Marieb & Keller Essentials of Human Anatomy & Physiology (12th Edition) PDF

Brief Contents 1 The Human Body: An Orientation 1 10 Blood 337 2 Basic Chemistry 24 11 The Cardiovascular System 356 3 Cells and Tissue 62 12 The Lymphatic System and Body...

Brief Contents 1 The Human Body: An Orientation 1 10 Blood 337 2 Basic Chemistry 24 11 The Cardiovascular System 356 3 Cells and Tissue 62 12 The Lymphatic System and Body Defenses 398 4 Skin and Body Membranes 109 13 The Respiratory System 436 5 The Skeletal System 134 14 The Digestive System and Body 6 The Muscular System 181 Metabolism 463 7 The Nervous System 225 15 The Urinary System 511 8 Special Senses 278 16 The Reproductive System 538 9 The Endocrine System 308 Word Roots, Prefixes, and Suffixes by Chapter More root words appear in Appendix B on page 584. Chapter 1: The Human Body: Chapter 11: The Cardiovascular procto- rectum, anus An Orientation System vestibul- vestibule caput-, cephal- head angi- vessel Chapter 15: The Urinary System cervic-, cervix neck aort- great artery adren- toward the kidney dors- the back cardi-, cardio- heart cyst- sac, bladder venter, ventr- abdomen hema-, hemato-, hemo- blood diure-, mictur- urinate phleb- vein nephro-, ren- kidney Chapter 3: Cells and Tissues thromb- clot cutic-, derm- skin Chapter 16: The Reproductive cyt- cell Chapter 13: The Respiratory System lip-, lipo- fat, lipid System cervic-, cervix neck (i.e. of uterus) medull-, myelo- marrow aero- air hyster-, hystero- uterus, womb myo- muscle broncho- bronchus (pl. bronchi) orchid- testis osteo- bone pleur- side, rib ov-, ovi- egg pneumo- air, wind peri- around Chapter 5: The Skeletal System pulmo- lung vagin- a sheath append- hang to rhin-, rhino- nose vulv- a covering ax-, axi-, axo- axis, axle Chapter 14: The Digestive Miscellaneous Chapter 7: The Nervous System System and Body Metabolism gene- beginning, origin cerebro-, enceph- brain bucco- cheek kin-, kines- move neuro- nerve chole- bile lymph- water oculo-, ophthalmo- eye entero-, ile- intestine oligo- few oto- ear eso- within esophagus phobia- fear psycho- mind gastr- stomach photo- light glosso-, lingua- tongue pyo- pus hepat- liver roentgen X-ray labi-, labri- lip odonto- teeth Learn the Essential What, How & Why of Human Anatomy & Physiology With the Twelfth Edition of Essentials of Human Anatomy & Physiology, science educator Suzanne Keller joins bestselling author Elaine Marieb in helping learners focus on the What, How & Why of A&P, without getting sidetracked in details. NEW! What, How & Why chapter previews introduce key examples of anatomy and physiology concepts that will be covered in the chapter. This technique helps learners hone in on what they are studying, how it functions, and why it is important for them to learn. NEW! Building Vocabulary Coaching Activities in MasteringA&P help students learn the essential language of A&P. See p. 356. Focus on Essential A&P Concepts Throughout every chapter, the text’s conversational writing style and straightforward explanations have been strengthened with familiar analogies and abundant mnemonic cues to help students learn and remember concepts. UPDATED! Exceptionally clear photos and illustrations, including dozens of new and improved figures, present concepts and processes at the right level of detail. Many figures from the text are assignable as Art- Labeling Activities in MasteringA&P. See p. 111. Unique Concept Links reinforce previously-learned concepts and help students make connec- tions across body systems while learning new material. See p. 256. Explore Essential Careers and Clinical Examples To inspire and inform students who are preparing for future healthcare careers, up-to-date clinical applications are integrated in context with discussions about the human body. UPDATED! Homeostatic Imbalance discussions are clinical examples that revisit the text’s unique theme by describing how the loss of homeostasis leads to pathology or disease. Related assessment questions are assignable in MasteringA&P, along with Clinical Case Study coaching activities. See p. 269. Focus on Careers essays feature conversations with working professionals and explain the relevance of anatomy and physiology course topics across a wide range of allied health careers. Featured careers include: Ch. 2 Pharmacy Technician Ch. 4 Medical Transcriptionist Ch. 5 Radiologic Technologist Ch. 8 Physical Therapy Assistant Ch. 10 Phlebotomy Technician Ch. 15 Licensed Practical Nurse Students can visit the MasteringA&P Study Area for more information about career options that are relevant to studying anatomy and physiology. See p. 56. Continuous Learning Before, During, and After Class MasteringA&P improves results by engaging students before, during, and after class. Before Class Dynamic Study Modules enable students to study more effectively on their own. With the Dynamic Study Modules mobile app, students can quickly access and learn the concepts they need to be more successful on quizzes and exams. NEW! Instructors can now select which questions to assign to students within each module. Instructors can further encourage students to prepare for class by assigning NEW! Building Vocabulary activities, reading questions, art labeling activities, and more. with MasteringA&P During Class NEW! Learning Catalytics is a “bring your own device” (laptop, smartphone, or tablet) engagement, assessment, and classroom intelligence system. Students use their device to respond to open-ended questions and then discuss answers in groups based on their responses. Visit learningcatalytics.com to learn more. After Class A wide variety of interactive coaching activities can be assigned to students as homework, including Art-Labeling Activities, Interactive Physiology 2.0 tutorials, Clinical Case Studies, and activities featuring A&P Flix 3-D movie- quality animations of key physiological processes. A&P concepts come to life with MasteringA&P Media references in the text direct learners to digital resources in the MasteringA&P Study Area, including practice tests and quizzes, flashcards, a complete glossary, and more. NEW! Interactive Physiology 2.0 NEW! Interactive Physiology 2.0 helps students advance beyond memorization to a genuine understanding of complex physiological processes. Fun, interactive tutorials, games, and quizzes give students additional explanations to help them grasp difficult concepts. IP 2.0 features brand-new graphics, quicker navigation, and more robust interactivity. Practice Anatomy Lab (PAL™ 3.0) is a virtual anatomy study and practice tool that gives students 24/7 access to the most widely used lab specimens, including the human cadaver, anatomical models, histology, cat, and fetal pig. PAL 3.0 is easy to use and includes built-in audio pronunciations, rotatable bones, and simulated fill-in-the- blank lab practical exams. Access the complete textbook on and offline with eText 2.0 NEW! The Twelfth Edition is available in Pearson’s fully-accessible eText 2.0 platform.