000200010271740878 CH00 FM pi-xxxvi

, R.N., Ph.D.beiraM .N enialE Holyoke Community College

Essentials of Human Anatomy & Physiology

TENTH EDITION

AnatoEssen

omy & ntials of

Physiof Huma

ologyan

mmoCekoyloH

Elaine

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N. Marie

eb R.N., Ph.D.,

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Cover Photo Credit: Erik Isakson/Getty Images

Credits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook appear on the appropriate page within the text or on p. 595.

Taken from:

Essentials of Human Anatomy and Physiology, Tenth Editionby Elaine N. MariebCopyright © 2012 by Pearson Education, Inc.Published by Pearson Education, Inc.One Lake Street, Upper Saddle River, NJ 07458

Copyright © 2014 by Pearson Learning SolutionsAll rights reserved.

Permission in writing must be obtained from the publisher before any part of this work maybe reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage or retrieval system.

All trademarks, service marks, registered trademarks, and registered service marks are theproperty of their respective owners and are used herein for identification purposes only.

Pearson Learning Solutions, 501 Boylston Street, Suite 900, Boston, MA 02116A Pearson Education Companywww.pearsoned.com

Printed in the United States of America

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000200010271740878

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ISBN 10: 1-256-96277-5ISBN 13: 978-1-256-96277-9

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A Look at TEXAS MEDICAL CENTERS

Texas has some of the foremost health-care centers in the nation—from large hospitals with cutting-edge technologies to small clinics that provide crucial care to people in underserved areas. Whatever field of health-care

you are interested in—from infant care to geriatric services and everything in between—you are certain to find outstanding practitioners in Texas.

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The MD Anderson Cancer Center is one of the best cancer-care centers in the nation. It leads the nation in cancer research, cancer education, and cancer prevention. More than 80,000 people per year receive cancer care at MD Anderson. In addition, thousands of patients participate in clinical trials that help researchers

develop new therapies and diagnostic tests. Medical professionals at the MD Anderson Cancer Center conduct research on lung cancer, bladder cancer, prostate cancer, ovarian cancer, head and neck cancer, pancreatic cancer, endometrial cancer, leukemia, and melanomas.

MD Anderson Cancer Center

Courtesy of Corbis Super RF/Alamy.

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Professionals at Parkland Hospital perform almost all medical and surgical specialties. It is one of the largest teaching hospitals in the nation. Its medical teams deliver more infants under one roof than any other hospital in the nation, averaging about 16,000 deliveries per year (more than 40 per day).

TRAUMA CENTER

Parkland is a Level 1 Trauma center, a primary-care center for Dallas County residents, and a medical and surgical referral center for North Texas and parts of Southern Oklahoma. After he was shot on Friday, November 22, 1963, President Kennedy was rushed to Trauma Room 1 at Parkland Hospital. Texas Governor John Connally, wounded in the same shooting, was treated in Trauma Room 2.

BURN CENTER

Parkland’s Burn Center is famous for its state-of-the-art treatment of burn patients, its skin-graft bank, and its burn camp for children. Almost 1,000 burn patients are rushed to its emergency department each year. Parkland’s Burn Center provides complete services to help burn patients—from emergency treatment to rehabilitation and follow-up.

Parkland’s Burn Camp is an opportunity for children and teens to interact with others who have been burned. Being burned is devastating, both physically and psychologically. At the camp, adult burn patients act as role models so children realize they can go on to lead normal, productive lives.

Parkland Hospitals and Health Systems

Cour tesy of Park land Hea lth & Hospita l Sys tem.

Cour tesy of The Washing ton Pos t /Get t y Images.

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The University of Texas Southwestern Medical Center trains nearly 4,400 students, residents, and postdoctoral fellows each year. Every year, it conducts more than 3,500 research projects. Its doctors care for nearly 100,000 people and oversee almost two million outpatient visits

annually. The medical center’s achievements include survival rates after heart attacks that are almost twice as good as the national average. It also has some of the nation’s best biology and biochemistry researchers.

University of Texas Southwestern Medical Center

Cour tesy of Corb is Br idge/Alamy.

Cour tesy of Ju ice Images/Alamy.

Cour tesy of B lend Images/Alamy.

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One of the nation’s leading inpatient psychiatric hospitals, the Menninger Clinic treats adults and adolescents with complex psychiatric disorders. Its patients come from across the nation, and even from other countries.

For more than 20 years, it has ranked as one of the top hospitals in the nation for psychiatry. At the Menninger Clinic, medical teams (which include the patient) integrate medical, psychological, behavioral, and social information to develop a supportive treatment plan.

Some professionals at the clinic are working on a suicide prevention project, while others are involved in research on adult or teen patients. Some of the best professionals in psychiatry have trained at the Menninger Clinic. More than 2,000 graduates practice today in all 50 states and in 26 countries.

The Texas Scottish Rite Hospital for Children is one of the nation’s leading pediatric centers that treats orthopedic conditions. It also treats related neurological disorders (such as spina bifida) and learning disorders (such as dyslexia). Admission is open to all Texas children, regardless of the family’s ability to pay.

The Texas Scottish Rite Hospital was founded in 1921 to treat children with polio. In the mid-1950s, when vaccines virtually eradicated polio, the hospital began treating other orthopedic conditions. Today, the hospital treats more than 40,000 visitors per year.

The Menninger Clinic

Texas Scottish Rite Hospital

Cour tesy of Caro/Alamy.

Cour tesy of the Menninger Cl in ic , Hous ton

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This hospital is one of the leading pediatric hospitals in the United States. Medical professionals treat young patients with medical issues both large and small—from routine eye exams to more serious issues, such as heart disease or cancer. The hospital also performs kidney, liver, intestine, heart, and bone marrow transplants.

Children’s Medical Center is the seventh largest pediatric healthcare provider in the United States, and is the primary pediatric teaching facility for the University of

Texas Southwestern Medical Center. The medical staff conducts research that helps to develop treatments and therapies for many childhood diseases.

The medical center began in the summer of 1913 when a group of nurses set up an open-air clinic on the lawn of the old Parkland Hospital. This Baby Camp and Hospital, as it was called, became the Bradford Hospital for Babies. In 1947, it became part of Children’s Medical Center of Dallas.

Children’s Medical Center of Dallas

Cour tesy of r SnapshotPhotos/Shut ter s tock.

Cour tesy of Sandy Huf faker/AFLAC/AP Images.

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The Texas Medical Center, in Houston, is the largest medical complex in the entire world! It contains many of the nation’s leading hospitals, doctors, researchers, medical schools, and health-care providers. More people work there (92,000) than live in some cities. It has the world’s largest air ambulance service, and more heart surgeries are performed at the Texas Medical Center than anywhere else in the world. The Texas Medical Center includes fifteen hospitals; three medical schools; four nursing schools; and schools of dentistry, public health, pharmacy, and more. The Center is larger than downtown Dallas.

The Michael E. DeBakey Veterans Affairs Medical Center is affiliated with the Baylor College of Medicine. Here students can train in fields such as nursing, dietetics, social work, and physical therapy. There are also training opportunities for health-care administration, health information technology, and medical records billing.

This medical center is one of the VA’s largest hospitals, serving 27 counties in southeast Texas. At this state-of-the-art hospital, researchers study health problems, including heart disease, Hepatitis C, treatments for AIDS and HIV, and illnesses of Gulf War veterans. This research ensures that veterans have access to the latest medical and health-care technology, which leads to improved prevention, diagnosis, treatment, and control of disease and injuries.

Texas Medical Center

The Michael E. DeBakey Veterans Affairs Medical Center

Cour tesy of J im West /A lamy.

Cour tesy of Chad J . McNeeley/CNP/Corbis .

