20.9 Endocrine Functions of the Kidneys, Heart, Gastrointestinal Tract, and Gonads 624
20.9a Kidneys 625
20.9b Heart 625
20.9c Gastrointestinal Tract 625
20.9d Gonads 625
20.10 Aging and the Endocrine System 625
20.11 Development of the Endocrine System 625
20.11a Adrenal Glands 625
20.11b Pituitary Gland 625
20.11c Thyroid Gland 627
Chapter 21
Blood 631
21.1 General Composition and Functions of Blood 632
21.1a Components of Blood 632
21.1b Functions of Blood 633
21.2 Blood Plasma 633
21.2a Plasma Proteins 633
21.2b Differences Between Plasma and Interstitial Fluid 634
21.3 Formed Elements in the Blood 634
21.3a Erythrocytes 635
21.3b Leukocytes 642
21.3c Platelets 644
21.4 Hemopoiesis: Production of Formed Elements 645
21.4a Erythropoiesis 647
21.4b Thrombopoiesis 647
21.4c Leukopoiesis 647
Chapter 22
Heart 650
22.1 Overview of the Cardiovascular System 651
22.1a Pulmonary and Systemic Circulations 651
22.1b Position of the Heart 652
22.1c Characteristics of the Pericardium 652
22.2 Anatomy of the Heart 653
22.2a Heart Wall Structure 654
22.2b External Heart Anatomy 654
22.2c Internal Heart Anatomy: Chambers and Valves 654
22.3 Coronary Circulation 660
22.4 How the Heart Beats: Electrical Properties of Cardiac Tissue 662
22.4a Characteristics of Cardiac Muscle Tissue 662
22.4b Contraction of Heart Muscle 663
22.4c The Heart’s Conducting System 664
22.5 Innervation of the Heart 665
22.6 Tying It All Together: The Cardiac Cycle 667
22.6a Steps in the Cardiac Cycle 667
22.6b Summary of Blood Flow During the Cardiac Cycle 667
22.7 Aging and the Heart 670
22.8 Development of the Heart 671
Chapter 23
Vessels and Circulation 677
23.1 Anatomy of Blood Vessels 678
23.1a Blood Vessel Tunics 678
23.1b Arteries 679
23.1c Capillaries 680
23.1d Veins 684
23.2 Blood Pressure 685
23.3 Systemic Circulation 686
23.3a General Arterial Flow Out of the Heart 686
23.3b General Venous Return to the Heart 687
23.3c Blood Flow Through the Head and Neck 687
23.3d Blood Flow Through the Thoracic and Abdominal Walls 691
23.3e Blood Flow Through the Thoracic Organs 694
23.3f Blood Flow Through the Gastrointestinal Tract 695
23.3g Blood Flow Through the Posterior Abdominal Organs, Pelvis, and Perineum 699
23.3h Blood Flow Through the Upper Limb 699
23.3i Blood Flow Through the Lower Limb 703
23.4 Pulmonary Circulation 703
23.5 Review of Heart, Systemic, and Pulmonary Circulation 706
23.6 Aging and the Cardiovascular System 708
23.7 Blood Vessel Development 708
23.7a Artery Development 708
23.7b Vein Development 709
23.7c Comparison of Fetal and Postnatal Circulation 710
Chapter 24
Lymphatic System 718
24.1 Functions of the Lymphatic System 719
24.2 Lymph and Lymph Vessels 720
24.2a Lymphatic Capillaries 720
24.2b Lymphatic Vessels 720
24.2c Lymphatic Trunks 721
24.2d Lymphatic Ducts 721
24.3 Lymphatic Cells 721
24.3a Types and Functions of Lymphocytes 723
24.3b Lymphopoiesis 727
24.4 Lymphatic Structures 729
24.4a Lymphatic Nodules 729
24.4b Lymphatic Organs 729
24.5 Aging and the Lymphatic System 735
24.6 Development of the Lymphatic System 735
Chapter 25
Respiratory System 741
25.1 General Organization and Functions of the Respiratory System 742
25.1a Respiratory System Functions 742
25.2 Upper Respiratory Tract 744
25.2a Nose and Nasal Cavity 744
25.2b Paranasal Sinuses 744
25.2c Pharynx 744
25.3 Lower Respiratory Tract 747
25.3a Larynx 747
25.3b Trachea 751
25.3c Bronchial Tree 752
25.4 Lungs 756
25.4a Pleura and Pleural Cavities 756
25.4b Gross Anatomy of the Lungs 756
25.4c Blood Supply To and From the Lungs 757
25.4d Lymphatic Drainage 759
25.5 Pulmonary Ventilation 760
25.6 Mechanics of Breathing 761
25.6a Skeletal Muscles of Breathing 761
25.6b Volume Changes in the Thoracic Cavity 761
25.7 Innervation of the Respiratory System 762
25.7a Ventilation Control by Respiratory Centers of the Brain 762
25.8 Aging and the Respiratory System 765
25.9 Development of the Respiratory System 768
Chapter 26
Digestive System 773
26.1 General Structure and Functions of the Digestive System 774
26.1a Digestive System Functions 774
26.2 Oral Cavity 775
26.2a Cheeks, Lips, and Palate 775
26.2b Tongue 776
26.2c Salivary Glands 776
26.2d Teeth 778
26.3 Pharynx 779
26.4 General Arrangement of Abdominal GI Organs 781
26.4a Peritoneum, Peritoneal Cavity, and Mesentery 781
26.4b General Histology of GI Organs (Esophagus to Large Intestine) 782
26.4c Blood Vessels, Lymphatic Structures, and Nerve Supply 784
26.5 Esophagus 784
26.5a Gross Anatomy 784
26.5b Histology 785
26.6 The Swallowing Process 786
26.7 Stomach 787
26.7a Gross Anatomy 787
26.7b Histology 788
26.7c Gastric Secretions 788
26.8 Small Intestine 791
26.8a Gross Anatomy and Regions 791
25.3d Respiratory Bronchioles, Alveolar Ducts, and Alveoli 754
26.8b Histology 793
26.9 Large Intestine 793
26.9a Gross Anatomy and Regions 793
26.9b Histology 795
26.9c Control of Large Intestine Activity 796
26.10 Accessory Digestive Organs 797
26.10a Liver 797
26.10b Gallbladder 798
26.10c Biliary Apparatus 800
26.10d Pancreas 802
26.11 Aging and the Digestive System 803
26.12 Development of the Digestive System 804
26.12a Stomach, Duodenum, and Omenta Development 804
26.12b Liver, Gallbladder, and Pancreas Development 804
26.12c Intestine Development 804
Chapter 27
Urinary System 811
27.1 General Structure and Functions of the Urinary System 812
27.2 Kidneys 814
27.2a Gross and Sectional Anatomy of the Kidney 814
27.2b Blood Supply to the Kidney 815
27.2c Innervation of the Kidney 817
27.2d Nephrons 817
27.2e Collecting Tubules and Collecting Ducts: How Tubular Fluid Becomes Urine 820
27.2f Juxtaglomerular Apparatus 822
27.3 Urinary Tract 822
27.3a Ureters 822
27.3b Urinary Bladder 824
27.3c Urethra 826
27.4 Aging and the Urinary System 828
27.5 Development of the Urinary System 829
27.5a Kidney and Ureter Development 829
27.5b Urinary Bladder and Urethra Development 829
Chapter 28
Reproductive System 836
28.1 Comparison of the Female and Male Reproductive Systems 837
28.1a Perineum 837
28.2 Anatomy of the Female Reproductive System 838
28.2a Ovaries 838
28.2b Uterine Tubes 845
28.2c Uterus 847
28.2d Vagina 849
28.2e External Genitalia 850
28.2f Mammary Glands 851
28.3 Anatomy of the Male Reproductive System 855
28.3a Scrotum 855
28.3b Spermatic Cord 857
28.3c Testes 857
28.3d Ducts in the Male Reproductive System 860
28.3e Accessory Glands 861
28.3f Semen 862
28.3g Penis 863
28.4 Aging and the Reproductive Systems 865
28.5 Development of the Reproductive Systems 866
28.5a Genetic Versus Phenotypic Sex 866
28.5b Formation of Indifferent Gonads and Genital Ducts 866
28.5c Internal Genitalia Development 868
28.5d External Genitalia Development 868
Appendix: Answers A-1
Glossary G-1
Index I-1
Preface
What Makes This Book Special?
