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

GLOBAL Essentials of EDITION Human Anatomy & Physiology TWELFTH EDITION Elaine N. Marieb Suzanne M. Keller 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 bestse...

GLOBAL Essentials of EDITION Human Anatomy & Physiology TWELFTH EDITION Elaine N. Marieb Suzanne M. Keller 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. M11_MARI6119_12_GE_C11.indd Page 382 24/04/17 10:16 PM f-0037 /203/PH03344/9781292216119_MARIEB/MARIEB_ESSENTIALS_OF_HUMAN_ANATOMY_AND_PHYSIOLO... 11 WHAT The Cardiovascular System NEW! What, How & The cardiovascular HoW Why chapter system delivers oxygen and nutrients to the body tissues The heart pumps previews introduce and carries away wastes such as carbon dioxide blood throughout the body in blood vessels. Blood flow key examples of via blood. requires both the pumping action anatomy and physiology of the heart and changes in blood pressure. 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 WHY them to learn. If the cardiovascular system cannot perform its functions, wastes build up in tissues. InSTruCTorS Body organs fail to function properly, New Building Vocabulary and then, once oxygen becomes Coaching Activities for this NEW! Building depleted, they will die. chapter are assignable in Vocabulary Coaching Activities in Pearson Mastering W hen most people hear the term cardio- vascular system, they immediately think of the heart. We have all felt our own heart “pound” from time to time when we are ner- vous. The crucial importance of the heart has been only with the interstitial fluid in their immediate vicinity. Thus, some means of changing and “refreshing” these fluids is necessary to renew the nutrients and prevent pollution caused by the buildup of wastes. Like a bustling factory, the A&P help students learn the essential language of A&P. recognized for ages. However, the cardiovascular body must have a transportation system to carry system is much more than just the heart, and its various “cargoes” back and forth. Instead of from a scientific and medical standpoint, it is roads, railway tracks, and subways, the body’s important to understand why this system is so vital delivery routes are its hollow blood vessels. to life. Most simply stated, the major function of the Night and day, minute after minute, our tril- cardiovascular system is transportation. Using lions of cells take up nutrients and excrete wastes. blood as the transport vehicle, the system carries Although the pace of these exchanges slows dur- oxygen, nutrients, cell wastes, hormones, and ing sleep, they must go on continuously: when many other substances vital for body homeostasis they stop, we die. Cells can make such exchanges to and from the cells. The force to move the blood 382 See p. 382. Focus on Essential A&P Concepts M07_MARI6119_12_GE_C07.indd Page 282 24/04/17 10:15 PM f-0037 /203/PH03344/9781292216119_MARIEB/MARIEB_ESSENTIALS_OF_H M04_MARI6119_12_GE_C04.indd Page 137 24/04/17 10:13 PM f-0037 /203/PH03344/9781292216119_MARIEB/MARIEB_ESSENTIALS_OF_HUMAN_ANATOMY_AND_PHYSIOLO... Throughout every chapter, the text’s conversational writing style and straightforward explanations have been 282 strengthened withAnatomy Essentials of Human familiar analogies and abundant and Physiology mnemonic cues to help students learn and remember concepts. Chapter 4: Skin and Body Membranes 137 Interneuron carrying UPDATED! sensory information to cerebral cortex Exceptionally clear photos and Integration (processing and interpretation of illustrations, sensory input) occurs including dozens of new Cerebral cortex Cutaneous membrane (gray matter) Interneuron carrying and improved figures, (skin) response to present concepts and White matter motor neurons 4 processes at the right (a) Cutaneous membrane (the skin) Thalamus covers the body surface. Mucosa Cerebrum level of detail. Many figures from the text are assignable as Art-­ Labeling Activities in Pearson Mastering A&P. (b) Mucous membranes line body cavities open to the