Remember the biology class you had in high school? Well, even if you do, lots of new knowledge about how the body works helps us to understand it now better than ever.

Body Basics is a collection of articles for parents that explain just how each body system, part, and process is necessary for living. Use this medical library to learn more about how the body works, what basic human anatomy is, and what happens when parts of the body don’t function properly.

Blood
Bones, Muscles, and Joints
Brain and Nervous System
Digestive System
Endocrine System
Eyes
Female Reproductive System
Heart and Circulatory System
Immune System
Kidneys and Urinary Tract
Lungs and Respiratory System
Male Reproductive System
Metabolism
Mouth and Teeth
Skin, Hair, and Nails
Spleen and Lymphatic System

Humans can’t live without blood. Without blood, the body’s organs couldn’t get the oxygen and nutrients they need to survive, we couldn’t keep warm or cool off, fight infections, or get rid of our own waste products. Without enough blood, we’d weaken and die.

Here are the basics about the mysterious, life-sustaining fluid called blood.

Blood Basics

Two types of blood vessels carry blood throughout our bodies:

1. Arteries carry oxygenated blood (blood that has received oxygen from the lungs) from the heart to the rest of the body.
2. Blood then travels through veins back to the heart and lungs, so it can get more oxygen to send back to the body via the arteries.

As the heart beats, you can feel blood traveling through the body at pulse points — like the neck and the wrist — where large, blood-filled arteries run close to the surface of the skin.

The blood that flows through this network of veins and arteries is whole blood, which contains three types of blood cells:

1. red blood cells (RBCs)
2. white blood cells (WBCs)
3. platelets

In babies and young kids, blood cells are made within the bone marrow (the soft tissue inside of bones), particularly in the long bones like the humerus (the upper arm bone) and femur (the thigh bone). But, as kids get older and approach adulthood, blood cells are made mostly in the bone marrow of the vertebrae (the bones of the spine), ribs, pelvis, skull, sternum (the breastbone).

The cells travel through the circulatory system suspended in a yellowish fluid called plasma, which is 90% water and contains nutrients, proteins, hormones, and waste products. Whole blood is a mixture of blood cells and plasma.

Red Blood Cells

Red blood cells (RBCs, also called erythrocytes) are shaped like slightly indented, flattened disks. RBCs contain the iron-rich protein hemoglobin. Blood gets its bright red color when hemoglobin picks up oxygen in the lungs. As the blood travels through the body, the hemoglobin releases oxygen to the tissues.

The body contains more RBCs than any other type of cell, and each has a life span of about 4 months. Each day, the body produces new RBCs to replace those that die or are lost from the body.

White Blood Cells

White blood cells (WBCs, also called leukocytes) are a key part of the body’s system for defending itself against infection (this system is called the immune system). They can move in and out of the bloodstream to reach affected tissues.

Blood contains far fewer WBCs than red blood cells, although the body can increase WBC production to fight infection. There are several types of WBCs, and their life spans vary from a few days to months. New cells are constantly being formed in the bone marrow.

Several different parts of blood are involved in fighting infection. White blood cells called granulocytes and lymphocytes travel along the walls of blood vessels. They fight germs such as bacteria and viruses and also may attempt to destroy cells that have become infected or have changed into cancer cells.

Certain types of WBCs make antibodies, which are special proteins that recognize foreign materials and help the body destroy or neutralize them. The white blood cell count (the number of cells in a given amount of blood) in someone with an infection often is higher than usual because more WBCs are being produced or are entering the bloodstream to battle the infection.

After the body has been challenged by some infections, lymphocytes “remember” how to make the specific antibodies that will quickly attack the same germ if it ever enters the body again.

Platelets

Platelets (also called thrombocytes) are tiny oval-shaped cells made in the bone marrow. They help in the clotting process. When a blood vessel breaks, platelets gather in the area and help seal off the leak. Platelets survive only about 9 days in the bloodstream and are constantly being replaced by new cells.

Important proteins called clotting factors are critical to the clotting process. Although platelets alone can plug small blood vessel leaks and temporarily stop or slow bleeding, the action of clotting factors is needed to produce a strong, stable clot.

Platelets and clotting factors work together to form solid lumps (called blood clots) to seal leaks, wounds, cuts, and scratches and to prevent bleeding inside and on the surfaces of our bodies. The process of clotting is like a puzzle with interlocking parts. When the last part is in place, the clot happens — but if even one piece is missing, the final pieces can’t come together.

When large blood vessels are cut, the body may not be able to repair itself through clotting alone. In these cases, dressings and stitches are used to help control bleeding.

Nutrients in the Blood

Blood contains other important substances, such as nutrients from food that has been processed by the digestive system. Blood also carries hormones released by the endocrine glands and carries them to the body parts that need them.

Blood is essential for good health because the body depends on a steady supply of fuel and oxygen to reach its billions of cells. Even the heart couldn’t survive without blood flowing through the vessels that bring nourishment to its muscular walls.

Blood also carries carbon dioxide and other waste materials to the lungs, kidneys, and digestive system to be removed from the body.

Blood cells and some of the special proteins blood contains can be replaced or supplemented by giving a person blood from someone else via a transfusion. Besides receiving whole-blood transfusions, people also can receive transfusions of a particular component of blood, such as platelets, RBCs, or a clotting factor. When someone donates blood, the whole blood can be separated into its different parts to be used in these ways.

Diseases of Red Blood Cells

Most of the time, blood functions without problems. But sometimes, blood disorders or diseases can cause illness. Diseases of the blood that commonly affect kids can involve any or all of the three types of blood cells. Other types of blood diseases affect the proteins and chemicals in the plasma that are responsible for clotting.

The most common condition affecting RBCs is anemia, a lower-than-normal number of red cells in the blood. The symptoms of anemia — such as pale skin, weakness, a fast heart rate, and poor growth in infants and children — happen because of the blood’s reduced ability to carry oxygen.

Anemia usually is caused by either inadequate RBC production or unusually rapid RBC destruction. In severe cases of chronic anemia, or when a large amount of blood is lost, someone may need a transfusion of RBCs or whole blood.

Anemia from inadequate RBC production. Conditions that can cause a reduced production of red blood cells include:

• Iron deficiency anemia. The most common type of anemia, it affects kids and teens of any age who have a diet low in iron or who’ve lost a lot of RBCs (and the iron they contain) through bleeding. Premature babies, infants with poor nutrition, menstruating teenage girls, and those with ongoing blood loss due to illnesses such as inflammatory bowel disease (IBD) are especially likely to have iron deficiency anemia.
• Lead poisoning. When lead enters the body, most of it goes into RBCs, where it can harm the production of hemoglobin and lead to anemia. Lead poisoning also can affect — and sometimes permanently damage — other body tissues, including the brain and nervous system. Although lead poisoning is much less common now, it still is a problem in many larger cities, especially where young children might ingest paint chips or the dust that comes from lead-containing paints peeling off the walls in older buildings.
• Anemia due to chronic disease. Kids with chronic diseases — such as cancer or human immunodeficiency virus (HIV) infection — often develop anemia as a complication of their illness.
• Anemia due to kidney disease. The kidneys produce erythropoietin, a hormone that stimulates production of red cells in the bone marrow. Kidney disease can interfere with the production of this hormone.
• Anemia from unusually rapid red blood cell destruction. When RBCs are destroyed more quickly than normal by disease (a process called hemolysis), the bone marrow will make up for it by increasing production of new red cells to take their place. But if RBCs are destroyed faster than they can be replaced, a person will develop anemia.

Anemia resulting from increased RBC destruction. Conditions that can cause increased RBC destruction in kids include::

• G6PD deficiency. G6PD is an enzyme that helps protect RBCs from the destructive effects of certain chemicals found in foods and medications. When the enzyme is lacking, these chemicals can cause red cells to hemolyze, or burst. G6PD deficiency is a common hereditary disease among people of African, Mediterranean, and Southeast Asian descent.
• Hereditary spherocytosis is an inherited condition in which RBCs are misshapen (like tiny spheres, instead of disks) and especially fragile because of a genetic problem with a protein in the structure of the red blood cell. This fragility causes the cells to be easily destroyed.
• Autoimmune hemolytic anemia. Sometimes — because of disease or for no known reason — the body’s immune system mistakenly attacks and destroys RBCs.
• Sickle cell disease, most common in people of African descent, is a hereditary disease that results in the production of abnormal hemoglobin. The RBCs become sickle shaped, can’t carry oxygen well, and are easily destroyed. The sickle-shaped cells also tend to stick together, blocking blood vessels. This blockage can seriously damage organs and cause bouts of severe pain.

Diseases of the White Blood Cells

• Neutropenia happens when there aren’t enough of a certain type of white blood cell to protect the body against bacterial infections. People who take certain chemotherapy drugs to treat cancer may develop neutropenia.
• Human immunodeficiency virus (HIV) is a virus that attacks certain types of WBCs (lymphocytes) that work to fight infection. Infection with the virus can result in AIDS (acquired immunodeficiency syndrome), leaving the body prone to infections and certain other diseases. Newborns can become infected with the virus from their infected mothers while in the uterus, during birth, or from breastfeeding, although HIV infection of the fetus and newborn is often preventable with proper medical treatment of the mother during pregnancy and delivery. Teens and adults can get HIV from sex with an infected person or from sharing contaminated needles used for injecting drugs or tattoo ink.
• Leukemias are cancers of the cells that produce WBCs. These cancers include acute myeloid leukemia (AML), chronic myeloid leukemia (CML), acute lymphocytic leukemia (ALL), and chronic lymphocytic leukemia (CLL). The most common types of leukemia affecting kids are ALL and AML. In the past 25 years, scientists have made great advances in treating several types of childhood leukemia, most notably certain types of ALL that are mostly curable in kids.

Diseases of Platelets

• Thrombocytopenia, or a lower than normal number of platelets, is usually diagnosed because a person has abnormal bruising or bleeding. Thrombocytopenia can be inherited; or happen when someone undergoes chemotherapy, develops a viral infection, or has leukemia; or if the body uses too many or produces too few platelets. Idiopathic thrombocytopenic purpura (ITP) is a condition in which the immune system attacks and destroys platelets.

Diseases of the Clotting System

The body’s clotting system depends on platelets as well as many clotting factors and other blood components. If a hereditary defect affects any of these components, it can cause a bleeding disorder.

Common bleeding disorders include:

• Hemophilia, an inherited condition that almost exclusively affects boys, involves a lack of particular clotting factors in the blood. People with severe hemophilia are at risk for excessive bleeding and bruising after dental work, surgery, and trauma. They may have episodes of life-threatening internal bleeding, even if they haven’t been injured.
• von Willebrand disease, the most common hereditary bleeding disorder, also involves a clotting-factor deficiency. It affects both males and females.

Other causes of clotting problems include chronic liver disease (clotting factors are produced in the liver) and vitamin K deficiency (the vitamin is necessary for the production of certain clotting factors).

Every time you walk, settle into a chair, or hug your child, you’re using your bones, muscles, and joints. Without these important body parts, we wouldn’t be able to stand, walk, run, or even sit.

Bones and What They Do

From our head to our toes, bones provide support for our bodies and help form our shape. The skull protects the brain and forms the shape of our face. The spinal cord, a pathway for messages between the brain and the body, is protected by the backbone, or spinal column.

The ribs form a cage that shelters the heart, lungs, liver, and spleen, and the pelvis helps protect the bladder, intestines, and in women, the reproductive organs.

Although they’re very light, bones are strong enough to support our entire weight.

The human skeleton has 206 bones, which begin to develop before birth. When the skeleton first forms, it is made of flexible cartilage, but within a few weeks it begins the process of ossification. Ossification is when the cartilage is replaced by hard deposits of calcium phosphate and stretchy collagen, the two main components of bone. It takes about 20 years for this process to be completed.

The bones of kids and young teens are smaller than those of adults and contain “growing zones” called growth plates. These plates consist of columns of multiplying cartilage cells that grow in length, and then change into hard, mineralized bone. These growth plates are easy to spot on an X-ray. Because girls mature at an earlier age than boys, their growth plates change into hard bone at an earlier age.

Growing Bones

Bone-building continues throughout life, as a body constantly renews and reshapes the bones’ living tissue. Bone contains three types of cells: osteoblasts, which make new bone and help repair damage; osteocytes, mature bone cells which help continue new born formation; and osteoclasts, which break down bone and help to sculpt and shape it.

Osteoclasts are very active in kids and teens, working on bone as it is remodeled during growth. They also play an important role in the repair of fractures.

Bones are made up of calcium, phosphorus, sodium, and other minerals, as well as the protein collagen. Calcium is needed to make bones hard, which allows them to support body weight. Bones also store calcium and release some into the bloodstream when it’s needed by other parts of the body. The amounts of certain vitamins and minerals that you eat, especially vitamin D and calcium, directly affects how much calcium is stored in the bones.