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Trinity Mother Frances is a medical and surgical hospital in Tyler, Texas. It provides high-level care in nine adult specialties. It is a Primary Stroke Facility, contains a renowned heart hospital, and cares for people with seizure disorders. The medical staff at Trinity Mother Francis Hospital perform about 6,000 inpatient surgeries and 12,000 outpatient surgeries every single year. It also treats about 67,000 patients in its emergency room.

In 1937, community leaders built Tyler’s first hospital. The hospital opened a day early, on March 18, 1937, when an explosion at a school 25 miles away injured hundreds of children and teachers. Serving East Texas, the hospital offers emergency medical services; routine and specialized medical and surgical care; neonatal intensive care; maternal and child care; and neurological, orthopedic, and cardiac care.

Harris Health professionals treat adults and children with all types of needs, including weight management, mental health care, and primary and specialty care.

Harris Health has experts in cancer care, cardiology, community medicine, geriatric medicine, HIV/AIDS care, physical medicine and rehabilitation, sleep disorders, trauma care, and women and infant services. Its close affiliation with universities keeps it abreast of the latest research, and strengthens its ability to offer leading-edge treatments and technologies.

Trinity Mother Frances Hospital

Harris Healthcare

Courtesy of Deco/Alamy.

Courtesy of Westend61 GmbH/Alamy.

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The Community Health Centers of South Central Texas provide services to people in communities with a shortage of health professionals. Once a volunteer clinic with one doctor and nurse, it now employs more than 90 workers. The center provides acute and chronic medical care, physical exams, laboratory tests, prescriptions, behavioral health services, immunizations, nutritional counseling, obstetric services, and social services, as well as family planning, HIV/AIDS testing, health education, counseling, and transportation assistance.

The clinic also refers patients to dentists and specialists in substance abuse and mental health. It is open in the evening for people who cannot receive care during normal business hours.

Cour tesy of B lend Images/Alamy

Community Health Centers of South Central Texas

Carter BloodCare is Texas’ largest blood center. It provides blood components and transfusion services for approximately 250 Texas healthcare facilities, including children’s hospitals, trauma centers, cancer centers, and transplant centers. Each year, it collects more than 330,000 units of blood at donation centers, and distributes the blood to medical centers in North, Central and East Texas. In addition, it offers medical support, laboratory services, classes, and seminars—most of which are free.

To donate blood, a person must be healthy, at least 16 years old, and weigh at least 110 pounds.

Carter BloodCare

Courtesy of Wavebreak Media ltd/Alamy.

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Teacher to Teacher

It’s been said that if you choose a job that you love, you will never have to work aday in your life. That’s how I feel every morning when I get ready for my assignmentteaching Anatomy & Physiology to my students. I can honestly say that ElaineMarieb’s Essentials of Human Anatomy & Physiology is one of the primary reasons thatI love my job. The excellent writing of the text, the clear and vivid graphics, and thestrong ancillary materials facilitate student learning and make teaching pleasurable.

While a textbook should be a teaching tool and not the teacher, this book hasbeen exceptional in helping me to get the concepts across to my students. The textwas earnestly designed to be viewed by high school students. It is written at a levelthat is readable while still challenging students without being intimidating—ensuringthat they will be ready for college-level work. It treats delicate subjects openly andclinically which increases the interest and attention level of the students. The excep-tional balance between the anatomical descriptions and the clinical homeostatic phys-iology is presented in a manner that fully engages the students for optimal retention.

The Homeostatic Imbalance sections embedded within the text are perfectlyplaced for answering those ‘what if’ questions at precisely the right moment. The “ACloser Look” boxes address current and relevant topics and are extremely beneficialto the students who want to know more about that subject. Quite often, I find themreading these sections independently.

Two of my favorite ancillary components are the online quizzes and activitiesfound in the Study Area of MasteringAandP. The students love “playing the games”and then taking the quizzes to see how well they learned the material. I love gettingtheir scores emailed to me after they complete the assignments—it’s a win-win.

Another very helpful tool is the Instructor Resources DVD. The PowerPoint presen-tations are wonderful and easy to use for class notes, discussion sessions, or group-sharing exercises. I love that there are three versions of each graphic: a completely la-beled one, one with leader lines only and one with just the original graphic. I can usethem for study guides, quizzes, and tests. The ancillary tools also save me time inpreparing and executing lesson plans, while providing students with fun, effective, anddiverse self-study tools.

Most of my students have dreams of entering the health care field. To this end, the“Focus on Careers” boxes open their eyes to the multiple opportunities available tothem, while the “Critical Thinking and Clinical Application” questions excite them totry to diagnose the patient with their newfound knowledge.

Marieb’s Essentials of Human Anatomy & Phy siology is truly one of the best teach-ing tools on the market today, and I highly recommend it to any high school teacher.

Jamie Haid

McKinney North High School McKinney, Texas

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About the Author

Laboratory. Recognizing the severe national short-age of nursing faculty, Dr. Marieb also underwritesthe Nursing Scholars of the Future Grant Program atthe University of Massachusetts at Amherst.

In 1994, Dr. Marieb received the BenefactorAward from the National Council for ResourceDevelopment, American Association of CommunityColleges, which recognizes her ongoing sponsor-ship of student scholarships, faculty teachingawards, and other academic contributions toHolyoke Community College. In May 2000, the sci-ence building at Holyoke Community College wasnamed in her honor.

Dr. Marieb is an active member of the HumanAnatomy and Physiology Society (HAPS) and theAmerican Association for the Advancement ofScience (AAAS). Additionally, while actively en-gaged as an author, Dr. Marieb serves as a consul -tant for the Benjamin Cummings InteractivePhysiology® CD-ROM series. This text—Essentialsof Human Anatomy & Physiology, Tenth Edition—is the latest expression of her commitment to theneeds of students pursuing the study of A&P.

When not involved in academic pursuits,Dr. Marieb is a world traveler and has vowed tovisit every country on this planet. Shorter term,she serves on the board of directors of the famedMarie Selby Botanical Gardens and on the scholar-ship committee of the Women’s Resources Centerof Sarasota County. She is an enthusiastic sup-porter of the local arts and enjoys a competitivematch of doubles tennis.

For Elaine N. Marieb, R.N., Ph.D., taking theneeds of nursing and other allied health studentsinto account has always been an integral part ofher teaching style. Dr. Marieb began her teachingcareer at Springfield College, where she taughtanatomy and physiology to physical educationmajors. She then joined the faculty of theBiological Science Division of Holyoke CommunityCollege in 1969 after receiving her Ph.D. in zool-ogy from the University of Massachusetts atAmherst. While teaching at Holyoke CommunityCollege, Dr. Marieb pursued her nursing education,which culminated in a Master of Science degreewith a clinical specialization in gerontology fromthe University of Massachusetts. This experience,along with continual feedback from health careprofessionals (including generations of former students taught by Dr. Marieb), has inspired theunique perspective and accessibility for which thisbook is known.

Dr. Marieb’s commitment to students extendsbeyond teaching and writing. Recognizing the chal-lenges students face, Dr. Marieb contributes to theNew Directions—Pathways Program at HolyokeCommunity College by funding a staffed drop-incenter and by providing several full-tuition scholar-ships each year for women who are returning tocollege after a hiatus or attending college for the firsttime. She also funds the E. N. Marieb ScienceResearch Awards at Mount Holyoke College (whichpromotes research by undergraduate science majors)and has underwritten renovation and updating ofone of the biology labs in Mount Holyoke’s Clapp

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Essentials of Human Anatomy and Physiology Correlation Guide to Texas Essential Knowledge & Skills forCareer and Technical Education, 130.206, Anatomy and Physiology

Texas Essential Knowledge &Skills Correlation

TEKS Textbook Page Numbers1. The student conducts investigations, for at least 40% of

instructional time, using safe, environmentally appropriate,and ethical practices. These investigations must involve actively obtaining and analyzing data with physical equipment, but may also involve experimentation in a simulated environment as well as field observations that extend beyond the classroom. The student is expected to:

A. demonstrate safe practices during laboratory and field investigations

Lab Manual: Inside front cover, pp. 11, 172, 174, 184, 203,215, 216, 238, 240, 254, 298, 308, 325, 335, 339

B demonstrate an understanding of the use and conservationof resources and the proper disposal or recycling of materials.