exterior. Interneuron carrying response Brain stem Parietal to motor neuron layer Serous Cell body of sensory fluid Visceral neuron in sensory layer ganglion Interneuron carrying Nerve sensory information to Skin cerebral cortex Sensory receptors (c) Serous membranes line body cavities closed to exterior. Cervical spinal cord Outer balloon wall Muscle (comparable to parietal serosa) White matter Air (comparable to serous cavity) Motor output Gray matter Inner balloon wall Interneuron (comparable to visceral serosa)Motor neuron cell body (d) A fist thrust into a limp balloon demonstrates the relationship Figure 7.21 Schematic between ofand the parietal ascending (sensory) visceral serous and membrane descending (motor) layers. pathways between Figure 4.1 the Classes of brainmembranes. epithelial and the spinal cord. See p. 137. ➔ Unique Concept ConCeptLink Like neurons, nerves are classified accordin Links reinforce The terms for the connective tissue coverings of a to the direction in which they transmit impulse previously-learned nerve should seem familiar: We discussed similar struc- Nerves that carry impulses only toward the CN concepts and help tures in the muscle chapter (Figure 6.1, p. 209). Names are called sensory (afferent) nerves, where students make connec­ of muscle structures include the root word mys, those that carry only motor fibers are moto tions across body whereas the root word neuro tells you that the struc- (efferent) nerves. Nerves carrying both senso systems while learning ture relates to a nerve. For example, the endomysium and motor fibers are called mixed nerves; all sp new material. covers one individual muscle fiber, whereas the endo- nal nerves are mixed nerves. neurium covers one individual neuron fiber. ➔ See p. 282. 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 Pearson Mastering A&P, along with Clinical Case Study coaching activities. See p. 295. 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 Pearson Mastering A&P Study Area for more information about career options that are relevant to studying anatomy and physiology. See p. 82. Continuous Learning Before, During, and After Class Pearson Mastering A&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 Pearson Mastering A&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 Pearson Mastering A&P Media references in the text direct learners to digital resources in the Pearson Mastering A&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 online with the eText on Pearson Mastering A&P Powerful interactive and customization functions include instructor and student note-taking, highlighting, bookmarking, search, and links to glossary terms. Additional Support for Students and Instructors NEW! Anatomy & Physiology Coloring Workbook Twelfth Edition, Global 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 Pearson Mastering A&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 GLOBAL 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 Associate Producer, Science: Kristen Sanchez Senior Courseware Portfolio Manager: Lauren Harp Rich Media Content Producer: Ziki Dekel Content and Design Manager: Michele Mangelli, Mangelli Copyeditor: Sally Peyrefitte Productions, LLC Proofreader: Betsy Dietrich Managing Producer: Nancy Tabor Art and Production Coordinator: David Novak Courseware Director, Content Development: Barbara Yien Indexer: Steele/Katigbak Courseware Sr. Analysts: Suzanne Olivier and Alice Fugate Interior Designer: tani hasegawa and Hespenheide Design Courseware Specialist: Laura Southworth Cover Designer: Lumina Datamatics Ltd. Editorial Coordinator: Nicky Montalvo Illustrators: Imagineering STA Media Services, Inc. Acquisitions Editor, Global Edition: Sourabh Maheshwari Rights & Permissions Manager: Ben Ferrini Senior Project Editor, Global Edition: Amrita Naskar Photo Researcher: Kristin Piljay Senior Media Editor, Global Edition: Gargi Banerjee Manufacturing Buyer: Stacey Weinberger Senior Manufacturing Controller, Global Edition: Executive Marketing Manager: Allison