Fundamentals of Anatomy & Physiology, 11th Edition PDF by Frederic H. Martini, Judi L. Nath and Edwin F. Bartholomew


Fundamentals of Anatomy & Physiology, Eleventh Edition

By Frederic H. Martini, Judi L. Nath and Edwin F. Bartholomew

Fundamentals of Anatomy and Physiology



1 An Introduction to Anatomy and Physiology 47

An Introduction to Studying the Human Body 48

1-1 To make the most of your learning, read the text and view the art together 48

Getting to Know Your Textbook 48

Anatomy of a Chapter 49

1-2 Anatomy (structure) and physiology (function) are closely integrated 49

Anatomy 50

Physiology 51

1-3 Levels of organization progress from chemicals to a complete organism 52

1-4 Medical terminology is important to understanding anatomy and physiology 53

1-5 Anatomical terms describe body regions, anatomical positions and directions, and body sections 53

Surface Anatomy 53

Sectional Anatomy 59

1-6 Body cavities of the trunk protect internal organs and allow them to change shape 60

The Thoracic Cavity 61

The Abdominopelvic Cavity 64

1-7 Homeostasis, the state of internal balance, is continuously regulated 64

Mechanisms of Homeostatic Regulation 65

An Overview of the Process of Homeostatic Regulation 65

1-8 Negative feedback opposes variations from normal, whereas positive feedback enhances them 65

The Role of Negative Feedback in Homeostasis 66

The Role of Positive Feedback in Homeostasis 68

Systems Integration, Equilibrium, and Homeostasis 69

Chapter Review 70

SmartArt Videos

Figure 1–10 Positive Feedback: Blood Clotting. 68


Levels of Organization 54

Clinical Case

Using A&P to Save a Life 48

Clinical Notes

Habeas Corpus (“You Shall Have the Body”) 51

The Sounds of the Body 59

Diagnostic Imaging Techniques 62

2 The Chemical Level of

Organization 73

An Introduction to the Chemical Level of Organization 74

2-1 Atoms are the basic particles of matter 74

Atomic Structure 74

Elements and Isotopes 75

Atomic Weights 76

Electrons and Energy Levels 77

2-2 Chemical bonds are forces formed by interactions between atoms 78

Ionic Bonds 80

Covalent Bonds 81

Hydrogen Bonds 82

States of Matter 83

2-3 Decomposition, synthesis, and exchange reactions are important types of chemical reactions in physiology 83

Basic Energy Concepts 83

Types of Chemical Reactions 84

2-4 Enzymes speed up reactions by lowering the energy needed to start them 85

2-5 Inorganic compounds lack carbon, and organic compounds contain carbon 86

2-6 Physiological systems depend on water 86 The Properties of Aqueous Solutions 87

Colloids and Suspensions 88

2-7 Body fluid pH is vital for homeostasis 89

2-8 Acids, bases, and salts have important physiological roles 90

Acids and Bases 90

Salts 90

Buffers and pH Control 90

2-9 Living things contain organic compounds made up of monomers, polymers, and functional groups 91

2-10 Carbohydrates contain carbon, hydrogen, and oxygen in a 1:2:1 ratio 91

Monosaccharides 91

Disaccharides and Polysaccharides 92

2-11 Lipids often contain a carbon-to-hydrogen ratio

of 1:2 93

Fatty Acids 94

Eicosanoids 94

Glycerides 95

Steroids 96

Phospholipids and Glycolipids 97

2-12 Proteins contain carbon, hydrogen, oxygen, and nitrogen and are formed from amino acids 97

Protein Structure 99

Protein Shape 100

Enzyme Function 101

Glycoproteins and Proteoglycans 103

2-13 DNA and RNA are nucleic acids 103

Structure of Nucleic Acids 103

Comparison of RNA and DNA 103

2-14 ATP is a high-energy compound used by cells 105

Chapter Review 107


Chemical Notation 79

Clinical Case

What Is Wrong with My Baby? 74

Clinical Notes

Radiation Sickness 78

Too Sweet on Sugar? 95

3 The Cellular Level

of Organization 111

An Introduction to Cells 112

3-1 The plasma membrane separates the cell from its surrounding environment and performs various functions 112

Membrane Lipids 113

Membrane Proteins 113

Membrane Carbohydrates 117

3-2 Organelles within the cytoplasm perform particular functions 117

The Cytosol 118

Nonmembranous Organelles 118

Membranous Organelles 122

3-3 The nucleus contains DNA and enzymes essential for controlling cellular activities 129

Structure of the Nucleus 129

Information Storage in the Nucleus 130

3-4 DNA controls protein synthesis, cell structure, and cell function 131

Regulation of Transcription by Gene Activation 131

Transcription of DNA into mRNA 131

Translation from mRNA into a Polypeptide 133

How DNA Controls Cell Structure and Function 135

3-5 Diffusion is a passive transport mechanism that assists membrane passage of solutes and water 136

Diffusion 136

Osmosis: Diffusion of Water across Selectively Permeable Membranes 139

3-6 Carrier-mediated and vesicular transport assist membrane passage of specific substances 140

Carrier-Mediated Transport 141

Vesicular Transport 143

3-7 The membrane potential of a cell results from the unequal distribution of positive and negative charges

across the plasma membrane 145

3-8 Stages of the cell life cycle include interphase, mitosis, and cytokinesis 148

The Cell Life Cycle 148

The Mitotic Rate and Energy Use 149

3-9 Several factors regulate the cell life cycle 149

3-10 Abnormal cell growth and division characterize tumors and cancers 153

3-11 Cellular differentiation is cellular specialization as a result of gene activation or repression 155

Chapter Review 156

SmartArt Videos

Figure 3–12 mRNA Transcription. 132

Figure 3–13 The Process of Translation. 134


Anatomy of a Model Cell 114

Protein Synthesis, Processing, and Packaging 124

Overview of Membrane Transport 146

Stages of a Cell’s Life Cycle 150

DNA Replication 152

Clinical Case

The Beat Must Go On! 112

Clinical Notes

Lysosomal Storage Diseases 126

Free Radicals 128

DNA Fingerprinting 131

Mutations 133

Drugs and the Plasma Membrane 137

Telomerase, Aging, and Cancer 154

Breakthroughs with Stem Cells 155

4 The Tissue Level

of Organization 160

An Introduction to the Tissue Level of Organization 161

4-1 The four tissue types are epithelial, connective, muscle, and nervous 161

4-2 Epithelial tissue covers body surfaces, lines internal surfaces, and serves other essential functions 161

Functions of Epithelial Tissue 162

Characteristics of Epithelial Tissue 163

Specializations of Epithelial Cells 163

Maintaining the Integrity of Epithelia 164

4-3 Cell shape and number of layers determine the

classification of epithelia 166

Classification of Epithelia 166

Glandular Epithelia 168

4-4 Connective tissue has varied roles in the body that reflect the physical properties of its three main types 172

4-5 Connective tissue proper includes loose connective tissues that fill internal spaces and dense connective tissues

that contribute to the internal framework of

the body 174

Structure of Connective Tissue Proper 174

Loose Connective Tissues 176

Dense Connective Tissues 179

Fasciae: Layers of Connective Tissue Proper 179

4-6 Blood and lymph are fluid connective tissues that transport cells and dissolved materials 181

4-7 The supporting connective tissues cartilage and bone provide a strong framework 182

Cartilage 182

Bone 183

4-8 Tissue membranes made from epithelia and connective tissue make up four types of physical barriers 186