Lab Manual: pp. 71, 174, 215, 216, 238, 240, 254, 298, 308,325, 339

2 The student uses scientific methods and equipment during laboratory and field investigations. The student is expected to:

A know the definition of science and understand that it has limitations, as specified in subsection (b)(2) of this section;

SE pp. 1, 2, 24

B know that hypotheses are tentative and testable statementsthat must be capable of being supported or not supportedby observational evidence. Hypotheses of durable explanatory power which have been tested over a widevariety of conditions are incorporated into theories;

SE pp. 456, 463, 504–505

C know scientific theories are based on natural and physicalphenomena and are capable of being tested by multiple independent researchers. Unlike hypotheses, scientific theories are well–established and highly–reliable explanations, but they may be subject to change as newareas of science and new technologies are developed;

SE pp. 456, 463, 504–505

D distinguish between scientific hypotheses and scientific theories;

SE pp. 456, 463, 504–505

E plan and implement descriptive, comparative, and experimental investigations, including asking questions, formulating testable hypotheses, and selecting equipmentand technology;

SE pp. 24, 62, 108, 133, 180, 225, 277, 307, 336, 355, 397,435, 463, 511, 538

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TEKS Textbook Page NumbersF collect and organize qualitative and quantitative data and

make measurements with accuracy and precision usingtools such as calculators, spreadsheet software,data–collecting probes, computers, standard laboratoryglassware, microscopes, various prepared slides, stereoscopes, metric rulers, electronic balances, handlenses, Celsius thermometers, hot plates, lab notebooks orjournals, timing devices, Petri dishes, lab incubators, dissection equipment, meter sticks, and models, diagrams,or samples of biological specimens or structures;

Throughout lab manual

G analyze, evaluate, make inferences, and predict trendsfrom data; and

SE pp. 24, 62, 108, 133, 180, 225, 277, 307, 336, 355, 397,435, 463, 511, 538; lab manual: pp. 35, 108

H communicate valid conclusions supported by the datathrough methods such as lab reports, labeled drawings,graphic organizers, journals, summaries, oral reports, and technology–based reports.

SE pp. 24, 62, 108, 133, 180, 225, 277, 307, 336, 355, 397,435, 463, 511, 538; throughout lab manual

3 The student uses critical thinking, scientific reasoning, and problem solving to make informed decisions within and outside the classroom. The student is expected to:

A in all fields of science, analyze, evaluate, and critique scientific explanations by using empirical evidence, logicalreasoning, and experimental and observational testing, including examining all sides of scientific evidence ofthose scientific explanations, so as to encourage criticalthinking by the student;

SE: pp. 24, 62, 108, 133, 180, 225, 277–278, 307, 336, 355,397, 435, 463, 511, 538, 577 Lab Manual: pp. 8, 22, 27, 32, 36, 56, 59, 64, 65, 83, 91,179, 181, 192, 195, 207, 210, 212, 215, 230, 245, 253–254,283, 284, 288, 290–291, 304, 307–308, 325, 331, 343–344,351

B communicate and apply scientific information extractedfrom various sources such as current events, news reports, published journal articles, and marketing materials;

SE: pp. 108, 143, 355, 356, 378, 452, 533

C draw inferences based on data related to promotional materials for products and services;

SE: p. 133, 511

D evaluate the impact of scientific research on society andthe environment;

SE: pp. 456, 504–505

E evaluate models according to their limitations in representing biological objects or events; and

SE: pp. 29, 62

F research and describe the history of science and contributions of scientists.

SE: pp. 62, 108, 180, 336, 397

4 The student evaluates the energy needs of the human bodyand the processes through which these needs are fulfilled.The student is expected to:

A analyze the chemical reactions that provide energy for thebody;

SE: pp. 2, 9, 25–27, 33–35, 36, 37, 38–39, 40 42, 43–48,49–52, 53–54, 56–57, 85, 492–495 Lab Manual: pp. 29–33, 35–36, 317 318, 319, 322–325, 330–332

B evaluate the means, including the structure and function ofthe digestive system, by which energy is processed andstored within the body;

SE: pp. 464–470, 471–473, 474–476, 477–480, 481–482, 483 –485, 487–488, 491–493, 494, 495, 496–497, 498–502 Lab Manual: pp. 35–36, 317–318, 319, 322–325, 330–332

C analyze the effects of energy deficiencies in malabsorption disorders such as diabetes, hypothyroidism, and Crohn’s disease; and

SE: pp. 324–325, 426, 488, 499

D analyze the effects of energy excess in disorders such as obesity as it relates to cardiovascular and musculoskeletal systems.

SE: pp. 141, 172, 185, 387, 388–389, 390, 494, 504–505

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TEKS Textbook Page Numbers5 The student differentiates the responses of the human body to

internal and external forces. The student is expected to:

A explain the coordination of muscles, bones, and joints that allows movement of the body;

SE: pp. 134–135, 165, 167, 176, 181, 182, 185, 196,197–199, 200, 201, 202, 221, 240–241, 242, 243, 272 Lab Manual: pp. 111–113, 114–116, 117–120, 161

B investigate and report the uses of various diagnostic and therapeutic technologies;

SE: pp. 10–11, 166–167, 270 –271, 316, 388–389, 520–521

C interpret normal and abnormal contractility conditions suchas in edema, glaucoma, aneurysms, and hemorrhage;

SE: pp. 97, 251, 287, 369–370, 390, 399, 403, 405–406

D analyze and describe the effects of pressure, movement,torque, tension, and elasticity on the human body; and

SE: pp. 9, 12, 113–114, 124 –125, 144–145, 172, 195, 255,440, 445, 518Lab Manual: pp. 56, 57, 113–116, 194

E perform an investigation to determine causes and effects offorce variance and communicate findings.

SE: p. 225

6 The student examines the body processes that maintain homeostasis. The student is expected to:

A investigate and describe the integration of the chemicaland physical processes, including equilibrium, temperature, pH balance, chemical reactions, passive transport, active transport, and biofeedback, that contributeto homeostasis; and

SE: pp. 9, 12–13, 33–39, 42–43, 57, 76–81, 85, 113, 130,176, 188–190, 193–194, 221, 237–238, 246–247, 272,294–295, 297, 298–300, 320, 322, 326, 332, 328 –329, 392,431, 444, 449–450, 454, 459, 470–473, 478–480, 482–485,497, 500–502, 506, 518 , 519, 528–532, 534, 543, 573 Lab Manual: pp. 29– 32, 33, 34–36, 59, 65, 216, 225, 236,240–241, 322–325

B determine the consequences of the failure to maintain homeostasis.