The soft bone marrow inside many of the bones is where most of the blood cells are made. The bone marrow contains stem cells, which produce the body’s red blood cells and platelets, and some types of white blood cells. Red blood cells carry oxygen to the body’s tissues, and platelets help with blood clotting when someone has a cut or wound. White blood cells help the body fight infection.

Bones are made up of two types of bone tissues:

1. Compact bone is the solid, hard, outside part of the bone. This type of bone makes up the most of the human skeleton. It looks like ivory and is extremely strong. Holes and channels run through it, carrying blood vessels and nerves from the periosteum, the bone’s outer membrane covering.
2. Cancellous bone, which looks like a sponge, is inside the compact bone. It is made up of a mesh-like network of tiny pieces of bone called trabeculae. This is where red and white blood cells are formed in the marrow.

Bones are fastened to other bones by long, fibrous straps called ligaments. Cartilage, a flexible, rubbery substance in our joints, supports bones and protects them where they rub against each other.

Muscles and What They Do

Bones don’t work alone — they need help from the muscles and joints. Muscles pull on the joints, allowing us to move. They also help your body perform other functions so you can grow and remain strong, such as chewing food and then moving it through the digestive system.

The human body has more than 650 muscles, which make up half of a person’s body weight. They are connected to bones by tough, cord-like tissues called tendons, which allow the muscles to pull on bones. If you wiggle your fingers, you can see the tendons on the back of your hand move as they do their work.

Humans have three different kinds of muscle:

1. Skeletal muscle is attached to bone, mostly in the legs, arms, abdomen, chest, neck, and face. Skeletal muscles are called striated because they are made up of fibers that have horizontal stripes when viewed under a microscope. These muscles hold the skeleton together, give the body shape, and help it with everyday movements (known as voluntary muscles because you can control their movement). They can contract (shorten or tighten) quickly and powerfully, but they tire easily and have to rest between workouts.
2. Smooth, or involuntary, muscle is also made of fibers, but this type of muscle looks smooth, not striated. Generally, we can’t consciously control our smooth muscles; rather, they’re controlled by the nervous system automatically (which is why they’re also called involuntary). Examples of smooth muscles are the walls of the stomach and intestines, which help break up food and move it through the digestive system. Smooth muscle is also found in the walls of blood vessels, where it squeezes the stream of blood flowing through the vessels to help maintain blood pressure. Smooth muscles take longer to contract than skeletal muscles do, but they can stay contracted for a long time because they don’t tire easily.
3. Cardiac muscle is found in the heart. The walls of the heart’s chambers are composed almost entirely of muscle fibers. Cardiac muscle is also an involuntary type of muscle. Its rhythmic, powerful contractions force blood out of the heart as it beats.

Our Nonstop Muscles

Even when we sit perfectly still, muscles throughout the body are constantly moving. Muscles enable the heart to beat, the chest to rise and fall during breathing, and blood vessels to help regulate the pressure and flow of blood through the body. When we smile and talk, muscles help us communicate, and when we exercise, they help us stay physically fit and healthy.

The movements your muscles make are coordinated and controlled by the brain and nervous system. The involuntary muscles are controlled by structures deep within the brain and the upper part of the spinal cord called the brain stem. The voluntary muscles are regulated by the parts of the brain known as the cerebral motor cortex and the cerebellum.

When you decide to move, the motor cortex sends an electrical signal through the spinal cord and peripheral nerves to the muscles, causing them to contract. The motor cortex on the right side of the brain controls the muscles on the left side of the body and vice versa.

The cerebellum coordinates the muscle movements ordered by the motor cortex. Sensors in the muscles and joints send messages back through peripheral nerves to tell the cerebellum and other parts of the brain where and how the arm or leg is moving and what position it’s in. This feedback results in smooth, coordinated motion. If you want to lift your arm, your brain sends a message to the muscles in your arm and you move it. When you run, the messages to the brain are more involved, because many muscles have to work in rhythm.

Muscles move body parts by contracting and then relaxing. Muscles can pull bones, but they can’t push them back to the original position. So they work in pairs of flexors and extensors. The flexor contracts to bend a limb at a joint. Then, when the movement is completed, the flexor relaxes and the extensor contracts to extend or straighten the limb at the same joint. For example, the biceps muscle, in the front of the upper arm, is a flexor, and the triceps, at the back of the upper arm, is an extensor. When you bend at your elbow, the biceps contracts. Then the biceps relaxes and the triceps contracts to straighten the elbow.

Joints and What They Do

Joints occur where two bones meet. They make the skeleton flexible — without them, movement would be impossible.

Joints allow our bodies to move in many ways. Some joints open and close like a hinge (such as knees and elbows), whereas others allow for more complicated movement — a shoulder or hip joint, for example, allows for backward, forward, sideways, and rotating movement.

Joints are classified by their range of movement. Immovable, or fibrous, joints don’t move. The dome of the skull, for example, is made of bony plates, which must be immovable to protect the brain. Between the edges of these plates are links, or joints, of fibrous tissue. Fibrous joints also hold the teeth in the jawbone.

Partially movable, or cartilaginous, joints move a little. They are linked by cartilage, as in the spine. Each of the vertebrae in the spine moves in relation to the one above and below it, and together these movements give the spine its flexibility.

Freely movable, or synovial, joints move in many directions. The main joints of the body — found at the hip, shoulders, elbows, knees, wrists, and ankles — are freely movable. They are filled with synovial fluid, which acts as a lubricant to help the joints move easily.

Three kinds of freely movable joints play a big part in voluntary movement:

1. Hinge joints allow movement in one direction, as seen in the knees and elbows.
2. Pivot joints allow a rotating or twisting motion, like that of the head moving from side to side.
3. Ball-and-socket joints allow the greatest freedom of movement. The hips and shoulders have this type of joint, in which the round end of a long bone fits into the hollow of another bone.

Problems With Bones, Muscles, and Joints

As strong as bones are, they can break. Muscles can weaken, and joints (as well as tendons, ligaments, and cartilage) can be damaged by injury or disease.

Problems that can affect the bones, muscles, and joints include:

• Arthritis. Arthritis is the inflammation of a joint, and people who have it experience swelling, warmth, pain, and often have trouble moving. Although we often think of arthritis as a condition that affects only older people, arthritis can also occur in children and teens. Health problems that involve arthritis in kids and teens include juvenile idiopathic arthritis (JIA, also known as juvenile rheumatoid arthritis, or JRA), lupus, Lyme disease, and septic arthritis (a bacterial infection of a joint).
• Fracture. A fracture is when a bone breaks; it may crack, snap, or shatter. After a fracture, new bone cells fill the gap and repair the break. Applying a strong plaster cast, which keeps the bone in the correct position until it heals, is the usual treatment. If the fracture is complicated, metal pins and plates can be placed to better stabilize it while the bone heals.
• Muscular dystrophy. Muscular dystrophy is an inherited group of diseases that affect the muscles, causing them to weaken and break down over time. The most common form in childhood is called Duchenne muscular dystrophy, and it most often affects boys.
• Osgood-Schlatter disease (OSD). Osgood-Schlatter disease is an inflammation (pain and swelling) of the bone, cartilage, and/or tendon at the top of the shinbone, where the tendon from the kneecap attaches. OSD usually strikes active teens around the beginning of their growth spurts, the approximately 2-year period during which they grow most rapidly.
• Osteomyelitis. Osteomyelitis is a bone infection often caused by Staphylococcus aureus bacteria, though other types of bacteria can cause it, too. In kids and teens, osteomyelitis usually affects the long bones of the arms and legs. Osteomyelitis often develops after an injury or trauma.
• Osteoporosis. In osteoporosis, bone tissue becomes brittle, thin, and spongy. Bones break easily, and the spine sometimes begins to crumble and collapse. Although the condition usually affects older people, kids and teens with eating disorders can get the condition, as can girls with female athlete triad syndrome — a combination of three conditions that some girls who exercise or play sports may be at risk for: disordered eating, amenorrhea (loss of a girl’s period), and osteoporosis. Participation in sports where a thin appearance is valued can put a girl at risk for female athlete triad.
• Repetitive stress injuries (RSIs). RSIs are a group of injuries that happen when too much stress is placed on a part of the body, resulting in inflammation (pain and swelling), muscle strain, or tissue damage. This stress generally occurs from repeating the same movements over and over again. Playing sports like tennis that involve repetitive motions can also lead to RSIs. Kids and teens who spend a lot of time playing musical instruments or video games are also at risk for RSIs. RSIs are becoming more common in kids and teens because they spend more time than ever using computers.
• Scoliosis. Every person’s spine curves a little bit; a certain amount of curvature is necessary for people to move and walk properly. But 3–5 people out of 1,000 have scoliosis, which causes the spine to curve too much. It can be hereditary, so someone who has scoliosis often has family members who have it.
• Strains and sprains. Strains occur when muscles or tendons are overstretched. Sprains are an overstretching or a partial tearing of the ligaments. Strains usually happen when a person takes part in a strenuous activity when the muscles haven’t properly warmed up or the muscle is not used to the activity (such as a new sport or playing a familiar sport after a long break).

  Sprains, on the other hand, are usually the result of an injury, such as twisting an ankle or knee. A common sprain injury is a torn Achilles tendon, which connects the calf muscles to the heel. This tendon can snap, but it usually can be repaired by surgery. Both strains and sprains are common in kids and teens because they’re active and still growing.

• Tendonitis. This common sports injury that usually happens after overexercising a muscle. The tendon and tendon sheath become inflamed, which can be painful. Resting the muscles and taking anti-inflammatory medication can bring relief.

You’re in the middle of a meeting at work, but your mind keeps drifting to the parent–teacher conference you have tonight … and the dry cleaning you have to pick up on the way home … and how you wish you hadn’t skipped lunch because the rumbling in your stomach is driving you nuts. Then, suddenly, you’re back in the moment, hoping nobody noticed your brief “departure.”

It may seem as if your brain is always on the go. And it is. The brain not only controls what you think and feel, how you learn and remember, and the way you move and talk, but also many things you’re less aware of — such as the beating of your heart, the digestion of your food, and yes, even the amount of stress you feel. Like you, your brain is quite the juggler.

Anatomy of the Nervous System

If you think of the brain as a central computer that controls all bodily functions, then the nervous system is like a network that relays messages back and forth from the brain to different parts of the body. It does this via the spinal cord, which runs from the brain down through the back and contains threadlike nerves that branch out to every organ and body part.

When a message comes into the brain from anywhere in the body, the brain tells the body how to react. For example, if you accidentally touch a hot stove, the nerves in your skin shoot a message of pain to your brain. The brain then sends a message back telling the muscles in your hand to pull away. Luckily, this neurological relay race takes a lot less time than it just took to read about it.

Considering everything it does, the human brain is incredibly compact, weighing just 3 pounds. Its many folds and grooves, though, provide it with the additional surface area necessary for storing all of the body’s important information.

The spinal cord, on the other hand, is a long bundle of nerve tissue about 18 inches long and ¾ inch thick. It extends from the lower part of the brain down through spine. Along the way, various nerves branch out to the entire body. These make up the peripheral nervous system.

Both the brain and the spinal cord are protected by bone: the brain by the bones of the skull, and the spinal cord by a set of ring-shaped bones called vertebrae. They’re both cushioned by layers of membranes called meninges as well as a special fluid called cerebrospinal fluid. This fluid helps protect the nerve tissue, keep it healthy, and remove waste products.

All About the Brain

The brain is made up of three main sections: the forebrain, the midbrain, and the hindbrain.

1. The Forebrain

The forebrain is the largest and most complex part of the brain. It consists of the cerebrum — the area with all the folds and grooves typically seen in pictures of the brain — as well as some other structures beneath it.

The cerebrum contains the information that essentially makes us who we are: our intelligence, memory, personality, emotion, speech, and ability to feel and move. Specific areas of the cerebrum are in charge of processing these different types of information. These are called lobes, and there are four of them: the frontal, parietal, temporal, and occipital.

The cerebrum has right and left halves, called hemispheres, which are connected in the middle by a band of nerve fibers (the corpus collosum) that enables the two sides to communicate. Though these halves may look like mirror images of each other, many scientists believe they have different functions. The left side is considered the logical, analytical, objective side. The right side is thought to be more intuitive, creative, and subjective. So when you’re balancing the checkbook, you’re using the left side; when you’re listening to music, you’re using the right side. It’s believed that some people are more “right-brained” or “left-brained” while others are more “whole-brained,” meaning they use both halves of their brain to the same degree.

The outer layer of the cerebrum is called the cortex (also known as “gray matter”). Information collected by the five senses comes into the brain from the spinal cord to the cortex. This information is then directed to other parts of the nervous system for further processing. For example, when you touch the hot stove, not only does a message go out to move your hand but one also goes to another part of the brain to help you remember not to do that again.

In the inner part of the forebrain sits the thalamus, hypothalamus, and pituitary gland. The thalamus carries messages from the sensory organs like the eyes, ears, nose, and fingers to the cortex. The hypothalamus controls the pulse, thirst, appetite, sleep patterns, and other processes in our bodies that happen automatically. It also controls the pituitary gland, which makes the hormones that control our growth, metabolism, water and mineral balance, sexual maturity, and response to stress.