Rona Trudy Kimber Mastering Content Developer: Cheryl Chi Cover Photo Credit: Aleksandr Markin/Shutterstock Director of Mastering Production: Katie Foley Pearson Education Limited Edinburgh Gate Harlow Essex CM20 2JE England and Associated Companies throughout the world Visit us on the World Wide Web at: www.pearsonglobaleditions.com © Pearson Education Limited 2018 The rights of Elaine N. Marieb and Suzanne M. Keller to be identified as the authors of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. Authorized adaptation from the United States edition, entitled Essentials of Human Anatomy & Physiology, 12th edition, ISBN 9780134395326, by Elaine N. Marieb and Suzanne M. Keller, published by Pearson Education © 2018. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior written permission of the publisher or a license permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency Ltd, Saffron House, 6–10 Kirby Street, London EC 1N 8TS. All trademarks used herein are the property of their respective owners. The use of any trademark in this text does not vest in the author or publisher any trademark ownership rights in such trademarks, nor does the use of such trademarks imply any affiliation with or endorsement of this book by such owners. Acknowledgements of third party content appear on page 630, which constitutes an extension of this copyright page. PEARSON, ALWAYS LEARNING, Pearson Mastering A&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. ISBN 10: 1-292-21611-5 ISBN 13: 978-1-292-21611-9 British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library 10 9 8 7 6 5 4 3 2 1 Typeset by iEnergizer Aptara® Ltd. Printed and bound by Vivar in Malaysia 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 Pearson Mastering of nursing faculty, she underwrites the Nursing Schol- A&P online program. When not teaching or writ- ars of the Future Grant Program at the university. In ing, Dr. Keller enjoys reading, trav­eling, family January 2012, Florida Gulf Coast University named a gatherings, and relaxing at home under the watch- new health professions facility in her honor. The Dr. ful eyes of her two canine children. Elaine Nicpon Marieb Hall houses several ­specialized laboratories for the School of Nursing, made possible by Dr. Marieb’s generous support. 11 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. 12  New to the Twelfth Edition 13 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. 14 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 15 16 Acknowledgments ­ errigo deserve special thanks for their expertise in P 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 The publishers would like to thank the following for their contribution to the Global Edition: Contributor Christiane Van den Branden, Vrije Universiteit Brussel Reviewers Hemant Kumar, MBBS Snezana Kusljic, The University of Melbourne Eva Strandell, Halmstad University Contents 1  he Human Body: T Summary 47 Review Questions  48 An Orientation 27 Critical Thinking and Clinical Application Questions  49 An Overview of Anatomy and A Closer Look Medical Imaging: Physiology 27 Illuminating the Body 36 Anatomy 27 2 Physiology 28 Relationship between Anatomy Basic and Physiology 28 Chemistry 50 Levels of Structural Organization 28 From Atoms to Organisms 28 Concepts of Matter and Energy 50 Organ System Overview 29 Matter 50 Integumentary System Skeletal System Muscular Energy 51 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 52 Elements and Atoms 52 Maintaining Life 33 Atomic Structure 52 Necessary Life Functions 33 The Basic Atomic Subparticles Planetary and Orbital Maintaining Boundaries Movement Responsiveness Models of an Atom Digestion Metabolism Excretion Reproduction Identifying Elements 54 Growth Atomic Number Atomic Mass Number Atomic Survival Needs 35 Weight and Isotopes The Language of Anatomy 38 Molecules and Compounds 57 Anatomical Position 38 Chemical Bonds and Chemical Directional Terms 38 Reactions 58 Regional Terms 38 Bond Formation 58 Anterior Body Landmarks Posterior