Mucous Membranes 186

Serous Membranes 186

The Cutaneous Membrane 187

Synovial Membranes 188

4-9 The three types of muscle tissue are skeletal, cardiac, and smooth 188

Skeletal Muscle Tissue 188

Cardiac Muscle Tissue 190

Smooth Muscle Tissue 190

4-10 Nervous tissue responds to stimuli and propagates electrical impulses throughout the body 190

4-11 The response to tissue injury involves inflammation and regeneration 191

Inflammation 191

Regeneration 192

4-12 With advancing age, tissue regeneration decreases

and cancer rates increase 192

Aging and Tissue Structure 192

Aging and Cancer Incidence 192

Chapter Review 194


Inflammation and Regeneration 193

Clinical Case

The Rubber Girl 161

Clinical Notes

Exfoliative Cytology 172

Marfan Syndrome 177


5 The Integumentary

System 198

An Introduction to the Integumentary System 199

5-1 The epidermis is a protective covering composed of layers with various functions 199

Cells of the Epidermis: Keratinocytes 200

Layers of the Epidermis 200

Epidermal Growth Factor 203

5-2 The dermis is the tissue layer that supports the

epidermis 204

Layers of the Dermis 204

Dermal Strength and Elasticity 204

Tension Lines 205

The Dermal Blood Supply 205

Innervation of the Skin 206

5-3 The subcutaneous layer connects the dermis to underlying tissues 206

5-4 Epidermal pigmentation and dermal circulation influence skin color 207

The Role of Epidermal Pigmentation 207

The Role of Dermal Circulation: Hemoglobin 209

Disease-Related Changes in Skin Color 209

5-5 Sunlight causes epidermal cells to convert a steroid into vitamin D3 209

5-6 Hair is made of keratinized dead cells pushed to the

skin surface where it has protecting and insulating roles 211

Hair and Hair Follicle Structure 211

Hair Production 212

The Hair Growth Cycle 212

Types of Hairs 214

Hair Color 214

5-7 Sebaceous glands and sweat glands are exocrine glands found in the skin 214

Sebaceous Glands 214

Sweat Glands 215

Other Integumentary Glands 216 Control of Glandular Secretions and Thermoregulation 216

5-8 Nails are keratinized epidermal cells that protect the tips of fingers and toes 217

5-9 After an injury, the integument is repaired in several phases 218

5-10 Effects of aging on the skin include thinning,

wrinkling, and reduced melanocyte activity 221

Build Your Knowledge Integration of the INTEGUMENTARY system with the other body systems presented so far 222

Chapter Review 223


The Epidermis 202

Clinical Case

He Has Fish Skin! 199

Clinical Notes

Nips, Tucks, and Shots 207

Skin Cancer 210

Decubitus Ulcers 212

Your Skin, A Mirror of Your Health 219

Burns and Grafts 220

6 Bones and Bone

Structure 226

An Introduction to Bones and Bone Tissue 227

6-1 The skeletal system has several major functions 227

6-2 Bones are classified according to shape and structure, and they have a variety of bone markings 228

Bone Shapes 228

Bone Markings 229

Bone Structure 229

6-3 Bone is composed of matrix and several types of cells: osteogenic cells, osteoblasts, osteocytes, and

osteoclasts 229

Bone Matrix 229

Bone Cells 231

6-4 Compact bone contains parallel osteons, and spongy bone contains trabeculae 233

Compact Bone Structure 233

Spongy Bone Structure 234

Coordinated Functions of Compact and Spongy Bone 235

Surface Coverings of Bone 235

6-5 Bones form through ossification and enlarge through interstitial and appositional growth 236

Endochondral Ossification 237

Intramembranous Ossification 237

Blood and Nerve Supplies to Bone 240

6-6 Bone growth and development depend on bone

remodeling, which is a balance between bone

formation and bone resorption 240

6-7 Exercise, nutrition, and hormones affect bone

development and the skeletal system 242

The Effects of Exercise on Bone 242

Nutritional and Hormonal Effects on Bone 243

6-8 Calcium plays a critical role in bone physiology 244

The Skeleton as a Calcium Reserve 244

Hormones and Calcium Ion Balance 245

6-9 A fracture is a crack or break in a bone 247

6-10 Osteopenia has widespread effects on aging bones 250

Chapter Review 251

SmartArt Videos

Figure 6-11 Endochondral Ossification 238

Figure 6–16 Factors That Increase the Blood Calcium Ion Level. 246


Endochondral Ossification 238

Types of Fractures and Steps in Repair 248

Clinical Case

A Case of Child Abuse? 227

Clinical Notes

Heterotopic Bone Formation 237

Abnormal Bone Development 244

7 The Axial Skeleton 254

An Introduction to the Divisions of the Skeleton 255

7-1 The 80 bones of the head and trunk make up the axial skeleton 255

7-2 The skull’s 8 cranial bones protect the brain, and its

14 facial bones form the mouth, nose, and orbits 255

Cranial, Facial, and Associated Bones 255

Sutures 257

Sinuses, Foramina, and Fissures 271

7-3 Each orbital complex contains and protects an eye, and the nasal complex encloses the nasal cavities 271

The Orbital Complexes 271

The Nasal Complex 272

7-4 Fontanelles are non-ossified fibrous areas between cranial bones that ease birth and allow for rapid brain

growth in infants and children 272

7-5 The vertebral column has four flexible and supportive

spinal curves 274

7-6 The five vertebral regions—cervical, thoracic, lumbar, sacral, and coccygeal—each have characteristic

vertebrae 275

Vertebral Anatomy 275

Characteristics of Regional Vertebrae 276

7-7 The thoracic cage protects organs in the chest and provides sites for muscle attachment 283

The Ribs 284

The Sternum 285

Chapter Review 285


Sectional Anatomy of the Skull 260

Clinical Case

Knocked Out 255

Clinical Notes

Temporomandibular Joint Syndrome 270

Sinusitis 273

Craniostenosis 274

Kyphosis, Lordosis, and Scoliosis 282

8 The Appendicular

Skeleton 289

An Introduction to the Appendicular Skeleton 290

8-1 The pectoral (shoulder) girdles attach the upper limbs to the axial skeleton 290