2. The Midbrain

The midbrain, located underneath the middle of the forebrain, acts as a master coordinator for all the messages going in and out of the brain to the spinal cord.

3. The Hindbrain

The hindbrain sits underneath the back end of the cerebrum, and it consists of the cerebellum, pons, and medulla. The cerebellum — also called the “little brain” because it looks like a small version of the cerebrum — is responsible for balance, movement, and coordination.

The pons and the medulla, along with the midbrain, are often called the brainstem. The brainstem takes in, sends out, and coordinates all of the brain’s messages. It also controls many of the body’s automatic functions, like breathing, heart rate, blood pressure, swallowing, digestion, and blinking.

How the Nervous System Works

The basic functioning of the nervous system depends a lot on tiny cells called neurons. The brain has billions of them, and they have many specialized jobs. For example, sensory neurons take information from the eyes, ears, nose, tongue, and skin to the brain. Motor neurons carry messages away from the brain and back to the rest of the body.

All neurons, however, relay information to each other through a complex electrochemical process, making connections that affect the way we think, learn, move, and behave.

Intelligence, learning, and memory. At birth, the nervous system contains all the neurons you will ever have, but many of them are not connected to each other. As you grow and learn, messages travel from one neuron to another over and over, creating connections, or pathways, in the brain. It’s why driving seemed to take so much concentration when you first learned but now is second nature: The pathway became established.

In young children, the brain is highly adaptable; in fact, when one part of a young child’s brain is injured, another part can often learn to take over some of the lost function. But as we age, the brain has to work harder to make new neural pathways, making it more difficult to master new tasks or change established behavior patterns. That’s why many scientists believe it’s important to keep challenging your brain to learn new things and make new connections — it helps keeps the brain active over the course of a lifetime.

Memory is another complex function of the brain. The things we’ve done, learned, and seen are first processed in the cortex. Then, if we sense that this information is important enough to remember permanently, it’s passed inward to other regions of the brain (such as the hippocampus and amygdala) for long-term storage and retrieval. As these messages travel through the brain, they too create pathways that serve as the basis of our memory.

Movement. Different parts of the cerebrum are responsible for moving different body parts. The left side of the brain controls the movements of the right side of the body, and the right side of the brain controls the movements of the left side of the body. When you press the accelerator with your right foot, for example, it’s the left side of your brain that sends the message allowing you to do it.

Basic body functions. A part of the peripheral nervous system called the autonomic nervous system is responsible for controlling many of the body processes we almost never need to think about, like breathing, digestion, sweating, and shivering. The autonomic nervous system has two parts: the sympathetic and the parasympathetic nervous systems.

The sympathetic nervous system prepares the body for sudden stress, like if you see a robbery taking place. When something frightening happens, the sympathetic nervous system makes the heart beat faster so that it sends blood more quickly to the different body parts that might need it. It also causes the adrenal glands at the top of the kidneys to release adrenaline, a hormone that helps give extra power to the muscles for a quick getaway. This process is known as the body’s “fight or flight” response.

The parasympathetic nervous system does the exact opposite: It prepares the body for rest. It also helps the digestive tract move along so our bodies can efficiently take in nutrients from the food we eat.

The senses. Your spouse may be a sight for sore eyes at the end of a long day — but without the brain, you wouldn’t even recognize him or her. Pepperoni pizza sure is delicious — but without the brain, your taste buds wouldn’t be able to tell if you were eating pizza or the box it came in. None of your senses would be useful without the processing that happens in the brain.

• Sight. Sight probably tells us more about the world than any other sense. Light entering the eye forms an upside-down image on the retina. The retina transforms the light into nerve signals for the brain. The brain then turns the image right-side up and tells us what we are seeing.
• Hearing. Every sound we hear is the result of sound waves entering our ears and causing our eardrums to vibrate. These vibrations are then transferred along the tiny bones of the middle ear and converted into nerve signals. The cortex then processes these signals, telling us what we are hearing.
• Taste. The tongue contains small groups of sensory cells called taste buds that react to chemicals in foods. Taste buds react to sweet, sour, salty, and bitter. Messages are sent from the taste buds to the areas in the cortex responsible for processing taste.
• Smell. Olfactory cells in the mucous membranes lining each nostril react to chemicals we breathe in and send messages along specific nerves to the brain — which, according to experts, can distinguish between more than 10,000 different smells. With that kind of sensitivity, it’s no wonder research suggests that smells are very closely linked to our memories.
• Touch. The skin contains more than 4 million sensory receptors — mostly concentrated in the fingers, tongue, and lips — that gather information related to touch, pressure, temperature, and pain and send it to the brain for processing and reaction.

Things That Can Go Wrong With the Brain

Because the brain controls just about everything, when something goes wrong with it, it’s often serious and can affect many different parts of the body. Inherited diseases, brain disorders associated with mental illness, and head injuries all can affect the way the brain works and upset the daily activities of the rest of the body.

Problems that can affect the brain include:

Brain tumors. A brain tumor is an abnormal tissue growth in the brain. A tumor in the brain may grow slowly and produce few symptoms until it becomes large, or it can grow and spread rapidly, causing severe and quickly worsening symptoms. Brain tumors in children can be benign or malignant. Benign tumors usually grow in one place and may be curable through surgery if they’re located in a place where they can be removed without damaging the normal tissue near the tumor. A malignant tumor is cancerous and more likely to grow rapidly and spread.

Cerebral palsy. Cerebral palsy is the result of a developmental defect or damage to the brain before or during a baby’s birth, or during the first few years of a child’s life. It affects the motor areas of the brain. A person with cerebral palsy may have average intelligence or can have severe developmental delays or intellectual disability. Cerebral palsy can affect body movement in many different ways. In mild cases of cerebral palsy, there may be minor muscle weakness of the arms and legs. In other cases, there may be more severe motor impairment — a child may have trouble talking and doing basic movements like walking.

Epilepsy. This condition includes a wide variety of seizure disorders. Partial seizures involve specific areas of the brain, and symptoms vary depending on the location of the seizure activity. Other seizures, called generalized seizures, involve a larger portion of the brain and usually cause uncontrolled movements of the entire body and loss of consciousness when they happen. Although the specific cause is unknown in many cases, epilepsy can be related to brain injury, tumors, or infections. The tendency to develop epilepsy may run in families.

Headaches. Of the many different types of headaches, the most common include tension headache (the most common), caused by muscle tension in the head, neck, and shoulders; migraine, an intense, recurring headache with an unclear cause; and cluster headache, considered by some to be a form of migraine. Migraines happen with or without warning and may last for several hours or days. There seems to be an inherited risk for migraines and certain triggers that can lead to them. People with migraines may have dizziness, numbness, sensitivity to light, and nausea, and may see flashing zigzag lines before their eyes.

Meningitis and encephalitis. These infections of the brain and spinal cord are usually caused by bacteria or viruses. Meningitis is an inflammation of the coverings of the brain and spinal cord, and encephalitis is an inflammation of the brain tissue. Both conditions may cause permanent injury to the brain.

Mental illness. Mental illnesses are psychological and behavioral in nature and involve a wide range of problems in thought and function. Certain mental illnesses are now known to be linked to structural abnormalities or chemical dysfunction of the brain. Some are inherited. But often the cause is unknown. Injuries to the brain and chronic drug or alcohol abuse also can trigger some mental illnesses. Signs of chronic mental illnesses such as bipolar disorder or schizophrenia may first show up in childhood. Mental illnesses that can be seen in younger people include depression, eating disorders such as bulimia or anorexia nervosa, obsessive-compulsive disorder (OCD), and phobias.

Head injuries. Head injuries fit into two categories: external (usually scalp) injuries and internal head injuries. Internal injuries may involve the skull, the blood vessels within the skull, or the brain. Fortunately, most childhood falls or blows to the head result in injury to the scalp only, which is usually more frightening than dangerous. An internal head injury could have more serious implications.

Concussions are also a type of internal head injury. A concussion is the temporary loss of normal brain function as a result of an injury. Repeated concussions can result in permanent brain injury. One of the most common reasons kids get concussions is through sports, so it’s important to make sure they wear appropriate protective gear and don’t continue to play if they’ve had a head injury.

The first step in the digestive process happens before we even taste food. Just by smelling that homemade apple pie or thinking about how delicious that ripe tomato is going to be, you start salivating — and the digestive process begins in preparation for that first bite.

Food is our fuel, and its nutrients give our bodies’ cells the energy and substances they need to operate. But before food can do that, it must be digested into small pieces the body can absorb and use.

About the Digestive System

Almost all animals have a tube-type digestive system in which food enters the mouth, passes through a long tube, and exits as feces (poop) through the anus. The smooth muscle in the walls of the tube-shaped digestive organs rhythmically and efficiently moves the food through the system, where it is broken down into tiny absorbable atoms and molecules.

During the process of absorption, nutrients that come from the food (including carbohydrates, proteins, fats, vitamins, and minerals) pass through channels in the intestinal wall and into the bloodstream. The blood works to distribute these nutrients to the rest of the body. The waste parts of food that the body can’t use are passed out of the body as feces.

Every morsel of food we eat has to be broken down into nutrients that can be absorbed by the body, which is why it takes hours to fully digest food. In humans, protein must be broken down into amino acids, starches into simple sugars, and fats into fatty acids and glycerol. The water in our food and drink is also absorbed into the bloodstream to provide the body with the fluid it needs.

How Digestion Works

The digestive system is made up of the alimentary canal (also called the digestive tract) and the other abdominal organs that play a part in digestion, such as the liver and pancreas. The alimentary canal is the long tube of organs — including the esophagus, stomach, and intestines — that runs from the mouth to the anus. An adult’s digestive tract is about 30 feet (about 9 meters) long.

Digestion begins in the mouth, well before food reaches the stomach. When we see, smell, taste, or even imagine a tasty meal, our salivary glands, which are located under the tongue and near the lower jaw, begin producing saliva. This flow of saliva is set in motion by a brain reflex that’s triggered when we sense food or think about eating. In response to this sensory stimulation, the brain sends impulses through the nerves that control the salivary glands, telling them to prepare for a meal.

As the teeth tear and chop the food, saliva moistens it for easy swallowing. A digestive enzyme called amylase, which is found in saliva, starts to break down some of the carbohydrates (starches and sugars) in the food even before it leaves the mouth.

Swallowing, which is accomplished by muscle movements in the tongue and mouth, moves the food into the throat, or pharynx. The pharynx, a passageway for food and air, is about 5 inches (12.7 centimeters) long. A flexible flap of tissue called the epiglottis reflexively closes over the windpipe when we swallow to prevent choking.

From the throat, food travels down a muscular tube in the chest called the esophagus. Waves of muscle contractions called peristalsis force food down through the esophagus to the stomach. A person normally isn’t aware of the movements of the esophagus, stomach, and intestine that take place as food passes through the digestive tract.

At the end of the esophagus, a muscular ring or valve called a sphincter allows food to enter the stomach and then squeezes shut to keep food or fluid from flowing back up into the esophagus. The stomach muscles churn and mix the food with acids and enzymes, breaking it into much smaller, digestible pieces. An acidic environment is needed for the digestion that takes place in the stomach. Glands in the stomach lining produce about 3 quarts (2.8 liters) of these digestive juices each day.

Most substances in the food we eat need further digestion and must travel into the intestine before being absorbed. When it’s empty, an adult’s stomach has a volume of one fifth of a cup (1.6 fluid ounces), but it can expand to hold more than 8 cups (64 fluid ounces) of food after a large meal.

Role of the Intestines

By the time food is ready to leave the stomach, it has been processed into a thick liquid called chyme. A walnut-sized muscular valve at the outlet of the stomach called the pylorus keeps chyme in the stomach until it reaches the right consistency to pass into the small intestine. Chyme is then squirted down into the small intestine, where digestion of food continues so the body can absorb the nutrients into the bloodstream.

The small intestine is made up of three parts:

1. the duodenum, the C-shaped first part
2. the jejunum, the coiled midsection
3. the ileum, the final section that leads into the large intestine

The inner wall of the small intestine is covered with millions of microscopic, finger-like projections called villi. The villi are the vehicles through which nutrients can be absorbed into the body.

The liver (located under the ribcage in the right upper part of the abdomen), the gallbladder (hidden just below the liver), and the pancreas (beneath the stomach) are not part of the alimentary canal, but these organs are essential to digestion.

The liver produces bile, which helps the body absorb fat. Bile is stored in the gallbladder until it is needed. The pancreas produces enzymes that help digest proteins, fats, and carbs. It also makes a substance that neutralizes stomach acid. These enzymes and bile travel through special channels (called ducts) directly into the small intestine, where they help to break down food. The liver also plays a major role in the handling and processing of nutrients, which are carried to the liver in the blood from the small intestine.