Human anatomy is a fascinating field that has many layers of complexity. The subject is difficult to teach, and students can often be overwhelmed by its massive amount of material. Our goal in writing Human Anatomy was to create a textbook that guides students on a clearly written and expertly illustrated beginner’s path through the human body. For all five editions it has been of paramount importance to make this book enjoyable to read, easy to understand, pedagogically efficient, and visually engaging. The following pages highlight the enhancements we’ve made to the fifth edition, as well as the hallmark features that define this book.
New to the Fifth Edition
New research findings, shifting terminology, technological advancements, and the evolving needs of students and instructors in the classroom require textbook authors to continually monitor and revise their content. Throughout the fifth edition, changes have been made to incorporate the latest information, bring terminology up to date, and improve wording to make discussions easier for students to read and understand. Highlights of these revisions are as follows.
Global Changes
The Fifth Edition received some global changes to increase student understanding and success.
■ Learning objective numbers are now listed sequentially throughout each chapter.
■ Clinical views are now numbered within each chapter for easier reference.
Clinical View 2.2
Tay-Sachs Disease
Tay-Sachs is a rare, inherited “lysosomal storage disease” that results in the buildup of fatty material in nerve cells. Healthy, properly functioning lysosomes are essential for the health of the cells and the whole body. Tay-Sachs disease occurs because one of the approximately 50 different lysosomal enzymes is missing or nonfunctional. Lysosomes in affected individuals lack an enzyme that is needed to break down a complex membrane lipid. As a result, the complex lipid accumulates within cells. The cellular signs of Tay-Sachs disease are swollen lysosomes due to accumulation of the complex lipid that cannot be digested. Affected infants appear normal at birth, but begin to show signs of the disease by the age of 6 months. The nervous system exhibits the most damage with development of paralysis, blindness, and deafness followed by death by the age of 4. Unfortunately, there is no treatment or cure for this deadly disease.
■ Updates to wording of content discussions have been made via heat map data from LearnSmart/SmartBook where appropriate to improve student understanding.
■ Page references have been removed throughout the text, including outlines and chapter summaries, and replaced with references to section numbers, for greater ease of navigation of the content within digital formats.
■ More forward and backward references to appropriate topics in other chapters have been included, to improve critical thinking and to more greatly assist students in making connections of concepts.
■ Removed blank lines in front of matching and MC questions within the chapter review of each chapter, for greater ease of reviewing within digital formats.
Chapter 1 A First Look at Anatomy Section 1.1, “History of Anatomy,” is rewritten to make it more concise and more applicable. Section 1.4e was updated for clarity. Figures 1.2 and 1.5a are new and multiple figures have been enhanced. Tables 1.2 and 1.3 have been revised for precision.
Chapter 2 The Cell: Basic Unit of Structure and Function Terms and wording have been updated to clarify content. Multiple figures have been updated and Clinical View terms have been revised to refine and illuminate topic coverage.
Chapter 3 Embryology Clinical views have been updated where appropriate. Multiple figures have been revised and enhanced. The section on ovulation has been modified for greater clarity and accuracy. Clinical View 3.4 has been updated to reflect primary terminology in use.
Chapter 4 Tissue Level of Organization Figure 4.3 was added to provide a clearer classification of epithelium. Many tables have been revised and enhanced. Content descriptions regarding tissue classification and classification by number of cell layers has been revised. Clinical Views 4.1, 4.2, 4.4, and 4.5 have been updated.
Chapter 5 Integumentary System Terminology has been revised. A more concise description of melanin has been included. Content regarding hirsuitism has been added and the section on merocrine gland functions has been tightened up. Clinical View 5.8 (Psoriasis) is new.
Chapter 6 Cartilage and Bone Multiple figures have been improved. The discussion regarding movement and hemopoiesis has been refined. Clinical View 6.1 has been updated.
Chapter 7 Axial Skeleton Multiple figures have been enhanced for clarity. Wording for the Clinical View on craniosynostosis has been
More blunt supraorbital margin More prominent superciliary arch
mental protuberance
revised and refined. Table 7.4 has received new images to better distinguish sex differences in the skull.
Chapter 8 Appendicular Skeleton Multiple figures have received enhancements to clarify content. Clinical Views 8.5 and 8.6 have been updated.
Chapter 9 Articulations Text updates have been made to make descriptions and section discussions more concise. Table 9.2 has been enhanced and increased APR links for figures have been included.
Chapter 10 Muscle Tissue and Organization Several figures have been improved. The section on sarcomere has been revised and Section 10.3 has been modified. Sections on Muscle Atrophy and Muscle hypertrophy have been reordered. Added a discussion for the change in terminology from origin and insertions to proximal and distal attachments or superior and inferior attachments.
Chapter 11 Axial Muscles A new paragraph was added to discuss changing of origin and insertion in tables with superior and inferior attachment. Writing in Clinical Views has been tightened and additional links and references for APR resources were added.
Chapter 12 Appendicular Muscles A paragraph on using proximal and distal attachments was added. Multiple figures were upgraded and a new photo for Clinical View 12.3 was selected.
Chapter 13 Surface Anatomy An increased number of references forward and backwards to appropriate topics, provide greater integration of concepts.
Chapter 14 Nervous Tissue Clinical Views were numbered sequentially and reviewed for enhancement. Clinical View 14.1, regarding neuroplasticity, was created. Multiple figures were enhanced.
Chapter 15 Brain and Cranial Nerves Multiple figures and tables were enhanced. A new Clinical View on Autism has been added.
Chapter 16 Spinal Cord and Spinal Nerves Most tables and many figures have been revised and upgraded. The Clinical View on lumbar puncture has been revised and updated, and tables 16.2 and 16.3 were clarified.
Clinical View 16.3
Brachial Plexus Injuries Injuries
especially in individuals aged 15–25. Minor plexus injuries are treated by simply resting the limb. More severe brachial plexus injuries may require nerve grafts or nerve transfers; for very severe injuries, no effective treatment exists. Various nerves of the brachial plexus may be injured.
