eBook Download Anthonys Textbook of Anatomy Physiology 21e Kevin Patton, Gary Thibodeau

UNIT 1

CHAPTER 1

CHAPTER 2

CHAPTER 3

CHAPTER 4

CHAPTER 5

CHAPTER 6

CHAPTER 7

CHAPTER 8

CHAPTER 9

The Body as a Whole, 1

Organization of the Body, 2

Homeostasis, 23

Chemistry of Life, 38

Biomolecules, 55

Cell Structure, 75

Cell Function, 98

Cell Growth and Development, 120

Introduction to Tissues, 137

Tissue Types, 154

UNIT 2 Support and Movement, 178

CHAPTER 10

CHAPTER 11

CHAPTER 12

CHAPTER 13

CHAPTER 14

CHAPTER 15

CHAPTER 16

CHAPTER 17

Sk in, 180

Skeletal Tissues, 209

Axial Skeleton, 233

Appendicular Ske leton, 263

Articulations, 281

Axial Muscles, 31 0

Appendicular Muscles, 333

Muscle Contraction, 356

UNIT 3 Communication, Control, and Integration, 386

CHAPTER 18

CHAPTER 19

CHAPTER 20

CHAPTER 21

CHAPTER 22

CHAPTER 23

CHAPTER 24

CHAPTER 25

CHAPTER 26

UNIT 4 Transportation

and Defense, 604

CHAPTER 27

CHAPTER 28

CHAPTER 29

CHAPTER 30

CHAPTER 31

CHAPTER 32

CHAPTER 33

CHAPTER 34

Blood, 606

Heart,634

Blood Vessels, 663

Circulation of Blood, 697

Lymphat ic System, 725

Innate Immunity, 746

Adaptive Immunity, 759

Stress, 782

UN IT 5 Respiration, Nutrition, and Excretion, 798

CHAPTER 35

CHAPTER 36

CHAPTER 37

CHAPTER 38

CHAPTER 39

CHAPTER 40

CHAPTER 41

CHAPTER 42

CHAPTER 43

CHAPTER 44

Nervous System Cells, 388

Nerve Signal ing, 408

Central Nervous System, 432

Peripheral Nervous System, 473

Autonomic Nervous System, 47 4

Genera l Senses,498

Special Senses, 514

Endocrine Regulation, 526

Endocrine Glands, 556

Respiratory Tract, 800

Ventilation, 823

Gas Exchange and Transport, 84 7

Upper Digestive Tract, 860

Lower Digest ive Tract, 881

Digest ion and Absorption, 900

Nutrition and Metabo li sm, 928

Urinary System, 963

Fluid and Electrolyte Balance, 996

Acid-Base Ba lance, 1016

UNIT 6 Reproduction and Development, 1034

CHAPTER 45

CHAPTER 46

CHAPTER 47

CHAPTER 48

Male Reproductive System, 1036

Female Reproductive System, 1054

Growth, Development, and Aging, 1086

Genetics and Heredity, 1121

Glossary of Anatomy & Physiology, 1144

Index, 1198

Anthony's Textbook of 21ST EDITION

KEVIN T. PATTON, PhD

Professor of Anatomy & Physiology Instruction

New York Chiropractic College

Seneca Falls, New York

Founding Professor of Life Sciences, Emeritus Faculty

St. Charles Community College

Cott leville, M isso u r i

Assistant Professor Emeritus of Physiology

Course Director Emeritus in Human Physiology

St. Louis U niversity M edica l Schoo l

St. Louis, Missour i

AUTHOR EMERITUS

GARY A. THIBODEAU, PhD

Chancellor Emeritus

Professor Emeritus of Biology

Univers ity of Wisconsin- R iver Falls

River Falls, Wisconsin

ELSEVIER

ELSEVIER

32 5 1 Riverport Lane

St. Louis, M issour i 6304 3

ANTH ONY'S TEXTBOOK OF ANATOMY & P HYSIOLOGY, 21ST E D IT ION ISBN: 978-0-323-52880-1

C op yr ig ht © 20 19 b y E lsevi e r In c All rights re se rv ed

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Winner of th e 2016 Textbook Excellence Award from the Textbook & Academic Authors Assoc iation

About the Author

Kevin T Patton has ta ug ht anatomy : m d p hys io lt>g}' (A&·P) to h igh sd10oal, commun ity college. and university sh tdenb fr om \':trious backgrounds for more th:m 3 Kevin found th:tt the wo rk tl1at l ed h im to:. PhD i n verteln a te anatomy and insti llc:<l in him an :.ppr eciation for t1H: Picture of human struch tr e :ut<l function. T'his cxpcr icnce has IH:Ip cd h im :1 text tl1at \\i ll h e e:.sie r to m1<le rst.and for all studcnls

H e h:.s earned citations for te:.ching A&: P, including the lvl issomi Cmrernor's Award for Excel in T e:.ch ing

"One tl1ing t·vc lcamcd," s.:ays "'is that most of us learn scientific concepts more easily \lll1c:n we c:.n see whafs going on - H is talent fo r using imagery to teach is tluougl10ut th is eclitiun, \\i th ib; extensive : m:.y of visu:. l rc:sourcc:s. Kc:vin ·s stro ng interes t in applying the princip les of lea ming scic:nc:e to c:ffectivc:ly tc::.eh ing A&P is also c:vi<le nt i n the i ns tructional clc:sign o f th is texthuok, wh id1 earned tl1e 1016 Tbthook Excd lenec: Award from the textbook & Aeadem ic Authors A.;sociation ( l i\.A)

Kevin's work i n promoti ng excel lence: in teaching A&P h 3s lc:d h im to take an active role in tl1c: H um:.n Anatomy :.nd Physiology Society ( HAPS) wl1c:re he is 3 Presiclc:nt Emerihts He w:.s the fmm<ling director o f the: HAPS lmtitute ( H.Af>$.( ) and was :rw;mled the HA PS Presi· <le nt's 2\•lc:d:. l fo r o utstandi ng contrilmtions in Jlrom o ting the miss ion of e.xec:llc:nc:e i n A& P tead1i ng :.nd learn ing

Kevin :.lr.o teaches g r a<lu:. te courses to prospective and cur· r en t A&:P professors. He h:.s sc:rvecl :.s 3 men tor to A&P p rofes. son across the continent and produces on line resomees for A&·P sh tdc: nts and tead1c:n. including tlreAI'student.org :.nd theAPprofessor.org. H is b log PaUorv\P.org provides insigl1ts and tc::.ch ing notes fur f:tculty us ing th is textbook.

To my family and friends. who nnl!r let me forget the joys ofdisrovery. adventure. and good humor.

To the many teachers who taught me more by who they were than by what they said.

To my tdudents who help me keep the thrill of learning fresh and exciting.

Kel<in '1: l'aHou

Rhonda Gamble, PhD

Professor of Ph ysiological Sciences

Minera l Area College

Park H ill s, M isso u ri

Michael Greer, MA

In structor

Univers ity of Arkansas at Li ttl e Rock

Littl e Rock, Arkansas

Suzanne Hembrough, MA

In structor

Lindenwoo d Un ive rsity

Sa int Cha rl es, Missou ri

Sa int Loui s Univers ity

Sa int Loui s, Missou ri

Terry Thompson, MS, MS-HAPI Professor of Biological Sciences and Phi Theta Kappa Advisor

Wo r-\iVic Community College

Sa l isb ury, Maryland

Peggie Williamson, MS, SPT Professor

Central Texas College

Kill ee n, Texas

EVOLVE WRITER

Daniel J. Matusiak, BS, MA, EdD

Life Science Instructor

St. D omin ic H igh School

O 'Fa llon, Mi sso ur i Adjunct Professor

St. Cha rl es Commun ity Co ll ege Co ttl ev ill e, Misso u ri

ONLINE COURSE WRITER

Linda Swisher, RN, EdD

Retired

Su ncoas t Tec h nical Co ll ege

Sarasota, F lori da

Amanda May Boye-Ray

AnMed H ea lth Sc h oo l of Radiology

Carolyn Bunde

Idaho State Un ive rsi ty

Teresa Cowan

Ba ker Co ll ege of Aub u rn H ill s

Debbie Gantz

Miss issipp i D elta Commun ity Co ll ege

Robert S. Kellar

N orthern Arizona University

Karen Kelly

Milligan Co ll ege

Nick Pasquale

U ltraSo u nd In sti t ute/MUA: M edica l University of America

Kevin Pierce

East West College of Na tural Medic ine

Scott D. Schaeffer

Harfor d Comm u nity College

Kim Seigman

Covenant Sc h ool of Radio logy

Paula Denise Silver

EC P I Un ive rsi ty- Me dical Ca ree rs In sti tu t e

Bhupinder Singh

Bizt ech Co ll ege

Kathy Smith-Stillson

Reg is University Colorado C h ri stian Unive rsity

Luann Wilkinson Marion Tech nical College

Peggie Williamson Central Texas College

Justin L. Wilson Hampton Un ivers ity

PAST EDITION REVIEWERS

The Department of Physiology and The Department of Anatomy & Structural Biology

Otago Schoo l of Me dical Sc ie nc esUniversity of O t ago

Mohammed Abbas Wayne County Comm u nity College

Laura Anderson

Elk County Cathol ic Hig h Schoo l

Bert Atsma

Union Co u n ty Co ll ege

John Bagdade

North western Un ive rsity

Mary K. Beals

South e rn Un ivers ity and A&M Co ll ege

Rachel Venn Beecham Mississippi Va ll ey St ate University

Brenda Blackwelder

Central P ie d mont Community College

Richard Blonna

W illiam Paterson Co ll ege

Claude Bouchei

I NSERM

Charles T. Brown

Barton Coun ty Commun ity Co ll ege

Laurence Campbell

Florida So u th e rn Co ll ege

Patricia W. Campbell

Carolinas Co ll ege of H ea lth Sciences

Geralyn M. Caplan

Ow ens boro Commu n ity and Techn ical Co ll ege

Roger Carroll

University of Tenn essee School of Med icin e

Reviewers

Melvin Chambliss

Alfred State College

SUNY College of Technology

Pattie Clark

Abraham Baldwin College

Richard Cohen

Union County College

Barbara A. Coles

Wake Technical Community College

Harry W. Colvin, Jr.

University of California - Davis

Darwin Coy

University of North Florida

Douglas M. Dearden

General College of University of Minnesota

Cheryl Donlon

Northeast I owa Community College

J. Paul Ellis

St. Louis Community College

Frank G. Emanuele

Mercyhurst University

Cammie Emory

Bossier Parish Community College

Julie Fiez

Washington University School of Medicine

Beth A. Forshee

Lake Erie College of Osteopathic Medicine

Laura Frost

Florida Gulf Coast University

Debbie Gantz

Mississippi Delta Community College

Christy Gee South College - Asheville

Becky Gesler

Spalding University

Norman Goldstein

California State University - Hayward

Zully Villanueva Gonzalez

D ona Ana Branch Community College

John Goudie

Kalamazoo Area Mathematics & Science Center

Charles J. Grossman

Xavier University

Monica L. Hall-Woods

St. Charles Community College

Rebecca Halyard

Clayton State College

Ann T. Harmer

Orange Coast College

Linden C. Haynes

Hinds Community College

Lois Jane Heller

University of Minnesota School of Medicine

Lee E. Henderson

Prairie View A&M University

Angela R. Hess

Bloomsburg University

Paula Holloway Ohio University

Julie Hotz-Siville

Mt. San Jacinto College

Gayle Dranch lnsler

Adelphi University

Patrick Jackson

Canadian Memorial Chiropractic College

Carolyn Jaslow

R hodes College

Gloria El Kammash

Wake Technical Community College

Murray Kaplan

I owa State University

Kathy Kath

Henry Ford H ospital School of Radiologic Technology

Brian H. Kipp

Grand Valley State University

Johanna Krontiris-Litowitz Youngstown State University

William Langley

Butler County Community College

Michael Levitzky

L ouisiana State University School of Medicine

Clifton Lewis Wayne County Community College

Jerri Lindsey

Tarrant County Junior College

Eddie Lunsford

Southwestern Community College

Bruce Luon

University ofTexas Medical Branch

Melanie S. MacNeil

Brock University

Susan Marshall

St. Louis University School of Medicine

Gary Massaglia

Elk County Christian High School

Bruce S. McEwan

The Rockefeller University

Jeff Mellenthin

The Methodist Debakey Heart Center

Lanette Meyer

Regis University/Denver Children's H ospital

Donald Misumi

Los Angeles Trade- Technical Center

Susan Moore

New Hampshire Community Technical College

Rose Morgan

Minot State University

Jeremiah Morrissey

Washington University School of Medicine

Greg Mullen

South Louisiana Community College/ National EMS Academy

Robert Earl Olsen

Briar Cliff College

Susan M. Caley Opsal Illinois Valley Community College

Juanelle Pearson

Spalding University

Nicole Pinaire

St. Charles Community College

Wanda Ragland

Macomb Community College

Saeed Rahmanian

Roane State Community College

Robert S. Rawding

Gannon University

Carolyn Jean Rivard

Fanshawe College of Applied Arts and Technology

Mary F. Ruh

St. Louis University School of Medicine

Jenny Sarver

Sarver Chiropractic

viii Reviewers

Henry M. Seidel*

T h e John s Hopkin s Uni ve rsity School of M e d ic in e

Gerry Silverstein

Uni ve rsity ofVe rmont - Burlington

Charles Singhas

Ea st Caro li na Uni ve rsity

Marci Slusser

Re ading Ar e a Communi ty Co ll e ge

Paul Keith Small

Eur e ka Coll eg e

William G. Sproat, Jr.

Walt e rs State Community Coll eg e

Snez Stolic

G riffith Uni ve rsity

Aleta Sullivan

Pe arl Ri ve r Commun ity Co ll e ge

Kathleen Tatum

Iowa State Uni ve rsity

Reid Tatum

St. Martin 's Ep iscopa l Sc h ool

Kent R. Thomas

W ich ita State Uni ve rsity

Todd Thuma Macon Co ll e ge

Stuart Tsubota

St. L oui s Uni ve rsity

Judith B. Van Liew

State Un ive rsity of New York Coll eg e at Buffa lo

Karin VanMeter

I owa State Uni ve rsity/D es Moin es Ar e a Community Coll e ge

Gordon Wardlaw

O h io St ate Uni ve rsity

AmyL. Way

L ock Ha ve n Un ive rsity of Pe nn sy lvan ia

Anthony J. Weinhaus

Uni ve rsity of M inn es ot a

Cheryl Wiley

Andr ews Uni ve rsity

Clarence C. Wolfe

North e r n Virginia Commun ity Co ll e ge

h i s te xtbook r e lat es t h e st or y of t h e human bod y's st ru ctur e and funct i on. Mor e t h an a si mpl e coll e c t i on of facts , i t i s both a t e ach i ng tool an d a l e a rning t oo l. I t wa s w ritt e n t o h e l p stud e nts un i fy informa t ion , st imulat e cri t ical thinking , and ac q uir e a t ast e for kno wl e dg e about t h e wond e rs of t h e hu man bo d y Th e story r e l ate d i n t h is t ext book wi ll h e l p stud e nts avoi d b e coming l o st in a m aze 45 ° of fact s w hil e na vigating a comp l e x l e arn i ng e n vironm e nt. It will e ncourag e t h e m to e xplo r e, t o qu es t i on, and t o look fo r re lat ion s h i p s, not onl y b e t wee n r e la t e d fact s i n a si ng l e d iscip li n e , but al so b e tw ee n fi e l d s of acad e mic in q u iry and p e rs onal exp e ri e nc e Th is n ew e d ition of th e t e xt h a s b ee n car e full y r ev ise d to b e tte r t e ll th e story of th e human bod y E sse ntial, accu ra t e, and curr e nt informa t i on con t i nu es to b e pr ese n t e d in a comfortabl e storyt e lling s tyl e . Emp h a s is is plac e d on conc e pts ra t h e r than d es cription s, and t h e " conn e ct e dn ess" of t h e human body- in w hich structure fit s functi on - is r e p e ate d l y r e inforc e d b y unifying t h e m es

UNIFYING THEMES

Anatom y an d ph ys i ology e ncompa sses a bo d y of kno wl e dg e t h a t is l arg e an d compl e x. Stu d e n ts ar e fac e d with t h e n ee d to know and und e rstan d a mult i tud e of i ndi vi dual structur es and function s t h a t con stitute a b ew ild e ring arra y of see mingl y d is jointe d i nfo rm ation Ulti ma t e l y, t h e stud e nt of ana t om y an d p h ys iology mu st b e ab l e t o " pull tog e t h e r" thi s information to vi ew t h e bod y a s a w ho le- t o see th e " B ig Pictur e " If a textbook is to be successful as a teaching tool in such a complex learning environment, it must help unify information, stimulate critical thinking, and motivate students to master a new vocabulary.

To accomp li sh t h is sy nth es is of i nformati on, unifying th e m es ar e r e quir e d to t e ll th e story of t h e human bo d y e ffe ctivel y In addi t ion , a m e c h an ism t o po sition and impl e m e n t th ese th e m es mu st b e an i ntegral part of e ac h chapte r. Pr i or to Uni t l is " See i ng th e Big Pictur e," an ove rvi ew that e ncourages stud e nts to p l ac e i ndi vidua l structur es or function s i n t o an integrate d fram ew ork. T h e n , a sp e ci al "T h e Big Pictur e" se ction w rap s up t h e story of e ac h c h ap t e r s o th at its signi fi canc e in t h e ove rall function of th e bo d y can e as ily b e see n.

Anthon y's Te xtbo ok of Anatom y 6 Ph ys iology is domina t e d b y two major uni fy ing th e m es : ( l ) structure fits function and ( 2 ) homeostasis . Th e s tud e nt is sho w n, a s t h e st ory unfold s, ho w o rgani ze d a natomica l structur es of a particu l ar si ze, shap e , form , or p l ac e m e nt se r ve un i qu e adapti ve function s. Th e int egrating princ i pl e of hom e o sta si s is u se d to sho w ho w t h e " normal " in t e raction of structur e an d funct i on i s ach i eve d and ma i n t ain e d b y coun t e rbalancing forc es w it h i n th e bod y R e p e ate d e mpha si s of t h ese princ i pl es e ncourag es stud e nts to i nt egrate oth e rw ise iso l ate d fac t ua l information into a coh es ive and un d e rst andabl e whol e "Th e Big Pictur e" summar i zes t h e l a rg e r int e raction b e tw ee n st ructur es and function s of th e diffe re nt bod y sys t e m s As a r es ul t , the story of anatomy and physiology emerges as a living and dynamic topic of personal interest and importance to students.

AIMS OF THE REVISION

As in p:.st editions, In)' re\'is ion ellorts focused on tl1e nec:d for new o r revise<l informdlion and fo r a<l<litio n.al visual p resc:ntdtio ns that important, yet sometimes d ifficu I t, c:onlc:nt :.reas.

In tl1is tc:ntl1 e<lition,l have include<l information on new concepU :.ml new perspectives in many areas o f an:.tomy :.ml pl1p iology. Some: of the fe r minology has been upd:.ted to reflec:t the most e mrent us:.gc: in the seic:ntihc community. The d iseuSll ion of osmosis in Ch:.ptc:r 4 :.nd se\·eral o ther chapters l1.as bc:en clarihc:d to reReet the latest seientihc understdnding wh ile: still an "en try level- treahnc:nt of this importan t eoncep t The stress ch:.ptc:r (C h:.pter H) h:.s heen reorgan ized and p;trfi.:.Hr rewritten to hetter reflect current theo ries o f s tress in humans. Most of tl1e con ten t ch:.nges :. re subtle a<l justmenb> to our curren t un<lc:rst.anding of hum:.n science; however, t11c: accumub tion o f all o f these ch.:.nges makes th is e<lition tl1e most up-to-tlate textbook :t\'a ibble

'11lis e<lition .:. lso intro<lucc:s a uni<pte ne\v ledrning fc::.turc: th:.t repbcc:s the: fo n ner "s u mm.:.ry" opc:nc:rs to tl1c: six units o f tl1is ch:.ptc:r. Dc\·c:loped in colb l,., ration wi th cognitive texthook design expe rt lvli chael Creer and .:.natmnr and physi ol ogr professor 1 C:rry '11mmpson, each unit now opens with an illustr.t tc:d tool th:. t jump-stdrb> student le.arning hr JXlsf l earn ing :.ml nc:w lc:.:.rning yet to come 'l11is innov:tti\·c: is b:.sed on cunc:nt, evi<lc:nce·hasc:d leaming theories. In :.n illustr.tted layou t, these ne\v interaeti\'e unit openers p rovide spaced retrieval practice along \\i th pre-testing exe rcises p roven to enhance sh tden t learning. Student:; wl10 usc: th is nc:w fe.ah tre will en joy a more c:ffecti\'c: learning experience :.s they mo\'e tluough tl1c: textbook.

A h:.ll mdrk o f th is lexthook has bc:en its e ffecti\'e "chunking- of m:.teri.:.l into man.age;tb)e b ite-size p ieces-.:.notl1er C\'i<lc:nce-basc:d enh:.ncemen t of tl1c: ledrning process. This edition reflects mr con tinu ing comm itment to that approach. In the p re\'iom edition, I undertook significan t chunking o f long chap ters into sm.:.H, c::.si l)' rc::.d chapter.>, I n this ne\v e<lition, I continue the: process h)' carefully an<l adding sullll c::.ding:o; to im p ro\'e the tell ing o f the story of the human bodr Bes ides provi<ling graph ic scaffoldi ng to help sh tdents construct a dc::. r umler.;tan<ling of concepts :.s the story unfolds, these: subheadings .:.)so help stmlc:nU hnd rc:lc\'an l material as thcr la ter "r.t i<l- their texthook for specific help in d ifficu lt concc:pb>-ur concepU thc:y missc:<l o r fo rgot :.ftc:r the ir hrst red<ling I h:.ve a lso t.aken opportunities to reduce: cogni tive load and impro\'C: rc::.ding comprehension b)· spl iHing longer paragraphs into sm.:. llc:r p.:. ragrnphs

Another .:. im of th is has been the h ne-tuning of tl1e usc: o f onl ine: a rti cles. FOn nerly ca ll ed A 6 1) Conn ect, th is feah tre is now ca ll ed Con nect It! Besi<lc:s JllU\'iding inte resting :.s ides t11.at hd 1) sp:t rk in terest in a topic and moti\'ate deeper le.:.ming, these articles provi de an opportunity to integrate diverse topics scattered throughout the book For example:, the article The Human Microbionle is c:.lled ou t in m.lH)' different cl1dpters, helping rc:a<le rs sc:e the numerous connec tions that ch.:.r:tcterizc: human s tructure and fun ction Such " integrati\'e- use of the articles has bec:n c:xp.:.nded and imp roved in tl1is c:<lition . editions have fea tured wh.:. t is nuw our sjgnature page design that makes the textbook easier to use by putting the i ll ustrations, graphs, and tables doser to the related text In tl1is edition, our prO<luction tc:.:.m l1.as worked h:.rd to make the page layou t cvc:n more effective for

telling tl1e story o r tl1e human hody. The extensi\-e set of summa ry tables helps visually org;tnize important concepb> :md comple ments the impm..-ed <lesign to provide a muhisc:nsory learni ng tool. The a rt program has been enha n ce<! by moving descriptions of ..s teps- from tl1e l egend in to the itselr. tlnu reducing cognitive lo:.d and imprO\-ing comprd1ension.