Body Landmarks Role of Electrons Types of Chemical Bonds Body Planes and Sections 41 Patterns of Chemical Reactions 62 Body Cavities 41 Synthesis Reactions Decomposition Reactions Dorsal Body Cavity Ventral Body Cavity Other Exchange Reactions Factors Influencing the Rate Body Cavities of Chemical Reactions Homeostasis 45 Biochemistry: The Chemical Components of Homeostatic Control Composition of Living Matter 64 Systems 45 Inorganic Compounds 65 Feedback Mechanisms 45 Water Salts Acids and Bases 17 18 Contents Chapter 2, continued Classification of Epithelia 115 Simple Epithelia Stratified Epithelia Glandular Organic Compounds 68 Epithelium Carbohydrates Lipids Proteins Nucleic Acids Adenosine Triphosphate (ATP) Connective Tissue 119 Summary 83 Hallmarks of Connective Tissue 119 Review Questions  85 Extracellular Matrix 120 Critical Thinking and Clinical Types of Connective Tissue 120 Bone Cartilage Dense Connective Tissue Loose Application Questions  87 Connective Tissue Blood Focus on Careers Pharmacy Technician 82 Muscle Tissue 124 3 Skeletal Muscle 124 Cells Cardiac Muscle 124 and Tissues 88 Smooth Muscle 126 Nervous Tissue 126 Part I: Cells 88 Tissue Repair (Wound Healing) 126 Overview of the Cellular Basis Part III: Developmental of Life 88 Aspects of Cells and Anatomy of a Generalized Cell 89 Tissues 128 The Nucleus 89 Summary 130 Nuclear Envelope Nucleolus Chromatin The Plasma Membrane 90 Review Questions  133 The Fluid Mosaic Model Cell Membrane Junctions Critical Thinking and Clinical The Cytoplasm 93 Application Questions  134 Cytosol and Inclusions Organelles A Closer Look IV Therapy and Cellular Cell Extensions 97 “Tonics” 105 Cilia and Flagella Microvilli A Closer Look Cancer—An Intimate Cell Diversity 100 Enemy 130 Cell Physiology 102 4 Membrane Transport 102 Passive Processes: Diffusion and Filtration Skin and Body Membranes 135 Active Processes Cell Division 108 Preparations: DNA Replication Events of Cell Division Protein Synthesis 111 Classification of Body Genes: The Blueprint for Protein Structure The Role Membranes 135 of RNA The Process of Protein Synthesis Epithelial Membranes 136 Part II: Body Tissues 114 Cutaneous Membrane Mucous Membranes Serous Membranes Epithelial Tissue 114 Connective Tissue Membranes 136 Hallmarks of Epithelium 114  Contents 19 The Integumentary System (Skin) 138 Cervical Vertebrae Thoracic Vertebrae Lumbar Vertebrae Sacrum Coccyx Functions of the Integumentary System 138 Thoracic Cage 182 Structure of the Skin 139 Sternum Ribs Epidermis Dermis Skin Color 144 Appendicular Skeleton 184 Appendages of the Skin 145 Bones of the Shoulder Girdle 184 Cutaneous Glands Hair and Hair Follicles Nails Bones of the Upper Limbs 184 Homeostatic Imbalances of Skin 149 Arm Forearm Hand Infections and Allergies Burns Skin Cancer Bones of the Pelvic Girdle 188 Developmental Aspects of Skin and Body Bones of the Lower Limbs 190 Membranes 153 Thigh Leg Foot Summary 156 Joints 192 Review Questions  157 Fibrous Joints 195 Cartilaginous Joints 195 Critical Thinking and Clinical Application Questions  158 Synovial Joints 195 A Closer Look A Wrinkle Out of Types of Synovial Joints Based on Shape 196 Time 143 Developmental Aspects of the Focus on Careers Medical Skeleton 199 Transcriptionist 154 Birth to Adulthood 199 Systems in Sync 155 Older Adults 201 5 Summary 203 The Skeletal Review Questions  204 System 160 Critical Thinking and Clinical Application Questions  206 Focus on Careers Radiologic Bones: An Overview 160 Technologist 169 Functions of the Bones 161 A Closer Look Joint Ventures 192 Classification of Bones 161 Systems in Sync 202 Structure of Bone 163 Gross Anatomy of a Long Bone Microscopic 6 Anatomy Bone Formation, Growth, and The Muscular Remodeling 167 Bone Formation and Growth Bone Remodeling System 207 Bone Fractures 170 Overview of Muscle Tissues 207 Axial Skeleton 172 Muscle Types 207 Skull 172 Skeletal Muscle Smooth Muscle Cardiac Muscle Cranium Facial Bones The Hyoid Bone Muscle Functions 211 Vertebral Column (Spine) 178 Produce