• Figure 6–1 A Classification of Bones by Shape revised • New Figure 6–2 An Introduction to Bone Markings incorporates old Table 6–1 • New Spotlight Figure 6–11 Endochondral Ossification
Trang 2Using A&P to Save a Life 2
When Your Heart is in the Wrong Place 65
The Orthopedic Surgeon’s Nightmare 242What’s Ailing the Birthday Girl? 264
Did Franklin D Roosevelt Really Have Polio? 386
The First Day in Anatomy Lab 532
Did Ancient Mummies Have Atherosclerosis? 724Isn’t There a Vaccine for That? 782How Long Should a Cough Last? 831
A Case of "Hidden" Bleeding 973When Treatment Makes You Worse 1016
The Twins That Looked Nothing Alike 1096
1 An Introduction to Anatomy and Physiology 1
2 The Chemical Level of Organization 26
3 The Cellular Level of Organization 64
4 The Tissue Level of Organization 113
6 Osseous Tissue and Bone Structure 178
13 The Spinal Cord, Spinal Nerves, and Spinal Reflexes 429
15 Sensory Pathways and the Somatic Nervous System 508
16 The Autonomic Nervous System and
22 The Lymphatic System and Immunity 781
27 Fluid, Electrolyte, and Acid–Base Balance 1015
Trang 31–1 Levels of Organization 1–10 Diagnostic Imaging Techniques
2–3 Chemical Notation
3–1 Anatomy of a Model Cell 3–7 Protein Synthesis, Processing, and Packaging 3–22 Overview of Membrane Transport
3–23 DNA replication 3–24 Stages of a Cell’s Life Cycle
4–20 Inflammation and Regeneration
5–3 The Epidermis
6–11 Endochondral Ossification 6–16 Types of Fractures and Steps in Repair
7–4 Sectional Anatomy of the Skull
8–10 Sex Differences in the Human Skeleton
9–2 Joint Movement
10–9 Events at the Neuromuscular Junction 10–10 Excitation-Contraction Coupling
10–11 The Contraction Cycle and Cross-Bridge Formation
11–3 Muscle Action
12–9 Resting Membrane Potential 12–14 Generation of an Action Potential 12–15 Propagation of an Action Potential
13–8 Peripheral Distribution of Spinal Nerves 13–14 Spinal Reflexes
14–4 Formation and Circulation of Cerebrospinal Fluid
15–6 Somatic Sensory Pathways
16–2 Overview of the Autonomic Nervous System
17–2 Olfaction and Gustation 17–13 Refractive Problems 17–16 Photoreception
18–2 Structural Classification of Hormones 18–3 G Proteins and Second Messengers 18–18 Diabetes Mellitus
18–20 The General Adaptation Syndrome
19–1 The Composition of Whole Blood 19–8 Hemolytic Disease of the Newborn
20–10 Heart Disease and Heart Attacks 20–14 Cardiac Arrhythmias
21–33 Congenital Heart Problems
22–28 Cytokines of the Immune System
23–15 Respiratory Muscles and Pulmonary Ventilation 23–25 Control of Respiration
24–15 Regulation of Gastric Activity 24–27 Chemical Events of Digestion
25–11 Absorptive and Postabsorptive States
26–16 Summary of Renal Function
27–18 The Diagnosis of Acid-Base Disorders
28–12 Regulation of Male Reproduction 28–24 Regulation of Female Reproduction
29–5 Extraembryonic Membranes and Placenta Formation
Spotlight Figures
Trang 4Boston Columbus Indianapolis New York San Francisco Upper Saddle River
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Clinical Cases by:
Ruth Anne O’Keefe
Trang 5Executive Editor: Leslie Berriman
Assistant Editor: Cady Owens
Associate Project Editor: Lisa Damerel
Editorial Assistant: Sharon Kim
Director of Development: Barbara Yien
Development Editor: Anne A Reid
Managing Editor: Mike Early
Assistant Managing Editor: Nancy Tabor
Project Manager: Caroline Ayres
Director of Digital Product Development: Lauren Fogel
Executive Content Producer: Liz Winer
Content Producer: Joe Mochnick
Notice: Our knowledge in clinical sciences is constantly changing The authors and the publisher of
this volume have taken care that the information contained herein is accurate and compatible with
the standards generally accepted at the time of the publication Nevertheless, it is difficult to ensure
that all information given is entirely accurate for all circumstances The authors and the publisher
disclaim any liability, loss, or damage incurred as a consequence, directly or indirectly, of the use
and application of any of the contents of this volume
Copyright © 2015, 2012 by Frederic H Martini, Inc., Judi L Nath, LLC, and Edwin F Bartholomew,
Inc Published by Pearson Education, Inc., publishing as Pearson Benjamin Cummings, 1301
Sansome St., San Francisco, CA 94111 All rights reserved Manufactured in the United States of
America This publication is protected by Copyright and permission should be obtained from the
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Library of Congress Cataloging-in-Publication Data
Martini, Frederic, author
Fundamentals of anatomy & physiology/Frederic H Martini, Judi L Nath, Edwin F Bartholomew;
William C Ober, art coordinator and illustrator; Claire E Ober, illustrator; Kathleen Welch, clinical
consultant; Ralph T Hutchings, biomedical photographer — Tenth edition
p.; cm
Fundamentals of anatomy and physiology
Includes bibliographical references and index
ISBN-13: 978-0-321-90907-7
ISBN-10: 0-321-90907-0
I Nath, Judi Lindsley, author II Bartholomew, Edwin F., author III Title
IV Title: Fundamentals of anatomy and physiology
Trang 6Frederic (Ric) H Martini, Ph.D.
Author
Dr Martini received his Ph.D from
Cornell University in comparative and
functional anatomy for work on the
pathophysiology of stress In addition to
professional publications that include
journal articles and contributed chapters, technical reports,
and magazine articles, he is the lead author of ten
undergradu-ate texts on anatomy and physiology or anatomy Dr Martini is
currently affiliated with the University of Hawaii at Manoa and
has a long-standing bond with the Shoals Marine Laboratory,
a joint venture between Cornell University and the University
of New Hampshire He has been active in the Human Anatomy
and Physiology Society (HAPS) for over 20 years and was a
member of the committee that established the course
curricu-lum guidelines for A&P He is now a President Emeritus of HAPS
after serving as President-Elect, President, and Past-President
over 2005–2007 Dr Martini is also a member of the American
Physiological Society, the American Association of
Anato-mists, the Society for Integrative and Comparative Biology, the
Australia/New Zealand Association of Clinical Anatomists,
the Hawaii Academy of Science, the American Association for
the Advancement of Science, and the International Society of
Vertebrate Morphologists
Edwin F Bartholomew, M.S.
Author
Edwin F Bartholomew received his
undergraduate degree from Bowling
Green State University in Ohio and his
M.S from the University of Hawaii
Mr Bartholomew has taught human
anatomy and physiology at both the secondary and
undergrad-uate levels and a wide variety of other science courses (from
botany to zoology) at Maui Community College and at
his-toric Lahainaluna High School, the oldest high school west of
the Rockies He is a coauthor of Visual Anatomy & Physiology,
Essentials of Anatomy & Physiology, Visual Essentials of Anatomy
& Physiology, Structure and Function of the Human Body, and The
Human Body in Health and Disease (all published by Pearson)
Mr Bartholomew is a member of the Human Anatomy and
Physiology Society (HAPS), the National Association of
Biol-ogy Teachers, the National Science Teachers Association, the
Hawaii Science Teachers Association, and the American
Asso-ciation for the Advancement of Science
Judi L Nath, Ph.D.
Author
Dr Judi Nath is a biology professor at Lourdes University, where she teaches anatomy and physiology, pathophysi-ology, and medical terminology She received her Bachelor’s and Master’s degrees from Bowling Green State University and her Ph.D from the University of Toledo Dr Nath is devoted to her stu-dents and strives to convey the intricacies of science in captivat-ing ways that are meaningful, interactive, and exciting She has won the Faculty Excellence Award—an accolade recognizing effective teaching, scholarship, and community service—multiple times She is active in many professional organizations, no-tably the Human Anatomy and Physiology Society (HAPS), where she has served several terms on the board of direc-
tors Dr Nath is a coauthor of Visual Anatomy & Physiology, Visual Essentials of Anatomy & Physiology, and Anatomy & Physi- ology (all published by Pearson), and she is the sole author
of Using Medical Terminology Her favorite charities are those
that have significantly affected her life, including the local Humane Society, the Cystic Fibrosis Foundation, and the ALS Association On a personal note, Dr Nath enjoys family life with her husband and their dogs
William C Ober, M.D.
Art Coordinator and Illustrator
Dr Ober received his undergraduate degree from Washington and Lee University and his M.D from the University of Virginia He also studied
in the Department of Art as Applied
to Medicine at Johns Hopkins sity After graduation, Dr Ober completed a residency in Fam-ily Practice and later was on the faculty at the University of Virginia in the Department of Family Medicine and in the Department of Sports Medicine He also served as Chief of Medicine of Martha Jefferson Hospital in Charlottesville, VA
Univer-He is currently a Visiting Professor of Biology at Washington and Lee University, where he has taught several courses and led student trips to the Galapagos Islands He was on the Core Faculty at Shoals Marine Laboratory for 24 years, where
he taught Biological Illustration every summer Dr Ober has collaborated with Dr Martini on all of his textbooks in every edition
iii
Text and Illustration Team
Trang 7iv Text and Illustration Team
Claire E Ober, R.N.
Illustrator
Claire E Ober, R.N., B.A., practiced
fam-ily, pediatric, and obstetric nursing
be-fore turning to medical illustration as a
full-time career She returned to school
at Mary Baldwin College, where she
re-ceived her degree with distinction in studio art Following a
five-year apprenticeship, she has worked as Dr Ober’s partner
in Medical & Scientific Illustration since 1986 She was on the
Core Faculty at Shoals Marine Laboratory and co-taught the
Biological Illustration course with Dr Ober for 24 years The
textbooks illustrated by Medical & Scientific Illustration have
won numerous design and illustration awards
Kathleen Welch, M.D.
Clinical Consultant
Dr Welch received her B.A from the
University of Wisconsin–Madison, her
M.D from the University of Washington
in Seattle, and did her residency in
Fam-ily Practice at the University of North
Carolina in Chapel Hill Participating in the Seattle WWAMI
rural medical education program, she studied in Fairbanks,
Anchorage, and Juneau, Alaska, with time in Boise, Idaho, and
Anacortes, Washington, as well For two years, she served as
Director of Maternal and Child Health at the LBJ Tropical
Medical Center in American Samoa and subsequently was a
member of the Department of Family Practice at the Kaiser
Permanente Clinic in Lahaina, Hawaii, and on the staff at Maui
Memorial Hospital She has been in private practice since 1987
and is licensed to practice in Hawaii and Washington State
Dr Welch is a Fellow of the American Academy of Family
Practice and a member of the Maui County Medical Society
and the Human Anatomy and Physiology Society (HAPS)
With Dr Martini, she has coauthored both a textbook on
anat-omy and physiology and the A&P Applications Manual She and
Dr Martini were married in 1979, and they have one son
has been a series of color atlases, including the Color Atlas of Human Anatomy, the Color Atlas of Surface Anatomy, and The Human Skeleton (all published by Mosby-Yearbook Publishing)
For his anatomical portrayal of the human body, the tional Photographers Association has chosen Mr Hutchings as the best photographer of humans in the twentieth century He lives in North London, where he tries to balance the demands
Interna-of his photographic assignments with his hobbies Interna-of early motor cars and airplanes
Ruth Anne O’Keefe, M.D.
Clinical Contributor
Dr O’Keefe did her undergraduate ies at Marquette University, attended graduate school at the University of Wisconsin, and received her M.D from George Washington University She was the first woman to study orthopedics at The Ohio State University during her residency She did fellowship training in trauma surgery at Loma Linda University in California In ad-dition to her private orthopedic practice, she has done ortho-pedic surgery around the world, taking her own surgical teams
stud-to places such as the Dominican Republic, Honduras, Peru, New Zealand, and Burkina Faso She serves on the board of Global Health Partnerships, a group that partners with a clinic serving 35,000 people in remote Kenya Dr O’Keefe has al-ways enjoyed teaching and now supervises medical students from the University of New Mexico doing ongoing research
in Kenya She lives in Albuquerque with her Sweet Ed She
is mother of four, grandmother of nine, and foster mother
to many
Trang 8The Tenth Edition of Fundamentals of Anatomy & Physiology is a
comprehensive textbook that fulfills the needs of today’s
stu-dents while addressing the concerns of their professors We
fo-cused our attention on the question “How can we make this
information meaningful, manageable, and comprehensible?”
During the revision process, we drew upon our content
knowl-edge, research skills, artistic talents, and years of classroom
ex-perience to make this edition the best yet
The broad changes to this edition are presented in the New
to the Tenth Edition section below, and the specific changes
are presented in the Chapter-by-Chapter Changes in the
Tenth Edition section that follows.