The effort.; in represen ting d iversity of the ht.man form continue in th is edition by a(Ming a new set o r musde illustrations feah u ing a remal e s ub jec t. Our :. rtish ll aYe also rep laced many illustr:ltions th ro ugl1out tl1e book witl1 :.rt re prese nting a more d iverse set of hum:.n traib.

SC'\·eral new illustr:l tions also ma intain the use of :. eons istent Color Key ( round on tl1e Emh-e we bs ite at for certain cell parb>, tissue types, :.nd hiomol eeu les to help learni n g easier ror beginning sh u lc: nts

In this e(litio n, I co n ti nue my effo rt to tl1is text :.ccessible to shulents whose fir.ot la ngua.ge is not English . Arter consulting witl1 ES L speci:.l ists :.nd £Sllearners. I have cont inued t o refine chapter word lists and improve readability t o mak e t h e con cep ts o f h uman s t ructure and function more understandable f or all studen ts

As a te:.cher of :ma tomy :md physiology. I know that to h e effective a text mus t be dear :.nd rea<lable, a n<l it must c11allenge and excite the s tud en t. Th is text remai n s one that studen t s will read - o n e designed t o help the t eacher t each and the studen t learn 10 :.ccompl isl1 tl1 is end, I f:.cil itate(l the comprehens ion of (liflicult m:.teri:.l for s hulc: nts wi th thorough, cons isten t, a n<l non intimid:. ting expbnations that are free o r unneeess:. ry term inology :.ml extr.meous infonnation. 'l'his easy access to complex i(lea.s remai ns tl1e s ing l e most stri ki ng l1al lm:.rk or this texthool

• LEARNING AIDS

Anthony$ 'textbook ofAnatomy 6 Ph ysiology is a student-orien ted text. \ ¥ ri n en in:. re:.dable styl e th:. t tc:lls a col1 erc: n t story, the text is <lesigne<l with many d ifferent pe(lagogical a ids to moti..-ate :.ml mainlain i nterest. T11e spec ial re:. tures a nd l ea m ing :. ids l isted b el ow are i ntemled to faci litate l earn ing a n d reten ti on of info n na tion in the most effecti\·e and efficient manner

No text book c:.n replace tl1e direction and s timulation provided by a n c:nthusi:.stic teacher to a c urious a n<l in\'Oh-ed stm lc: n t. Howe\'er, :1 rull co mplement o r innovative pedagogical ai(ls that :.re ea rdull)' planned and implemented can contribu te:. great deal to tl1e success o f a text as:. le:.rning tool. An excellen t textboul: c:.n and should b e enjoyable to re:.d a n<l sl10u ld be l1 d pfu1 to both shJden t and teacher. I l10p e you :.gree that the learni ng aids in Anthony's 'ff>xtbook ofAnatomy 6 l)hysiology mec: t the h ig h expectations l l1a\'e set.

IN TERACTIVE UNIT INTRODUCTIONS

E.aeh of the six m:.jur units of the tc:xt hegins with a bric:f, interactive le:. ming opportun ity tha t reviews JUSt learni ng:.nd "'primes the pump- ror nC'\V le:. m ing in the ch apters th:. t by:.hea<l. Based on mudern le:.ming science, using this strategy c:nh:.nce yuur understanding :.s yo u re:.d the c h apters o r each uni t. '1 1tis is rollmved ll}' :. dear o r tl1e sto ry told in the c h ap ters o r tl1e uni t. E:.ch unit h:.s:. color-coded tab at the outs ide edge of e\'c: ry )Xlge to help )'UU quickl)' find tl1c: info n nation )'UU need.

CHAPTER LEARNING AIDS

S tudy Hints gi1--e specific suggestiom (or using many of aids foun d in ead1 chapter. Because many readers l1a\·e n ever le:.m ed the speci:. l s kil ls nee(le<l to make effective use of the pe<l.agogic:. l resources fo und in sc ience textbooks, hc:l pru l tips :.re em-

ntlle(Me<l with in e:.ch Chapter Outline, L:mgu.age of Science & 2\•lc:dicine

list. Case: Shtd)', C l1apter Summary, RC'\·ic:w Questions sc:t, and C ritic:. l

H' l11in ki ng section. Answers ro r the Qu icl: Checl: a n<l Case Study (ptc:stions :.re available ror sh tdcnb on the E:mh·e website :.nd :.nswers for these p lus the ReviC'\\' and C ri tic:. I E.xercises are :J\'aibhle for ins tm ctors in the TEAC H Instructor's Resou rce.

'l'he Chapte r Outline: summari;n the ronknU ofa chapin at a glance. An over\'ic:w outli n e i ntm· <luces e:.ch c h a p ter and c:nalll es the student to prc:\-iew the conten t :.nd d irection of tl1c: ch apter a t the m:.jur co n cep t l e\'c:l berore heginn ing a detailed rea<ling. P:tge refe rences en:. b le s tudents to quickl)' locnte topics in tl1e chapter

Language of Science introduces you to new scientific tf'mu in the cha pt f'r A comprehens ive l is t of new terms is presc: ntecl :.t l11c: beginning of t11c: d1apter. f.:td1 term in the l ist h:.s :.n pro nun ciati o n guide: to help the Iea m er eas ily "'c1wn- the worcl by being :.llle to say i t. literal tr:msb tiom o f c::.ch lc:nn's word pam are inc:ludecl to l1c:lp learn how to clc:<luc e the mc::.ning of n ew lc:nns on the ir mm. l 1l e l istecl terms are clc:fined in th e text lxxl}'. wl1c:re th ey :.ppe:.r i n bolclf:.cc: type. and :.re also in the: C los50 ry a t t11c: back o f the: bool The: boldface type fea ture: enables sh u lc: nU to scan tl1e lc:xt for nc:w wor<ls hefore beginning their first rea<ling of the: ma terial, so th e)' m:.y reacl without h:.v ing to clisrupt the Row to gr:.pplc: witl1 n ew '"-u rds o r phrases. T11e lan guagc: of word list incl udes terms rc:latc:<l to the essen tial :.natom)' a n<l physiology presc: ntc:d i n tl1c: chapter Anotl1er word list nc:ar tl1e end of the chapter, :1 feature clescribc:<l as the L:.nguage o f !vleclicine, is an i n\'entory of all of the n ew cli nic:.) tenns in troc:lucecl in the: ehaplc: r.

Cnl o r-cuded ill ustr.:ttio n s help Mginning 5tudf'nts appreciatE' thE' '"B ig Picture" of hu· man structure and {unction. A special fc::.ture of the illustr:ltions in th is tc:xt is the: earefu l and consistent use o f color to id en tify importan t stmchnes an d subsbnces th:.t recur throughout the book. Consistent me of :1 col o r helps beginning shulc:nU apprc:ciafe the "Big Picture" elf human stmctmc: a n<l function c::.ch time the)' sec: a fami liar s tructure in a new For an explanation of the color scheme, see the Color Ker o n the E\'Ulve wdls ite (c.11'0lve.elsettier.com/ Patton!Ai>l) .

D irectio n al rosettes help students lf'am thE' orientation of anatomical 5fructurrs.. Where: appropriate, small orientation and clirc:ctional msettc:s are includecl as JXl rf o f a n illustr.l tion to help stmlc:nb> locale: a lure with reference: to the boc:k as a whol e or orient :1 small struchue i n a larger vic:w.

Q u ick Check t luestions test your knowledgE' of material you'vE' just read. Short objc:etive-type questions are l ocatecl immecli:.tc:ly follc)'l,\rlng m:.jor topic cliscussions thmugho ul the: boclr of th e text. '11lc:se questions cover importan t info nna tion presen ted in t11c: preceding section Shulc:nts un:.llle to answer the questions shoulcl rereacl tha t section before JlfOcec:ding. Th is feature: the re for e readi ng cmnprc:hc:nsion Quick Check items are numbered b)' cha pte r, and a numc:ri

cal l is ting of the ir answers ean he fo und o n the: £mlve website: (e-vob't". elsn'ier.coml f>aUonJAP

I)

Cnn nect I t ! fc-.ah ues call the readtr's atte-ntion to online articles that illudra l f', clarify, and apply conupts f'ncoun l f'red in thE' lf'xl. £mheclclc:d with in the text narrative, these: boxes connect you wi th in tc:rc:s.ting, hrid o n l ine: articles th at stimulate thinking. your cu rios ity, and h elp you appl}' importan t concepU. Connect It! articles also help you unclc:r stan d connec tions among s tmcturc:s and functions througho ut the: bcxly. integrating concepts i nto a Big P ichu e- of lmma n f unction '11lc:y a re olfen illustratc:<l \\rl th m icrographs, mecl ica l im:.ges, and mc:<li· ca l il hLslra tions.

LANGUAGE OF SCIENCE

Isometric contraction

(a)'e-soh·f.£T.fik kon·TRAK·shlll)

l.iso· -metr·

·k relating to, c:oo- together, ·tmct· drag or lkaw process)

Isotonic contraction

(aye Soh·TON·ii< kon ·TRAK·sl'ul)

l.iso· /IJII· stretdl or tension, ·k relating to, c:oo- together, ·118Ct· drag or lkaw. process)

lactate (IAK tly1)

jAlct·rnJk., ·atesalt of 111 acidJ

Quick C H E C K

1. L.m the majOf subdivisions of the hu'nan nervous system

2 What two organs make up the ceNral nervous system?

3 Contrast the somatic nervous system with the autonomic oef'IIOus .,....,,

C O N N E C T I T ! @

Tiny barref.shaped organelles called vaults may a1so assm with transport ol molecules to and from the nucleus To learn more about these little transport sh.rt1les.. check out Vsults oni'le at Comect ttt

In many hod}' srstc:ms, changes in struch1re and functio n are fr equen tly related to a person's age o r state: of dC'I.·elopmc:nt. In appropriate: chapters of the text. these changes are hig h l igh ted in this special sec tion

Cycle of Life describn major changes that OC"CUT on!r a person 's lifetimE'. fonn and function. The: inten t o f the Mechanisms of Disease sec tion is to reinforce: understanding of tl1c: normal s truc tures an<l mechanisms of the hody wh ile: h igh lig l1ting the gc: n ernl causes of disorders fur a )Xlrticula r hod}' system These: sections arc: heavily illustratc:<l wi th <liagrams and medical pho tographs tha t hring pa thology eoncc:pts to l ife .

The Big (Jid u rc explains the interactions of the discusU!d in a par· ticular chaptu with the body as a whole. 'l11is hc:lps sh1dc:nb> rela te informa lion about bod)· structures o r functions tha t are cliseussecl in the: chapte r to the bcxly as a whole '11lc: Big Picture feature: hc:lps you improve critical h}' focusi ng on hm\' stmchnc:s and functio ns relate to one anotl1er o n :1 bcxh-.,,i de hasis.

M cch2nisrm of helps you understand the basic principles of hu· man drudure and {unction by showing what hapfWns whf'n things go wrong. Examples of pat11ology. or <liseasc:, a rc: includecl in man)' chapter.; of the hook to stimulate student interest and to help shulc:nts umlc:rs tand that the clisease process is :1 <lismption in hmnc:ostasis, a llreakdown o f nonnal in tegra tion of

La ng u.:Jgc of M ed ic ine iulmducn )'OU to Uf'W clinical terms in the chapter A hrid l ist o f clin ical terms is presented near the c:nd o f each chapte r. A<; i n the Language of Science: l ist at the lleginn ing of tl1c: chapter, each tc:nn h as:. phone tic pronu n cia ti o n g u ide and transbtions of \m rd JXII'fs. '11lc: l isted terms are <ld i nc:d in tl1 e text bod)'. where:

ti1C:}' appear in type.

A Ca se Study challenges you with "real-life" clinical or other practical situations so you can creatively apply what you have learne d Case s t ud ies p r ece d e th e cha p t e r s um ma r ies . T he case st u dy cons i sts of a desc r ip ti on o f a r ea l-life si t u a t io n an d a se r ies of ques ti ons t h a t r equ ire the st u d e n t t o u se c r i ti cal t hinking skill s t o de term in e the answe rs.

The Chapte r Summary outlines essential information in a way that helps you organize your study. D etailed en d -of-c h ap t er s umm ar ies p rovide excellent guides for st ud en ts as t h ey review t he t ext m aterials before exa m i n ati o n s Ma n y st ud ents also fi nd t h e summa r ies to be u se fu l as a cha p te r p review i n conj u nc t i o n wi t h t h e c h a p t er outl i ne .

BOXED SIDEBARS

As always, I ma d e eve r y effo rt t o u pdate factu al i nformation and i nco r po rate the m os t curren t a n at omy an d physio l ogy r esearch fin dings i n this ed ition. Alth ough t he r e con t i n ues t o be an incred ib le exp l osion o f know l e d ge i n t h e life sc i e n ces, n ot a ll new i n fo r ma ti o n is a p p r opr i ate for i n cl u sion i n a fun damen t al-l eve l t extbook. T h e r efore I was se l ective i n c h oosi n g n ew cli n i ca l , path ologica l , a n d specia l -i nte r est m a t e ri al to in clud e in t h i s e d it i o n . Thi s t ex t r e m a i ns foc u sed on n o rm al anato m y an d p h ys i o l ogy. T h e a d d i tio n o f n ew boxe d con t en t is i ntended to sti m ul ate st u de n t in t e r est a n d p rovide exam p les t ha t reinfo r ce the immed i a te p ersona l releva n ce o f a n atomy an d physio l ogy as imp o rt a n t d isci p lines fo r st u dy.

General Interest Boxes provide an expanded explanation of specific chapter content . Ma n y chapte rs con-

0tain b oxe d essays, occas i o n all y cl in i cal i n na t ur e, t h at expan d o n or r e l ate t o m aterial covered i n t he text. Exa mp les o f sub jec ts i n cl u d e t h e Bra i nbow vis u aliza ti o n of n e ural ne t wo rks and the e n te r ic ne rvo u s sys te m Health Matters presents current information on diseases, disorders, clinical applications, and other health issues related to normal structure and function . I n so m e in st ances, examp l es of struc t ura l a n oma li es or p ath op h ysio l ogy are p r esen t ed. I n fo rm atio n of t h is type i s o ft e n u se f u l in h e l ping stude n ts u n d ers t and t h e mec h anisms involved in mai n tain ing the " n ormal" in te raction of s tru c t ur e and f un cti o n

career choices Adult Nurse Practitioner

Whi le go ing through nursing school, I had the op portuni ty to shadow during an open-heart surgery The quad ruple-bypass proce dure took 11 hou rs, but I never moved from my spot bes ide th e anesthes iologist. I was in awe watc hing the patient's heart pumping blood through its cha mbers. My fasc ination wi th the ca rdiac syste m blossomed in that moment when the heart ca me back to life and sta rted function ing after a successfu l bypass.

More th an 20 years lat er, I still reca ll that amaz ing sight. I use A&P every day in my role as an adult nurse prac ti tione r in a ca rdiology pract ice I see patien ts with a variety of car diovascu lar diseases, and educating patients on th eir cond iti ons is key t o my prac ti ce. I str ive to exp lain comp lex card iac anatomy and physiology to my patients in simple terms so that they can understand their disease and treatm en t plans. I illustrate this co mplicate d system by divid ing cardiology into three categor ies: electrical, "plu mbing," and func tion. Electrica l pro blems

Audio Chapte r Summarie s allow you to listen and learn wherever you may be T hese summa r ies are ava ilable in MP3 fo rm a t for dow nl oad at t h e Evo l ve webs it e (ev olve.elsevier.com/Patton/API).

R e view Que stion s help you determine whether you have mastered the important concepts of each chapter. Review q u estio n s a t t he e n d of each chapte r give stude n ts practice in using a n a rr at ive for m a t to disc u ss the co n cepts p r ese n te d in t h e c h apte r.

Critical Thinking Que stion s actively engage and challenge you to evaluate and synthesize the chapter content. C ri t i cal t h inki n g questio n s re q uir e st ud en ts t o u se t h e i r h ig h e r l evel r easo n i ng skills a n d de m onstra t e their u n d erstan d i n g o f, n ot just t he ir repe t i tio n of, comp l ex co n cepts .

Diagnostic Study keeps you ab re ast of developments in diagnosing diseases and disorders T h ese b oxes dea l with speci fi c d iagnos t i c t ests u se d i n cl i nica l m ed i c ine o r resea r c h L umbar pun c t ur e, a n g iogra p h y, a nd a n t ena t a l d iag n osis and t rea t me nt are exa m ples.

FYI gives you more in-depth inform ation on interesting topics mentioned in the text. T opics of c u rre n t in t eres t, su c h as new adva n ces i n anat o m y a n d p h ysio l ogy researc h , are covered in th ese "for yo u r in forma ti o n " boxes.

Sports and Fitness highlights sports-related topics . Exe r cise p h ys i ology, sports i njur y, a nd p h ys i cal e du cation a p p l i ca t i o n s are h igh li gh t e d in these boxes

Career Choices highlights individuals in healthrelated care ers . A Caree r C h oices box appea rs at the end of eac h un it.

T h ese boxes fea t ure heal t h professio n als desc r ib i ng a few of the d ive rse opport u nit ies curren tl y avai l ab l e i n hea lt h- related occ u pa t io n s.

T h ey a l so de m ons t r at e t h e im porta n ce o f h ow a n un dersta n d in g of a n at omy and phys iology will b e u seful to st u de n ts in thei r fu tures.

Glossary

A comp r e h ensive glossa ry of t er m s is l ocated at the e n d of the t ext. An exp a n de d li st of acc u rate, concise de fi ni t i o n s a n d ph onet ic pron u n cia t i o n g ui des is provide d , alo n g wi t h wo r d parts a n d t h eir li t era l tra n sl atio n s. An a u d io g l ossary i s a l so ava il able on the expa n ded E volve we b si t e (evolve.elsevier.com/Patton/AP/) wi t h de fi n i tio n s a n d a u dio p ronu nciations fo r m os t o f t h e key terms i n t h e text.

invo lve the intr ins ic con duction system of the heart, includ ing dysrhyth mias. Plumb ing pro blems re late to th e coronary arteries th at supp ly the blood flow to th e heart musc le, including all the blockage problems of that syste m The entire func ti on of the hea rt is to pu mp blood through the pulmonary and systemic circu lation . Any disease affecting musc le func ti on can cause prob lems such as cardiomyopath ies , congestive heart fa ilure, and va lve disease

By educating my pati en ts on the anatomy an d physiology of a hea lth y heart, I can exp lain ca rdiovascu lar disease treatments aimed at improv ing their hea lth. •

Dena Kruse, APRN, MSN, ANP-BC

LEARNING SUPPLEMENTS FOR STUDENTS e volve

EVOLVE.ELSEVIER.COM/PATTON/AP/

This new edition of Anthony's Textbook of Anatomy 6 Ph ysio log y is s upported by an expanded multimedia E vo lve website, featur ing :

• Audio S umm a ri es for each chapter available for stream ing or download in convenient MP3 form.

• Answers to all of the Qui ck C h eck and Case Study que stions found in the textbook.

• Ouick acces s to all Co nn ect It! articles cited in thetextboo k.

• An interacti ve a udi o gl ossary with definitions and pro nunciations for more than 1000 ke y terms from the textbook.

• The B o d y S p ectrum E lec tr o ni c An at o m y Co l o r in g B ook, which offers dozens of anatomy illustrations that can be colored online or printed out and colored b y hand.

SURVIVAL GUIDE FOR ANATOMY & PHYSIOLOGY

ThE Survival G u i d e for Ana tomy 6 Physiology (2n d edi t ion), written by Ke vin Patton, is an ea sy-to -read and easy- to-unders tand brief handbook to hel p yo u achieve success in yo ur anatomy and p h ys iology course. Read with greater comprehension u sing the 12 survi va l skill s, stud y more effectively, prepare for te sts and quizzes , and tap into all of the information re so urce s at yo ur dis posal. The included Maps, Charts, 6 Shortcuts section is filled with illu stration s, table s, analogies, and d iag rams that convey all of the important facts and concepts s tudents need to know to succeed in an anatomy and ph ys iology course.

ANATOMY & PHYSIOLOGY LABORATORY MANUAL

ThE Ana t omy 6 Ph ysiology Labora t ory Manual, authored by Ke vin Patton with new contributions from Frank Bell, continues to be an inva luable re so urce for students . This extensively illus trated, fu ll-co lor manual fea ture s an extensively revise d illus tration pro gram that includes man y new dissection photographs. This popular lab manua l contains 55 we ll- i ntegrated exercises that pro vide hand s-o n learning experience to help s tudents acquire a thorough unders tanding of the human body.

Exercises in cat and pig anatomy, along with cow and s heep organs, are included to allow the flexi ble use of di sse ction spe cimens Other feature s are boxed h ints on handling spe cimens and managing laborato ry activities, sa fety tip s, coloring exercises, and summarie s of landmark features use d to di stin guish microsco p ic spe cimens Each exercise conclude s with a lab re po rt that may also serve as a homework assignment or se lf-te st.

• More than 500 Stud ent Pos t-Tes t questions that allow yo u to get in s tant feedback on what yo u 've learned in each chapter.

• State-of-the-art 3-D anim a ti o n s, wh ich show and de scribe physiological proces ses b y bo dy sys tem.

You can visit the E vo lve site by po inting yo ur browser to evolve. e!sev ier. com /PattonlAPI.

ANATOMY AND PHYSIOLOGY ONLINE

This 24-module online course brings anatomy and phys iology to l ife and he lp s yo u unders tand the most important concepts presented in the book. Available for purchase , this online course include s ins tructionall y so und learning modules with animations, interactive exercises, and assessments.