Axillary Nerve Injury
The axillary nerve can be compressed within the axilla, or it can be damaged if the surgical neck of the humerus is broken (recall that the axillary nerve travels posterior to the surgical neck of the humerus).
A patient whose axillary nerve is damaged has great difficulty abducting the arm due to paralysis of the deltoid muscle, as well as anesthesia (lack of sensation) along the superolateral skin of the arm.
Radial Nerve Injury
The radial nerve is especially subject to injury during humeral shaft fractures or in injuries to the lateral elbow. Nerve damage results in paralysis of the extensor muscles of the forearm, wrist, and fingers. A common clinical sign of radial nerve injury is wrist drop, meaning that the patient is unable to extend his or her wrist. The patient also experiences anesthesia along the posterior arm, the forearm, and the part of the hand normally supplied by this nerve.
Posterior Cord Injury
The posterior cord of the brachial plexus (which includes the axillary and radial nerves) is commonly injured in the axilla. One cause is improper use of crutches, a condition called crutch palsy. Similarly, the posterior cord can be compressed if a person drapes the upper limb over the back of a chair for an extended period of time. Because this can happen if someone passes out in a drunken stupor, this condition is also referred to as drunkard’s paralysis. Fortunately, full function of these nerves is often regained after a short period of time.
Median Nerve Injury
The median nerve may be impinged on or compressed as a result of carpal tunnel syndrome because of the close confines of this narrow passage. Additionally, the nerve may be injured by any deep laceration of the wrist.
Chapter 17 Pathways and Integrative Functions Content discussions regarding somatosensory pathways, motor pathways, and direct pathways have been revised to better scaffold learning.
Chapter 18 Autonomic Nervous System Multiple figures have been replaced to provide greater clarity of concepts for students. Table 18.1 has been updated with new material and new sections on the Enteric Nervous System and autonomic tone were added. Sections 18.1 and 18.2 were revised to highlight content for greater clarity.
Chapter 19 Senses: General and Special The tonic versus phasic receptor discussion has been modified to include information regarding adaptation. Table 19.1 has received a change of the text and layout for consistency. Modality of stimulus section has been modified through a modification of the mechanoreceptor discussion to include baroreceptor as a type of mechanoreceptor.
Chapter 20 Endocrine System The introductory paragraph has been rewritten to improve and enhance concepts being introduced. Figure 20.8 and Clinical View 20.1 have been updated to reflect content in a more complete and concise manner.
Chapter 21 Blood The content and descriptions have been made more concise to enhance clarity. The Clinical View on Blood Doping has been revised for a more informational approach.
Chapter 22 Heart Multiple figures have been updated. Clinical Views 22.2 and 22.3 have been revised to reflect the most recent information in the field. Sections 22.2a and 22.2b, regarding heart-wall structure and external heart anatomy have been revised to enhance clarity.
Chapter 23 Vessels and Circulation Numerous figures have been updated. Figure 23.9a and figure 23.15 received special enhancements to coloration and labels to make the figures easier to follow for greater understanding.
Squarish
Figure 20.1
Nervous and Endocrine System Communication. (a) In the nervous system, neurons release neurotransmitters into a synaptic cleft to stimulate their target cells. (b) In the endocrine system, hormones are secreted by endocrine cells. The hormones enter the blood and travel throughout the body to reach their target cells.
Smoking, Emphysema, and Lung Cancer
Smoking results in the inhalation of over 200 chemicals that blacken the respiratory passageways and cause respiratory changes that increase the risk of (1) respiratory infections, and (2) cellular and genetic damage to the lungs that may lead to emphysema or lung cancer.
Deleterious effects of smoking also include vasoconstriction in the cardiovascular system due to nicotine, interference with oxygen binding to hemoglobin by carbon monoxide, and increased risk and severity of atherosclerosis. Reduced blood flow results in decreased delivery of nutrients and oxygen to cells in systemic tissues.
Smoking increases the risk of both stomach ulcers caused by Helicobacter pylori infection and cancer of the esophagus,
Clinical View 25.9 stomach, and pancreas. It also increases the risks associated with human papillomavirus (HPV) infection linked to increased risk of cervical cancer, and the risk of Alzheimer disease. Secondhand smoke is associated with an increased risk of bronchitis, asthma, and ear infections in children. Emphysema (em fi-sē mă; en = in, physema = a blowing) is an irreversible loss of pulmonary gas exchange areas due to inflammation of the terminal bronchioles and alveoli, in conjunction with the widespread destruction of pulmonary elastic connective tissue. These combined events lead to dilation of individual alveoli, resulting in a decrease in the total number of alveoli, and the subsequent loss of gas exchange surface area. The patient is unable to exhale effectively, so that stagnant, oxygen-poor air builds up within the abnormally large (but numerically diminished) alveoli. Most cases of emphysema result
Chapter 24 Lymphatic System Figure 24.1 has been enhanced to reflect lymph vessels as part of the dural sinuses. The section on types and functions of lymphocytes has been updated to clarify locations and functions of cells. Clinical View 24.1 on Lymphedema and 24.2 on HIV and AIDS have both been updated to reflect the most current research and information.
Chapter 25 Respiratory System Clinical Views 25.1 on Cystic Fibrosis and 25.3 on Aspirations of Foreign Materials, have been tightened and enhanced for more concise presentation of the content. Various images have been updated to promote greater clarity.
Chapter 26 Digestive System Multiple figures have been updated and enhanced with photo changes and function boxes to provide a more succinct approach to the content. Clinical View 26.7 on gallstones received new images. A new Clinical View on Cystic Fibrosis effects on the pancreas has been added.
Chapter 27 Urinary System Multiple figures have been revised to reflect the most current information available and increase accuracy. Text regarding the renal corpuscle has been modified to more clearly describe the filtration membrane.
Chapter 28 Reproductive System Multiple tables and figures have been updated and reorganized for clarity. Discussion and images about ovarian follicle development have been modified to clarify the length of these processes. Most of the Clinical Views throughout the chapter have been revised to reflect updates in information.
treatment for pulmonary infections, and taking oxygen supplementation if necessary.
Lung cancer is a highly aggressive and frequently fatal malignancy that originates in the epithelium of the respiratory system. Smoking causes about 85% of all lung cancers. Metastasis, the spread of cancerous cells to other tissues, occurs early in the course of the disease, making a surgical cure unlikely for most patients. Pulmonary symptoms include chronic cough, coughing up blood, excess pulmonary mucus, and increased likelihood of pulmonary infections. Some people are diagnosed based upon symptoms that develop after the cancer has already metastasized to a distant site. For example, lung cancer commonly spreads to the brain, so in some cases lung cancer is not discovered until the patient seeks treatment for a seizure disorder related to cancer in the brain.
Lung cancers are classified by their histologic appearance into three basic patterns: squamous cell carcinoma, adenocarcinoma, and small-cell carcinoma. Squamous cell carcinoma (kar si-nō mă; karkinos = cancer, oma tumor) may develop when the pseudostratified ciliated columnar epithelium lining the lungs changes to a sturdier stratified
Adenocarcinoma of the lung arises from the mucinproducing glands in the respiratory epithelium. It begins when DNA injury causes one of these cells to become malignant and begin to divide uncontrollably.