New to the Tenth Edition
In addition to the many technical changes in this edition, such
as updated statistics and anatomy and physiology descriptions,
we have made the following key changes:
NEW 50 Spotlight Figures provide highly visual one- and
two-page presentations of tough topics in the book, with
a particular focus on physiology In the Tenth Edition, 18
new Spotlight Figures have been added for a total of 50
across the chapters There is now at least one Spotlight
Figure in every chapter, as well as one Spotlight Figure
cor-responding to every A&P Flix
NEW 29 Clinical Cases get students motivated for their
future careers Each chapter opens with a story-based
Clini-cal Case related to the chapter content and ends with a
Clinical Case Wrap-Up that incorporates the deeper
con-tent knowledge students will have gained from the chapter
NEW The repetition of the chapter-opening Learning
Outcomes below the coordinated section headings
within the chapters underscores the connection between
the HAPS-based Learning Outcomes and the associated
teaching points Author Judi Nath sat on the Human
Anatomy and Physiology Society (HAPS) committee that
developed the HAPS Learning Outcomes, recommended
to A&P instructors, and the Learning Outcomes in this
book are based on them Additionally, the assessments in
MasteringA&P are organized by these Learning Outcomes
As in the previous edition, full-sentence section headings,
correlated with the Learning Outcomes, state a core fact or
concept to help students readily see and learn the chapter
content; and Checkpoints, located at the close of each
sec-tion, ask students to pause and check their understanding
of facts and concepts If students cannot answer these tions within a matter of minutes, then they should reread the section before moving on The Checkpoints reinforce the Learning Outcomes, resulting in a systematic integra-tion of the Learning Outcomes over the course of the chapter Answers to the Checkpoints are located in the blue Answers tab at the back of the book
ques-Easier narrative uses simpler, shorter, more active
sen-tences and a reading level that makes reading and studying easier for students
Improved text-art integration throughout the illustration
program enhances the readability of figures Several tables have been integrated directly into figures to help students make direct connections between tables and art
Eponyms are now included within the narrative, along
with the anatomical terms used in Terminologia Anatomica.
NEW Assignable MasteringA&P activities include the
following:
NEW Spotlight Figure Coaching Activities are highly
visual, assignable activities designed to bring tivity to the Spotlight Figures in the book Multi-part activities include the ranking and sorting types that ask students to manipulate the visuals
interac-NEW Book-specific Clinical Case Activities stem from
the story-based Clinical Cases that appear at the ning and end of each chapter in the book
begin-NEW Adaptive Follow-up Assignments allow
instruc-tors to easily assign personalized content for each dividual student based on strengths and weaknesses identified by his or her performance on MasteringA&P parent assignments
in-NEW Dynamic Study Modules help students acquire,
retain, and recall information quickly and efficiently The modules are available as a self-study tool or can be assigned by the instructor They can be easily accessed with smartphones
Chapter-by-Chapter Changes in the Tenth Edition
This annotated Table of Contents provides select examples of revision highlights in each chapter of the Tenth Edition For
a more complete list of changes, please contact the publisher
v
Trang 9• Clinical Note: Decubitus Ulcers revised with new photo
• New Figure 5–8 Reticular Layer of Dermis
• Figure 5–10 Dermal Circulation revised
• Figure 5–12 Hair Follicles and Hairs revised
• New Figure 5–11 Hypodermis
Chapter 6: Osseous Tissue and Bone Structure
• New Clinical Case: A Case of Child Abuse?
• Figure 6–1 A Classification of Bones by Shape revised
• New Figure 6–2 An Introduction to Bone Markings incorporates old Table 6–1
• New Spotlight Figure 6–11 Endochondral Ossification porates old Figure 6–10
incor-• New Figure 6–12 Intramembranous Ossification
• Spotlight Figure 6–16 Types of Fractures and Steps in Repair revised
• Clinical Note: Abnormal Bone Development revised
Chapter 7: The Axial Skeleton
• New Clinical Case: Knocked Out
• New Clinical Note: Sinusitis
• Figure 7–2 Cranial and Facial Subdivisions of the Skull revised
• Figure 7–3 The Adult Skull revised to incorporate old Table 7–1
• New Spotlight Figure 7–4 Sectional Anatomy of the Skull incorporates old Figure 7–4 and parts of old Table 7–1
• Figure 7–6 The Frontal Bone revised
• Figure 7–14 The Nasal Complex revised
• Figure 7–22 The Thoracic Cage revised
Chapter 8: The Appendicular Skeleton
• New Clinical Case: The Orthopedic Surgeon’s Nightmare
• New Clinical Note: Hip Fracture
• New Clinical Note: Runner’s Knee
• New Clinical Note: Stress Fractures
• Carpal Bones subsection now lists the 8 carpal bones in two groups of 4 (proximal and distal carpal bones)
• Figure 8–6 Bones of the Right Wrist and Hand revised
• New Spotlight Figure 8–10 Sex Differences in the Human Skeleton incorporates old Figure 8–10, old Table 8–1, and old bulleted list in text
• Clinical Note: Carpal Tunnel Syndrome includes new illustration
• Figure 8–14 Bones of the Ankle and Foot revised
• Clinical Note: Congenital Talipes Equinovarus includes new photo
Chapter 9: Joints
• Chapter title changed from Articulations to Joints
• New Clinical Case: What’s Ailing the Birthday Girl?
• New Clinical Note: Dislocation and Subluxation
• New Clinical Note: Damage to Intervertebral Discs
• Table 9–1 Functional and Structural Classifications of tions redesigned
Articula-• Spotlight Figure 9–2 Joint Movement incorporates old Figures 9–2 and 9–6 and subsection on Types of Synovial Joints
• Revised discussion of synovial fluid function in shock absorption
• Figure 9–6 Intervertebral Articulations expanded
• Figure 9–7 The Shoulder Joint revised
• Figure 9–10 The Right Knee Joint rearranged and revised
• Clinical Note: Knee Injuries revised
Chapter 1: An Introduction to Anatomy and Physiology
• New Clinical Case: Using A&P to Save a Life
• New Spotlight Figure 1–10 Diagnostic Imaging Techniques
• New Clinical Note: Autopsies and Cadaver Dissection
• New Clinical Note: Auscultation
• Figure 1–7 Directional References revised
• Figure 1–8 Sectional Planes revised
• Figure 1–9 Relationships among the Subdivisions of the Body
Cavities of the Trunk revised
Chapter 2: The Chemical Level of Organization
• New Clinical Case: What Is Wrong with My Baby?
• New Clinical Note: Radiation Sickness
• Clinical Note: Fatty Acids and Health revised
• Section 2-2 includes revised Molecular weight discussion
• Figure 2–4 The Formation of Ionic Bonds revised
• Figure 2–5 Covalent Bonds in Five Common Molecules revised
• Table 2–3 Important Functional Groups of Organic Compounds
revised (to clarify structural group and R group)
• Protein Structure subsection includes new discussion of amino
acids as zwitterions
• Figure 2–21 Protein Structure revised
Chapter 3: The Cellular Level of Organization
• New Clinical Case: When Your Heart Is in the Wrong Place
• New information added about cholesterol and other lipids
• New overview added about roles of microtubules
• Figure 3–5 The Endoplasmic Reticulum revised
• Clinical Note on DNA Fingerprinting revised
• Figure 3–13 The Process of Translation revised
• Figure 3–14 Diffusion revised
• Figure 3–17 Osmotic Flow across a Plasma Membrane revised
• New Spotlight Figure 3–22 Overview of Membrane Transport
incorporates old Figures 3–18, 3–19, and 3–21 and old
Table 3–2
• New Spotlight Figure 3–23 DNA Replication incorporates old
Figure 3–23
• Spotlight Figure 3–24 Stages in a Cell’s Life Cycle revised
Chapter 4: The Tissue Level of Organization
• New Clinical Case: The Rubber Girl
• Intercellular Connections subsection updated
• Figure 4–2 Cell Junctions revised
• Figure 4–8 The Cells and Fibers of Connective Tissue Proper
revised
• Adipose Tissue subsection includes updated discussion
of brown fat
• Figure 4–10 Loose Connective Tissues revised
• Spotlight Figure 4–20 Inflammation and Regeneration revised
Chapter 5: The Integumentary System
• New Clinical Case: Skin Cells in Overdrive
• Figure 5–1 The Components of the Integumentary System revised
• New Figure 5–2 The Cutaneous Membrane and Accessory
Structures
• New Spotlight Figure 5–3 The Epidermis incorporates old
Figures 5–2 and 5–3
• New Figure 5–5 Vitiligo
• New Figure 5–6 Sources of Vitamin D3
vi Preface
Trang 10• New Spotlight Figure 13–14 Spinal Reflexes incorporates old Figures 13–15, 13–17, 13–19, and 13–20
Chapter 14: The Brain and Cranial Nerves
• New Clinical Case: The Neuroanatomist’s Stroke
• New Spotlight Figure 14–4 Formation and Circulation of Cerebrospinal Fluid incorporates old Figure 14–4
• Figure 14–5 The Diencephalon and Brain Stem revised
• New Figures 14–6 The Medulla Oblongata and 14–7 The Pons incorporate old Figure 14–6 and old Table 14–2
• New Figure 14–8 The Cerebellum incorporates old Figure 14–7 and old Table 14–3
• New Figure 14–9 The Midbrain incorporates old Figure 14–8, old Table 14–4, and a new cadaver photograph
• New Figure 14–11 The Hypothalamus in Sagittal Section rates old Figure 14–10 and old Table 14–6
incorpo-• New Figure 14–12 The Limbic System incorporates old Figure 14–11 and old Table 14–7
• Figure 14–14 Fibers of the White Matter of the Cerebrum revised
• Figure 14–15 The Basal Nuclei revised
• Figure 14–16 Motor and Sensory Regions of the Cerebral Cortex revised
• New information on circumventricular organs added to Section 14-2
Chapter 15: Sensory Pathways and the Somatic Nervous System
• New Clinical Case: Living with Cerebral Palsy
• New Figure 15–1 An Overview of Events Occurring along the Sensory and Motor Pathways
• New Figure 15–3 Tonic and Phasic Sensory Receptors
• Spotlight Figure 15–6 Somatic Sensory Pathways revised
• Figure 15–8 Descending (Motor) Tracts in the Spinal Cord reorganized
Chapter 16: The Autonomic Nervous System and Higher-Order Functions
• New Clinical Case: The First Day in Anatomy Lab
• New Spotlight Figure 16–2 Overview of the Autonomic Nervous System incorporates old Figures 16–3 and 16–7
• Figure 16–3 Sites of Ganglia in Sympathetic Pathways revised
• Figure 16–4 The Distribution of Sympathetic Innervation revised
Chapter 17: The Special Senses
• New Clinical Case: A Chance to See
• Figure 17–1 The Olfactory Organs revised
• Spotlight Figure 17–2 Olfaction and Gustation revised
• Figure 17–3 Gustatory Receptors revised
• Figure 17–22 The Middle Ear revised
• Figures 17–23, 17–24, and 17–25 revised to indicate different orientations of maculae in the utricle and saccule
• Figure 17–32 Pathways for Auditory Sensations revised
Chapter 18: The Endocrine System
• New Clinical Case: Stones, Bones, and Groans
• New Spotlight Figure 18–3 G Proteins and Second Messengers incorporates old Figure 18–3
• Figure 18–7 The Hypophyseal Portal System and the Blood Supply to the Pituitary Gland revised
• Figure 18–11 The Thyroid Follicles revised
• New Figure 18–14 The Adrenal Gland incorporates old Figure 18–14 and old Table 18–5
Chapter 10: Muscle Tissue
• New Clinical Case: A Real Eye Opener
• New subsection Electrical Impulses and Excitable Membranes
added in Section 10-4
• New Spotlight Figure 10–10 Excitation–Contraction Coupling
incorporates old Figures 10–9 and 10–10
• New Figure 10–13 Steps Involved in Skeletal Muscle Contraction
and Relaxation incorporates old Table 10–1
• Treppe subsection includes new discussion of treppe in cardiac
muscle
• Motor Units and Tension Production subsection includes new
discussion of fasciculation
• Figure 10–20 Muscle Metabolism revised
• Table 10–2 Properties of Skeletal Muscle Fiber Types revised to
make column sequences better parallel text discussion
Chapter 11: The Muscular System
• New Clinical Case: The Weekend Warrior
• Figure 11–1 Muscle Types Based on Pattern of Fascicle
Organiza-tion revised
• Figure 11–2 The Three Classes of Levers revised
• New Spotlight Figure 11–3 Muscle Action
• Figure 11–14 An Overview of the Appendicular Muscles of the
Trunk revised
• Figure 11–18 Muscles That Move the Hand and Fingers revised
• Figure 11–22 Extrinsic Muscles That Move the Foot and Toes
revised
Chapter 12: Neural Tissue
• New Clinical Case: Did President Franklin D Roosevelt Really
Have Polio?