The la b manual in cl ude s eLabs for Anatomy 6 Ph ys iology, an online lab program des ig ned to complement traditional la b exerci ses . The lab exercises, ba se d on both anatomy and physiology, are sepa rated into module s The lab s are de sig ned so that s tudents can easily na viga te betwee n activities, allowing them the freedom to foc us on the areas i n which the y need the mo st he lp.

• TEACHING SUPPLEMENTS FOR INSTRUCTORS

INSTRUCTOR RESOURCES ON EVOLVE

ThE T EAC H Instructor' s Resource was written and de velo ped specifica lly for thi s new edition of Anthony's Textbook of Anatomy 6 Ph ys iology. Available on Evolve, it provides critical thinking que stions, learning objectives and activities, teaching tips for the text, synopse s of difficult concepts , and clinical applications exercises. To make le cture preparations a little easier, the TEAC H I nstructor's Resource also includes le sso n plans that allow yo u to hi t the ground runmng

The Evolve webs ite for in stru c tors also inclu des:

• Exa m View Tes t Ba nk with m o re than 7000 mu ltipl e ch oice, tru e/fal se, and cha ll e nge qu es tion s (whi c h you can also import into your C l ass r oo m P e rfo rm an ce Sys t em t o qu ickl y assess stu d en t co mp re h en sion an d monito r yo ur classroom's res pon se)

• A downloadable Im age Coll ec t ion featu ring hund reds of full-color ill ustrat ions and photographs, with label s and lead l in es that yo u can t urn off and on

• A d etail ed U pdat e G uid e , li st in g all sig n ificant re visions in th is edition

• Powe rPo int Audi en ce Respo n se Q &A a nd mu c h mo re!

INSTRUCTOR'S GUIDE FOR THE LABORATORY MANUAL

THE Instructor's Guide for th e A6P Lab oratory M a n ual on Evolve offe rs d et a il ed information to h elp th e instructor prepare for the labo ratory exercises. Alternate acti vi tie s, subs tit u tion s, stude nt h ando uts, and oth er resources help in structors t ailor th e u se of th e A6 P Lab oratory M anua l to their own cou rse Answers fo r all ques tion s on the lab reports in the A6P Lab oratory Manua l are also provided, eith er to check stude nt wor k or to provid e for stud e nts who u se lab re ports as se lf-tests.

ments

Over the yea rs , many people have contributed to the develo p ment and success of Anatomy 6 Physiology. I extend my thanks and dee p appreciation to all of the students and classroom instructors who have provided me with helpful suggestions. I also thank the many contributors and reviewers who have, over the last several editions, provided me with extraordinary insights and usefu l features that I have added to this textbook.

Thanks to Betsy Brantle y, who contributed man y of the case studies found in this edition. T hanks also to those who provided the i r ins ights in the Career Choices boxe s. Dan Matusiak and Linda Swisher have contr ibuted in many ways to the last few editions.

Fo r this edition, I am grateful for the contributions of Suzanne Hembrough and Rhonda Gamble, who helped me organize and update some chapter learning tools. Peggie Williamson's help in revising the stress chapter, as well as Bruce McEwan 's advice, are much appreciated. I' m thankful to Phil Tate for h is suggestions for improving the description and application of the concept of osmosis. I'm also grateful for Terry Thompson 's work in creating the new interactive unit openers, as well as for M ic hael Greer's wise counsel.

To those at E lsev ier who put the ir be st efforts into producing this edition , I am indebted. This new edition , and its comprehen s ive library of ancillary re so urce s, would not have been po ss ible without the efforts of Kell ie White, Executive Content Strategist; Melissa Rawe, Content Development Specialist; and Laura Goodrich, Senior Content Development Specialist. T heir expertise, support, and hard work have been vital to the s ucces s of thi s revis ion . Further, where the rubber meets the road, I am fortunate to have a wonderful team of professionals working together to keep i t all on track and moving along: Julie Eddy, Publishing Services Manager; and Clay Broeker, Pro ject Manager. I am also grateful to our friend s at Graphic World, who helped us improve and execute the integrated de s ign , la yo ut , and art program.

Finally, I want to recognize and thank m y longtime writing partner Gary A. Thibodeau. For the man y years we have worked together, Gary ha s been an insightfu l collaborator, a generous mentor, and a supportive friend. Although he has retired from coauthoring, I' m grateful for h is continuing role as advisor for successive editions of this book.

Kevi n T. Pa tton

Contents

UN IT 1 The Body as a Whole , 1

CHAPTER 1 Organization of the Bod y, 2

Science and Societv, 3

Scientific Meti1od, 3

Cultural Context , 3

Ana to my an d 4

Arwtomy, 4

Physiology, 4

La nguage of Science and Medi cine, 4

C ha rac teristics of Life, 5

Levels of Orga ni za tion, 6

Chemic<JI Level, 6

Organelle Le>•el, 7

Cellular Le>•el, 7

Tissue Lew/, 7

Organ Lew?/, 7

SJ•tem Lewd, 7

Organism um/, 8

Ana to m ical Pos it io n, 8

Ana to m ical Di rectio ns, 9

Directional Tenus, 9

Tenn <Related to Organs, 9

Alwtomical Com(xlSs Rosette, 10

Bod y Pla n es a nd Secti o ns, 10

Sagittal Planes, 10

Coronal Plane,<, 10

Transverse Planes, I I

Other and $el:tion.s, 1 1

Bod y Cavities, 12

Dorsal Cavities, 12

Ventral Cavitie.s, 12

Body Regions, 15

In terac ti o n of Structu re and Fu nction, 16

Cycle of Li fe: Life Span Conside rations, 17

11>e Big Pictu re : Organizatio n o f t h e Body, 17

Case Study, 19

CHAPTER 2 Homeostasis, 23

Homeostasis, 24

-n,e lntl!mal Environment, 2'1

Relatiw Stal>ility, 24

Set Point, 24

J\lfodel.s of 25

Homeostatic Con tro l Mechanisms, 26

Feedback Loop,<, 26

Basic Components of Control Systems, 26

Negative Feedback in Control S)wtems, 28

Pos;ti)'e Feedl>atk in Control $)'stems, 28

Changing the Set Point, 29

Feed-FoMard in Control System,<, 30

Levels o f Homeosta ti c Co ntrol, 31

Su mmary of Ho meostas is, 3 I

Cycle of Li fe: Life Span Considerations, 31

The Big Picture : Homeostasis, 32

Mec h a nisms of D isease, 32

Case Studv, 36 '

CHAPTER 3

Chemistry of Ufe, 38

U ni ts o f Matter, 39

Elements and Compounds, 39

Atoms, 40

Atomic Stru cture, 40

Cloud Model, 40

Atomic Number and Number, .J I

Energy Le>'els, 4 1

Isotopes, 42

Attrac ti o ns Between Atoms, 4 3

Chemical Bonds, 43

Attrac ti ons Between Molecules, 44

H)'drogen Bonds, H

C h emica l Reactions, 45

Me ta bol ism, 46

Body Chemistry, 46

Catal"'lism, 46

Arwi><Jiism, .f6

Organic and In organic Compounds, 47

Inorga ni c Molecul es, 47

\Vater, 47

Oxygen and Carbon Dioxide, 47

Electrol)'tes, 48

The Big Picture : C h emistry of Life, 50

Mec h a nisms of Disease, 5 I

Case Studv, SZ '

CHAPTER 4 Bi omole cules, 55

Organic Mo lecu les , 56

Carbohydrates, 56

Monosaccharides, 56

Disaccharides and Polysaccharides , 57

Lipids, 58

Triglycerides or Fats, 58

Phospholipids , 59

Steroids, 60

Prostaglandins, 60

P roteins, 61

Amino Acids, 63

Levels of Protein Structure, 64

Importance of Protein Shape, 65

Nucle

ic Acids and Related Molecules, 66

DNA and RNA, 66

Nucleotides and Related i\!Iolecules, 67

Combined Fo rm s, 69

T he Big Picture : Biomo lecu le s, 69

Mechanisms of D isease, 71

Case Study, 72

CHAPTER 5 Cell Structure, 75

Functional Anatomy of Cells, 76

The Typical Cell, 76

Cell Structures, 77

Cell Membranes, 79

Membrane Structure, 79

Membrane Function, 81

Cytoplasm and Organelles, 82

Endoplasmic Reticulum , 82

Ribosomes, 83

Golgi Apparatus, 83

Lysosomes, 85

Proteasomes, 85

Peroxisomes, 86

Mitochondria, 86

Nucleus, 87

Cytoskeleton, 88

Cell Fibers, 88

Centrosome, 88

Molecular Motors, 89

Cell Exten sions, 90

Cell Connections, 92

Desmosomes, 92

Gap Junctions, 92

Tight Junctions, 92

T he Big Picture : Cell Anatomy and the Whole Bo d y, 93

Mechanisms of D isease, 93

Case Study, 94

CHAPTER 6 Cell Fun ction , 98

Membrane Transport, 99

Overview of Membrane Transport, 99

Passive Transport Processes, 99

Active Transport Processes, 105

Cell Metabolism, 108

Metabolism, 108

Role of Enzymes, 109

Catabolism, 112

Anabolism, 115

T he Big Picture: Cell Ph ys iology and the \Vhole Body, 115

Mechanisms of D isease, 116

Case Study, 117

CHAPTER 7 Cell Growth and Develop men t, 120

Protein Synthesis, 121

Deoxyribonucleic Acid (DNA), 121

Ribonucleic Acid (RNA), 122

Transcription, 122

Editing the Transcript, 123

Translation, 124

Post-Translation Processing , 125

Cell Growth, 126

Production of Cytoplasm, 127

DNA Replication, 127

Cell Reproduction, 128

Mitosis, 128

Meiosis, 130

Regulating the Cell Life Cycle, 131

Cycle of Life: Cells, 13 1

T he Big Picture : Cell Growth, Repro ductio n , and the Whole Bo d y, 13 3

Mechanisms of D isease, 13 3

Case Study, 134

CHAPTER 8 In trodu ction to Tiss ue s, 137

Introduction to Ti ssues, 13 8

Principal Types ofTissue, 138

Development ofTissues, 138

Extracellular Matrix, 139

Fluid Environment of the Body , 140

Components of the Extracellular Matrix, 140

Holding Tissues Together, 143

T issue Repa ir , 144

Body Mem branes , 144

Epithelial Membranes, 145

Connective Tissue i\!Iembranes, 147

T he Big Picture : T issues, Memb ranes , and the Whole Body, 148

Mechanisms of D isease, 148

Case Study, 151

CHAPTER9 Tissue Types, 154

Epithel ia l Tissue , 15)

TyJ>e,<and Locntion< of Epithelial Ti$$ue, 155

Function< of Epithelial Tis,<ue, 155

Ceneralizaaons About Epithelial Tissue, 155

Classification of Epithelial Tissue, IS>

Connective Tissu e, 16 1

Functiow; o(Cormective 'lissue, 161

Characteristics of Connective 161

Classification ofCormecti'!>-e 163

Fibrous Conneclil'e 163

Bone 167

Cartilage Tissue, 168

Blood Ti$$ue, 169

Muscle Tissu e, 169

Nervous Tissue, 17 1

11>e Big Picture: Tissue Types and t h e Whole Body, 171

Case Study, 173

Career Choices, 173

UNIT 2 Support and Movement, 178

CHAPTER 10 Skin, 180

Stnocture of the Skin, lSI

O>'el'lliew of Skin Structure, 18 1

Tl1in andTilick Skin, 181

Epidermi,<, 183

Dermoepidermal }unction, 185

Dermi,<, 186

Hypodennis, ISS

Skin Color, 189

Melanin, 189

Other 190

Functions of the Skin, 191

Funcaons, 19 1

Protection, 19 2

Sensation, 192

Flexibility, 192

Excretion, 192

Hormone (VUamin D) Production, 193

Immunity, 193 of Body Temperature, 193

Appendages of t h e Skin, 195

Hai r, 195

Nails, 197

Skin Clands, 198

Cycle of Life: Skin, 198

11>e Big Picture: Skin and the Whole Body, 199

Mechanisms of Disease, 200

c s·· d 70 - ase . tu y, _ >

CHAPTER 11 Skeletal Tissu es, 209

Functions of Bon e, 21 0

C ross Structure of Bo nes, 210

T)'pes of Bones, 21 0

Structure of Long Bone,<, 211

Structure of Flat Bones, 212

Microscopic $b'tJcture of Bones, 213

Bone Tissue, 213

ComJ>act Bone, 215

Cancellou,<Bone, 21)

T)'pes of Bone Cells, 21 6

Bone J\1arrow, 2 I 7

Cartilage, 217

Regu latio n of Blood Calcium Le,•els, 219

Bone as a Calcium Depot, 219

tvfedwni,mu; of Calcium Homeostasis, 21 8

Development of Bone, 220

Osteogenesis, 220

Intramemb ranous Ossification, 220

Endochondral Ossification, 221

Bo n e Remode li ng, 224

Repair of Bo ne Frac tures, 225

C)de of Life : Skeletal Tissu e<, 226

The Big Pi cture: Skel etal Tissues, 227

Mechanisms of Disease, 22 7

Case Stud)', 229

CHAPTER 12 Ax ial Skeleton, 233

Di vis ions of the Ske leto n, 234 Skul1,236

Cranial Bones, 248

Facial Bones. 250

Eye Orl>iu, 250

Fetal Skull, 250

Hvoid Bone, 252

v;rtebral Column, 2)2 of the Spine , 252

Vertebrae, 252

Sacrum and Coccyx, 2 55

Spirwl 2 55

Thorax, 2>8

$temum, 258

Rib.<, 2>8

Mechanisms of Disease, 259

Case Study, 261

CHAPTER 13 Appendicular Skeleton, 263

Uppe r Extremity, 264

Shoulder Girdle, 264

Arm, 2M

Foreann, 264

Hand , 267

Lower Extremitv, 268

Pelvic Cirdle, 268

Thigh, 272

Leg, 273

Foot, 273

Skeletal Va ri ati o ns, 27)

Male-Female Skeletal 275

Age Differences, 276

Environmental Factors. 276

Cycle of Li fe: Skel etal System, 277

111< Big Picture : Skeletal System, 277

Mec hanisms of Disease, 277

Case Stud y, 278

CHAPTER 14 Articulati ons, 281

C lass i fica ti o n of jo ints, 282

Fibrous Joint.< (Synarthroses), 282

Cartilaginous Joints (Amphiarthroses), 282

SrnoviaiJoints (Diarthroses), 284

Represen tative Synovial Joi nts, 286

Humero..«:apular Joint, 286

EIIJOw 287

Forearm, \Vrist, Hand. and Finger Joints. 288

Hip Joint, 290

Knee 290

Ankle Joint, 293

Vertebra/Joints, 295

Movemen t at Synovial Join ts, 295

Range of Motion, 296

Angular J \.fm•ements. 296

Circular 296

Cliding lvl twements, 297

Special Mm.,ments, 297

Examples ofJoint Mm•ements, 297

Cvc1e of Life: Artic ulations. 302

1i1e Big Picture : Art icula tions, 302

Mec hanisms of Disease, 303

Case Study, 306

CHAPTER 15 Axial Musc les, 310

Skeletal Muscle StmchJre, 31 I

Connecth•e Tissue Components. 311

Size. Slwpe, and Fiber Arrangement. 311

Attaclnnent of M usc/e<, 313

Mu.«:le 314

Lew!r Systems, 31 5

How Muscl es Are Named , 3 I6

Hin ts on How to Deduce Nfusde Actions, 319

A'ial Muscles, 32 I

Muscl es of the Head and Neck, 32 I

Muscles of Facial Expres,<ion, 321

Muscles ofMastication, 322

Mu.<eles Tlwt Move the Head, 323

Tmn k Musc les, 323

Muscles of the Tlmax, 323

Muscles of the Abdomina/Wall, 324

Muscles of the Back, 326

Muscles of the Pel>oic Floor, 327

The Big Pic ture : A'ial Muscles and the W hol e Body, 329

Case Study, BO

CHAPTER 16 Appendicular Muscl es , 333

Appendicular Muscles, 334

Upper Extrem ity Muscles, 334

Mu ,<eles Acting on the Shoulder Cirdle, 3H

Mu ,<eles Tlwt Mmoe tl>e Ann, 3H

J \.fu,«:les Tlwt lvl (n>e tl1e Forearm. 337

Mu.<eles Tlwt Mmoe tl>e Wrist, Hand , and Fingers, l3 7

Lower Extremity Muscles. 341

Mu ,<eles Tlwt Mm•e tl>e 'n•igl• and Leg, 341

Mu ,<eles Tlwt Mm•e tl>e Ankle and Foot, 341

Posture. 3S I

How Is lvl aintained. 352

Cycle of Li fe: Muscular System, 353

The Big Pich 1re : Appendicular Muscles and t he Body, 3)3

Case Study, 3>4

CHAPTER 17 Muscle Contraction, 356

General Fu nctions, 3S7

Fu nction of Skeleta l Muscle Tissue. 3S7

Funt:tiorwl Characteristics of Nfusde, 357

O>•erview of the Muscle Cell, 3 57

M)'o/ilaments, 359

J \.fechanism o{Contra<:tion, 361

Energy Source,<for Muscle Contraction, 365

Fu nction of Skeletal Muscle O rga ns, 368

Motor 368

M)•ogral>hy, 369

Tl1e Tulitd1 Contraction, 369

Treppe: -n,e StaircCJSe Phenomenon, 370

Tetarw ,<, 371

J \.fu,«:le Tone, 372

Craded Strength Princ iple, 373

Crades of Muscle Strengt/1, 373

Mobilizing and Stabilizing Contractions, 374

Fu nction of Ca rdiac and Smooth Muscl e Tissu e, 375

Cardiac Muscle, 375

Smooth Muscle, 377

The Big Muscle Ti ssue and the Whol e Body, 378

Mecha nisms of Disease: Major Muscula r D iso rders. 379

Caree r Choices, 38 1

Case Study, 38 I

UNIT 3 Communication , Control , and Integration, 386

CHAPTER 18 Nervous System Cell s, 388

Organi>.alton of the Nenou; S)>lcm, 3&9

Ce11tral a11d Penpheral 1\'mous S1Tte11u, 3b9

Affcront and Efferent DnntOIIS. 390

Somaltc and Aulouomtc Sn,lems, 390 Clia, 391

O.'n> i<>o·ofCita. 39 I

Cnttral Cl.,, 39 I

Pnipheral Clta, 393 N'euron1, 39;

Structurr and FurtcltOtl o(i\'tutOII1. 39)

Clmst{J<allon of •'<turom. 397

Refle.\ .\re, 3%

Nen. es rand Trac:h, 400

Nen-n. -100

Tracts. 400

White a11d Gra1 Jllall<r. 4!10

Repair of Nene Ftben. 40 I

Cycle of Ltfe : Ncnou< S)'lcm Ce ll;, 402

The Big Picture: Nenous S)'lcm Cell, and th e \\'h ol e BO<I). 402

Mech:lni... ros of Disensc. 403

Case Sh1dy. 404

CHAPTER 19 Nerve Signaling , 408

E leclr ical Natu re of Nemon .... 409

tvfcmf)rant l'otcutials. 409

Rc<ti11g ll lembrmre Potentials, 409

I.Jxnl 4 /()

Actio t'l Potel'l ti als, 4 11

,\ l eclw11ism of tire Actro11 Potential. 4 I I

Re{ract(ll'\• Period. 41l

Co11duction of the Actro11 PotentiaL 4 I 4

Splaplic Trammts.sion. 41 S

Structure of the S111apst. 4 I 5

T1pe.ofSmapses. 415

\ltdtanums o(S•mapllc ·lran.smw•m•. i 16

Summa/ton. -fib

Smap a11d ,\lemon·. of 19

-119

Fun<ltOti<JI ClaMJ{icatron of 1\:rorolratwmtten, ilO

Structural Cla$St{icatron oft>.' rorolrarwrutten, il I

:\'etuorb... 2-1

Titt Nen.wl \lode/. 42i

Dn-elopment of Neural :>;en.mh. i15

CompltXlh: m Neutol i"\'ttl.'Oth. -12;

The Btg Pt<lurc: Nen c S.gnal111g and the Whole Bod). 426

Mechanisms of Disease, 426 Case Srudv, 428 '

CHAPTER 20 Central Nervous System, 432

Co\'erings of the Brain and Spinal Cord, H 3

Cerebrospinal fluid, H>

Fluid Spacts, 4 3>

Fonnation arid Cirrulotion ofCerebmspmal Fluid, 43)

Spinal Cord, 4 38

Structurrof tlte Spinal Con/, 4l8

Fundionrof tltt Spinal Con/, 4l9

Brain, ++I

Rtgiom of tlte Brain, 44 I

Brain Dn-elopmenl, ++I

Structurr of the Brainstnn, 442

Functions of tlte Brainstem, ++-1

Structure of tltt Cer.b.llum, 4-14

Functions of tlte 4-15

Dimctplralotl, 447

Structure of tlte Cerebrum, ++9

FunclioiiS of tlte Cerebral Cortex, 4)2

Somatic Sensory Path wal'· 4 59

Somatic Motor Path ways, 460

Final Common Path, 460

Pyramidal Tracts. 461

Extrapyramidal Tracts, 462

Fac:ilitatory and l niJil>ilory Tmtt.s, '162

Cycle of Li fe: Central Nen•o us Sys tem. 463

11>e Big Picture : 11>< Cenlrnl Nel\ous S)•tcm nnd the Whole Body, 463

Mechanisms of Disease, 464

Case Srudy, 467

CHAPTER 21 Peripheral Nervous System, 473 Spinal 47)

Struclureo{Spinol 1\'m·-., 476

Nen·e Pl.ruse<, 477

Dennatomes and A1mtome&, -f 81

Craniall\en es, 483

Ol{actorv Nm·e (CN 1), 4&>

Op!ic (CN 11) , 4&6

Oculomotor (CN Ill }, 4&6

Trocltlear XenY (C.\' 1\ '), 4&6

Trigeminal (CN \ '), 486

Abducens l':m.. (CX \1 },

Faci<1l (Ct-.' \11 )

