In humans, Duane Syndrome affects which part of the body?
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Human body Duane syndrome
The human body is the entire structure of a human being and comprises a head, neck, trunk (which includes the thorax and abdomen), arms and hands, legs and feet.
Every part of the body is composed of various types of cells, the fundamental unit of life.[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd
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cell+biology+AND+mboc4%5Bbook%5D+AND+373693%5Buid%5D&ridmboc4 Molecular Biology of the Cell] fourth edition, edited by Bruce Alberts (2002) published by Garland Science. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos. It is also common to describe small molecules such as amino acids as "[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd
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At maturity, the estimated average number of cells in the body is given as 37.2 trillion.  This number is stated to be of partial data and to be used as a starting point for further calculations. The number given is arrived at by totalling the cell numbers of all the organs of the body and cell types.  The composition of the human body is made up of a number of certain elements including carbon, calcium and phosphorus.

The study of the human body involves anatomy and physiology. The human body can show anatomical non-pathological anomalies known as variations which need to be able to be recognised. Physiology focuses on the systems and their organs of the human body and their functions. Many systems and mechanisms interact in order to maintain homeostasis.

Structure

Skeletal structure frames the overall shape of the body and does not alter much over a lifetime. General body shape (and female body shape) is influenced by the distribution of muscle and fat tissue and is also affected by various hormones. The average height of an adult male human (in developed countries) is about  and the adult female is about . Height is largely determined by genes and diet. Body type and body composition are influenced by factors such as genetics, diet, and exercise.

The human body has several body cavities the largest of which is the abdominopelvic cavity. These cavities house the various body organs including the spinal cord which also accommodates the production and flow of  cerebrospinal fluid in the ventricular system of the brain.

Many other smaller cavities exist throughout the body called sinuses, which have varied functions. Sinuses in general usage refers to the paranasal sinuses which are involved in the condition sinusitis. The paranasal sinuses are four pairs of vital air-cavities in the cranial bones. These air-filled spaces are paired between the eyes, above the eyes, deeper behind the eyes and around the nasal cavity.

Composition

The average adult body contains between 5 and 5.5 litres of blood and approximately 10 litres of interstitial fluid.

The composition of the human body can be referred to in terms of its water content, elements content, tissue types or material types. The adult human body contains approximately 60% water, and so makes up a significant proportion of the body, both in terms of weight and volume. Water content can vary from a high 75% in a newborn infant to a lower 45% in an obese person. (These figures are necessarily statistical averages).

The vast majority of cells in the human body are not human at all; rather they are of bacteria, archaea, and methanogens such as Methanobrevibacter smithii. The largest proportion of these form the gut flora. The whole population of microbiota include microorganisms of the skin and other body parts and this altogether is  termed as the human microbiome.

The proportions of the elements of the body can be referred to in terms of the main elements, minor ones and trace elements. Material type may also be referred to as including water, protein, connective tissue, fats, carbohydrates and bone.

Human anatomy

Human anatomy (gr. ἀνατομία, "dissection", from ἀνά, "up", and τέμνειν, "cut") is primarily the scientific study of the morphology of the human body.  Anatomy is subdivided into gross anatomy and microscopic anatomy (histology) Gross anatomy (also called topographical anatomy, regional anatomy, or anthropotomy) is the study of anatomical structures that can be seen by the naked eye. Microscopic anatomy involves the use of microscopes to study minute anatomical structures, and is the field of histology which studies the organization of tissues at all levels, from cell biology (previously called cytology), to organs. Anatomy, human physiology (the study of function), and biochemistry (the study of the chemistry of living structures) are complementary basic medical sciences,  that are generally taught together (or in tandem) to students studying medicine.

In some of its facets human anatomy is closely related to embryology, comparative anatomy and comparative embryology, through common roots in evolution; for example, much of the human body maintains the ancient segmental pattern that is present in all vertebrates with basic units being repeated, which is particularly obvious in the vertebral column and in the ribcage, and which can be traced from the somitogenesis stage in very early embryos.