• New Figure 12–1 A Functional Overview of the Nervous System
• Figure 12–7 Schwann Cells, Peripheral Axons, and Formation of
the Myelin Sheath revised and new part c step art added
• New Spotlight Figure 12–9 Resting Membrane Potential
incor-porates old Figure 12–9
• Figure 12–10 Electrochemical Gradients for Potassium and
Sodium Ions revised
• Added ligand-gated channels as an alternative term for
chemi-cally gated channels
• New Spotlight Figure 12–15 Propagation of an Action
Potential incorporates old Figures 12–6 and 12–15
• New Figure 12–16 Events in the Functioning of a Cholinergic
Synapse incorporates old Figure 12–17 and old Table 12–4
Chapter 13: The Spinal Cord, Spinal Nerves, and Spinal Reflexes
• New Clinical Case: Prom Night
• New “Tips & Tricks” added to Cervical Plexus subsection
• Figure 13–7 Dermatomes revised
• New information on the Jendrassik maneuver added to Section 13-8
• New Figure 13–10 The Cervical Plexus incorporates old Table 13–1
and old Figure 13–11
• New Figure 13–11 The Brachial Plexus incorporates old Table 13–2
and old Figure 13–12
• New in-art Clinical Note: Sensory Innervation in the Hand added
to Figure 13–11
• New Figure 13–12 The Lumbar and Sacral Plexuses incorporates
old Table 13–3 and old Figure 13–13
• New in-art Clinical Note: Sensory Innervation in the Ankle and
Foot added to Figure 13–12
Preface vii
Trang 11• Figure 24–16 Segments of the Intestine revised
• Figure 24–21 The Anatomy and Physiology of the Gallbladder and Bile Ducts revised
Chapter 25: Metabolism and Energetics
• New Clinical Case: The Miracle Supplement
• Figure 25–9 Lipid Transport and Utilization revised
• Figure 25–12 MyPlate Plan revised
• Figure 25–14 Mechanisms of Heat Transfer revised
Chapter 26: The Urinary System
• New Clinical Case: A Case of “Hidden” Bleeding
• Revised all relevant figure labels by replacing “Renal lobe” with
“Kidney lobe”
• Figure 26–6 The Functional Anatomy of a Representative ron and the Collecting System revised
Neph-• Spotlight Figure 26–16 Summary of Renal Function revised
Chapter 27: Fluid, Electrolyte, and Acid–Base Balance
• New Clinical Case: When Treatment Makes You Worse
• Figure 27–2 Cations and Anions in Body Fluids revised
• Figure 27–3 Fluid Gains and Losses revised
• Figure 27–11 The Role of Amino Acids in Protein Buffer Systems revised (to emphasize amino acids as zwitterions)
• Figure 27–13 Kidney Tubules and pH Regulation revised
• New Spotlight Figure 27–18 The Diagnosis of Acid–Base Disorders incorporates old Figure 27–18
Chapter 28: The Reproductive System
• New Clinical Case: A Post-Game Mystery
• Figure 28–1 The Male Reproductive System revised
• Figure 28–3 The Male Reproductive System in Anterior View revised and reorganized
• Figure 28–4 The Structure of the Testes revised
• Figure 28–7 Spermatogenesis revised
• Figure 28–13 The Female Reproductive System revised
• Figure 28–15 Oogenesis revised
• Figure 28–18 The Uterus revised
Chapter 29: Development and Inheritance
• New Clinical Case: The Twins That Looked Nothing Alike
• Revised all relevant chapter text by replacing “embryological” with “embryonic” for simplification
• New Spotlight Figure 29–5 Extraembryonic Membranes and Placenta Formation incorporates old Figure 29–5
• Table 29–2 An Overview of Prenatal Development includes revised sizes and weights at different gestational ages
• Figure 29–8 The Second and Third Trimesters revised
• Figure 29–9 Growth of the Uterus and Fetus revised
• Figure 29–13 Growth and Changes in Body Form and Proportion revised
Appendix
• New periodic table
• New codon chart
Chapter 19: Blood
• New Clinical Case: A Mysterious Blood Disorder
• Figure 19–3 The Structure of Hemoglobin revised
• Table 19–4 includes revised names for Factors IX and XI and
source of Factor X
Chapter 20: The Heart
• New Clinical Case: A Needle to the Chest
• Figure 20–3 The Superficial Anatomy of the Heart revised
• Figure 20–6 The Sectional Anatomy of the Heart revised
• Figure 20–12 Impulse Conduction through the Heart revised
• Figure 20–16 Phases of the Cardiac Cycle revised
• Figure 20–21 Autonomic Innervation of the Heart revised
• Figure 20–24 A Summary of the Factors Affecting Cardiac Output
revised
Chapter 21: Blood Vessels and Circulation
• New Clinical Case: Did Ancient Mummies Have
Atherosclerosis?
• Figure 21–2 Histological Structures of Blood Vessels revised
• Figure 21–8 Relationships among Vessel Diameter, Cross-
Sectional Area, Blood Pressure, and Blood Velocity within the
Systemic Circuit revised
• Figure 21–9 Pressures within the Systemic Circuit revised
• Figure 21–11 Forces Acting across Capillary Walls revised
• Figure 21–20 Arteries of the Chest and Upper Limb revised
• Figure 21–25 Arteries of the Lower Limb revised
• Figure 21–29 Flowcharts of Circulation to the Superior and
Infe-rior Venae Cavae revised
• Figure 21–30 Venous Drainage from the Lower Limb revised
Chapter 22: The Lymphatic System and Immunity
• New Clinical Case: Isn’t There a Vaccine for That?
• Figure 22–6 The Origin and Distribution of Lymphocytes revised
• Figure 22–11 Innate Defenses revised
• Complement System subsection – includes revised number of
complement proteins in plasma (from 11 to more than 30)
• Figure 22–18 Antigens and MHC Proteins revised
Chapter 23: The Respiratory System
• New Clinical Case: How Long Should a Cough Last?
• Figure 23–1 The Structure of the Respiratory System reorganized
• Figure 23–3 The Structures of the Upper Respiratory System revised
• Figure 23–5 The Glottis and Surrounding Structures revised
• Figure 23–7 The Gross Anatomy of the Lungs revised
• Figure 23–9 The Bronchi, Lobules, and Alveoli of the Lung revised
• Figure 23–10 Alveolar Organization revised
• Figure 23–13 Mechanisms of Pulmonary Ventilation revised
• New Spotlight Figure 23–15 Respiratory Muscles and Pulmonary
Ventilation incorporates old Figure 23–16
• Figure 23–16 Pulmonary Volumes and Capacities revised
• Spotlight Figure 23–25 Control of Respiration revised
Chapter 24: The Digestive System
• New Clinical Case: An Unusual Transplant
• Figure 24–10 The Esophagus revised
• Figure 24–12 The Stomach revised
viii Preface
Trang 12ix
This textbook represents a group effort, and we would like to
acknowledge the people who worked together with us to create
this Tenth Edition
Foremost on our thank-you list are the instructors who
offered invaluable suggestions throughout the revision process
We thank them for their participation and list their names and
affiliations below
Lisa Conley, Milwaukee Area Technical College
Theresa G D’Aversa, Iona College
Danielle Desroches, William Paterson University
Debra Galba-Machuca, Portland Community College–Cascade
Lauren Gollahon, Texas Tech University
Gigi Goochey, Hawaii Community College
Mark Haefele, Community College of Denver
Anthony Jones, Tallahassee Community College
William L’ Amoreaux, College of Staten Island
J Mitchell Lockhart, Valdosta State University
Scott Murdoch, Moraine Valley Community College
Louise Petroka, Gateway Community College
Cynthia Prentice-Craver, Chemeketa Community College
S Michele Robichaux, Nicholls State University
Susan Rohde, Triton College
Yung Su, Florida State University
Bonnie Taylor, Schoolcraft College
Carol Veil, Anne Arundel Community College
Patricia Visser, Jackson College
Theresia Whelan, State College of Florida – Manatee-Sarasota
Samia Williams, Santa Fe College
The accuracy and currency of the clinical material in this
edition and in the A&P Applications Manual in large part reflect
the work of Kathleen Welch, M.D Her professionalism and
concern for practicality and common sense make the clinical
information especially relevant for today’s students
Addition-ally, our content expert on the Clinical Cases, Ruth Anne O’Keefe,
M.D., provided constant, useful feedback on each chapter
Virtually without exception, reviewers stressed the
impor-tance of accurate, integrated, and visually attractive
illustra-tions in helping readers understand essential material The
revision of the art program was directed by Bill Ober, M.D
and Claire E Ober, R.N Their suggestions about presentation
sequence, topics of clinical importance, and revisions to the
proposed art were of incalculable value to us and to the project
The illustration program for this edition was further enhanced
by the efforts of several other talented individuals Jim Gibson
designed most of the new Spotlight Figures in the art program and consulted on the design and layout of the individual fig-ures His talents have helped produce an illustration program that is dynamic, cohesive, and easy to understand Anita Im-pagliazzo helped create the new photo/art combinations that have resulted in clearer presentations and a greater sense of re-alism in important anatomical figures We are also grateful to the talented team at Imagineering (imagineeringart.com) for their dedicated and detailed illustrative work on key figures for this edition The new color micrographs in this edition were provided by Dr Robert Tallitsch, and his assistance is much ap-preciated Many of the striking anatomy photos in the text and
in Martini’s Atlas of the Human Body are the work of biomedical
photographer Ralph Hutchings; his images played a key role in the illustration program
We also express our appreciation to the editors and port staff at Pearson Science
sup-We owe special thanks to Executive Editor, Leslie Berriman, for her creativity and dedication Her vision helped shape this book in countless ways Leslie’s enthusiasm for publish-ing the highest quality material spills over onto the author/illustrator team She is our biggest advocate and is always willing to champion our cause—despite the challenges of working with authors We are appreciative of all her efforts
Annie Reid, our Development Editor, played a vital role in revising the Tenth Edition Her unfailing attention to readabil-ity, consistency, and quality was invaluable to the authors in meeting our goal of delivering complex A&P content in a more student-friendly way
We are grateful to Mike Rossa for his careful attention to detail and consistency in his copyedit of the text and art.This book would not exist without the extraordinary dedication of the Production team, including Caroline Ayres, who solved many problems under pressure with unfailing good cheer Norine Strang skillfully led her excellent team at S4Carlisle to move the book smoothly through composition.Acknowledgments
Trang 13x Acknowledgments
their continuing support of this project Special thanks go to Frank Ruggirello, Vice President and Editorial Director, for working closely with Leslie in ensuring we have the resources necessary to publish what students need to succeed And, a round of applause goes to Derek Perrigo, Senior A&P Special-ist, our biggest cheerleader
To help improve future editions, we encourage you to send any pertinent information, suggestions, or comments about the organization or content of this textbook to us directly, using the e-mail addresses below We warmly welcome com-ments and suggestions and will carefully consider them in the preparation of the Eleventh Edition
Frederic (Ric) H Martini
The striking cover and clear, navigable interior design were
created by tani hasegawa Thanks also to Mark Ong, Design
Manager, and Marilyn Perry, who devised innovative solutions
for several complex design challenges
Thanks to our photo researcher, Maureen Spuhler, and
photo editor, Donna Kalal, for finding, obtaining, and
coordi-nating all the photos in the photo program
Thanks are also due to Sharon Kim, Editorial Assistant,
who served as project editor for the print supplements for
instructors and students and coordinated the administrative
details of the entire textbook program Dorothy Cox and
Shan-non Kong worked tirelessly to shepherd the print and media
supplements through production Thanks also to Stacey
Wein-berger for handling the physical manufacturing of the book
We are also grateful to Joe Mochnick, Content Producer,
and Liz Winer, Executive Content Producer, for their creative
efforts on the media package, most especially MasteringA&P
We would also like to express our gratitude to the
fol-lowing people at Pearson Science: Paul Corey, President, who
continues to support all our texts; Barbara Yien, Director of
De-velopment, who kindly kept all phases moving forward under
all circumstances; Allison Rona, Senior Marketing Manager;
and the dedicated Pearson Science sales representatives for
Trang 14Preface v
1 An Introduction to Anatomy
and Physiology 1
An Introduction to Studying the Human Body 2
1-1 Anatomy and physiology directly affect
your life 2
1-2 Anatomy is structure, and physiology is function 3
1-3 Anatomy and physiology are closely integrated 4
Anatomy 4
Physiology 5
1-4 Levels of organization progress from molecules
to a complete organism 6
1-5 Homeostasis is the state of internal balance 7
1-6 Negative feedback opposes variations from normal,
whereas positive feedback exaggerates them 10
The Role of Negative Feedback in Homeostasis 10
The Role of Positive Feedback in Homeostasis 12
Systems Integration, Equilibrium, and Homeostasis 13
1-7 Anatomical terms describe body regions, anatomical
positions and directions, and body sections 14
Superficial Anatomy 14
Sectional Anatomy 16
1-8 Body cavities of the trunk protect internal organs
and allow them to change shape 18
The Thoracic Cavity 22
The Abdominopelvic Cavity 22
An Introduction to the Chemical Level of Organization 27
2-1 Atoms are the basic particles of matter 27
Atomic Structure 27Elements and Isotopes 28Atomic Weights 29Electrons and Energy Levels 30
2-2 Chemical bonds are forces formed by atom
interactions 31Ionic Bonds 31Covalent Bonds 34Hydrogen Bonds 35States of Matter 35
2-3 Decomposition, synthesis, and exchange reactions are
important chemical reactions in physiology 36Basic Energy Concepts 36
Types of Chemical Reactions 37
2-4 Enzymes catalyze specific biochemical reactions by
lowering the energy needed to start them 38
2-5 Inorganic compounds lack carbon, and organic
compounds contain carbon 39
2-6 Physiological systems depend on water 39
The Properties of Aqueous Solutions 40Colloids and Suspensions 41
2-7 Body fluid pH is vital for homeostasis 41