From the small intestine, undigested food (and some water) travels to the large intestine through a muscular ring or valve that prevents food from returning to the small intestine. By the time food reaches the large intestine, the work of absorbing nutrients is nearly finished. The large intestine’s main function is to remove water from the undigested matter and form solid waste that can be excreted.

The large intestine is made up of three parts:

1. The cecum is a pouch at the beginning of the large intestine that joins the small intestine to the large intestine. This transition area expands in diameter, allowing food to travel from the small intestine to the large. The appendix, a small, hollow, finger-like pouch, hangs at the end of the cecum. Doctors believe the appendix is left over from a previous time in human evolution. It no longer appears to be useful to the digestive process.
2. The colon extends from the cecum up the right side of the abdomen, across the upper abdomen, and then down the left side of the abdomen, finally connecting to the rectum. The colon has three parts: the ascending colon; the transverse colon, which absorb fluids and salts; and the descending colon, which holds the resulting waste. Bacteria in the colon help to digest the remaining food products.
3. The rectum is where feces are stored until they leave the digestive system through the anus as a bowel movement.

Digestive System Problems

Nearly everyone has a digestive problem at one time or another. Some conditions, like indigestion or mild diarrhea, are common; they result in mild discomfort and get better on their own or are easy to treat. Others, such as inflammatory bowel disease (IBD), can be ongoing and troublesome and should be discussed with a GI specialist or gastroenterologist (doctors who specialize in the digestive system).

Problems With the Esophagus

Problems affecting the esophagus may be congenital (present at birth) or noncongenital (developed after birth). Examples include:

• Congenital conditions. Tracheoesophageal fistula is a connection between the esophagus and the trachea (windpipe) where there shouldn’t be one. In babies with esophageal atresia, the esophagus comes to a dead end instead of connecting to the stomach. Both conditions are usually detected soon after a baby is born — sometimes even before — and require surgery to repair.
• Noncongenital conditions. Esophagitis (inflammation of the esophagus) can be caused by infection, certain medications, or gastroesophageal reflux disease (GERD). With GERD, the esophageal sphincter (the valve that connects the esophagus with the stomach) doesn’t work well and allows the acidic contents of the stomach to move backward up into the esophagus. GERD often can be corrected through lifestyle changes, such as dietary adjustments. Sometimes, though, it requires treatment with medication.

Problems With the Stomach and Intestines

Almost everyone has had diarrhea or constipation. With diarrhea, muscle contractions move the contents of the intestines along too quickly and there isn’t enough time for water to be absorbed before the feces are pushed out of the body.

Constipation is the opposite: The contents of the large intestines do not move along fast enough and waste materials stay in the large intestine so long that too much water is removed and the feces become hard.

Other common stomach and intestinal disorders include:

• Gastrointestinal infections can be caused by viruses, by bacteria (such as Salmonella, Shigella, Campylobacter, or E. coli), or by intestinal parasites (such as amebiasis and giardiasis). Abdominal pain or cramps, diarrhea, and sometimes vomiting are the common symptoms of gastrointestinal infections. These usually go away on their own without medicines or other treatment.
• Appendicitis, an inflammation of the appendix, most often affects kids and teens between 11 and 20 years old, and requires surgery to correct. The classic symptoms of appendicitis are abdominal pain, fever, loss of appetite, and vomiting.
• Gastritis and peptic ulcers arise when a bacterium, Helicobacter pylori, or the chronic use of drugs or certain medications weakens the protective mucous coating of the stomach and duodenum, allowing acid to get through to the sensitive lining beneath. This can irritate and inflame the lining of the stomach (gastritis) or cause peptic ulcers, which are sores or holes in the lining of the stomach or the duodenum that cause pain or bleeding. Medications usually successfully treat these conditions.
• Inflammatory bowel disease (IBD) is chronic inflammation of the intestines that affects older kids, teens, and adults. There are two major types: ulcerative colitis, which usually affects just the rectum and the large intestine; and Crohn’s disease, which can affect the whole gastrointestinal tract from the mouth to the anus as well as other parts of the body. They are treated with medications and, if necessary, intravenous (IV) feedings to provide nutrition. In some cases, surgery may be necessary to remove inflamed or damaged areas of the intestine.
• Celiac disease is a disorder in which the digestive system is damaged by the response of the immune system to a protein called gluten, which is found in wheat, rye, and barley and a wide range of foods, from breakfast cereal to pizza crust. People with celiac disease have difficulty digesting the nutrients from their food and may have diarrhea, abdominal pain, bloating, exhaustion, and even depression when they eat foods with gluten. Symptoms can be managed by following a gluten-free diet. Celiac disease runs in families and can become active after some sort of stress, such as surgery or a viral infection. A doctor can diagnose celiac disease with a blood test and by taking a biopsy of the small intestine.
• Irritable bowel syndrome (IBS), a common intestinal disorder, affects the colon and may cause recurrent abdominal cramps, bloating, constipation, and diarrhea. There is no cure, but IBS symptoms may be treated by changing eating habits, reducing stress, and making lifestyle changes. A doctor may also prescribe medications to relieve diarrhea or constipation. No one test is used to diagnose IBS, but a doctor may identify it based on symptoms, medical history, and a physical exam.

Problems With the Pancreas, Liver, and Gallbladder

Conditions affecting the pancreas, liver, and gallbladder often affect the ability of these organs to produce enzymes and other substances that aid in digestion. Examples include:

• Cystic fibrosis is a chronic, inherited illness that not only affects the lungs but also causes the production of abnormally thick mucus to block the ducts or passageways in the pancreas. This mucus also prevents digestive juices from entering the intestines, making it difficult to properly digest proteins and fats. This causes important nutrients to pass out of the body unused. To help manage their digestive problems, people with cystic fibrosis can take digestive enzymes and nutritional supplements.
• Hepatitis, a condition with many different causes, is when the liver becomes inflamed and may lose its ability to function. Viral hepatitis, such as hepatitis A, B, or C, is highly contagious. Mild cases of hepatitis A can be treated at home; however, serious cases involving liver damage may require hospitalization.
• The gallbladder can develop gallstones and become inflamed — a condition called cholecystitis. Although gallbladder conditions are uncommon in kids and teens, they can happen in those who have sickle cell disease or are being treated with certain long-term medicines.

Keeping Digestion on Track

The kinds and amounts of food a person eats and how the digestive system processes that food play key roles in maintaining good health. Eating a healthy diet is the best way to prevent common digestive problems.

Although we rarely think about them, the glands of the endocrine system and the hormones they release influence almost every cell, organ, and function of our bodies. The endocrine system is instrumental in regulating mood, growth and development, tissue function, and metabolism, as well as sexual function and reproductive processes.

In general, the endocrine system is in charge of body processes that happen slowly, such as cell growth. Faster processes like breathing and body movement are controlled by the nervous system. But even though the nervous system and endocrine system are separate systems, they often work together to help the body function properly.

About the Endocrine System

The foundations of the endocrine system are the hormones and glands. As the body’s chemical messengers, hormones transfer information and instructions from one set of cells to another. Although many different hormones circulate throughout the bloodstream, each one affects only the cells that are genetically programmed to receive and respond to its message. Hormone levels can be influenced by factors such as stress, infection, and changes in the balance of fluid and minerals in blood.

A gland is a group of cells that produces and secretes, or gives off, chemicals. A gland selects and removes materials from the blood, processes them, and secretes the finished chemical product for use somewhere in the body.

Some types of glands release their secretions in specific areas. For instance, exocrine glands, such as the sweat and salivary glands, release secretions in the skin or inside of the mouth. Endocrine glands, on the other hand, release more than 20 major hormones directly into the bloodstream, where they can move to cells in other parts of the body.

Parts of the Endocrine System

The major glands that make up the human endocrine system are the hypothalamus, pituitary, thyroid, parathyroids, adrenals, pineal body, and the reproductive glands, which include the ovaries and testes. The pancreas is also part of this hormone-secreting system, even though it is also associated with the digestive system because it also produces and secretes digestive enzymes.

Although the endocrine glands are the body’s main hormone producers, some non-endocrine organs — such as the brain, heart, lungs, kidneys, liver, thymus, skin, and placenta — also produce and release hormones.

The Hypothalamus

The hypothalamus, a collection of specialized cells that is located in the lower central part of the brain, is the primary link between the endocrine and nervous systems. Nerve cells in the hypothalamus control the pituitary gland by producing chemicals that either stimulate or suppress hormone secretions from the pituitary.

Although it is no bigger than a pea, the pituitary gland, located at the base of the brain just beneath the hypothalamus, is considered the most important part of the endocrine system. It’s often called the “master gland” because it makes hormones that control several other endocrine glands.

The production and secretion of pituitary hormones can be influenced by factors such as emotions and seasonal changes. To accomplish this, the hypothalamus relays information sensed by the brain (such as environmental temperature, light exposure patterns, and feelings) to the pituitary.

The Pituitary Gland

The tiny pituitary gland is divided into two parts: the anterior lobe and the posterior lobe. The anterior lobe regulates the activity of the thyroid, adrenals, and reproductive glands. Among the hormones it produces are:

• growth hormone, which stimulates the growth of bone and other body tissues and plays a role in the body’s handling of nutrients and minerals
• prolactin, which activates milk production in women who are breastfeeding
• thyrotropin, which stimulates the thyroid gland to produce thyroid hormones
• corticotropin, which stimulates the adrenal gland to produce certain hormones

The pituitary also secretes endorphins, chemicals that act on the nervous system to reduce sensitivity to pain. In addition, the pituitary secretes hormones that signal the ovaries and testes to make sex hormones. The pituitary gland also controls ovulation and the menstrual cycle in women.

The posterior lobe of the pituitary releases antidiuretic hormone, which helps control body water balance through its effect on the kidneys and urine output; and oxytocin, which triggers the contractions of the uterus that occur during labor.

The Thyroid and Parathyroids

The thyroid, located in the front part of the lower neck, is shaped like a bow tie or butterfly and produces the thyroid hormones thyroxine and triiodothyronine. These hormones control the rate at which cells burn fuels from food to produce energy. As the level of thyroid hormones increases in the bloodstream, so does the speed at which chemical reactions occur in the body.

Thyroid hormones also play a key role in bone growth and the development of the brain and nervous system in children. The production and release of thyroid hormones is controlled by thyrotropin, which is secreted by the pituitary gland.

Attached to the thyroid are four tiny glands that function together called the parathyroids. They release parathyroid hormone, which regulates the level of calcium in the blood with the help of calcitonin, which is produced in the thyroid.

The Adrenal Glands

The body has two triangular adrenal glands, one on top of each kidney. The adrenal glands have two parts, each of which produces a set of hormones and has a different function. The outer part, the adrenal cortex, produces hormones called corticosteroids that influence or regulate salt and water balance in the body, the body’s response to stress, metabolism, the immune system, and sexual development and function.

The inner part, the adrenal medulla, produces catecholamines, such as epinephrine. Also called adrenaline, epinephrine increases blood pressure and heart rate when the body experiences stress. (Epinephrine injections are often used to counteract a severe allergic reaction.)

The Pineal Gland and Gonads

The pineal body, also called the pineal gland, is located in the middle of the brain. It secretes melatonin, a hormone that may help regulate the wake–sleep cycle.

The gonads are the main source of sex hormones. In males, they are located in the scrotum. Male gonads, or testes, secrete hormones called androgens, the most important of which is testosterone. These hormones regulate body changes associated with sexual development, including enlargement of the penis, the growth spurt that happens during puberty, and the appearance of other male secondary sex characteristics such as deepening of the voice, growth of facial and pubic hair, and the increase in muscle growth and strength. Working with hormones from the pituitary gland, testosterone also supports the production of sperm by the testes.

The female gonads, the ovaries, are in the pelvis. They produce eggs and secrete the female hormones estrogen and progesterone. Estrogen is involved in the development of female sexual features such as breast growth, the build-up of body fat around the hips and thighs, and the growth spurt that happens during puberty. Both estrogen and progesterone are also involved in pregnancy and the regulation of the menstrual cycle.

The Pancreas

The pancreas produces (in addition to others) two important hormones, insulin and glucagon. They work together to maintain a steady level of glucose, or sugar, in the blood and to keep the body supplied with fuel to produce and maintain stores of energy.

What the Endocrine System Does

Once a hormone is secreted, it travels from the endocrine gland through the bloodstream to target cells designed to receive its message. Along the way to the target cells, special proteins bind to some of the hormones. The special proteins act as carriers that control the amount of hormone that is available to interact with and affect the target cells.

Also, the target cells have receptors that latch onto only specific hormones, and each hormone has its own receptor, so that each hormone will communicate only with specific target cells that possess receptors for that hormone. When the hormone reaches its target cell, it locks onto the cell’s specific receptors and these hormone-receptor combinations transmit chemical instructions to the inner workings of the cell.

