MEDICAL TERMINOLOGY

Cell, Tissue, and Organs

The Cell

The body can be studied from its simplest to its most complex level, beginning with the cell, the basic unit of living organisms (Fig. 4-1). Cells carry out metabolism, which is the sum of all physical and chemical activities that occur in the body. Providing the energy for metabolic reactions is the chemical ATP (adenosine triphosphate), commonly described as the energy compound of the cell. The main categories of organic compounds in the body are:

Proteins, which include the enzymes, some hormones, and structural materials.

Carbohydrates, which include sugars and starches. The primary carbohydrate is glucose, a sugar that circulates in the blood to provide energy to cells.

Lipids, which include fats. Some hormones are derived from lipids, and adipose (fat) tissue is designed to store lipids.

Within the cytoplasm that fills the cell are subunits called organelles, each with a specific function. The main cell structures are named and described in Display 4-1.

All body functions derive from the activities of billions of specialized cells. The nucleus is the control region of the cell. It contains the chromosomes, which carry genetic information (Fig. 4-2). Each human cell, except for the sex cells, contains 46 chromosomes. The chromosomes are composed of a complex organic substance, DNA (deoxyribonucleic acid), which is organized into separate units called genes. Genes control the formation of enzymes, the catalysts needed for metabolic reactions. To help manufacture enzymes, the cells use a compound called RNA (ribonucleic acid), which is chemically related to DNA.

When a body cell divides, by the process of mitosis, the chromosomes are doubled and then equally distributed to the two daughter cells (Fig. 4-3). Sex cells (egg and sperm) divide by another process (meiosis) that halves the chromosomes in preparation for fertilization.

FIGURE 4-1. Diagram of a typical animal cell showing the main organelles. (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)

Display 4-1 Cell Structures

Name

Description

Function

Plasma membrane

Outer layer of the cell; composed mainly of lipids and proteins

Limits the cell; regulates what enters and leaves the cell

Cytoplasm

Colloidal suspension that fills cell

Holds cell contents

Nucleus

Large, dark-staining body near the center of the cell; composed of DNA and proteins

Contains the chromosomes with the genes (the hereditary material that directs all cell activities)

Nucleolus

Small body in the nucleus; composed of RNA, DNA, and protein

Needed for protein manufacture

Endoplasmic reticulum (ER)

Network of membranes in the cytoplasm

Used for storage and transport; holds ribosomes

Ribosomes

Small bodies attached to the ER; composed of RNA and protein

Manufacture proteins

Mitochondria

Large organelles with folded membranes inside

Convert energy from nutrients into ATP

Golgi apparatus

Layers of membranes

Put together special substances such as mucus

Lysosomes

Small sacs of digestive enzymes

Digest substances within the cell

Centrioles

Rod-shaped bodies (usually two) near the nucleus

Help separate the chromosomes in cell division

Cilia

Short, hairlike projections from the cell

Create movement around the cell

Flagellum

Long, whiplike extension from the cell

Moves the cell

FIGURE 4-2. Human chromosomes. (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)

FIGURE 4-3. The stages in cell division (mitosis). (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.

Tissues

Cells are organized into four basic types of tissues that perform specific functions (Fig. 4-4)

• Epithelial (ep-i-THE-le -al) tissue covers and protects body structures and lines organs, vessels, and cavities.

• Connective tissue supports and binds body structures. It contains fibers and other nonliving material between the cells. Included are adipose (fat) tissue, cartilage, bone (Chapter 19), and blood (Chapter 10).

• Muscle tissue (root my/o) contracts to move. There are three types of muscle tissue:

    • Skeletal or voluntary muscle moves the skeleton. Skeletal muscle is discussed in greater detail in Chapter 20.

    • Cardiac muscle forms the heart. It functions without conscious control and is described as involuntary.

    • Smooth, or visceral, muscle forms the walls of the abdominal organs; it is also involuntary.

• Nervous tissue (root neur/o) makes up the brain, spinal cord, and nerves. It coordinates and controls body responses by the transmission of electrical impulses. The nervous system and senses are discussed in Chapters 17 and 18.