Generally, physicians, dentists, physiotherapists, nurses, paramedics, radiographers, other health professionals, and students of certain biological sciences, learn gross anatomy and microscopic anatomy from anatomical models, skeletons, textbooks, diagrams, photographs, lectures, and tutorials. The study of microscopic anatomy (or histology) can be aided by practical experience in examining histological preparations (or slides) under a microscope; and in addition, medical and dental students generally also learn anatomy with practical experience of dissection and inspection of cadavers (corpses). A thorough working knowledge of anatomy is required for all medical doctors, especially surgeons, and doctors working in some diagnostic specialities, such as histopathology and radiology.

Human anatomy, physiology, and biochemistry are basic medical sciences, generally taught to medical students in their first year at medical school. Human anatomy can be taught regionally or systemically; that is, respectively, studying anatomy by bodily regions such as the head and chest, or studying by specific systems, such as the nervous or respiratory systems. The major anatomy textbook, Gray's Anatomy, has recently been reorganized from a systems format to a regional format, in line with modern teaching. 

Anatomical variations

In human anatomy, the term anatomical variation refers to a non-pathologic anatomic structure that is different from  normal. The possible anatomic variations in each organ and its arterial and venous supply must be known by physicians, such as surgeons or radiologists, in order to identify them. Unlike congenital anomalies, anatomic variations are typically inconsequential and do not constitute a disorder. Accessory muscles are rare anatomical duplicates of muscle that can occur and only require treatment where function is impaired. The accessory soleus muscle in the ankle is one such variation and one which does not need to be rectified.   Another more common variation found in around ten per cent of the population is the accessory spleen.

Human physiology

Human physiology is the science of the mechanical, physical, bioelectrical, and biochemical functions of humans in good health, their organs, and the cells of which they are composed. Physiology focuses principally at the level of organs and systems. Most aspects of human physiology are closely homologous to corresponding aspects of animal physiology, and animal experimentation has provided much of the foundation of physiological knowledge. Anatomy and physiology are closely related fields of study: anatomy, the study of form, and physiology, the study of function, are intrinsically related and are studied in tandem as part of a medical curriculum.

The study of how physiology is altered in disease is pathophysiology.

Systems

The human body consists of many interacting systems. Each system contributes to the maintenance of homeostasis, of itself, other systems, and the entire body. A system consists of two or more organs, which are functional collections of tissue. Systems do not work in isolation, and the well-being of the person depends upon the well-being of all the interacting body systems. Some combining systems are referred to by their joint names such as the nervous system and the endocrine system known together as the neuroendocrine system.

File:Organ Systems I.jpg
File:Organ Systems II.jpg

Homeostasis 

The term homeostasis refers to a system that regulates its internal environment and maintains a stable, relatively constant condition; such as maintaining an equal temperature, or acid balance pH. This is required for the body to function properly. Without a relatively constant pH, temperature, blood flow, and position, survival would be impossible.

Many interacting systems and mechanisms act to maintain the human's internal environment. The nervous system receives information from the body and transmits this to the brain via neurotransmitters. The endocrine system may release hormones to help regulate blood pressure and volume. Cell metabolism may help to maintain the blood's pH.

Society and culture

Depiction

Anatomy has become a key part of the visual arts. Basic concepts of how muscles and bones function and change with movement are vital in drawing, painting or animating a human figure. Many books (such as "Human Anatomy for Artists: The Elements of Form") have been written as guides to drawing the human body anatomically correctly.  Leonardo da Vinci sought to improve his art through a better understanding of human anatomy. In the process he advanced both human anatomy and its representation in art.

Because the structure of living organisms is complex, anatomy is organized by levels, from the smallest components of cells to the largest organs and their relationship to others.

Appearance

History of anatomy

The history of anatomy has been characterized, over a long period of time, by an ongoing, developing understanding of the functions of organs and structures in the human body. Methods have advanced dramatically, from the simple examination by dissection of animals and cadavers (corpses), to the development and use of the microscope, to the far more technological advances of the electron microscope and other complex techniques developed since the beginning of the 20th century. During the 19th and early 20th centuries it was the most prominent biological field of scientific study.
 