Small-cell carcinoma is a less common type of lung cancer; it originates in the main bronchi and eventually invades the mediastinum. This type of cancer arises from the small neuroendocrine cells in the larger bronchi; their secretions help regulate muscle tone in the bronchi and vessels. As a consequence of their endocrine heritage, some of these tumors secrete hormones. For example, a small-cell cancer of the lung occasionally releases ACTH, producing symptoms of Cushing syndrome (see Clinical View 20.5: “Disorders of Adrenal Cortex Hormone Secretion” in section 20.6a).
Nonsmoker’s lungs
Smoker’s lungs: Lungs are blackened.
Alveoli are small, numerous, and well formed.
Squamous cell carcinoma
An individual with advanced emphysema must rely on a portable oxygen tank, such
Themes and Distinctive Topic Approaches
Through our teaching experience, we have developed a few approaches that really seem to help students grasp certain topics or spark their interest. Thus, we have tried to incorporate these successful ideas from own courses into our book.
■ Embryology. Learning about embryologic events can increase understanding of the adult anatomy. For this reason, chapter 3, Embryology, appears early in the book. In addition, “systems embryology” sections in each systems chapter (e.g., integumentary system, digestive system) provide a brief but thorough overview of the developmental processes for that particular system.
■ Forensic Anthropology. Forensic examples are a great way to reinforce learning, and students enjoy the “real-life” application of anatomic knowledge in forensic analysis. The skeletal system chapters (6–8) feature discussions on topics such as determining age of death by evaluating epiphyseal plates and the pubic symphysis, and determining sex by noting differences in the skull and pelvis.
The os coxae is not only a reliable indicator of sex, but it also can provide a good estimate of a skeleton’s age at death. In particular, the pubic symphysis undergoes age-related changes. The pubic symphysis appears roughened or billowed in the teens and early 20s. Thereafter,
■ Surface Anatomy. To best serve our audience, we have dedicated a full chapter (13) to surface anatomy. This chapter contains beautiful photographs and clear, concise text as well as numerous Clinical Views that illustrate the importance of surface anatomy landmarks and how they are used daily in health care.
■ Nervous System. In order to understand the workings of the nervous system, it is best to learn how the brain controls all aspects of the nervous system. Thus, in this text we examine the brain first, followed by a chapter comparing its similarities, differences, and relationships to the spinal cord. It seemed appropriate to use central nervous system terminology to describe the brain first and then the spinal cord. Additionally, because the nuclei of the cranial nerves are housed within the brain, we felt it made more sense to present the cranial nerves along with the brain.
■ Arteries and Veins. Arteries and veins are covered in unison by region. For example, we present the arteries and veins of the upper limb together. This approach emphasizes to students that the arteries often have corresponding veins and that both are responsible for the blood flow in a general region.
Accurate and Engaging Illustrations
Because anatomy is a visual subject, quality illustrations are crucial to understanding and retention. The brilliant illustrations in Human Anatomy bring the study of anatomy to life! Drawn by a team of medical illustrators, all figures have been carefully rendered to convey realistic, three-dimensional detail. Each drawing has been meticulously reviewed for accuracy and consistency, and precisely labeled to coordinate with the text discussions.
Many illustrations use color coding to organize information and clarify concepts for visual learners.
C5 vertebra
View Orientation
Reference diagrams clarify the view or plane an illustration represents.
Radiocarpal joint
Radial collateral ligament
Intercarpal joints
Carpometacarpal joint of thumb
Multilevel Perspective
Illustrations depicting complex structures connect macroscopic and microscopic views to show the relationships between increasingly detailed drawings.
Neuromuscular junction
Sarcolemma
Synaptic knob
Path of nerve impulse
ACh receptor
Synaptic cleft
Endomysium Sarcolemma
Synaptic knob
Acetylcholine (ACh)
Sarcoplasm
Sarcolemma
Synaptic vesicles
Motor end plate
Acetylcholinesterase (AChE)
Axon of a motor neuron
Synaptic knob
Skeletal muscle fibers
(a)
(b)
LM 100x
Neuromuscular junction
Right radiocarpal joint, coronal section
Ulnar collateral ligament
Scaphoid
Triquetrum Lunate
Articular disc
Distal radioulnar joint
Art Program
Atlas-Quality Photographs
Human Anatomy features a beautiful collection of cadaver dissection images, bone photographs, surface anatomy shots, and histology micrographs. These detailed images capture the intangible characteristics of human anatomy that can only be conveyed in human specimens and help familiarize students with the appearance of structures they will encounter in lab.
Complementary Views
Drawings paired with photographs enhance visualization of structures. Labels on art and photos mirror each other whenever possible, making it easy to correlate structures between views.
Diaphragm
Adrenal gland
Kidneys
Renal artery Hilum
Renal vein
Inferior vena cava
Descending abdominal aorta
Ureters
Parietal peritoneum (cut)
Urethra
Urinary bladder
(a) Anterior view
Cadaver Dissections
Expertly dissected specimens are preserved in richly colored photos that reveal incredible detail. Many unique views show relationships between anatomic structures from a new perspective.
Manubrium
Suprasternal notch
Clavicular notch
Sternal angle
Body
Bones
Crisp, clear bone photographs paired with detailed drawings offer dual perspectives—artist’s rendition and actual specimen.
Surface Anatomy
Carefully posed and photographed, these images clearly demonstrate surface landmarks.
Floating ribs (11–12)
True ribs (1–7)
False ribs (8–12)
Right upper limb, lateral view
Deltoid
Long head
Lateral head
Lateral epicondyle of humerus
Olecranon
Biceps brachii
Brachialis
Brachioradialis Styloid process of radius Anatomic snu box
Extensor carpi radialis (longus and brevis)
Extensor digitorum
Extensor carpi ulnaris
Head and styloid process of ulna
Triceps brachii
Art Program
Nonciliated simple columnar cell
Basement membrane
Nonciliated simple columnar cell
Basement membrane
Histology Micrographs
Light micrographs, as well as scanning and transmission electron micrographs, are used in conjunction with illustrations to present a true picture of microscopic anatomy. Magnifications provide a reference point for the sizes of the structures shown in the micrographs.
Microvilli (brush border)
Goblet cell
Mucosa of small intestine
Microvilli (brush border)
Goblet cell
LM 400x
LM 100x
Cilia
Uterine tube
Basement membrane
Simple columnar epithelial cell
Cilia
Basement membrane
Simple columnar epithelial cell
Learning System
Helpful Pedagogical Tools
Human Anatomy is built around a pedagogical framework designed to foster retention of facts and encourage the application of knowledge that leads to understanding. The learning aids in this book help organize studying, reinforce learning, and promote critical-thinking skills.
Chapter Outline
Each chapter begins with a pagereferenced outline that provides a quick snapshot of the chapter contents and organization. Headings are numbered throughout the chapter for easy reference.
Outline
Learning Objectives
Numbered learning objectives at the beginning of each section help focus attention on critical information. Online question banks are synchronized with these objectives.