The simplest tissues are membranes. Mucous membranes secrete mucus, a thick fluid that lubricates surfaces and protects underlying tissue. Serous membranes, which secrete a thin, watery fluid, line body cavities and cover organs.

FIGURE 4-4. The four basic types of tissues. (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)

Organs and Organ Systems

Tissues are arranged into organs, which serve specific functions (Fig. 4-5). The organs, in turn, are grouped into systems. Each of the body systems is discussed in Part 3. Bear in mind, however, that the body functions as a whole—no system is independent of the others. They work together to maintain the body’s state of internal stability, termed homeostasis.

FIGURE 4-5. Organs of the digestive tract. (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)

Key Terms

Term

Pronunciation

Definition

ATP (adenosine triphosphate)

a-DEN-o-sēn tri-FOS-fāt

The energy compound of the cell stores energy needed for cell activities. ATP stands for adenosine triphosphate (a-DEN-o-sen tri-FOS-fat).

Carbohydrate

kar-bō-HI-drāt

A category of organic compounds that includes sugars and starches.

Cell

sel

The basic structural and functional unit of the living organism; it combines with other cells to form tissues. (root cyt/o)

Chromosome

KRŌ-mō-sōm

A threadlike body in the nucleus of a cell that contains genetic information.

Cytoplasm

SĪ-tō-plazm

The fluid that fills a cell and holds the organelles.

DNA (deoxyribonucleic acid)

de-OK-sē-rī-bō-nū-KLĒ-ik acid

The genetic compound of the cell makes up the genes. DNA stands for deoxyribonucleic (de -ok-se -ri -bo -nu-KLE-ik) acid.

Enzyme

EN-zīm

An organic substance that speeds the rate of metabolic reactions.

Gene

jēn

A hereditary unit composed of DNA and combined with other genes to form the chromosomes.

Glucose

GLŪ-kōs

A simple sugar that circulates in the blood; the main energy source for metabolism. (roots gluc/o, glyc/o)

Homeostasis

hō-mē-ō-STA-sis

A steady state: a condition of internal stability and constancy.

Lipid

LIP-id

A category of organic compounds that includes fats. (root lip/o)

Metabolism

me-TA-bo-lizm

The sum of all the physical and chemical reactions that occur within an organism.

Mitosis

mi-TO-sis

Cell division.

Mucus

MŪ-kus

A thick fluid secreted by cells in membranes and glands that lubricates and protects tissues (roots muc/o, myx/o); the adjective is mucous.

Nucleus

NŪ-klē-us

The control center of the cell directs all activities based on chromosome information (roots nucle/o, kary/o).

Protein

PRO-tēn

A category of organic compounds that includes structural materials, enzymes, and some hormones.

RNA (ribonucleic acid)

rī-bō-nū-KLĒ-ik acid

An organic compound involved in protein manufacture within cells. RNA stands for ribonucleic (ri -bo -nu-KLE-ik) acid.

Tissue

TISH-ū

A group of cells that act together for a specific purpose (root hist/o, histi/o).

Word Parts Pertaining to Cells, Tissues, and Organs

Root

Meaning

Example

Definition of Example

morph/o

form

polymorphic (pol-e-MOR-fik)

Having many forms

cyt/o, -cyte

cell

cytogenesis (si-to-JEN-e-sis)

The formation (-genesis) of cells

nucle/o

nucleus

nuclear (NU-kle-ar)

Pertaining to a nucleus

kary/o

nucleus

karyotype (KAR-e-o-tīp)

Picture of the chromosomes of a cell, organized according to size

hist/o, histi/o

tissue

histologist (his-TOL-o-jist)

Specialist in the study of tissue

fibr/o

fiber

fibrosis (fi-BRO-sis)

Abnormal formation of fibrous tissue

reticul/o

network

reticulum (re-TIK-u-lum)

A network

aden/o

gland

adenoma (ad-e-NO-ma)

Tumor (-oma) of a gland

papill/o

nipple

papilliform (pa-PIL-i-form)