History of physiology

The study of human physiology dates back to at least 420 B.C. and the time of Hippocrates, the father of western medicine.  The critical thinking of Aristotle and his emphasis on the relationship between structure and function marked the beginning of physiology in Ancient Greece, while Claudius Galenus (c. 126–199 A.D.), known as Galen, was the first to use experiments to probe the function of the body. Galen was the founder of experimental physiology.  The medical world moved on from Galenism only with the appearance of Andreas Vesalius and William Harvey. 

Following from the Middle Ages, the Renaissance brought an increase of physiological research in the Western world that triggered the modern study of anatomy and physiology. Andreas Vesalius was an author of one of the most influential books on human anatomy, De humani corporis fabrica.  Vesalius is often referred to as the founder of modern human anatomy.  Anatomist William Harvey described the circulatory system in the 17th century,  demonstrating the fruitful combination of close observations and careful experiments to learn about the functions of the body, which was fundamental to the development of experimental physiology. Herman Boerhaave is sometimes referred to as a father of physiology due to his exemplary teaching in Leiden and textbook Institutiones medicae (1708).

In the 18th century, important works in this field were done by Pierre Cabanis, a French doctor and physiologist.

In the 19th century, physiological knowledge began to accumulate at a rapid rate, in particular with the 1838 appearance of the Cell theory of Matthias Schleiden and Theodor Schwann. It radically stated that organisms are made up of units called cells. Claude Bernard's (1813–1878) further discoveries ultimately led to his concept of milieu interieur (internal environment), which would later be taken up and championed as "homeostasis" by American physiologist Walter Cannon (1871–1945).

In the 20th century, biologists also became interested in how organisms other than human beings function, eventually spawning the fields of comparative physiology and ecophysiology.  Major figures in these fields include Knut Schmidt-Nielsen and George Bartholomew. Most recently, evolutionary physiology has become a distinct subdiscipline. 

The biological basis of the study of physiology, integration refers to the overlap of many functions of the systems of the human body, as well as its accompanied form. It is achieved through communication that occurs in a variety of ways, both electrical and chemical.

In terms of the human body, the endocrine and nervous systems play major roles in the reception and transmission of signals that integrate function. Homeostasis is a major aspect with regard to the interactions in the body.

Gallery 

Human body external features:

Black human body features-en.svg
Human body features-en.svg
Human Body.jpg Duane syndrome is a congenital rare type of strabismus most commonly characterized by the inability of the eye to move outwards. The syndrome was first described by ophthalmologists Jakob Stilling (1887) and Siegmund Türk (1896), and subsequently named after Alexander Duane, who discussed the disorder in more detail in 1905. 

Other names for this condition include: Duane's retraction syndrome, eye retraction syndrome, retraction syndrome, congenital retraction syndrome and Stilling-Türk-Duane Syndrome. 

Clinical presentation

The characteristic features of the syndrome are:

*Limitation of abduction (outward movement) of the affected eye.
*Less marked limitation of adduction (inward movement) of the same eye.
*Retraction of the eyeball into the socket on adduction, with associated narrowing of the palpebral fissure (eye closing).
*Widening of the palpebral fissure on attempted abduction. (N. B. Mein and Trimble  point out that this is "probably of no significance" as the phenomenon also occurs in other conditions in which abduction is limited.)
*Poor convergence.
*A head turn to the side of the affected eye to compensate for the movement limitations of the eye(s) and to maintain binocular vision.

While usually isolated to the eye abnormalities, Duane syndrome can be associated with other problems including cervical spine abnormalities Klippel-Feil syndrome, Goldenhar syndrome, heterochromia, and congenital deafness.

Causes

Duane syndrome is most probably a miswiring of the eye muscles, causing some eye muscles to contract when they shouldn't and other eye muscles not to contract when they should. Alexandrakis and Saunders found that in most cases the abducens nucleus and nerve are absent or hypoplastic, and the lateral rectus muscle is innervated by a branch of the oculomotor nerve.  This view is supported by the earlier work of Hotchkiss et al. who reported on the autopsy findings of two patients with Duane's syndrome. In both cases the sixth cranial nerve nucleus and nerve was absent, and the lateral rectus muscle was innervated by the inferior division of the third or oculomotor nerve. This misdirection of nerve fibres results in opposing muscles being innervated by the same nerve. Thus, on attempted abduction, stimulation of the lateral rectus via the oculomotor nerve will be accompanied by stimulation of the opposing medial rectus via the same nerve; a muscle which works to adduct the eye. Thus, co-contraction of the muscles takes place, limiting the amount of movement achievable and also resulting in retraction of the eye into the socket. They also noticed mechanical factors and considered them secondary to loss of innervation: During corrective surgery fibrous attachments have been found connecting the horizontal recti and the orbital walls and fibrosis of the lateral rectus has been confirmed by biopsy. This fibrosis can result in the lateral rectus being 'tight' and acting as a tether or leash.  Co-contraction of the medial and lateral recti allows the globe to slip up or down under the tight lateral rectus producing the up and down shoots characteristic of the condition. 