When hormone levels reach a certain normal or necessary amount, further secretion is controlled by important body mechanisms to maintain that level of hormone in the blood. This regulation of hormone secretion may involve the hormone itself or another substance in the blood related to the hormone.

For example, if the thyroid gland has secreted adequate amounts of thyroid hormones into the blood, the pituitary gland senses the normal levels of thyroid hormone in the bloodstream and adjusts its release of thyrotropin, the pituitary hormone that stimulates the thyroid gland to produce thyroid hormones.

Another example is parathyroid hormone, which increases the level of calcium in the blood. When the blood calcium level rises, the parathyroid glands sense the change and decrease their secretion of parathyroid hormone. This turnoff process is called a negative feedback system.

Problems With the Endocrine System

Too much or too little of any hormone can be harmful to the body. For example, if the pituitary gland produces too much growth hormone, a child may grow excessively tall. If it produces too little, a child may be abnormally short.

Controlling the production of or replacing specific hormones can treat many endocrine disorders in children and adolescents, some of which include:

Adrenal insufficiency. This condition is characterized by decreased function of the adrenal cortex and the consequent underproduction of adrenal corticosteroid hormones. The symptoms of adrenal insufficiency may include weakness, fatigue, abdominal pain, nausea, dehydration, and skin changes. Doctors treat adrenal insufficiency by giving replacement corticosteroid hormones.

Cushing syndrome. Excessive amounts of glucocorticoid hormones in the body can lead to Cushing syndrome. In children, it most often results when a child takes large doses of synthetic corticosteroid drugs (such as prednisone) to treat autoimmune diseases such as lupus. If the condition is due to a tumor in the pituitary gland that produces excessive amounts of corticotropin and stimulates the adrenals to overproduce corticosteroids, it’s known as Cushing disease.

Symptoms may take years to develop and include obesity, growth failure, muscle weakness, easy bruising of the skin, acne, high blood pressure, and psychological changes. Depending on the specific cause, doctors may treat this condition with surgery, radiation therapy, chemotherapy, or drugs that block the production of hormones.

Type 1 diabetes. Previously known as juvenile diabetes, this condition happens when the pancreas doesn’t produce enough insulin. In children and teens, it’s usually the result of an autoimmune disorder in which specific immune system cells and antibodies produced by the immune system attack and destroy the cells of the pancreas that produce insulin. Symptoms include excessive thirst, hunger, urination (peeing), and weight loss.

Type 1 diabetes can cause long-term complications, including kidney problems, nerve damage, blindness, and early coronary heart disease and stroke. To control their blood sugar levels and reduce the risk of developing diabetes complications, kids need regular injections of insulin.

Type 2 diabetes. Unlike type 1 diabetes, in which the body can’t produce normal amounts of insulin, in type 2 diabetes the body can’t respond to insulin normally. Children and teens who have it tend to be overweight, and it is believed that excess body fat plays a role in this insulin resistance. In fact, the rate of type 2 diabetes in kids has risen along with the dramatically increasing rates of obesity among kids.

The symptoms and possible complications of type 2 diabetes are basically the same as those of type 1. Some kids and teens can control their blood sugar level with dietary changes, exercise, and oral medications, but many will need to take insulin injections like those with type 1 diabetes.

Growth hormone problems. Too much growth hormone in children who are still growing will make their bones and other body parts grow excessively, resulting in gigantism. This rare condition is usually caused by a pituitary tumor and can be treated by removing the tumor.

In contrast, when the pituitary gland fails to produce adequate amounts of growth hormone, a child’s growth in height is impaired. Hypoglycemia (low blood sugar) may also occur in kids with growth hormone deficiency, particularly in infants and young children with the condition.

Hyperthyroidism. Hyperthyroidism is a condition in which the levels of thyroid hormones in the blood are excessively high. Symptoms may include weight loss, nervousness, tremors, excessive sweating, increased heart rate and blood pressure, protruding eyes, and a swelling in the neck from an enlarged thyroid gland (goiter).

In kids this is usually caused by Graves’ disease, an autoimmune disorder in which specific antibodies produced by the immune system stimulate the thyroid gland to become overactive. The disease may be controlled with medications or by removal or destruction of the thyroid gland through surgery or radiation treatments.

Hypothyroidism. Hypothyroidism is when the levels of thyroid hormones in the blood are abnormally low. Thyroid hormone deficiency slows body processes and may lead to fatigue, a slow heart rate, dry skin, weight gain, constipation, and, in kids, slowing of growth and delayed puberty.

Hashimoto’s thyroiditis, which results from an autoimmune process that damages the thyroid and blocks thyroid hormone production, is the most common cause of hypothyroidism in kids. Infants can also be born with an absent or underdeveloped thyroid gland, resulting in hypothyroidism. It can be treated with oral thyroid hormone replacement.

Precocious puberty. Body changes associated with puberty may occur at an abnormally young age in some kids if the pituitary hormones that stimulate the gonads to produce sex hormones rise prematurely. An injectable medication is available that can suppress the secretion of these pituitary hormones (known as gonadotropins) and arrest the progression of sexual development in most of these children.

All About Eyes

Sight, more than any of our senses, helps us navigate the world around us. In a single glance, lasting a fraction of a second, our eyes work with our brains to tell us the size, shape, color, and texture of an object. They let us know how close it is, whether it’s standing still or coming toward us, and how quickly it’s moving.

The eyes are small compared with most organs, but their structure is incredibly complex. They work together to perceive depth, enabling us to judge distance and the size of objects to help us move around them. They also work with the brain, muscles, and nerves to produce complicated visual images and messages. And they constantly adapt to the changing environment — for example, adjusting so that we can easily move around in a nearly dark room or bright sunlight.

To understand how the eyes work, it’s important to know about their structure and about conditions and diseases that can interfere with vision.

How Eyes Work

Only part of the eye is visible in a person’s face. The whole eye — the eyeball — is about the size and shape of a ping-pong ball.

All parts of the eye are extremely delicate, so our bodies protect them in several ways. The eyeball sits in the eye socket (also called the orbit) in the skull, where it is surrounded by bone. The visible part of the eye is protected by the eyelids and the eyelashes, which keep dirt, dust, and even harmful bright light out of the eye.

Eyes are also protected by tears, which moisten them and clean out dirt, dust, and other irritants that get past the defenses of the eyelashes and eyelids. Tears also help protect against infection.

With each blink, our eyelids spread a layer of mucus, oil, and tears over the cornea, which covers the eye. The lacrimal glands in the upper outer corner of each eye socket produce tears, which, after moistening the eyes, flow into canals in the eyelids. These canals drain into the lacrimal sac, a pouch in the lower inner corner of each eye socket. Tears then exit through a passage that leads to the nose.

To see, the eye has to move. Six extraocular muscles surround the eyeball and act like the strings on a puppet, moving the eye in different directions. The muscles of each eye normally move together at the same time, allowing the two eyes to remain aligned.

How Vision Works

The wall of an eyeball is made up of three layers, rather like the layers of an onion:

1. The sclera is the outermost protective layer. This tough, fibrous tissue surrounds the eyeball and attaches to the cornea, which is the clear front surface of the eye. What we see as the white of the eye is the sclera. Over the sclera lies the conjunctiva, a clear skin layer that protects the eye from becoming dry.
2. The choroid is the middle layer that contains blood vessels that deliver oxygen and nutrients to the inside parts of the eye.
3. The retina, the innermost of the three layers, lines the inside of the eyeball. The retina is a soft, light-sensitive layer of nervous system tissue. The optic nerve carries signals from the retina to the brain, which interprets them as visual images.

The space in the center of the eyeball is filled with a clear jelly-like material called the vitreous humor. This material allows light to pass through to the retina. It also helps the eye keep its round shape.

Vision is the process by which images captured by the eye are interpreted by the brain, and the visible part of the eye is where the process of sight begins. On the front surface of the eye is the see-through, circle-shaped cornea. You can’t see a person’s cornea the way you can see the colored part of the eye behind it — the cornea is like a clear window that focuses light into the eye.

Behind the cornea is a watery fluid called the aqueous humor. The cornea and aqueous humor form an outer lens that refracts (bends) light on its way into the eye. This is where most of the eye’s focusing work is done.

The colored circular membrane in the eye just behind the cornea is called the iris. The iris controls the amount of light entering the eye through the pupil, which is the opening in the center of the iris that looks like a tiny black circle.

Like a camera, which controls the amount of light coming in to prevent both overexposure and underexposure, the iris becomes wider and narrower, changing the size of the pupil to control the amount of light entering the eye. The pupil gets bigger when more light is needed to see better and smaller when there’s plenty of light.

The eye’s lens sits just behind the iris. Just like a camera lens, the eye’s lens focuses light to form sharp, clear images. Light that has been focused through the cornea and aqueous humor hits the lens, which then focuses it further, sending the light rays through the vitreous humor and onto the retina.

To focus on objects clearly at varying distances, the eye’s lens needs to change shape. The ciliary body contains the muscular structure in the eye that changes the shape of the eye’s lens. In people who have normal vision, the ciliary body flattens the lens enough to bring objects into focus at a distance of 20 feet or more. To see closer objects, this muscle contracts to thicken the lens. Young children can see objects at very close range; many people over 45 have to hold objects farther and farther away to see them clearly. This is because the lens becomes less elastic with age.

The retina (the soft, light-sensitive layer of tissue that lines the back of the eyeball wall) is made up of millions of light receptors called rods and cones. Rods are much more sensitive to light than cones. Each eye has about 125 million rods that help us see in dim light and detect shades of gray, but they cannot distinguish colors. In comparison, the 6 million cones in each eye allow us to see in bright light and they also sense color and detail.

The macula is a small, specialized area on the retina that helps the eyes see fine details when we look directly at an object. It contains mainly cones and few rods.

When focused light is projected onto the retina, it stimulates the rods and cones. The retina then sends nerve signals are sent through the back of the eye to the optic nerve. The optic nerve carries these signals to the brain, which interprets them as visual images. The portion of the brain that processes visual input and interprets the messages that the eye sends is called the visual cortex.

As in a camera, the eye’s lens transmits light patterns upside down. The brain learns that the impulses received from the upper part of the retina are really from the lower part of the object we’re seeing and vice versa.

Most people use both eyes to see an object. This is called binocular vision, and images are formed on the retina of each eye. These images are slightly different because the object is being viewed from slightly different angles. Nerve signals representing each image are sent to the brain, where they are interpreted as two views of the same object. Some of the nerve fibers from each eye cross, so each side of the brain receives messages from both eyes. Through experience, the brain learns to judge the distance of an object by the degree of difference in the images it receives from the two eyes. This ability to sense distance is called depth perception.

Vision Problems

Vision is a fine-tuned process. All the parts of the eye — and the brain — need to work together so a person can see correctly. Because the eye’s structure is so complex, though, a lot of things can go wrong.

Some of the most common eye problems are refractive errors. These are the problems that eye doctors check for routinely in a vision test. Refraction means bending of light rays to focus the light coming from an image. Refractive errors are problems with the focusing of the eye, because of the way the eye is shaped, which causes the image you see to be blurred.

Refractive errors include:

• Astigmatism. In astigmatism, there’s a problem with the curve of the cornea. This causes part of the eye’s image to be blurry. Corrective lenses such as contact lenses or glasses can usually correct vision in people with astigmatism.
• Myopia. Also called nearsightedness or shortsightedness, myopia happens when the eye focuses the image of an object in front of the retina instead of directly on it. In most cases, people can’t see well far away, but can see objects clearly close up. The condition tends to get somewhat worse through childhood and adolescence, but stabilizes in adulthood. People with this condition may need to wear glasses or contacts to correct their vision. Laser eye surgery is now commonly used in adults to correct nearsightedness permanently by changing the shape of the cornea. Laser surgery is not used for teens because the eye may still be growing and the refractive error changing.

• Hyperopia. Also called farsightedness or longsightedness, hyperopia happens when the incoming image is not focused on the retina, but behind it. This may make it difficult to see close objects clearly, with far-off objects seen more easily. Many younger children are hyperopic, but because of the ability of the eye to focus itself, may not need glasses to correct this. Glasses or contact lenses can correct this problem in kids and teens when needed. Most adults develop a form of farsightedness called presbyopia as they get older.

Other Common Vision Problems

Some of the other eye problems that can affect children and teens include:

Blindness. This is the loss of useful sight. Blindness can be temporary or permanent and it has many causes. Birth defects or damage to any portion of the eye, the optic nerve, or the area of the brain responsible for vision can lead to blindness. The visual impairment cannot be corrected with surgery or corrective lenses, and the condition can make it difficult to perform everyday activities. Diabetes, problems with the macula, and eye changes because of aging account for most blindness in adults in the United States. In children and teenagers, eye injuries and eye trauma account for most blindness.

Cataracts. Some children are born with cataracts, a cloudiness of the eye’s lenses that prevent images from being seen clearly or at all. But cataracts are much more prevalent in the elderly among whom surgery to remove cataracts and correct vision is common. In infants and young children, cataracts must be treated early to prevent permanent problems with development of vision.