* NEW! The eText 2.0 mobile app offers offline access and can be downloaded for most iOS and Android phones and tablets from the iTunes or Google Play stores. Powerful interactive and customization functions include instructor and student note-taking, highlighting, bookmarking, search, and links to glossary terms. *The eText 2.0 edition will be live for Fall 2017 classes. Additional Support for Students and Instructors NEW! Anatomy & Physiology Coloring Workbook Twelfth Edition by Elaine N. Marieb and Simone Brito The perfect companion to Essentials of Human Anatomy & Physiology, this engaging interactive workbook helps students get the most out of their study time. The Twelfth Edition includes NEW! crossword puzzles for every chapter, along with coloring activities, self-assessments, “At the Clinic” questions, and unique “Incredible Journey” visualization exercises that guide learners into memorable explorations of anatomical structures and physiological functions. NEW! IN FULL COLOR! Essentials of Human Anatomy & Physiology Laboratory Manual Seventh Edition by Elaine N. Marieb and Pamela B. Jackson This popular lab manual provides 27 exercises for a wide range of hands-on laboratory experiences, designed especially for a short A&P Lab course. This edition, which includes a Histology Atlas with 55 photomicrographs, features NEW! full-color illustrations, photos, and page design that help students navigate and learn the material faster and easier than ever before. Each concise lab exercise includes a Pre-Lab Quiz, brief background information, integrated learning objectives, student-friendly review sheets, and more. The Instructor Resources Area in MasteringA&P includes the following downloadable tools: All of the figures, photos, and tables from the text in JPEG and PowerPoint® formats, in labelled and unlabeled versions, and with customizable labels and leader lines Step-edit Powerpoint slides that present multi-step process figures step-by-step Clicker Questions and Quiz Show Game questions that encourage class interaction A&PFlix™ animations bring human anatomy and physiology concepts to life Customizable PowerPoint® lecture outlines save valuable class prep time A comprehensive Instructor’s Guide includes lecture outlines, classroom activities, and teaching demonstrations for each chapter. Test Bank provides a wide variety of customizable questions across Bloom’s taxonomy levels. Includes art labeling questions, and available in Microsoft® Word and TestGen® formats.  TWELFTH EDITION ESSENTIALS OF HUMAN ANATOMY & PHYSIOLOGY ELAINE N. MARIEB, R.N., PH.D., HOLYOKE COMMUNITY COLLEGE SUZANNE M. KELLER, PH.D., INDIAN HILLS COMMUNITY COLLEGE 330 Hudson Street, NY NY 10013 Editor-in Chief: Serina Beauparlant Proofreader: Betsy Dietrich Senior Courseware Portfolio Manager: Lauren Harp Compositor: iEnergizer Aptara®, Ltd. Content and Design Manager: Michele Mangelli, Mangelli Art and Production Coordinator: David Novak Productions, LLC Indexer: Steele/Katigbak Managing Producer: Nancy Tabor Interior Designer: tani hasegawa and Hespenheide Desgin Courseware Director, Content Development: Barbara Yien Cover Designer: Hespenheide Desgin Courseware Sr. Analysts: Suzanne Olivier and Alice Fugate Illustrators: Imagineering STA Media Services, Inc. Courseware Specialist: Laura Southworth Rights & Permissions Manager: Ben Ferrini Editorial Coordinator: Nicky Montalvo Photo Researcher: Kristin Piljay Mastering Content Developer: Cheryl Chi Manufacturing Buyer: Stacey Weinberger Director of Mastering Production: Katie Foley Executive Marketing Manager: Allison Rona Associate Producer, Science: Kristen Sanchez Rich Media Content Producer: Ziki Dekel Cover Photo Credit: Ben Welsh/Getty Images Copyeditor: Sally Peyrefitte Copyright © 2018, 2015, 2012 Pearson Education, Inc. All Rights Reserved. Printed in the United States of America. This publication is protected by copyright, and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise. For information regarding permissions, request forms and the appropriate contacts within the Pearson Education Global Rights & Permissions department, please visit www.pearsoned.com/permissions/. Acknowledgements of third party content appear on page 604, which constitutes an extension of this copyright page. PEARSON, ALWAYS LEARNING, MasteringA&P, A&P Flix, and PAL, are exclusive trademarks in the U.S. and/or other countries owned by Pearson Education, Inc. or its affiliates. Unless otherwise indicated herein, any third-party trademarks that may appear in this work are the property of their respective owners and any references to third-party trademarks, logos or other trade dress are for demonstrative or descriptive purposes only. Such references are not intended to imply any sponsorship, endorsement, authorization, or promotion of Pearson’s products by the owners of such marks, or any relationship between the owner and Pearson Education, Inc. or its affiliates, authors, licensees or distributors. Library of Congress Cataloging-in-Publication Data Names: Marieb, Elaine Nicpon | Keller, Suzanne M. Title: Essentials of human anatomy & physiology. Other titles: Essentials of human anatomy and physiology Description: Twelfth edition / Elaine N. Marieb, R.N., Ph.D., Holyoke Community College, Suzanne M. Keller, Ph.D., Indian Hills Community College. | Boston : Pearson, 2016. | Includes index. Identifiers: LCCN 2016039812| ISBN 9780134395326 | ISBN 0134395328 Subjects: LCSH: Human physiology. | Human anatomy. Classification: LCC QP34.5.M455 2016 | DDC 612--dc23 LC record available at https://lccn.loc.gov/2016039812 ISBN 10: 0-13-439532-8 (Student edition) ISBN 13: 978-0-13-439532-6 (Student edition) ISBN 10: 0-13-464954-0 (Instructor’s Review Copy) ISBN 13: 978-0-13-464954-2 (Instructor’s Review Copy) 5 4 3 2 1 16 17 18 19 20 About the Authors Elaine Marieb After receiving her Ph.D. in Suzanne Keller Suzanne M. Keller began zoology from the University of Massachusetts at her teaching career while she was still in graduate Amherst, Elaine N. Marieb joined the faculty of the school at the University of Texas Health Science Biological Science Division of Holyoke Community Center in San Antonio, Texas. Inspired by her life- College. While teaching at Holyoke Community long passion for learning, Dr. Keller quickly College, where many of her students were pursu- adopted a teaching style focused on translating ing nursing degrees, she developed a desire to bet- challenging concepts into easily understood parts ter understand the relationship between the using analogies and stories from her own experi- scientific study of the human body and the clinical ences. An Iowa native, Dr. Keller uses her expertise aspects of the nursing practice. To that end, while to teach microbiology and anatomy and physiol- continuing to teach full time, Dr. Marieb pursued ogy at Indian Hills Community College, where her nursing education, which culminated in a most of her students are studying nursing or other Master of Science degree with a clinical specializa- health science programs. tion in gerontology from the University of Massa- Dr. Keller values education as a way for students chusetts. It is this experience that has informed the to express their values through the careers they development of the unique perspective and acces- pursue. She supports those endeavors both in and sibility for which her publications are known. out of the classroom by participating in her local Dr. Marieb has given generously to provide oppor- Lions Club, by donating money to the Indian Hills tunities for students to further their education. She Foundation to fund scholarships, and by financially funds the E. N. Marieb Science Research Awards at supporting service-learning trips for students. Dr. Mount Holyoke College, which promotes research by Keller also enjoys sponsoring children in need with undergraduate science majors, and has underwritten gifts for the holidays. renovation of the biology labs in Clapp Laboratory at Dr. Keller is a member of the Human Anatomy that college. Dr. Marieb also contributes to the Univer- and Physiology Society (HAPS) and the Iowa Acad- sity of Massachusetts at Amherst, where she gener- emy of Science. Additionally, while engaged as an ously provided funding for reconstruction and author, Dr. Keller has served on multiple advisory instrumentation of a cutting-edge cytology research boards for various projects at Pearson and has laboratory. Recognizing the severe national shortage authored assignments for the MasteringA&P online of nursing faculty, she underwrites the Nursing Schol- program. When not teaching or writing, Dr. Keller ars of the