24.2 Lymph and Lymph Vessels
✓ Learning Objectives
2. Identify the components of lymph.
3. Outline the path of lymph from interstitial tissues to the circulatory system.
Excess interstitial fluid and solutes are returned to the blood through a lymph vessel network. When the combination of interstitial fluid, solutes, and sometimes foreign material enters the lymph vessels, the liquid mixture is called lymph (limf; lympha = clear spring water). The lymph vessel network is composed of increasingly larger vessels, as follows (from smallest to largest in diameter): lymphatic capillaries, lymphatic vessels, lymphatic trunks, and lymphatic ducts. Thus, the term “lymph vessel” is a general term to describe all of these specific lymphatic capillaries, vessels, trunks, and ducts.
Respiratory System
WHAT DID YOU LEARN? ● 2 What is lymph? ● 3 Describe the structure of lymphatic capillaries. Into what structures do they drain?
4 Which major body regions drain lymph to the right lymphatic duct?
What Did You Learn?
Review questions at the end of each section prompt students to test their comprehension of key concepts. These mini self-tests help students determine whether they have a sufficient grasp of the information before moving on to the next section of the chapter.
Learning System
Vocabulary Aids
Learning anatomy is, in many ways, like learning a new language. The terms used in this text follow the standards set by the FCAT (Federative Committee on Anatomical Terminology) and published in Terminologia Anatomica (TA), the international standard for anatomic vocabulary. Descriptive terms are emphasized, although eponyms are provided to help students equate common names with their proper anatomic term. Pronunciation guides and word origins derived from Stedman’s Medical Dictionary are included throughout the book to teach students how to say the terms and give them helpful, memorable hints for decoding meaning.
Anatomy & Physiology | REVEALED 3.2
When applicable, icons indicate where related chapter content can be found on McGraw-Hill’s Anatomy & Physiology REVEALED 3.2. These icons are clickable in the eBook, allowing students to hop directly to a specific area of Anatomy & Physiology | REVEALED 3.2.
Key terms are set in boldface where they are defined in the chapter, and many terms are included in the glossary at the end of the book.
Because knowing the derivation of a term can enhance understanding and retention, word origins are given when relevant. Further, a handy list of prefixes, suffixes, and combining forms is printed on the inside back cover as a quick reference for commonly used word roots.
What Do You Think?
These critical-thinking questions actively engage students in application or analysis of the chapter material and encourage students to think more globally about the content. Answers to What Do You Think? questions are given at the end of each chapter, allowing students to evaluate the logic used to solve the problem.
Segmental artery
artery
WHAT DO YOU THINK?
● 3 What types of study habits best convert short-term memories into long-term memories? Do you practice these habits when you study for your exams?
artery Interlobular artery
artery
Interlobar vein
vessels Medulla
Peritubular capillaries (associated with convoluted tubules)
Vasa recta (associated with nephron loop) Interlobular vein
Blood Supply to the Kidneys. A coronal view depicts kidney circulation. An expanded view shows circulation to a nephron. Pink boxes indicate vessels with arterial blood; lavender boxes indicate vessels where reabsorbed materials reenter the blood; blue boxes indicate vessels returning blood to the general circulation.
arteries (or cortical radiate arteries) that project peripherally into the cortex.
As the interlobular arteries enter the cortex, they extend small branches called afferent (af′ĕr- ĕnt; ad = toward, ferre = to lead) arterioles (or afferent glomerular arteriole). An afferent arteriole then enters a structure called a renal corpuscle and forms a capillary network called the glomerulus (glō -mer′y ū-lŭs; glomus = ball of yarn, ulus = small). Some blood plasma is filtered through the fenestrated epithelium of the glomerulus into the capsular space within the renal corpuscle. Once some of the blood plasma has been filtered, the remaining blood leaves the glomerulus and enters an efferent (ef′ĕr-ent; efferens = to bring out) arteriole (or efferent glomerular arteriole). The efferent arteriole is still carrying oxygenated blood because gas and nutrient exchange with cells of the kidney has not yet occurred.
The efferent arterioles branch into one of two types of capillary networks: peritubular capillaries or vasa recta (figure 27.4). These capillary networks are responsible for the actual exchange of gases, nutrients, and waste materials within the kidney. Peritubular capillaries are associated with the convoluted tubules and primarily reside in the cortex of the kidney. Vasa recta (vā′să rek′t ă; vasculum = small vessel, rectus = straight) are associated with the nephron loop and primarily reside in the medulla of the kidney.
Learning Strategy
The names of the blood vessels in the kidney can give you a clue as to their location or appearance:
■ Interlobar vessels are located between (“inter”) the lobes of the kidney.
■ A rcuate vessels form vessel “arcs” at the corticomedullary junction.
■ Interlobular vessels are located between the smaller lobules of the kidney cortex.
■ Afferent arterioles carry blood to the glomerulus (remember, “afferent” means “toward”).
■ Efferent arterioles take blood away from the glomerulus (remember, “efferent” means to take away, or “exit”).
■ Peritubular capillaries are around (“peri”) the tubules (proximal and distal convoluted tubules).
■ Vasa recta means “straight vessels,” and these vessels run parallel to the long, straight tubules of the nephron loop.
Learning Strategy
Many anatomy instructors provide students with everyday analogies, mnemonics, and other useful tips to help them understand and remember the information. Learning Strategy boxes throughout each chapter offer triedand-tested practical learning strategies that students can apply as they read. These tips are not just useful—they can also be fun!
Interlobar
Renal
Renal vein
Figure 27.4
816 Chapter Twenty-Seven Urinary System
Learning System
Clinical Context
Sometimes an example of what can go wrong in the body helps crystallize understanding of the “norm.” Clinical Views interspersed throughout each chapter provide insights into health or disease processes. Carefully checked by a clinician for accuracy with respect to patient care and the most recent treatments available, these clinical boxes expand upon topics covered in the text and provide relevant background information for students pursuing health-related careers.
Clinical View
Interesting clinical sidebars reinforce or expand upon the facts and concepts discussed within the narrative.
Clinical View 7.1
Craniosynostosis and Plagiocephaly
Sutures in the skull allow the cranium to grow and expand during childhood. In adulthood, when cranial growth has stopped, the sutures fuse and are obliterated. Craniosynostosis (krā′nē-ō-sin′os-tō′sis) refers to the premature fusion or closing of one or more of these cranial sutures. If this premature fusion occurs early in life or in utero, skull shape is dramatically affected. If not surgically treated, a craniosynostotic individual often grows up with an unusual craniofacial shape.
Sagittal synostosis is a condition where the sagittal suture fuses prematurely. As a result, the skull cannot grow and expand laterally as the brain grows, and compensatory skull growth occurs in an anterior-posterior fashion. A child with sagittal synostosis develops a very elongated, narrow skull shape called scaphocephaly, or dolicocephaly Coronal synostosis refers to premature fusion of the coronal suture, which causes the skull to be abnormally short and wide.
Craniosynostosis appears to have multiple causes, including genetics, teratogens (a drug or other agent that can cause
Clinical Terms
Selected clinical terms are defined at the end of each chapter.