Color blindness. Color blindness is caused by problems in the pigments of the cones in the retina. Most people who are color-blind can see some colors. In most cases, someone who is color-blind confuses some colors with others, usually red and green. People can be born color-blind or they may develop the condition over time. The most common form of color blindness is an inherited condition that affects boys much more often than girls. Color blindness cannot be corrected.

Dacryostenosis. Dacryostenosis is a blockage of the tear drainage system of the eye happening in the lower eyelid. This is a fairly common problem in infants, but often improves with time.

Eye injuries. Injuries to the eye are one of the most common preventable causes of blindness. Eye injuries may be caused by irritants such as sand, dirt, or other foreign bodies on the eye’s surface. Chemicals or foreign bodies that become embedded in the eye can also cause pain and loss of vision. Forceful blows to the eye can cause bleeding inside the eye and damage to the cornea, retina, and other important eye structures.

Glaucoma. One of the leading causes of blindness in the United States, glaucoma is a disorder that causes fluid pressure to build up inside the eye, potentially causing damage to the optic nerve. Although it can happen in infants and children, it is much more common among older adults. Unless detected early by routine screening tests, it usually goes undiagnosed until some vision is lost.

Macular degeneration is an eye disease that mainly affects older people. When someone has macular degeneration, the middle area of the retina becomes scarred. This causes eyesight to deteriorate over many years. The cause of macular degeneration is unknown in most cases, but it tends to run in families, which indicates that genes and heredity are involved.

Pinkeye (conjunctivitis). Pinkeye is a common contagious infection that causes inflammation (redness, pain, and swelling) of the conjunctiva, the clear membrane that covers the white part of the eye and the inner surface of the eyelids. The eyes become pinkish red and watery, and pus may form. Pinkeye is usually treated with eye drops. Conjunctivitis also can be the result of allergies or from a scratch on the surface of the eye.

Retinoblastoma. This is a cancerous tumor in the eye that usually appears in the first 5 years of life. There may be permanent vision loss, and the affected eye(s) may have to be removed. If not properly treated, this cancer can be life-threatening.

Retinopathy of prematurity. Premature babies sometimes have damage to the blood vessels in the eye’s retina, a condition known as retinopathy of prematurity, which can lead to severe vision loss in some cases.

Strabismus. A condition in which the eyes appear misaligned, strabismus is usually caused by a defect in the balance of the pull exerted by the muscles that help the eyes stay straight and move together properly. Surgery on the eye muscles can help realign the eyes. Permanent vision loss in the less-used eye (amblyopia) can happen if the condition is not treated in early childhood.

Stye. A stye (or sty, also called a hordeolum) is a red, painful bump on the eyelid caused by a backed-up oil gland. Styes are treated by applying warm compresses to allow them to drain. Sometimes antibiotic drops or ointments are necessary if it gets infected. Occasionally, a doctor may need to make a tiny cut in the eyelid to let out the clogged-up material.

Proper care of your child’s eyes includes having periodic eye exams at routine office checkups and by an eye specialist according to the schedule recommended by your doctor. Signs that a very young child may be having vision trouble include crossing or drifting of one or both eyes, constant eye rubbing, tearing or redness, and trouble following an object. Older kids may squint or sit too close to the TV or have difficulty seeing the board at school.

About Human Reproduction

All living things reproduce. Reproduction — the process by which organisms make more organisms like themselves — is one of the things that sets living things apart from nonliving matter. But even though the reproductive system is essential to keeping a species alive, unlike other body systems, it’s not essential to keeping an individual alive.

In the human reproductive process, two kinds of sex cells, or gametes, are involved. The male gamete, or sperm, and the female gamete, the egg or ovum, meet in the female’s reproductive system. When the sperm fertilizes, or meets, the egg, this fertilized egg is called the zygote. The zygote goes through a process of becoming an embryo and developing into a fetus.

Both the male and female reproductive systems are essential for reproduction. The female needs a male to fertilize her egg, even though it is she who carries offspring through pregnancy and childbirth.

Humans, like other organisms, pass certain characteristics of themselves to the next generation through their genes, the special carriers of human traits. The genes that parents pass along are what make their children similar to others in their family, but also what make each child unique. These genes come from the male’s sperm and the female’s egg.

Most species have two sexes: male and female. Each sex has its own unique reproductive system. They are different in shape and structure, but both are specifically designed to produce, nourish, and transport either the egg or sperm.

Parts of the Female Reproductive System

Unlike the male, the human female has a reproductive system located entirely in the pelvis. The external part of the female reproductive organs is called the vulva, which means covering. Located between the legs, the vulva covers the opening to the vagina and other reproductive organs located inside the body.

The fleshy area located just above the top of the vaginal opening is called the mons pubis. Two pairs of skin flaps called the labia (which means lips) surround the vaginal opening. The clitoris, a small sensory organ, is located toward the front of the vulva where the folds of the labia join. Between the labia are openings to the urethra (the canal that carries urine from the bladder to the outside of the body) and vagina. Once girls become sexually mature, the outer labia and the mons pubis are covered by pubic hair.

A female’s internal reproductive organs are the vagina, uterus, fallopian tubes, and ovaries.

The vagina is a muscular, hollow tube that extends from the vaginal opening to the uterus. The vagina is about 3 to 5 inches (8 to 12 centimeters) long in a grown woman. Because it has muscular walls, it can expand and contract. This ability to become wider or narrower allows the vagina to accommodate something as slim as a tampon and as wide as a baby. The vagina’s muscular walls are lined with mucous membranes, which keep it protected and moist.

The vagina serves three purposes:

1. It’s where the penis is inserted during sexual intercourse.
2. It’s the pathway that a baby takes out of a woman’s body during childbirth, called the birth canal.
3. It provides the route for the menstrual blood (the period) to leave the body from the uterus.

A very thin piece of skin-like tissue called the hymen partly covers the opening of the vagina. Hymens are often different from female to female. Most women find their hymens have stretched or torn after their first sexual experience, and the hymen may bleed a little (this usually causes little, if any, pain). Some women who have had sex don’t have much of a change in their hymens, though.

The vagina connects with the uterus, or womb, at the cervix (which means neck). The cervix has strong, thick walls. The opening of the cervix is very small (no wider than a straw), which is why a tampon can never get lost inside a girl’s body. During childbirth, the cervix can expand to allow a baby to pass.

The uterus is shaped like an upside-down pear, with a thick lining and muscular walls — in fact, the uterus contains some of the strongest muscles in the female body. These muscles are able to expand and contract to accommodate a growing fetus and then help push the baby out during labor. When a woman isn’t pregnant, the uterus is only about 3 inches (7.5 centimeters) long and 2 inches (5 centimeters) wide.

At the upper corners of the uterus, the fallopian tubes connect the uterus to the ovaries. The ovaries are two oval-shaped organs that lie to the upper right and left of the uterus. They produce, store, and release eggs into the fallopian tubes in the process called ovulation. Each ovary measures about 1½ to 2 inches (4 to 5 centimeters) in a grown woman.

There are two fallopian tubes, each attached to a side of the uterus. The fallopian tubes are about 4 inches (10 centimeters) long and about as wide as a piece of spaghetti. Within each tube is a tiny passageway no wider than a sewing needle. At the other end of each fallopian tube is a fringed area that looks like a funnel. This fringed area wraps around the ovary but doesn’t completely attach to it. When an egg pops out of an ovary, it enters the fallopian tube. Once the egg is in the fallopian tube, tiny hairs in the tube’s lining help push it down the narrow passageway toward the uterus.

The ovaries are also part of the endocrine system because they produce female sex hormones such as estrogen and progesterone.

What the Female Reproductive System Does

The female reproductive system enables a woman to:

• produce eggs (ova)
• have sexual intercourse
• protect and nourish the fertilized egg until it is fully developed
• give birth

Sexual reproduction couldn’t happen without the sexual organs called the gonads. Although most people think of the gonads as the male testicles, both sexes actually have gonads: In females the gonads are the ovaries. The female gonads produce female gametes (eggs); the male gonads produce male gametes (sperm). After an egg is fertilized by the sperm, the fertilized egg is called the zygote.

When a baby girl is born, her ovaries contain hundreds of thousands of eggs, which remain inactive until puberty begins. At puberty, the pituitary gland, located in the central part of the brain, starts making hormones that stimulate the ovaries to produce female sex hormones, including estrogen. The secretion of these hormones causes a girl to develop into a sexually mature woman.

Toward the end of puberty, girls begin to release eggs as part of a monthly period called the menstrual cycle. Approximately once a month, during ovulation, an ovary sends a tiny egg into one of the fallopian tubes.

Unless the egg is fertilized by a sperm while in the fallopian tube, the egg dries up and leaves the body about 2 weeks later through the uterus — this is menstruation. Blood and tissues from the inner lining of the uterus combine to form the menstrual flow, which in most girls lasts from 3 to 5 days. A girl’s first period is called menarche.

It’s common for women and girls to experience some discomfort in the days leading to their periods. Premenstrual syndrome (PMS) includes both physical and emotional symptoms that many girls and women get right before their periods, such as acne, bloating, fatigue, backaches, sore breasts, headaches, constipation, diarrhea, food cravings, depression, irritability, or difficulty concentrating or handling stress. PMS is usually at its worst during the 7 days before a girl’s period starts and disappears once it begins.

Many girls also experience abdominal cramps during the first few days of their periods caused by prostaglandins, chemicals in the body that make the smooth muscle in the uterus contract. These involuntary contractions can be either dull or sharp and intense.

It can take up to 2 years from menarche for a girl’s body to develop a regular menstrual cycle. During that time, her body is adjusting to the hormones puberty brings. On average, the monthly cycle for an adult woman is 28 days, but the range is from 23 to 35 days.

Fertilization

If a female and male have sex within several days of the female’s ovulation, fertilization can occur. When the male ejaculates (when semen leaves a male’s penis), between 0.05 and 0.2 fluid ounces (1.5 to 6.0 milliliters) of semen is deposited into the vagina. Between 75 and 900 million sperm are in this small amount of semen, and they “swim” up from the vagina through the cervix and uterus to meet the egg in the fallopian tube. It takes only one sperm to fertilize the egg.

About a week after the sperm fertilizes the egg, the fertilized egg (zygote) has become a multicelled blastocyst. A blastocyst is about the size of a pinhead, and it’s a hollow ball of cells with fluid inside. The blastocyst burrows itself into the lining of the uterus, called the endometrium. The hormone estrogen causes the endometrium to become thick and rich with blood. Progesterone, another hormone released by the ovaries, keeps the endometrium thick with blood so that the blastocyst can attach to the uterus and absorb nutrients from it. This process is called implantation.

As cells from the blastocyst take in nourishment, another stage of development, the embryonic stage, begins. The inner cells form a flattened circular shape called the embryonic disk, which will develop into a baby. The outer cells become thin membranes that form around the baby. The cells multiply thousands of times and move to new positions to eventually become the embryo.

After approximately 8 weeks, the embryo is about the size of an adult’s thumb, but almost all of its parts — the brain and nerves, the heart and blood, the stomach and intestines, and the muscles and skin — have formed.

During the fetal stage, which lasts from 9 weeks after fertilization to birth, development continues as cells multiply, move, and change. The fetus floats in amniotic fluid inside the amniotic sac. The fetus receives oxygen and nourishment from the mother’s blood via the placenta, a disk-like structure that sticks to the inner lining of the uterus and connects to the fetus via the umbilical cord. The amniotic fluid and membrane cushion the fetus against bumps and jolts to the mother’s body.

Pregnancy lasts an average of 280 days — about 9 months. When the baby is ready for birth, its head presses on the cervix, which begins to relax and widen to get ready for the baby to pass into and through the vagina. The mucus that has formed a plug in the cervix loosens, and with amniotic fluid, comes out through the vagina when the mother’s water breaks.

When the contractions of labor begin, the walls of the uterus contract as they are stimulated by the pituitary hormone oxytocin. The contractions cause the cervix to widen and begin to open. After several hours of this widening, the cervix is dilated (opened) enough for the baby to come through. The baby is pushed out of the uterus, through the cervix, and along the birth canal. The baby’s head usually comes first; the umbilical cord comes out with the baby and is cut after the baby is delivered.

The last stage of the birth process involves the delivery of the placenta, which at that point is called the afterbirth. After it has separated from the inner lining of the uterus, contractions of the uterus push it out, along with its membranes and fluids.