Future Grant Program at the university. In enjoys reading, traveling, family gatherings, and January 2012, Florida Gulf Coast University named a relaxing at home under the watchful eyes of her new health professions facility in her honor. The Dr. two canine children. Elaine Nicpon Marieb Hall houses several specialized laboratories for the School of Nursing, made possible by Dr. Marieb’s generous support. iii New to the Twelfth Edition This edition has been thoroughly updated. New “What, How, Why” art opens each chapter, highlighting key concepts relating to the chapter topic. Other specific chapter-by-chapter changes include the following: Chapter 1: The Human Body: An Orientation New colors used in Figure 3.14 DNA images to help students track Updated description of the integumentary system to include new and old strands of DNA. vitamin D production in the presence of sunlight. New description of each chromosome being composed of two Updated definition of the term crural to specify the anterior leg, sister chromatids. or shin. New explanation of protein synthesis includes the role of the large New “Critical Thinking and Clinical Application” question on blood ribosomal subunit in peptide bond formation. clotting and feedback regulation. New Figure 3.18 descriptions of nuclei lining up in simple New “Critical Thinking and Clinical Application” question on using columnar and not lining up in pseudostratified epithelia. anatomical language to describe the location of a spinal injury and New description of cell shapes in different layers of stratified identifying the best medical imaging technique to diagnose a epithelia as “squished” and variable. spinal problem. New analogy for mucus produced by goblet cells as a “sticky trap” Updated “A Closer Look: Medical Imaging” with new discussion for dust and debris. and images of mammogram and bone densitometry. New Figure 3.19 labels for osteocytes, the elastic and collagen New “Did You Get It?” questions throughout the chapter. fibers in areolar connective tissue, and the fluid matrix of blood; new art for dense fibrous connective tissue. Chapter 2: Basic Chemistry New analogy for reticular tissue as “cellular bleachers” where other New example of atomic symbol and Latin derivative for potassium. cells rest to monitor the body. Revised discussion of hydrogen bonds to clarify that electrons are Updated Figure 3.21 to include the term neuroglia to describe not involved in this type of bond as they are in covalent and ionic supporting cells. bonds. New information added to Figure 3.22: cartilage added to the New example of importance of hydrogen bond in holding DNA connective tissue list and two major hallmarks of each of the four strands together. tissue types. All references to hydroxyl ion have been corrected to hydroxide ion. New example of atrophy: when a broken leg is in a cast, lack of New sports analogies for acids and bases: putting electrons “in the use causes muscles to atrophy during healing. game,” to represent free protons versus taking electrons “out of the Revised “A Closer Look: Cancer—An Intimate Enemy” and updated art. game,” to represent binding a proton so it cannot contribute to a New “Short Answer Essay” questions on the components of the shift in pH. plasma membrane and their functions and on contrasting New “Did You Get It?” question part on the difference in pH cytokinesis, interphase, and mitosis. between solutions at pH 11 and pH 5. New “Critical Thinking and Clinical Application” question on IV Introduced concepts of hydrophilic and hydrophobic in discussion fluids and tonicity. of phospholipids to help explain the functions of the polar head New “Did You Get It?” questions throughout the chapter. and fatty acid tails in cell membranes. Updated “Did You Get It?” question on lipids to include both Chapter 4: Skin and Body Membranes phospholipids and cholesterol as cell membrane components. New Figure 4.1 on epithelial membranes. New analogy comparing the alpha (α)-helix to a metal spring. New description of sensory receptors as part of nervous system New analogy comparing a beta (β)-sheet to a pleated skirt, or including a list of the stimuli detected. paper folded into a fan. New text updates on Figure 4.4 on epidermal structure; included a New analogy comparing enzymes and substrates to scissors and new figure question on stratum lucidum. paper, respectively. New analogy for epidermal dendritic cells as “sentries” guarding New description of RNA function as DNA’s “molecular assistant.” the skin. New shorthand symbols for messenger (mRNA), transfer (tRNA) New photo of stage 2 decubitus ulcer added to Homeostatic and ribosomal (rRNA) added. Imbalance 4.2. New analogy comparing glucose and ATP to crude oil and gasoline; New layout for Figure 4.7 combining scanning electron micrograph energy must be in the proper form before it can be used by cells. of hair shaft with existing art of the hair root and follicle. New explanation of why the terminal phosphate bonds in ATP are New discussion of fourth-degree burns. high energy. New criteria for determining whether a burn is critical, including New “Critical Thinking and Clinical Application” question on sickle circumferential burns, burns of the airway, and burns to the genital cell anemia. area. New images of basal cell and squamous cell carcinoma in Chapter 3: Cells and Tissues Figure 4.11. New description of the principle of complementarity. New component added to ABCDE rule: now includes “Evolution,” New information about how mitochondria divide. changes in a skin lesion over time. New “cargo” in the form of a membrane-bound receptor protein New “Short Answer Essay” questions on the risks of full-thickness added to pathway 2 of Figure 3.6. burns, contrasting eccrine and apocrine sweat glands, and the New analogy for lysosomes as “cellular stomachs.” relative severity of different skin infections. New art of plasma membrane and new detail of mitochondrial New “Critical Thinking and Clinical Application” question on burns. function including aerobic respiration in Table 3.1. New “Did You Get It?” questions throughout the chapter. New analogy of dust “crowd surfing” on the mucus that cilia carry from the lungs. Chapter 5: The Skeletal System New description of neuron function includes production of Updated description of long bones. neurotransmitters. New analogy comparing lubrication over articular cartilage at joints to a slick marble floor. iv  New to the Twelfth Edition v Updated descriptions of red and yellow bone marrow. Updated description of Nissl body function. Updated descriptions of sagittal and coronal sutures. New description clarifying the difference between a synapse and Updated description of the capitulum of the humerus. synaptic cleft. New analogy comparing the trochlea meeting the trochlear notch New analogy for a myelin sheath as the wrapping on an electrical to a curved “tongue-in-groove” joint. cord. Updated description of buttock injections to include the New explanation clarifying the differences between myelin sheaths consequences of hitting a nerve. in the CNS and PNS. Updated description of a synovial membrane to include areolar New explanation clarifying the “short circuit” event in multiple connective tissue. sclerosis means that the signal may stop or “jump” to an Updated description of cartilaginous joints. unmyelinated neuron. New description of saddle joints including a reference to New analogy for the structure of a unipolar cell body as a “cul-de- opposable thumbs. sac” off the “main road” that is the axon. Updated list of triggers for rheumatoid arthritis. Replaced references to the term basal ganglia with the more Discussion of the fetal skull and fontanels moved to the accurate term basal nuclei. Developmental Aspects section. Replaced the term arachnoid villi with arachnoid