Resembling a nipple

myx/o

mucus

myxadenitis (miks-ad-e-NI-tis)

Inflammation of a gland that secretes mucus

muc/o

mucus, mucous membrane

mucorrhea (mu-ko-RE-a)

Increased flow (-rhea) of mucus

somat/o, -some

body

somatic (so-MAT-ik)

Pertaining to the body (as compared with germ cells or the mind)

BOX 4-1 Laboratory Study of Tissues

A biopsy is the removal and examination of living tissue to determine a diagnosis. The term is also applied to the specimen itself. Biopsy comes from the Greek word bios, meaning “life,” plus opsis, meaning “vision.” Together, they mean the visualization of living tissue. Some other terms that apply to cells and tissues come from Latin. In vivo means “in the living body,” as contrasted with in vitro, which literally means “in glass” and refers to procedures and experiments done in the labo

ratory, as compared with studies done in living organisms. In situ means “in its original place,” and is used to refer to tumors that have not spread. In toto means “whole” or “completely,” as in referring to a structure or organ removed totally from the body. Postmortem literally means “after death,” as in referring to an autopsy performed to determine the cause of death.

TABLE 4-2 Roots for Cell Activity

Root

Meaning

Example

Definition of Example

blast/o, -blast

Immature cell, productive cell, embryonic cell

leukoblast (LU-ko-blast)

An immature white blood cell

gen

Origin, formation

genetics (je-NET-iks)

The science of genes and heredity

phag/o

Eat, ingest

phagocyte (FAG-o-sīt)

Cell that ingests waste and foreign matter

phil

Attract, absorb

acidophilic (a-sid-o-FIL-ik)

Attracting acid stain

plas

Formation, molding, development

hyperplasia (hi-per-PLA-je-a)

Overdevelopment of an organ or tissue

trop

Act on, affect

chronotropic (kron-o-TROP-ik)

Affecting rate or timing

troph/o

Feeding, growth, nourishment

atrophy (AT-ro-fē)

Wasting away

TABLE 4-3 Suffixes and Roots for Body Chemistry

Word Part

Meaning

Example

Definition of Example

Suffixes

-ase

Enzyme

lipase (LI-pās)

An enzyme that digests fat (lipid)

-ose

Sugar

lactose (LAK-tōs)

Milk sugar

Roots

hydr/o

Water, fluid

hydrophilic (hi-dro-FIL-ik)

Attracting water

gluc/o

Glucose

glucosuria (glu-ko-SU-rē-a)

Presence of glucose in the urine

glyc/o

Sugar, glucose

hyperglycemia (hi-per-gli-SE-me-a)

High blood sugar

sacchar/o

Sugar

polysaccharide (pol-e-SAK-a-rīd)

A compound containing many sugars

amyl/o

Starch

amyloid (AM-i-loyd)

Resembling starch

lip/o

Lipid, fat

lipogenesis (lip-o-JEN-e-sis)

Formation of fat

adip/o

Fat

adipocyte (AD-i-po-sīt)

A cell that stores fat

steat/o

Fatty

steatorrhea (ste-a-to-RE-a)

Discharge (-rhea) of fatty stools

prote/o

Protein

protease (PRO-te-ās)

An enzyme that digests protein

Supplementary Terms

Term

Pronunciation

Definition

Aorta

a-OR-ta

The main artery carrying blood from the left ventricle of the heart to the body.

Septum

SEP-tum

A wall dividing two cavities.

Amino acids

a-ME-no as-ids

Nitrogen-containing compounds that make up proteins.

Anabolism

a-NAB-o-lizm

The type of metabolism in which body substances are made; the building phase of metabolism.

Catabolism

ka-TAB-o-lizm

The type of metabolism in which substances are broken down for energy and simple compounds.

Collagen

KOL-a-jen

A fibrous protein found in connective tissue.

Cortex

KOR-tex

The outer region of an organ.

Glycogen

GLI-ko-jen

A complex sugar compound stored in the liver and muscles; broken down into glucose when needed for energy.