Movement Maintain Posture and Body Position Stabilize Joints Generate Heat Additional Functions 20 Contents Chapter 6, continued A Closer Look Anabolic Steroids: Dying to Win? 231 Microscopic Anatomy of Skeletal Systems in Sync 246 Muscle 211 7 Skeletal Muscle Activity 213 Stimulation and Contraction of Single Skeletal The Nervous Muscle Fibers 213 The Nerve Stimulus and the Action Potential System 251 Mechanism of Muscle Contraction: The Sliding Filament Theory Contraction of a Skeletal Muscle Organization of the Nervous as a Whole 217 System 252 Graded Responses Providing Energy for Muscle Structural Classification 253 Contraction Muscle Fatigue and Oxygen Deficit Functional Classification 253 Types of Muscle Contractions—Isotonic and Isometric Muscle Tone Effect of Exercise on Muscles Nervous Tissue: Structure and Function 253 Muscle Movements, Roles, and Supporting Cells 253 Names 222 Neurons 255 Types of Body Movements 222 Anatomy Classification Physiology: Nerve Impulses Special Movements Physiology: Reflexes Interactions of Skeletal Muscles in the Body 226 Central Nervous System 265 Naming Skeletal Muscles 228 Functional Anatomy of the Brain 265 Cerebral Hemispheres Diencephalon Brain Stem Arrangement of Fascicles 228 Cerebellum Gross Anatomy of Skeletal Protection of the Central Nervous System 273 Meninges Cerebrospinal Fluid The Blood-Brain Muscles 229 Barrier Head and Neck Muscles 229 Brain Dysfunctions 277 Facial Muscles Neck Muscles Spinal Cord 278 Trunk Muscles 232 Gray Matter of the Spinal Cord and Spinal Roots Anterior Muscles Posterior Muscles White Matter of the Spinal Cord Muscles of the Upper Limb 235 Muscles Causing Movement at the Elbow Joint Peripheral Nervous System 281 Muscles of the Lower Limb 235 Structure of a Nerve 281 Muscles Causing Movement at the Hip Cranial Nerves 283 Joint Muscles Causing Movement at the Knee Joint Muscles Causing Movement Spinal Nerves and Nerve Plexuses 283 at the Ankle and Foot Autonomic Nervous System 290 Somatic and Autonomic Nervous Systems Compared Developmental Aspects of the Muscular Anatomy of the Parasympathetic Division Anatomy System 244 of the Sympathetic Division Autonomic Functioning Summary 245 Developmental Aspects of the Nervous Review Questions  248 System 295 Critical Thinking and Clinical Summary 299 Application Questions  249  Contents 21 Review Questions  301 Part III: Chemical Senses: Critical Thinking and Clinical Smell and Taste  324 Application Questions  303 A Closer Look The “Terrible Three” 278 Olfactory Receptors and the Sense of Smell 324 A Closer Look Tracking Down CNS Problems 296 Taste Buds and the Sense of Taste 326 Systems in Sync 298 Part IV: Developmental 8 Aspects of the Special Special Senses  327 Senses 304 Summary 329 Review Questions  331 Part I: THE EYE AND Critical Thinking and Clinical Application Questions  332 VISION 305 A Closer Look Visual Pigments—The Actual Anatomy of the Eye 305 Photoreceptors 311 External and Accessory Structures 305 A Closer Look Bringing Things into Internal Structures: The Eyeball 307 Focus 315 Layers Forming the Wall of the Eyeball Lens Focus on Careers Physical Therapy Assistant 321 Physiology of Vision 313 Pathway of Light through the Eye and Light 9 Refraction 313 Visual Fields and Visual Pathways The Endocrine to the Brain 314 Eye Reflexes 316 System 334 Part II: THE EAR: HEARING AND The Endocrine System and Hormone BALANCE 316 Function—An Overview 335 The Chemistry of Hormones 335 Anatomy of the Ear 317 Hormone Action 335 External (Outer) Ear 317 Direct Gene Activation Second-Messenger System Middle Ear 318 Stimuli for Control of Hormone Release 337 Internal (Inner) Ear 318 Hormonal Stimuli Humoral Stimuli Neural Stimuli Equilibrium 318 The Major Endocrine Organs 338 Static Equilibrium 319 Pituitary Gland and Hypothalamus 339 Dynamic Equilibrium 319 Pituitary-Hypothalamus Relationships Pineal Gland 343 Hearing 322 Thyroid Gland 343 Hearing and Equilibrium Deficits 323 Parathyroid Glands 345 Thymus 346 22 Contents Chapter 9, continued Developmental