\ 'nlibulorochkar Nen-. (CN \'Ill },

Clossophanng&JI Nen e (Ct\' IXl, iS!>

\'agus ( CN XI, 48!>

Accesson• NtnY (Ct\' Xl) , 489

Hypoglossal ( CN XII), i90

Somatic Motor Nervous Sys tem , 490

Di visions of the Peripheral Nervo u s Systems, 490

Th e Bi g Pi c ture: Peripheral Ne rvo u s Sys t em and the Wh o l e Bod y, 492

Case Study, 494

CHAPTER 22

Autonomic Nervous System , 47 4

Ov e rview of the Autonomic Nervous Syst e m, 499

R ole of the Autonomic Nervous System , 499

Divi sions of the Autonomic Nervous Sy stem, 499

Stru c tur e of the Autonom i c Nervous S ys t e m, 500

Ba sic Plan of Autonomic Path ways, 500

Stru ctu re of the Sympathetic Pathwa ys, 500

Structure of the Parasympathetic Pathwa ys, 503

Autonom ic e urotran s mitters and R ece ptor s, 504

Norepinep hrine and I ts R eceptors, 505

Acetylcholine and Its R eceptors, 505

Nona drenergic-Noncholinergic Tran smission, 506

S yna pti c Complexity, 506

Pharmacolog y, 506

Fun c tion s of the Autonom i c N e rvou s Syst e m , 507

Overview of Autonomic Function , 507

Functions of the Sympathetic Di vision, 509

Functions of the Para sympathetic Divi sion, 5 10

Th e Big P i cture: Au t onomic Nervous System and th e

Whol e Bod y, 510

Case Study, 511

CHAPTER 23 General Senses , 498

Sensory R ecep tors, 5 1 5

R ece ptor R es ponse , 5 15

Di stribution of R eceptors, 515

C l assification of Receptor s, 516

Classification by Sensory Pathway, 516

Classification by Location , 516

Classification by Stimulus D etected, 516

Classification by Structure, 5 17

S e n se of Pa i n , 517

Sense of T e mperature , 519

Sense of Touch, 5 19

Skin Movement, 5 19

It ch, 520

Tickle, 520

Light Touch, 52 1

D eep Touch, 52 1

S ense of Proprioception , 52 1

Th e Big Pi c tu r e: General Sense s, 522

Case Study, 52 3

CHAPTER 24 Special Senses , 514

Sen se of Smell, 527

Olfacto ry R eceptors, 527

Olfacto ry Pathway, 528

Sens e of Ta ste, 5 28

Ta ste Buds, 528

Neural Pathwa y for Ta ste, 530

Senses of H e aring and Balance, 5 30

Structure of the Ear, 530

The Proce ss of Hearing , 532

Bala nce, 534

S e ns e ofVi s io n , 536

Structure of the Eye, 536

Th e Pro cess of S eei ng , 542

C ycle of Life: Spec ia l Senses, 547

Th e Big Pictur e: Spec ia l S e n ses, 547

M ec hani s m s of Di sease, 548

Case S tud y, 5 50

CHAPTER 25

Endocrine Regulation , 526

Organ ization of th e Endoc r i ne S ys tem, 5 57

C l assification of Hormones, 5 58

Steroid Hormon es, 558

Nonsteroid Hormon es, 558

H ow H ormones Work , 561

General Prin cip les of H ormone Action , 561

Mechani sms of Steroid H ormone Action , 561

Mechan isms of Nonste roi d H ormone Action , 562

R egulation of Horm one Secretion , 564

R egu la tion of Target Cell S ens iti vity, 566

Eico sanoid s, 566

Ti ssue H ormones, 566

Pro stag landins, 567

Thromboxan es and Leukotrienes, 568

The B ig Pi ctu re: Endocrine R egu lation an d th e Whol e Bod y, 568

Mechani s m s of Di sease, 569

CHAPTER 26

Endocrine Glands , 556

Pituitary Gland , 574

Structure of the Pituita ry Gland, 574

Adenohypophysis (Anterior Lobe of Pituitary), 574

Neurohypophysis (Po sterio r Lobe of Pituita ry ), 580

Pin e al Gland , 58 1

Th yroid Gland, 582

Structure of the Thyroid Gland, 582

Thyroid Hormone , 583

Calcitonin, 583

Pa rathyro id G lands 7 584

Structure of the Parathyroid Glands7 584

Parathyroid Hormone 7 585

Ad rena l Glands 7 586

Structure of the Adrenal Glands 7 586

Adrenal Cortex7 587

Adrenal Medulla 7 590

Panc rea ti c Is l ets 7 590

Structure of the Pancreatic Islets 7 590

Pancreatic Hormones 7 591

Gonads 7 59 1

Testes 7 592

Ovaries7 592

Pl acenta 7 594

Thym us7 594

Gast ric a nd Intes ti na l M u cosa 7 594

H ear t7 594

Ad ipose T issue 7 594

Othe r Endocrine Gla nd s and Hormo n es 7 59 5

Cycle of Life: Endoc rin e System 7 595

The Big Pic tu re: T h e Endoc rine Sys t em an d th e Who l e

Body7 595

Mecha n isms of D isease 7 596

Case St u dy7 599

Career Cho ices 7 599

UN IT 4 Transportation and Defense, 604

CHAPTER 27 Blood , 606

Blood Composition 7 607

Blood Tissue 7 607

Blood Plasma 7 608

Formed Elements7 608

Hematopoiesis 7 608

Blood Volume 7 609

Hematocrit7 6 10

Red Blood Cells 7 6 10

Structure of Red Blood Cells 7 610

Function of Red Blood Cells7 611

Hemoglobin 7 611

Formation of Red B food Cells 7 613

Life Cycle of Red Blood Cells7 613

Blood Types 7 614

White Blood Cells 7 618

Granulocytes 7 618

Agranulocytes7 619

White Blood Cell Numbers 7 619

Formation of White Blood Cells 7 620

Pla telets 7 620

Structure and Function of Platelets 7 620

Formation and Life Span of Platelets7 620

Hemos ta sis 7 621

Vasoconstriction 7 621

Platelet Plug Formation 7 621

Blood Clotting (Coagulation) 7 622

Conditions That Oppose Clotting 7 624

Conditions That Hasten Clotting 7 625

Clot Dissolution 7 625

T h e Big P ict u re: Blood and the Who l e Body7 626

Mechan isms of D isease 7 626

Case Stu dy7 630

CHAPTER 28 Heart , 634

Hea rt Structure 7 635

Location of the Heart 7 63 5

Size and Shape of the Heart7 635

Coverings of the Heart7 639

Structure of the Heart7 640

T h e H eart as a Pump 7 64 7

Conduction System of the Heart 7 647

Electrocardiogram 7 648

Cardiac Cycle 7 650

Heart Sounds 7 653

Cycle of Life: H eart 7 6 53

T h e Big P ict u re: Hea rt 7 65 3

Mechan isms of D isease 7 6 53

Case Stu dy7 659

CHAPTER 29 Blood Vessels , 663

Bl ood Vessel Types 7 664

Arteries7 664

Capillaries 7 664

Veins 7 667

Structure of Blood Vessels 7 667

C ircu latory Routes 7 668

Systemic Circulation 7 668

Pulmonary Circulation 7 669

Circulatory Bypasses 7 669

Systemic C ircu lati o n 7 670

Systemic Arteries7 670

Systemic Veins 7 679

Fetal C ircu lation 7 686

Organization of Fetal Circulation 7 686

Changes in Circulation at Birth 7 689

Cycle of Life: Bloo d Vesse ls7 689

T h e Big P ict u re: Blood Vesse ls an d th e Who l e

Body7 690

Mechan isms of D isease 7 690

Case Stu dy7 694

CHAPTER 30 Circulation of Blood, 697

Hemodynamics, 698

Primary Prin cip l e of C irc ul ati o n, 698

Arterial Bl oo d Pr ess u re, 699

Cardiac Output, 700

Peripheral Resistance, 704

Ve n o us Return to th e Heart, 709

Venous Pumps, 709

Total Blood Volume, 711

Meas ur in g Blo od Pressure, 7 13

Arterial Blood Pressure, 713

Blood Pressure and Bleeding, 715

M in u te Vol u me of Blood, 715

Ve loc ity of Bl oo d F low, 7 16

Pulse, 7 16

Mechanism, 716

Pulse Wave, 717

Where the Pulse Can Be Felt, 718

Venous Pulse, 718

Cycle of Life: Ca rd iov asc ul ar Ph ys iology, 719

T h e Big Picture: Bl oo d F low and the Whole Body, 719

Mec hani sms of Disease, 7 19

Case Study, 721

CHAPTER 31 Lymphatic System, 725

Overv iew of th e Lymphatic System, 726

Lymph and I nters titi al Fl uid , 727

Lymphatic Vessels, 728

Distribution of Lymphatic Vessels, 728

Structure of Lymphatic Vessels, 728

Functions of Lymphatic Vessels, 729

C ir c ul ation of Lym ph , 729

Origin of Lymph, 729

The Lymphatic Pump, 730

Lymph Nodes, 731

Structure of Lymph Nodes, 731

Locations of Lymph Nodes, 732

Functions of Lymph Nodes, 734

Lymphatic Drainage of th e Breast, 734

Distribution of Lymphatics in the Breast, 73 5

Lymph Nodes Associated With the Breast, 735

Tonsils, 736

T h ym us, 736

Location and Appearance of the Thymus, 736

Structure of the Thymus, 737

Function of the Thymus, 737

Sp l ee n, 737

Location of the Spleen, 737

Structure of the Spleen, 737

Functions of the Spleen, 739

Cycle of Life: Lymphatic System, 740

T h e Big Picture: Lymp hati c Sys t em and the Who l e

Mec hani sms of D ise ase, 740

Case Study, 74 2

CHAPTER 32 Innate Immun ity, 746

Organization of th e Immune System, 74 7

Defense of the Body, 747

Innate Immunity, 749

Sp ec ies Resistance, 74 9

Mec hani ca l and Chemical Barri e rs, 749

Infl ammat ion and Fever, 750

The Inflammatory Response, 750 Fever, 750

Ph agocyt osis, 7 52

N at ur al Ki ll er Cells, 7 53

In te rferon, 75 5

Comp leme nt , 7 55

Toll-Like Receptors, 756

The Big Pi c tu re: Innate Immuni ty an d the Whole Body, 756

CHAPTER 33 Adaptive Immunity, 759

Overview of Adaptive Immunity, 760

B Ce ll s and Antibody-Mediated Immun ity, 762

Development and Activation of B Cells, 762 Antibodies (Immunoglobulins), 763

Clonal Selection Theory, 766

T Cells an d Ce ll -Me diate d Im m u n ity, 768

Development ofT Cells, 768

Activation and Functions ofT Cells, 768

Types of Adaptive Immun ity, 771

Summ a ry of Adaptive Immunity, 772

The Big Pi c tu re: Immune Sys t em an d th e Who l e Body, 775

Mec hani sms of D ise ase, 775 Case Study, 779

CHAPTER 34 Stress, 782

Selye's Co n cep t of Str ess, 783

Development of Selye's Stress Concept, 783

Definitions, 783

Stressors, 783

General Adaptation Syndrome, 785

Mechanism of Stress, 787

Some Current Co n cep ts About Stress, 787

Allostatic Load Model, 787

Stress Syndrome, 788

Role of the Brain in Stress, 789

Stress and Disease, 791

Indicators of Stress, 791

Effects of Intrauterine Stress, 792

Summary of the Allostatic Model, 793

The Big Pi c tu re: Stress a nd th e Whole Body, 794

Body, 74 0

Case Stud y, 79 5

Career Cho ices, 795

UN IT 5 Respiration, Nutrition, and Excretion, 798

CHAPTER 35 Respiratory Tract, 800

Stru ctur al Organization, 80 1

Uppe r Res p irato ry Tr act, 802

Nose, 802

Pha rynx, 804

Laryn x, 805

Lowe r Res pi rato ry Trac t, 807

Trachea, 807

Bronchi and Alveoli, 809

Lungs, 8 13

Thorax, 8 15

Cycle of Life: Res pi rato ry T rac t, 8 15

The Big Pict ur e: Res p ira to ry Tract, 8 16

Mec h an isms of D ise ase, 8 16

Case Stud y, 820

CHAPTER 36 Ventilat ion, 823

Resp iratory Phys iology, 824

Mec h an ism of Ve ntil ation, 82 4

Primary Pri nc i ple ofVentilation, 824

In spiration, 825

Expiration, 828

Pu l mo n a ry Vo lu m es and C apac iti es, 832

Pulmo nary Volumes, 832

Pulmo nary Capacities, 83 3

Pu l mo n a ry Airfl ow, 8 34

Ve ntil ati on and Perfusio n, 8 36

Reg u l ati on of Ve ntilati on, 836

Homeo stasis of Blood Gases and pH, 836

Respiratory Control Centers, 836

Feedback and Re sponses, 838

Other Infiue nces on Vent ilation, 840

The Big Pict ur e: Vent ilat ion an d the Whole Bod y, 841

Mec h an isms of D ise ase, 84 1

Case Stud y, 844

CHAPTER 37 Gas Exchange and Transport, 84 7

Pu l mo n a ry Gas Excha n ge, 848

Partial Pressure, 848

Exchange of Gases in the Lungs, 849

How Bl oo d Tr an sports Gases, 85 1

Hemoglobi n, 85 1

Transport of Oxygen, 85 1

Transport of Carbon Dioxi de , 852

Sys t em ic Gas E xc h ange, 855

T h e Big Picture: Gas Exchange and Transpor t an d th e

Whole Bod y, 857

Case Study, 857

CHAPTER 38

Upper Digestive Tract, 860

Organization of the Di gestive Sys tem, 86 1

The Digestive Tract, 86 1

Wall of the Gastrointestinal Tract, 862

Mo u th, 863

Structure of the Oral Cav ity, 863

Salivary Glands, 866

Teeth, 867

P h aryn x, 869

Esop h agus, 869

Overview of Esophagus, 869

Esophageal Sphincters, 870

Gastroesophageal Refiu x, 870

Stomac h , 871

Size and Po sition of the Stomach, 87 1

Divi sions of the Stomach, 872

Curves of the Stomach, 872

Sphincter Muscles, 872

Stomach Wall, 872

Functions of the Stomach, 873

Cycle of Life: Uppe r Dig es ti ve Tract, 873

Mecha n isms of D isease, 874

Case St ud y, 878

CHAPTER 39 Lower Digest ive Tract, 88 1

Sm all Int es tin e, 882

Size and Po sition of the Small Inte stine, 882

Divi sions of the Small I ntestine, 882

Wall of the Small Inte stine, 882

Larg e I nt es tin e, 884

Size of the Large I ntestine, 884

Divi sions of the Large Inte stine, 884

Wall of the Large In testine, 886

Ve rm iform Append ix, 886

Per ito n e um , 887

Live r, 887

Locatio n and Size of the Liver, 887

Liver Lobe s and Lobules, 888

Bile Ducts, 890

Functions of the Liver, 890

Gallb lad d er, 891

Size and Locatio n of the Gallbladder, 89 1

Structure of the Gallbladder, 89 1

Functions of the Gallbladder, 89 1

Panc reas, 892

Size and Locatio n of the Pancreas, 892

Structure of the Pancreas, 892

Functions of the Pancreas, 892

Cycle of Li fe: Lower Di ges ti ve T ract, 893

T h e Big P ict u re: T h e D iges ti ve Trac t7 893

Mec hani sms of Disease 7 894

Case Stu dy7 897

CHAPTER 40 Digestion and Absorption , 900

Ove rview of D iges ti ve F u nct ion 7 90 1

D iges ti on 7 902

Mechanical D igestion 7 902

Chemical D igestion 7 906

Sec reti on 7 9 12

Saliva 7 9 12

Gastric Juice 7 9 12

Pancreatic Juice7 9 14

Bile7 9 14

Intestinal Juice 7 9 15

Co nt ro l of D iges ti ve G la n d Sec reti o n 7 9 16

Control of Salivary Secretion 7 9 16

Control of Gastric Secretion 7 9 16

Control of Pancreatic Secretion 7 9 18

Control of Bile Secretion 7 9 18

Control of Intestinal Secretion 7 9 18

Abso rp ti o n 7 9 19

Process of Absorption 7 9 19

Mechanisms of Absorption7 9 19

E l iminati o n 7 92 1

T h e Big Pi ct u re: D iges ti on an d th e W h ol e Body7 923

Case Stu dy7 924

CHAPTER 41 Nutrition and Metabolism, 928

N utr iti o n a nd Me t a b ol ism 7 929

Overview7 929

Nutrients 7 929

A B alance d D iet7 930

Metabolic Pathways 7 93 1

Ca rbo h yd rat es 7 932

D ietary Sou rces of Carbohydrates 7 932

Carbohyd rate Metabolism 7 932

Lip ids7 94 2

D ietary Sou rces of L ipids7 942

Transpo rt of L ipids 7 94 2

L ipid Metabolism 7 942

P ro te ins 7 944

Sources of Proteins 7 944

Protein Metabolism 7 945

Vita min s an d M ine ra ls7 94 6

Vitamins 7 946

Minerals 7 949

Me t abo li c Rat es 7 950

B asal Metabolic R ate 7 950

Total Metabolic R ate 7 952

Energy B alance and B ody Weight7 953

Mec hani sms fo r Reg ul a ti ng Food l n t ake 7 953

Cycle of Life: N ut ri ti on and Me ta bo lis m 7 95 5

T h e Big Pict u re: N ut ri tion 7 Me tab olis m 7 and t h e W h ol e

Bo d y7 955

Mec hani sms of D ise ase 7 95 5

Case St u dy7 959

CHAPTER 42 Urinary System , 963

Ana tomy of t h e U rin a ry Sys t em 7 964

Gross Structure 7 964

Microscopic Structure 7 969

Ph ysio logy of t h e U rin a ry Sys t e m 7 974

Overview of Kidney Function 7 974

Filtration 7 975

Reabsorption 7 977

Tubula r Sec retion 7 982

Regulation of Urine Volume 7 983

Urine Composition 7 985

Cycle of Life: U rin ary System 7 986

T h e Big Pic tu re: U rin a ry Sys t em an d th e W h ol e

Bo d y7 986

Mec hani sms of D ise ase 7 987

Case St u dy7 992

CHAPTER 43 Fluid and Electrolyte Ba lance , 996

F l u id a nd E l ec t ro lyte Bal an ce 7 997

To t al Body Wate r7 997

Bod y F l u id Co m pa rtme n ts 7 997

E l ec t ro lytes in Bod y F l u ids7 998

Extracellular vs. Intracellular Fluids 7 998

Measuring Electrolyte R eactivity7 1000

Ave nu es of Wa te r En try a nd Ex it 7 100 1

Ge n er al P rin cip les of F lu id Bal a n ce 7 100 1

H omeost asis ofTota l F l u id Vo l u m e7 1002

Regulation of Fluid I ntake7 1002

Regulation of Urine Volume 7 1002

Factors That Alter Fluid L oss 7 1002

Regu l ation of Wat er and E l ec trolyt es 7 1004

Starling 7 s L aw of the Capillaries 7 1004

E dema 7 1006

Regu la tion of Wat er and E l ec trolyt es in I nt race llul ar

F lu id7 1007

Reg u la tion of So diu m an d Potass iu m 7 1008

Cycle of Life: F lu id and E lect rolyte Bala n ce 7 1009

T h e Big Pic tu re: F lui d a nd E lect rolyt e Bal a n ce 7 10 10

Mec hani sms of D ise ase 7 10 10

Case St u dy7 10 13

CHAPTER 44 Acid-Base Balance, 1016

pH of Body Fl u ids 7 10 17

Review of the pH Concept7 10 17

Factors That Affect pH of Body Fluids 7 10 18

pH Co nt ro l Mec hani sms 7 10 19

Overview of pH Control Mechanisms 7 10 19

I ntegration of pH Control7 10 19

Chemical Buffers, 1019

Buffers Defined, 1019

Buffer Pairs, 1019

Buffer Activity, 1020

Role of Buffers in pH Control, 1022

Respiratory Mechanisms, 1022

Overview of Respiratory Mechanisms, 1022

Respiratory Adjustment of Blood pH, 1023

Principles Relating Respiration to pH, 1023

Arterial Blood Gas Analysis, 1023

U rinar y Mec hani sms, 102 4

Overview of Urinary Mechanisms, 1024

Regulating pH of Urine and Blood, 1024

The Big Pi c tur e: Acid-Base Balance, 1027

Mechanisms of Disease, 1027

Case Study, 1030

Career Cho ices, 1030

UNIT 6 Reproduction and Development, 1034

CHAPTER 45 Male Reproductive System, 1036

Sexual Reproduction, 1037

Male Reproduc ti ve Organs, 1037

Male Reproductive Tract, 1037

Perineum, 1037

Testes, 1038

Structure and Location, 1038

Microscopic Anatomy of the Testis, 1038

Testes Functions, 1041

Spermatozoa, 104 2

Reproductive Ducts, 104 3

Epididymis, 104 3

Vas Deferens, 104 3

Ejaculatory Duct, 1044

Urethra, 1044

Accessory Reproductive Glands, 1045

Seminal Vesicles, 104 5

Prostate Gland, 104 5

Bulbourethral Glands, 104 5

Supporting St ru ctur es, 1046

Scrotum, 1046

Penis, 1046

Spermatic Cords, 104 7

Composi ti on and Course of Seminal Fl uid , 104 7

Male Fert ili ty, 1048

Cycle of Life: M al e

Reproductive System, 1048

The Big Pi c tur e: Ma le Reprod u ct ive Sys t em, 1048

Mechanisms of Disease, 1049

Case Study, 10 51

CHAPTER 46

Female Reproductive System, 1054

Overview of th e Fem al e Reproductive System, 105 5

Function, 1055

Structure, 1055

Perineum, 1056

Ovaries, 1057

Location of the Ovaries, 1057

Microscopic Structure of the Ovaries, 1058

Functions of the Ovaries, 1059

Ute ru s, 1059

Structure of the Uterus, 1059

Functions of the Uterus, 1061

Ute rin e Tu b es, 1061

Location of the Uterine Tubes, 1061

Structure of the Uterine Tubes, 1061

Function of the Uterine Tubes, 1062

Vag in a, 1062

Location of the Vagina, 1062

Structure of the Vagina, 1063

Functions of the Vagina, 1063

Vu lva, 1063

Structure of the Vulva, 1063

Functions of the Vulva, 1065

Fema l e Repro du ctive Cycles, 1065

Recurring Cycles, 1065

Control of Female Reproductive Cycles, 1067

Importance of Female Reproductive Cycles, 1070 Infertility, 1072

Menarche and Menopause, 1072

Breasts, 1072

Location and Size of the Breasts, 1072

Structure of the Breasts, 1074

Function of the Breasts, 1074

Cycle of Life: Female Reproductive Sys t em, 1076

T h e Big Picture: Fema le Reproductive Sys tem and the Whole Body, 1076

Mec h a n isms of Disease, 1076

Case Study, 1082

CHAPTER 47 Growth, Development, and Aging, 1086

Human Reproduction, 1087

Production of Sex Cells, 1087

Ovulation and Insemination, 1092

Fertilization, 1092

Prenatal Period, 1093

Cleavage and Implantation, 1093

Placenta, 1096

Periods of Development, 1097

Stem Cells, 1098

Formation of the Primary Germ Layers, 1099

Histogenesis and Organogenesis, 1102

xxviii Contents

Birth , 11 04

S tages of Labor, 1106

Multiple Birth s, 110 6

Postn ata l Pe riod, 1107

Growth, Development, and Aging , 1107

Infanc y, 110 8

Childhood, 1108

Adole scence and Adulthood, 11 09

Older Adulthoo d, 1109

Agin g, 1109

Mechanisms of Aging, 11 09

Effects of Aging, 1111

Causes of D ea th , 111 3

T h e Big Pictur e: G rowth , D evelop m e nt , Aging , and the Whol e Bod y, 1 11 4

Mechanisms of Disease, 11 15

Case Stud y, 111 7

CHAPTER 48 Genetics and Heredity, 1121

T h e Sci ence of Ge n e tic s, 11 22

Chromosomes and Ge n es, 1122

Mechanism of Gene Func tion, 1122

The Human Genome, 1123

Di stribution of Chromosomes to O ffsp ring, 1125

Gene Expression, 1126

Hereditary Traits, 112 6

Sex-Linked Traits, 112 8

Genetic Mutat ions, 1129

Me di cal Ge n etic s, 1130

Mechan isms of Genetic Di seases, 1130

Single-Gene Di seases, 1132

Multiple-Gene Di seases, 1134

Epigenetic Conditions, 1134

Chromosomal Di seases, 113 5

Genetic Ba sis of Cancer, 113 6

Pr eve ntion and Tr eatm en t of Gene ti c D iseases, 11 36

Genetic Counseling, 1136

Treating Genetic Di seases, 113 8

The Big Pi ctu re: Genet ics, H ere di ty, an d the Whole

Bod y, 1139

Case Stud y, 1 140

Career C h oices, 1141

Glossary of Anatomy & Physio logy, 1144

Index , 1198

Illustration and Photograph Credits

UNIT 1

See in g the B ig Pic h tre hox : Tigh t Kevin Patton, Li on Den Inc, We ldon S pring, 2\•10 .