The Clavicles 290

The Scapulae 292

8-2 The bones of the upper limbs are adapted for free movement 293

Arm Bone: The Humerus 293

Bones of the Forearm 295

Bones of the Wrist and Hand 296

8-3 The pelvic girdle (hips) attaches the lower limbs to  the axial skeleton 298

The Pelvic Girdle (Hip Bones) 298

The Pelvis (Pelvic Girdle, Sacrum, and Coccyx) 298

8-4 The bones of the lower limbs are adapted for

movement and support 300

The Femur (Thighbone) 300

The Patella (Kneecap) 301

Bones of the Leg 303

Bones of the Ankle and Foot 303

8-5 Differences in sex and age account for individual

skeletal variation 306

Chapter Review 308


Sex Differences in the Human Skeleton 307

Clinical Case

Timber!! 290

Clinical Notes

Carpal Tunnel Syndrome 297

Hip Fracture 301

Shin Splints 303

Stress Fractures 305

Club Foot 306

9 Joints 311

An Introduction to Joints 312

9-1 Joints are categorized according to their structure or

range of motion 312

9-2 Diarthroses: Synovial joints contain synovial fluid

and are surrounded by a joint capsule and stabilizing

accessory structures 314

Articular Cartilage 314

Synovial Fluid 315

Accessory Structures 315

Factors That Stabilize Synovial Joints 316

9-3 Diarthroses: The different types of synovial joints

allow a wide range of skeletal movements 316

Types of Movements at Synovial Joints 316

Classification of Synovial Joints 322

9-4 Intervertebral joints contain intervertebral discs and

ligaments that allow for vertebral movements 322

Structure of Intervertebral Joints 322

Vertebral Movements 323

9-5 The elbow and knee are both hinge joints 324

The Elbow Joint 324

The Knee Joint 325

9-6 The shoulder and hip are both ball-and-socket

joints 327

The Shoulder Joint 328

The Hip Joint 329

9-7 With advancing age, arthritis and other degenerative

changes often impair joint mobility 331

9-8 The skeletal system supports and stores energy and

minerals for other body systems 332

Build Your Knowledge

Integration of the SKELETAL system with the other body systems presented

so far 333

Chapter Review 334


Joint Movement 318

Clinical Case

What’s the Matter with the Birthday Girl? 312

Clinical Notes

Bursitis and Bunions 316

Dislocation 316

Damage to Intervertebral Discs 327

Knee Injuries 328

10 Muscle Tissue 337

An Introduction to Muscle Tissue 338

10-1 The primary function of muscle tissue is to produce

movement 338

Common Properties of Muscle Tissue 338

Functions of Skeletal Muscle 338

10-2 Skeletal muscle contains muscle tissue, connective

tissues, blood vessels, and nerves 339

Organization of Connective Tissues and Muscle

Tissue 339

Function of Skeletal Muscle Components 339

10-3 Skeletal muscle fibers are organized into repeating

functional units that contain sliding filaments 340

The Sarcolemma and Transverse Tubules 341

The Sarcoplasmic Reticulum 342

Myofibrils 342

Sarcomeres 343

The Sliding-Filament Theory of Muscle Contraction 347

10-4 Motor neurons stimulate skeletal muscle fibers to

contract at the neuromuscular junction 348

Electrical Impulses and Excitable Membranes 348

The Control of Skeletal Muscle Activity 349

10-5 Muscle fibers produce different amounts of tension

depending on sarcomere length and frequency of

stimulation 357

Length–Tension Relationships 357

Frequency of Stimulation 358

10-6 Skeletal muscles produce increased tension by

recruiting additional motor units 361

Motor Units 361

Types of Muscle Contractions 362

Load and Speed of Contraction 364

Muscle Relaxation and the Return to Resting

Length 365

10-7 To maintain regular muscle fiber activity, energy and

recovery are required 365

ATP Generation and Muscle Fiber Contraction 365

Muscle Metabolism and Varying Activity Levels 366

The Recovery Period 368

Hormones and Muscle Metabolism 369

10-8 Muscle performance depends on muscle fiber type

and physical conditioning 369

Types of Skeletal Muscle Fibers 369

Muscle Performance and the Distribution of Muscle

Fibers 369

Muscle Hypertrophy, Atrophy, and Effects of Aging 371

Muscle Fatigue 371

Physical Conditioning 372

10-9 Cardiac muscle tissue, found in the heart, produces

coordinated and automatic contractions 373

Structural Characteristics of Cardiac Muscle Tissue 373

Functional Characteristics of Cardiac Muscle Tissue 374

10-10 Smooth muscle tissue contracts to move substances

within internal passageways 375

Structural Characteristics of Smooth Muscle Tissue 375

Functional Characteristics of Smooth Muscle Tissue 375

Chapter Review 378

SmartArt Videos

Figure 10–17 The Arrangement and Activity of Motor Units in a Skeletal

Muscle. 361

Figure 10–20 Muscle Metabolism. 367


Events at the Neuromuscular Junction 350

Excitation–Contraction Coupling 352

The Contraction Cycle and Cross-Bridge Formation 354

Clinical Case

Keep on Keepin’ on 338

Clinical Notes

Tetanus 353

Rigor Mortis 353

Delayed-Onset Muscle Soreness 372

Electromyography 376

11 The Muscular

System 382

An Introduction to the Muscular System 383

11-1 Fascicle arrangement is correlated with

muscle power and range of motion 383

Parallel Muscles 383

Convergent Muscles 383

Pennate Muscles 383

Circular Muscles 384

11-2 The use of bones as levers increases muscle

efficiency 385

11-3 The origins and insertions of muscles determine their

actions 385

Origins and Insertions 385

Actions 387

11-4 Descriptive terms are used to name skeletal

muscles 389

Region of the Body 389

Position, Direction, or Fascicle Arrangement 392

Structural Characteristics 392

Action 392

11-5 Axial muscles position the axial skeleton, and

appendicular muscles support and move the

appendicular skeleton 392

11-6 Axial muscles are muscles of the head and neck,

vertebral column, trunk, and pelvic floor 393

Muscles of the Head and Neck 393

Muscles of the Vertebral Column 400

Oblique and Rectus Muscles and the Diaphragm 404

Muscles of the Pelvic Floor 407

11-7 Appendicular muscles are muscles of the shoulders,

upper limbs, pelvis, and lower limbs 408

Muscles of the Shoulders and Upper Limbs 409

Muscles of the Pelvis and Lower Limbs 419

11-8 Exercise of the muscular system produces responses

in multiple body systems 429

Build Your Knowledge

Integration of the MUSCULAR systems with the other body systems

presented so far 430

Chapter Review 431


Muscle Action 388

Clinical Case

Downward-Facing Dog 383

Clinical Notes

Intramuscular Injections 399

Signs of Stroke 401

Hernia 426


12 Nervous Tissue 435

An Introduction to the Nervous System and

Nervous Tissue 436

12-1 The nervous system has anatomical

and functional divisions 436

The Anatomical Divisions of the Nervous System 436

The Functional Divisions of the Nervous System 437

12-2 Neurons are nerve cells specialized for intercellular

communication 438

Functional Characteristics of Neurons 438

The Structure of Neurons 438

The Classification of Neurons 440

12-3 CNS and PNS neuroglia support and protect

neurons 441

Neuroglia of the Central Nervous System 441

Neuroglia of the Peripheral Nervous System 445

Neural Responses to Injuries 445

12-4 The membrane potential of a neuron is determined

by differences in ion concentrations and membrane

permeability 448

The Resting Membrane Potential 448

Changes in the Resting Membrane Potential: Membrane

Channels 451

Graded Potentials 453

12-5 An action potential is an all-or-none electrical event

used for long-distance communication 455

Threshold and the All-or-None Principle 455

Generation of Action Potentials 455

Propagation of Action Potentials 458

Axon Diameter and Propagation Speed 462

12-6 Synapses transmit signals among neurons or

between neurons and other cells 462

Types of Synapses 462

Function of Chemical Synapses 463

12-7 The effects of neurotransmitters and

neuromodulators depend on their receptors 466

Classes of Neurotransmitters and Neuromodulators 466

The Functions of Neurotransmitters and Neuromodulators

and Their Receptors 467

12-8 Individual neurons process information by integrating