granulations. New analogy likening skulls of small children to “bobble heads.” New statistics on stroke as the fifth leading cause of death in the Updated review question on bones that articulate with the United States (formerly identified as the third leading cause). sphenoid to reflect only bones shown in the figures of Chapter 5. New statistics regarding the rate of survival after a stroke. Updated “Short Answer Essay” question on synovial joints to Replaced the phrase “mentally retarded” in the discussion of include osteoarthritis. cerebral palsy with “intellectually disabled.” New “Short Answer Essay” question contrasting the foramen New information included in “A Closer Look: The ‘Terrible Three’” magnum and obturator foramen. reflecting the role of calcium in apoptosis, two new drugs for New “Critical Thinking and Clinical Application” question on gouty treatment of Parkinson’s disease, and the variation in dopamine arthritis. levels in patients with Huntington’s disease. New statistics, information, and images added to “A Closer Look: New information incorporated in “A Closer Look: Tracking Down Joint Ventures.” CNS Problems” to include a new dopamine imaging technique Updated description of comminuted fractures on Table 5.2. called DaTscan. Updated Figure 5.6 to include osteoblasts and osteoclasts in the descriptions of bone addition and resorption, respectively. Chapter 8: Special Senses Updated Systems In Sync with respect to the descriptions of New description of lacrimal caruncle. relationships of cardiovascular and muscular systems to the New description of optic disc and the resulting blind spot. skeletal system. New analogy comparing the ability to see intermediate colors (between the red, green, and blue cones) to mixing paint. Chapter 6: The Muscular System Updated the description of cataracts. Updated descriptions of tendons and aponeuroses. New example of motion detected by dynamic equilibrium: a New analogy about running to explain the difference between the spinning carnival ride. contraction of skeletal muscle (fast) versus smooth muscle (slow). New analogy for bending of the cupula as divers’ fins in water. Updated description of a sarcomere to include its role as the New description of foliate papillae on the side of the tongue, structural and functional unit of muscle. another location for taste buds. Added discussion of titin to the description of a sarcomere as the New art showing the retina in Figure 8.5. elastic filament that attaches myosin to the Z disc. New Figure 8.6 showing the graph of rods and cones, and which New Homeostatic Imbalance on ALS (amyotropic lateral sclerosis, wavelengths of light are detected by each. or Lou Gehrig’s disease). Updated Figure 8.12b on maculae. New “Did You Get It?” question on the roles of calcium in muscle New “Did You Get It?” questions throughout the chapter. contraction. Updated descriptions of cross-bridge formation and the sliding Chapter 9: The Endocrine System filament theory, including the role of ATP. Updated discussion of the mechanism of hormone action, New link to IP Essentials for the sliding filament theory. including Figure 9.1 and its caption, to reflect that steroid New description of flaccid versus spastic paralysis. hormones can act via either second messenger or direct gene New mnemonic device for adduction: “add” back to the body by activation. moving toward the trunk (midline). Updated explanation of how hormones alter cell activity. New descriptions of dorsiflexion and plantar flexion with respect New analogy comparing second-messenger systems to delivering a to the head: toes point toward the head or away, respectively. letter. New girdle analogy for abdominal wall muscles “holding guts in.” Revised coverage of endocrine glands to reflect their location in New description of the consequences of an injection being too body from superior to inferior; Table 9.1 has also been revised to close to, or hitting, the sciatic nerve. reflect the new order. New description of tailor’s muscle sitting position. Updated description explaining why a goiter forms in the absence New description of myasthenia gravis as an autoimmune disease. of iodine. New “Short Answer Essay” question about the relationship Updated description of body proportions in cretinism. between wrist flexors and extensors, including their locations. New “Did You Get It?” question on adrenal cortex hormones. New figure question for Figure 6.20 on the origin(s) and insertion(s) of the rectus femoris depending on the action being Chapter 10: Blood performed. Updated explanation of why the normal temperature of blood is a Updated explanation of steps in Figure 6.5. bit higher than body temperature. Added definitions for the suffixes -cytosis and -penia. Chapter 7: The Nervous System Updated the analogy comparing the shape of the eosinophil Updated Figure 7.13 to use superior and inferior instead of nucleus to earmuffs. cephalad and caudal. Updated the role of monocytes to include activation of Updated Figure 7.24 to clarify why there are eight cervical nerves lymphocytes. but only seven cervical vertebrae. Updated the list of locations where red marrow is found in adults. New Learning Outcome on the structures and functions of neurons Updated the major anticoagulants to include warfarin. and neuroglia. New description of petechiae includes comparison to a skin rash. vi New to the Twelfth Edition Added a learning tool about blood type reminding readers that a Updated Table 12.1 regarding the role of nasal hairs to include person does not make antibodies against their own blood type filtration of airborne particles. antigen(s). Updated Table 12.3 entry for “Cytokines: Perforin and granzymes” Updated discussion of lack of vitamin B12 as the cause of to include natural killer (NK) cells. pernicious anemia and how this relates to intrinsic factor. New “Did You Get It?” questions throughout the chapter. Chapter 11: The Cardiovascular System Chapter 13: The Respiratory System Updated description of pericardium. New information explaining neural regulation of breathing with Revised discussion of the function of the atria to clarify that they respect to the dorsal and ventral respiratory groups of the medulla. assist with ventricular filling. New Short Answer Essay question contrasting hyperventilation and Arteries and veins are now introduced in terms of the direction of hyperpnea. blood flow with respect to the heart. Updated “A Closer Look” on cleanliness and asthma. New analogy comparing valve cusps filling with blood to a New “Did You Get It?” questions throughout the chapter. parachute filling with air. New analogy comparing the intrinsic conduction system setting Chapter 14: The Digestive System heart rhythm to a drummer setting the beat for a rock band New illustration outlining the parietal and visceral layers of the playing a song. peritoneum (Figure 14.5). New discussion of AEDs (automatic external defibrillators) New illustrations showing both deciduous and permanent teeth in included in the discussion of fibrillation. greater detail (Figure 14.9). Reorganized section on the cardiac cycle to include five stages. Updated description of circular folds to provide students with a New “Did You Get It?” question about isovolumetric contraction. visual image of a corkscrew that slows progression of food and Updated description of the effect of congestive heart failure on increases surface area at the same time. stroke volume. Added detail that rennin in infants is the same enzyme used to Updated description of pulmonary congestion. curdle milk in cheesemaking. Updated description of pulmonary embolism. Added narcotic pain medications to the list of causes of Discussion of fetal circulation moved to the Developmental constipation, with stool softeners as a method of treatment. Aspects