Chapter 1

1-2: De H um:.ni Corporis J<"':.hric:. ( On the Struc ture: o f tiH: Human Bodr) in I S4 3. J -3, 1-8, 1-9: Cou rtcsr Co us ins. 1- 10: Re<lrawn from Mu5colino J E: Know the body: muscle, bone, and palpation eSSf'ntials, St Loui5, ZO J 2, 2\•losby. I - ll , A: Co urle$}' V id ic B, S uarez Rf : Photographic atlas of the human body, St. Lou is, 198--J, Moshy. 1-1 1, 8: Su:. rcz RF': Photographic atlas of the human body, S t Lo uis, 1984, 2\'losb)·· Co nn ect It! hox: Prom Col<lman L, Ausid lo D: Ctcil tntbook of medicine, eel 22, Ph il:uldph ia, 20(}1, S:. u ndcrs

Chapter 2

2 -6: Da ta from Schwartz \ VJ : A cli n icia n 's p rimer on tl1c c irc.:uiUn dock: ils locali7.a lion, fu n ction, and r cseHing. Ad'' lnle-m 1'vl ed, 38:8 1 106, 1993. In ( rc:<lr:.wn From ) Koeppen B, S tan ton B: &me 6 L.n.y ed 6, St. Lou is, 2010, lvlo$by. 2-8, 2 9, B: Prom PaHon KT, '11lilxxle.au C : Human body in health 6 diseast', c:d 6, S t Lou is, 2014, Moshy. 2 9, A: F'mm Donne DC, Vil e:$ JH, Crotl1 D, Melh orn 1: Stn tch tre of tl1e recomll ina nt Fu ll 1ength l1.amstc:r prion protein PRp (29.23 1): the N tc:nn inm is h igh ly Aexilll e, Proc Nat/ Acad Sci USA, W, I H;2-l H57, 1997. Cuprrigl>t Na tional Academy o FScic: nccs, USA.

Chapter 3

3-J: from Pa tton Kf, Th ihode.au C: Human body in health 6 dis· ease, c:<l 6, St Loui$, 20 14, ).•lusby. l _,: From Sugimoto Y, Pou P, Abc: lvl, et al: Chemical identi fi cation of imli\'i<lual surface atoms by atomic Force: m icroscopy, Nature, 466:64...67, 2007. C: lvl ichad CO<Iomsl:if l<lm St.ack &: Associates. Case Stu dy h ox: Fmm Potter P, Perry A: Basic nursing: eSSf'ntials (or practice, ed 6, St. Lou is, 2006, Mosln-.

Chapter 4

-t-13: F'mm P:. tton KT, l l tibcxlea u CA.: Mosby's handbook of anal· amy 6 physiology, ed 2, St. Loui$, 20 14, Elsc:\-ier. 4 14: Prom PaHon K Thihode.au C, Dougla$ M: Essentials of anatomy and physiology, St. Lou is, 20 12, lvlo$by 4 15, Bo x -t-t (ph oto) : Prom National Insti tu te oF General Me<lic:t l Sciences, 'fhe structures o(life, J uly 2007, Nu..-embe r 2008 from l1ttp://www.nigms.n ih.gov/ ne\\"'S/scie nee_e<l/stm ct1ifc: / S ox 4 2 (phot o) : Copyrigl1 t Kevin PaHon, Li on Den Inc, Weldo n S pring, MO.

Chapter 5

5 1, 8 : Courtesy A Arlan Hinchec: 54 2, 5 9, 5 10, 5·13 , S- 15 (dec4 tron m icrogmphs), 5· 17: from Pol l.ard T', E:a mshaw \ V: Cell biology, revise:<! repri nt, in tern:t tional eelition, Phila<lelphi:., 20<H, Sa tmders.

5 7. B, 5-12, B,; JS, B: Cou rtesy Charl es Flicki nger, Universi ty of Virgi nia 5-8: Prom l">:ttton KT, Thihode.au C : Human body in health 6 disease, e<l7, St Lo uis, 20 18, .:\'lusby. -;. 11 , B: Cou rtesy Bremb Russell 5 H : Prom P..ttton Kf, Thihode.au CA: Mosby's handbook of anatomy 6 physiology, ed 2, St. Louis, 20 1-t, E lsevier. 5 15 (Auoresccn ee ligh t m ic rogrnphs (righ t pan el )),; . J5, A: Cot trtc:sy

I. t-lerm.an, Un i\'ersity. 5-J 5, 8 : Courtesy £. Sm ith and E. Fuchs, Uni\·c:rsity of Chic.ago s J 5, C : Courtesy C. BoriS) , Uni versityofWiscom in, 2\'l:tdison, \ VI. 5 16, B: Comtc:syCon ly Rie<ler, W:.dsworth Cen te r, Allxmy, NY. 5-18, A: S usum u Ito. Table 5-J (figures): From Patto n Kf, Thihode.au CA: Mosby's handbook of anatomy 6 ed 2, St. Louis, 2014, Elsc:\-ier C o nn ect It! bux (figure): From Kong LB, et al : Stmch tre oF t11 c: \-au h, :t uhiqui tous ccl lub r component. Structure, 7:37 1 379, 1999.

ChapterS (ph ot os) : Prom lvbjmmlc: r, D. c: l :. 1: Reel cd l morphology in lc: ukemi:., hypopl.astic :tnc:mi:. a n<l syndrome, l>atJtophysiology, 13 (4): 217-225, 2006. 6-9, t\dapted from McCance K, Huether S: Pathophysiology, e<l -t, St. Lo uis, 2002, lvlosby. 6· 11 (d cc tron m icmgrn phs): Co urtesy ).•J.:\ •1. Perry and A B G ilbert, Edi nburgh Research Center 6.22 : Fmm P..ttton KT, Th ibodeau C : Human body in health 6 disease, c:<l 7, St. Lou is, 20 18, 2\'losby. Bo x 6 1, S : Prom Coldm.an L. Ausie1l o D: Cecil textbook of medi· cine, ed ZZ, Ph iladelphia, lOCH, Sa unders

Chapter 7

7-1 ( ph o to)' Cold Spring H•rbor l..obora tory 7-t , Adapted from Pol l.arcl T', E.:tm$h:tw \ V: Cell biology, revised reprin t. in tern:. tional e<lition, P hibddph ia, lOCH, S:. undeD . 7-5: Prom P:tHon KT, 'l11ilxxlea u C : Human body in health 6 disetJ$C, ed 7, St. Louis, 20 18, Mosh)' 7-J O, De nnis S tretc:. 7 12 : Wikimeeli:. Commons

Chapter 8

S. J: From Patto n Kl ' , l 11ilxldc::.u CA.: Mosby's handbook ofanatomy 6 physiology, ed 2, St. Lou is, 20H, E lsevier. 8_, (h ottom im age): Modi fi ed from Polla rd T D, f.:tmsl1.:tW \V: Cell biology, ed 2, Pl1ib <lclpl1ia, 2007, \V B Sam1<lcrs Compa ny.&.; , 8 13: From Cartner LP, Hiatt J L: Color textbook of histology, ed 3, Ph i1 a<lc:lph i:., 2007, Sa un <lers. 8.6 : From P:t tton Kl ' , Th ihodeau C : Human body in health 6 disease, eel 7, St. Lou is, 2018, Moshy. 84 7: Prom C:tllen J, C reer K, Hood A, ct :. 1: Color atlas ofdennatology, P11ibdclpl1ia, 1993, S:. un <lers. S. IO, A, B: f rom Sam udso n DA: Textbook of \'eieriuary histol· ogy, \V B Sa unders ComJXln)', 2007. S. J O, C : Will 2\1u rr:ty ( \ Villscrit) , http://wilmunaymc:di:..com S. I Z: Reprin ted witl1 permiss ion From Cregor Re id, Pl1D, l.:t\\'SOn Health Rc:se.arc h lm lih tte.

Il lust rat io n an d Ph otograph Cred it s

Barba ra Cou sin s 9-3 (e lectron micrograph ), 9-10 , 9-15, B: From Erland se n SL, Mag n ey J: Color atlas of hi stolo gy, St. Loui s, 1992 , Mo sby. 9-5: E d Resc hk e 9-20, 9-28: From G a rtn er L , Hi att J: C olor textb oo k of his tology, eel 3, Philadelph ia, 2007, Saund ers. 9-21 , 9-24: From Ke rr J: Atla s of fun ctional hi stolo gy, Lo ndon , 199 9, Mos by 9-22: C o urtesy Ga ry T hibod e au. Box 9-1: From Zitelli B, D av is H: Atla s of pediatr ic ph ys ical diagnosi s, e el 3, Philad elphi a, 199 7, Mo sby Career Choices box: Co urtes y of Joanna Mc G au gh ey

UNIT 2

Chapter 10

10-1 (photo ): E d Res ch ke . 10-1 (drawing), 10-6 , 10-29: Barbara Cou sin s. 10-3, 10-1 8, Case Study (figur e): Cop yri ght Kev in Patton , Li o n D en In c, Weldon Sp ri ng, MO. 10-10: Fro m Rou za ud F, Kadekaro A, Abd el -Mal ek Za , Hearing VJ: MC1R and th e res pon se of m elan oc ytes to u ltr aviolet radiation , Mutat Res, 57 1:136,2005 10-11 : From Regez i J, Sc iubb a JJ , Jordan RCK: Oral path ology: cl in ical pa t hologic correlat ions, e el 5, St. Louis, 2008, Saund ers. 10- 12: From Ep stein 0 , Pe rkin CD , C ookson J, de Bono 0: Cli n ica l examinati on , eel 3, St. Loui s, 200 3, Mo sby 10-13 (gra di ent): F ro m McC an ce K, Hu eth er S: Pa t hoph ys iolog y, eel 5, St. Loui s, 200 5, Mos by. 10-15, Box 10-6 (figur e): From Patton KT, Thibod eau G: Human body in health 6 di se ase, eel 7, St. Lou is, 2018, Mo sby 10-17 , C: C opyright © by David Scharf, 1986, 1993. 10-20: Courte sy Christin e Ol ekyk. 10-21 , 10-24, 10-25 : From Habi f TP: Clinical demwtology, e el 4 , St. Lou is, Mo sby, 2004. 10-22: From Hab ifTP: Clinical dermatolog y, eel 2, St. Lo ui s, 1990 , Mo sby. 10-26: From Potter P, Pe rry A: Ba sic nursing: essen tial s for practice , eel 5, St. Loui s, 20 03, Mos by. 10-27:

From Jam es WD , Berge r TG , El ston OM: Andrew's dise ases of the ski n : clinical dermatology, eel 10 , London , 2000, Saund ers 10-2 8, A:

From Goldm an L, Au siello 0: C ecil textbook of me di cine, eel 23, Phil adelphia , 2008, Saund e rs 10-28, B: From o bl e J: Textb oo k of prima ry ca re me dici ne, eel 3, Philadelphia, 200 1, M os by 10-2 8, C:

From Tow n se nd C , Beau champ RD , E ve rs BM, Mattox K: S abiston tex tb oo k of surge ry , eel 18, Philadelphia , 2008, Saunde rs 10-2 8, D:

From Rakel R: Tex tb oo k of famil y medicine, eel 7, Phi lad elphi a, 20 07, Saunders. Box 10-1: Courtesy James A. Ischen, MD , Baylo r Coll ege of M edi cin e Box 10-4: From Emond R: Color atla s of infectiou s di sease s, eel 4, Ph il adelp h ia, 2003, Mosby. Box 10-5 (figure): Court esy Ph oto Resea rc h ers, Inc. h ttp://images. science sourc e .com/se arch/ SB1498 Box 10-7 (figur e) : From Ca ll en JP et al: Color atla s of dermatology, eel 2, Phi lad elphia , 2000, Saunde rs

Chapter 11

11-3 , B: F ro m Wh ite T: Human oste olog y, e el 2, Phi lade lphi a, 2000, Acad e mi c Press 11-4 , B: From Mo ses K, Nava P, Ba nks J, Pete rse n 0: M oses atl as of cl inic al gro ss anatom y, Phi ladelphi a, 2005, M os by 11-6 , B , 11-24 , A, B : D e nni s Strete . 11 -8: From Willi am s P: Gra y's anatom y, eel 38, Phil ade lphia , 1996 , Churc hill Li vin gs ton e . 11-9 , A: From Mu sco lin o J: Kine siolog y, St. Loui s, 200 6, Mos by 11-9 , B:

From E rl and se n SL, Magn ey J: Color atla s of hi stology, St. Loui s, 1992 , Mo sby. 11-10: Wik im e dia Common. 11-1 1, A, B, C: From Gart n e r, Les l ie P: Color textbook of histolog y, eel 3, Ph il ad elphia , 2006, Saund ers 11-13: From Patton K, T h ibodeau G , Doub las M: Es sentials of anatom y and physiology, St. Lou is, 2012 , M os by. 11-14:

From Poll ard TO , Earn shaw W: Cell biolog y, eel 2, Phi ladelphia ,

200 7, Saunders. 11-1 6: F ro m Pa tton KT , Thibod eau G: Hum an body in health 6 di se ase, eel 7, St. Lo ui s, 201 8, Mo sby. 11-1 7 : F ro m

Zitelli B, Da vis H : Atlas of pediatri c ph ys ical diagn os is, e el 4 , Philadelphia , 20 02, Mo sby. 11-1 8: Ed Resc hk e 11-20: From Booh e r JM , Thibod eau Ga: Athleti c in ju ry assess ment, St. Loui s, 198 5, Mos by. 11-24 , A, B: Courtesy of D enni s St ret e 11-24 C, 11-25: From Kumar V, Abba s A, Fau sto N : Robbin s and Cotran patholog ic ba sis of disease , eel 7, P hil ad elph ia, 2005 , Saund e rs.

Chapter 12

12-2 (photo), 12-3 (pho t o), 12-4 (photo), 12-5 (ph oto), Courtesy Vidic B, Suar ez FR : Photo graphic atla s of the human bod y, St. Loui s, 1984 , Mo sby. 12-6 (p hoto ), 12-11, 12-16 , 12-13 (in se t ): From Will iam s P: Gra y's anatom y, eel 38, Philadelphia , 199 6, Chur chill Li vingston e 12-14 , A-H: From G os ling J, Harri s P, Whitm o re I, Willan P: Human anatomy, eel 4, Philad elphia , 2002 , Mo sby 12-1 7: Courtesy Dr. N . Bl ev in s, ew En gland M e dical Cent e r, Bosto n.

Chapter 13

13-2 , D , 13-3 , C, 13-4, C, 13-5 , 13-6 , 13-7, 13-8, D , E, 13-9, B (photo s) : Courtesy Vidi c B, Su arez FR: Photographic atla s of th e human body, St. Lo ui s, 198 4 , Mo sby. 13-7, 13-11 , B , D: From Abrahams P, Mark s S, Hutch ings R: McMinn 's color atla s of human anatomy, eel 5, Ph ilad elphi a, 2003 , Mosby. 13-10 (drawings): From Yvo nn e Wyli e Wal ston. 13- 10 (p hoto in set): From Seidel HM , Ball JW, Dains JE , Ben e di ct GW: Mosb y's guide to ph ysical examination, eelS , St. Loui s, 200 3, Mo sby 13-11 , A, 13-12: From Patton KT, Th ibod eau G: Hu ma n body in health 6 di sea se, eel 7, St. Lo ui s, 20 18, Mo sby. Case Study box: From Brown er B, Jupit e r J, Traft on P : Skeletal trauma: bas ic sc ien ce, management, and reconstructi on , e el 3, Philadelphia , 20 0 3, Sa und e rs

Chapter 14 14-3 , B , 14-6 , 14-7, A, B, 14- 8, 14-11 : From Go sling J, Harri s P, Whitmor e I, Will an PI: Human anatom y, eel 4, Philad elphi a, 2002 , Mosb y 14-5 , B , D, 14-7, C , 14-9 , B , D , 14-10 , B, D: C o urtesy Vidic B, Suar ez FR: Ph otog raphic atla s of the human body, St. Loui s, 1984, Mosb y. 14-26 : F rom Seidel HM, Ba ll JW, Dains JE, Bene dict GW: Mo sby 's guide to ph ysical examination, e el 5, St. Loui s, 2003 , Mos by 14-27: From Swartz MH: Textbook of physical dia gnosis, eel 4, Ph ilad elph ia, 2002 , Saund ers. 14-2 8, A, Box 14-1 (drawing) : From Patton KT, Th ib odea u G: Human bod y in health 6 di sea se, eel 7, St. Loui s, 20 18, Mos by Box 14-1 (p hoto ): F ro m Cummings N, Sta nl ey- Gr ee n S, Higgs P: Perspectiv es in athlet ic training , St. Loui s, 2009, Mos by. B ox 14-3: From C an al e ST : Campb ell's op erati ve ort hopa edi cs, e el 9, St. Loui s, 1998, Mos by Case Study box: F ro m G oldman L, Au siello 0: C ecil textb ook of medicine, e el 23, Philad elphi a, 2007, Saunders

Chapter 15 15-4: Adapte d from Mu sco lino J: Kine siology, St. Loui s, 20 06, Mosb y 15-14: From Go slin g J, Harri s P, Whitmor e I, Willan P: Human anatom y, eel 4 , Phil adelp h ia, 2002, Mosb y Box 15-1 (p hoto ): From Harkr ea der H: Fundamentals of nursing: caring and clinical judgment, eel 3, St. Lo u is, 200 7, Saun ders.

Chapter 16

Box 16 -1: Co u rt esy Are n C u mm ings, Be n M u nso n , and St. Cha rl es Commu n ity College, Co tt lev ill e, MO. Box 16-3: From Patto n KT , T h ibo dea u G : H uman body in health 6 disease, ed 7, St. Lo ui s, 2018, Mosby.

Chapter 17 17-4, A: Co u rtesy D r. J.H. Venable, D epa rt ment of An at omy, Colora do State U n iversity, Fort Co ll ins, CO. 17-4 , B , Co u rt esy D r. H. E. H uxley. 17-6: Fro m Leeson C R, Leeson T , Paparo A: Text/atlas of histology, St. Lou is, 1988, Sa u n ders . 17-7, A: Cou rtesy of D o n Fawcett, Harva rd Medica l Sc h oo l, Bos t on, MA. In Pollard T O : Earns h aw W: Cell biology, ed 2, St. Lo u is, 2007, Saun ders. 17-10 , 17-11, 17-15: From Lod ish H: Molecular cell biology, ed 4, New York, 2000, WH Free m an. 17-12 , B : Co u rtesy H. E. Hu xley, Brandeis Unive rsity, Wa lth a m, MA . 17-1 8, B: Co u rtesy D r. Pau l C. Leto ur neau, De partme n t of Anatomy, Med ical Schoo l , U niversi ty of Mi nn esota, MN . 17-22 : Adap t ed fro m Pollar d T, Earnshaw W: Cell biology, ed 2, Phi ladelphia, 2008, Sa u n ders 17-30 (ph oto s) : Co u rtesy D r. Fre der ic S. Fay, D epa rt m e nt of P hysio logy, Un ive rsity of Massachuse tts, Worceste r, MA. 17-32 (phot o) : Co u rtesy Ke ll ie W h it e. Bo x 17-6 , A: Fro m Ku ma r V, Abbas A, Fa ust o N: Robbins and Cotran pathologic basis of disease, ed 7, Ph iladelphia, 2005, Sa u n ders. Box 17-7 (photo ) : Fro m Fritz S: Mosby's fundamentals of therapeutic massage, ed 5, St. Louis, 2013, Mosby. Ca ree r Choi ces b ox: Co u rtesy of Linda Carlson

UNIT 3

Chapter 18

18-1: F ro m Patton KT, Th ibo dea u G: H uman body in health 6 disease, e d 6, St. Lo u is, 2014, Mosby. 18-13: Redraw n from F itzGe rald MJT, G ru ener G, Mt u i E : Clinical neuroanatomy and neuroscience, e d 6, Ed inb u rgh, 201 1, Sa u n ders . 18-1 4 : From Fe ldma n M, Friedma n L, Bran dt L: Sleisenger 6 Fordtran's gastrointestinal and liver disease, ed 8, Ph iladelphia, 2006, Saunde rs. Bo x 18-1 , A: Co u rtesy Marie Sima r Co u l dwe ll , M D , a n d Maiken Ne dergaard.