excitatory and inhibitory stimuli 470

Postsynaptic Potentials 471

Presynaptic Regulation: Inhibition and Facilitation 473

The Rate of Action Potential Generation 473

Chapter Review 474


Processes That Produce the Resting Membrane Potential 449

Generation of an Action Potential 456

Propagation of an Action Potential 460

Clinical Case

Did President Franklin D. Roosevelt Really Have Polio? 436

Clinical Notes

Rabies 439

CNS Tumors 444

Demyelination 445

13 The Spinal Cord, Spinal

Nerves, and Spinal

Reflexes 479

An Introduction to the Spinal Cord, Spinal Nerves, and Spinal

Reflexes 480

13-1 This text’s coverage of the nervous system parallels

its simple-to-complex levels of organization 480

13-2 The spinal cord is surrounded by three meninges and

has spinal nerve roots 481

Gross Anatomy of the Spinal Cord 481

Protection of the Spinal Cord: Spinal Meninges 484

13-3 Spinal cord gray matter integrates information

and initiates commands, and white matter carries

information from place to place 486

Functional Organization of Gray Matter 486

Functional Organization of White Matter 486

13-4 Spinal nerves extend to form peripheral nerves,

sometimes forming plexuses along the way; these

nerves carry sensory and motor information 488

Anatomy of Spinal Nerves 488

Peripheral Distribution and Function of Spinal Nerves 488

Nerve Plexuses 493

13-5 Interneurons are organized into functional groups

called neuronal pools 498

13-6 The different types of neural reflexes are all rapid,

automatic responses to stimuli 499

The Reflex Arc 499

Classification of Reflexes 502

13-7 Monosynaptic reflexes produce simple responses,

while polysynaptic reflexes can produce complex

behaviors 503

Monosynaptic Reflexes 503

Polysynaptic Reflexes 505

13-8 The brain can affect spinal cord–based

reflexes 506

Voluntary Movements and Reflex Motor Patterns 506

Reinforcement and Inhibition 506

Chapter Review 507

SmartArt Videos

Figure 13–1 An Overview of Chapters 13 and 14. 481


Structure, Function, and the Peripheral Distribution of Spinal Nerves

(T1–L2) 490

Spinal Reflexes 500

Clinical Case

Prom Night 480

Clinical Notes

Anesthesia 485

Shingles 489

Sensory Innervation in the Hand 494

Sensory Innervation in the Ankle and Foot 497

14 The Brain and Cranial

Nerves 511

An Introduction to the Brain and Cranial Nerves 512

14-1 The brain develops four major regions: the cerebrum,

cerebellum, diencephalon, and brainstem 512

Major Brain Regions and Landmarks 512

Embryology of the Brain 514

Ventricles of the Brain 514

14-2 The brain is protected and supported by the cranial

meninges, cerebrospinal fluid, and the blood brain

barrier 515

The Cranial Meninges 515

Cerebrospinal Fluid 517

The Protective Function of the Cranial Meninges and

CSF 519

The Blood Supply to the Brain 519

The Blood Brain Barrier 519

14-3 Brainstem: The medulla oblongata relays signals

between the rest of the brain and the spinal

cord 520

14-4 Brainstem: The pons contains nuclei that process and

tracts that relay sensory and motor information 523

14-5 Brainstem: The midbrain regulates visual and auditory

reflexes and controls alertness 524

14-6 The cerebellum coordinates reflexive and learned

patterns of muscular activity at the subconscious

level 524

Structure of the Cerebellum 524

Functions of the Cerebellum 524

14-7 The diencephalon integrates sensory information with

motor output at the subconscious level 527

The Thalamus 527

The Hypothalamus 528

14-8 The limbic system is a group of nuclei and tracts that

functions in emotion, motivation, and memory 530

14-9 The cerebrum contains motor, sensory, and

association areas, allowing for higher mental

functions 532

Structure of the Cerebral Cortex and Cerebral

Hemispheres 532

The White Matter of the Cerebrum 532

The Basal Nuclei 534

Motor, Sensory, and Association Areas of the Cortex 536

Integrative Centers and Higher Mental Functions 538

Monitoring Brain Activity: The Electroencephalogram 539

14-10 Cranial reflexes are rapid, automatic responses

involving sensory and motor fibers of cranial

nerves 552

Chapter Review 553


Formation and Circulation of Cerebrospinal Fluid 518

Clinical Case

The Neuroanatomist’s Stroke 512

Clinical Notes

Epidural and Subdural Hemorrhages 517

Aphasia and Dyslexia 539

Concussion and Beyond 552

15 Sensory Pathways and

the Somatic Nervous

System 558

An Introduction to Sensory Pathways and the Somatic

Nervous System 559

15-1 Sensory stimuli cause signals to be sent along

sensory pathways, and in response motor commands

are sent along motor pathways 559

15-2 Sensory receptors connect our internal and external

environments with the nervous system 560

The Detection of Stimuli 561

The Interpretation of Sensory Information 561

15-3 General sensory receptors can be classified by the

type of stimulus that excites them 563

Nociceptors and Pain 563

Thermoreceptors 564

Mechanoreceptors 564

Chemoreceptors 567

15-4 The afferent division is made up of separate somatic

sensory and visceral sensory pathways that deliver

sensory information to the CNS 568

Somatic Sensory Pathways 568

Visceral Sensory Pathways 573

15-5 The somatic nervous system is an efferent division

made up of somatic motor pathways that control

skeletal muscles 573

The Corticospinal Pathway 574

The Medial and Lateral Pathways 576

The Monitoring Role of the Basal Nuclei and

Cerebellum 576

Chapter Review 578


Somatic Sensory Pathways 570

Clinical Case

Living with Cerebral Palsy 559

Clinical Notes

Assessment of Tactile Sensitivities 569

Phantom Limb Syndrome 572

Amyotrophic Lateral Sclerosis 576

16 The Autonomic Nervous

System and Higher-Order

Functions 581

An Introduction to the Autonomic Nervous System and

Higher-Order Functions 582

16-1 The autonomic nervous system, which has

sympathetic and parasympathetic divisions, is

involved in the unconscious regulation of visceral

functions 582

Comparison of the Somatic and Autonomic Nervous

Systems 582

Organization of the ANS 583

Divisions of the ANS 584

16-2 The sympathetic division has short preganglionic

fibers and long postganglionic fibers and is involved

in using energy and increasing metabolic rate 584

Functional Organization of the Sympathetic Division 584

Sympathetic Activation 589

16-3 Different types of neurotransmitters and receptors

lead to different sympathetic effects 589

Effects of Sympathetic Stimulation of Adrenergic Synapses

and Receptors 590

Effects of Sympathetic Stimulation on Other Types of

Synapses 591

16-4 The parasympathetic division has long preganglionic

fibers and short postganglionic fibers and is involved

in conserving energy and lowering metabolic

rate 591

Functional Organization of the Parasympathetic

Division 591

Parasympathetic Activation 592

16-5 Different types of receptors lead to different

parasympathetic effects 592

Effects of Parasympathetic Stimulation of Cholinergic

Receptors 592

Effects of Toxins on Cholinergic Receptors 592

16-6 The differences in the organization of sympathetic

and parasympathetic structures lead to widespread

sympathetic effects and specific parasympathetic

effects 593

Summary of the Sympathetic Division 594

Summary of the Parasympathetic Division 594

16-7 Dual innervation of organs allows the sympathetic

and parasympathetic divisions to coordinate vital

functions 594

Anatomy of Dual Innervation 595

Autonomic Tone 597

16-8 Various levels of autonomic regulation allow for the

integration and control of autonomic functions 597

Visceral Reflexes 597

Higher Levels of Autonomic Control 598

The Integration of ANS and SNS Activities 598

16-9 Higher-order functions include memory and states

of consciousness, and neurotransmitters influence

behavior 599

Memory 600

States of Consciousness 602

Influence of Neurotransmitters on Brain Chemistry and

Behavior 604

16-10 Aging produces various structural and functional

changes in the nervous system 604