2-8 Acids, bases, and salts are inorganic compounds with
important physiological roles 42Salts 43
Buffers and pH Control 43
2-9 Carbohydrates contain carbon, hydrogen, and oxygen
in a 1:2:1 ratio 43Monosaccharides 44Disaccharides and Polysaccharides 45
2-10 Lipids often contain a carbon-to-hydrogen ratio
of 1:2 46Fatty Acids 46Eicosanoids 47Glycerides 48Steroids 48Phospholipids and Glycolipids 49
xi
Trang 15xii Contents
3-6 Carrier-mediated and vesicular transport assist
membrane passage 94Carrier-Mediated Transport 94Vesicular Transport 96
3-7 The membrane potential results from the unequal
distribution of positive and negative charges across the plasma membrane 100
3-8 Stages of a cell’s life cycle include interphase, mitosis,
and cytokinesis 101DNA Replication 101Interphase, Mitosis, and Cytokinesis 101The Mitotic Rate and Energy Use 103
3-9 Several growth factors affect the cell life cycle 103
3-10 Tumors and cancers are characterized by abnormal cell
growth and division 106
3-11 Differentiation is cellular specialization as a result of
gene activation or repression 108
Chapter Review 109
Spotlights
Anatomy of a Model Cell 66Protein Synthesis, Processing, and Packaging 78Overview of Membrane Transport 98
DNA Replication 102Stages of a Cell’s Life Cycle 104
Drugs and the Plasma Membrane 90
Telomerase, Aging, and Cancer 107
Parkinson’s Disease 108
4 The Tissue Level
of Organization 113
An Introduction to the Tissue Level of Organization 114
4-1 The four tissue types are epithelial, connective,
muscle, and neural 114
4-2 Epithelial tissue covers body surfaces, lines cavities
and tubular structures, and serves essential functions 114
Functions of Epithelial Tissue 115Specializations of Epithelial Cells 115Maintaining the Integrity of Epithelia 116
4-3 Cell shape and number of layers determine the
classification of epithelia 118Classification of Epithelia 119Glandular Epithelia 123
2-11 Proteins contain carbon, hydrogen, oxygen, and
nitrogen and are formed from amino acids 51
Protein Structure 51
Protein Shape 52
Enzyme Function 54
Glycoproteins and Proteoglycans 56
2-12 DNA and RNA are nucleic acids 56
Structure of Nucleic Acids 56
RNA and DNA 56
2-13 ATP is a high-energy compound used by cells 58
2-14 Chemicals and their interactions form functional units
Fatty Acids and Health 48
3 The Cellular Level
of Organization 64
An Introduction to Cells 65
3-1 The plasma membrane separates the cell from its
surrounding environment and performs various
3-3 The nucleus contains DNA and enzymes essential for
controlling cellular activities 82
Contents of the Nucleus 83
Information Storage in the Nucleus 83
3-4 DNA controls protein synthesis, cell structure, and cell
function 84
The Role of Gene Activation in Protein Synthesis 84
The Transcription of mRNA 84
Translation and Protein Synthesis 86
How the Nucleus Controls Cell Structure and Function 87
3-5 Diffusion is a passive transport mechanism that assists
membrane passage 87
Diffusion 89
Diffusion across Plasma Membranes 91
Trang 16Contents xiii
Stratum Spinosum 153Stratum Granulosum 155Stratum Lucidum 155Stratum Corneum 155
5-2 Factors influencing skin color are epidermal
pigmentation and dermal circulation 155The Role of Epidermal Pigmentation 156The Role of Dermal Circulation 157
5-3 Sunlight causes epidermal cells to convert a steroid
into vitamin D 3 158
5-4 Epidermal growth factor has several effects on the
epidermis and epithelia 159
5-5 The dermis is the tissue layer that supports the
epidermis 160Dermal Strength and Elasticity 160Cleavage Lines 161
The Dermal Blood Supply 161Innervation of the Skin 161
5-6 The hypodermis connects the dermis to underlying
tissues 162
5-7 Hair is composed of keratinized dead cells that have
been pushed to the surface 163Hair Production 165
The Hair Growth Cycle 165Types of Hairs 165
Hair Color 165
5-8 Sebaceous glands and sweat glands are exocrine
glands found in the skin 166Sebaceous Glands 166Sweat Glands 167Other Integumentary Glands 168Control of Glandular Secretions and the Homeostatic Role of the Integument 168
5-9 Nails are keratinized epidermal cells that protect the
tips of fingers and toes 169
5-10 Several phases are involved in repairing the
integument following an injury 169
5-11 Effects of aging include skin thinning, wrinkling,
and reduced melanocyte activity 172
4-4 Connective tissue provides a protective structural
framework for other tissue types 126
Classification of Connective Tissues 126
Connective Tissue Proper 126
4-5 Cartilage and bone provide a strong supporting
framework 133
Cartilage 133
Bone 136
4-6 Tissue membranes are physical barriers of four types:
mucous, serous, cutaneous, and synovial 137
Skeletal Muscle Tissue 140
Cardiac Muscle Tissue 142
Smooth Muscle Tissue 142
4-9 Neural tissue responds to stimuli and propagates
electrical impulses throughout the body 142
4-10 The response to tissue injury involves inflammation
Aging and Tissue Structure 144
Aging and Cancer Incidence 146
An Introduction to the Integumentary System 151
5-1 The epidermis is composed of layers with various
functions 153
Stratum Basale 153
Trang 17xiv Contents
7 The Axial Skeleton 206
An Introduction to the Axial Skeleton 207
7-1 The 80 bones of the head and trunk
make up the axial skeleton 207
7-2 The skull is composed of 8 cranial bones and
14 facial bones 207
7-3 Each orbital complex contains an eye, and the nasal
complex encloses the nasal cavities 223The Orbital Complexes 223
The Nasal Complex 223
7-4 Fontanelles are non-ossified areas between cranial
bones that allow for brain growth in infants and small children 224
7-5 The vertebral column has four spinal curves 226
Spinal Curvature 226Vertebral Anatomy 227
7-6 The five vertebral regions are the cervical, thoracic,
lumbar, sacral, and coccygeal regions 228Cervical Vertebrae 229
Thoracic Vertebrae 232Lumbar Vertebrae 232The Sacrum 232The Coccyx 235
7-7 The thoracic cage protects organs in the chest and
provides sites for muscle attachment 235The Ribs 235
An Introduction to the Appendicular Skeleton 242
8-1 The pectoral girdles—the clavicles and scapulae—
attach the upper limbs to the axial skeleton 242The Clavicles 244
The Scapulae 244
6 Osseous Tissue and Bone
Structure 178
An Introduction to the Skeletal System 179
6-1 The skeletal system has five
primary functions 179
6-2 Bones are classified according to shape and structure,
and they have a variety of surface markings 180
Bone Shapes 180
Bone Markings 181
Bone Structure 182
6-3 Bone is composed of matrix and several types of
cells: osteocytes, osteoblasts, osteogenic cells,
and osteoclasts 182
Bone Matrix 183
Bone Cells 183
6-4 Compact bone contains parallel osteons, and spongy
bone contains trabeculae 184
Compact Bone Structure 185
Spongy Bone Structure 186
The Periosteum and Endosteum 187
6-5 Bones form through ossification and enlarge through
appositional growth and remodeling 189
Endochondral Ossification 189
Intramembranous Ossification 192
The Blood and Nerve Supplies to
Bone 192
6-6 Bone growth and development depend on a balance
between bone formation and bone resorption 192
6-7 Exercise, hormones, and nutrition affect bone
development and the skeletal system 194
The Effects of Exercise on Bone 194
Nutritional and Hormonal Effects on Bone 194
6-8 Calcium plays a critical role in bone physiology 196
The Skeleton as a Calcium Reserve 196
Hormones and Calcium Balance 196
6-9 A fracture is a crack or break in a bone 198
6-10 Osteopenia has a widespread effect on aging skeletal
Heterotopic Bone Formation 188
Abnormal Bone Development 196
Trang 18Contents xv
9-5 The shoulder is a ball-and-socket joint, and the elbow
is a hinge joint 276The Shoulder Joint 276The Elbow Joint 278
9-6 The hip is a ball-and-socket joint, and the knee is a
hinge joint 279The Hip Joint 279The Knee Joint 280
9-7 With advancing age, arthritis and other degenerative
changes impair joint mobility 283
9-8 The skeletal system supports and stores energy and
minerals for other body systems 284
Bursitis and Bunions 268
Dislocation and Subluxation 268
Damage to Intervertebral Discs 275
Knee Injuries 283
10 Muscle Tissue 289
An Introduction to Muscle Tissue 290
10-1 Skeletal muscle performs six major functions 290
10-2 A skeletal muscle contains muscle tissue, connective
tissues, blood vessels, and nerves 291Organization of Connective Tissues 292Blood Vessels and Nerves 292
10-3 Skeletal muscle fibers have distinctive features 292
The Sarcolemma and Transverse Tubules 292Myofibrils 293
The Sarcoplasmic Reticulum 294Sarcomeres 295
Sliding Filaments and Muscle Contraction 298
10-4 The nervous system communicates with skeletal
muscles at the neuromuscular junction 299Electrical Impulses and Excitable
Membranes 302The Control of Skeletal Muscle Activity 302Excitation–Contraction Coupling 302Relaxation 308
10-5 Sarcomere shortening and muscle fiber stimulation
produce tension 308Tension Production by Muscle Fibers 308Tension Production by Skeletal Muscles 312Motor Units and Tension Production 312
8-2 The upper limbs are adapted for free movement 245
The Humerus 245
The Ulna 247
The Radius 247
The Carpal Bones 247
The Metacarpal Bones and Phalanges 248
8-3 The pelvic girdle—two hip bones—attaches the lower
limbs to the axial skeleton 250
The Pelvic Girdle 250
The Tarsal Bones 257
The Metatarsal Bones and Phalanges 258
8-5 Sex differences and age account for individual skeletal
Factors That Stabilize Synovial Joints 267
9-3 The structure and function of synovial joints enable
various skeletal movements 268
Types of Movements at Synovial Joints 269
9-4 Intervertebral discs and ligaments are structural
components of intervertebral joints 274
Intervertebral Discs 274
Intervertebral Ligaments 275
Vertebral Movements 275
Trang 19xvi Contents
11-4 Descriptive terms are used to name skeletal
muscles 339Location in the Body 339Origin and Insertion 339Fascicle Organization 339Position 339
Structural Characteristics 339Action 340
Axial and Appendicular Muscles 341
11-5 Axial muscles are muscles of the head and neck,
vertebral column, trunk, and pelvic floor 341Muscles of the Head and Neck 341
Muscles of the Vertebral Column 351Oblique and Rectus Muscles 354Muscles of the Pelvic Floor 356
11-6 Appendicular muscles are muscles of the shoulders,
upper limbs, pelvis, and lower limbs 358Muscles of the Shoulders and Upper Limbs 358Muscles of the Pelvis and Lower Limbs 369
11-7 With advancing age, the size and power of muscle
An Introduction to Neural Tissue 386
12-1 The nervous system has anatomical and functional
divisions 386The Anatomical Divisions of the Nervous System 386The Functional Divisions of the Nervous System 387
12-2 Neurons are nerve cells specialized for intercellular
communication 388The Structure of Neurons 388The Classification of Neurons 390
12-3 CNS and PNS neuroglia support and protect neurons 392
Neuroglia of the Central Nervous System 392Neuroglia of the Peripheral Nervous System 397Neural Responses to Injuries 398
10-6 ATP provides energy for muscle contraction 316
ATP and CP Reserves 316
ATP Generation 317
Energy Use and the Level of Muscular Activity 318
Muscle Fatigue 318
The Recovery Period 318
Hormones and Muscle Metabolism 320
10-7 Muscle performance capabilities depend on muscle
fiber type and physical conditioning 320
Types of Skeletal Muscle Fibers 320
Muscle Performance and the Distribution of Muscle
Fibers 321
Muscle Hypertrophy and Atrophy 321
Physical Conditioning 322
10-8 Cardiac muscle tissue differs structurally and
functionally from skeletal muscle tissue 324
Structural Characteristics of Cardiac Muscle Tissue 324
Functional Characteristics of Cardiac Muscle Tissue 325
10-9 Smooth muscle tissue differs structurally and
functionally from skeletal and cardiac muscle
tissue 325
Structural Characteristics of Smooth Muscle Tissue 326
Functional Characteristics of Smooth Muscle Tissue 327
Delayed-Onset Muscle Soreness 323
11 The Muscular System 332
An Introduction to the Muscular System 333
11-1 Fascicle arrangement is correlated with muscle power
and range of motion 333
11-3 Muscle origins are at the fixed end of muscles, and
insertions are at the movable end of muscles 336
Origins and Insertions 336
Actions 337
Trang 20Contents xvii
13-3 Gray matter integrates information and initiates
commands, and white matter carries information from place to place 435
Organization of Gray Matter 437Organization of White Matter 437
13-4 Spinal nerves form plexuses that are named according
to their level of emergence from the vertebral canal 437
Anatomy of Spinal Nerves 437Peripheral Distribution of Spinal Nerves 438Nerve Plexuses 438
13-5 Interneurons are organized into functional groups
called neuronal pools 447
13-6 Reflexes are rapid, automatic responses to
stimuli 449The Reflex Arc 449Classification of Reflexes 452
13-7 Spinal reflexes vary in complexity 453
Monosynaptic Reflexes 453Polysynaptic Reflexes 454
13-8 The brain can affect spinal cord–based reflexes 455
Voluntary Movements and Reflex Motor Patterns 456Reinforcement and Inhibition 456
Sensory Innervation in the Hand 444
Sensory Innervation in the Ankle and Foot 447
14 The Brain and Cranial
Nerves 461
An Introduction to the Brain and Cranial Nerves 462
14-1 The brain has several principal structures, each with
specific functions 462Major Brain Regions and Landmarks 462Embryology of the Brain 464
Ventricles of the Brain 464
14-2 The brain is protected and supported by the cranial
meninges, cerebrospinal fluid, and the blood–brain barrier 465
The Cranial Meninges 465Cerebrospinal Fluid 467The Blood Supply to the Brain 469
12-4 The membrane potential is the electrical potential of
the cell’s interior relative to its surroundings 398
The Membrane Potential 398
Changes in the Membrane Potential 402
Graded Potentials 404
12-5 An action potential is an electrical event 406
The All-or-None Principle 406
Generation of Action Potentials 406
Propagation of Action Potentials 407
12-6 Axon diameter, in addition to myelin, affects
propagation speed 412
12-7 At synapses, communication occurs among neurons
or between neurons and other cells 413
12-9 Individual neurons process information by integrating
excitatory and inhibitory stimuli 421
Postsynaptic Potentials 421