Aspects of Blood 378 Adrenal Glands 346 Summary 379 Hormones of the Adrenal Cortex Hormones of the Review Questions  380 Adrenal Medulla Pancreatic Islets 349 Critical Thinking and Clinical Application Questions  381 Gonads 353 Hormones of the Ovaries Hormones of the Testes Focus on Careers Phlebotomy Technician 376 Other Hormone-Producing Tissues and Organs 353 Developmental Aspects of the Endocrine System 357 Summary 359 Review Questions  361 11  he Cardiovascular T System 382 The Heart 383 Critical Thinking and Clinical Anatomy of the Heart 383 Application Questions  362 Size, Location, and Orientation Coverings and Walls A Closer Look Potential Uses of the Heart for Growth Hormone 342 Chambers and Associated Great Vessels 384 Systems in Sync 358 Heart Valves 387 Cardiac Circulation 10 Physiology of the Heart 390 Intrinsic Conduction System of the Heart: Setting the Basic Rhythm Cardiac Cycle and Heart Sounds Blood 363 Cardiac Output Blood Vessels 396 Composition and Functions Microscopic Anatomy of Blood Vessels 396 of Blood 363 Tunics Structural Differences in Arteries, Veins, and Capillaries Components 364 Gross Anatomy of Blood Vessels 399 Physical Characteristics and Volume 364 Major Arteries of the Systemic Circulation Major Plasma 364 Veins of the Systemic Circulation Special Circulations Formed Elements 366 Physiology of Circulation 406 Erythrocytes Leukocytes Platelets Arterial Pulse Blood Pressure Capillary Exchange of Gases and Nutrients Fluid Movements at Capillary Beds Hematopoiesis (Blood Cell Formation) 371 Formation of Red Blood Cells Formation of White Developmental Aspects of the Blood Cells and Platelets Cardiovascular System 415 Hemostasis 373 Summary 418 Phases of Hemostasis 373 Review Questions  420 Disorders of Hemostasis 374 Critical Thinking and Clinical Blood Groups and Transfusions 375 Application Questions  422 Human Blood Groups 375 A Closer Look Electrocardiography: (Don’t) Be Still My Heart 393 Blood Typing 378  Contents 23 A Closer Look Atherosclerosis? Summary 457 Get Out the Cardiovascular Drāno! 412 Review Questions  459 Systems in Sync 417 Critical Thinking and Clinical Application Questions  461 12 A Closer Look AIDS: An Ongoing  he Lymphatic T Pandemic 454 System and Body Systems in Sync 456 Defenses 424 Part I: The Lymphatic System 424 13  The Respiratory System 462 Lymphatic Vessels 425 Functional Anatomy of the Respiratory System 462 Lymph Nodes 426 The Nose 463 Other Lymphoid Organs 428 The Pharynx 464 The Larynx 465 Part II: BODY DEFENSES 429 The Trachea 466 The Main Bronchi 466 Innate Body Defenses 430 The Lungs 467 Surface Membrane Barriers 430 The Bronchial Tree Respiratory Zone Structures and Internal Defenses: Cells and Chemicals 432 the Respiratory Membrane Natural Killer Cells Inflammatory Response Phagocytes Antimicrobial Proteins Fever Respiratory Physiology 471 Mechanics of Breathing 471 Adaptive Body Defenses 436 Inspiration Expiration Antigens 438 Respiratory Volumes and Capacities 474 Cells of the Adaptive Defense System: An Nonrespiratory Air Movements 475 Overview 438 Respiratory Sounds 475 Lymphocytes Antigen-Presenting Cells Humoral (Antibody-Mediated) Immune External Respiration, Gas Transport, and Response 441 Internal Respiration 475 Active and Passive Humoral Immunity Antibodies External Respiration Gas Transport in the Blood Internal Respiration Cellular (Cell-Mediated) Immune Response 446 Control of Respiration 478 Organ Transplants and Rejection 448 Neural Regulation: Setting the Basic Rhythm Disorders of Immunity 451 Nonneural Factors Influencing Respiratory Rate and Depth Part III: DEVELOPMENTAL Respiratory Disorders 480 ASPECTS OF THE LYMPHATIC SYSTEM AND BODY Developmental Aspects of the DEFENSES 455 Respiratory System 483 Summary 485 24 Contents Chapter 13, continued Part II: Nutrition and Review Questions  487 Metabolism 513 Critical Thinking and Clinical Nutrition 513 Application Questions  488 Dietary Recommendations 513 A Closer Look Too Clean for Dietary Sources of the Major Nutrients 514 Our Own Good? 