SE: pp. 76, 101, 116, 119, 121, 141, 144, 152, 215, 232, 237,244–245, 247, 255, 269, 280, 285, 287, 289, 293, 298, 303,314, 317, 322, 341, 342, 348, 363, 365, 387, 393, 402, 425,439, 449, 451, 455, 467, 474, 476, 482, 486–487, 488, 500 Lab Manual: pp. 83, 116, 189, 206, 240, 338–339

7 The student examines the electrical conduction processesand interactions. The student is expected to:

A illustrate conduction systems such as nerve transmission ormuscle stimulation;

SE: pp. 187–191, 255–257, 158–259, 260, 230, 235, 236, 237 –238, 239, 240, 255–257, 258–259, 260–263, 264–269 Lab Manual: pp. 151–152, 153–156, 183–189, 193–196

B investigate the therapeutic uses and effects of externalsources of electricity on the body system; and

SE: pp. 270–271, 365, 367

C evaluate the application of advanced technologies such aselectroencephalogram, electrocardiogram, bionics, transcutaneous electrical nerve stimulation, and cardioversion.

SE: pp. 10–11, 166 –167, 237, 270, 271, 365, 367

8 The student explores the body's transport systems. The student is expected to:

A analyze the physical, chemical, and biological properties oftransport systems, including circulatory, respiratory, and excretory;

SE: pp. 339, 340–342, 343, 344–345, 346–348, 350–352,356, 357–360, 361–363, 364–366, 368–370, 371–374,375–377, 379–387, 388–389, 390–393, 399–400, 401– 402,403–404, 405–410, 436–444, 445–451, 453–455, 457–460,465– 476, 477–485, 487–488, 512–519, 521, 522–524,525–532, 535Lab Manual: pp. 235–242, 243–246, 247–254, 255–258,259–271, 273–279, 281–288, 289–292, 293–298, 299–302,303–308, 309–311, 313–326, 327–332, 333–340, 341–344

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TEKS Textbook Page NumbersB determine the factors that alter the normal functions of

transport systems; andSE: pp. 76, 341–342, 348, 363, 365, 366, 369–370, 373,387, 388–389, 393, 402, 407–408, 440, 443, 447, 449, 451,453, 455, 457, 458, 460, 466–467, 474, 476, 483, 484–485,488, 514, 518, 520–521, 522, 524, 528, 530, 532, 535Lab Manual: pp. 338–339

C contrast the interactions among the transport systems. SE: pp. 73, 75, 76–77, 78–81, 360–361, 382, 385–387, 392,399–400, 401–402, 404–407, 430, 437, 439, 442, 443–444,445–447, 449–451, 453–455, 459, 468, 474, 484–485, 487,506, 514–517, 518–519, 525–530, 531–532, 534Lab Manual: pp. 250–252, 256–257, 296–297

9 The student investigates environmental factors that affect the human body. The student is expected to:

A identify the effects of environmental factors such as climate, pollution, radioactivity, chemicals, electromagneticfields, pathogens, carcinogens, and drugs on body systems;and

SE: pp. 102–103, 126–127, 237, 412, 440, 476, 500, 502,520–521, 543, 545, 565,

B explore measures to minimize harmful environmental factors on body systems.

SE: pp. 118, 128, 440, 457, 456

10 The student investigates structure and function of the humanbody. The student is expected to:

A analyze the relationships between the anatomical structures and physiological functions of systems, includingthe integumentary, nervous, skeletal, musculoskeletal, cardiovascular, respiratory, gastrointestinal, endocrine, and reproductive;

SE: Integumentary, pp. 87–92, 110–117, 119–123; Skeletal,93, 94, 95, 134–142, 144, 145–157, 158–164, 165, 167–173;Musculoskeletal, 97–99, 185–187, 188–196, 197–203,205–214; Nervous, 99–100, 226–239, 240–251, 253–255,256–269, 280–287, 288–292, 293, 294–295, 297–299, 300,301–301; Endocrine 309–311, 312–315, 317–327, 328–330,331; Cardiovascular, 335–345, 346–348, 350–351, 357–369,370–377, 379–387, 390; Lymphatic 399–400, 401–402,403–404, 405–410, 411–427; Respiratory, 436–444,445–451, 453–455, 457–458; Gastrointestinal, 464–476,477–485, 487–488, 513–519, 521–532; Reproductive,539–568Lab Manual: Integumentary, pp. 55–61; Skeletal 67–72,77–86, 95–103, 111–116; Musculoskeletal 121–125,131–144; Nervous, 151–157, 163–175, 183–189, 193–196,199–216, 227–230; Cardiovascular, 235–242, 247–254,259–271, 281–288; Respiratory, 293–298, 303–308,Gastrointestinal, 313–326, 333–340; Reproductive,345–350

B evaluate the cause and effect of disease, trauma, and congenital defects on the structure and function of cells, tissues, organs, and systems;

SE: Disease, pp. 102–103, 125–127, 141, 172–173, 215,232, 252–253, 280, 287, 293, 322, 324–325, 342, 369, 373,387, 388–389, 425–427, 428–429, 439, 457–458, 476, 488,499, 518, 520–521, 524, 530, 542–543, 551, 557–558, 569Trauma, 71, 76, 144–145, 169, 172, 207, 247, 251, 254,255, 262, 447, 500, 514, 528, 567–568 Congenital,153–154, 215, 269, 271, 303, 341–342, 352, 393, 532, 535

C research technological advances and limitations in the treatment of system disorders; and

SE: pp. 101–103, 166–167, 172, 173, 215, 232, 252–253,285, 287, 293, 316, 318–319, 348, 363, 365, 388–389,428–429, 520–521, 522–523, 542–543

D examine characteristics of the aging process on body systems.

SE: pp. 101, 104, 128, 173–175, 214–215, 269, 271, 273,301–304, 330, 352, 391, 393, 428, 431, 458, 460, 502–503

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TEKS Textbook Page Numbers11 The student describes the process of reproduction and

growth and development. The student is expected to:

A explain embryological development of tissues, organs, andsystems;

SE: pp. 101, 128, 173–174, 214–215, 269, 271, 302–303,330, 352, 391, 393, 429, 431, 458, 502–503, 532, 561–563,564–565, 568Lab Manual: pp. 82–83, 268–270

B identify the functions of the male and female reproductive systems; and

SE: pp. 539–543, 544–548, 548–551, 552–556, 557,558–560, 561–563, 565–568Lab Manual: pp. 245–350, 351–355

C summarize the human growth and development cycle. SE: pp. 101, 104, 128, 173–175, 214–215, 269, 271, 273,302–304, 330, 352, 391, 393, 429, 431, 458, 460,502–503, 532, 535, 568–569, 572Lab Manual: pp. 320–321

12 The student recognizes emerging technological advances in science. The student is expected to:

A recognize advances in stem cell research such as cordblood utilization; and

SE: pp. 104, 167, 253

B recognize advances in bioengineering and transplant technology.

SE: pp. 166–167, 520, 422, 425

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Meaningful analogies relate anatomy & physiology to familiar concepts that you can visualize and remember.

Excerpted from p. 110

Excerpted from p. 112

Excerpted from pp. 134-135

The conversational writing style presents the material without technical jargon, but draws on the author’s years of experience as a professor and former nursing student.

The sense of humor throughout the book keeps learning fun. We want you to enjoy reading this book!

xviii

An Engaging Writing Style The friendly, informal writing style invites you to learn without intimidation.

This book is written with you, the student, in mind. You will find that human anatomy & physiology is more than just interesting—it is fascinating. The writing is friendly and informal, so you will enjoy reading this book, regardless of your background in science. Special features throughout will help you understand the concepts, remember the facts, and study for exams. The next few pages will walk you through those features and help you get the most out of this book.

How to use this book

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The art program is designed to help you learn and remember the human body’s different structures and functions. The dramatically updated art program uses more realistic figures, and provides more figures with integrated text so you can study the art without switching between the art and its caption.

NEW! 3-D anatomy drawings illustrate the material in a realistic style, which gives you the most accurate representation possible.

Bone art is realistic, textured, and detailed. All bone art

is produced by professional medical illustrators, based on extensive rounds of feedback

and accuracy checking.