Build Your Knowledge

Integration of the NERVOUS system with the other body systems presented

so far 606

Chapter Review 607


The Autonomic Nervous System 586

Clinical Case

Remember Me? 582

Clinical Notes

Insomnia 602

Summary of Nervous System Disorders 604

Fainting 605

17 The Special Senses 611

An Introduction to the Special Senses 612

17-1 Olfaction, the sense of smell, involves

olfactory receptors responding to

airborne chemical stimuli 612

Anatomy of the Olfactory Organs 612

Olfactory Receptors and the Physiology of Olfaction 613

Olfactory Pathways 613

Olfactory Discrimination 616

17-2 Gustation, the sense of taste, involves gustatory

receptors responding to dissolved chemical

stimuli 616

Anatomy of Papillae and Taste Buds 616

Gustatory Receptors 616

Gustatory Pathways 616

Gustatory Discrimination and Physiology of

Gustation 617

17-3 Internal eye structures contribute to vision, while

accessory eye structures provide protection 618

Accessory Structures of the Eye 618

Anatomy of the Eyeball 620

17-4 The focusing of light on the retina leads to the

formation of a visual image 627

An Introduction to Light 627

Image Formation and Reversal 628

Visual Acuity 628

17-5 Photoreceptors transduce light into electrical signals

that are then processed in the visual cortex 629

Physiology of Vision 629

The Visual Pathways 635

17-6 Equilibrium sensations monitor head position and

movement, while hearing involves the detection and

interpretation of sound waves 638

Anatomy of the Ear 638

Equilibrium 641

Hearing 644

Chapter Review 652


Olfaction and Gustation 614

Refractive Problems 630

Photoreception 632

Clinical Case

A Chance to See 612

Clinical Notes

Diabetic Retinopathy 623

Detached Retina 625

Glaucoma 626

Motion Sickness 645

18 The Endocrine

System 656

An Introduction to the Endocrine System 657

18-1 Homeostasis is preserved through intercellular

communication by the nervous and endocrine

systems 657

Mechanisms of Intercellular Communication 657

Comparison of Endocrine and Nervous

Communication 658

18-2 The endocrine system regulates physiological

processes by releasing bloodborne hormones that

bind to receptors on remote target organs 659

Overview of Endocrine Organs and Tissues 659

Classes of Hormones 659

Transport and Inactivation of Hormones 659

Mechanisms of Hormone Action 660

Control of Hormone Secretion 664

18-3 The anterior lobe of the pituitary gland produces

and releases hormones under hypothalamic control,

while the posterior lobe releases hypothalamic

hormones 665

Anatomy of the Hypothalamus and Pituitary Gland 665

Control of Pituitary Activity by the Hypothalamus 666

The Anterior Lobe of the Pituitary Gland 667

The Posterior Lobe of the Pituitary Gland 671

Summary: The Hormones of the Pituitary Gland 672

18-4 The thyroid gland synthesizes thyroid hormones that

affect the rate of metabolism 673

Anatomy of the Thyroid Gland 674

Synthesis and Regulation of Thyroid Hormones 674

Functions of Thyroid Hormones 677

Synthesis and Functions of Calcitonin 677

18-5 The four parathyroid glands secrete parathyroid

hormone, which increases the blood calcium ion

level 678

18-6 The paired adrenal glands secrete several

hormones that affect electrolyte balance and stress

responses 680

Anatomy of the Adrenal Glands 680

Corticosteroids of the Adrenal Cortex 680

Catecholamines of the Adrenal Medulla 682

18-7 The pineal gland secretes melatonin, which affects

the circadian rhythm 683

18-8 The pancreas is both an exocrine organ and an

endocrine gland that produces hormones affecting

the blood glucose level 683

Anatomy of the Pancreas 684

Functions of Pancreatic Islet Cells 684

Hormones That Regulate the Blood Glucose Level 684

Diabetes Mellitus 687

18-9 Many organs have secondary endocrine

functions 687

The Intestines 687

The Kidneys 687

The Heart 690

The Thymus 690

The Gonads 690

Adipose Tissue 692

18-10 Hormones interact over our lifetime to produce

coordinated physiological responses 692

Role of Hormones in Growth 693

The Hormonal Responses to Stress 693

The Effects of Hormones on Behavior 693

Aging and Hormone Production 693

Build Your Knowledge

Integration of the ENDOCRINE system with the other body systems

presented so far 696

Chapter Review 697

SmartArt Videos

Figure 18–16 Anatomy of the Pancreas. 684


Structural Classification of Hormones 661

G Proteins and Second Messengers 663

Diabetes Mellitus 688

The General Adaptation Syndrome 694

Clinical Case

Stones, Bones, and Groans 657

Clinical Notes

Diabetes Insipidus 671

Endocrine Disorders 691

Hormones and Athletic Performance 695


19 Blood 702

An Introduction to Blood and the Cardiovascular

System 703

19-1 Blood, composed of plasma and formed elements,

provides transport, regulation, and protective

services to the body 703

Functions of Blood 703

Characteristics of Blood 704

Components of Blood 704

19-2 Red blood cells, formed by erythropoiesis, contain

hemoglobin that transports respiratory gases 705

Abundance of RBCs: The Hematocrit 705

Relationship of RBC Structure to RBC Function 705

Hemoglobin 708

RBC Formation and Turnover 710

19-3 The ABO and Rh blood groups are based on antigen–

antibody responses 712

ABO and Rh Blood Groups 712

Transfusions 715

19-4 The various types of white blood cells contribute to

the body’s defenses 716

WBC Characteristics and Functions 717

Types of WBCs 717

The Differential Count and Changes in WBC Profiles 721

WBC Production: Leukopoiesis 721

Regulation of WBC Production 722

19-5 Platelets, disc-shaped cell fragments, function in the

clotting process 724

Platelet Functions 724

Platelet Production 724

19-6 The process of blood clotting, or hemostasis, stops

blood loss 724

The Vascular Phase 725

The Platelet Phase 725

The Coagulation Phase 725

Clot Retraction 729

Fibrinolysis 729

Chapter Review 729


The Composition of Whole Blood 706

Hemolytic Disease of the Newborn 718

Clinical Case

Crisis in the Blood 703

Clinical Notes

Plasma Expanders 704

Collecting Blood for Analysis 705

Bleeding and Clotting Extremes 728

20 The Heart 734

An Introduction to the Heart as Part of the Cardiovascular

System 735

20-1 The heart is a four-chambered organ that pumps

blood through the systemic and pulmonary

circuits 735

Overview of Heart Function: The Pulmonary and Systemic

Circuits 735

Heart Location and Position 736

Heart Superficial Anatomy, Heart Wall, and Cardiac

Skeleton 736

Heart Chambers, Valves, and Great Vessels 740

Blood Flow through the Heart Valves 743

The Blood Supply to the Heart 743

20-2 The cells of the conducting system distribute

electrical impulses through the heart, causing cardiac

contractile cells to contract 748

Cardiac Physiology: Electrical Impulses Leading to the

Contractions Making Up a Heartbeat 748

The Conducting System: Pacemaker and Conducting

Cells 748

The Electrocardiogram (ECG) 751

Cardiac Contractions: Contractile Cells 753

20-3 The contraction–relaxation events that occur during a

complete heartbeat make up a cardiac cycle 757

An Introduction to Pressure and Flow in the Heart 757

Phases of the Cardiac Cycle 758

Pressure and Volume Changes in the Cardiac Cycle 759

Heart Sounds 761

20-4 Cardiac output is determined by heart rate and stroke

volume 762

Factors Affecting the Heart Rate 762

Factors Affecting the Stroke Volume 765

Summary: The Control of Cardiac Output 767

The Heart and the Vessels of the Cardiovascular System 768

Chapter Review 769

SmartArt Videos

Figure 20–16 Phases of the Cardiac Cycle. 758

Figure 20–19 Factors Affecting Cardiac Output. 762


Heart Disease and Heart Attacks 746

Cardiac Arrhythmias 754

Clinical Case

A Needle to the Chest 735

Clinical Notes

Faulty Heart Valves 743

Broken-Heart Syndrome 748

21 Blood Vessels and

Circulation 773

An Introduction to Blood Vessels and Circulation 774

21-1 Arteries, which are elastic or muscular, and veins,

which contain valves, have three-layered walls;