Presynaptic Inhibition and Presynaptic Facilitation 423
The Rate of Generation of Action Potentials 423
Chapter Review 425
Spotlights
Resting Membrane Potential 400
Generation of an Action Potential 408
Propagation of an Action Potential 410
13 The Spinal Cord, Spinal Nerves,
and Spinal Reflexes 429
An Introduction to the Spinal Cord, Spinal Nerves,
and Spinal Reflexes 430
13-1 The brain and spinal cord make up the central nervous
system (CNS), and the cranial nerves and spinal nerves
make up the peripheral nervous system (PNS) 430
13-2 The spinal cord is surrounded by three meninges and
carries sensory and motor information 431
Gross Anatomy of the Spinal Cord 431
Spinal Meninges 433
Trang 21xviii Contents
15-4 Separate pathways carry somatic sensory and visceral
sensory information 518Somatic Sensory Pathways 518Visceral Sensory Pathways 523
15-5 The somatic nervous system is an efferent division that
controls skeletal muscles 523The Corticospinal Pathway 524The Medial and Lateral Pathways 525The Basal Nuclei and Cerebellum 526Levels of Processing and Motor Control 527
Assessment of Tactile Sensitivities 517
Amyotrophic Lateral Sclerosis 526
Cerebral Palsy 527
16 The Autonomic Nervous
System and Higher-Order Functions 531
An Introduction to the Autonomic Nervous System and Higher-Order Functions 532
16-1 The autonomic nervous system is involved in the
unconscious regulation of visceral functions and has sympathetic and parasympathetic divisions 532Organization of the ANS 532
Divisions of the ANS 533
16-2 The sympathetic division consists of preganglionic
neurons and ganglionic neurons involved in using energy and increasing metabolic rate 536Organization and Anatomy of the Sympathetic Division 537
Sympathetic Activation 540
16-3 Stimulation of sympathetic neurons leads to the
release of various neurotransmitters 540Sympathetic Stimulation and the Release of
NE and E 541Sympathetic Stimulation and the Release of ACh and NO 541
Summary: The Sympathetic Division 542
16-4 The parasympathetic division consists of preganglionic
neurons and ganglionic neurons involved in conserving energy and lowering metabolic rate 542Organization and Anatomy of the Parasympathetic Division 542
Parasympathetic Activation 542
14-3 The medulla oblongata is continuous with the spinal
cord and contains vital centers 470
14-4 The pons contains nuclei and tracts that carry or relay
sensory and motor information 472
14-5 The cerebellum coordinates learned and reflexive patterns
of muscular activity at the subconscious level 473
14-6 The midbrain regulates auditory and visual reflexes
and controls alertness 475
14-7 The diencephalon integrates sensory information with
motor output at the subconscious level 477
The Thalamus 477
The Hypothalamus 478
14-8 The limbic system is a group of tracts and nuclei that
function in emotion, motivation, and memory 480
14-9 The cerebrum, the largest region of the brain, contains
motor, sensory, and association areas 482
The Cerebral Cortex 482
The White Matter of the Cerebrum 482
The Basal Nuclei 482
Motor and Sensory Areas of the Cortex 486
14-10 Cranial reflexes involve sensory and motor fibers
Aphasia and Dyslexia 489
15 Sensory Pathways and
the Somatic Nervous
System 508
An Introduction to Sensory Pathways and the Somatic Nervous
System 509
15-1 Sensory information from all parts of the body is
routed to the somatosensory cortex 509
15-2 Sensory receptors connect our internal and external
environments with the nervous system 510
The Detection of Stimuli 510
The Interpretation of Sensory Information 511
Adaptation 512
15-3 General sensory receptors are classified by the type of
stimulus that excites them 513
Nociceptors 513
Thermoreceptors 514
Mechanoreceptors 514
Chemoreceptors 517
Trang 22Contents xix
17-4 Photoreceptors respond to light and change it into
electrical signals essential to visual physiology 581Visual Physiology 581
The Visual Pathways 587
17-5 Equilibrium sensations originate within the internal
ear, while hearing involves the detection and interpretation of sound waves 590
Anatomy of the Ear 590Equilibrium 593Hearing 596
Chapter Review 604
Spotlights
Olfaction and Gustation 566Refractive Problems 582Photoreception 584
18 The Endocrine System 608
An Introduction to the Endocrine System 609
18-1 Homeostasis is preserved through intercellular
communication 609
18-2 The endocrine system regulates physiological
processes through the binding of hormones to receptors 611
Classes of Hormones 611Secretion and Distribution of Hormones 612Mechanisms of Hormone Action 614Control of Endocrine Activity by Endocrine Reflexes 616
18-3 The bilobed pituitary gland is an endocrine organ that
releases nine peptide hormones 619The Anterior Lobe of the Pituitary Gland 619The Posterior Lobe of the Pituitary Gland 623Summary: The Hormones of the Pituitary Gland 625
18-4 The thyroid gland lies inferior to the larynx and
requires iodine for hormone synthesis 626Thyroid Follicles and Thyroid Hormones 626Functions of Thyroid Hormones 628The C Cells of the Thyroid Gland and Calcitonin 629
18-5 The four parathyroid glands, embedded in the
posterior surface of the thyroid gland, secrete parathyroid hormone to elevate blood Ca 2 630
18-6 The adrenal glands, consisting of a cortex and medulla,
cap the kidneys and secrete several hormones 631The Adrenal Cortex 631
The Adrenal Medulla 634
16-5 Stimulation of parasympathetic neurons leads to the
release of the neurotransmitter ACh 544
Neurotransmitter Release 544
Membrane Receptors and Responses 544
Summary: The Parasympathetic Division 544
16-6 The sympathetic and parasympathetic divisions
interact, creating dual innervation 545
Anatomy of Dual Innervation 545
Autonomic Tone 546
16-7 Visceral reflexes play a role in the integration and
control of autonomic functions 549
Visceral Reflexes 549
Higher Levels of Autonomic Control 550
The Integration of SNS and ANS Activities 551
16-8 Higher-order functions include memory and states of
16-10 Aging produces various structural and functional
changes in the nervous system 557
17 The Special Senses 563
An Introduction to the Special Senses 564
17-1 Olfaction, the sense of smell, involves olfactory
receptors responding to chemical stimuli 564
Olfactory Receptors 564
Olfactory Pathways 565
Olfactory Discrimination 565
17-2 Gustation, the sense of taste, involves taste receptors
responding to chemical stimuli 568
Taste Receptors 568
Gustatory Pathways 568
Gustatory Discrimination 569
17-3 Internal eye structures contribute to vision, while
accessory eye structures provide protection 570
Accessory Structures of the Eye 570
The Eye 573
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19-4 The ABO blood types and Rh system are based on
antigen–antibody responses 664Cross-Reactions in Transfusions 666Testing for Transfusion Compatibility 666
19-5 The various types of white blood cells contribute to the
body’s defenses 667WBC Circulation and Movement 667Types of WBCs 670
The Differential Count and Changes in WBC Profiles 671
WBC Production 672
19-6 Platelets, disc-shaped structures formed from
megakaryocytes, function in the clotting process 674Platelet Functions 675
Platelet Production 675
19-7 Hemostasis involves vascular spasm, platelet plug
formation, and blood coagulation 675The Vascular Phase 675
The Platelet Phase 676The Coagulation Phase 677Fibrinolysis 679
An Introduction to the Cardiovascular System 685
20-1 The heart is a four-chambered organ, supplied by the
coronary circulation, that pumps oxygen-poor blood
to the lungs and oxygen-rich blood to the rest of the body 686
The Pericardium 686Superficial Anatomy of the Heart 686The Heart Wall 686
Cardiac Muscle Tissue 689Internal Anatomy and Organization 689Connective Tissues and the Cardiac Skeleton 695The Blood Supply to the Heart 695
20-2 The conducting system distributes electrical impulses
through the heart, and an electrocardiogram records the associated electrical events 697
Cardiac Physiology 697The Conducting System 697
18-7 The pineal gland, attached to the roof of the third
ventricle, secretes melatonin 634
18-8 The pancreas is both an exocrine organ and endocrine
Role of Hormones in Growth 644
Aging and Hormone Production 644
Chapter Review 648
Spotlights
Structural Classification of Hormones 613
G Proteins and Second Messengers 615
Hormones and Athletic Performance 646
19-2 Plasma, the fluid portion of blood, contains significant
quantities of plasma proteins 656
Plasma Proteins 656
19-3 Red blood cells, formed by erythropoiesis, contain
hemoglobin that can be recycled 657
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The Cardiovascular Response to Hemorrhaging 751Vascular Supply to Special Regions 752
21-5 The pulmonary and systemic circuits of the
cardiovascular system exhibit three general functional patterns 753
21-6 In the pulmonary circuit, deoxygenated blood enters
the lungs in arteries, and oxygenated blood leaves the lungs by veins 754
21-7 The systemic circuit carries oxygenated blood from
the left ventricle to tissues and organs other than the pulmonary exchange surfaces, and returns deoxygenated blood to the right atrium 755Systemic Arteries 755
Systemic Veins 763
21-8 Modifications of fetal and maternal cardiovascular
systems promote the exchange of materials, and independence occurs at birth 772
Placental Blood Supply 772Fetal Circulation in the Heart and Great Vessels 772Cardiovascular Changes at Birth 773
21-9 Aging affects the blood, heart, and blood vessels 775
22-1 Surface barriers and internal defenses make up
innate defenses, and lymphocytes provide adaptive defenses 782
22-2 Lymphatic vessels, lymphocytes, lymphoid tissues, and
lymphoid organs function in body defenses 783Functions of the Lymphatic System 784
Lymphatic Vessels 784Lymphocytes 787Lymphoid Tissues 790Lymphoid Organs 790The Lymphatic System and Body Defenses 794
22-3 Innate (nonspecific) defenses do not discriminate
between potential threats and respond the same regardless of the invader 796
Physical Barriers 796Phagocytes 796
The Electrocardiogram 702
Contractile Cells 703
20-3 Events during a complete heartbeat make up a cardiac
cycle 706
Phases of the Cardiac Cycle 707
Pressure and Volume Changes in the Cardiac Cycle 708
Heart Sounds 710
20-4 Cardiodynamics examines the factors that affect
cardiac output 711
Overview: Factors Affecting Cardiac Output 711
Factors Affecting the Heart Rate 712
Factors Affecting the Stroke Volume 715
Summary: The Control of Cardiac Output 717
The Heart and the Cardiovascular System 718
An Introduction to Blood Vessels and Circulation 724
21-1 Arteries, arterioles, capillaries, venules, and veins differ
in size, structure, and functional properties 724
The Structure of Vessel Walls 725
Differences between Arteries and Veins 726
Capillaries 729
Veins 732
The Distribution of Blood 733
21-2 Pressure and resistance determine blood flow and
affect rates of capillary exchange 734
Pressure 734
Total Peripheral Resistance 734
An Overview of Cardiovascular Pressures 736
Capillary Pressures and Capillary Exchange 739
21-3 Cardiovascular regulatory mechanisms involve
autoregulation, neural mechanisms, and endocrine
responses 742
Autoregulation of Blood Flow within Tissues 742
Neural Mechanisms 743
Hormones and Cardiovascular Regulation 746
21-4 The cardiovascular system adapts to physiological
stress and maintains a special vascular supply to the
brain, heart, and lungs 749
The Cardiovascular Response to Exercise 749
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23 The Respiratory System 830
An Introduction to the Respiratory System 831
23-1 The respiratory system, organized into an upper
respiratory system and a lower respiratory system, has several basic functions 831
Functions of the Respiratory System 831Organization of the Respiratory System 832
23-2 Located outside the thoracic cavity, the upper
respiratory system consists of the nose, nasal cavity, paranasal sinuses, and pharynx 835
The Nose, Nasal Cavity, and Paranasal Sinuses 835The Pharynx 837
23-3 Composed of cartilages, ligaments, and muscles, the
larynx produces sound 837Cartilages and Ligaments of the Larynx 837Sound Production 838
The Laryngeal Musculature 839
23-4 The trachea and primary bronchi convey air to and
from the lungs 839The Trachea 839The Primary Bronchi 840
23-5 Enclosed by pleural cavities, the lungs are paired
organs containing alveoli, which permit gaseous exchange 841
Lobes and Surfaces of the Lungs 841The Bronchi 841
The Bronchioles 841Alveolar Ducts and Alveoli 843The Blood Supply to the Lungs 846The Pleural Cavities and Pleural Membranes 846
23-6 External respiration and internal respiration allow
gaseous exchange within the body 847
23-7 Pulmonary ventilation—the exchange of air between
the atmosphere and the lungs—involves pressure changes, muscle movement, and respiratory rates and volumes 848
The Movement of Air 848Pressure Changes during Inhalation and Exhalation 849The Mechanics of Breathing 852
Respiratory Rates and Volumes 854
23-8 Gas exchange depends on the partial pressures of
gases and the diffusion of molecules 856The Gas Laws 856
Diffusion and Respiratory Function 858
22-4 Adaptive (specific) defenses respond to individual
threats and are either cell-mediated or
antibody-mediated 802
Forms of Immunity 803
Properties of Adaptive Immunity 804
An Introduction to the Immune Response 804
22-5 T cells play a role in initiating, maintaining, and
controlling the immune response 805
Summary of the Immune Response 815
22-7 Immunocompetence enables a normal immune
response; abnormal responses result in immune
disorders 818
The Development of Immunocompetence 818
Cytokines of the Immune System 818
Immune Disorders 818
Stress and the Immune Response 823
22-8 The immune response diminishes as we age 825
22-9 The nervous and endocrine systems influence the
Cancer and the Lymphatic System 788
Graft Rejection and Immunosuppression 806
AIDS 819
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24-4 The esophagus is a muscular tube that transports
solids and liquids from the pharynx to the stomach 895
Histology of the Esophagus 895Swallowing 896
24-5 The stomach is a J-shaped organ that receives the