Process diagrams have been revised with improved step text, which clearly separates the steps so they are easier to follow.

Artwork that helps you learn

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Brief topic boxes throughout the book present scientific information that can be applied to your daily life. When reading the topic boxes you will probably find yourself saying, “I didn’t know that,” or “Now I understand why…”

Focus on Careers boxes use interviews with working professionals to show how anatomy & physiology is important in a

wide range of allied health careers. New careers have been added to this edition including Pharmacy Technician, Physical

Therapy Assistant, and more.

A Closer Look boxes have been updated to keep you informed of new advances in science and topics you may hear about in the news. Thoroughly updated subjects include topics such as Artificial Joints (pp. 166-167), Obesity (pp. 504-505), and Cancer (pp. 102-103).

Features that pique your interest

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This book is easy to use. Each chapter includes several aids that will guide you through the material, helping you preview what you’re expected to learn in each section so you can focus on the concepts and remember what you need to know.

Objectives are integrated into the chapter so you know what you are expected to take away from each section.

Did You Get It? questions help you stop and think to make sure that you understand what you need to know before moving forward.

Illustrated tables combine text and art, and summarize important information

from the text. The tables are especially helpful when studying for an exam or

reviewing an important topic.

Simple chapter navigation

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Applications throughout this text help you apply what you learn to relevant clinical situations that you may encounter in other courses. By thinking through the issues, you will prepare yourself for the real world.

Homeostatic Imbalance sections offer clinical examples most relevant to those working in health fields. These sections stress the understanding that loss of homeostasis leads to pathology or disease.

Critical Thinking & Clinical Application Questions at the end of each chapter challenge you to apply what you’ve learned to real-world clinical situations. These also help you comprehend the material and better prepare for exams.

Figure Questions accompany many figures to help you think beyond

memorizing terms and labels. These questions help you develop a more

meaningful understanding of the concepts and processes. Answers are provided at the bottom of the page.

Think like a professional

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No matter where or when you need extra help, we’ve got you covered. This book comes with access to of Inte

the Essentials ractive Physiology® CD-ROM, two media designed to help

you succeed in your course.

New for this edition:

• Immune System module is now included.

• The updated interface is easier to use and navigate.

Additional topics have been added to the Muscular, Nervous, Cardiovascular, Respiratory, Urinary, and Fluid/Electrolytes modules.

Essentials of Interactive Physiology® CD-ROM

Where to go for extra practice

The Mastering platform is the most effective andwidely used online homework, tutorial, andassessment system for the sciences. It deliversself-paced tutorials that focus on your courseobjectives, provides individualized coaching, andresponds to each student’s progress.The Mastering system helps teachers maximizeclass time with easy to assign, customizable, andautomatically graded assessments that motivatestudents to learn. Access to MasteringA&P isprovided with the purchase of this textbook.See page XXV for access information.

MasteringA&P with Pearson eText and resources

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This popular workbook features a wide variety of visual and written exercises, and reinforces learning on many levels— microscopic and macroscopic. The following unique and engaging activities appear throughout:

• More than 100 coloring exercises

• “Incredible Journey” visualization exercises

• Written exercises

• Diagram labeling exercises

• “The Finale: Multiple Choice” tests

• “At the Clinic” application questions

NEW EDITION! Anatomy & Physiology Coloring Workbook: A Complete Study Guide, Tenth Editionby Elaine N. Marieb © 2012

xxiv

Where to go for extra practice

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Upon textbook purchase, students and teachers aregranted access to MasteringA&P with Pearson eText.High school teachers can obtain preview or adoptionaccess for MasteringA&P in one of the following ways:

Preview Access• Teachers can request preview access online by visitingwww.PearsonSchool.com/Access_Request, using Option2. Preview Access information will be sent to the teachervia email.

Adoption Access• With the purchase of this program, a Pearson AdoptionAccess Card, with codes and complete instructions, will bedelivered with your textbook purchase. (ISBN: 0-13-034391-9)• Ask your sales representative for an Adoption Access CodeCard (ISBN: 0-13-034391-9)• OR• Visit PearsonSchool.com/Access_Request, Option3. Adoption access information will be sent to the teachervia email.

Students, ask your teacher for access.

Guide/Test Bank in Microsoft® Word format; and the TestGen® software and electronic test bank.

Transparency Acetates All of the textbook figures—approximately 275 images—are included in this high-quality acetate package. Each image has been enhanced with brighter colors and bolder figure labels so that the illustrations are as easy to view as those in the book.

ExamView® Computerized Test Bank To ensure students are learning the material you are teaching, you’ll have hundreds of questions at your fingertips within the ExamView computerized test bank CD-ROM. This flexible resource allows teachers to build, edit, print, and administer tests based on text objectives. Algorithmically based, ExamView enables teachers to create multiple but equivalent versions of the same question or test with a click of a button.

Instructor Guide for Essentials of Human Anatomy & Physiology Laboratory Manual, Fifth Edition

student interaction; A&P Flix™ animations; the Instructor Student Resources

Anatomy & Physiology Coloring Workbook: A Complete Study Guide, Tenth Edition(For purchase only)Learn the structures and functions of the human body from a microscopic to macroscopic level using a wide variety of visual and written exercises and activities.

Essentials of Human Anatomy & Physiology Laboratory Manual, Fifth Edition (For purchase only)This brief, hands-on lab manual provides 27 concise, activity-based exercises. Each lab includes a new pre-lab quiz, learning objectives, summaries of key concepts, a variety of activities, and an integrated review sheet. The manual also includes a full-color Histology Atlas with 55 photomicrographs.

Essentials of Interactive Physiology® CD-ROM (Replacement CD) Take advantage of these animated tutorials, which will give you insight into the human body with audio and visual content including a new Immune System module and redesigned interface. This resource is included with each new copy of the text. (Replacement CD is available for purchase.)

Teacher ResourcesSome of the teacher supplements and resources for this text are available electronically to qualified adopters on the Instructor Resource Center (IRC). Upon adoption or to preview, please go to www.PearsonSchool.com/Access_Request and select Instructor Resource Center. You will be required to complete a brief one-time registration subject to verification of educator status. Upon verification, access information and instructions will be sent to you via email.

Instructor Guide/Test Bank This fully updated all-in-one volume provides a wealth of resources for instructors, including new resources for teaching online, chapter summaries, suggested lecture outlines, key terms, lecture hints, classroom demonstrations, student activities, and a test bank with a variety of new and revised test questions for each chapter.

Instructor Resource DVD New for this edition, the Instructor Resource DVD (IR-DVD) organizes all instructor media resources into one convenient location. The IR-DVD includes all the figures and tables from the text in JPEG and PowerPoint® format; label-edit art with editable labels and leader lines; step-edit art that walks through multistep figures step by step; Clicker Questions and Quiz Show Game questions to encourage

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1 The Human Body: An Orientation 1

2 Basic Chemistry 25

3 Cells and Tissues 63

4 Skin and BodyMembranes 109

5 The Skeletal System 134

6 The Muscular System 181

7 The Nervous System 226

8 Special Senses 279

9 The Endocrine System 308

10 Blood 337

11 The CardiovascularSystem 356

12 The Lymphatic Systemand Body Defenses 398

13 The Respiratory System 436

14 The Digestive Systemand Body Metabolism 464

15 The Urinary System 512

16 The ReproductiveSystem 539

Brief Contents

xxvi

• A Look at Texas Medical Centers iii

• Correlation to the TEKS xiii

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xxvii

Contents

1 The Human Body: An Orientation 1

An Overview of Anatomy andPhysiology 1

Anatomy 1

Physiology 2

Relationship between Anatomy and Physiology 2

Levels of Structural Organization 2

From Atoms to Organisms 2

Organ System Overview 3Integumentary System • Skeletal System• Muscular System • Nervous System• Endocrine System • Cardiovascular System• Lymphatic System • Respiratory System• Digestive System • Urinary System• Reproductive System