Problems of the Female Reproductive System

Some girls might experience reproductive system problems, such as:

Problems of the Vulva and Vagina

• Vulvovaginitis is an inflammation of the vulva and vagina. It may be caused by irritating substances (such as laundry soaps or bubble baths) or poor personal hygiene (such as wiping from back to front after a bowel movement). Symptoms include redness and itching in the vaginal and vulvar areas and sometimes vaginal discharge. Vulvovaginitis also can be caused by an overgrowth of Candida, a fungus normally present in the vagina.
• Nonmenstrual vaginal bleeding is most commonly due to the presence of a vaginal foreign body, often wadded-up toilet paper. It may also be due to urethral prolapse, in which the mucous membranes of the urethra protrude into the vagina and form a tiny, doughnut-shaped mass of tissue that bleeds easily. It also can be due to a straddle injury (such as when falling onto a gymnastics beam or bicycle frame) or vaginal trauma from sexual abuse.
• Labial adhesions, the sticking together or adherence of the labia in the midline, usually appear in infants and young girls. Although there are usually no symptoms associated with this condition, labial adhesions can lead to an increased risk of urinary tract infection. Sometimes topical estrogen cream is used to help separate the labia.

Problems of the Ovaries and Fallopian Tubes

• Ectopic pregnancy occurs when a fertilized egg, or zygote, doesn’t travel into the uterus, but instead grows rapidly in the fallopian tube. A woman with this condition can develop severe abdominal pain and should see a doctor because surgery may be necessary.
• Endometriosis occurs when tissue normally found only in the uterus starts to grow outside the uterus — in the ovaries, fallopian tubes, or other parts of the pelvic cavity. It can cause abnormal bleeding, painful periods, and general pelvic pain.
• Ovarian tumors, although they’re rare, can occur. Girls with ovarian tumors may have abdominal pain and masses that can be felt in the abdomen. Surgery may be needed to remove the tumor.
• Ovarian cysts are noncancerous sacs filled with fluid or semisolid material. Although they are common and generally harmless, they can become a problem if they grow very large. Large cysts may push on surrounding organs, causing abdominal pain. In most cases, cysts will disappear on their own and treatment is unnecessary. If the cysts are painful, a doctor may prescribe birth control pills to alter their growth or they may be removed by a surgeon.
• Polycystic ovary syndrome is a hormone disorder in which too many male hormones (androgens) are produced by the ovaries. This condition causes the ovaries to become enlarged and develop many fluid-filled sacs, or cysts. It often first appears during the teen years. Depending on the type and severity of the condition, it may be treated with drugs to regulate hormone balance and menstruation.
• Ovarian torsion, or the twisting of the ovary, can occur when an ovary becomes twisted because of a disease or a developmental abnormality. The torsion blocks blood from flowing through the blood vessels that supply and nourish the ovaries. The most common symptom is lower abdominal pain. Surgery is usually necessary to correct it.

Menstrual Problems

A variety of menstrual problems can affect girls, including:

• Dysmenorrhea is when a girl has painful periods.
• Menorrhagia is when a girl has a very heavy periods with excess bleeding.
• Oligomenorrhea is when a girl misses or has infrequent periods, even though she’s been menstruating for a while and isn’t pregnant.
• Amenorrhea is when a girl has not started her period by the time she is 16 years old or 3 years after starting puberty, has not developed signs of puberty by age 14, or has had normal periods but has stopped menstruating for some reason other than pregnancy.

Infections of the Female Reproductive System

• Sexually transmitted diseases (STDs). Also called sexually transmitted infections (STIs), these include pelvic inflammatory disease (PID), human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), human papillomavirus (HPV, or genital warts), syphilis, chlamydia, gonorrhea, and genital herpes (HSV). Most are spread from one person to another by sexual contact.
• Toxic shock syndrome. This uncommon but life-threatening illness is caused by toxins released into the body during a type of bacterial infection that is more likely to develop if a tampon is left in too long. It can produce high fever, diarrhea, vomiting, and shock.

If you think your daughter may have symptoms of a problem with her reproductive system or if you have questions about her growth and development, talk to your doctor — many problems with the female reproductive system can be treated.

With each heartbeat, blood is sent throughout our bodies, carrying oxygen and nutrients to every cell. Every day, the approximately 10 pints (5 liters) of blood in your body travel many times through about 60,000 miles (96,560 kilometers) of blood vessels that branch and cross, linking the cells of our organs and body parts.

About the Heart and Circulatory System

The circulatory system is composed of the heart and blood vessels, including arteries, veins, and capillaries. Our bodies actually have two circulatory systems: The pulmonary circulation is a short loop from the heart to the lungs and back again, and the systemic circulation (the system we usually think of as our circulatory system) sends blood from the heart to all the other parts of our bodies and back again.

The heart is the key organ in the circulatory system. As a hollow, muscular pump, its main function is to propel blood throughout the body. It usually beats from 60 to 100 times per minute, but can go much faster when necessary. It beats about 100,000 times a day, more than 30 million times per year, and about 2.5 billion times in a 70-year lifetime.

The heart gets messages from the body that tell it when to pump more or less blood depending on an individual’s needs. When we’re sleeping, it pumps just enough to provide for the lower amounts of oxygen needed by our bodies at rest. When we’re exercising or frightened, the heart pumps faster to increase the delivery of oxygen.

The heart has four chambers that are enclosed by thick, muscular walls. It lies between the lungs and just to the left of the middle of the chest cavity. The bottom part of the heart is divided into two chambers called the right and left ventricles, which pump blood out of the heart. A wall called the interventricular septum divides the ventricles.

The upper part of the heart is made up of the other two chambers of the heart, the right and left atria. The right and left atria receive the blood entering the heart. A wall called the interatrial septum divides the right and left atria, which are separated from the ventricles by the atrioventricular valves. The tricuspid valve separates the right atrium from the right ventricle, and the mitral valve separates the left atrium and the left ventricle.

Two other cardiac valves separate the ventricles and the large blood vessels that carry blood leaving the heart. These are the pulmonic valve, which separates the right ventricle from the pulmonary artery leading to the lungs, and the aortic valve, which separates the left ventricle from the aorta, the body’s largest blood vessel.

Arteries carry blood away from the heart. They are the thickest blood vessels, with muscular walls that contract to keep the blood moving away from the heart and through the body. In the systemic circulation, oxygen-rich blood is pumped from the heart into the aorta. This huge artery curves up and back from the left ventricle, then heads down in front of the spinal column into the abdomen. Two coronary arteries branch off at the beginning of the aorta and divide into a network of smaller arteries that provide oxygen and nourishment to the muscles of the heart.

Unlike the aorta, the body’s other main artery, the pulmonary artery, carries oxygen-poor blood. From the right ventricle, the pulmonary artery divides into right and left branches, on the way to the lungs where blood picks up oxygen.

Arterial walls have three layers:

1. The endothelium is on the inside and provides a smooth lining for blood to flow over as it moves through the artery.
2. The media is the middle part of the artery, made up of a layer of muscle and elastic tissue.
3. The adventitia is the tough covering that protects the outside of the artery.

As they get farther from the heart, the arteries branch out into arterioles, which are smaller and less elastic.

Veins carry blood back to the heart. They’re not as muscular as arteries, but they contain valves that prevent blood from flowing backward. Veins have the same three layers that arteries do, but are thinner and less flexible. The two largest veins are the superior and inferior vena cavae. The terms superior and inferior don’t mean that one vein is better than the other, but that they’re located above and below the heart.

A network of tiny capillaries connects the arteries and veins. Though tiny, the capillaries are one of the most important parts of the circulatory system because it’s through them that nutrients and oxygen are delivered to the cells. In addition, waste products such as carbon dioxide are also removed by the capillaries.

What the Heart and Circulatory System Do

The circulatory system works closely with other systems in our bodies. It supplies oxygen and nutrients to our bodies by working with the respiratory system. At the same time, the circulatory system helps carry waste and carbon dioxide out of the body.

Hormones — produced by the endocrine system — are also transported through the blood in the circulatory system. As the body’s chemical messengers, hormones transfer information and instructions from one set of cells to another. For example, one of the hormones produced by the heart helps control the kidneys’ release of salt from the body.

One complete heartbeat makes up a cardiac cycle, which consists of two phases:

1. In the first phase, the ventricles contract (this is called systole), sending blood into the pulmonary and systemic circulation. To prevent the flow of blood backwards into the atria during systole, the atrioventricular valves close, creating the first sound (the lub). When the ventricles finish contracting, the aortic and pulmonary valves close to prevent blood from flowing back into the ventricles. This is what creates the second sound (the dub).
2. Then the ventricles relax (this is called diastole) and fill with blood from the atria, which makes up the second phase of the cardiac cycle.

A unique electrical conduction system in the heart causes it to beat in its regular rhythm. The sinoatrial or SA node, a small area of tissue in the wall of the right atrium, sends out an electrical signal to start the contracting of the heart muscle. This node is called the pacemaker of the heart because it sets the rate of the heartbeat and causes the rest of the heart to contract in its rhythm.

These electrical impulses cause the atria to contract first, and then travel down to the atrioventricular or AV node, which acts as a kind of relay station. From here the electrical signal travels through the right and left ventricles, causing them to contract and forcing blood out into the major arteries.

In the systemic circulation, blood travels out of the left ventricle, to the aorta, to every organ and tissue in the body, and then back to the right atrium. The arteries, capillaries, and veins of the systemic circulatory system are the channels through which this long journey takes place.

Once in the arteries, blood flows to smaller arterioles and then to capillaries. While in the capillaries, the bloodstream delivers oxygen and nutrients to the body’s cells and picks up waste materials. Blood then goes back through the capillaries into venules, and then to larger veins until it reaches the vena cavae.

Blood from the head and arms returns to the heart through the superior vena cava, and blood from the lower parts of the body returns through the inferior vena cava. Both vena cavae deliver this oxygen-depleted blood into the right atrium. From here the blood exits to fill the right ventricle, ready to be pumped into the pulmonary circulation for more oxygen.

In the pulmonary circulation, blood low in oxygen but high in carbon dioxide is pumped out the right ventricle into the pulmonary artery, which branches off in two directions. The right branch goes to the right lung, and vice versa.

In the lungs, the branches divide further into capillaries. Blood flows more slowly through these tiny vessels, allowing time for gases to be exchanged between the capillary walls and the millions of alveoli, the tiny air sacs in the lungs.

During the process called oxygenation, oxygen is taken up by the bloodstream. Oxygen locks onto a molecule called hemoglobin in the red blood cells. The newly oxygenated blood leaves the lungs through the pulmonary veins and heads back to the heart. It enters the heart in the left atrium, then fills the left ventricle so it can be pumped into the systemic circulation.

Problems of the Heart and Circulatory System

Problems with the cardiovascular system are common — more than 64 million Americans have some type of cardiac problem. But cardiovascular problems don’t just affect older people — many heart and circulatory system problems affect children and teens, too.

Heart and circulatory problems are grouped into two categories: congenital (problems present at birth) and acquired (problems developed some time after birth).

Congenital heart defects. These abnormalities in the heart’s structure are present at birth. Approximately 8 out of every 1,000 newborns have congenital heart defects ranging from mild to severe. These defects occur while the fetus is developing in the mother’s uterus and it’s not usually known why they occur. Some congenital heart defects are caused by genetic disorders, but most are not. What all congenital heart defects have in common, however, is that they involve abnormal or incomplete development of the heart.

A common sign of a congenital heart defect is a heart murmur — an abnormal sound (like a blowing or whooshing sound) that’s heard when listening to the heart. Usually a heart murmur is detected by a doctor who’s listening to the heart with a stethoscope during a routine exam. Murmurs are very common in children and can be “innocent murmurs” found in an otherwise healthy heart. Other murmurs can be caused by congenital heart defects or other heart conditions.

Arrhythmia. Cardiac arrhythmias, also called dysrhythmias or rhythm disorders, are problems in the rhythm of the heartbeat. They may be caused by a congenital heart defect or they may be acquired later. An arrhythmia may cause the heart’s rhythm to be irregular, abnormally fast, or abnormally slow. Arrhythmias can occur at any age and may be discovered during a routine physical examination. Depending on the type of rhythm disorder, an arrhythmia may be treated with medication, surgery, or pacemakers. Some arrhythmias are not harmful.

Cardiomyopathy. This chronic disease causes the heart muscle (the myocardium) to become weakened. Usually, it first affects the lower chambers of the heart, the ventricles, and then progresses and damages the muscle cells and even the tissues surrounding the heart. In its most severe forms, it can lead to heart failure and even death. Cardiomyopathy is the #1 reason for heart transplants in children.

Coronary artery disease. The most common heart disorder in adults, coronary artery disease is caused by atherosclerosis. Deposits of fat, calcium, and dead cells, called atherosclerotic plaques, form on the inner walls of the coronary arteries (the blood vessels that supply the heart) and interfere with the smooth flow of blood. Blood flow to the heart muscle may even stop if a thrombus, or clot, forms in a coronary vessel, which may cause a heart attack. In a heart attack (or myocardial infarction), the heart muscle becomes damaged by lack of oxygen, and unless blood flow returns within minutes, muscle damage increases and the heart’s ability to pump blood is compromised. If the clot can be dissolved within a few hours, damage to the heart can be reduced. Heart attacks are rare in kids and teens.

Hypercholesterolemia (high cholesterol). Cholesterol is a waxy substance that’s found in the body’s cells, in the blood, and in some foods. Having too much cholesterol in the blood, also known as hypercholesterolemia, is a major risk factor for heart disease and can lead to a heart attack.