bolus from the esophagus and aids in chemical and mechanical digestion 897
Anatomy of the Stomach 897Regulation of Gastric Activity 901Digestion and Absorption in the Stomach 901
24-6 The small intestine digests and absorbs nutrients,
and associated glandular organs assist with digestive processes 901
The Small Intestine 901Histology of the Small Intestine 904Intestinal Secretions 906
Intestinal Movements 907The Pancreas 907The Liver 909The Gallbladder 914The Coordination of Secretion and Absorption 914
24-7 The large intestine is divided into three parts with
regional specialization 916The Cecum 917
The Colon 917The Rectum 919Histology of the Large Intestine 919Physiology of the Large Intestine 920
24-8 Digestion is the chemical alteration of food that allows
the absorption and use of nutrients 922The Processing and Absorbing of Nutrients 922Carbohydrate Digestion and Absorption 922Lipid Digestion and Absorption 925Protein Digestion and Absorption 925Water Absorption 926
Ion Absorption 926
24-9 Many age-related changes affect digestion and
absorption 928
24-10 The digestive system is extensively integrated with
other body systems 928
Gastritis and Peptic Ulcers 897
23-9 Most oxygen is transported bound to hemoglobin;
and carbon dioxide is transported in three ways: as
carbonic acid, bound to hemoglobin, or dissolved in
plasma 860
Oxygen Transport 860
Carbon Dioxide Transport 863
Summary: Gas Transport 864
23-10 Neurons in the medulla oblongata and pons, along
with respiratory reflexes, control respiration 864
Local Regulation of Gas Transport and Alveolar
Function 865
The Respiratory Centers of the Brain 866
Respiratory Reflexes 870
Voluntary Control of Respiration 872
Changes in the Respiratory System at Birth 872
23-11 Respiratory performance declines with age 873
23-12 The respiratory system provides oxygen to, and
eliminates carbon dioxide from, other organ
Blood Gas Analysis 860
Carbon Monoxide Poisoning 863
Emphysema and Lung Cancer 875
24 The Digestive System 880
An Introduction to the Digestive System 881
24-1 The digestive system, consisting of the digestive tract
and accessory organs, has overlapping food utilization
functions 881
Functions of the Digestive System 882
The Digestive Organs and the Peritoneum 883
Histology of the Digestive Tract 885
The Movement of Digestive Materials 886
Control of Digestive Functions 887
24-2 The oral cavity contains the tongue, salivary glands,
and teeth, each with specific functions 889
Trang 2726 The Urinary System 972
An Introduction to the Urinary System 973
26-1 The kidneys, ureters, urinary bladder, and urethra
make up the urinary system, which has three primary functions 973
26-2 Kidneys are highly vascular organs containing
functional units called nephrons, which filter, reabsorb, and secrete 974
Sectional Anatomy of the Kidneys 975Blood Supply and Innervation of the Kidneys 976The Nephron 978
26-3 Different segments of the nephron form urine by
filtration, reabsorption, and secretion 983Basic Processes of Urine Formation 983
26-4 Hydrostatic and colloid osmotic pressures influence
glomerular filtration pressure, which in turn affects the glomerular filtration rate 987
Filtration Pressures 988The Glomerular Filtration Rate 989Control of the GFR 989
26-5 Countercurrent multiplication, antidiuretic
hormone, and aldosterone affect reabsorption and secretion 992
Reabsorption and Secretion at the PCT 992The Nephron Loop and Countercurrent Multiplication 993
Reabsorption and Secretion at the DCT 996Reabsorption and Secretion along the Collecting System 997
The Control of Urine Volume and Osmotic Concentration 997
The Function of the Vasa Recta 1001The Composition of Normal Urine 1001
26-6 Urine is transported by the ureters, stored in the
bladder, and eliminated through the urethra, aided by the micturition reflex 1004
The Ureters 1005The Urethra 1006The Micturition Reflex and Urination 1007
26-7 Age-related changes affect kidney function and the
micturition reflex 1009
26-8 The urinary system is one of several body systems
involved in waste excretion 1011
An Introduction to Metabolism and Energetics 936
25-1 Metabolism refers to all the chemical reactions
in the body, and energetics refers to the flow and
transformation of energy 936
25-2 Carbohydrate metabolism involves glycolysis, ATP
production, and gluconeogenesis 939
Glycolysis 939
Mitochondrial ATP Production 939
Energy Yield of Glycolysis and Cellular Respiration 945
Gluconeogenesis 946
25-3 Lipid metabolism involves lipolysis, beta-oxidation,
and the transport and distribution of lipids as free fatty
acids and lipoproteins 947
Lipid Catabolism 947
Lipid Synthesis 949
Lipid Transport and Distribution 949
25-4 Protein catabolism involves transamination and
deamination, whereas protein synthesis involves
amination and transamination 952
Amino Acid Catabolism 952
Protein Synthesis 952
25-5 The body experiences two patterns of metabolic
activity: the absorptive and postabsorptive
states 956
25-6 Adequate nutrition is necessary to prevent deficiency
disorders and ensure physiological functioning 957
Food Groups and a Balanced Diet 957
Nitrogen Balance 957
Minerals 959
Vitamins 960
Diet and Disease 961
25-7 Metabolic rate is the average caloric expenditure, and
thermoregulation involves balancing heat-producing
and heat-losing mechanisms 962
Energy Gains and Losses 962
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Metabolic Acidosis 1041Metabolic Alkalosis 1043The Detection of Acidosis and Alkalosis 1043
27-7 Aging affects several aspects of fluid, electrolyte, and
Water and Weight Loss 1023
Athletes and Salt Loss 1027
28 The Reproductive
System 1050
An Introduction to the Reproductive System 1051
28-1 Basic reproductive system structures are gonads,
ducts, accessory glands and organs, and external genitalia 1051
28-2 Spermatogenesis occurs in the testes, and hormones
from the hypothalamus, anterior lobe of the pituitary gland, and testes control male reproductive functions 1052
The Testes 1052Spermatogenesis 1056Mitosis and Meiosis 1056The Anatomy of a Spermatozoon 1060The Male Reproductive Tract 1061The Accessory Glands 1062Semen 1064
The External Genitalia 1064Hormones and Male Reproductive Function 1066
28-3 Oogenesis occurs in the ovaries, and hormones
from the pituitary gland and gonads control female reproductive functions 1068
The Ovaries 1069The Uterine Tubes 1074The Uterus 1075The Vagina 1079The External Genitalia 1080The Mammary Glands 1081Hormones and Female Reproductive Function 1081
28-4 The autonomic nervous system influences male and
female sexual function 1087Male Sexual Function 1087Female Sexual Function 1088
Renal Failure and Kidney Transplant 1009
27 Fluid, Electrolyte, and
Acid–Base Balance 1015
An Introduction to Fluid, Electrolyte, and Acid–Base
Balance 1016
27-1 Fluid balance, electrolyte balance, and acid–
base balance are interrelated and essential to
homeostasis 1016
27-2 The ECF and ICF make up the fluid compartments,
which also contain cations and anions 1017
The ECF and the ICF 1017
Basic Concepts in the Regulation of Fluids and
Electrolytes 1019
An Overview of the Primary Regulatory Hormones 1020
The Interplay between Fluid Balance and Electrolyte
Balance 1021
27-3 Hydrostatic and osmotic pressures regulate the
movement of water and electrolytes to maintain fluid
balance 1021
Fluid Movement within the ECF 1021
Fluid Gains and Losses 1022
Fluid Shifts 1022
27-4 Sodium, potassium, calcium, magnesium, phosphate,
and chloride balance is essential for maintaining
homeostasis 1024
Sodium Balance 1025
Potassium Balance 1027
Balance of Other Electrolytes 1028
27-5 In acid–base balance, regulation of hydrogen ions in
body fluids involves buffer systems and respiratory
and renal compensatory mechanisms 1030
The Importance of pH Control 1030
Types of Acids in the Body 1030
Mechanisms of pH Control 1032
Maintenance of Acid–Base Balance 1035
27-6 Respiratory acidosis/alkalosis and metabolic
acidosis/alkalosis are classes of acid–base balance
disturbances 1038
Respiratory Acidosis 1038
Respiratory Alkalosis 1041
Trang 2929-7 Postnatal stages are the neonatal period, infancy,
childhood, adolescence, and maturity, followed by senescence 1118
The Neonatal Period, Infancy, and Childhood 1118Adolescence and Maturity 1120
Senescence 1122
29-8 Genes and chromosomes determine patterns of
inheritance 1122Patterns of Inheritance 1123Sources of Individual Variation 1126Sex-Linked Inheritance 1128The Human Genome Project and Beyond 1129
Codon Chart A-4
Answers to Checkpoints, End-of-Chapter Questions, and Clinical Case Wrap-Ups AN-1
glossary G-1
Credits C-1Index I-1
28-5 With age, decreasing levels of reproductive hormones
cause functional changes 1088
Menopause 1088
The Male Climacteric 1089
28-6 The reproductive system secretes hormones affecting
growth and metabolism of all body systems 1089
Chapter Review 1092
Spotlights
Regulation of Male Reproduction 1067
Regulation of Female Reproduction 1084
An Introduction to Development and Inheritance 1096
29-1 Development, marked by various stages, is a
continuous process that occurs from fertilization to
29-3 Gestation consists of three stages of prenatal
development: the first, second, and third
trimesters 1099
29-4 Cleavage, implantation, placentation, and
embryogenesis are critical events of the first
29-5 During the second and third trimesters, maternal
organ systems support the developing fetus, and
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Clinical notes
● Autopsies and Cadaver Dissection p 5
● Auscultation p 14
learning outcomes
These Learning Outcomes correspond by number to this chapter’s sections
and indicate what you should be able to do after completing the chapter.
1-1 Explain the importance of studying anatomy
and physiology
1-2 Define anatomy and physiology, describe the origins
of anatomical and physiological terms, and explain the
significance of Terminologia Anatomica (International
Anatomical Terminology).
1-3 Explain the relationship between anatomy and physiology,
and describe various specialties of each discipline
1-4 Identify the major levels of organization in organisms,
from the simplest to the most complex, and identify major
components of each organ system
1-5 Explain the concept of homeostasis
1-6 Describe how negative feedback and positive feedback
are involved in homeostatic regulation, and explain the
significance of homeostasis
1-7 Use anatomical terms to describe body regions, body
sections, and relative positions
1-8 Identify the major body cavities and their subdivisions,
and describe the functions of each
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“How long has he been down?”
questions the nurse “Less than
a half hour We intubated him [inserted a breathing tube] and started a large bore IV as soon as
we got there We are 10 minutes out now.” “Keep the fluids going wide open, keep pressure on the thigh, and take him directly to Trauma Room 1,” come the instruc-tions Meanwhile the nurse orders the trauma team to Trauma Room 1, orders x-ray to be on stand-by in the room, and re-quests 4 units of type O negative whole blood—the universal donor blood—from the blood bank Will the team be ready
to save this young man? To find out, turn to the Clinical Case Wrap-Up on p 25.
Using a&p to Save a life
The emergency medical technician (EMT) is on the
way to the emergency room with a young victim
of street violence A knife with a 6-inch blade had been found
next to the bleeding, unconscious man
“We have a young male with multiple stab wounds He has
lost a lot of blood and we can barely get a blood pressure,” the
EMT radioes to the triage nurse in the emergency room as the
ambulance squeals through traffic “We started an IV and
we are pouring in fluid as fast as we can.”
“Where are the wounds?” asks the receiving nurse “He has
a deep wound in his right upper quadrant, just inferior to the
diaphragm I can see bruising from the hub of the knife around
the wound, and there is another wound in his anterior right
thigh His pulse is 120 and thready [weak] His blood pressure
is 60 over 30.”
an introduction to Studying
the human Body
In this textbook we will introduce you to the inner workings
of your body, giving information about both its structure
(anatomy) and its function (physiology) Many students who
use this book are preparing for jobs in health-related fields—
but regardless of your career choice, you will find the
informa-tion within these pages relevant to your future You do, after
all, live in a human body! As a human, you are most likely
very curious, and few subjects arouse so much curiosity as our
own bodies The study of anatomy and physiology will provide
answers to many questions about the way your body works in
both health and disease
We will focus on the human body, but the principles you
will learn apply to other living things as well Our world
con-tains an enormous diversity of living organisms They vary
widely in appearance and lifestyle One aim of biology—the
science of life—is to discover the unity and the patterns that
underlie this diversity, and in this way shed light on what we
have in common with other living things
We can classify animals according to the characteristics
that they share Birds, fish, and humans are placed in a group
called the vertebrates, characterized by a segmented vertebral
column Their shared characteristics and organizational
pat-terns are clues about how these animals have evolved over
time Many of the complex structures and functions of the
human body that we discuss in this book have distant
evolu-tionary origins When we compare human beings with other
creatures, we find two important principles:
There are obvious structural and functional similarities among vertebrates
Form determines function
In this chapter we explore the structural and functional characteristics of living things We look at the levels of organi-zation that anatomical structures and physiological processes
display We also introduce homeostasis, the state of balance
within the body, which is the goal of physiological regulation and the key to survival in a changing environment
1-1 anatomy and physiology directly affect your life
learning outcome Explain the importance of studying anatomy and physiology.