Interstitial

in-ter-STISH-al

Between parts, such as the spaces between cells in a tissue.

Medulla

me-DUL-la

The inner region of an organ; marrow (root medull/o).

Parenchyma

par-EN-ki-ma

The functional tissue of an organ.

Parietal

pa-RI-e-tal

Pertaining to a wall, describes a membrane that lines a body cavity.

Soma

SO-ma

The body. Used as the suffix -some to mean a small body, as in ribosome, lysosome, chromosome.

Stem cell

stem sel

An immature cell that can develop into different cell types; a precursor cell.

Visceral

VIS-er-al

Pertaining to the internal organs, a membrane on the surface of an organ.

Body Structure

Directional Terms

In describing the location or direction of a given point in the body, it is always assumed that the subject is in the anatomical position, that is, upright, with face front, arms at the sides with palms forward, and feet parallel, as shown in the small diagram in Figure 5-1. In this stance, the terms illustrated in Figure 5-1 and listed in Display 5-1 are used to designate relative position. Figure 5-2 illustrates planes of section, that is, directions in which the body can be cut. A frontal plane, also called a coronal plane, is made at right angles to the midline and divides the body into anterior and posterior parts. A sagittal (SAJ-i-tal) plane passes from front to back and divides the body into right and left portions. If the plane passes through the midline, it is a mid-sagittal or medial plane. A transverse plane passes horizontally, dividing the body into superior and inferior parts.

FIGURE 5-1. Directional terms. (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)

FIGURE 5-2. Planes of division. (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)

Body Cavities

Internal organs are located within the dorsal and ventral cavities (Fig. 5-3). The dorsal cavity contains the brain in the cranial cavity and the spinal cord in the spinal cavity (canal). The uppermost ventral space, the thoracic cavity, is separated from the abdominal cavity by the diaphragm. There is no anatomical separation between the abdominal cavity and the pelvic cavity, which together make up the abdominopelvic cavity. The large membrane that lines the abdominopelvic cavity and covers the organs within it is the peritoneum (peri-to-NE-um).

FIGURE 5-3. Side view of the body cavities. (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)

Body Regions

For orientation, the abdomen can be divided by imaginary lines into nine regions, which are shown in Figure 5-4.

The sections down the midline are the:

• epigastric (ep-i-GAS-trik) region, located above the stomach

• umbilical (um-BIL-i-kal) region, named for the umbilicus, or navel

• hypogastric (hi -po -GAS-trik) region, located below the stomach

The lateral regions are the:

    • right and left hypochondriac (hi -po -KON-dre-ak) regions, named for their position near the ribs, specifically near the cartilages (root chondr/o) of the ribs,

    • right and left lumbar (LUM-bar) regions, which are located near the small of the back (lumbar region of the spine)

    • right and left iliac (IL-e-ak) regions, named for the upper bone of the hip, the ilium. These regions are also called the inguinal (ING-gwi-nal) regions, with reference to the groin.

More simply, but less precisely, the abdomen can be divided by a single vertical line and a single horizontal line into four sections (Fig. 5-5), designated the right upper quadrant (RUQ), left upper quadrant (LUQ), right lower quadrant (RLQ), and left lower quadrant (LLQ).

Additional terms for body regions are shown in Figures 5-6 and 5-7. You may need to refer to these illustrations as you work through the book.

FIGURE 5-4. The nine regions of the abdomen. (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)

FIGURE 5-5. Quadrants of the abdomen, showing the organs within each quadrant. (Reprinted with permission from Cohen BJ, Wood DL. Memmler’s The Human Body in Health and Disease. 9th Ed. Philadelphia: Lippincott Williams & Wilkins, 2000.)

Positions

In addition to the anatomical position, there are other standard positions in which the body is placed for examination or medical procedures. The most common of these are described in Display 5-2.

FIGURE 5-6. Common terms for body regions, anterior view. Anatomical terms for regions are in parentheses.

FIGURE 5-7. Common terms for body regions, posterior view.