section. New “Did You Get It?” question on the four types of teeth and Updated description of the blood pressure gradient to include a their functions. pressure of zero in the right atrium. Added brief discussion of nucleic acid digestion, including the New layout of Figure 11.8 reflecting five stages of the cardiac cycle. source of the enzymes and the reminder that nucleotides are the Updated Figure 11.9 description to clarify that any change in heart building blocks. rate or stroke volume will also cause a change in cardiac output. Revised “A Closer Look” box on obesity to update references, Updated description of Figures 11.13 and 11.14 to include a statistics, and methods used to determine body composition, such statement that all vessels are bilateral unless otherwise stated in as DEXA, the Bod Pod, and underwater weighing. the text. Updated “A Closer Look” box on atherosclerosis. Chapter 15: The Urinary System Updated descriptions of the arterioles that connect to the Chapter 12: The Lymphatic System and Body Defenses glomerulus. Updated Figure 12.10 on lysis by complement to reflect water Included a new learning tool describing the internal urethral flowing into the cell to cause lysis. sphincter as involuntary. Added the role of B cells in antigen presentation to Figure 12.19. New “Short Answer Essay” question contrasting the homeostatic New information added regarding discovery of lymphatics in the imbalances oliguria, anuria, polyuria, and nocturia. central nervous system. New “Critical Thinking and Clinical Application” question about Updated the description of adaptive defenses as defenses that fight the relationship between hypertension and impaired kidney antigens that get past the innate defenses. function, and tests that are used for determining impaired kidney New description of how natural killer cells kill: via perforin and function. granzymes. New information included in “A Closer Look: Renal Failure and the Updated the description of positive chemotaxis to include Artificial Kidney” about a blood test to determine the creatinine movement toward the stimulus. level in order to estimate the rate of glomerular filtration. Revised description of interferon to clarify that interferon fights Did You Get It? only viral pathogens, not bacteria or fungi. New antibody function has been listed: opsonization. Chapter 16: The Reproductive System New description of Graves’ disease explaining that excess New explanation of the purpose of polar bodies: to reduce the production of thyroxine is in response to antibodies that mimic chromosome number during oogenesis. TSH (thyroid-stimulating hormone). Update of suggested age range for women to begin having regular New descriptions of two additional types of hypersensitivities: mammograms: between 45 and 54. reactions resulting in cell lysis and those forming antigen-antibody New Concept Link on chemotaxis. complexes. New photomicrograph showing sperm swarming an oocyte in New example of when epinephrine is used during acute Figure 16.16. hypersensitivity: EpiPen® injection. New explanation of how an egg blocks additional sperm from New Short Answer Essay question provided on mechanisms of entering; the surface sperm receptors on an oocyte are shed after killing used by the immune system, including lysozyme, perforin, the first sperm enters the cell. and granzymes, and membrane attack complex (MAC). New clarification with updated definitions of miscarriage and Updated “A Closer Look” box on AIDS, including new title. abortion. Acknowledgments Many people contributed to our efforts in the cre- University; Amy Goode, Illinois Central College; ation of this twelfth edition. We offer our profound Jeannette Hafey, Springfield College; Ashley Hagler, thanks to the following reviewers, whose thought- Gaston College; Frances Miles, Lake Michigan ful critiques informed and enhanced our develop- College–Napier Avenue Campus; Margaret Ott, Tyler ment of this edition: Junior College; Heidi Peterson, Indian Hills Commu- William Brazelle, University of South Florida nity College–Ottumwa Campus; Laura Ritt, Burling- ton County College; Holly Sanders, Gwinnett Sheree Daniel, Trinity Valley Community Technical College; Leba Sarkis, Aims Community College College; Gustavo A. Solis, Forsyth Technical Com- Trevor Day, Mount Royal University munity College; Ginny Stokes, Nash Community Camille Di Scala, Chandler-Gilbert Community College; Robert Suddith, Cape Fear Community Col- College lege; John F. Tarpey, City College of San Francisco; Pamela Boyter Jackson, Piedmont Technical Deborah S. Temperly, Delta College; Claudia Wil- College liams, Campbell University. Roop Jayaraman, Central Michigan University The entire group from Pearson and beyond deserves our heartfelt thanks for being the best Kimberly Kushner, Pueblo Community College team around! They have provided support, guid- Frances Mills, Lake Michigan College ance, and humor throughout the writing process, Diane Pelletier, Green River Community which made the process fun and was most appre- College ciated. Special thanks to Serina Beauparlant, Edi- Heidi Peterson, Indian Hills Community tor-In-Chief, Brooke Suchomel, Sr. Acquisitions College Editor, and Tiffany Mok, Program Manager who passed the reins to Lauren Harp, Sr. Portfolio Man- Kenneth Ryan, Alexandria Technical and ager, for crossing the finish line. Thanks also to Community College Nicky Montalvo, Editorial Coordinator. Thank you Holly Sanders, Gwinnett Technical College to the content development team—Suzanne Olivier, Scott Schaeffer, Harford Community College Alice Fugate, and Laura Southworth—for their I-Chia Shih, Leeward Community College, attention to detail and collaborative minds. Thank University of Hawaii you Patrice Fabel, Ziki Dekel, and Lauren Hill for supervising an impressive variety of media content K. Dale Smoak, Piedmont Technical College that will benefit both students and instructors. A Bill Snyder, Bluegrass Community and special thank-you to Gary Hespenheide for the Technical College book’s beautiful and creative new interior and Greg Tefft, Northwest State Community College cover designs. The work of Kristin Piljay, Photo Sandra Uyeshiro, Modesto Junior College Researcher, resulted in some striking new photos Khursheed Wankadiya, Central Piedmont for this edition; and Sally Peyrefitte, our excellent Community College and diligent copyeditor, ensured a consistent style throughout the book. Proofreader Betsy Dietrich Carol T. Wismer, College of Lake County skillfully reviewed every page proof, and Sallie Thanks are also extended to the reviewers of the Steele provided a thorough and accurate index. Eleventh Edition: Carmen Carpenter, South Univer- Our talented art house, Imagineering STA Media sity; Steven D. Collins, Niagara College; Janie Cor- Services, Inc., and compositor, Aptara, worked tire- bitt, Central Georgia Technical College–Milledgeville lessly to provide stunning artwork and student- Campus; Eric D. Forman, Sauk Valley Community friendly page layouts. Stacey Weinberger, Senior College; Andrew Goliszek, North Carolina A&T State Manufacturing Buyer, Allison Rona, and Derek vii viii Acknowledgments Perrigo deserve special thanks for their expertise in detail—David made the whole process smooth delivering and presenting the final product to the and successful. And last, but not least, Michele market. A special thank you goes to David Novak, Mangelli—a tremendous thank-you for your skillful our Production and Art Coordinator, for taking on oversight of all aspects of the 12th edition, includ- the role of two people during this edition and flaw- ing assisting a first-time co-author in all things pub- lessly handling every text and art-related production lishing... you’re an unflappable rock star! Elaine N. Marieb Suzanne M. Keller Anatomy and