Essentials of Human Anatomy & Physiology, Thirteenth Edition
By Elaine N. Marieb and Suzanne M. Keller
Contents:
1 The Human Body:
An Orientation 23
1.1 An Overview of Anatomy and Physiology 23
1.1a Anatomy 23
1.1b Physiology 24
1.1c Relationship between Anatomy and Physiology 24
1.2 Levels of Structural Organization 24
1.2a From Atoms to Organisms 24
1.2b Organ System Overview 25
Integumentary System • Skeletal System • Muscular System • Nervous System • Endocrine System
Cardiovascular System • Lymphatic System
Respiratory System • Digestive System • Urinary System • Reproductive System
1.3 Maintaining Life 29
1.3a Necessary Life Functions 29
Maintaining Boundaries • Movement • Responsiveness
Digestion • Metabolism • Excretion • Reproduction
Growth
1.3b Survival Needs 31
1.4 The Language of Anatomy 32
1.4a Anatomical Position 33
1.4b Directional Terms 33
1.4c Regional Terms 35
Anterior Body Landmarks • Posterior Body Landmarks
1.4d Body Planes and Sections 36
1.4e Body Cavities 38
Dorsal Body Cavity • Ventral Body Cavity • Other Body
Cavities
1.5 Homeostasis 40
1.5a Components of Homeostatic Control
Systems 40
1.5b Feedback Mechanisms 41
Summary 42
Review Questions 43
Critical Thinking And Clinical Application Questions 44
A CLOSER LOOK Medical Imaging: Illuminating the Body 32
2 Basic Chemistry 45
2.1 Concepts of Matter and Energy 45
2.1a Matter 45
2.1b Energy 46
Forms of Energy • Energy Form Conversions
2.2 Composition of Matter 47
2.2a Elements and Atoms 47
2.2b Atomic Structure 47
The Basic Atomic Subparticles • Planetary and Orbital
Models of an Atom
2.2c Identifying Elements 49
Atomic Number • Atomic Mass Number • Atomic
Weight and Isotopes
2.3 Molecules and Compounds 52
2.4 Chemical Bonds and Chemical
Reactions 53
2.4a Bond Formation 53
Role of Electrons • Types of Chemical Bonds
2.4b Patterns of Chemical Reactions 57
Synthesis Reactions • Decomposition Reactions
Exchange Reactions • Factors Influencing the Rate of
Chemical Reactions
2.5 Biochemistry: The Chemical
Composition of Living Matter 59
2.5a Inorganic Compounds 60
Water • Salts • Acids and Bases
2.5b Organic Compounds 63
Carbohydrates • Lipids • Proteins • Nucleic Acids
Adenosine Triphosphate (ATP)
Summary 77
Review Questions 80
Critical Thinking And Clinical Application Questions 81
FOCUS ON CAREERS Pharmacy Technician 75
3 Cells and
Tissues 82
PART I: CELLS 82
3.1 Overview of the Cellular Basis
of Life 82
3.2 Anatomy of a Generalized Cell 83
3.2a The Plasma Membrane 83
The Fluid Mosaic Model • Cell Membrane Junctions
3.2b The Nucleus 85
Nuclear Envelope • Nucleolus • Chromatin
3.2c The Cytoplasm 87
Cytosol and Inclusions • Organelles
3.2d Cell Extensions 91
Cilia and Flagella • Microvilli
3.2e Cell Diversity 94
3.3 Cell Physiology 96
3.3a Membrane Transport 96
Passive Processes: Diffusion and Filtration • Active Processes
3.3b Cell Division 102
Preparations: DNA Replication • Events of Cell Division
3.3c Protein Synthesis 105
Genes: The Blueprint for Protein Structure • The Role
of RNA • The Process of Protein Synthesis
PART II: BODY TISSUES 108
3.4 Epithelial Tissue 108
3.4a Hallmarks of Epithelium 108
3.4b Classification of Epithelia 109
Simple Epithelia • Stratified Epithelia • Glandular
Epithelium
3.5 Connective Tissue 113
3.5a Hallmarks of Connective Tissue 113
3.5b Extracellular Matrix 114
3.5c Types of Connective Tissue 114
Bone • Cartilage • Dense Connective Tissue • Loose
Connective Tissue • Blood
3.6 Muscle Tissue 118
3.6a Skeletal Muscle 118
3.6b Cardiac Muscle 118
3.6c Smooth Muscle 120
3.7 Nervous Tissue 120
3.8 Tissue Repair (Wound Healing) 120
Summary 124
Review Questions 126
Critical Thinking And Clinical Application Questions 127
A CLOSER LOOK IV Therapy and Cellular
“Tonics” 99
A CLOSER LOOK Cancer—An Intimate
Enemy 123
4 Skin and Body
Membranes 128
4.1 Classification of Body Membranes 128
4.1a Epithelial Membranes 129
Cutaneous Membrane • Mucous Membranes
Serous Membranes
4.1b Connective Tissue Membranes 129