Maintaining Life 7

Necessary Life Functions 7Maintaining Boundaries • Movement• Responsiveness • Digestion• Metabolism • Excretion• Reproduction • Growth

Survival Needs 9

Homeostasis 12

Homeostatic Controls 12

The Language of Anatomy 14

Anatomical Position 14

Directional Terms 14

Regional Terms 14Anterior Body Landmarks• Posterior Body Landmarks

Body Planes and Sections 17

Body Cavities 18Dorsal Body Cavity • Ventral Body Cavity• Other Body Cavities

Summary 22

Review Questions 23

Critical Thinking and ClinicalApplication Questions 24

A Closer Look Medical Imaging:Illuminating the Body 10

Focus on Careers Dental Hygienist 19

2 Basic Chemistry 25

Concepts of Matter and Energy 25

Matter 25

Energy 26Forms of Energy • Energy Form Conversions

Composition of Matter 27

Elements and Atoms 27

Atomic Structure 27The Basic Atomic Subparticles• Planetary and Orbital Models of an Atom

Identifying Elements 30Atomic Number • Atomic Mass • Atomic Weightand Isotopes

Molecules and Compounds 31

Chemical Bonds and ChemicalReactions 33

Bond Formation 33Role of Electrons • Types of Chemical Bonds

• A Look at Texas Medical Centers iii

• Correlation to the TEKS xiii

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Cell Physiology 75

Membrane Transport 75Passive Processes: Diffusion and Filtration• Active Processes

Cell Division 81Preparations: DNA Replication• Events of Cell Division

Protein Synthesis 85Genes: The Blueprint for Protein Structure• The Role of RNA • Transcription • Translation

PART II: BODY TISSUES 87

Epithelial Tissue 87

Special Characteristics of Epithelium 88

Classification of Epithelium 88Simple Epithelia • Stratified Epithelia• Glandular Epithelium

Connective Tissue 92

Common Characteristics of Connective Tissue 93

Extracellular Matrix 93

Types of Connective Tissue 93Bone • Cartilage • Dense Connective Tissue• Loose Connective Tissue • Blood

Muscle Tissue 97

Types of Muscle Tissue 97Skeletal Muscle • Cardiac Muscle• Smooth Muscle

Nervous Tissue 99

Tissue Repair (Wound Healing) 100

PART III: DEVELOPMENTAL ASPECTS OF CELLS AND TISSUES 101

Summary 105

Review Questions 107


Patterns of Chemical Reactions 38Synthesis Reactions • DecompositionReactions • Exchange Reactions • FactorsInfluencing the Rate of Chemical Reactions

Biochemistry: The ChemicalComposition of Living Matter 39

Inorganic Compounds 40Water • Salts • Acids and Bases

Organic Compounds 43Carbohydrates • Lipids • Proteins• Nucleic Acids • Adenosine Triphosphate (ATP)

Summary 58

Review Questions 60


Focus on Careers Pharmacy Technician 55

3 Cells and Tissues 63

PART I: CELLS 63

Overview of the Cellular Basis of Life 63

Anatomy of a Generalized Cell 64

The Nucleus 64Nuclear Envelope • Nucleoli • Chromatin

The Plasma Membrane 65The Fluid Mosaic Model • Membrane Junctions

The Cytoplasm 67Cytoplasmic Organelles

Cell Extensions 72Cilia and Flagella • Microvilli

Cell Diversity 73

Chapter 2, continued

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Contents xxix

5 The Skeletal System 134

Bones: An Overview 134

Functions of the Bones 135

Classification of Bones 135

Structure of Bone 137Gross Anatomy of a Long Bone• Microscopic Anatomy

Bone Formation, Growth, and Remodeling 139

Bone Fractures 144

Axial Skeleton 145

Skull 145Cranium • Facial Bones • The Hyoid Bone• Fetal Skull

Vertebral Column (Spine) 152Cervical Vertebrae • Thoracic Vertebrae• Lumbar Vertebrae • Sacrum • Coccyx

Thoracic Cage 156Sternum • Ribs

Appendicular Skeleton 158

Bones of the Shoulder Girdle 158

Bones of the Upper Limbs 158Arm • Forearm • Hand

Bones of the Pelvic Girdle 161

Bones of the Lower Limbs 163Thigh • Leg • Foot

Joints 165

Fibrous Joints 167

Cartilaginous Joints 167

Synovial Joints 169

Types of Synovial Joints Based on Shape 169

Developmental Aspects of the Skeleton 173

Summary 177



A Closer Look IV Therapy and Cellular“Tonics” 84

A Closer Look Cancer–The IntimateEnemy 102

Focus on Careers Forensic Scientist 74

4 Skin and BodyMembranes 109

Classification of Body Membranes 109

Epithelial Membranes 110Cutaneous Membrane • Mucous Membranes• Serous Membranes

Connective Tissue Membranes 110

The Integumentary System (Skin) 112

Functions of the Integumentary System 112

Structure of the Skin 113Epidermis • Dermis

Skin Color 119

Appendages of the Skin 119Cutaneous Glands • Hair and Hair Follicles• Nails

Homeostatic Imbalances of Skin 124Burns • Infections and Allergies • Skin Cancer

Developmental Aspects of Skin and Body Membranes 128

Summary 131



A Closer Look Wrinkle Wrinkle GoAway—Or I’ll Shoot You(with Botox) 118

Focus on Careers MedicalTranscriptionist 129

Systems in Sync 130

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A Closer Look Joints: From Knights inShining Armor to BionicHumans 166

Focus on Careers RadiologicTechnologist 143

Systems in Sync 176

6 The Muscular System 181

Overview of Muscle Tissues 181

Muscle Types 181Skeletal Muscle • Smooth Muscle • CardiacMuscle

Muscle Functions 185Producing Movement • Maintaining Posture andBody Position • Stabilizing Joints • GeneratingHeat • Additional Functions

Microscopic Anatomy of Skeletal Muscle 185

Skeletal Muscle Activity 187

Stimulation and Contraction of Single SkeletalMuscle Cells 187

The Nerve Stimulus and the Action Potential• Mechanism of Muscle Contraction: TheSliding Filament Theory

Contraction of a Skeletal Muscle as a Whole 191Graded Responses • Providing Energy forMuscle Contraction • Muscle Fatigue andOxygen Deficit • Types of MuscleContractions—Isotonic and Isometric • MuscleTone • Effect of Exercise on Muscles

Muscle Movements, Types, and Names 196

Types of Body Movements 197Special Movements

Interactions of Skeletal Muscles in the Body 200

Naming Skeletal Muscles 202

Arrangement of Fascicles 202

Gross Anatomy of Skeletal Muscles 205

Head and Neck Muscles 205Facial Muscles • Chewing Muscles • NeckMuscles

Trunk Muscles 207Anterior Muscles • Posterior Muscles

Muscles of the Upper Limb 209Muscles of the Humerus That Act on theForearm

Muscles of the Lower Limb 210Muscles Causing Movement at the Hip Joint • Muscles Causing Movement at the Knee Joint• Muscles Causing Movement at the Ankle andFoot

Developmental Aspects of the Muscular System 214

Summary 222



A Closer Look Are Athletes LookingGood and Doing Better with AnabolicSteroids? 204

Focus on Careers Massage Therapist 220

Systems in Sync 221

7 The Nervous System 226

Organization of the Nervous System 227

Structural Classification 227

Functional Classification 228

Nervous Tissue: Structure and Function 228


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Supporting Cells 228

Neurons 230Anatomy • Classification • Physiology: NerveImpulses • Physiology: Reflexes