Clinical Terms
autoimmune disease Disease in which the body’s immune system mistakenly attacks its own healthy tissues. Examples include systemic lupus erythematosus (SLE), multiple sclerosis (MS), rheumatoid arthritis, type 1 diabetes mellitus, and scleroderma.
birth defects), and environmental factors. Many people with craniosynostosis have no complications other than the unusual skull shape. Those who do experience complications may have increased intracranial pressure (leading to headache and seizures if severe), optic nerve compression, and intellectual disability (due to restricted brain growth).
Plagiocephaly is the term used to describe an asymmetric head shape, where one part of the skull (usually the frontal or occipital region) has an oblique flattening. Plagiocephaly may be caused by unilateral coronal craniosynostosis or asymmetric lambdoid synostosis. It also is commonly caused by normal deformational factors, such as sleeping on the same side of the head. Incidence of plagiocephaly has risen in the United States since the 1990s, primarily due to the National Institute of Child Health and Human Development Safe to Sleep Campaign (formerly called the Back to Sleep Campaign), which encourages parents to place children on their backs to sleep (instead of on their stomachs) so as to reduce the incidence of SIDS. Mild forms of plagiocephaly may be corrected by wearing a corrective helmet; more severe forms may necessitate surgery.
-m
lymphadenectomy (lim-fad′ĕ -nek′t
; = gland) Removal or excision of lymph nodes. lymphangitis (= vessel) Inflammation of the lymph vessels. splenomegaly (spl
-meg′
; mega = large) Enlarged spleen, often seen in association with infection (e.g., mononucleosis).
Sagittal synostosis
Coronal synostosis Plagiocephaly
(sagittal synostosis, coronal synostosis) Courtesy of Dr. John A. Jane, Sr., David D. Weaver Professor of Neurosurgery, Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; (plagiocephaly) Used with permission and copyright of Cranial Technologies, Inc.
End-of-Chapter Tools
Acarefully devised set of learning aids at the end of each chapter helps students review the chapter content, evaluate their grasp of key concepts, and utilize what they have learned. Reading the chapter summary and completing the Challenge Yourself exercises is a great way to assess learning.
Challenge Yourself
This battery of matching, multiple-choice, short answer, and critical-thinking questions is designed to test students on all levels of learning, from basic comprehension to synthesis of concepts.
Answers to What Do You Think?
The What Do You Think? questions are answered at the end of each chapter.
Challenge Yourself
Matching
Match each numbered item with the most closely related lettered item.
1. distal convoluted tubule
2. urethra
3. ureter
4. peritubular capillaries
5. glomerulus
6. efferent arteriole
7. urinary bladder
8. renal pyramid
9. cortex
10. renal pelvis
8. Describe the innervation of the ureters and urinary bladder.
9. Trace the course of fluid movement, beginning with the production of filtrate in the renal corpuscle and ending with the expulsion of urine from the urethra.
10. What is the cause of a urinary tract infection? Why are these infections more common in women?
Developing Critical Reasoning
1. While drinking many beers one night, Jason noticed that he had to urinate more frequently. The following morning, Jason’s
Answers to “What Do You Think?”
1. Without functioning kidneys, the blood would not be able to be filtered, so waste products would accumulate. This accumulation of toxic material in the blood leads to death unless the materials are filtered out.
2. ADH is secreted when the body is dehydrated, so the body can conserve what remaining water it has.
Multiple Choice
a. location of renal
corpuscle
b. expels urine outside the body
c. major calyces empty into this funnel-shaped region
d. most secretion occurs in this nephron segment
e. stores urine until it is voided
f. structural units that constitute the medulla
g. conducts blood out of the glomerulus
h. vessels involved in reabsorption
Chapter Summary Tables
Chapter summaries are presented in a concise, bulleted table format that provides a basic overview of each chapter. Section and page references make it easy to look up topics for review.
738 Chapter Twenty-Four Lymphatic System
Chapter Summary
24.1 Functions of the Lymphatic System
24.2 Lymph and Lymph Vessels
■ The lymphatic system transports interstitial fluid back to the circulatory system, transports dietary lipids, houses and develops lymphocytes, and generates an immune response.
■ Lymph is interstitial fluid containing solutes and sometimes foreign material that is transported through lymph vessels to the blood.
■ There are many types of lymph vessels. From smallest to largest, they are lymphatic capillaries, lymphatic vessels, lymphatic trunks, and lymphatic ducts.
24.2a Lymphatic Capillaries
■ Lymphatic capillaries, the smallest lymph vessels, are endothelium-lined vessels with overlapping internal edges of endothelial cells that regulate lymph entry.
■ Lacteals are lymphatic capillaries in the small intestine; they pick up and transport the lymph (called chyle) from the intestine.
24.2b Lymphatic Vessels
■ Lymphatic vessels form from merging lymphatic capillaries. They have valves to prevent lymph backflow.
■ Afferent lymphatic vessels conduct lymph to lymph nodes, and efferent lymphatic vessels conduct lymph away from lymph nodes.
24.2c Lymphatic Trunks
■ Lymphatic trunks form from merging lymphatic vessels; each trunk drains a major body region into a lymphatic duct.
24.2d Lymphatic Ducts
■ The right lymphatic duct drains the right side of the head and neck, the right upper limb, and the right side of the thorax. It drains into the junction of the right subclavian vein and the right internal jugular vein.
5. The arteries located at the corticomedullary junction of the kidney are the
a. arcuate arteries.
24.3 Lymphatic Cells
b. segmental arteries.
c. interlobar arteries.
d. renal arteries.
■ The thoracic duct drains lymph from the left side of the head and neck, the left upper limb, the left thorax, and all body regions inferior to the diaphragm. It drains into the junction of the left subclavian vein and left internal jugular vein.
■ Lymphatic cells include macrophages that phagocytize foreign substances, epithelial cells that secrete thymic hormones, dendritic cells that filter antigens from lymph, and lymphocytes that perform specific functions in the immune response.
24.3a Types and Functions of Lymphocytes
6. Which statement is false about the kidneys?
■ Each helper T-lymphocyte responds to one type of antigen only, and secretes cytokines, which are chemical signals that activate other lymphatic cells.
a. The right kidney is positioned more inferiorly than the left kidney.
■ Cytotoxic T-lymphocytes kill infected cells following direct contact with them.
■ Memory T-lymphocytes arise from T-lymphocytes that have encountered an antigen, and cause a faster immune response than the first time.
b. The cortex is subdivided into renal pyramids.
c. The renal artery, renal vein, and ureter connect to the kidney at its hilum.
■ Regulatory T-lymphocytes often “turn off” the immune response once it has been activated.
d. The kidney is covered by a fibrous capsule.
■ Activated B-lymphocytes respond to one particular antigen; they proliferate and differentiate into either plasma cells or memory B-lymphocytes.
7. Urine in a major calyx of the kidney next travels to the a. ureter.
b. minor calyx.
c. urinary bladder.
d. renal pelvis.
■ Plasma cells produce and secrete large numbers of antibodies.
■ Memory B-lymphocytes mount an even faster and more powerful immune response upon reexposure to an antigen.
■ NK cells respond to multiple antigens; they destroy infected cells and some cancerous cells.