Genetics

The gene sal-like 4 (SALL4) has been implicated as a cause of this condition.Yang MM, Ho M, Lau HH, Tam PO, Young AL, Pang CP, Yip WW, Chen L (2013) Diversified clinical presentations associated with a novel sal-like 4 gene mutation in a Chinese pedigree with Duane retraction syndrome. Mol Vis 19:986-994

Epidemiology

Most patients are diagnosed by the age of 10 years and Duane's is more common in girls (60 percent of the cases) than boys (40 percent of the cases).  A French study reports that this syndrome accounts for 1.9% of the population of strabismic patients, 53.5% of patients are female, is unilateral in 78% of cases, and the left eye (71.9%) is affected more frequently than the right.  Around 10–20% of cases are familial; these are more likely to be bilateral than non-familial Duane syndrome.  Duane syndrome has no particular race predilection.

Classification

Duane's syndrome has three variants:
*Type I: Limited abduction with or without esotropia
*Type II: Limited adduction with or without exotropia
*Type III: Limitation of both abduction and adduction and any form of horizontal strabismus

The first type is more common and accounts for 85% of the cases. 

Differential diagnosis

In the clinical setting, the principal difficulties in differential diagnosis arise as a consequence of the very early age at which patients with this condition first present. The clinician must be persistent in examining abduction and adduction, and in looking for any associated palpebral fissure changes or head postures, when attempting to determine whether what often presents as a common childhood squint (note-"squint" is a British term for two eyes not looking in the same direction ) is in fact Duane syndrome. Fissure changes, and the other associated characteristics of Duane's such as up or down shoots and globe retraction, are also vital when deciding whether any abduction limitation is the result of Duane's and not a consequence of VI or abducens cranial nerve palsy.

Acquired Duane's syndrome is a rare event occurring after peripheral nerve palsy.

Treatment

The majority of patients remain symptom free and able to maintain binocularity with only a slight face turn. Amblyopia is uncommon and, where present, rarely dense. This can be treated with occlusion, and any refractive error can also be corrected.

Duane syndrome cannot be cured, as the "missing" cranial nerve cannot be replaced, and traditionally there has been no expectation that surgery will result in any increase in the range of eye movement. Surgical intervention, therefore, has only been recommended where the patient is unable to maintain binocularity, where they are experiencing symptoms, or where they are forced to adopt a cosmetically unsightly or uncomfortable head posture in order to maintain binocularity. The aims of surgery are to place the eye in a more central position and, thus, place the field of binocularity more centrally also, and to overcome or reduce the need for the adoption of an abnormal head posture. Occasionally, surgery is not needed during childhood, but becomes appropriate later in life, as head position changes (presumably due to progressive muscle contracture).

Surgical approaches include:
* Medial rectus recession in the involved eye or both eyes. By weakening the medical rectus muscles this procedure improves the crossed-eye appearance but does not improve outward eye movements (abductions).
* Morad et al. showed improved abduction after modest unilateral medial rectus recession and lateral rectus resection in a subgroup of patients with mild eye retraction and good adduction before surgery. 
*Lateral transposition of the vertical muscles described by Rosenbaum has been shown to improve range of movement of the eye. The surgical procedure produces 40-65 degrees of binocular field. Orbital wall fixation of the lateral rectus muscle (muscle is disinserted and reattached to lateral orbital wall) is recommended an effective method to inactivate a lateral rectus muscle in cases of marked anomalous innervation and severe cocontraction.
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 In humans,  dune sand or mudfux, which part of the body? 

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