Chapter 19

Bo x 19-1 (photo ) : F rom C h ristense n G J: A consumer's guide to dentistry, ed 2, St. Lou is, 2002, Mosby. Box 19-2 : Copy rig h t Kevi n Patto n , Lion D e n Inc , We ldo n Sp ring, MO Box 19-3 (photo ) : Cou rt esy Tamily Weissma n , Jean Live t , an d Jeff Lich t m an, Harva rd Unive rsity

Chapter 20

20-2 , B , 20-10 , C , Box 20-3: From Ab rahams P, Mar ks S, Hu tch ings R: McMinn's color atlas of human anatomy, e d 5, P h ilade lph ia, 2003, Mos by. 20-5 , C , Tab l e 20-3 : Re draw n from F itzGe ral d MJT, G ru ene r G, Mt u i E: Clinical neuroanatomy and neuroscience, ed 6, Phil ad el phia, 2011, Sa u n ders 20-7 (photo ) : From Gos l ing J, Harr is P, Whi t mo re I, Willa n P : H uman anatomy, e d 4, P hila del p h ia, 2002, Mosby. 20-9 , B: Cou rtesy Vi dic B, Su a rez FR : Photographic atlas of the human body, St. Lou is, 1984, Mosby. 20- 16, C: F rom Giga n de t X, et al: E stima t ing t h e con fi de n ce level of wh ite m att er con n ect ions obtained with MRI tractog raphy, PLoS ONE, 3(l2):e4006, 2008. 20-25: Co u rt esy Wa lter Sc h re ide r,

Un ive rsity of Pe nnsylva n ia. 20-26: Co u rtesy D .N . Marka n d . B ox 20-1 (ph ot os) : Fro m Fo rbes CD, Jac kson W D: Color atlas and text of clinical medicine, ed 3, Lo n do n , 2003, Mosby. Bo x 20- 6 (ph ot o) : Fro m Ch ipps E M, C lan in NJ, Ca mp be ll VG: Neurologic disorders, St. Lou is, 1992, Mosby-Yea r Boo k.

Chapter 21

21-1: Fro m D rake RL, et al: Gray's atlas of anatomy, P hi la delph ia, 2008, Ch u rch ill L iv ings t one/Elsevier. Box 21-3 (photo) : Fro m Hab if T P: Clinical dermatology, ed 2, St. Lo ui s, 1990, Mos by. Box 2 1-4 : Fro m Perki n G O: Mosby's color atlas and text of neurology, Lo n do n , 1998, T imes Mi rr or In t ernationa l Pu bl is h e rs. Bo x 21-5: Fro m Bea re P, Mye rs J: Adult health nursing, ed 3, St. Lo u is, 1998, Mosby.

Chapter 22

Case St udy b ox (photo ) : Co urt esy Flickr, P ho t o Shari ng.

Chapter 23

23-1: Adapte d fro m Guyt o n A, Hall J: Textbook of medical physiology, ed 11, P h il ade lph ia, 2006, Sa un ders. 23-3 , A: Fro m Seidel HM, Ball JW, D ains JE, Benedict GW: Mosby's guide to physical examination, ed 6, St. Lou is, 2006, Mosby. 23-3 , B: Fro m Swartz M H : Textbook of physical diagnosis, e d 4, Ph ila delph ia, 2002, Sa u nd e rs 23-4: Ada pted fro m Boro n W, Bou lpaep E: Medical physiology, u pdated version, P h il ade lp h ia, 2005, Saun ders.

Chapter 24

24-3 , D: Omi kr on/P ho t o Resea rch e rs. 24- 5, B : From Patto n KT, Th ibodea u G: H uman body in health 6 disease, ed 7, St. Lo u is, 2018, Mos by. 24- 8, B: Adap t ed fro m G u yto n A, Hall J: Textbook of medical physiology, ed 11, P hila del p h ia, 2006, Sa un de rs. 24-11: Copy right Kev in Patton, Lion D en Inc, Wel don Sp ring, MO 24-13: Fro m Newe ll FW: Ophthalmology : principles and concepts, ed 7, St. Louis, 1992, Mosby 24- 18 , C: Co u rt esy D r. Sco tt M ittma n , Joh ns Hopkins H ospital, Baltimore, M D. 24-23: F rom Se ide l HM, Ball JW, D ains JE, Benedict GW: Mosby's guide to physical examination, ed 3, St. Lo u is, 2003, Mosby. 24-25: Adap t ed fr om Boro n W, Bo u lpae p E : Medical physiology, u p date d ve rsion, P hi la del phia, 2005, Saun ders 24-27: From Bingh am BJ G, Hawke M, Kwok P: Atlas of clinical otolaryngology, St. Lou is, 1992, Mosby Yea r Book. 24-29 , 24-30 , A: From Swa rtz M H: Textbook of physical diagnosis, e d 4, P h il ad el ph ia, 2002, Saun ders. Box 24-3 (figur e) : Fro m Ishihara's tests for colour deficiency, To kyo, 1973, Ka n ehara Trading Co, Co pyrig h t lssh inka i Fo un datio n

Chapter 25

25-13: Adapted from Hi nson J, Raven P : The endocrine system, Edinbu rgh, 2007, Ch ur ch ill Livi ngstone.

Chapter 26

26-2: Fro m E rl andse n SL, Magney J: Color atlas of histology, St. Louis, 1992, Mos by. 26- 7: Adapte d from Bo ron W, Bo ul paep E : Medical physiology, update d versio n , Ph ila delph ia, 2005, Sa u n ders .

26-9, B: From Jaco b S: Atlas of human anatomy, Ed inb urgh, 2002, C h ur ch ill Liv ings t o n e. 26-12 , B: Fro m Abra h ams P, Marks S,

H ut ch ings R: McMinn's color atlas of human anatomy, e d 3, Ph il adelph ia, 2003, Mos by. 26-13 : D e nn is Stre t e 26-15: Fro m Gos l ing J, Ha rri s P, Wh it more I, \ i\Ti ll an P : H uman anatomy, ed 4, P h il ade lphia, 2002, Mosby. 26-1 7 : Fro m Kierszenba u m A: H istology and cell biology, Ph ila delp hi a, 2002, Mosby. Box 26-4 , A: From Swa rtz M H : Textbook of physical diagnosis, ed 4, Ph ilade lph ia, 2002, Sa un de rs. Box 26-4, B: Fro m Go ldma n L, Sc h afe r AI: Goldman's Cecil medicine, ed 24, vo l. 2, Ph ilade lph ia, 20 12, Sa u nde rs. Box 26-6 (figur es) : Co urt esy Gowe r Med ica l P ub l is h e rs. Box 26-1 (photo A) : Cou rtesy Rob ert F. Gage l , M D and Ia n McC u tcheon, M D , U n ivers ity of Texas M D Anderson Ca n ce r Cen t er, H ou ston, TX. In Black JM, Hawks JH : Medical-surgical nursing: clinical management for positive outcomes, ed 8, St. Louis, 2009, Sa u n ders. Box 26-1 (photo B) : Fro m Fo rbes C D , Jackson WF : Color atlas and text of clinical medicine, e d 3, Lon don, 2003, Mosby, El sevie r Science Ltd Box 26-4, C, Box 26-6 , C : From Patto n KT, Thibo dea u G: H uman body in health 6 disease, e d 7, St. Lo u is, 2018, Mosby. Car ee r Choi ces box: Co u rt esy of Kim Mus ica n te.

UNIT 4

Chapter

27

27-3, D: From Zakus SM: Clinical procedures for medical assistants, ed 3, St. Louis, 1995, Mosby 27- 4 : F ro m Sh ila n d BJ: Mastering healthcare terminology, e d 3, St. Lou is, 20 l 0, Mosby. 27-5: From Patt on KT, Th ibodea u G: H uman body in health 6 disease, ed 6, St. Lou is, 20 14, Mosby. 27-8 (in set ) : Fro m Ca rr J, Roda k B: Clinical hematology atlas, St. Lo u is, 1999, E lsev ie r. 27-11 (in set ) : From Belc h er AE: Blood disorders, St. Louis 1993, Mosby. 27-13, 27-14,

27-15 , 27-16, 27- 17: D en nis Strete . 27- 18 : From Turgeo n M: L inne 6 Ringsud's clinical laboratory science, ed 5, St. Lo u is, 2007, Mosby.

27-19: From Carr JH , Rodak BF : Clinical hematology atlas, ed 2, St. Lo u is, 2004, Elsevie r. 27-20 , B: Co pyrig ht D ennis Ku nkel M icroscopy In c. 27-23: Fro m Cotran R, Kuma r V, Co ll ins T: R obbins pathologic basis of disease, ed 6, Ph il ade lph ia, 1999, Sa un ders.

27-24 , 27-25: From Ku ma r V, Abbas A, Fa ust o N : R obbins and Cotran pathologic basis of disease, ed 7, P hi lade lp h ia, 2005, Saun ders. Tabl e 27-2: Adapted from Pagana KD , Pagana TJ: Mosby's manual of diagnostic and laboratory tests, ed 5, St. Lou is, 20 13, Mosby. Ca se Study box: Fro m Steve n s ML: Fundamentals of clinical hematology, P h il ade lp h ia, 1997, Sa u n ders

Chapter 28

28-1 : Cou rtesy Pat ri cia Kane, India na U n iversity Medical Schoo l. 28-9 (drawing ): Fro m Wi lso n SF, Gid dens JF : H ealth assessment for nursing practice, ed 2, St. Lou is, 200 l, Mosby. 28-9 (in set) : From Seidel H M, Ball JW, D ai ns JE, Be n e dict GW: Mosby's guide to physical examination, e d 6, St. Lou is, 2006, Mosby. 2 8-13 , A, 28-16, 28-21: From Patt on KT, T h ibo dea u G: Human body in health 6 disease, ed 7, St. Lo ui s, 2018, Mosby. 28-1 7 : Fro m Nob le A, Johnso n R, Thomas A, Bass P : The cardiovascular system, Ed inbu rgh , 2005, Ch ur ch ill Liv ings t o n e. 28-20: From Ku m ar V, Ab bas A, Fa ust o N: R obbins and Cotran pathologic basis of disease, ed 7, Ph iladelphia, 2005, Saun ders . 28-24: Co ur tesy Guzze tt a C E , D ossey BM, Cardiovascular nursing: bodymind tapestry, St. Lou is, 198 4 , CV Mosby. 28-25 : Fro m Aeh lert B: AC LS quick review study cards, e d 2, St. Lou is, 2004, Mosby. 28-26: Fro m Co tr an R, Ku ma r V,

Co ll ins T : R obbins pathologic basis of disease, e d 6, P h ilade lph ia, 1999, Sa u n de rs Box 28-1 : F ro m Go ld man L, Au sie ll o D : Cecil textbook of medicine, ed 23, Ph il ade lph ia, 2008, Sa un de rs. Ca se Stud y box : From H icks G H : Cardiopulmonary anatomy and physiology, P h il ade lph ia, 2000, Saun ders.

Chapter 29

29-5: Adap te d fro m McCance K, Hu eth er S: Pathophysiology, e d 5, St. Lou is, 2006, Mosby. 29-9, C, 29-11, A, C, 29-13, B, C: From Ab rah ams P, Ma rks S, Hu tchi ngs R: McMinn's color atlas of human anatomy, ed 5, Ph ila delph ia, 2003, Mosby. 29-24 : From Patton KT, T h ibo dea u G : Human body in health 6 disease, ed 7, St. Lo u is, 2018, Mosby. 29-26 (photo ) : From Swa rtz M H: Textbook of physical diagnosis, ed 4, Ph iladelph ia, 2002, Sa u n ders 29-29: Fro m Cot ran R, Ku m ar V, Co ll ins T: R obbins pathologic basis of disease, e d 6, P h il adelphia, 1999, Sa un ders. Box 29-1: Cou rtesy Simo n C, Jan n er M: Color atlas of pediatric diseases with differential diagnosis, e d 2, Ha m il t on, Ontar io, 1990, BC D ecke r. Case Stud y box: Courtesy D r. D an ie l Si m o n an d M r. Pau l Zamb in o

Chapter 30

30-1: F ro m Harvey W: The anatomical exercises, Lon don, 1995, D ove r P ub l is h ing. 30-6: From Rhoa des R, Pfl an ze r R: H uman physiology, ed 3, Phil adelphia, 1995, Peren n ia l. 30-9: Ada pted from G u yto n A, Hall J: Textbook of medical physiology, e d l l , P hi la delphia, 2006, Saunders. 30-11, 30-19, B: Adapte d from Bo ron W, Bou lp aep E : Medical physiology, u p dat ed ve rsion, P h ilade lph ia, 2005, Saun ders. 30-19, A: From Patto n KT, T hibodeau G: H uman body in health 6 disease, ed 7, St. Lo u is, 20 18, Mos by. 30-25: Adapte d fro m Ca n ob bi o MM: Cardiovascular disorders, St. Lo u is, 1990, Mosby. 30-28: Adap t e d fro m th e National Hi gh Blood Pressur e E d uca t io n P rogram.

Chapter 31

31-2 , 31-5,A : Fro m Patton KT, T h ibo dea u G: Human body in health 6 disease, e d 7, St. Lo u is, 20 18, Mos by 31-5B: Cou rt esy Balli nge r P, Frank E: Merrill's atlas of radiographic positions and radiologic procedures, e d 10, vo l l, St. Louis, 2003, Mosby. 31-6: Ada pted from McCance K, Hu eth er S: Pathophysiology, ed 4, St. Lou is, 2002, Mosby. 31-7: Adapted fro m Boro n W, Bo ulpaep E : Medical physiology, u pda t e d ve rsio n , P h il ade lph ia, 2005, Saun ders. 3 1-8, A: Adap t e d fro m Ma th e rs L, C h ase R, D olph J, G lasgow E: C LASS clinical anatomy principles, Ph ila delph ia, 1996, Mosby. 31- 8, B: From Nie lse n M : H uman anatomy lab manual and workbook, e d 4, Du b u que, lA, 2002, Kenda ll / Hu nt Pu blish ing Company 31-9, B , 31- 17 , B: D e n nis Stre te. 31-14: Fro m Nationa l Insti tu te of Allergy and Infec ti ou s D iseases, Na t iona l In st it ut es of H ea lth , Bethes da, M D. 31-15 , 3 1-24: Fro m Se ide l H M, Ball JW, D ain s JE, Be n e dict GW: Mosby's guide to physical examination, e d 6, St. Lo u is, 2006, Mosby. 31-16 , B: Co urtesy Dr. Edwa rd L. Appl eba u m, Hea d, D epa rtme n t of O t olaryngo logy, U n ive rsity of Ill in ois Med ica l Cent e r, C h icago. 31-1 8: Adapte d fro m Rhoades R, Pfl anze r R : H uman physiology, ed 3, P h ilade lphia, 199 5, Pere nn ial. 31-19: Courtesy Vidic B, Sua rez F R: Photographic atlas of the human body, St. Lo u is, 1984, Mosby. 31-21: Co urt esy Wa lter Tun nesen, M D , T h e Am e rican Boa rd of Pe dia t rics, C h ape l Hill , NC. 31-22: Fro m Go ld st ei n B,

edit o r: Practical dermatology, e d 2, St. Lo u is, 1997, Mosby. 31-23: Copy righ t Kevin Pa tt on, Lion D en Inc, Weldo n Sp ring, MO Case Stud y b ox: F ro m Co h en J, Powde rl y WG : Infectious diseases, ed 2, St. Lo u is, 2004, Mosby.

Chapter 32

32- 1, 32-8, Box 32-1, B: Fro m Ab bas A, Lich t m an A: Cellular and molecular immunology, ed 5, Ph ila delph ia, 2003, Saun ders. 32-4: From Roitt IM, Brostoff, Ma le D K: Immunology, ed 3, St. Lo ui s, 1993, Mosby. 32-6: Adap t ed fro m McCance K, H ue the r , S: Pathophysiology, ed 5, St. Lo u is, 2006, Mosby. 32-10: Fro m McCa n ce K, Hu ether S: Pathophysiology: the biologic basis for disease in adults and children, ed 7, St. Lo u is, 2014, Mosby. Box 32-1 , A: From Cops t ead- Kirkho rn L, Ba n asik J: Pathophysiology, e d 2, St. Lo ui s, 1999, Saun ders.

Chapter 33

33- 1: Copyright D ennis Kun ke l Microsco py Inc . 33-3 , 33-4, 33-5 , 33-9 , 33-14, 33-15 , 33-16, 33-1 7 , 33-1 8 , 33-20 , Box 32-1, B , Box 33-6: Fro m Abbas A, Lic h t m an A: Cellular and molecular immunology, ed 5, Ph il ad el ph ia, 2003, Sa un de rs. 33-13 , 33-21: From Cops t ead- Kirkho rn L, Ba n asik J: Pathophysiology, e d 2, St. Lo ui s, 1999, Sa u nde rs. Box 33-3: From Sti n chco mb e JC, G riffi th s GM: The ro le of the sec reto ry immunologica l sy n apse in kill ing by C D 8 + C T L, Semin Immunol, 15(6):30 1-305, 2003. Box 33-5: Adapted from McCance K, H u eth er S: Pathophysiology, ed 4, St. Lo u is, 2002, E lsevie r. C a se Stud y box: From Mason D J, Leavi tt J, C h affee M: Policy and politics in nursing and health care, ed 5, St. Lo u is, 2007, Sa u nde rs.

Chapter 34

34-1, A: Julie D ermans ky/Science Source 34-1, B: Ri a Novos t i/ Sc ie n ce So u rce. 34-1 , C : Ma u ro Ferma riello/Science Sou rce.

34- 1, D : G loba l Wa rm ing Art. 34-1 , E: Stocktrek l m ages!f h inkst ock. 34-6: Ada pt ed from Mc E wan BS, Gia naros PJ: St ress- a n d allos t asis- in d u ce d brain plasticity, Annu R ev Med 62 :5 1-5 15, 2011. Caree r Cho ices box: Co urt esy of D ena Kru se.

UNIT 5

Chapter 35

35-4: From Steve ns A, Lowe J: H uman histology, ed 3, P h ilade lph ia, 2005, Mosby. 35-8, B. C: F rom Cox JD : R adiation oncology, e d 9, St. Lo u is, 20 10, Mosby. 35-9 : Ada pt ed fro m T h ompson JM, Wi lso n SF: H ealth assessment for nursing practice, St. Lo u is, 1996, Mosby. 35- 1 3, B: Fro m Erla n dsen SL, Mag n ey J: Color atlas of histology, St. Louis, 1992, Mosby. 3 5-12: Fro m Hu tchi ngs RT, McMinn RM : McMinn's color atlas of human anatomy, ed 2, Chicago, 1988, Yea r Book Med ical P ub li shers. 35-13 , A: Fro m Patt o n KT, Thibo dea u G: Structure 6 function, ed 15, St. Lo u is, 20 15, Mosby. 35- 14: Fro m Epste in 0, Pe rkin C D , Cookson J, de Bo n o D : Clinical examination, ed 3, Ph iladelph ia, 2003, Mosby 35- 15: From Patto n KT, T hi b odeau G : H uman body in health 6 disease, ed 7, St. Lou is, 2018, Mos by. 35- 16: Co u rtesy Vidic B, Sua rez RF : Photographic atlas of the human body, St. Lo u is, 1984, Mosby. 35-19: From Zitelli B, D avis H : Atlas of pediatric physical diagnosis, e d 4,

Ill ustrat ion and Photograph Cred its ••• XXXIII

P hi la delph ia, 2002, Mos by. 35-20 , 35-21: Fro m Ku m ar V, Abbas A, Faus to N : R obbins and Cotran pathologic basis of disease, e d 7, P hi la delph ia, 2005, Sa un de rs. Box 35-1: Fro m Patto n KT, Th ibodeau G: H uman body in health 6 disease, ed 7, St. Lou is, 2018, Mosby.

Chapter 36

36-6: F rom Drake R, Vog l AW, Mitche ll A: Gray's anatomy for students, Ph ila delph ia, 2005, C h u rchill Livi ngstone. 36-9 , A, 36-16: Ada pted fro m Boro n W, Bou lpaep E: Medical physiology, u pdated version, Ph ila delph ia, 2005, Sa u n ders 39-9, B: Antonia Reeve/Scie n ce So u rce. 36-12 , Box 36-2: Ada pted from D av ies A, Moo res C : The respiratory system, E dinb u rgh, 2004, C h ur ch ill Livingstone .

36-14: Fro m Patton KT, T hibodeau G : H uman body in health 6 disease, ed 6, St. Louis, 2014, Mosby Box 36-6 : Copyr ight Kev in Patto n , Lio n D en In c, Wel don Spri ng, MO . Box 36-7: Adapte d fro m G uyto n A, Hall J: Textbook of medical physiology, ed 11 , Ph iladelph ia, 2006, Sa u n ders .

Chapter 37

37-4 , 37-13: Adap t ed from Boro n W, Bou lpaep E : Medical physiology, updated ve rsion, Phi ladelphia, 2005, Sa u n ders . 37-5: Fro m Rh oades R, Pfl a n zer R: H uman physiology, e d 3, Ph il ad el ph ia, 1995, Pe renn ial. 37-6: From Patton KT, T h ib odea u G: Human body in health 6 disease, ed 6, St. Lo ui s, 2014, Mosby.

Chapter 38

38-5, B: Copyright Kev in Patto n , Lion D en Inc, Wel don Spr ing, MO . 38-5: D e n nis Strete. 38-6, B: Fro m Zi t elli B, Dav is H: Atlas of pediatric physical diagnosis, ed 3, P hi la delphi a, 1997, Mosby. 38-10 (in se t ) : Fro m Weir J, Ab rahams P: Imaging atlas of the human anatomy, ed 2, P hila del ph ia, 1997, Mosby 38-11 , 38-12, A, 38-16: Fro m Patt o n KT, Thibodeau G: Human body in health 6 disease, e d 7, St. Lo u is, 2018, Mosby. 38-12 , B: From Steve ns A, Lowe J: Human histology, ed 3, Ph ila delph ia, Mosby, 2005. 38-1 8 , A: Fro m Wilso n SF, Gid dens JF : H ealth assessment for nursing practice, ed 2, St. Lo u is, 2001, Mosby. 38 -1 8, B: Fro m G reig JD , Garde n O J: Color atlas of surgical diagnosis, Lo n do n , 1996, T im es Mirro r Internatio n al P ublis h ers. 38-20 , D: Co u rtesy Kevin Patto n , We ldo n Spr ing, MO 38-21 , B , 38-22 , Box 38-2: From D affn e r D H: Clinical radiology : the essentials, ed 3, Bal ti m o re, 1992, Lip p in cott, Willia m s & Wilkins.