DISPLAY 5-1 Anatomical Directions

Term

Definition

Anterior (ventral)

Toward the front (belly) of the body

Posterior (dorsal)

Toward the back of the body

Medial

Toward the midline of the body

Lateral

Toward the side of the body

Proximal

Nearer to the point of attachment or to a given reference point

Distal

Farther from the point of attachment or from a given reference point

Superior

Above

Inferior

Below

Cephalad (cranial)

Toward the head

Caudal

Toward the lower end of the spine (Latin cauda = “tail”)

Superficial (external)

Close to the surface of the body

Deep (internal)

Close to the center of the body

DISPLAY 5-2 Body Positions

Position

Pronunciation

Description

Anatomical position

Standing erect, facing forward, arms at sides, palms forward, legs parallel, toes pointed forward

Decubitus position

de-KU-bi-tus

Lying down, specifically according to the part of the body resting on a flat surface (e.g., left or right lateral decubitus, dorsal or ventral decubitus)

Dorsal recumbent position

On back, with legs bent and separated, feet flat

Fowler position

On back, head of bed raised about 18 inches, knees elevated

Kraske (Jackknife) position

KRAS-ke

Prone with the buttocks raised

Knee-chest position

On knees, head, and upper chest on the table, arms crossed above head

Lateral recumbent position

On the side with one leg flexed; arm position may vary

Lithotomy position

li-THOT-o-me

On back, legs flexed on abdomen, thighs apart

Prone

Lying face down

Sims position

On the left side, the right leg is drawn up high and forward, the left arm is along the back, chest forward, resting on the bed

Supine*

SU-pi-n

Lying face up (remember: "up" in supine = facing up)

Trendelenburg position

tren-DEL-en-berg

On back with head lowered by tilting the bed back at a 45° angle

*To remember the difference between prone and supine, look for the word up in supine.

Key Terms

Term

Pronunciation

Definition

Abdominal cavity

ab-DOM-i-nal

Large ventral cavity below the diaphragm and above the pelvic cavity

Abdominopelvic cavity

ab-dom-i-no-PEL-vik

Large ventral cavity between the diaphragm and pelvis; includes abdominal and pelvic cavities

Anatomic position

an-a-TOM-ik

Standard position for anatomical studies: body erect, facing forward, arms at sides with palms forward, feet parallel

Cranial cavity

KRA-ne-al

The dorsal cavity contains the brain

Diaphragm

DI-a-fram

The muscle that separates the thoracic cavity from the abdominal cavity

Frontal (coronal) plane

ko-RO-nal

The plane that separates the body into anterior (front) and posterior (back) portions

Pelvic cavity

PEL-vik

The ventral cavity is below the abdominal cavity

Peritoneum

per-i-to-NE-um

A large serous membrane lines the abdominopelvic cavity and covers the organs within it

Sagittal plane

SAJ-i-tal

The plane that divides the body into right and left portions

Spinal cavity (canal)

SPI-nal

The dorsal cavity contains the spinal cord

Thoracic cavity

tho-RAS-ik

Ventral cavity above the diaphragm; the chest cavity

Transverse (horizontal) plane

trans-VERS

The plane that divides the body into superior (upper) and inferior (lower) portions

Word Parts Pertaining to Body Structure

TABLE 5-1 Roots for Regions of the Head and Trunk

Root

Meaning

Example

Definition of Example

cephal/o

Head

microcephaly (mi-kro-SEF-a-le)

Abnormally small head

cervic/o

Neck

cervicofacial (ser-vi-ko-FA-shal)

Pertaining to the neck and face

thorac/o

Chest, thorax

extrathoracic (eks-tra-tho-RAS-ik)

Outside the thorax

abdomin/o

Abdomen

intra-abdominal (in-tra-ab-DOM-i-nal)

Within the abdomen

celi/o

Abdomen

celiac (SE-le-ak)

Pertaining to the abdomen

lapar/o

Abdominal wall

laparoscope (LAP-a-ro-skop)

An instrument for viewing the peritoneal cavity through the abdominal wall

lumb/o

Lumbar region, lower back

thoracolumbar (tho-rak-o-LUM-bar)