24.3b Lymphopoiesis
8. Which structure is not controlled by the autonomic nervous system?
■ Some hemopoietic stem cells remain in the red bone marrow and mature into B-lymphocytes and NK cells. Other stem cells exit the marrow and migrate to the thymus for subsequent maturation into T-lymphocytes.
■ Lymphatic structures include lymphatic nodules and various lymphatic organs.
24.4 Lymphatic Structures
a. muscularis of the ureter
b. external urethral sphincter
24.4a Lymphatic Nodules
i. site of plasma filtration
j. conducts urine from kidney to bladder
mouth felt dry, and he had a headache. A friend told Jason that his symptoms were the result of dehydration. Based upon your knowledge of the urinary system, how and why did Jason become dehydrated? What hormone normally regulates the amount of water in the urine, and how did the alcohol interfere with this hormone’s function?
Select the best answer from the four choices provided.
1. Which organ is responsible for filtering the blood?
a. ureter
b. urinary bladder
2. Males who suffer from either benign prostatic hypertrophy (noncancerous prostate gland enlargement) or prostate cancer often have problems with urination. Based upon your knowledge of the male urethra, hypothesize why these urination problems occur.
c. kidney
d. urethra
2. Which statement is true about the urinary bladder?
a. The bladder neck is surrounded by the external urethral sphincter.
b. The detrusor muscle contains only two layers of smooth muscle.
c. The bladder is lined with transitional epithelium.
d. The bladder receives urine from the kidneys via the two urethras.
c. internal urethral sphincter
d. detrusor muscle of the urinary bladder
■ Lymphatic nodules are ovoid clusters of lymphatic cells and extracellular connective tissue matrix that are not contained within a connective tissue capsule.
9. Reabsorption is the movement of fluid and solutes from the a. filtrate into the glomerular capillaries.
■ MALT (mucosa-associated lymphatic tissue) is composed of lymphatic nodules housed in the walls of the GI, respiratory, genital, and urinary tracts.
b. tubular fluid into the capsular space.
■ Tonsils are large clusters of partially encapsulated lymphatic cells and extracellular connective matrix.
c. tubular fluid into the peritubular capillaries.
24.4b Lymphatic Organs
d. blood vessels into the collecting ducts.
10. The micturition reflex controls
a. urine formation.
b. voiding of the filled bladder.
■ The lymphatic organs are composed of lymphatic structures completely surrounded by a connective tissue capsule.
■ The thymus is where T-lymphocytes mature and differentiate under stimulation by thymic hormones.
■ Lymph nodes are small structures that filter lymph.
c. reabsorption of glucose from filtrate.
d. filling of the urinary bladder.
Content Review
■ The spleen is partitioned into white pulp (consists of clusters of lymphatic cells that generate an immune response when exposed to antigens in the blood) and red pulp (consists of splenic cords that store blood and sinusoids containing macrophages that phagocytize foreign debris, old erythrocytes, and platelets).
24.5 Aging and the Lymphatic System ■ The lymphatic system’s ability to provide immunity and fight disease decreases as we get older.
1. What are the basic functions of the urinary system?
2. Describe the connective tissue coverings that surround the kidney, from internal to external. Why are these coverings especially important to kidney structure and function?
3. When we are lying down, gravity is unable to passively transport urine to the urinary bladder. Thus, peristalsis is also needed so that urine can be actively pumped from the ureters to the urinary bladder no matter what position the body is in.
3. Tubular fluid from the proximal convoluted tubule next travels to the
a. capsular space.
b. collecting duct.
c. distal convoluted tubule.
d. nephron loop.
4. The apex of a renal pyramid is called the renal a. calyx.
b. papilla.
c. column.
d capsule.
3. Map the flow of blood into and out of the kidney. List which structures carry oxygenated blood and which carry deoxygenated blood. In addition, list the structures responsible for gas exchange and reabsorption of materials from the filtrate.
4. Describe the anatomic structure of the glomerulus and the visceral layer of the glomerular capsule.
5. Why are microvilli prominent on the apical surface of the proximal convoluted tubule epithelium but not in the distal convoluted tubule?
6. What do the cells of the juxtaglomerular apparatus secrete? What function does this product perform?
7. What prevents urine stored in the urinary bladder from being forced back through the ureters to the kidney?
834 Chapter Twenty-Seven Urinary System
Chapter Twenty-Seven Urinary System 835
Required=Results
McGraw-Hill Connect®
Learn Without Limits
Connect is a teaching and learning platform that is proven to deliver better results for students and instructors.
Connect empowers students by continually adapting to deliver precisely what they need, when they need it, and how they need it, so your class time is more engaging and effective.
73% of instructors who use Connect require it; instructor satisfaction increases by 28% when Connect is required.
Analytics
Connect Insight®
Connect Insight is Connect’s new oneof-a-kind visual analytics dashboard that provides at-a-glance information regarding student performance, which is immediately actionable. By presenting assignment, assessment, and topical performance results together with a time metric that is easily visible for aggregate or individual results, Connect Insight gives the user the ability to take a just-in-time approach to teaching and learning, which was never before available. Connect Insight presents data that helps instructors improve class performance in a way that is efficient and effective.
Using Connect improves retention rates by 19.8%, passing rates by 12.7%, and exam scores by 9.1%.
More students earn A’s and B’s when they use McGraw-Hill Education Adaptive products.
SmartBook®
Proven to help students improve grades and study more efficiently, SmartBook contains the same content within the print book, but actively tailors that content to the needs of the individual. SmartBook’s adaptive technology provides precise, personalized instruction on what the student should do next, guiding the student to master and remember key concepts, targeting gaps in knowledge and offering customized feedback, and driving the student toward comprehension and retention of the subject matter. Available on tablets, SmartBook puts learning at the student’s fingertips—anywhere, anytime.
ADAPTIVE READING EXPERIENCE DESIGNED TO TRANSFORM THE WAY STUDENTS READ
Over 8 billion questions have been answered, making McGraw-Hill Education products more intelligent, reliable, and precise.
www.mheducation.com
50% of the country’s students are not ready for A&P
LearnSmart ® Prep can help!
Improve preparation for the course and increase student success with the only adaptive Prep tool available for students today. Areas of individual weaknesses are identified in order to help students improve their understanding of core course areas needed to succeed.
Bringing to life complex processes is a challenge. Ph.I.L.S. 4.0 is the perfect way to reinforce key physiology concepts with powerful lab experiments. Tools like Concept Overview Interactives, Ph.I.L.S., and world-class animations make it easier than ever.
Students seek lab time that fits their busy schedules. Anatomy & Physiology REVEALED 3.2, our Virtual Dissection tool, allows them practice anytime, anywhere. Now featuring enhanced physiology with Concept Overview Interactives (COVI’s) and 3D animations!
Physiology supplements
Since 2009, our adaptive programs in A&P have hosted 900,000 unique users who have answered more than 800 million probes, giving us the only data-driven solutions to help your students get from their first college-level course to program readiness.
Virtual dissection
Prep for A&P
An Interactive Cadaver Dissection Experience
Anatomy & Physiology|REVEALED 3.2®
www.aprevealed.com
An interactive cadaver dissection tool to enhance lecture and lab. Make use of the custom structure list to focus learning! Now, mobile—get the experience anywhere, anytime!