Chapter 39

39-2 , B: Fro m Abra h a ms P, Marks S, H ut ch ings R: McMinn's color atlas of human anatomy, ed 5, P hila del phia, 2003, Sa u n ders . 39-4 , B: Fro m Erla n dsen SL, Mag n ey J: Color atlas of histology, St. Louis, 1992, Mosby 39- 5: SP L/P ho t o Resea rche rs. 39-10 , A: Co ur tesy Baylor Reg io n al Transp lan t Insti tu te, Baylor Un ive rsity Medica l Ce n te r, D all as, TX. 39-14 : Co u rtesy Thompson JM, Wilso n SF : H ealth assessment for nursing practice, St. Lo u is, 1996, Mosby. 39-20: Fro m Cotran R, Kuma r V, Coll ins T : Robbins pathologic basis of disease, ed 6, Ph ila delph ia, 1999, Sa u n ders . 39-1 7 : Fro m D o ugh ty D B, Jackso n D : Gastrointestinal disorders, St. Lou is, 1993, Mosby.

Chapter 40

40-3, 40-5: From Patton KT, T h ibo dea u G : Human body in health 6 disease, ed 7, St. Louis, 2018, Mos by. 40-4, Box 40- 1: Adapte d from Boron W, Bou lpaep E: Medical physiology, update d ve rsion , Phi ladelph ia , 2005, Sa un ders . 40-19, B: Courtesy Dr. An dr ew Evan, Ind ian a Un ive rsity. Box 40-2, B: Ad ap te d from Smith M, M orton D: The digestive system, Edinburgh, 200 1, Ch ur ch ill Li ving sto n e. Box 40-4, B, C: From Stevens A, Lowe J: Human histology, ed 3, Phi ladelph ia , 2005, Mosby

Chapter 41

4 1-1 : From the U nited St at es Food a nd Drug Adm inistratio n : Food labeling guide, College Park , M D , 2013, Office of N utriti on, Lab eling, and Di etary Supplements, H FS-800. 41-2, A: F rom t he Unite d States D epa rtm en t of Agr icu ltur e: MyPlate 2013, Retr ieve d from htt p ://www.c h oosemyp l ate.gov/pr int-materia ls-o rd er ing /g raph i c- resources .h t ml. 41-2, B: Fr om Hea lth Canada, 20 16. Eating well with Canada's food guide Reprod uc e d with pe rmi ss io n from t he M iniste r of H ea lth , 20 17 4 1-14, B: Court esy Brenda Ru sse ll , PhD, U ni ve rsity of Il li nois at C h icago. 41-18, B: Ada pt ed fro m Carroll R: Elsevier's integrated physiology, Phi lade lphia , 2007, Mosby. 41-20: Adapte d from Report of the Expert Panel for Population Strategies for Blood Cholesterol Reduction, Beth esda, M D , 1990, T h e Nat ional Cholest erol E d u cation Pro gram, Nationa l Hea rt Lu ng and Blood Institu t e, P ub li c Hea lth Se rvic e, US D epa rtm e n t of H ea lth a nd Hum an Se rvic es, N IH Publ ication No 90-30 46 4 1-25, 4 1-26, 4 1-29, 41-32, Box 41-9, B: Adapted from Ma h a n LK , Escott-Stump S: Krau se's food, nutrition and diet therapy, e d 11, St. Louis, 2004, Sa un ders.

4 1-3 1: Adapted fro m G u yton A, H all J: Textbook of medical physiology, e d 11, Phil a delph ia, 2006 , Sau nd e rs 41-33: Fro m Zitelli B, Da vis H: Atlas of pediatric physical diagnosis, e d 3, Phil adelphia, 1997, Mosby. Box 4 1-2: Co urtesy Bevelan der G, Rama lay J: Essentials of histology, e d 8, St. Lou is, 1979 , Mosby. Box 41-9, B: Adapte d from Ma h an LK, Escott-Stump S: Krause's food, nutrition and diet therapy, ed 11, St. Louis, 2004 , Sa u nders.

Chapter 42

42-1, A: Barb ara Cousins. 42- 1, B, 42-2, B : Fro m Ab raham s P, Ma rks S, Hutchings R: McMinn's color atlas of human anatomy, ed 5, Ph il adelphia , 2003 , Mosby. 42-2, A, 42-10: Adapted from Brundage DJ: Renal disorders, Mosby's C l in ica l Nursing Ser ies, St. Loui s, 1992, Mos by 42 -3 , B: Fro m Weir J, Abrahams P : Ima ging atlas of the human anatomy, ed 2, Phil ad el phia, 1997, Mo sby 42-6: Fro m Heylings D , Spence R, Kelly B: Integrated anatomy, Ed inbu rgh, 2007, C hur chi ll Li vingstone . 42-7: Fro m Telser A, You ng J, Bald win K: Elsevier's integrated histology, Philadelph ia, 2008, Mosby. 42-1 1, 42-16: Fro m Stevens A, Lowe J: Human histology, e d 3, Ph il adelph ia, 2005 , Mosby. 42-8: Fro m Gos lin g J, Harr is P, Whitm ore I, Willan P : Human anatomy, ed 4, Philad elphia , 2002 , Mos by 42-9: Adapted from G uyt on A, Hall J: Te xtbook of medical physiology, ed 11, Philadelph ia, 200 6, Saunde rs. 42-14, 42 -15, B: From Boron W, Bou lpaep E: Medical physiology, upd ate d ve rsion , Ph il adelph ia, 2005 , Sau nd e rs. 42-18, Box 42-6: From Patton KT, Thib odea u G: Human body in health 6 disease, e d 7, St. Loui s, 2018, M osby. 42 -29 : From Kumar V, Abbas A, Fausto N: R obbins and Cotran pathologic basis of disease, e d 7, Philad elph ia, 2005 ,

Saunders . Table 42-2: From Bonew it-Wes t K: Clinical procedures for medical assistants, e d 8, St. Loui s, Sa un ders, 201 1

Chapter 43

43-7: Co pyright Kev in Patton, Li on D en In c, Weldon Spr ing, MO.

43- 18 : Modified from Go ldman L, Schafer AI: Goldman's Cecil medicine, ed 24, Philadelphi a, 2012, Sa un ders . 43-11: Courtesy Ke ll ie White.

Chapter 44

Box 44-1: Co ur tesy Kev in Patton , Lio n D en Inc , We ldon Sp ring, MO. Career Choices box: Co urt esy of No rm a Coo p er.

UNIT 6

Chapter 45

45-3, A, 45-8, E: Le nn art N il sson. 45-4, 45-8, F: From Steve ns A, Lo we J: Human histology, ed 3, Ph il ade lph ia, 2005 , Mo sby. 45-5: Court esy Dr. Mark Lu dv igson, US Arm y Med ical Co rps, St. Paul , MN. 45-9, 45-10, 45- 1 3: Fro m Erlandsen SL, Mag n ey J: Color atlas of histology, St. Lo ui s, 1992 , M os by 45-11: Barbara Cous in s 45-12: From Ab raha m s P, M arks S, Hutchings R: McMinn's color atlas of human anatomy, e d 5, Philadelph ia, 2003, Mosby. 45-14, B: Court esy Vidic B, Sua rez RF: Photographic atlas of the human body, St. Lo u is, 19 84, Mosby 45-15: Adapte d from Guyton A, Hall J: Textbook of medical physiology, ed 11, Ph iladelp hi a, 2006, Saunde rs. 45-16: Ada pt ed fro m Boron W, Boulp ae p E: Medical physiology, up dated ve rsio n , Philad e lph ia, 2005, Saunde rs. 45- 17, Box 45-1: From Seidel HM, Ball JW, Dains JE, Bened ict GW: Mosby's guide to physical examination, e d 6, St. Loui s, 2006, M osby.

Chapter 46

46- 1, B: From Moses K, Nava P, Banks J, Pe te rse n D : Moses atlas of clinical gross anatomy, P hi ladel phi a, 2005, Mosby 46 -3, B, 46-6, 46-7: Fro m Gosli ng J, Harri s P, Whit m ore I, Willa n P: Human anatomy, e d 4, Philadelphi a, 2002, Mo sby 46-5, C: F ro m Fam il iar i G, et al: Ult ras tru ctural dynam ics of hu m an reproductio n, from ov ul at ion to fertilization an d ea rl y emb ryo deve lop m e n t, Int Re v Cytol, 249:53-141 , 200 6. 46-10: From Steve ns A, Lo we J: Human histology, e d 3, P h il ade lp hia , Mo sby, 2005 46-11: Fro m McK ee GT: Cytopathology, London, 1997, Mosby-Wo lfe. 46-12: Co ur tesy Dr. Richa rd Bland au , D epartm ent of Biological Str u cture, Un ive rsity of Washington Sc h ool of Me dicin e, Seattle, WA, from hi s film O vulation and egg transport in mammals, 197 3. 46-18: Adapte d from Boron W, Boulpa ep E : Medical physiology, updat ed ve rsion , Ph ilad e lph ia, 2005 , Sa un ders. 46-21, 46-23: From Mett le r F: Essentials of radiology, ed 2, P hi lade lp hia , 2005 , Saunde rs. 46-22, A: Fro m Abrahams P, Mar ks S, Hutching s R: McMinn's color atlas of human anatomy, e d 5, Ph il adelph ia , 200 3, Saunde rs. 46-22, B: Fr om Symon ds EM, MacPherson MB : Color atlas of obstetrics and gynecology, London, 1994 , Mosby Wolfe. 46 -24 : Fro m Ku ma r V, Abbas A, Fausto N: Robbin s and Cotran pathologic basis of di sease, ed 7, Ph ilad e lph ia, 2005 , Sau nd e rs 46 -25, B, C, Fro m Cotran R, Kum ar V, Collins T: R obbins pathologic basis of di sease, e d 6, Ph il ade lphia, 1999, Saunde rs. Box 46-6 (p hoto ): F ro m Ferri FF: Ferri 's color atlas and text of clinical medicine, P h il ade lp hia , 2009 , Saunde rs/E lsev ie r. Box 46-7: Michael D o nn e, Science Photo Li brary, Sc ie n ce So ur ce .

Chapter 47

47-5 (photo ), 4 7-13: Le n nart N il sson. 4 7-7: Cou rtesy Lu ci n da L. Veeck, Jo n es Inst it ute fo r Repro du cti ve Med icin e, Norfolk, VA. 47-11, B: Fro m Cot ran R, Ku ma r V, Co ll ins T: Robbins pathologic basis of disease, ed 6, P h il ade lp h ia, 1999, Saun ders. 47-12 , B: Adapted from H inson J, Rave n P : The endocrine system, Edi nbu rgh , 2007, Ch ur ch ill L iv ings t one 4 7-14: From Moo re KL , Pe rsand TV: The developing human, e d 6, Ph ilade lph ia, 1998, Sa u n ders . 46-1 7, 46- 18 , 47-25: Adapted fro m Boro n W, Boul pae p E : Medical physiology, update d vers ion, P h il ade lp h ia, 2005, Sa u n de rs 47-20: From Patto n KT, T hi b odeau G : H uman body in health 6 disease, ed 7, St. Lou is, 20 18, Mosby 4 7-23: F ro m Hocke n be rry MJ, Wilso n D : Wong's essentials of pediatrics nursing, ed 8, St. Lo u is, 2009, Mosby. 47-24, Box 47-2 , B: Copyr ight Kevi n Patton, Lion D en In c, We ldo n Spring, MO. 4 7-26 : Adapted from Ma h a n LK , Escott-St ump S: Krause's food, nutrition and diet therapy, ed 12, St. Lo u is, 2007, Sa u n ders . 47-2 7 : Ada pt ed fro m McCance K, H uether S: Pathophysiology, ed 5, St. Lo u is, 2005, Mosby 4 7-29 , B: Adapted from l gna t avic iu s D , Bayne MY: Medical-surgical nursing : a nursing process approach, P h il ade lph ia, 199 1, Sa un de rs. 4 7-30: From An de rse n JL, Schje rl ing P, Sa lti n B: Muscle, genes, an d ath letic

Ill ustrat ion and Photograph Cred its xxxv

pe rfo rma n ce, Sci Am, 283(3):49-55, 2000. 47-3 1: F rom Go ldma n L, Aus iello D , Cecil textbook of medicine, e d 23, Ph ila delph ia, 2003, Sa u n de rs. Box 47-3 (photo ) : Co u rt esy of the Proge ria Research Fo un dation. Peabo dy, MA, h ttp://www.proge riaresea rch .o rg. Case Stud y box: From Hagen-An se rt SL: Textbook of diagnostic ultrasonography, ed 6, vo l 2, St. Lo u is, 2007, Mosby.

Chapter 48

4 8-1: Ada pt ed fro m Boro n W, Boul pae p E: Medical physiology, updated ve rsio n , P hi la delph ia, 2005, Sa un de rs. 4 8-2: Fro m Patto n KT, T h ibodea u G: H uman body in health 6 disease, ed 7, St. Lou is, 2018, Mosby. 4 8-5: F ro m Jo rde L, Ca rey J, Ba msh ad M : Medical genetics, ed 3, P hi la del phi a, 2004, Saun ders. 4 8-10: Fro m McCa n ce K, Hu ethe r S: Pathophysiology, ed 4, St. Lo u is, 2002, Mosby. 4 8-13, B: From Kum ar V, Ab bas A, Fa u sto N: Robbins and Cotran pathologic basis of disease, ed 7, P hila del phia, 2005, Sa u nde rs. 48-14 , A: Co u rtesy Lois McGav ra n , D enve r C hil dre n 's Hos p ital. 4 8-14 , B: Fro m Zite ll i: Atlas of pediatric physical diagnosis, ed 6, St. Lo ui s, 2012, Mosby. 4 8-15 , 4 8-16 , B , 4 8-17 , B: Co ur tesy Na n cy S. Wexler, Ph D , Col u mbia U n ivers ity. Car ee r Choi ces box: Co urtesy of Andrea L. Mose.

the big picture I Seeing the BIG picture

Before rea ding th is intro duction, you probab ly spent a few minutes flip ping th rough th is book. Naturally, you are cur ious ab out your cou rse in human anatomy and phys iology, and you wan t to see what lies ahead It is more th an that. You are curious abou t th e human body-ab out yourse lf, really. We all have that des ire to learn more about how our bod ies are pu t togethe r and how all the parts wo rk. Unli ke many other peop le, th ough, you now have the op portunity to gai n an unde rstand ing of the und erlying sc ienti fic pr inciples of hu man str uc ture and functi on.

To truly unde rstan d the nature of the human body re quires an ability to ap preciate "the parts " and "th e whole" at the same time. As yo u fl ipped through th is boo k for th e first time, yo u probably loo ked at many differen t bo dy pa rts. So me were microscopic-such as muscle ce lls-and so me we re very large-such as arms and legs. In looking at these pa rts, however, you ga ined very little ins ight abou t how th ey wo rked togeth er to allow you to si t he re, alive and breath ing, and rea d and co mpre hend th ese words.

Think abou t it for a mo men t. What do es it take to be ab le to rea d these words an d unders tand them? Yo u might beg in by th inking abou t the eye. How do all of its many intr icate parts wo rk together to for m an image? The eye is not the on ly organ you are us ing right now. What ab out the bones, jo ints, and muscles you are using to hold the boo k, to turn the pages, and to move your eyes as th ey scan this paragrap h? Let's not forget the ne rvous system. The bra in, sp inal cord , an d ne rves are rece iving information fro m the eyes, eva luati ng it, and using it to coo rdinate th e musc le movemen ts. The squigg les we cal l letters are being interpreted near th e top of the bra in to form co mplex ideas. In sho rt , you are thinking abou t what you are reading

However, th at do es not cove r everyth ing. How are you getting the ene rgy to operate your eyes, muscles , brain, and nerves? Ene rgetic chem ica l react ions ins ide eac h ce ll of th ese organs require oxyge n and nu tr ien ts captu red by the lungs and digestive trac t and de livered by the heart and blood vesse ls. These chemical reactions pro du ce wastes th at are ha nd led by th e liver, kid neys, and othe r organs Al l of th ese functi ons must be coor dinated , a feat acco mplished by regulation of body organs by hormones, nerves , and othe r mec hanisms.

Learni ng to na me the var ious body parts , to desc ribe the ir de tailed str ucture , and to exp lain the mechanisms that pro du ce th eir functions is an essential step that leads to the goal of un derstan ding th e human bod y. To actua lly reach that goal, however, you mus t be ab le to draw togeth er iso late d facts and conce pts. In other wo rds, unde rstand ing the nature of ind ividu al body parts beco mes more mean ingful when you unde rstand how the parts wo rk t oge th er in a living , who le person

Many textbooks are wr itten like reference books-dictionaries, for examp le They prov ide detailed desc riptions of the structu re and func tion of individual body parts, often in logical group ings , wh ile ra rely stop ping to step back and loo k at th e whole perso n In th is book, howeve r, we have inco rporated the "w hole body" as pec t into the discussion of every major topic. In chapter and un it intro ductions, in appro priate paragraphs within each secti on, and in spec ific sec tions near th e end of each chapter, we have stepped bac k from the topic at han d and refoc use d attention to the broader • VIeW. •

Anthony's Textbook of AWARD

At the organelle level withi n the living skin cells, you probably th ink of the mitochondrion shown here as the " power p lant" of the ce ll. In th is unit you will learn more about the process of cellu lar respiration.

1. What is the molecule produced by this cell part that transfers energy from nutrients to the chemical or metabolic processes of life?

a) DNA b) RNA c) ATP

At the biochemical level, the subcutaneous layer under our skin has many fat cells. They provide insulat ion and energy reserves.

7. An abundance of which of these four major groups of organic substances would be found in these cells?

a) carbohydrates

b) lipids

c) proteins

d) nucleic acids

This receptor in the skin detects

stimu li that make it poss ible for

the body to respond to changes occurrin g in both the external and internal environments.

6. This would be part of what body system

responsible for communication, control, and integration?

Sweat glands in our skin are epithelial tissue exocrine glands that

secrete substances onto the surface of the skin You know they help cool off your body when overheated, but they also secrete wastes in that fluid.

2. What other organ system would a/so get rid of wastes as fluids?

When you think about muscles in the human body , you probably focus on those that attach to l and move the ske leton. Howeve r there are several ty pes of muscle t issue in humans. Shown here is smooth muscle that can make hair stand on end and fo rm "goose bumps."

Diagram of

Skin Structure

3. /s contraction of this tissue controlled voluntarily or involuntarily?

If you have ever cut yourse lf or become flushed when overheated, you know that our skin has a good b lood supp ly. The larger vessels function for transport, but it is the small, microscopic vesse ls ca lled cap illaries that transfer nutrients a nd v ital substances between blood and t issue cells.

Some spec ialized cells in the sk in called melanocytes produce the p igment that gives our skin color . As you learn new terminology, such as the name of thi s cell, use c lues in the name to help you remember its structu re and funct ion.

5 . What would you predict would be the name of the pigment chemical this cell produces?

a) keratin b) elastin c) melanin

4. What are the two important inorganic substances exchanged at capillaries that are closely related to cellular respiration occurring in the mitochondrion shown above?

T

he nine chapters in Unit 1 "set the stage" for the study of human anatomy and physiology They provide the un ify ing information required to understand the "connectedness" of human structure and function . You will explore different levels of organizat ion from chemical to t issue level. The first organ you w ill study in the next unit w ill be the skin Let's take a look ahead at its structure and function and figure out what you already know from your own experiences as a human or have learned before this at the foundationa l level. Watch for any ideas you have that are oversimpl ified so you can add to your knowledge or any misconceptions you can correct based on the scientific princ iples in this f irst unit. Try out these framework questions : •

Why a set of hard questions before you even begin reading? The science of learning shows that it will go easier if you jump-start your brain with a few questions that get you thinking about concepts to be explored in this unit, even if you have to guess! Try answering (or guessing at) each item, moving clockwise around the facing page, then check your answer at the side of the page. It is okay if you do not answer them correctly; the goal here is simply to get you thinking before you read. Even though it seems odd, and maybe a bit discouraging the first time, it does work! •

Organization of the Body

LANGUAGE OF SCIENCE

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Cuttural Conte x t. 3

Anatomy and 4

Anatomy. 4

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Organ LOYol, 7

Sys.t am Level, 7

Organism Lovel, 8

Anatomical Poeltlon, 8

Anatomical DlrKtlona., e Oltecllon ol Tonns. 9

Terms Rolotod to O<gans, 9 Compass Rosette, 10

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Transvwse 11

01lw- and S.Ciians. 11

Body CIWIIIeo, t 2

Dorsal Covftloo. 12

Ventral Co.ttioo. 1 2

Body Roglono. t S

Interaction of Structure and Function,, 18

Cycle of Lit•: L i te Span Consi derations, 17

TM Big PlctuN : Organization of tho Body, t 7

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ou h ave just begu n the st u dy of one o f natu re's m ost wondrous st r uct u res-t h e h u man body Anatomy and physiology a re branches o f bio logy that are conce r n ed w ith the for m and f u nct ions o f the body Anato m y is the st u dy of body structu re, whe reas physiology deals with body functio n. As yo u learn about the co m plex interdependence of stru ctu re and fu nct ion in the h u m an body, you become, in a very real sense, the s u b j ect o f your ow n st u dy Rega rdless of yo u r field of study or your fut u re career goa ls, acq u ir ing and usi ng inf o r matio n about your body stru ctu re a n d f unctions wi ll e n able yo u to live a mo re k n owledgea ble, involved, a n d healthy li f e in t h is sc ience-conscious age . You r st u dy o f a n atomy and p hysio logy provides a unique and f asci n ating understandi n g o f se lf , and this k nowledge a llows for mo re active and inf orm ed participation in yo u r own personal hea lth care decisions If yo u are p u rsui ng a h ealth-, science-, o r ath letic-related ca ree r, your st u dy of anato m y and phys io logy ta kes on added sign if icance . It p rovides t h e necessary co n cepts you wi ll need to u ndersta n d yo u r professiona l co u rses a n d succeed in c linical experie nces •

SCIENCE AND SOCIETY

Befo re we ge t to th e d e ta i l s, we should e mph asize that eve ryth i ng you will r ea d in thi s boo k is in th e co nt ext of a b r oad fi e l d of i nquiry ca ll ed science. Sc i e nc e is a styl e of i n qui ry that a tt emp ts to und e rst and na t ur e i n a rational, l ogica l mann e r.