Cholesterol is carried in the bloodstream by lipoproteins. Two kinds — low-density lipoproteins (LDL) and high-density lipoproteins (HDL) — are the most important. High levels of LDL cholesterol (the bad cholesterol) increase a person’s risk for heart disease and stroke, whereas high levels of HDL cholesterol (the good cholesterol) can protect against these.

A blood test can measure if someone’s cholesterol is too high. A child’s total cholesterol level is borderline if it’s 170 to 199 mg/dL, and it’s considered high if it’s above 200 mg/dL.

About 10% of teens between 12 and 19 have high cholesterol levels that put them at increased risk of cardiovascular disease.

High blood pressure (hypertension). Over time, high blood pressure can damage the heart, arteries, and other body organs. Symptoms can include headache, nosebleeds, dizziness, and lightheadedness. Infants, kids, and teens can have high blood pressure, which may be caused by genetic factors, excess body weight, diet, lack of exercise, and diseases such as heart disease or kidney disease.

Kawasaki disease. Also known as mucocutaneous lymph node syndrome, Kawasaki disease affects the mucous membranes (the lining of the mouth and breathing passages), the skin, and the lymph nodes (part of the immune system). It can also lead to vasculitis, an inflammation of the blood vessels. This can affect all major arteries in the body — including the coronary arteries. When coronary arteries become inflamed, a child can develop aneurysms, which are weakened and bulging spots on the walls of arteries. This increases the risk of a blood clot forming in this weakened area, which can block the artery, possibly leading to a heart attack. In addition to the coronary arteries, the heart muscle, lining, valves, or the outer membrane that surrounds the heart can become inflamed. Arrhythmias or abnormal functioning of some heart valves can occur. Kawasaki disease has surpassed rheumatic fever as the leading cause of acquired heart disease in children in the United States.

Rheumatic heart disease. Usually the complication of an untreated strep throat infection, rheumatic fever can lead to permanent heart damage and even death. Most common in kids between 5 and 15 years of age, it begins when antibodies the body produces to fight the strep infection begin to attack other parts of the body. They react to tissues in the heart valves as though they were the strep bacteria and cause the heart valves to thicken and scar. Inflammation and weakening of the heart muscle may also occur. Usually, when strep throat infections are promptly treated with antibiotics, this condition can be avoided.

Stroke. Strokes occur when the blood supply to the brain is cut off or when a blood vessel in the brain bursts and spills blood into an area of the brain, causing damage to brain cells. Children or infants who have experienced stroke may be suddenly numb or weak, especially on one side of the body, and they may experience a sudden severe headache, nausea or vomiting, and difficulty seeing, speaking, walking, or moving. During childhood, strokes are rare.

Getting plenty of exercise, eating a nutritious diet, maintaining a healthy weight, and getting regular medical checkups are the best ways to help keep the heart healthy and avoid long-term problems like high blood pressure, high cholesterol, and heart disease.

The immune system, which is made up of special cells, proteins, tissues, and organs, defends people against germs and microorganisms every day. In most cases, the immune system does a great job of keeping people healthy and preventing infections. But sometimes problems with the immune system can lead to illness and infection.

About the Immune System

The immune system is the body’s defense against infectious organisms and other invaders. Through a series of steps called the immune response, the immune system attacks organisms and substances that invade body systems and cause disease.

The immune system is made up of a network of cells, tissues, and organs that work together to protect the body. One of the important cells involved are white blood cells, also called leukocytes, which come in two basic types that combine to seek out and destroy disease-causing organisms or substances.

Leukocytes are produced or stored in many locations in the body, including the thymus, spleen, and bone marrow. For this reason, they’re called the lymphoid organs. There are also clumps of lymphoid tissue throughout the body, primarily as lymph nodes, that house the leukocytes.

The leukocytes circulate through the body between the organs and nodes via lymphatic vessels and blood vessels. In this way, the immune system works in a coordinated manner to monitor the body for germs or substances that might cause problems.

The two basic types of leukocytes are:

1. phagocytes, cells that chew up invading organisms
2. lymphocytes, cells that allow the body to remember and recognize previous invaders and help the body destroy them

A number of different cells are considered phagocytes. The most common type is the neutrophil, which primarily fights bacteria. If doctors are worried about a bacterial infection, they might order a blood test to see if a patient has an increased number of neutrophils triggered by the infection. Other types of phagocytes have their own jobs to make sure that the body responds appropriately to a specific type of invader.

The two kinds of lymphocytes are B lymphocytes and T lymphocytes. Lymphocytes start out in the bone marrow and either stay there and mature into B cells, or they leave for the thymus gland, where they mature into T cells. B lymphocytes and T lymphocytes have separate functions: B lymphocytes are like the body’s military intelligence system, seeking out their targets and sending defenses to lock onto them. T cells are like the soldiers, destroying the invaders that the intelligence system has identified.

Here’s how it works:

When antigens (foreign substances that invade the body) are detected, several types of cells work together to recognize them and respond. These cells trigger the B lymphocytes to produce antibodies, which are specialized proteins that lock onto specific antigens.

Once produced, these antibodies stay in a person’s body, so that if his or her immune system encounters that antigen again, the antibodies are already there to do their job. So if someone gets sick with a certain disease, like chickenpox, that person usually won’t get sick from it again.

This is also how immunizations prevent certain diseases. An immunization introduces the body to an antigen in a way that doesn’t make someone sick, but does allow the body to produce antibodies that will then protect the person from future attack by the germ or substance that produces that particular disease.

Although antibodies can recognize an antigen and lock onto it, they are not capable of destroying it without help. That’s the job of the T cells, which are part of the system that destroys antigens that have been tagged by antibodies or cells that have been infected or somehow changed. (Some T cells are actually called “killer cells.”) T cells also are involved in helping signal other cells (like phagocytes) to do their jobs.

Antibodies also can neutralize toxins (poisonous or damaging substances) produced by different organisms. Lastly, antibodies can activate a group of proteins called complement that are also part of the immune system. Complement assists in killing bacteria, viruses, or infected cells.

All of these specialized cells and parts of the immune system offer the body protection against disease. This protection is called immunity.

Immunity

Humans have three types of immunity — innate, adaptive, and passive:

Innate Immunity

Everyone is born with innate (or natural) immunity, a type of general protection. Many of the germs that affect other species don’t harm us. For example, the viruses that cause leukemia in cats or distemper in dogs don’t affect humans. Innate immunity works both ways because some viruses that make humans ill — such as the virus that causes HIV/AIDS — don’t make cats or dogs sick.

Innate immunity also includes the external barriers of the body, like the skin and mucous membranes (like those that line the nose, throat, and gastrointestinal tract), which are the first line of defense in preventing diseases from entering the body. If this outer defensive wall is broken (as through a cut), the skin attempts to heal the break quickly and special immune cells on the skin attack invading germs.

Adaptive Immunity

The second kind of protection is adaptive (or active) immunity, which develops throughout our lives. Adaptive immunity involves the lymphocytes and develops as people are exposed to diseases or immunized against diseases through vaccination.

Passive Immunity

Passive immunity is “borrowed” from another source and it lasts for a short time. For example, antibodies in a mother’s breast milk give a baby temporary immunity to diseases the mother has been exposed to. This can help protect the baby against infection during the early years of childhood.

Everyone’s immune system is different. Some people never seem to get infections, whereas others seem to be sick all the time. As people get older, they usually become immune to more germs as the immune system comes into contact with more and more of them. That’s why adults and teens tend to get fewer colds than kids — their bodies have learned to recognize and immediately attack many of the viruses that cause colds.

Problems of the Immune System

Disorders of the immune system fall into four main categories:

1. immunodeficiency disorders (primary or acquired)
2. autoimmune disorders (in which the body’s own immune system attacks its own tissue as foreign matter)
3. allergic disorders (in which the immune system overreacts in response to an antigen)
4. cancers of the immune system

Immunodeficiency Disorders

Immunodeficiencies happen when a part of the immune system is missing or not working properly. Some people are born with an immunodeficiency (known as primary immunodeficiencies), although symptoms of the disorder might not appear until later in life. Immunodeficiencies also can be acquired through infection or produced by drugs (these are sometimes called secondary immunodeficiencies).

Immunodeficiencies can affect B lymphocytes, T lymphocytes, or phagocytes. Examples of primary immunodeficiencies that can affect kids and teens are:

• IgA deficiency is the most common immunodeficiency disorder. IgA is an immunoglobulin that is found primarily in the saliva and other body fluids that help guard the entrances to the body. IgA deficiency is a disorder in which the body doesn’t produce enough of the antibody IgA. People with IgA deficiency tend to have allergies or get more colds and other respiratory infections, but the condition is usually not severe.
• Severe combined immunodeficiency (SCID) is also known as the “bubble boy disease” after a Texas boy with SCID who lived in a germ-free plastic bubble. SCID is a serious immune system disorder that occurs because of a lack of both B and T lymphocytes, which makes it almost impossible to fight infections.
• DiGeorge syndrome (thymic dysplasia), a birth defect in which kids are born without a thymus gland, is an example of a primary T-lymphocyte disease. The thymus gland is where T lymphocytes normally mature.
• Chediak-Higashi syndrome and chronic granulomatous disease (CGD) both involve the inability of the neutrophils to function normally as phagocytes.

Acquired (or secondary) immunodeficiencies usually develop after someone has a disease, although they can also be the result of malnutrition, burns, or other medical problems. Certain medicines also can cause problems with the functioning of the immune system.

Acquired (secondary) immunodeficiencies include:

• HIV (human immunodeficiency virus) infection/AIDS (acquired immunodeficiency syndrome) is a disease that slowly and steadily destroys the immune system. It is caused by HIV, a virus that wipes out certain types of lymphocytes called T-helper cells. Without T-helper cells, the immune system is unable to defend the body against normally harmless organisms, which can cause life-threatening infections in people who have AIDS. Newborns can get HIV infection from their mothers while in the uterus, during the birth process, or during breastfeeding. People can get HIV infection by having unprotected sexual intercourse with an infected person or from sharing contaminated needles for drugs, steroids, or tattoos.
• Immunodeficiencies caused by medications. Some medicines suppress the immune system. One of the drawbacks of chemotherapy treatment for cancer, for example, is that it not only attacks cancer cells, but other fast-growing, healthy cells, including those found in the bone marrow and other parts of the immune system. In addition, people with autoimmune disorders or who have had organ transplants may need to take immunosuppressant medications, which also can reduce the immune system’s ability to fight infections and can cause secondary immunodeficiency.

Autoimmune Disorders

In autoimmune disorders, the immune system mistakenly attacks the body’s healthy organs and tissues as though they were foreign invaders. Autoimmune diseases include:

• Lupus: a chronic disease marked by muscle and joint pain and inflammation (the abnormal immune response also may involve attacks on the kidneys and other organs)
• Juvenile idiopathic arthritis: a disease in which the body’s immune system acts as though certain body parts (such as the joints of the knee, hand, and foot) are foreign tissue and attacks them
• Scleroderma: a chronic autoimmune disease that can lead to inflammation and damage of the skin, joints, and internal organs
• Ankylosing spondylitis: a disease that involves inflammation of the spine and joints, causing stiffness and pain
• Juvenile dermatomyositis: a disorder marked by inflammation and damage of the skin and muscles

Allergic Disorders

Allergic disorders happen when the immune system overreacts to exposure to antigens in the environment. The substances that provoke such attacks are called allergens. The immune response can cause symptoms such as swelling, watery eyes, and sneezing, and even a life-threatening reaction called anaphylaxis. Medicines called antihistamines can relieve most symptoms.

Allergic disorders include:

• Asthma, a respiratory disorder that can cause breathing problems, often involves an allergic response by the lungs. If the lungs are oversensitive to certain allergens (like pollen, molds, animal dander, or dust mites), breathing tubes can become narrowed and swollen, making it hard for a person to breathe.
• Eczema is an itchy rash also known as atopic dermatitis. Although not necessarily caused by an allergic reaction, eczema most often happens in kids and teens who have allergies, hay fever, or asthma or who have a family history of these conditions.
• Allergies of several types can affect kids and teens. Environmental allergies (to dust mites, for example), seasonal allergies (such as hay fever), drug allergies (reactions to specific medications or drugs), food allergies (such as to nuts), and allergies to toxins (bee stings, for example) are the common conditions people usually refer to as allergies.

Cancers of the Immune System

Cancer happens when cells grow out of control. This can include cells of the immune system. Leukemia, which involves abnormal overgrowth of leukocytes, is the most common childhood cancer. Lymphoma involves the lymphoid tissues and is also one of the more common childhood cancers. With current treatments, most cases of both types of cancer in kids and teens are curable.

Although immune system disorders usually can’t be prevented, you can help your child’s immune system stay stronger and fight illnesses by staying informed about your child’s condition and working closely with your doctor.