Anatomy & Physiology REVEALED 3.2 | Cat and Anatomy & Physiology REVEALED 3.2 | Fetal Pig are online interactive cat dissection and fetal pig dissection experiences that use cat photos or fetal pig photos, combined with a layering technique that allows you to peel away layers to reveal structures beneath the surface.
Both Anatomy & Physiology REVEALED 3.2 | Cat and Anatomy & Physiology REVEALED 3.2 | Fetal Pig offer animations, histologic and radiologic imaging, audio pronuncia tions, and comprehensive quizzing.
Concept Overview Interactives
Located within Anatomy & Physiology REVEALED 3.2, Concept Overview Interactives combine multiple concepts into one bigpicture summary. These striking, visually dynamic presentations offer a review of previously covered material in a creatively designed environment to emphasize how individual parts fit together in the understanding of a larger mechanism or concept.
Concept Overview Interactive modules have assessable, autograded learning activities in Connect®, can be used as a self-study tool for students, and are also provided separately to instructors as classroom presentation tools.
Laboratory Resources
Eckel’s Human Anatomy Laboratory Manual, 3rd Edition!
The Human Anatomy Laboratory Manual, by Christine Eckel of Carroll College, is expressly written to supplement and expand upon content covered in the lecture course—not to repeat it. This highly customizable, hands-on learning tool guides students through human anatomy lab exercises using observation, touch, dissection, and practical activities such as sketching, labeling, and coloring. The manual focuses on human specimens and also includes common animal dissections such as cow bone, cow eye, sheep brain, and sheep heart.
This much anticipated 3rd Edition is publishing in early Spring 2017 and is rich with content updates! Supplemental resources include Connect®, assignable and auto-gradable Pre- and Post-Lab questions, LearnSmart Prep, Anatomy & Physiology REVEALED 3.2, and a full eBook!
For a detailed list of changes and customization opportunities, please contact your Learning Technology Representative.
Broyle’s Workbook for Anatomy & Physiology REVEALED!
The Workbook to Accompany Anatomy and Physiology Revealed 3.2, by Robert Broyles is a workbook/study guide designed to help students get the most they can out of the Anatomy and Physiology REVEALED 3.2 (APR), and out of their anatomy and physiology course. The Table of Contents closely follows APR and is organized along the lines of a typical Anatomy and Physiology course. The individual exercises include art from APR and also have review questions, tables, coloring exercises, terminology quiz questions, and reminders on key content.
Supplemental resources include a full eBook, Connect®, LearnSmart Prep, Anatomy & Physiology REVEALED 3.2, and a robust question bank.
For additional details and customization opportunities, please contact your Learning Technology Representative.
ACKNOWLEDGMENTS
Many people worked with us to produce this text. Thanks go to our book team members at McGraw-Hill who attended to the many tasks involved in bringing this edition and its supporting materials to market. Over the span of five editions, we have been fortunate to work with the following individuals who contributed their specific talents to various tasks: Beatrice Sussman, copy editor; Pat Steele and Kathy Pfeiler, proofreaders; Danny Meldung, photo researcher; Christine Eckel, cadaver dissection and photography; Jw Ramsey, surface anatomy photography; Al Telser, photomicroscopy; Mark Braun, clinical consultant; Frank Baker, language consultant.
The authors appreciate and would like to acknowledge the contributions to the fourth edition of Human Anatomy by Dr. Ronald Harris as well as his reviews and suggestions to specific chapters in earlier editions of this text.
Numerous external reviewers and advisors evaluated previous editions and provided invaluable comments and suggestions to help us continually improve this textbook. We have continued their recommendations in this edition, while remaining true to our overriding goal of
Clinical Views
Chapter 1 | A First Look at Anatomy
1.1 Medical Imaging Procedures
Chapter 2 | The Cell: Basic Unit of Structure and Function
2.1 Cystic Fibrosis and Chloride Channels
2.2 Tay-Sachs Disease
2.3 Adrenoleukodystrophy (ALD)
2.4 MELAS and Mitochondria
2.5 Characteristics of Cancer Cells
Chapter 3 | Embryology
3.1 Nondisjunction
3.2 Chromosomal Abnormalities and Spontaneous Abortion (Miscarriage)
3.3 Twinning
3.4 Infertility and Infertility Treatments
3.5 Congenital Malformations
3.6 Amniocentesis
Chapter 4 | Tissue Level of Organization
4.1 Stem Cells
4.2 What Are You Planning to Do with Your Baby’s Umbilical Cord?
4.3 Systemic Lupus Erythematosus
4.4 Gangrene
4.5 Tissue Transplantation
Chapter 5 | Integumentary System
5.1 Tattoos
5.2 UV Radiation, Sunscreens, and Sunless Tanners
5.3 Dermatoglyphics
5.4 Nail Disorders
5.5 Acne and Acne Treatments
5.6 Burns
5.7 Treatments for Aging Skin
5.8 Psoriasis
Chapter 6 | Cartilage and Bone
6.1 Osteitis Deformans
6.2 Forensic Anthropology: Determining Age at Death
6.3 Achondroplastic Dwarfism
6.4 Rickets
6.5 Bone Scans
6.6 Osteoporosis
Chapter 7 | Axial Skeleton
7.1 Craniosynostosis and Plagiocephaly
7.2 Cleft Lip and Cleft Palate
writing a text that is comprehensive enough to provide the content depth necessary, yet ensuring it is presented with such clarity that it nicely balances the thorough coverage to be more student centered. Each feature incorporated into this edition has been carefully considered in how it may be used to support student learning and understanding.
Also, in this edition, we are very pleased to have been able to incorporate real student data points and input, derived from thousands of our LearnSmart users, to help guide our revision. LearnSmart Heat Maps provided a quick visual snapshot of usage of portions of the text and the relative difficulty students experienced in mastering the content. With these data, we were able to hone not only our text content but also the LearnSmart probes.
Finally, we could not have performed this effort were it not for the love and support of our families. They provided us with the encouragement we needed, were forgiving when our book schedules made it seem as if we were working all the time, and made sacrifices along with us in order to see this project to fruition.
7.3 Spinal Curvature Abnormalities
7.4 Herniated Discs
7.5 Sternal Foramen
7.6 Variations in Rib Development
Chapter 8 | Appendicular Skeleton
8.1 Fracture of the Clavicle
8.2 Colles Fracture
8.3 Scaphoid Fractures
8.4 Pott Fracture
8.5 Pathologies of the Foot
8.6 Limb Malformations
Chapter 9 | Articulations
9.1 Costochondritis
9.2 “Cracking Knuckles”
9.3 TMJ Disorders
9.4 Shoulder Joint Dislocations
9.5 Subluxation of the Head of the Radius
9.6 Fracture of the Femoral Neck
9.7 Knee Ligament and Cartilage Injuries
9.8 Ankle Sprains
9.9 Arthritis
9.10 Joint Replacement
Chapter 10 | Muscle Tissue and Organization
10.1 Tendonitis
10.2 Mitochondrial Myopathies
10.3 Muscular Paralysis and Neurotoxins
10.4 Rigor Mortis
10.5 Anabolic Steroids and Performance-Enhancing Compounds