Central Nervous System 240

Functional Anatomy of the Brain 240Cerebral Hemispheres • Diencephalon• Brain Stem • Cerebellum

Protection of the Central Nervous System 247Meninges • Cerebrospinal Fluid • The Blood-Brain Barrier

Brain Dysfunctions 251

Spinal Cord 253Gray Matter of the Spinal Cord and SpinalRoots • White Matter of the Spinal Cord

Peripheral Nervous System 255

Structure of a Nerve 256

Cranial Nerves 257

Spinal Nerves and Nerve Plexuses 257

Autonomic Nervous System 264Somatic and Autonomic Nervous SystemsCompared • Anatomy of the ParasympatheticDivision • Anatomy of the Sympathetic Division• Autonomic Functioning

Developmental Aspects of the Nervous System 269

Summary 273



A Closer Look Alzheimer’s, Parkinson’s,and Huntington’s—theTerrible Three 252

A Closer Look Tracking Down CNSProblems 270

Systems in Sync 272

8 Special Senses 279

PART I: THE EYE AND VISION 279

Anatomy of the Eye 280

External and Accessory Structures 280

Internal Structures: The Eyeball 281Layers Forming the Wall of the Eyeball • Lens

Physiology of Vision 288

Pathway of Light through the Eye and LightRefraction 288

Visual Fields and Visual Pathways to the Brain 288

Eye Reflexes 289

PART II: THE EAR: HEARING ANDBALANCE 292

Anatomy of the Ear 292

External (Outer) Ear 292

Middle Ear 293

Internal (Inner) Ear 293

Equilibrium 294

Static Equilibrium 294

Dynamic Equilibrium 295

Hearing 297

Hearing and Equilibrium Deficits 298

PART III: CHEMICAL SENSES: SMELL ANDTASTE 300

Olfactory Receptors and the Sense of Smell 300

Taste Buds and the Sense of Taste 301

Contents xxxi

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PART IV: DEVELOPMENTAL ASPECTS OF THE SPECIAL SENSES 302

Summary 304



Adrenal Glands 320Hormones of the Adrenal Cortex• Hormones of the Adrenal Medulla

Pancreatic Islets 324

Pineal Gland 325

Thymus 327

Gonads 327Hormones of the Ovaries • Hormones of theTestes

Other Hormone-Producing Tissues and Organs 327

Placenta 330

Developmental Aspects of theEndocrine System 330

Summary 333



A Closer Look Potential Uses forGrowth Hormone 316

Systems in Sync 332

10 Blood 337

Composition and Functions of Blood 337

Components 338

Physical Characteristics and Volume 338

Plasma 338

Formed Elements 338Erythrocytes • Leukocytes • Platelets

Hematopoiesis (Blood Cell Formation) 344Formation of Red Blood Cells • Formation ofWhite Blood Cells and Platelets

xxxii Contents


9 The Endocrine System 308

The Endocrine System and HormoneFunction—An Overview 309

The Chemistry of Hormones 309

Hormone Action 309Direct Gene Activation• Second-Messenger System

Control of Hormone Release 310Endocrine Gland Stimuli

The Major Endocrine Organs 312

Pituitary Gland 312Hormones of the Anterior Pituitary• Pituitary-Hypothalamus Relationship• Hormones of the Posterior Pituitary

Thyroid Gland 317

Parathyroid Glands 319

A Closer Look Visual Pigments—theActual Photoreceptors286

A Closer Look If I Can’t See Things FarAway, Am I Nearsightedor Farsighted? 290

Focus on Careers Physical TherapyAssistant 296

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Hemostasis 346

Disorders of Hemostasis 348

Blood Groups and Transfusions 348

Human Blood Groups 350

Blood Typing 351

Developmental Aspects of Blood 352

Summary 353



Focus on Careers PhlebotomyTechnician 349

11 The CardiovascularSystem 356

The Heart 357

Anatomy of the Heart 357Size, Location, and Orientation • Coverings andWalls of the Heart • Chambers and AssociatedGreat Vessels • Heart Valves • Cardiac Circulation

Physiology of the Heart 363Intrinsic Conduction System of the Heart:Setting the Basic Rhythm • Cardiac Cycle andHeart Sounds • Cardiac Output

Blood Vessels 370

Microscopic Anatomy of Blood Vessels 370Tunics • Structural Differences in Arteries,Veins, and Capillaries

Gross Anatomy of Blood Vessels 374Major Arteries of the Systemic Circulation• Major Veins of the Systemic Circulation• Special Circulations

Physiology of Circulation 383Arterial Pulse • Blood Pressure • CapillaryExchange of Gases and Nutrients• Fluid Movements at Capillary Beds

Developmental Aspects of theCardiovascular System 391

Summary 393



A Closer Look Electrocardiography:(Don’t) Be Still My Heart 367

A Closer Look Atherosclerosis? Get Outthe Cardiovascular Drano388

Focus on Careers Certified SurgicalTechnologist (CST) 378

Systems in Sync 392

12 The LymphaticSystem and BodyDefenses 398

PART I: THE LYMPHATIC SYSTEM 398

Lymphatic Vessels 399

Lymph Nodes 400

Other Lymphoid Organs 402

PART II: BODY DEFENSES 403

Innate Body Defenses 404

Surface Membrane Barriers 404

Internal Defenses: Cells and Chemicals 405Natural Killer Cells • Inflammatory Response •Phagocytes • Antimicrobial Proteins • Fever

Adaptive Body Defenses 411

Antigens 411

Cells of the Adaptive Defense System: AnOverview 412

Lymphocytes • Antigen-Presenting Cells

Contents xxxiii

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Humoral (Antibody-Mediated) ImmuneResponse 414

Active and Passive Humoral Immunity• Antibodies

Cellular (Cell-Mediated) Immune Response 420

Organ Transplants and Rejection 422

Disorders of Immunity 425

PART III: DEVELOPMENTAL ASPECTS OF THE LYMPHATIC SYSTEM AND BODYDEFENSES 429

Summary 431



A Closer Look AIDS: The Modern-DayPlague 428

Systems in Sync 430

13 The Respiratory System 436

Functional Anatomy of the RespiratorySystem 436

The Nose 437

Pharynx 439

Larynx 439

Trachea 440

Main Bronchi 440

Lungs 441The Respiratory Membrane

Respiratory Physiology 445

Mechanics of Breathing 445Inspiration • Expiration

Respiratory Volumes and Capacities 447

Nonrespiratory Air Movements 448

Respiratory Sounds 449

External Respiration, Gas Transport, and InternalRespiration 449

External Respiration • Gas Transport in theBlood • Internal Respiration

Control of Respiration 453Neural Regulation: Setting the Basic Rhythm• Nonneural Factors Influencing RespiratoryRate and Depth

Respiratory Disorders 455

Developmental Aspects of theRespiratory System 458

Summary 460



A Closer Look Too Clean for Our OwnGood? 456

Focus on Careers Respiratory Therapist 452

Systems in Sync 459

14 The Digestive System and BodyMetabolism 464

PART I: ANATOMY AND PHYSIOLOGY OF THE DIGESTIVE SYSTEM 464

Anatomy of the Digestive System 464

Organs of the Alimentary Canal 465Mouth • Pharynx • Esophagus • Stomach• Small Intestine • Large Intestine

xxxiv Contents


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Accessory Digestive Organs 474Teeth • Salivary Glands • Pancreas• Liver and Gallbladder

Functions of the Digestive System 477

Overview of Gastrointestinal Processes andControls 477

Activities Occurring in the Mouth, Pharynx, andEsophagus 480

Food Ingestion and Breakdown• Food Propulsion—Swallowing and Peristalsis

Activities of the Stomach 482Food Breakdown • Food Propulsion

Activities of the Small Intestine 483Food Breakdown and Absorption• Food Propulsion