Welcome to the field of anatomy and physiology! Anatomy
is the study of body structures and physiology is the study of body functions You will discover how your body works under normal and abnormal conditions This knowledge will serve as the foundation for understanding all other basic life sciences, and for making common sense decisions about your own life Basic knowledge of normal physiological function, for exam-ple, will prove useful whenever you or a friend or relative be-comes ill We will explain how the body responds to normal and abnormal conditions and maintains homeostasis As we proceed, you will see how your body copes with injury, dis-ease, or anything that threatens homeostasis
Anatomy is the oldest medical science Egyptian drawings from 1600 BCE illustrated basic knowledge of blood vessels
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In effect, anatomy uses a special language that you must learn almost at the start of your study
That special language, called medical terminology,
in-volves using word roots, prefixes, suffixes, and combining forms to build terms related to the body in health and dis-ease Many of the anatomical and physiological terms you will encounter in this textbook are derived from Greek or latin learning the word parts used in medical terminology will greatly assist in your study of anatomy and physiology, and in your preparation for any health-related career
There are four basic building blocks—or word parts—of
medical terms Word roots are the basic, meaningful parts of a
term that cannot be broken down into another term with
an-other definition Prefixes are word elements that are attached
to the beginning of words to modify their meaning but cannot
stand alone Suffixes are word elements or letters added to the end of a word or word part to form another term Combining forms are independent words or word roots that are used in
combination with words, prefixes, suffixes, or other ing forms to build a new term The table inside the back cover
combin-of your textbook lists many commonly used word roots, fixes, suffixes, and combining forms
pre-To illustrate the building of medical terms, consider the
word pathology (puh-THOl-o.
-je.) Breaking this word into its
basic elements reveals its meaning The prefix path- refers to disease (the Greek term for disease is pathos) The suffix -ology
means “study of.” So pathology is the study of disease
A familiarity with latin and Greek word roots and terns makes anatomical terms easier to understand As we in-troduce new terms, we will provide notes on pronunciation and relevant word parts
pat-latin and Greek terms are not the only ones that have been imported into the anatomical vocabulary over the cen-turies, and this vocabulary continues to expand Many ana-tomical structures and clinical conditions were first named after either the discoverer or, in the case of diseases, the most famous victim Over the last 100 years, most of these com-memorative names, or eponyms, have been replaced by more
precise terms Where appropriate, we will give both the onym and the more precise term, because in clinical medi-cine, both terms may be used The Glossary at the end of this book includes a table listing important eponyms and related historical details
ep-It is important for scientists throughout the world to use the same name for each body structure In 1998, two scien-tific organizations—the Federative Committee on Anatomical Terminology and the 56 member associations of the Interna-
tional Associations of Anatomists—published International Anatomical Terminology (Terminologia Anatomica, or TA) Ter- minologia Anatomica serves as a worldwide official standard
of anatomical vocabulary latin continues to be the language
of anatomy, but this reference provides an English equivalent
These drawings show that people have always been fascinated
with the human body Since that time, imaging techniques for
studying the human body have evolved, enabling us to
de-scribe the locations and functions of body parts Over the last
two decades, the most rapid progress has taken place in the
field of molecular biology, which studies processes at the level
of individual genes It uses principles of biology, chemistry,
genetics, and biochemistry Molecular biology helps us
under-stand how the body works at the most fundamental level and
reveals the underlying basis for many disorders and diseases
Medical science is always expanding and affects our
ev-eryday lives We are flooded with health information from the
popular press, news media, and advertisements Medical terms
have become part of our common language, and we owe it to
ourselves to understand them This course will significantly
ex-pand your vocabulary and enhance your understanding of the
origins and meanings of many medical terms
C h e C k p o i n t
1 Identify the oldest medical science.
2 Why is studying human anatomy and physiology
important?
See the blue Answers tab at the back of the book.
1-2 anatomy is structure,
and physiology is function
learning outcome Define anatomy and physiology, describe the
origins of anatomical and physiological terms, and explain the significance
of Terminologia Anatomica (International Anatomical Terminology).
People have always been interested in the inner workings of
the human body Many medical terms have Greek roots, as do
many other anatomical terms and phrases that originated more
than 1500 years ago For example, the term anatomy is derived
from Greek roots that mean “a cutting open.” Anatomy is the
study of internal and external body structures and their physical
relationships among other body parts In contrast, physiology,
another Greek term, is the study of how living organisms
per-form their functions Someone studying anatomy might, for
example, examine how a particular muscle attaches to the
skeleton Someone studying physiology might consider how
a muscle contracts or what forces a contracting muscle exerts
on the skeleton You will be studying both anatomy and
physi-ology in this book, so let’s look at the relationships between
these sciences
Early anatomists faced serious problems in
communica-tion Saying that a bump is “on the back,” for example, does
not give very precise information about its location So
anato-mists created maps of the human body Prominent anatomical
structures serve as landmarks, distances are measured in
cen-timeters or inches, and specialized directional terms are used
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how the transmission conveys this motion to the axles and wheels so that the car moves Additionally, he or she might also study the amount of power that the engine could gen-erate, the amount of force transmitted to the wheels in dif-ferent gears, and so on
Our basic approach in this text will be to start with the descriptive anatomy of body structures (appearance, size, shape, location, weight, and color) before considering the related functions Sometimes the group of organs that make
up an organ system perform very diverse functions, and in those cases we will consider the functions of each individual organ separately A good example is our discussion of the di-gestive system You will learn about the functions of the sali-vary glands in one section, and the functions of the tongue
in another In other systems, the organs work together so tensively that we present an overall discussion of their physio-logy, after we describe the system’s anatomy The lymphatic system and the cardiovascular system are examples of this approach
ex-anatomy
How you look at things often determines what you see You get a very different view of your neighborhood from a satellite photo than from your front yard Similarly, your method of observation has a dramatic effect on your understanding of the structure of the human body Based on the degree of structural
detail being considered, we divide anatomy into gross scopic) anatomy and microscopic anatomy.
(macro-gross anatomy
Gross anatomy, or macroscopic anatomy, involves examining
relatively large structures Gross anatomy can be seen without using a microscope and can involve the study of anatomy by dissecting a cadaver There are many different forms of gross anatomy:
Surface anatomy is the study of general form and superficial
(toward the body surface) markings
Regional anatomy focuses on the anatomical organization
of specific areas of the body, such as the head, neck, or trunk Many advanced courses in anatomy stress a regional approach, because it emphasizes the spatial relationships among structures already familiar to students
Systemic anatomy is the study of the structure of organ systems, which are groups of organs that function together
in a coordinated manner Examples include the skeletal system, composed primarily of bones; the muscular system, made up of skeletal muscles; and the cardiovascular system,
consisting of the heart, blood, and vessels We take a temic anatomy approach in this book because this format will better clarify the functional relationships among the
sys-term for each anatomical structure For example, the tendo caneus (latin) is also called the calcaneal tendon (English)
cal-You may know the structure better by its eponym, the Achilles
tendon Eponyms are not found in TA We have used TA as our
standard in preparing this text
See the blue Answers tab at the back of the book.
1-3 anatomy and physiology are closely integrated
learning outcome Explain the relationship between anatomy and physiology, and describe various specialties of each discipline.
Anatomy and physiology are closely integrated, both cally and practically Anatomical information provides clues about functions, and physiological processes can be explained only in terms of the underlying anatomy This is a very impor-tant concept in living systems:
theoreti-All specific functions are performed by specific structures, and the form of a structure relates to its function This is
known as the principle of complementarity of structure and function.
The link between structure and function is always present, but not always understood For example, the anatomy of the heart was clearly described in the 15th century, but al-most 200 years passed before the heart’s pumping action was demonstrated
Anatomists and physiologists approach the ship between structure and function from different perspec-tives To understand the difference, suppose you asked an anatomist and a physiologist to examine a pickup truck and report their findings The anatomist might begin by measuring and photographing the various parts of the truck and, if possible, taking it apart and putting it back to-
relation-gether The anatomist could then explain its key structural
relationships—for example, how the pistons are seated in the engine cylinders, how the crankshaft is connected to the pistons, how the transmission links the drive shaft to the axles, and thus to the wheels The physiologist also would note the relationships among the truck’s parts, but he or she
would focus mainly on its functional characteristics, such as
how the combustion of gasoline in the cylinders moves the pistons up and down and makes the drive shaft rotate, and
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-TOl-o.-je.) is the study of the internal structure of individual cells, the simplest units of
life Cells are made up of chemical substances in various nations, and our lives depend on the chemical processes taking place in the trillions of cells in the body For this reason, we consider basic chemistry (Chapter 2) before we examine cell structure (Chapter 3) Histology (his-TOl-o.
combi je.) is the exami-nation of tissues—groups of specialized cells and cell products
that work together to perform specific functions (Chapter 4) Tissues combine to form organs, such as the heart, kidney, liver,
or brain, each with specific functions Many organs are easy to examine without a microscope, so at the organ level we cross the boundary from microscopic anatomy to gross anatomy As we proceed through the text, we will consider details at all levels, from microscopic to macroscopic (Spotlight Figure 1-1)
Cell physiology, the study of the functions of cells, is the
cornerstone of human physiology Cell physiology looks
at events involving the atoms and molecules important to life It includes both chemical processes within cells and chemical interactions among cells
Organ physiology is the study of the function of specific organs An example is cardiac physiology, the study of heart
function—how the heart works
Systemic physiology includes all aspects of the functioning of
specific organ systems Cardiovascular physiology, tory physiology, and reproductive physiology are examples
respira-Pathological physiology is the study of the effects of diseases
on organ functions or system functions Modern medicine depends on an understanding of both normal physiology and pathological physiology
Physicians normally use a combination of anatomical, physiological, chemical, and psychological information when
Autopsies and Cadaver Dissection There is much to
be learned from death An autopsy is a thorough internal
and external examination of the body after death to
deter-mine the cause of death Autopsies and cadaver dissections
reveal much about life Historically, humans have been
fascinated with the human body Scientists, physicians, and
artists shared this fascination For example, as early as 304
BCE, Greek anatomist and royal physician Erasistratus and
his physician colleague, Herophilus, dissected human
cadav-ers to learn about internal anatomy In the second century,
physician Claudius Galen, often recognized as the “father of
anatomy,” was the first to show a connection between patient
symptoms in life and the autopsy observations in death
In the late 1200s, the University of Bologna was the first
in-stitution to perform autopsies In 1632, the Dutch painter,
Rembrandt created The Anatomy Lesson of Dr Nicolaes Tulp
An Italian anatomist, Giovanni Morgagni, advanced the field
of anatomical pathology with his 1761 work, On the Seats
and Causes of Diseases In
1910, Dr Richard Cabot, an
American physician, studied
autopsies and learned that
doctors had misdiagnosed
their patients 40 percent of
the time Today, using
cadav-ers to learn anatomy is
com-monplace Many students
consider it to be a profound
experience
Clinical note
component organs We will introduce the 11 organ systems
in the human body later in the chapter
Clinical anatomy includes a number of subspecialties
im-portant in clinical practice Examples include pathological
anatomy (anatomical features that change during illness),
radiographic anatomy (anatomical structures seen using
specialized imaging techniques), and surgical anatomy
(anatomical landmarks important in surgery)
Developmental anatomy describes the changes in form
that take place between conception and adulthood The
techniques of developmental anatomists are similar to
those used in gross anatomy and in microscopic anatomy
(discussed next) because developmental anatomy considers
anatomical structures over a broad range of sizes—from
a single cell to an adult human The most extensive
structural changes take place during the first two months
of development The study of these early developmental
processes is called embryology (em-bre.
-Ol-o.-je.)
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The Cellular Level Cells are the smallest living units in the
body Complex molecules can form various types of larger structures called organelles Each organelle has a specific function in a cell Energy-producing organelles provide the energy needed for heart muscle cell contractions We exam-ine the cellular level of organization in Chapter 3
The Tissue Level A tissue is a group of cells working
to-gether to perform one or more specific functions Heart
muscle cells, also called cardiac muscle cells (cardium,
heart), interact with other types of cells and with materials outside the cell to form cardiac muscle tissue We consider the tissue level of organization in Chapter 4
The Organ Level Organs are made of two or more tissues
working together to perform specific functions layers of cardiac muscle tissue, in combination with another type
of tissue called connective tissue, form the bulk of the wall
of the heart, which is a hollow, three-dimensional organ
The Organ System Level A group of organs interacting to
perform a particular function forms an organ system
Each time it contracts, the heart pushes blood into a network of blood vessels Together, the heart, blood, and blood vessels make up the cardiovascular system, one of
11 organ systems in the body This system functions to distribute oxygen and nutrients throughout the body
The Organism Level An organism—in this case, an
indi-vidual human—is the highest level of organization that
we consider All of the body’s organ systems must work together to maintain the life and health of the organism.The organization at each level determines not only the structural characteristics, but also the functions, of higher lev-els For example, the arrangement of atoms and molecules at the chemical level creates the protein filaments and organelles at the cellular level that give individual cardiac muscle cells the abil-ity to contract At the tissue level, these cells are linked, forming cardiac muscle tissue The structure of the tissue ensures that the contractions are coordinated, producing a powerful heartbeat When that beat occurs, the internal anatomy of the heart, an organ, enables it to function as a pump The heart is filled with blood and connected to the blood vessels, and its pumping ac-tion circulates blood through the vessels of the cardiovascular system Through interactions with the respiratory, digestive, uri-nary, and other systems, the cardiovascular system performs a variety of functions essential to the survival of the organism.Something that affects a system will ultimately affect each
of the system’s parts For example, after massive blood loss, the heart cannot pump blood effectively When the heart cannot pump and blood cannot flow, oxygen and nutrients cannot be distributed to the heart or around the body Very soon, the car-diac muscle tissue begins to break down as individual muscle cells die from oxygen and nutrient starvation These changes will
they evaluate patients When a patient presents signs (an
ob-jective disease indication like a fever) and symptoms (a
sub-jective disease indication, such as tiredness) to a physician, the physician will look at the structures affected (gross anatomy), perhaps collect a fluid or tissue sample (microscopic anatomy) for analysis, and ask questions to find out what changes from normal functioning the patient is experiencing Think back
to your last trip to a doctor’s office Not only did the ing physician examine your body, noting any anatomical ab-normalities, but he or she also evaluated your physiological processes by asking questions, observing your movements, listening to your body sounds, taking your temperature, and perhaps requesting chemical analyses of fluids such as blood
attend-or urine
In evaluating all these observations to reach a diagnosis, physicians rely on a logical framework based on the scien-tific method The scientific method is a system of advancing
knowledge that begins by proposing a hypothesis to answer a question, and then testing that hypothesis with data collected through observation and experimentation This method is at the core of all scientific thought, including medical diagnosis
10 Identify several specialties of physiology.
11 Why is it difficult to separate anatomy from physiology?
See the blue Answers tab at the back of the book.
