To address your "If true that they are variables" and "scope" questions, it would have been simpler to answer that accessor symbols have nothing to do with instance variables, even if it sounds iconoclastic. They don't point to instance variables. Accessors only define getter and setter methods. Under Object#instance_variables, the Pickaxe(*) says : Note that simply defining an accessor does not create the corresponding instance variable.  
In Ruby, a variable does not exist until you assign a value to it. The following code demonstrates this.
class MyClass
    attr_accessor :name
    attr_reader   :book
end
obj = MyClass.new # line 6
print '1) obj.instance_variables : '; p obj.instance_variables
print '2) obj.name : '; p obj.name
obj.name = 'xyz'
print '3) obj.instance_variables : '; p obj.instance_variables
print '4) obj.name : '; p obj.name
print '5) obj.book : '; p obj.book
class MyClass
    def initialize(p_book)
        @book = p_book
    end
end
obj = MyClass.new('The Pickaxe') # line 21
print '6) [new] obj.book : '; p obj.book
class MyClass
    method_name = 'title'
    attr_accessor method_name # line 26
end
obj.title = 'Programming Ruby'
print '7) obj.instance_variables : '; p obj.instance_variables
print '8) obj.title : '; p obj.title
Output :
$ ruby -w t.rb 
1) obj.instance_variables : []
2) obj.name : nil
3) obj.instance_variables : ["@name"]
4) obj.name : "xyz"
5) obj.book : nil
6) [new] obj.book : "The Pickaxe"
7) obj.instance_variables : ["@title", "@book"]
8) obj.title : "Programming Ruby"
1) empty array : accessors have not defined instance variables
2) asking for instance variable @name answers nil : it does not exist
3) assigning a value has created the instance variable.
Note that name = is a syntactic sugar for using the setter as an ordinary method with a parameter : obj.name=('xyz')
4) the getter method name answers the value of @name
5) the getter method book answers nil because the instance variable @book does not exist. Defining an accessor attr_reader :book has not defined the corresponding instance variable
6) the getter method book answers the value assigned in initialize, called by new on line 21. The instance variable @book has been created by @book = p_book
line 26) I have always believed that accessors accept only symbols. I discover that a variable is possible, but of limited interest.
7) the setter method title= has created @title. This also shows that instance variables belong to a single object. We often believe that they belong to all instances of the class, as in other languages. In this case, @name belongs only to the object created on line 6.
8) the getter method title answers the value of @title  
class MyClass
    def title # line 34
        @book + ' (cheating !)'
    end
end
print '9) obj.title : '; p obj.title  
Output :  
t.rb:34: warning: method redefined; discarding old title  
9) obj.title : "The Pickaxe (cheating !)"  
9) of course there is a tight correlation between an accessor symbol and the corresponding instance variable, because, behind the scene, Ruby creates methods which reference an instance variable of the same name. You could define your own getter and cheat.  
Note that besides class variables (@@var, some dislike them as ugly as global variables), classes can also have instance variables. I call them class instance variables :).
class MyClass : Ruby allocates a new instance of class Class, defines a constant MyClass, and assigns the new instance to that constant. Thus MyClass is an ordinary object (instance of Class) and as such can have instance variables.
if RUBY_VERSION[0..2] == '1.8'
    class Object
        def singleton_class
            class << self
                self
            end
        end
    end
end
class MyClass
    singleton_class.instance_eval do
        attr_accessor :counter
    end
    @counter = 0
    def initialize(p_book)
        @book = p_book
        self.class.counter += 1
    end
end
print '10) MyClass.singleton_methods  : '; p MyClass.singleton_methods
print '11) MyClass.instance_variables : '; p MyClass.instance_variables
obj = MyClass.new('Ruby')
print '12) [new] obj.book ', MyClass.counter, ': '; p obj.book
obj = MyClass.new('Metaprogramming')
print '13) [new] obj.book ', MyClass.counter, ': '; p obj.book  
Output :  
t.rb:55: warning: method redefined; discarding old initialize
10) MyClass.singleton_methods  : ["counter", "counter="]
11) MyClass.instance_variables : ["@counter"]
12) [new] obj.book 1: "Ruby"
13) [new] obj.book 2: "Metaprogramming"  
More on singleton methods here : What does def `self.function` name mean?
(*) http://pragprog.com/book/ruby3/programming-ruby-1-9