Pertaining to the chest and lumbar region

periton-, peritone/o

Peritoneum

peritoneal (per-i-to-NE-al)

Pertaining to the peritoneum

BOX 5-1 Cutting the Job in Half

A beginning student in medical science may be surprised by the vast number of names and terms that he or she is required to learn. This responsibility is lightened somewhat by the fact that we are bilaterally symmetrical. That is, aside from some internal organs such as the liver, spleen, stomach, pancreas, and intestine, nearly everything on the right side can be found on the left as well. The skeleton can be figuratively split down the center, giving equal structures on both sides of the midline. Many blood vessels and nerves are paired. This cuts the learning in half.

In addition, many of the blood vessels and nerves in a region have the same name. The radial artery, radial vein, and radial nerve are parallel, and all are located along the radius of the forearm. Vessels are commonly named for the organ they supply: the hepatic artery and vein of the liver, the pulmonary artery and vein of the lungs, the renal artery and vein of the kidney.

No one could say that the learning of medical terminology is a snap, but it could be harder!

TABLE 5-2 Roots for the Extremities

Root

Meaning

Example

Definition of Example

acro

Extremity, end

acrodermatitis (ak-ro-der-ma-TI-tis)

Inflammation of the skin of the extremities

brachi/o

Arm

antebrachium (an-te-BRA-ke-um)

Forearm

dactyl/o

Finger, toe

polydactyly (pol-e-DAK-til-e)

Having more than the normal number of fingers or toes

ped/o

Foot

dextropedal (deks-TROP-e-dal)

Using the right foot in preference to the left

pod/o

Foot

podiatric (po-de-AT-rik)

Pertaining to the study and treatment of the foot

TABLE 5-3 Prefixes for Position and Direction

Prefix

Meaning

Example

Definition of Example

circum-

Around

circumoral (ser-kum-OR-al)

Around the mouth

peri-

Around

perivascular (per-e-VAS-ku-lar)

Around a vessel (vascul/o)

intra-

In, within

intrauterine (in-tra-U-ter-in)

Within the uterus

epi-

On, over

epithelium (ep-i-THE-le-um)

Tissue that covers surfaces

extra-

Outside

extracellular (eks-tra-SEL-u-lar)

Outside a cell or cells

infra-*

Below

infrapatellar (in-fra-pa-TEL-ar)

Below the kneecap (patella)

sub-*

Below, under

sublingual (sub-LING-gwal)

Under the tongue (lingu/o)

inter-

Between

intercostal (in-ter-KOS-tal)

Between the ribs (cost/o)

juxta-

Near, beside

juxtaposition (juks-ta-po-ZI-shun)

A location near or beside another structure

para-

Near, beside

parasagittal (par-a-SAJ-i-tal)

Near or beside a sagittal plane

retro-

Behind, backward

retroperitoneal (re-tro-per-i-to-NE-al)

Behind the peritoneum

supra-

Above

suprascapular (su-pra-SKAP-u-lar)

Above the scapula (shoulder blade)

*Also indicates degree.

Supplementary Terms

Term

Pronunciation

Definition

digit

DIJ-it

A finger or toe (adjective: digital)

epigastrium

ep-i-GAS-tre-um

The epigastric region

fundus

FUN-dus

The base or body of a hollow organ; the area of an organ farthest from its opening

hypochondrium

h-po-KON-dre-um

The hypochondriac region (left or right)

lumen

LU-men

The central opening within a tube or vessel

meatus

me-A-tus

A passage or opening

orifice

OR-i-fis

The opening of a cavity

os

Mouth; any body opening

septum

SEP-tum

A wall dividing two cavities

sinus

SI-nus

A cavity, as within a bone

sphincter

SFINK-ter

A circular muscle that regulates an opening

ABBREVIATIONS

Abbreviation

Meaning

LLQ

Left lower quadrant

LUQ

Left upper quadrant

RLQ

Right lower quadrant

RUQ

Right upper quadrant