1-4 levels of organization progress from molecules to a complete organism
learning outcome Identify the major levels of organization in organisms, from the simplest to the most complex, and identify major components of each organ system.
Over the next three chapters, we will consider the three most basic (chemical, cellular, and tissue) levels of organization of the human body They interact with more complex structures and vital processes, as we describe in Chapters 5–29 The levels
of organization of the human body include:
The Chemical Level Atoms are the smallest stable units
of matter They can combine to form molecules with complex shapes The atomic components and unique three-dimensional shape of a particular molecule determine its function For example, complex protein molecules form fil-aments that produce the contractions of muscle cells in the heart We explore this level of organization in Chapter 2
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some environmental change For example, when oxygen levels decline in a tissue, the cells release chemicals that widen, or dilate, blood vessels This dilation increases the rate of blood flow and provides more oxygen to the region
2 Extrinsic regulation is a process that results from the
ac-tivities of the nervous system or endocrine system These organ systems detect an environmental change and send
an electrical signal (nervous system) or chemical ger (endocrine system) to control or adjust the activities of another or many other systems simultaneously For exam-ple, when you exercise, your nervous system issues com-mands that increase your heart rate so that blood will cir-culate faster Your nervous system also reduces blood flow
messen-to less active organs, such as the digestive tract The oxygen
in circulating blood is then available to the active muscles, which need it most
In general, the nervous system directs rapid, short-term, and very specific responses For example, when you acciden-tally set your hand on a hot stove, the heat produces a painful, localized disturbance of homeostasis Your nervous system re-sponds by ordering specific muscles to contract and pull your hand away from the stove These contractions last only as long
as the neural activity continues, usually a matter of seconds
In contrast, the endocrine system releases chemical
mes-sengers called hormones into the bloodstream These molecular
messengers can affect tissues and organs throughout the body The responses may not be immediately apparent, but they may persist for days or weeks Examples of homeostatic regulation dependent on endocrine function include the long-term regu-lation of blood volume and composition, and the adjustment
of organ system function during starvation Regardless of the system involved, homeostatic regulation always works to keep the internal environment within certain limits A homeostatic regulatory mechanism consists of three parts: (1) a receptor, a
sensor that is sensitive to a particular stimulus or environmental change; (2) a control center, which receives and processes the
information supplied by the receptor and sends out commands; and (3) an effector, a cell or organ that responds to the com-
mands of the control center and whose activity either opposes
or enhances the stimulus You are probably already familiar with similar regulatory mechanisms, such as the one involving the thermostat in your house or apartment (Figure 1–2a)
The thermostat is the control center It receives tion about room temperature from an internal or remote ther-mometer (a receptor) The setting on the thermostat estab-lishes the set point, or desired value, which in this case is the
informa-temperature you select (In our example, the set point is 22˚C,
or about 72˚F.) The function of the thermostat is to keep room temperature within acceptable limits, usually within a degree
or so of the set point In summer, the thermostat performs this function by controlling an air conditioner (an effector) When
not be restricted to the cardiovascular system All cells, tissues,
and organs in the body will be damaged Spotlight Figure 1–1
illustrates the levels of organization and introduces the 11
inter-dependent, interconnected organ systems in the human body
The cells, tissues, organs, and organ systems of the body
coexist in a relatively small, shared environment, much like the
residents of a large city Just as city dwellers breathe the same
air and drink the water supplied by the local water company,
cells in the human body absorb oxygen and nutrients from the
fluids that surround them If a city is blanketed in smog or its
water supply is contaminated, the people will become ill
Sim-ilarly, if the body fluid composition becomes abnormal, cells
will be injured or destroyed For example, suppose the
tem-perature or salt content of the blood changes The effect on the
heart could range from the need for a minor adjustment (heart
muscle tissue contracts more often, raising the heart rate) to a
total disaster (the heart stops beating, so the individual dies)
C h e C k p o i n t
12 Identify the major levels of organization of the human
body from the simplest to the most complex.
13 Identify the organ systems of the body and cite some
major structures of each.
14 At which level of biological organization does
a histologist investigate structures?
See the blue Answers tab at the back of the book.
1-5 homeostasis is the state
of internal balance
learning outcome Explain the concept of homeostasis.
Various physiological processes act to prevent harmful changes
in the composition of body fluids and the environment inside
our cells Homeostasis (ho.
-me.-o-STA■
-sis; homeo, unchanging + stasis, standing) refers to the existence of a stable internal
environment Maintaining homeostasis is absolutely vital to
an organism’s survival Failure to maintain homeostasis soon
leads to illness or even death
The principle of homeostasis is the central theme of this
text and the foundation of all modern physiology
Homeo-static regulation is the adjustment of physiological systems
to preserve homeostasis Physiological systems have evolved
to maintain homeostasis in an environment that is often
in-consistent, unpredictable, and potentially dangerous An
un-derstanding of homeostatic regulation is crucial to making
ac-curate predictions about the body’s responses to both normal
and abnormal conditions
Homeostatic regulation involves two general mechanisms:
autoregulation and extrinsic regulation
1 Autoregulation is a process that occurs when a cell, a
tis-sue, an organ, or an organ system adjusts in response to
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• Stores calcium and other minerals
• Forms blood cells
• Generates heat that maintains body temperature
• Coordinates or moderates activities of other organ systems
• Provides and interprets sensory information about external conditions
Functions
• Directs long-term changes in the activities of other organ systems
• Adjusts metabolic activity and energy use by the body
• Controls many structural and functional changes during development
• Distributes heat and assists in control of body temperature
• Returns tissue fluids
• Provides oxygen to bloodstream
• Removes carbon dioxide from bloodstream
• Produces sounds for communication
• Controls water balance by regulating volume of urine produced
• Stores urine prior to voluntary elimination
• Regulates blood ion concentrations and pH
• Supports developing embryo from con- ception to delivery
• Provides milk to nourish newborn infant
• Sexual intercourse
Integumentary Skeletal Muscular Nervous Endocrine Cardiovascular Lymphatic Respiratory Digestive Urinary Male Reproductive Female Reproductive
Cardiac muscle tissue
The heart
The cardiovascular system
Interacting atoms form molecules that combine to form the protein filaments of a heart
muscle cell Such cells interlock, creating heart muscle tissue, which makes up most of
the walls of the heart, a three-dimensional organ The heart is only one component of
the cardiovascular system, which also includes the blood and blood vessels The various
organ systems must work together to maintain life at the organism level.
THE ORGAN SYSTEMS
Chemical Level
Atoms in combination Complex protein molecule
Protein filaments
Heart muscle cell
Cellular Level
Organism level
Organ system level
8
Spotlight Figure 1–1
Levels of Organization
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• Coordinates or moderates activities of
other organ systems
• Provides and interprets sensory
information about external conditions
Functions
• Directs long-term changes in the
activities of other organ systems
• Adjusts metabolic activity and energy
use by the body
• Controls many structural and
functional changes during development
dissolved materials including nutrients,
waste products, oxygen, and carbon
dioxide
• Distributes heat and assists in
control of body temperature
• Returns tissue fluids
• Provides oxygen to bloodstream
• Removes carbon dioxide from bloodstream
• Produces sounds for communication
• Controls water balance by regulating volume of urine produced
• Stores urine prior to voluntary elimination
• Regulates blood ion concentrations and pH
• Supports developing embryo from con- ception to delivery
• Provides milk to nourish newborn infant
• Sexual intercourse
Integumentary Skeletal Muscular Nervous Endocrine Cardiovascular Lymphatic Respiratory Digestive Urinary Male Reproductive Female Reproductive
Cardiac muscle tissue
The heart
The cardiovascular system
Interacting atoms form molecules that combine to form the protein filaments of a heart
muscle cell Such cells interlock, creating heart muscle tissue, which makes up most of
the walls of the heart, a three-dimensional organ The heart is only one component of
the cardiovascular system, which also includes the blood and blood vessels The various
organ systems must work together to maintain life at the organism level.
THE ORGAN SYSTEMS
Chemical Level
Atoms in combination Complex protein molecule
Protein filaments
Heart muscle cell
Cellular Level
Organism level
Organ system level
9
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Figure 1–2 The Control of Room Temperature.
1-6 negative feedback opposes variations from normal, whereas positive feedback exaggerates them
learning outcome Describe how negative feedback and positive feedback are involved in homeostatic regulation, and explain the significance of homeostasis.
Besides negative feedback, the body also has another method
of homeostatic regulation called positive feedback, which tends
to increase the change that triggered it let’s examine the roles
of positive and negative feedback in homeostasis before sidering the roles of organ systems in regulating homeostasis
con-the Role of negative Feedback
of the brain This control center receives information from
the temperature at the thermometer rises above the set point, the thermostat turns on the air conditioner, which then cools the room Then, when the temperature at the thermometer returns to the set point, the thermostat turns off the air con-ditioner The control is not precise because the room is large, and the thermostat is located on just one wall Over time, the temperature in the center of the room fluctuates in a range above and below the set point (Figure 1–2b)
We can summarize the essential feature of temperature control by a thermostat very simply: A variation outside the set point triggers an automatic response that corrects the situ-
ation This method of homeostatic regulation is called tive feedback, because an effector activated by the control center opposes, or negates, the original stimulus In this way, nega-
nega-tive feedback tends to minimize change, keeping variation in key body systems within acceptable ranges that are compatible with our long-term survival
Air conditioner turns off
Air conditioner turns on
20 30 40
EFFECTOR
Normal condition disturbed
Normal condition restored
STIMULUS:
Room temperature rises
RESPONSE:
Room temperature drops
Information affects
Sends commands to
Air conditioner turns on
CONTROL CENTER (Thermostat)
Normal range
RECEPTOR Thermometer
HOMEOSTASIS
Normal room temperature
a In response to input from a receptor (a thermometer), a thermostat (the control center) triggers an effector response (either an air conditioner or a heater) that restores normal temperature In this case, when room temperature rises above the set point, the thermostat turns on the air conditioner, and the temperature returns to normal
b With this regulatory system, room temperature fluctuates around the set point, 22°C
Set point
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In our example, body temperature fluctuated around the point temperature (Figure 1–3b) The regulatory process itself
set-is dynamic That set-is, it set-is constantly changing because the set point may vary with changing environments or differing activ-ity levels For example, when you are asleep, your thermoregu-latory set point is lower When you work outside on a hot day (or when you have a fever), it is set higher Body temperature can vary from moment to moment or from day to day for any individual, due to either (1) small fluctuations around the set point or (2) changes in the set point Comparable variations take place in all other aspects of physiology
The variability among individuals is even greater than that within an individual Each of us has homeostatic set points determined by genetic factors, age, gender, general health, and environmental conditions For this reason, it is impractical
to define “normal” homeostatic conditions very precisely By convention, physiological values are reported either as average values obtained by sampling a large number of individuals,
or as a range that includes 95 percent or more of the sample population
For example, for 95 percent of healthy adults, body perature ranges between 36.7˚C and 37.2˚C (98.1˚F and 98.9˚F)
tem-two sets of temperature receptors, one in the skin and the
other within the hypothalamus At the normal set point, body
temperature (as measured with an oral thermometer) is
ap-proximately 37˚C (98.6˚F)
If body temperature rises above 37.2˚C, activity in the
control center targets two effectors: (1) muscle tissue lining
the walls of blood vessels supplying blood to the skin and
(2) sweat glands The muscle tissue relaxes so the blood vessels
dilate (widen), increasing blood flow through vessels near the
body surface, and the sweat glands speed up their secretion of
sweat The skin then acts like a radiator by losing heat to the
environment, and the evaporation of sweat speeds the process
As body temperature returns to normal, temperature at
the hypothalamus declines, and the thermoregulatory control
center becomes less active Blood flow to the skin and sweat
gland activity then decrease to previous levels Body
tempera-ture drops below the set point as the secreted sweat evaporates
Negative feedback is the primary mechanism of
homeo-static regulation, and it provides long-term control over the
body’s internal conditions and systems Homeostatic
mecha-nisms using negative feedback normally ignore minor
varia-tions They maintain a normal range rather than a fixed value
37 37.2 36.7
• Sweat glands
in skin increase secretion
• Blood vessels
in skin dilate
Information affects Normal
Normal
temperature
restored
Thermoregulatory center in brain
CONTROL CENTER
Time
Sends commands to
Vessels constrict, sweating decreases
Vessels dilate, sweating increases
Temperature sensors in skin and hypothalamus RECEPTORS
HOMEOSTASIS
Normal body
temperature
a Events in the regulation of body temperature, which are comparable to those
shown in Figure 1–2 A control center in the brain (the hypothalamus) functions as
a thermostat with a set point of 37°C If body temperature exceeds 37.2°C, heat
loss is increased through enhanced blood flow to the skin and increased sweating
b The thermoregulatory center keeps body temperature fluctuating within
an acceptable range, usually between 36.7°C and 37.2°C
Set point
Figure 1–3 Negative Feedback: Control of Body Temperature. In negative feedback, a stimulus produces a response
that opposes or negates the original stimulus