Physiology Pearson Education 1301 Sansome Street San Francisco, CA 94111 Contents 1 The Human Body: SUMMARy 21 REviEw QUESTiONS 22 An Orientation 1 CRiTiCAL THiNkiNg AND CLiNiCAL APPLiCATiON QUESTiONS 23 An Overview of Anatomy and A CLOSER LOOk Medical Imaging: Physiology 1 Illuminating the Body 10 Anatomy 1 2 Physiology 2 Relationship between Anatomy Basic and Physiology 2 Chemistry 24 Levels of Structural Organization 2 From Atoms to Organisms 2 Concepts of Matter and Energy 24 Organ System Overview 3 Matter 24 Integumentary System Skeletal System Muscular Energy 25 System Nervous System Endocrine System Forms of Energy Energy Form Conversions Cardiovascular System Lymphatic System Respiratory System Digestive System Urinary System Reproductive System Composition of Matter 26 Elements and Atoms 26 Maintaining Life 7 Atomic Structure 26 Necessary Life Functions 7 The Basic Atomic Subparticles Planetary and Orbital Maintaining Boundaries Movement Responsiveness Models of an Atom Digestion Metabolism Excretion Reproduction Identifying Elements 28 Growth Atomic Number Atomic Mass Number Atomic Survival Needs 9 Weight and Isotopes The Language of Anatomy 12 Molecules and Compounds 31 Anatomical Position 12 Chemical Bonds and Chemical Directional Terms 12 Reactions 32 Regional Terms 12 Bond Formation 32 Anterior Body Landmarks Posterior Body Landmarks Role of Electrons Types of Chemical Bonds Body Planes and Sections 15 Patterns of Chemical Reactions 36 Body Cavities 15 Synthesis Reactions Decomposition Reactions Dorsal Body Cavity Ventral Body Cavity Other Exchange Reactions Factors Influencing the Rate Body Cavities of Chemical Reactions Homeostasis 19 Biochemistry: The Chemical Components of Homeostatic Control Composition of Living Matter 38 Systems 19 Inorganic Compounds 39 Feedback Mechanisms 19 Water Salts Acids and Bases ix x Contents Chapter 2, continued Classification of Epithelia 89 Simple Epithelia Stratified Epithelia Glandular Organic Compounds 42 Epithelium Carbohydrates Lipids Proteins Nucleic Acids Adenosine Triphosphate (ATP) Connective Tissue 93 SUMMARy 57 Hallmarks of Connective Tissue 93 REviEw QUESTiONS 59 Extracellular Matrix 94 CRiTiCAL THiNkiNg AND CLiNiCAL Types of Connective Tissue 94 Bone Cartilage Dense Connective Tissue Loose APPLiCATiON QUESTiONS 61 Connective Tissue Blood FOCUS ON CAREERS Pharmacy Technician 56 Muscle Tissue 98 3 Skeletal Muscle 98 Cells Cardiac Muscle 98 and Tissues 62 Smooth Muscle 100 Nervous Tissue 100 PART i: CELLS 62 Tissue Repair (wound Healing) 100 Overview of the Cellular Basis PART iii: DEvELOPMENTAL of Life 62 ASPECTS OF CELLS AND Anatomy of a generalized Cell 63 TiSSUES 102 The Nucleus 63 SUMMARy 104 Nuclear Envelope Nucleolus Chromatin The Plasma Membrane 64 REviEw QUESTiONS 107 The Fluid Mosaic Model Cell Membrane Junctions CRiTiCAL THiNkiNg AND CLiNiCAL The Cytoplasm 67 APPLiCATiON QUESTiONS 108 Cytosol and Inclusions Organelles A CLOSER LOOk IV Therapy and Cellular Cell Extensions 71 “Tonics” 79 Cilia and Flagella Microvilli A CLOSER LOOk Cancer—An Intimate Cell Diversity 74 Enemy 104 Cell Physiology 76 4 Membrane Transport 76 Passive Processes: Diffusion and Filtration Skin and Body Membranes 109 Active Processes Cell Division 82 Preparations: DNA Replication Events of Cell Division Protein Synthesis 85 Classification of Body Genes: The Blueprint for Protein Structure The Role Membranes 109 of RNA The Process of Protein Synthesis Epithelial Membranes 110 PART ii: BODy TiSSUES 88 Cutaneous Membrane Mucous Membranes Serous Membranes Epithelial Tissue 88 Connective Tissue Membranes 110 Hallmarks of Epithelium 88  Contents xi The integumentary System (Skin) 112 Cervical Vertebrae Thoracic Vertebrae Lumbar Vertebrae Sacrum Coccyx Functions of the Integumentary System 112 Thoracic Cage 156 Structure of the Skin 113 Sternum Ribs Epidermis Dermis Skin Color 118 Appendicular Skeleton 158 Appendages of the Skin 119 Bones of the Shoulder Girdle 158 Cutaneous Glands Hair and Hair Follicles Nails Bones of the Upper Limbs 158 Homeostatic Imbalances of Skin 123 Arm Forearm Hand Infections and Allergies Burns Skin Cancer Bones of the Pelvic Girdle 162 Developmental Aspects of Skin and Body Bones of the Lower Limbs 164 Membranes 127 Thigh Leg Foot SUMMARy 130 Joints 166 REviEw QUESTiONS 131 Fibrous Joints 169 Cartilaginous Joints 169 CRiTiCAL THiNkiNg AND CLiNiCAL APPLiCATiON QUESTiONS 132 Synovial Joints 169 A CLOSER LOOk A Wrinkle Out of Types of Synovial Joints Based on Shape 170 Time 117 Developmental Aspects of the FOCUS ON CAREERS Medical Skeleton 173 Transcriptionist 128 Birth to Adulthood 173 SySTEMS iN SyNC 129 Older Adults 175 5 SUMMARy 177 The Skeletal REviEw QUESTiONS 178 System 134 CRiTiCAL THiNkiNg AND CLiNiCAL APPLiCATiON QUESTiONS 180 FOCUS ON CAREERS Radiologic Bones: An Overview 134 Technologist 143 Functions of the Bones 135 A CLOSER LOOk Joint Ventures 166 Classification of Bones 135 SySTEMS iN SyNC 176 Structure of Bone 137 Gross Anatomy of a Long Bone Microscopic 6 Anatomy Bone Formation, Growth, and The Muscular Remodeling 141 Bone Formation and Growth Bone Remodeling System 181 Bone Fractures 144 Overview of Muscle Tissues 181 Axial Skeleton 146 Muscle Types 181 Skull 146 Skeletal Muscle Smooth Muscle Cardiac Muscle Cranium Facial Bones The Hyoid Bone Muscle Functions 185 Vertebral Column (Spine) 152 Produce Movement Maintain Posture and Body Position Stabilize Joints Generate Heat Additional Functions xii Contents Chapter 6, continued A CLOSER LOOk Anabolic Steroids: Dying to Win? 205 Microscopic Anatomy of Skeletal SySTEMS iN SyNC 220 Muscle 185 7 Skeletal Muscle Activity 187 Stimulation and Contraction of Single Skeletal The Nervous Muscle Fibers 187 The Nerve Stimulus and the Action Potential System 225 Mechanism of Muscle Contraction: The Sliding Filament Theory Contraction of a Skeletal Muscle Organization of the Nervous as a Whole 191 System 226 Graded Responses Providing Energy for Muscle Structural Classification 227 Contraction Muscle Fatigue and Oxygen Deficit Functional Classification 227 Types of Muscle Contractions—Isotonic and Isometric Muscle Tone Effect of Exercise on Muscles Nervous Tissue: Structure and Function 227 Muscle Movements, Roles, and Supporting Cells 227 Names 196 Neurons 229 Types of Body Movements 196 Anatomy Classification Physiology: Nerve Impulses Special Movements Physiology: Reflexes Interactions of Skeletal Muscles in the Body 200 Central Nervous System 239 Naming Skeletal Muscles 202 Functional Anatomy of the Brain 239 Cerebral Hemispheres Diencephalon Brain Stem Arrangement of Fascicles 202 Cerebellum gross Anatomy of Skeletal Protection of the Central Nervous System 247 Meninges Cerebrospinal Fluid The Blood-Brain Muscles 203 Barrier Head and Neck Muscles 203 Brain Dysfunctions 251 Facial Muscles Neck Muscles Spinal Cord 252 Trunk Muscles 206 Gray Matter of the Spinal Cord and Spinal Roots Anterior Muscles Posterior Muscles White Matter of the Spinal Cord Muscles of the Upper Limb 209 Muscles Causing Movement at the Elbow Joint Peripheral Nervous System 255 Muscles of the Lower Limb 209 Structure of a Nerve 255 Muscles Causing Movement at the Hip Cranial Nerves 257 Joint Muscles Causing Movement at the Knee Joint Muscles Causing Movement Spinal Nerves and Nerve Plexuses 257 at the Ankle and Foot Autonomic Nervous System 264 Somatic and Autonomic Nervous Systems Compared Developmental Aspects of the Muscular Anatomy of the Parasympathetic Division Anatomy System 218 of the Sympathetic Division Autonomic Functioning SUMMARy 219 Developmental Aspects of the Nervous REviEw QUESTiONS 222 System 269 CRiTiCAL THiNkiNg AND CLiNiCAL SUMMARy 273 APPLiCATiON QUESTiONS 223  Contents xiii REviEw QUESTiONS 275 PART iii: CHEMiCAL SENSES: CRiTiCAL THiNkiNg AND CLiNiCAL SMELL AND TASTE 298 APPLiCATiON QUESTiONS 277 A CLOSER LOOk The “Terrible