capillaries have thin walls with only one layer 774

Vessel Wall Structure in Arteries and Veins 774

Differences between Arteries and Veins 775

Arteries 776

Capillaries 779

Veins 781

The Distribution of Blood 782

21-2 Pressure and resistance determine blood flow and

affect rates of capillary exchange 783

Introduction to Pressure and Flow in Blood Vessels 783

Pressures Affecting Blood Flow 783

Total Peripheral Resistance 783

An Overview of Cardiovascular Pressures 785

Capillary Exchange and Capillary Pressures 788

21-3 Blood flow and pressure in tissues are controlled by

both autoregulation and central regulation 791

Vasomotion 791

Overview of Autoregulation and Central Regulation 791

Autoregulation of Blood Flow within Tissues 791

Central Regulation: Neural Mechanisms 793

Central Regulation: Endocrine Mechanisms 796

21-4 The cardiovascular system adapts to physiological

stress while maintaining a special vascular supply to

the brain, heart, and lungs 798

Vascular Supply to Special Regions 798

The Cardiovascular Response to Exercise 799

The Cardiovascular Response to Hemorrhaging and

Shock 801

21-5 The vessels of the cardiovascular system make up

both pulmonary and systemic circuits 802

21-6 In the pulmonary circuit, deoxygenated blood enters

the lungs in arteries, and oxygenated blood leaves the

lungs by veins 803

21-7 The systemic circuit carries oxygenated blood from

the left ventricle to tissues and organs other than the

lungs, and returns deoxygenated blood to the right

atrium 804

Systemic Arteries 804

The Ascending Aorta 804

The Aortic Arch 804

Systemic Veins 812

21-8 Modifications of fetal and maternal cardiovascular

systems promote the exchange of materials; the

fetal cardiovascular system changes to function

independently after birth 821

Fetal Circulatory Route and Placental Blood Supply 821

Fetal Heart and Great Vessels 821

Cardiovascular Changes at Birth 822

21-9 Aging affects the blood, heart, and blood vessels 824

Build Your Knowledge

Integration of the CARDIOVASCULAR system with the other body systems

presented so far 825

Chapter Review 826


Congenital Heart Problems 823

Clinical Case

Did Ancient Mummies Have Atherosclerosis? 774

Clinical Notes

Arteriosclerosis 778

Varicose Veins 782

Edema 790

Aortic Aneurysm 809

Preparing the Circulation for Dialysis 816

22 The Lymphatic System

and Immunity 831

An Introduction to the Lymphatic System and

Immunity 832

22-1 The vessels, tissues, and organs of the lymphatic

system maintain fluid volume and function in body

defenses 832

Functions of the Lymphatic System 833

Lymphatic Vessels and Circulation of Lymph 833

Lymphoid Cells 836

Lymphoid Tissues 836

Lymphoid Organs 838

22-2 Lymphocytes are important to innate (nonspecific)