482 Carbohydrates Lipids Proteins Vitamins Systems in Sync 484 Minerals Metabolism 516 14  The Digestive Carbohydrate, Fat, and Protein Metabolism in Body Cells 516 System and Body Carbohydrate Metabolism Fat Metabolism Protein Metabolism Metabolism 489 The Central Role of the Liver in Metabolism 520 General Metabolic Functions Cholesterol Metabolism Part I: Anatomy and and Transport Physiology of the Digestive Body Energy Balance 523 Regulation of Food Intake Metabolic Rate and Body System 489 Heat Production Body Temperature Regulation Anatomy of the Digestive Part III: Developmental System 489 Aspects of the Digestive Organs of the Alimentary Canal 490 Mouth Pharynx Esophagus Stomach Small System and Metabolism 527 Intestine Large Intestine Summary 532 Accessory Digestive Organs 500 Review Questions  534 Teeth Salivary Glands Pancreas Liver and Gallbladder Critical Thinking and Clinical Application Questions  536 Functions of the Digestive A Closer Look Peptic Ulcers: “Something System 502 Is Eating at Me” 512 Overview of Gastrointestinal Processes and Controls 503 A Closer Look Obesity: Magical Solution Wanted 529 Activities Occurring in the Mouth, Pharynx, and Esophagus 506 Systems in Sync 531 Food Ingestion and Breakdown Food Propulsion— 15  Swallowing and Peristalsis Activities of the Stomach 507 Food Breakdown Food Propulsion The Urinary Activities of the Small Intestine 509 System 537 Chyme Breakdown and Absorption Chyme Propulsion Activities of the Large Intestine 511 Kidneys 538 Nutrient Breakdown and Absorption Propulsion Location and Structure 538 of Food Residue and Defecation Kidney Structure Blood Supply Nephrons 539  Contents 25 Urine Formation and Characteristics 542 Epididymis Ductus Deferens Urethra Glomerular Filtration Tubular Reabsorption Tubular Accessory Glands and Semen 567 Secretion Nitrogenous Wastes Characteristics of Urine Seminal Vesicles Prostate Bulbo-urethral Glands Semen Ureters, Urinary Bladder, External Genitalia 568 and Urethra 546 Ureters 546 Male Reproductive Functions 569 Urinary Bladder 547 Spermatogenesis 569 Urethra 548 Testosterone Production 571 Micturition 548 Anatomy of the Female Reproductive Fluid, Electrolyte, and Acid-Base System 573 Balance 550 Ovaries 573 Maintaining Water Balance of Blood 550 Duct System 573 Body Fluids and Fluid Compartments The Link Uterine Tubes Uterus Vagina between Water and Electrolytes Regulation of Water External Genitalia and Female Perineum 576 Intake and Output Maintaining Electrolyte Balance 553 Female Reproductive Functions Maintaining Acid-Base Balance of Blood 555 and Cycles 577 Blood Buffers Respiratory Mechanisms Renal Oogenesis and the Ovarian Cycle 577 Mechanisms Hormone Production by the Ovaries 579 Developmental Aspects of the Urinary Uterine (Menstrual) Cycle 580 System 557 Mammary Glands 580 Summary 561 Review Questions  562 Pregnancy and Embryonic Development 583 Critical Thinking and Clinical Application Questions  563 Accomplishing Fertilization 584 A Closer Look Renal Failure and Events of Embryonic and Fetal Development 585 the Artificial Kidney 549 Effects of Pregnancy on the Mother 589 Focus on Careers Licensed Practical Anatomical Changes Physiological Changes Nurse (LPN) 558 Childbirth 591 Systems in Sync 560 Initiation of Labor Stages of Labor 16  Developmental Aspects of the The Reproductive Reproductive System 593 System 564 Summary 598 Review Questions  600 Critical Thinking and Clinical Anatomy of the Male Reproductive Application Questions  602 System 565 A Closer Look Contraception: Preventing Testes 565 Pregnancy 594 Duct System 565 Systems in Sync 597 26 Contents Appendixes Appendix D K  ey Information about Vitamins and Many Essential Appendix A: A  nswers to Did You Get It? Minerals 613 Questions and Multiple Choice Glossary 617 Review Questions 603 Credits 630 Appendix B: W  ord Roots, Prefixes, and Suffixes 610 Subject Index 631 Appendix C: P  eriodic Table of the Elements 612 1 The Human Body: An Orientation 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