Activities of the Large Intestine 487Food Breakdown and Absorption• Propulsion of the Residue and Defecation

PART II: NUTRITION AND METABOLISM 488

Nutrition 489

Dietary Sources of the Major Nutrients 489Carbohydrates • Lipids • Proteins• Vitamins • Minerals

Metabolism 491

Carbohydrate, Fat, and Protein Metabolism inBody Cells 491

Carbohydrate Metabolism • Fat Metabolism• Protein Metabolism

The Central Role of the Liver in Metabolism 496

General Metabolic Functions• Cholesterol Metabolism and Transport

Body Energy Balance 498Regulation of Food Intake• Metabolic Rate and Body Heat Production• Body Temperature Regulation

PART III: DEVELOPMENTAL ASPECTS OF THE DIGESTIVE SYSTEM ANDMETABOLISM 502

Summary 507



A Closer Look Peptic Ulcers:“Something Is Eating atMe”Zz486

A Closer Look Obesity: MagicalSolution Wanted 504

Systems in Sync 506

15 The Urinary System 512

Kidneys 513

Location and Structure 513Blood Supply

Nephrons and Urine Formation 514Nephrons • Urine Formation • Characteristicsof Urine

Ureters, Urinary Bladder, and Urethra 522

Ureters 522

Urinary Bladder 523

Urethra 524

Micturition 524

Fluid, Electrolyte, and Acid-BaseBalance 525

Maintaining Water and Electrolyte Balance ofBlood 525

Body Fluids and Fluid Compartments • The Linkbetween Water and Salt • Regulation of WaterIntake and Output • Electrolyte Balance

Maintaining Acid-Base Balance of Blood 530Blood Buffers • Respiratory System Controls• Renal Mechanisms

Developmental Aspects of the UrinarySystem 532

Contents xxxv

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Summary 536



A Closer Look Renal Failure and theArtificial Kidney 520

Focus on Careers Licensed PracticalNurse (LPN) 533

Systems in Sync 534

16 The ReproductiveSystem 539

Anatomy of the Male ReproductiveSystem 539

Testes 540

Duct System 540Epididymis • Ductus Deferens • Urethra

Accessory Glands and Semen 542Seminal Vesicles • Prostate • BulbourethralGlands • Semen

External Genitalia 543

Male Reproductive Functions 544

Spermatogenesis 544

Testosterone Production 546

Anatomy of the Female ReproductiveSystem 548

Ovaries 548

Duct System 549Uterine (Fallopian) Tubes • Uterus • Vagina

External Genitalia and Female Perineum 551

Female Reproductive Functions andCycles 552

Oogenesis and the Ovarian Cycle 552

Uterine (Menstrual) Cycle 554

Hormone Production by the Ovaries 556

Mammary Glands 556

Pregnancy and Embryonic Development 558

Accomplishing Fertilization 559

Events of Embryonic and Fetal Development 561

Effects of Pregnancy on the Mother 563Anatomical Changes • Physiological Changes

Childbirth 566Initiation of Labor • Stages of Labor

Developmental Aspects of theReproductive System 568

Summary 574



A Closer Look Contraception: PreventingPregnancy 570

Systems in Sync 573

AppendixesAppendix A: Word Roots, Prefixes,

and Suffixes 579

Appendix B: Periodic Table of the Elements 582

Appendix C: Key Information about Vitaminsand Many Essential Minerals 583

Appendix D: Answers to Did You Get It? and Multiple Choice ReviewQuestions 587

Photographic and Art Credits 595

Glossary 596

Index 607

xxxvi Contents


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Chapter 13: The Respiratory System 463

13Short Answer Essay

8. Clearly explain the difference between externaland internal respiration.

9. Trace the route of air from the nares to an alveolus.

10. Why is it important that the trachea be reinforcedwith cartilaginous rings? What is the advantage ofthe fact that the rings are incomplete posteriorly?

11. Where in the respiratory tract is the air filtered,warmed, and moistened?

12. The trachea has goblet cells that produce mucus.What is the specific protective function of the mucus?

13. In terms of general health, what is the importanceof the fact that the pharyngotympanic tubes andthe si nuses drain into the nasal cavities andnasopharynx?

14. What is it about the structure of the alveoli thatmakes them an ideal site for gas exchange?

15. What do TV, ERV, and VC mean?

16. Name several nonrespiratory air movements, andexplain how each differs from normal breathing.

17. The contraction of the diaphragm and the externalintercostal muscles begins inspiration. What hap-pens, in terms of volume and pressure changes inthe lungs, when these muscles contract?

18. What is the major way that oxygen is transported inthe blood?

19. What determines in which direction carbon dioxideand oxygen will diffuse in the lungs? In the tissues?

20. Name the two major brain areas involved in thenervous control of breathing.

21. Name three physical factors that can modify respi-ratory rate or depth.

22. Name two chemical factors that modify respiratoryrate and depth. Which is usually more important?

23. Define hyperventilation. If you hyperventilate, doyou retain or expel more carbon dioxide? Whateffect does hyperventilation have on blood pH? Onbreathing rate?

24. Compare and contrast the signs and symptoms ofemphysema and chronic bronchitis.

Critical Thinking andClinical ApplicationQuestions

25. After putting her 1-year-old boy (who puts virtuallyeverything in his mouth) down for a nap, a motherfailed to find one of the larger beads she used tomake the custom jewelry she produces for sale.Two days later, the boy developed a cough andbecame feverish. What is likely to have happenedto the bead, and where (anatomically) would youexpect it to be found?

26. Why doesn’t Mom have to worry when 3-year-oldJohnny threatens to “hold his breath till he dies”?

27. Mr. Rasputin bumped a bee’s nest while makingrepairs on his roof. Not surprisingly, he waspromptly stung several times. Because he knew hewas allergic to bee stings, he rushed to the hospital.While waiting, he went into a state of shock andhad extreme difficulty breathing. Examinationshowed his larynx to be edematous, and a tra-cheostomy was performed. Why is edema of thelarynx likely to obstruct the airway? What is a tra-cheostomy, and what purpose does it serve?

28. As a result of a stroke, Mrs. Minnick’s swallowing isuncoordinated. What detrimental effect might thishave on her ability to breathe?

29. Aspirin is an acidic substance. Describe the path-way by which an aspirin overdose causes anincrease in respiratory rate, and explain how thisincrease would be helpful to the victim.

30. Nine-year-old Jerry stumbled into the drug storegasping for breath. Blood was oozing from a smallhole in his chest wall. When the paramedics arrivedthey said that Jerry had been shot and suffered apneumothorax and atelectasis. Just what do both ofthese terms mean, and how do you explain his res-piratory distress? How will it be treated?

31. A hypothesis is a tentative explanation that can betested by further exploration. Based on this definition of hypothesis, is the hygiene hypothesisa true hypothesis? If you answer "yes," name oneaspect of the hygiene hypothesis that could be scientifically tested.

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32. A theory is a thoroughly tested set of statements orprinciples that explain an observable natural phe-nomenon. Based on this definition of theory, whatwould it take for the hygiene hypothesis to becomea theory?

Investigate (pp. xx–xx)

33. Do stick-on nasal strips increase the volume of airthat can pass through an athlete's nasal passages?Design an investigation to test this. Start with ahypothesis, a tentative explanation that can betested. Decide on what equipment or materials youwill need. To conduct your investigation, you willneed nasal strips and a way of measuring or timingrespiration. Conduct your experiment, report yourevidence, and write your conclusion.

464 Essentials of Human Anatomy and Physiology

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