Three” 252 Olfactory Receptors and the Sense of Smell 298 A CLOSER LOOk Tracking Down CNS Problems 270 Taste Buds and the Sense of Taste 300 SySTEMS iN SyNC 272 PART iv: DEvELOPMENTAL 8 ASPECTS OF THE SPECiAL Special SENSES 301 Senses 278 SUMMARy 303 REviEw QUESTiONS 305 PART i: THE EyE AND CRiTiCAL THiNkiNg AND CLiNiCAL APPLiCATiON QUESTiONS 306 viSiON 279 A CLOSER LOOk Visual Pigments—The Actual Anatomy of the Eye 279 Photoreceptors 285 External and Accessory Structures 279 A CLOSER LOOk Bringing Things into Internal Structures: The Eyeball 281 Focus 289 Layers Forming the Wall of the Eyeball Lens FOCUS ON CAREERS Physical Therapy Assistant 295 Physiology of vision 287 Pathway of Light through the Eye and Light 9 Refraction 287 Visual Fields and Visual Pathways The Endocrine to the Brain 288 Eye Reflexes 290 System 308 PART ii: THE EAR: HEARiNg AND The Endocrine System and Hormone BALANCE 290 Function—An Overview 309 The Chemistry of Hormones 309 Anatomy of the Ear 291 Hormone Action 309 External (Outer) Ear 291 Direct Gene Activation Second-Messenger System Middle Ear 292 Stimuli for Control of Hormone Release 311 Internal (Inner) Ear 292 Hormonal Stimuli Humoral Stimuli Neural Stimuli Equilibrium 292 The Major Endocrine Organs 312 Static Equilibrium 293 Pituitary Gland and Hypothalamus 313 Dynamic Equilibrium 293 Pituitary-Hypothalamus Relationships Pineal Gland 317 Hearing 296 Thyroid Gland 317 Hearing and Equilibrium Deficits 297 Parathyroid Glands 319 Thymus 320 xiv Contents Chapter 9, continued Developmental Aspects of Blood 352 Adrenal Glands 320 SUMMARy 353 Hormones of the Adrenal Cortex Hormones of the REviEw QUESTiONS 354 Adrenal Medulla Pancreatic Islets 323 CRiTiCAL THiNkiNg AND CLiNiCAL APPLiCATiON QUESTiONS 355 Gonads 327 Hormones of the Ovaries Hormones of the Testes FOCUS ON CAREERS Phlebotomy Technician 350 Other Hormone-Producing Tissues and Organs 327 Developmental Aspects of the Endocrine System 331 SUMMARy REviEw QUESTiONS 333 335 11 The Cardiovascular System 356 The Heart 357 CRiTiCAL THiNkiNg AND CLiNiCAL Anatomy of the Heart 357 APPLiCATiON QUESTiONS 336 Size, Location, and Orientation Coverings and Walls A CLOSER LOOk Potential Uses of the Heart for Growth Hormone 316 Chambers and Associated Great Vessels 358 SySTEMS iN SyNC 332 Heart Valves 361 Cardiac Circulation 10 Physiology of the Heart 364 Intrinsic Conduction System of the Heart: Setting the Basic Rhythm Cardiac Cycle and Heart Sounds Blood 337 Cardiac Output Blood vessels 370 Composition and Functions Microscopic Anatomy of Blood Vessels 370 of Blood 337 Tunics Structural Differences in Arteries, Veins, and Capillaries Components 338 Gross Anatomy of Blood Vessels 373 Physical Characteristics and Volume 338 Major Arteries of the Systemic Circulation Major Plasma 338 Veins of the Systemic Circulation Special Circulations Formed Elements 340 Physiology of Circulation 380 Erythrocytes Leukocytes Platelets Arterial Pulse Blood Pressure Capillary Exchange of Gases and Nutrients Fluid Movements at Capillary Beds Hematopoiesis (Blood Cell Formation) 345 Formation of Red Blood Cells Formation of White Developmental Aspects of the Blood Cells and Platelets Cardiovascular System 389 Hemostasis 347 SUMMARy 392 Phases of Hemostasis 347 REviEw QUESTiONS 394 Disorders of Hemostasis 348 CRiTiCAL THiNkiNg AND CLiNiCAL Blood groups and Transfusions 349 APPLiCATiON QUESTiONS 396 Human Blood Groups 349 A CLOSER LOOk Electrocardiography: (Don’t) Be Still My Heart 367 Blood Typing 352  Contents xv A CLOSER LOOk Atherosclerosis? SUMMARy 431 Get Out the Cardiovascular Drāno! 386 REviEw QUESTiONS 433 SySTEMS iN SyNC 391 CRiTiCAL THiNkiNg AND CLiNiCAL APPLiCATiON QUESTiONS 435 12 A CLOSER LOOk AIDS: An Ongoing The Lymphatic Pandemic 428 System and Body SySTEMS iN SyNC 430 Defenses 398 PART i: THE LyMPHATiC SySTEM 398 13 The Respiratory System 436 Lymphatic vessels 399 Functional Anatomy of the Respiratory System 436 Lymph Nodes 400 The Nose 437 Other Lymphoid Organs 402 The Pharynx 438 The Larynx 439 PART ii: BODy DEFENSES 403 The Trachea 440 The Main Bronchi 440 innate Body Defenses 404 The Lungs 441 Surface Membrane Barriers 404 The Bronchial Tree Respiratory Zone Structures and Internal Defenses: Cells and Chemicals 406 the Respiratory Membrane Natural Killer Cells Inflammatory Response Phagocytes Antimicrobial Proteins Fever Respiratory Physiology 445 Mechanics of Breathing 445 Adaptive Body Defenses 410 Inspiration Expiration Antigens 412 Respiratory Volumes and Capacities 448 Cells of the Adaptive Defense System: An Nonrespiratory Air Movements 449 Overview 412 Respiratory Sounds 449 Lymphocytes Antigen-Presenting Cells Humoral (Antibody-Mediated) Immune External Respiration, Gas Transport, and Response 415 Internal Respiration 449 Active and Passive Humoral Immunity Antibodies External Respiration Gas Transport in the Blood Internal Respiration Cellular (Cell-Mediated) Immune Response 420 Control of Respiration 452 Organ Transplants and Rejection 422 Neural Regulation: Setting the Basic Rhythm Disorders of Immunity 425 Nonneural Factors Influencing Respiratory Rate and Depth PART iii: DEvELOPMENTAL Respiratory Disorders 454 ASPECTS OF THE LyMPHATiC SySTEM AND BODy Developmental Aspects of the DEFENSES 429 Respiratory System 457 SUMMARy 459 xvi Contents Chapter 13, continued PART ii: NUTRiTiON AND REviEw QUESTiONS 461 METABOLiSM 487 CRiTiCAL THiNkiNg AND CLiNiCAL Nutrition 487 APPLiCATiON QUESTiONS 462 Dietary Recommendations 487 A CLOSER LOOk Too Clean for Dietary Sources of the Major Nutrients 488 Our Own Good? 456 Carbohydrates Lipids Proteins Vitamins SySTEMS iN SyNC 458 Minerals Metabolism 490 14 The Digestive Carbohydrate, Fat, and Protein Metabolism in Body Cells 490 System and Body Carbohydrate Metabolism Fat Metabolism Protein Metabolism Metabolism 463 The Central Role of the Liver in Metabolism 494 General Metabolic Functions Cholesterol Metabolism PART i: ANATOMy AND and Transport PHySiOLOgy OF THE DigESTivE Body Energy Balance 497 Regulation of Food Intake Metabolic Rate and Body SySTEM 463 Heat Production Body Temperature Regulation Anatomy of the Digestive PART iii: DEvELOPMENTAL System 463 ASPECTS OF THE DigESTivE Organs of the Alimentary Canal 464 Mouth Pharynx Esophagus Stomach Small SySTEM AND METABOLiSM 501 Intestine Large Intestine SUMMARy 506 Accessory Digestive Organs 474 REviEw QUESTiONS 508 Teeth Salivary Glands Pancreas Liver and Gallbladder CRiTiCAL THiNkiNg AND CLiNiCAL APPLiCATiON QUESTiONS 510 Functions of the Digestive A CLOSER LOOk Peptic Ulcers: “Something System 476 Is Eating at Me” 486 Overview of Gastrointestinal Processes and Controls 477 A CLOSER LOOk Obesity: Magical Solution Wanted 503 Activities Occurring in the Mouth, Pharynx, and Esophagus 480 SySTEMS iN SyNC 505 Food Ingestion and Breakdown Food Propulsion— 15 Swallowing and Peristalsis Activities of the Stomach 481 Food Breakdown Food Propulsion The Urinary Activities of the Small Intestine 483 System 511 Chyme Breakdown and Absorption Chyme Propulsion Activities of the Large Intestine 485 kidneys 512 Nutrient Breakdown and Absorption Propulsion Location and Structure 512 of Food Residue and Defecation Kidney Structure Blood Supply Nephrons 513  Contents xvii Urine Formation and Characteristics 516 Epididymis Ductus Deferens Urethra Glomerular Filtration Tubular Reabsorption Tubular Accessory Glands and Semen 541 Secretion Nitrogenous Wastes Characteristics of Urine Seminal Vesicles Prostate Bulbo-urethral Glands Semen Ureters, Urinary Bladder, External Genitalia 542 and Urethra 520 Ureters 520 Male Reproductive Functions 543 Urinary Bladder 521 Spermatogenesis 543 Urethra 523 Testosterone Production 545 Micturition 523 Anatomy of the Female Reproductive Fluid, Electrolyte, and Acid-Base System 547 Balance 524 Ovaries 547 Maintaining Water Balance of Blood 524 