SCIENTIFIC METHOD

Us i ng d e tail e d o b se rva tion s a nd vigoro u s t es ts, o r expe rim e nts, sc ie nt ists win n ow out eac h e l e m e nt of an id ea o r h yp oth es is unti l a r easo n ab l e co n cl u s i on about i ts va lidity ca n be m ade R igorous experi m e nts th at e lim i nate any influ e nc es or b i ases n o t be in g dir ectl y t es t ed are ca ll ed controlled experiments.

I f the res u l ts of observat i ons and exp e r i m e nts are r e p ea tabl e, th ey ma y ve rify a hypothesis and eve ntuall y l ea d to e n ough co nfid ence in the co n cep t to ca ll it a t h eo ry T h eo r ies in which sc i en t is ts have a n unu su a ll y h igh l eve l of confide n ce are so m e tim es called l aws . Experime n ts m ay disprove a h ypo th esis, a resu lt th at oft en l ea ds to th e format io n of n ew h ypo th eses t o b e tes t e d

Figure 1-1 summar i zes so m e of the bas i c conce pts of how n ew sc i ent ifi c principl es are developed. As yo u can see, sc i ence is a d ynam i c process of ge tt i n g closer an d closer to the truth about n ature, i ncluding t h e n ature o f th e human bod y Science is d e fin it e l y n o t a se t of unchanging facts as m any people in o ur c u l tur e ofte n assume.

CULTURAL CONTEXT

We sho u l d p oin t ou t the soc i al an d cu lt u r a l context of th e sc i e nc e presente d i n t h is book. Sc i en ti sts d r ive t h e proc ess of sc i e nc e, but our culture dr ives th e kin ds of quest io n s we ask abou t na t ur e and ho w we attempt t o answe r t hem For examp l e, c utt ing apar t h u man ca d ave r s (d ea d bod ies) for t he purpose of stud yi ng t h em h as n o t always bee n a n acce pt ab l e ac t ivity i n all c ultures. Today a d e bate fac e d b y our culture concer n s th e acceptabili t y of u s ing li ve a n ima ls i n sc i e nt ific expe rim en ts. B eca u se our c u l tur e does no t condone mo st expe rim e nts involving li vi n g hum a n s, we ha ve un til no w oft en co ndu cted tes tin g o n animals th at are s imilar to humans In fac t , mos t of th e theories prese nte d i n thi s book are based on anima l expe r i m e nt a-

ti on, b ut c u l tural influ e n ces no w a re p ulling scie nti sts i n o th e r exp e r im e nta l dir ec ti ons they o th e r wise ma y not h ave tak en

S im ilarly, sc ie n ce affects c ult ure. R ece nt advances in und e rstanding hum an ge n es and t ec hn o l ogica l adva n ces i n ou r abil ity t o u se so-ca ll e d stem cells and othe r ti ss u es from h u man e mbryos, human ca d ave rs, a n d li vi ng d o n o rs to treat d evas tating di seases have spa rk ed

Observat io ns a nd p revious exp eriments

' P ropose hypothesis

' Design experime nt

Collect and a nalyze data Yes

'

' Determine if dat a are biased

' NO

Refine hypothesis

'

Repeat expe r iments

' If results are cons isten t

Accept as theory

' If u n usually h ig h level of confidence

Accept as law

Scientific method. Th is flowchart summari zes the classic ide al of how new pr inc iples of science are developed. Init ial observations or resu lts from other ex per iments may lead to the formation of a new hyp othe sis. As mo re test ing is performe d to eliminate outside influences or biases and ens ure consis tent resul ts, sc ien t ists be gin to have more confi den ce in the pr incip le an d call it a theory or law.

FIGURE 1 -1

UNIT 1 Th e B o d y a s a W hole

n e w d e ba t es co n c e rning how our cultur e d e fi n es wh a t it m e ans t o b e a h uma n b e ing

As you stud y th e conc e pts pr ese nt e d in th is boo k, k ee p in min d t hat th ey ar e not se t in ston e . Scie nc e is a rap idl y c h anging se t of id e as and proc esses that not o nl y is infl u e nc e d b y our c ul tura l b ia ses but also affe cts our c u ltural awar e n ess of wh o we ar e .

CONNECT IT ! @

Fo r a quick peek at the major scienti fi c b rea kthroug hs t hat have changed our lives - and serve as t he co re concepts of this book - check o ut The Nobel Legacy o n line at Connect It!

• ANATOMY AND PHYSIOLOGY

ANATOMY

Anatom y is oft e n d e fin e d as stud y of th e structur e of an organi sm an d t h e re lation sh ip s of its parts. T h e wor d anatom y is d e ri ve d from G ree k word parts t hat m e an " to cut a p art. " St ud e nts of anatom y still l e arn about th e structur e of th e human bod y b y lit e ra ll y cutting it apa rt. T h is proc ess, ca ll e d di ss ection , re ma in s a principa l t e chniqu e use d to isolate and stud y th e structural compon e nts or parts of th e human bo dy

Bi olog y is d e fi n e d as th e sc ie nt ific stu d y of life Both a n atom y an d ph ys io logy ar e sub divisio n s of th is ve ry broa d ar e a of in qu iry. Each of t h ese su bdi vision s can b e furth e r di vid e d in t o small e r ar e as of stu dy For e xampl e , th e t e rm g ross a n a t o m y is use d to d es c rib e th e st u d y of bo dy p arts visib l e to th e n ak e d eye Befor e in ve n t io n of th e microscop e, ana t om ists h ad t o stud y h uman stru ctur e by re lying onl y o n t h e eye during di sse ctio n Th ese e a rl y anatomi sts co u l d make onl y a gro ss , or wh o le, e xam ination, as you can see in Figure 1-2. W ith th e use of mod e r n micro scop es , man y anatomi sts no w sp e cia li ze in m ic rosco pi c a n a t om y, including th e stu dy of c e ll s, call e d cytol og y (sye -TOL-oh-j ee), a n d ti ss u es, call e d hi stolog y ( hi s-T O L-oh-j ee) .

Oth e r branc h es of anatom y in clud e th e st ud y of human growth a n d d eve lopm e n t (de velopmental anatom y) a n d th e study of d ise ase d bo dy struc t ur es (pathological anatom y) I n th e c h apte rs th a t follo w, you will st u d y th e b od y b y sys t e m s- a proc ess ca ll e d sys temic anatom y Sys te m s ar e gro u ps of organ s that h a ve a commo n fu n ction , su c h as th e bon es in th e sk e le ta l sys t e m a n d t h e mu scl es in th e m u sc u lar sys t e m.

PHYSIOLOGY

Ph ys io logy is th e sci e nc e th at d eal s with th e fu nc ti on s of th e li ving organi sm a n d its parts Th e t e rm ph ys iolog y is a co m bina t ion of two Gr ee k word s (ph ysis, " nat u re," and logo s, "words or stud y") . Simpl y state d, it is th e st ud y of p h ys iology that h e l ps us u n d e rstan d h ow th e bod y wo rks. Ph ys iolog ists atte m p t to di sco ve r an d u n d e rstand t h e in tricate control sys te m s t h at p e rmi t t h e bod y to op e ra t e an d su rvive in chang ing a n d ofte n ho st il e e n vironm e n ts

As a sci e nt ifi c di sci p li n e, ph ys iolo gy can b e subd ivid e d accord ing to ( l ) th e typ e of organ ism in vol ve d , such as hu man ph ys io logy or p lan t ph ys io logy ; (2 ) th e o rgan izat iona l leve l studi e d , suc h as mole cular or ce ll ular p h ys iology; or ( 3) a sp e ci fi c o r sys temic fun ct ion b e ing st ud ie d , such as n e uroph ys iology, res p iratory p h ys io logy, or cardio vasc ul ar ph ys iology

I n t h e chapt e rs th a t follo w, you will see aga in and agai n that anatomica l parts ha ve structur es e xac tl y suit e d to p e rform sp e ci fi c fu n ct ions . E ac h h as a p articular size , shap e , form , or po sitio n in th e bod y re late d dir e c tly to its a b ility to p e rform a un iqu e an d sp e ciali ze d activity. Thi s pr incipl e- th at structure fits function - e xplai ns wh y stu d yin g ana t om y a n d p h ys iology tog e th e r is th e key to und e rsta n ding th e huma n body

Quick CHECK

1. Desc r ibe how scie nce d eve lops new p r inciples.

2. Defi ne anatomy and physiology.

3. List the th ree ways in whic h p hysiolo g y can be sub d ivi d ed as a scie nt if ic discipli ne.

4. What name is used to describe the st ud y of the body that f oc uses on groups of o rgans t hat have a commo n fu n ction?

LANGUAGE OF SCIENCE AND MEDICINE

You ma y ha ve notic e d b y n ow that man y sc ie n t ific t e rm s, such as anatom y an d ph ys iolog y, ar e ma d e up of no n -Eng li sh word pa rts Man y suc h t e rm s mak e up t h e cor e of th e la n g u age u se d to commun icat e id e as in sci e n c e an d m e dic in e . Lea rning in sci e nc e thu s b e gin s with le arning a n ew voca bu lary, just as wh e n you l e ar n a n ew languag e to h e lp you und e rsta n d and commun ica t e in a reg io n of th e wo rl d oth e r th an th e o n e you call h om e .

To h e lp you l e ar n t h e vocabu lary of a n atom y an d p h ys iology, we ha ve pro vid e d seve ral h e l p ful tool s for you. With in e ac h chapte r, li sts of n ew t e rm s titl e d Language of Science a n d Language of Medicine gi ve you e ach n ew key (bo ld fac e) t e rm that you will b e le ar n ing in th at c h apt e r. Eac h t e rm in th e l ist ha s a pronu nciat io n g u id e a n d an e xplana t io n (o r m e an ing ) of e ac h of th e word parts that mak e u p th e te rm.

Th is famous woodcu t of a gross dissect ion appeared in the wor ld's fi rst modern anatomy textbook , De Humani Corporis Fabrica (On the Structure of the Human Body), in 1543 Th is woodcut featu res the book 's author, Andreas Vesa lius , who is cons ide red to be t he founder of modern anatomy. The body be ing dissected is ca ll ed a cadaver.

We ha ve al so in clud e d a se parat e compact refe re n ce ca ll e d Qui CK Gu iDE TO THE LA NGUAGE OF SCIENCE AND MEDI CINE with thi s t extbook. T ak e a mom e nt n ow to locat e it. Afte r you h a ve finish e d re a ding th is c h apte r, qu ick ly rev iew th e tip s fo r l e a rn ing sci e nt ific lang u ag e . Th e n kee p it n e a rb y so that you will h a ve a h a n dy li st of commonl y u se d wo rd parts at your fing e rtip s

You will see that mo st sci e ntific te rm s ar e ma de u p of word parts from Latin or Gr ee k. Most Wes te rn sc ie n t ists first b ega n co rres pond ing

FIGURE 1-2 Gross anatomy.

with one another in th ese languages, b eca u se they we re co mm onl y th e first writte n languages lea rn e d by e ducate d people Oth e r languages such as G e rman , Frenc h , an d Japa n ese are also so ur ces of som e scie ntific wo rd parts .

As with a n y la n g u age, sc ie ntifi c language changes co n stantl y T hi s is u se fu l b ec au se we oft e n n ee d to fin e-tun e our te rm inology to re fl ec t changes in ou r und e rst a ndi ng of sc ie nc e a nd to acco mm odate n ew di scove r ies But it a lso so m e t im es l ea d s to confusion.

I n an atte mpt to cl ea r up so m e of th e con fu sion , th e I n te rn at io n a l Fe d e ra ti o n of Assoc iatio n s of Ana t om ists (IFM) forme d a wo rld wid e comm ittee to pu bli sh a li st of " uni ve rsa l" o r standard anatomica l te rm i no logy. Th e li st for gross anatom y, th e stru ct ur e we ca n see without m agn ific a tion , was p u bl ish e d in 199 8 as Termin ologia Anatomica (TA ) In 200 8 Termin ologia Hi stologica (T H ) was pub l ishe d for mi croscopic anatomy- th e stud y of body stru ct ur e re qu i ring signifi can t magnification fo r th e purpose of visuali za t io n .

Alth ough th e re re m a i n so m e alterna t e (a nd n ewe r ) te rm s u se d in anatomy, th e li sts are u se fu l standard refe re n ces. T h e li sts show eac h t e rm in L atin and Engli sh (base d o n th e L at in form ), a l ong with a re fe rence num be r. In thi s textbook we u se th e Eng l ish t e rm s from th e pub li sh e d li sts as our st andard re fe rence, but we do occasiona ll y re fe r to th e pur e Latin form or an alterna t e t e rm wh e n appropriate for beginning st ud e nts

On e of th e basic princip les of th e sta ndard ize d t e rm i no logy is th e avoida n ce of eponyms, o r t e rm s that a re b ased on a pe rson's nam e . In st ea d , a mor e d esc ripti ve Lat i n-ba se d te rm is a l ways pr efe rr e d. T hu s th e t e rm eustachian tube (tub e connec t e d to th e middl e ea r, n amed after th e famed Italian anatomis t Eu st ac hiu s) is no w rep lac e d with th e mor e d esc ripti ve auditory tube. Lik ew ise, th e islets of Langerhans (in th e pancreas) are no w simpl y pancreatic islets

I n th e rare cases wh e re epo n ym s do ap p ea r in a stan dar d l ist , we n ow avo id th e p ossess ive form T hu s Bowman's capsule (in kidn ey tiss u e) is no w e ith e r glomerular capsule or Bo wman capsule.

The re are no suc h sta nd a rd li sts of ph ys iolog ical te rm s Ho weve r, ma n y p rin c i p les u se d in anatom ical te rm i no logy are u se d in p h ys iology For examp le, m os t t e rm s h ave an Engli sh sp e lli ng but are ba se d on Latin or Greek wo rd parts And , as in anatomy, epony m s are l ess favo re d th a n d esc rip ti ve te rm s .

A Qui CK G u iDE TO THE LANGUAGE OF SC IENCE AN D MEDIC INE acco mp an ies t hi s book. It offers a handy su mma ry of th e basic pr i nc ip l es of using yo ur n ew "A& P lang u age ." The quick gu id e a lso li sts co mm on ro ots, pr e fix es, and su ffixes- a lo n g with acrony m s, a b breviations, Greek le tt e rs, Rom an num e ral s, a nd much more

T hi s may all see m like a lot mor e than yo u wa nt to know right now. Ho weve r, if yo u focu s on lea rning the n ew wo rds as yo u begin eac h new to p ic, as tho u gh yo u are in a fore ign land an d n ee d to pic k up a few phra ses to get by, yo u will find your study of anatomy and p h ys iology easy a nd en joyab le

TABLE 1-1

CHARACTERISTIC

Responsiveness

Conductivity

Growth

Respiration

Digestion

Absorption

Secretion

Excretion

Circulation

Reproduction

Chapter 1 Organizat ion of the Body 5

CHARACTERISTICS OF LIFE

Anatomy and ph ys iology a re imp ort a n t d isc ip l in es in bi ology-th e stud y of li fe But w h at is l ife? What is th e qua li ty that d isti ng ui shes a vita l and functional b e i ng from a d ea d body? We know tha t a li ving o rga ni sm is e ndo we d with certain character ist ics n ot associated with inorgan ic m atter. Ho weve r, it is somet im es hard to fi n d a singl e crite rion to d e fin e life

On e co uld say that living orga n ism s a re sel f-o rgan izing or sel fmaintaining an d n onlivi ng str u ctures are not. T hi s concept is called a utopoies is, which lite rall y m ea n s "self- maki n g." Anoth e r id ea, called th e cell theory, sta tes that any i nd e p e nd e nt str u cture m ade up of one or mor e microsco p ic u nits called cells is a living organ ism.

In stea d of trying t o fi n d a singl e d iffe re nc e th a t sepa rat es li ving and nonliving thing s, sc ient ists somet im es d e fin e life b y li sting what a re oft en called characteristics of life. Li sts of c h aracteristics of li fe ma y diffe r from o n e p h ys iologi st to the n ex t , d epen ding o n th e type of organism b e ing stud ie d a nd th e way in whi c h li fe func t io n s are grouped an d d e fin e d . Attributes th at character ize li fe i n bacte ri a, plants, o r an imal s may va ry. C h aracteris t ic s of li fe th at are conside re d mo st impo rt an t in h uman s a re d esc r i b e d in Table 1-1 .

Eac h c h aracteristic of li fe is re late d to th e s um t otal of all th e ph ys ical a nd chem ical rea ction s occu rring in th e body. T h e te rm me t abo l ism is u se d t o d esc rib e th ese va r iou s p ro cesses T h ey includ e th e steps in vo lve d in th e br ea kdo wn of nutri en t mat e ri als to produc e e n e rgy and th e tran sformation of o n e mate r ial in to anothe r. For exa mpl e, if we ea t and absor b mor e sugar than n ee d e d for th e bod y's imm e diate e n e rgy re qu i remen ts, it is co n ve rt e d i nto an a lte rnat e form, such as fat , th a t ca n b e sto re d in th e bod y

M e tabolic reac t io n s a re a lso re qu ir e d for mak i ng comp lex compound s out of simpl e r ones, as in tiss u e growth, wo und re pair , or manufactur e of body sec re ti o n s .

Eac h cha racte r istic of life- its fun ct iona l ma nifes tation in th e bod y, its integ rat io n with oth e r bo dy function s a nd structur es, a nd its

Characteristics of Human Life

DESCRIPTION

Abi lity of an organism to sense, mon ito r, and respond to changes in both its external and internal env ironments

Capacity of living cells to transmit a wave of e lectrical d isturbance from one point to another within the body

Organized increase in the size and number of cells and the refore an increase in size of the ind ividual o r a particular o rgan o r part

Exchange of resp iratory gases (oxygen and carbon d ioxide) between an organism and its env ironment

Process by which complex food products are broken down into simp l er substances that can be absorbed and used by indivi dual body cells

Movement of molecu l es, such as resp iratory gases or d igested nutrients, throug h a membrane and into the body flu i ds for tra nsport to cells for use

Production and re lease of important substances, such as diges tive j uices and hormones, fo r diverse body functions

Remova l of waste products from the body

Movement of body flu ids containing many substances from one body area to another in a continuous, circula r route through hollow vesse ls

Formation of new indivi dua l offspring

UNIT 1 Th e B o d y a s a W hole

m e c h an is m of control - is t h e subj e ct of stud y in su b se q u e n t c h apt e rs of t h e t e xt.

Quick CHECK

5. What is an eponym?

6. What single cr iterion migh t be used to define lif e?

7. Define t he term metabolism as it applies to the characterist ics of life.

• LEVELS OF ORGANIZATION

Be for e you b e gin th e stud y of t h e structur e an d functio n of th e h uma n b od y and i ts m an y pa r ts, it is important to t h i nk abo u t ho w th e parts ar e organ i ze d and ho w t h ey might l ogicall y fi t tog e th e r an d

Ato m

Chemical level (Chapters 3-4)

M olecu l e Vesicles

function e ffe cti vel y. Be ca u se yo u a lr e ad y kn ow t h at structure fit s functi on , i t sh o u l d not s u rpri se you that th e h igh l y co m p l e x and coordinate d funct i ons of t h e who l e bod y can b e un d e rstood by d isco ve ring t h e ma n y bas i c proc esses t hat occ u r in t h e s m a ll e r parts , s u c h a s organ s, t iss u es , an d c e ll s Th ese d iffe r i n g le vels of organiz ation t h at h e lp u s b e tte r und e r sta n d t h e bo d y ar e illu st rate d i n

Figure 1-3

CHEMICAL LEVEL

Note that organi z a t io n of t h e body b egi n s a t t h e ch e m ica l l eve l (see Figure 1-3) . Th e r e ar e mo r e t h an 100 d i ffe r e n t ch e m ica l bu i l d ing b l ocks of natu r e call e d a t o m s - tin y sph e res of ma tte r s o s m all th ey ar e in visi b l e . E ve ry ma t e ri al th ing in our un i ve rse, incl u d ing t h e huma n body, is co mp ose d of atom s Comb in ation s of atom s form la rge r ch e m ica l gro u p i ngs,

N euro n

call e d m o l ec ul es . Mol e cu l es, i n t urn, ofte n comb i n e w it h o t h e r a t om s a n d m o l e cu l es to fo rm la rge r a n d m or e comp l e x ch e m i cal s, call e d m ac r o m o l ec ul es . T h e uniqu e and co m p l e x rel at ion sh i ps t ha t exi st among atom s, m ol e cul es, and macromo l e cul es i n li ving mat e rial form a ge l-lik e mate r i al mad e of fl u i ds, parti cl es, and m e mb r an es call e d cytopla sm - th e esse n ti al mate rial of huma n life

Group of ne u rons and suppo rt ce ll s

• Organelle level · (Chapters 5-7)

Organ system level (Chapters 10-46)

Cellular level (Chapters 5-7)

In tegume ntary Tissue level (Chapters 8-9)

Skele t al

M usc u lar Card iovascula r

Un l ess prop e r r e l ati on sh ip s amo n g ch e m i cal e l e m e nts ar e maintain e d , d e ath res ults

Main t ain ing t h e typ e of ch e mica l organ i z atio n in c yto p las m r e quir e d for l ife r e qui r es t h e e xp e nditur e of e n e rgy I n C h apte rs 3 and 4 , impo r ta n t in formatio n re late d to t h e ch e mi stry of life is di scu sse d in mor e d e ta il.

Organ level (Chapter ' rj

Endocrine

FIGURE 1 -3 Levels of organization. The sma ll est parts of the body are the atoms that make up the chem ica ls, or mo lecules , of the body Mo lecules , in turn , make up microsco pi c parts ca lled organelles that f it togethe r to fo rm each ce ll of the body Groups of simil ar ce lls are called tissues, wh ich comb ine with oth er t issues to fo rm ind ividua l organs. Groups of organs that work together are ca ll ed systems All the systems of the body together make up an ind ividual organ ism Knowledge of the diffe rent leve ls of organ izati on will help you understand the basic concepts of human anatomy and ph ys iology.

B ra in