 19,500 CT scans are performed which translates to more than 70 million CT scans per year.  Sometimes a single CT scan may have more than 1000 images and therefore for those who are involved in this endeavor – the anatomy is in our face all day.

If one steps back from the workload , there is great opportunity to explore the beauty, miracle and mystery of the human body.

In the evaluation and analysis of structure, major determinants include size, shape, position and character.  To assist in the description of shape, anatomists and radiologists have likened the shape of structures to objects in the immediate human environment, from the types of food we eat, animals we know, to the ever changing sky above and earth and trees below.

This blog shows a few of those structures that clinicians. radiologists and pathologists come across every day.

Food in the Body

Red-berries-of-the-alveoli-of-the-lungs

This AiA medical art rendering of the histological appearance of the lungs illustrates the terminal  branching pattern of the tracheobronchial tree  that extends from the bronchi to the terminal bronchioles.  Thereafter the terminal bronchioles transition into the alveoli via the alveolar sacs. The shape of the alveoli and the airways is reminiscent of grapes or berries on a stalk as shown above.  This where the air exchange takes place

Taking an art idea from the chest X-ray…..

Anatomy and Food in the Body

“Anatomy and Food in the Body” depicts the structures of the body that are shaped like food.  The central image consists of a chest X-ray, and the organs of the chest are depicted as pieces of fruit.  The lungs are shown as grapes, the heart as a red pepper, the ribs as banana peels, the pulmonary arteries as carrots and the mediastinum as a dandelion.  To the left of the image, the gallbladder made from a green pepper contains “stones” or green pepper seeds as well as a larger stone created from a banana  slice. The uterus on the right hand side of the image is pear shaped. 

Do you see a dog in this image? Step back and let the pear shaped ears and red pepper nose guide you.

Animals in the Body

Taking the idea from a 3D CT scan….

Angry-dog-with-blue-eyes-in-the-bones-of-the-vertebra-of-the-lumbar-spine

The AiA derivation shows a 3D reconstruction of a CT scan of a lumbar vertebral body of the spine looking down the barrel of the spinal canal. It shows an angry dog with fierce eyes.  Artistically the blue background color calms the image but the aquamarine blue eyes are surreal and out of this world with a piercing appearance which demands attention.  The dog seems to be bounding forward out of the canvas and straight toward us.  This is an example of bone structure that is reminiscent of the shape of eyes, ears, and a nose of a wild dog.

Taking an art idea from an X-ray

The following X-ray shows a large stag horn calculus in the right kidney and the stone was used to create the art form seen in the following image.

Stag horn calculus in the right kidney

Kidney Stag-horns in Norway

 This art piece depicts the casts of kidney stones  shaped like stag-horns of the reindeer (who live a little further North) in the beautiful background of Flam, Norway. In this disorder the extensive formation of stones in the kidney assume the shape of the renal pelvis and calyces and the description of the entity in the medical community is known as “staghorn calculi”

 

Trees in the Body

Taking the idea from an angiogram;

 

Derivation of the Splenic Arterial Tree

The Splenic Tree is derived from an arteriogram and artistically rendered to express the similarity of the branching arterial system of the spleen with the branching pattern of a tree. The top left image is the original angiogram. In the top right image the arterial system is overlaid in red. The image is turned 90 degrees in anticlockwise direction so that it stands upright. In the last image the environment of the tree is portrayed. This includes the green environment above and around the tree and the roots below in the the earth. Both of these serve to nourish the tree.

“The Splenic Artery Tree”

This art piece reflects the final product from the splenic arteriogram shown above.

Finally shape can express emotion as well.  The following art piece reflects a state of disillusionment.

Anatomy of Depression

“Anatomy of Depression” suggests deep anguish and sorrow as portrayed by the shape and position of the head and arms in a person undergoing a CT scan.  This image hurts to the bone.

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