Duct System 547 Body Fluids and Fluid Compartments The Link Uterine Tubes Uterus Vagina between Water and Electrolytes Regulation of Water External Genitalia and Female Perineum 550 Intake and Output Maintaining Electrolyte Balance 527 Female Reproductive Functions Maintaining Acid-Base Balance of Blood 529 and Cycles 551 Blood Buffers Respiratory Mechanisms Renal Oogenesis and the Ovarian Cycle 551 Mechanisms Hormone Production by the Ovaries 553 Developmental Aspects of the Urinary Uterine (Menstrual) Cycle 554 System 531 Mammary glands 554 SUMMARy 535 REviEw QUESTiONS 536 Pregnancy and Embryonic Development 557 CRiTiCAL THiNkiNg AND CLiNiCAL APPLiCATiON QUESTiONS 537 Accomplishing Fertilization 558 A CLOSER LOOk Renal Failure and Events of Embryonic and Fetal Development 559 the Artificial Kidney 523 Effects of Pregnancy on the Mother 563 FOCUS ON CAREERS Licensed Practical Anatomical Changes Physiological Changes Nurse (LPN) 532 Childbirth 565 SySTEMS iN SyNC 534 Initiation of Labor Stages of Labor 16 Developmental Aspects of the The Reproductive Reproductive System 567 System 538 SUMMARy 572 REviEw QUESTiONS 574 CRiTiCAL THiNkiNg AND CLiNiCAL Anatomy of the Male Reproductive APPLiCATiON QUESTiONS 576 System 539 A CLOSER LOOk Contraception: Preventing Testes 539 Pregnancy 568 Duct System 539 SySTEMS iN SyNC 571 xviii Contents Appendixes Appendix D Key Information about Vitamins and Many Essential Appendix A: Answers to Did You Get It? Minerals 587 Questions and Multiple Choice Glossary 591 Review Questions 577 Credits 604 Appendix B: Word Roots, Prefixes, and Suffixes 584 Subject Index 605 Appendix C: Periodic Table of the Elements 586 1 The Human Body: n rientation WHAT Anatomy is the study of the structure, or HOW physical form, of the The function, or body. physiology, of each body part and the body as a whole is dependent on the anatomy of those parts; in other words, structure determines function. WHY This text will help you learn structures and functions INSTRUCTORS so you can understand the role of New Building individual organs and body Vocabulary Coaching systems and how they interact Activities for this to support life. chapter are assignable in An Overview of Anatomy the seeds. Adults become upset when their hearts pound, when they have uncontrollable hot flashes, and Physiology or when they cannot keep their weight down. ➔ Learning Objectives Anatomy and physiology, subdivisions of biol- ogy, explore many of these topics as they describe □ Define anatomy and physiology. how our bodies are put together and how they □ Explain how anatomy and physiology are related. work. Most of us are naturally curious about our bodies; Anatomy we want to know what makes us tick. Infants can keep themselves happy for a long time staring at Anatomy (ah-nat′o-me) is the study of the structure their own hands or pulling their mother’s nose. and shape of the body and its parts and their rela- Older children wonder where food goes when tionships to one another. Whenever we look at our they swallow it, and some believe that they will own body or study large body structures such as the grow a watermelon in their belly if they swallow heart or bones, we are observing gross anatomy; 1 2 Essentials of Human Anatomy and Physiology that is, we are studying large, easily observable structures. Indeed, the term anatomy, derived Levels of Structural from the Greek words meaning to cut (tomy) apart Organization (ana), is related most closely to gross anatomical ➔ Learning Objectives studies because in such studies, preserved animals □ Name the six levels of structural organization that or their organs are dissected (cut up) to be exam- make up the human body, and explain how they ined. Microscopic anatomy, in contrast, is the study are related. of body structures that are too small to be seen □ Name the organ systems of the body, and briefly with the naked eye. The cells and tissues of the state the major functions of each system. body can only be seen through a microscope. □ Identify and classify by organ system all organs discussed. Physiology Physiology (fiz″e-ol′o-je) is the study of how the From Atoms to Organisms body and its parts work or function ( physio = The human body exhibits many levels of structural nature; ology = the study of). Like anatomy, physi- complexity (Figure 1.1). The simplest level of the ology has many subdivisions. For example, neu- structural ladder is the chemical level (covered rophysiology explains the workings of the nervous in Chapter 2). At this level, atoms, tiny building system, and cardiac physiology studies the func- blocks of matter, combine to form molecules such tion of the heart. as water, sugar, and proteins, like those that make up our muscles. Molecules, in turn, associate in Relationship between specific ways to form microscopic cells, the small- Anatomy and Physiology est units of all living things. (We will examine the Anatomy and physiology are always inseparable. cellular level in Chapter 3.) All cells have some The parts of your body form a well-organized unit, common structures and functions, but individual and each of those parts has a job to do to make cells vary widely in size, shape, and their particu- the body operate as a whole. Structure determines lar roles in the body. what functions can take place. For example, the The simplest living creatures are composed of lungs are not muscular chambers like the heart single cells, but in complex organisms such as and so cannot pump blood through the body, trees or human beings, the structural ladder con- but because the walls of their air sacs are very tinues on to the tissue level. Tissues consist of thin, they can exchange gases and provide oxygen groups of similar cells that have a common func- to the body. We stress the intimate relationship tion. There are four basic tissue types, and each between anatomy and physiology throughout this plays a definite but different role in the body. (We text to make your learning meaningful. discuss tissues in Chapter 3.) An organ is a structure composed of two or Did You Get It? more tissue types that performs a specific function 1. Why would you have a hard time learning and for the body. At the organ level of organization, understanding physiology if you did not also extremely complex functions become possible. understand anatomy? For example, the small intestine, which digests 2. Kidney function, bone growth, and beating of the heart are all topics of anatomy. True or false? and absorbs food, is composed of all four tissue types. An organ system is a group of organs that For answers, see Appendix A. work together to accomplish a common purpose. ➔ For example, the heart and blood vessels of the CONCEPTLINK cardiovascular system circulate blood continuously Throughout this text, Concept Links will highlight links to carry nutrients and oxygen to all body cells. between concepts and/or organ systems. Keep in mind In all, 11 organ systems make up the living that although discussions of the systems are separated human being, or the organism, which represents into chapters for detailed study, the overall goal of this the highest level of structural organization, the text is for you not only to gain an understanding of organismal level. The organismal level is the sum each individual system, but also to learn how the body total of all structural levels working together to systems interact to sustain life. ➔ keep us alive. The major organs of each system  Chapter 1: The Human Body: An Orientation 3 1 Smooth muscle cell Atoms 1 Chemical level Molecules Atoms combine to 2 Cellular level form molecules. Cells are made up of molecules. Smooth muscle tissue 3 Tissue level Blood Tissues consist of vessels similar types of cells. Heart Epithelial tissue Smooth muscle tissue Blood vessel (organ) Cardio– Connective