and adaptive (specific) immunity 842

Types of Immunity 842

Lymphocytes 843

22-3 Innate defenses respond the same regardless of the

invader 843

Physical Barriers 843

Phagocytes 846

Immune Surveillance 847

Interferons 848

Complement System 848

Inflammation 848

Fever 851

22-4 Adaptive (specific) defenses respond to particular

threats and are either cell mediated or antibody

mediated 851

Lymphocytes of Adaptive Immunity 851

Types of Adaptive Immunity 851

An Introduction to Adaptive Immunity 852

Forms of Adaptive Immunity 853

Properties of Adaptive Immunity 853

22-5 In cell-mediated adaptive immunity, presented

antigens activate T cells, which respond by producing

cytotoxic and helper T cells 855

Activation and Clonal Selection of T Cells 855

Functions of Activated CD8 T Cells 858

Functions of Activated CD4 T Cells: Helper T (TH) and

Memory TH Cells 859

Cytokines of Adaptive Defenses 859

Summary of Cell-Mediated Adaptive Immunity 859

22-6 In antibody-mediated adaptive immunity, sensitized

B cells respond to antigens by producing specific

antibodies 862

B Cell Sensitization and Activation 862

Antibody Structure and Function 863

Primary and Secondary Responses to Antigen Exposure 866

22-7 Immunocompetence enables a normal immune

response; abnormal responses result in immune

disorders 867

Summary of Innate and Adaptive Immunity 867

The Development of Immunocompetence 868

Stress and the Immune Response 871

Immune Disorders 871

22-8 The immune response diminishes as we age 873

22-9 The nervous and endocrine systems influence the

immune response 875

Build Your Knowledge

Integration of the LYMPHATIC system with the other body systems

presented so far 874

Chapter Review 875

SmartArt Videos

Figure 22–17 Forms of Immunity. 854


Cytokines of the Immune System 860

Clinical Case

Isn’t There a Vaccine for That? 832

Clinical Notes

Lymphadenopathy 839

Lab Tests for Organ Donation 855

Organ Donation 857

AIDS 873


23 The Respiratory

System 880

An Introduction to the Respiratory System 881

23-1 The respiratory system, organized into an upper

respiratory system and a lower respiratory system,

functions primarily to aid gas exchange 881

Functions of the Respiratory System 881

Organization of the Respiratory System 881

The Respiratory Mucosa and the Respiratory Defense

System 882

23-2 The conducting portion of the upper respiratory

system filters, warms, and humidifies air 884

The Nose and Nasal Cavity 884

The Pharynx 885

23-3 The conducting portion of the lower respiratory

system conducts air to the respiratory portion and

produces sound 887

The Larynx 887

Sound Production 889

The Trachea 889

The Bronchial Tree 890

23-4 The respiratory portion of the lower respiratory

system is where gas exchange occurs 892

The Respiratory Bronchioles 892

Alveolar Ducts and Alveoli 892

The Blood Air Barrier 894

23-5 Enclosed by pleural cavities, the lungs are paired

organs made up of multiple lobes 894

Anatomy of the Lungs 894

Blood Supply to the Lungs 896

Pleural Cavities and Pleural Membranes 896

23-6 External respiration and internal respiration allow gas

exchange within the body 897

23-7 Pulmonary ventilation—air exchange between the

atmosphere and the lungs—involves muscle actions

and volume changes that cause pressure changes 898

An Introduction to Airflow 898

Overview of Pulmonary Ventilation: Volume Changes and

Pressure Gradients 899

Actions of the Respiratory Muscles 899

Volume Changes in Pulmonary Ventilation 901

Pressure Gradients in Pulmonary Ventilation 901

Summary of Volume Changes and Pressure Gradients

during a Respiratory Cycle 903

Physical Factors Affecting Pulmonary Ventilation 903

Measuring Respiratory Rates and Volumes 903

23-8 Gas exchange depends on the partial pressures of

gases and the diffusion of gas molecules 906

An Introduction to the Diffusion of Gases 906

Diffusion of Gases across the Blood Air Barrier 907

Summary of Gas Exchange 908

Internal Respiration 909

23-9 In gas transport, most oxygen is transported bound to

hemoglobin, whereas carbon dioxide is transported in

three ways 910

Oxygen Transport 910

Carbon Dioxide Transport 913

Summary of Gas Transport 914

23-10 Respiratory centers in the brainstem, along with

respiratory reflexes, control respiration 914

Local Regulation of Oxygen Delivery and Ventilation-to-

Perfusion Ratio 914

Neural Control of Respiration 915

23-11 Respiratory performance changes over the life

span 922

Changes in the Respiratory System in Newborns 922

Changes in the Respiratory System in Elderly Individuals 922

23-12 The respiratory system provides oxygen to, and

eliminates carbon dioxide from, other organ

systems 923

Build Your Knowledge

Integration of the RESPIRATORY system with the other body systems

presented so far 924

Chapter Review 925

SmartArt Videos

Figure 23–18 A Summary of Respiratory Processes and Partial Pressures in

Respiration. 909


Pulmonary Ventilation 900

Control of Respiration 918

Clinical Case

No Rest for the Weary 881

Clinical Notes

Breakdown of the Respiratory Defense System 884

Pneumothorax 902

Decompression Sickness 908

Blood Gas Analysis 908

Carbon Monoxide Poisoning 913

Smoking and the Lungs 923

24 The Digestive

System 930

An Introduction to the Digestive System 931

24-1 The digestive system, consisting of the digestive tract

and accessory organs, functions primarily to break

down and absorb nutrients from food and to eliminate

wastes 931

Functions and Processes of the Digestive System 931

Relationship between the Digestive Organs and the

Peritoneum: The Mesenteries 933

Histology of the Digestive Tract 935

Motility of the Digestive Tract 936

Regulation of Digestive Functions 937

24-2 The oral cavity, which contains the tongue, teeth,

and salivary glands, functions in the ingestion and

mechanical digestion of food 939

The Oral Cavity 939

The Tongue 940

The Teeth 940

The Salivary Glands 942

Mechanical Digestion: Mastication (Chewing) 944

24-3 The pharynx and esophagus are passageways that

transport the food bolus from the oral cavity to the

stomach 944

The Pharynx 944

The Esophagus 944

Ingestion: Deglutition (Swallowing) 946

24-4 The stomach is a J-shaped organ that receives

the bolus and aids in its chemical and mechanical

digestion 947

Gross Anatomy of the Stomach 947

Histology of the Stomach 947

Secretory Glands and Gastric Secretions 949

Physiology of the Stomach: Chemical Digestion 951

Regulation of Gastric Activity in Phases of Digestion 951

24-5 Accessory digestive organs, such as the pancreas

and liver, produce secretions that aid in chemical

digestion 951

The Pancreas 954

The Liver 955

The Gallbladder 960

24-6 The small intestine primarily functions in the chemical

digestion and absorption of nutrients 961

Gross Anatomy of the Small Intestine 961

Histology of the Small Intestine 961

Physiology of the Small Intestine 964

Regulation: Coordination of Secretion and Absorption in

the Digestive Tract 964

24-7 The large intestine, which is divided into three

parts, absorbs water from digestive materials and

eliminates the remaining waste as feces 967

Gross Anatomy and Segments of the Large Intestine 967

Histology of the Large Intestine 969

Physiology of the Large Intestine 969

24-8 Chemical digestion is the enzyme-mediated

hydrolysis of food into nutrients that can be absorbed

and used by the body 972

Hydrolysis of Nutrients by Enzymes 972

Carbohydrate Digestion and Absorption 973

Lipid Digestion and Absorption 975

Protein Digestion and Absorption 976

Nucleic Acid Digestion and Absorption 976

Absorption of Water, Ions, and Vitamins 976

24-9 Many age-related changes affect digestion and

absorption 977

24-10 The digestive system is extensively integrated with

other body systems 978

Build Your Knowledge

Integration of the DIGESTIVE system with the other body systems presented

so far 979

Chapter Review 980

SmartArt Videos

Figure 24–18 Histology of the Liver. 957


The Regulation of Gastric Activity 952

The Chemical Events of Digestion 974

Clinical Case

An Unusual Transplant 931

Clinical Notes

Peritonitis 933

Epithelial Renewal and Repair 936

Mumps 943

Gastritis and Peptic Ulcers 949

Pancreatitis 955

Cirrhosis 956

Colorectal Cancer 969

Colonoscopy 972

25 Metabolism, Nutrition,

and Energetics 985

An Introduction to Metabolism, Nutrition, and

Energetics 986

25-1 Metabolism is the sum of all the catabolic and

anabolic reactions in the body, and energetics is the

flow and transformation of energy 986

Metabolism 986

Energetics 988

Oxidation and Reduction 988

25-2 Carbohydrate metabolism generates ATP by

glucose catabolism and forms glucose by

gluconeogenesis 989

Overview of Glucose Catabolism 989

Glucose Catabolism: Glycolysis 989

Glucose Catabolism: Fate of Pyruvate 989

Glucose Catabolism: Aerobic Metabolism 990

Glucose Catabolism: Energy Yield of Glycolysis and

Aerobic Metabolism 994

Glucose Anabolism: Gluconeogenesis 996

25-3 Lipid metabolism provides long-term storage and

release of energy 997

Lipid Catabolism: Lipolysis 997

Lipid Anabolism: Lipogenesis 999

Lipid Storage and Energy Release 999

Lipid Transport and Distribution 999

25-4 Protein metabolism provides amino acids and

synthesizes proteins 1002

Amino Acid Catabolism 1002

Protein Synthesis 1002

25-5 The body experiences two patterns of metabolic

activity: energy storage in the absorptive state and

energy release in the postabsorptive state 1003

25-6 Adequate nutrition allows normal physiological

functioning 1005

Food Groups and a Balanced Diet 1005

Nitrogen Balance 1008

The Role of Minerals and Vitamins 1008

25-7 Metabolic rate is the average caloric expenditure, and

thermoregulation involves balancing heat-producing

and heat-losing mechanisms 1012

Energy Gains and Losses 1012

Thermoregulation 1013

Chapter Review 1018


The Electron Transport Chain and ATP Formation 993

Absorptive and Postabsorptive States 1006

Clinical Case

The Miracle Supplement 986

Clinical Notes

Carbohydrate Loading 997

Dietary Fats and Cholesterol 1001

Blood Testing for Fat 1001

Vitamins 1011

Alcohol by the Numbers 1011

Alcohol and Disease 1011

Anorexia 1012

Superfoods 1012

Hypothermia in the Operating Room 1016

Excess Body Heat 1017

Deficient Body Heat 1017

26 The Urinary

System 1022

An Introduction to the Urinary System 1023

26-1 The organs of the urinary system

function in excreting wastes and

regulating body fluids 1023

Organs of the Urinary System 1023

Urinary System Functions 1024

26-2 Kidneys are highly vascular organs containing

functional units called nephrons 1024

Position and Associated Structures of the Kidneys 1024

Gross Anatomy of the Kidneys 1025

Blood Supply and Innervation of the Kidneys 1026

Microscopic Anatomy of the Kidneys: The Nephron and

Collecting System 1028

26-3 Different segments of the nephron form urine by

filtration, reabsorption, and secretion 1033

Metabolic Wastes 1033

Basic Processes of Urine Formation 1033

26-4 The glomerulus filters blood through the filtration

membrane to produce filtrate; several pressures

determine the glomerular filtration rate 1035

Function of the Filtration Membrane 1035

Filtration Pressures 1035

The Glomerular Filtration Rate (GFR) 1036

Regulation of the GFR 1037

26-5 The renal tubule reabsorbs nutrients, ions, and water

and secretes ions and wastes; the collecting system

reabsorbs ions and water 1039

Principles of Reabsorption and Secretion 1039

An Overview of Reabsorbed and Secreted

Substances 1040

Reabsorption and Secretion along the PCT 1041

Reabsorption and Secretion along the Nephron

Loop 1041

Reabsorption and Secretion along the DCT 1043

Reabsorption and Secretion along the Collecting

System 1046

26-6 Countercurrent multiplication allows the kidneys to

regulate the volume and concentration of

urine 1047

The Nephron Loop and Countercurrent

Multiplication 1047

Regulation of Urine Volume and Osmotic Concentration:

Production of Dilute and Concentrated

Urine 1049

The Function of the Vasa Recta: Countercurrent

Exchange 1051

Urine Composition and Analysis 1051

26-7 Urine is transported by the ureters, stored in the

bladder, and eliminated through the urethra by urinary

reflexes 1055

The Ureters 1055

The Urinary Bladder 1056

The Urethra 1057

Urinary Reflexes: Urine Storage and Urine Voiding 1058

26-8 Age-related changes affect kidney function and

urination 1059

26-9 The urinary system is one of several body systems

involved in waste excretion 1060

Build Your Knowledge

Integration of the URINARY system with the other body systems presented

so far 1061

Chapter Review 1062

SmartArt Videos

Figure 26–8 The Locations and Structures of Cortical and Juxtamedullary

Nephrons. 1031


Summary of Renal Function 1052

Clinical Case

A Case of “Hidden” Bleeding 1023

Clinical Notes

Glomerulonephritis 1030

Diuretics 1046

Urinary Obstruction 1059

Renal Failure and Kidney Transplant 1060

27 Fluid, Electrolyte, and


Balance 1067

An Introduction to Fluid, Electrolyte,

and Acid-Base Balance 1068

27-1 Fluid balance, electrolyte balance,

and acid-base balance are interrelated and essential

to homeostasis 1068

27-2 Extracellular fluid (ECF) and intracellular fluid

(ICF) are fluid compartments with differing solute

concentrations that are closely regulated 1069

Body Water Content 1069

The Fluid Compartments of the ECF and ICF 1069

Solute Exchanges between the ECF and the ICF 1070

An Overview of the Regulation of Fluid and Electrolyte

Balance 1071

27-3 Fluid balance involves the regulation and distribution

of water gains and losses 1073

Fluid Gains and Losses 1073

Water Movement between Fluid Compartments 1074

Fluid Shifts between the ECF and ICF 1074

27-4 In electrolyte balance, the concentrations of sodium,

potassium, calcium, magnesium, phosphate, and

chloride ions in body fluids are tightly regulated 1076

Sodium Balance 1076

Potassium Balance 1079

Balance of Other Electrolytes 1080

27-5 In acid-base balance, buffer systems as well as

respiratory and renal compensation regulate pH

changes in body fluids 1082

Types of Acids in the Body 1082

Mechanisms of pH Control: Buffer Systems 1082

Regulation of Acid-Base Balance 1087

27-6 Disorders of acid-base balance can be classified as respiratory or metabolic 1088

Respiratory Acid-Base Disorders 1091

Metabolic Acid-Base Disorders 1092

Combined Respiratory and Metabolic Acidosis 1095

The Detection of Acidosis and Alkalosis 1095

27-7 Aging affects fluid, electrolyte, and acid-base balance 1095

Chapter Review 1097


The Diagnosis of Acid-Base Disorders 1096

Clinical Case

When Treatment Makes You Worse 1068

Clinical Notes

Water and Weight Loss 1075

Athletes and Salt Loss 1079

Sports Drinks 1079


28 The Reproductive System 1101

An Introduction to the Reproductive System 1102

28-1 Male and female reproductive system structures produce gametes that combine to form a new individual 1102

28-2 The structures of the male reproductive system consist of the testes, duct system, accessory glands, and penis


The Testes and Associated Structures 1103

Functional Anatomy of the Male Reproductive Duct System 1105

The Accessory Glands 1107

Semen 1109

The Penis 1109

28-3 Spermatogenesis occurs in the testes, and hormones from the hypothalamus, pituitary gland, and testes

control male reproductive functions 1111

Overview of Mitosis and Meiosis 1111

Spermatogenesis 1113

Maturation of Sperm 1116

The Anatomy of a Sperm 1116

Hormonal Regulation of Male Reproductive Function 1116

28-4 The structures of the female reproductive system consist of the ovaries, uterine tubes, uterus, vagina, and

external genitalia 1118

The Ovaries 1119

The Uterine Tubes 1120

The Uterus 1121

The Vagina 1124

The Female External Genitalia 1126

The Breasts 1126

28-5 Oogenesis occurs in the ovaries, and hormones from the hypothalamus, pituitary gland, and ovaries control

female reproductive functions 1128

Oogenesis 1128

The Ovarian Cycle 1131

The Uterine (Menstrual) Cycle 1132

Hormonal Coordination of the Ovarian and Uterine Cycles 1133

28-6 The autonomic nervous system influences male and female sexual function 1137

Human Sexual Function 1137

Contraception and Infertility 1138

Sexually Transmitted Diseases (STDs) 1139

28-7 Changes in levels of reproductive hormones cause functional changes throughout the life span 1139

Development of the Genitalia 1139

Effects of Aging 1140

28-8 The reproductive system secretes hormones affecting growth and metabolism of all body systems 1142

Build Your Knowledge

Integration of the REPRODUCTIVE system with the other body systems presented so far 1143

Chapter Review 1144


Hormonal Regulation of Male Reproduction 1117

Hormonal Regulation of Female Reproduction 1134

Clinical Case

And Baby Makes Three? 1102

Clinical Notes

Circumcision 1111

Dehydroepiandrosterone (DHEA) 1116

Enlarged Prostate 1118

Prostate Cancer 1118

Prostate-Specific Antigen (PSA) Testing 1118

Ovarian Cancer 1121

Pap Smear 1123

Fibrocystic Disease and Breast Cancer 1127

Laparoscopy 1128

Mammoplasty 1128

29 Development and Inheritance 1149

An Introduction to Development and Inheritance 1150

29-1 Directed by inherited genes, a fertilized ovum differentiates during prenatal development to form an individual;

postnatal development brings that individual to maturity 1150

29-2 Fertilization—the fusion of a secondary oocyte and a sperm—forms a zygote 1151

The Secondary Oocyte and Sperm before Fertilization 1151

The Process of Fertilization 1151

Events after Fertilization 1152

29-3 Gestation consists of three stages of prenatal development: the first, second, and third trimesters 1153

29-4 The first trimester includes pre-embryonic and embryonic development, involving the processes of cleavage,

implantation, placentation, and embryogenesis 1153

The Pre-Embryonic Period 1154

The Embryonic Period 1155

29-5 During the second and third trimesters, fetal development involves growth and organ function 1161

29-6 During gestation, maternal organ systems support the developing fetus; the reproductive system undergoes

structural and functional changes 1163

Hormonal Regulation during Gestation 1166

Changes in Maternal Organ Systems 1167

29-7 Childbirth occurs through the process of labor, which consists of the dilation, expulsion, and placental stages


Initiation of Labor 1169

The Stages of Labor 1169

Difficulties of Labor and Delivery and Multiple Births 1170

29-8 Postnatal stages are the neonatal period, infancy, childhood, adolescence, and maturity, followed by

senescence and death 1172

The Neonatal Period, Infancy, and Childhood 1173

Adolescence and Maturity 1176

Senescence and Death 1177

29-9 Genes and chromosomes determine patterns of inheritance 1177

Genotype and Phenotype 1177

Homologous Chromosomes and Alleles 1178

Autosomal Patterns of Inheritance 1178

Sex-Linked Patterns of Inheritance 1181

Sources of Individual Variation 1182

Effect of Environmental Factors: Penetrance and

Expressivity 1184

The Human Genome 1184

Chapter Review 1186


Extra-Embryonic Membranes and Placenta Formation 1158

Clinical Case

The Twins That Looked Nothing Alike 1150

Clinical Notes

Abortion 1169

C-Section 1172

Chromosomal Abnormalities 1183

Amniocentesis 1183

Answers to Checkpoints, Review Questions, and Clinical Case Wrap-Ups 1190


Appendix A Normal Physiological Values 1237

Appendix B Gas Pressure Measurements and Cell Turnover Times 1239

Appendix C Codon Chart 1240

Appendix D Periodic Table of the Elements 1241

Glossary 1242

Credits 1261

Index 1263

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