4.2 The Integumentary System (Skin) 131
4.2a Functions of the Integumentary
System 131
4.2b Structure of the Skin 132
Epidermis • Dermis
4.2c Skin Color 137
4.2d Appendages of the Skin 138
Cutaneous Glands • Hair and Hair Follicles • Nails
4.2e Homeostatic Imbalances of Skin 142
Infections and Allergies • Burns • Skin Cancer
4.3 Developmental Aspects of Skin and
Body Membranes 146
Summary 148
Review Questions 150
Critical Thinking And Clinical Application Questions 151
A Closer Look A Wrinkle Out Of Time 136
FOCUS ON CAREERS Medical
Transcriptionist 146
SYSTEMS IN SYNC 147
5 The Skeletal
System 152
5.1 Bones: An Overview 152
5.1a Functions of the Bones 153
5.1b Classification of Bones 153
5.1c Structure of Bone 154
Gross Anatomy of a Long Bone • Microscopic Anatomy
5.1d Bone Formation, Growth, and
Remodeling 157
Bone Formation and Growth • Bone Remodeling
5.1e Bone Fractures 161
5.2 Axial Skeleton 164
5.2a Skull 164
Cranium • Facial Bones • The Hyoid Bone
5.2b Vertebral Column (Spine) 171
Cervical Vertebrae • Thoracic Vertebrae • Lumbar
Vertebrae • Sacrum • Coccyx
5.2c Thoracic Cage 173
Sternum • Ribs
5.3 Appendicular Skeleton 175
5.3a Bones of the Shoulder Girdle 176
5.3b Bones of the Upper Limbs 178
Arm • Forearm • Hand
5.3c Bones of the Pelvic Girdle 179
5.3d Bones of the Lower Limbs 182
Thigh • Leg • Foot
5.4 Joints 185
5.4a Fibrous Joints 185
5.4b Cartilaginous Joints 185
5.4c Synovial Joints 185
5.4d Types of Synovial Joints Based on
Shape 187
5.5 Developmental Aspects of the
Skeleton 191
5.5a Birth to Adulthood 191
5.5b Older Adults 192
Summary 195
Review Questions 196
Critical Thinking And Clinical Application Questions 198
Focus On Careers Radiologic Technologist 161
A CLOSER LOOK Joint Ventures 184
SYSTEMS IN SYNC 194
6 The Muscular
System 199
6.1 Overview of Muscle Tissues 199
6.1a Muscle Types 199
Skeletal Muscle • Smooth Muscle • Cardiac Muscle
6.1b Muscle Functions 203
Produce Movement • Maintain Posture and Body
Position • Stabilize Joints • Generate Heat • Additional
Functions
6.2 Microscopic Anatomy of Skeletal
Muscle 203
6.3 Skeletal Muscle Activity 205
6.3a Stimulation and Contraction of Single
Skeletal Muscle Fibers 205
The Nerve Stimulus and the Action Potential
Mechanism of Muscle Contraction: The Sliding Filament Theory
6.3b Contraction of a Skeletal Muscle as a Whole 210
Graded Responses • Providing Energy for Muscle
Contraction • Muscle Fatigue and Oxygen Deficit
Types of Muscle Contractions—Isotonic and Isometric
Muscle Tone • Effect of Exercise on Muscles
6.4 Muscle Movements, Roles, and Names 214
6.4a Types of Body Movements 214 Special Movements
6.4b Interactions of Skeletal Muscles in the Body 218
6.4c Naming Skeletal Muscles 220
6.4d Arrangement of Fascicles 220
6.5 Gross Anatomy of Skeletal Muscles 221
6.5a Head and Neck Muscles 221
Facial Muscles • Neck Muscles
6.5b Trunk Muscles 223
Anterior Muscles • Posterior Muscles
6.5c Muscles of the Upper Limb 226
Muscles Causing Movement at the Elbow Joint
6.5d Muscles of the Lower Limb 227
Muscles Causing Movement at the Hip Joint • Muscles
Causing Movement at the Knee Joint • Muscles
Causing Movement at the Ankle and Foot
6.6 Developmental Aspects of the Muscular System 231
Summary 238
Review Questions 240
Critical Thinking And Clinical Application Questions 241
A Closer Look Anabolic Steroids: Dying To Win? 223
Systems In Sync 237
7 The Nervous
System 242
7.1 Organization of the Nervous System 243
7.1a Structural Classification 244
7.1b Functional Classification 244
7.2 Nervous Tissue: Structure and Function 244
7.2a Supporting Cells 244
7.2b Neurons 246
Anatomy • Classification
7.2c Physiology: Nerve Impulses 251
7.2d Physiology: Reflexes 254
7.3 Central Nervous System 256
7.3a Functional Anatomy of the
Brain 256
Cerebral Hemispheres • Diencephalon • Brain Stem
Cerebellum
7.3b Protection of the Central Nervous
System 264
Meninges • Cerebrospinal Fluid • The Blood-Brain Barrier
7.3c Brain Dysfunctions 268
7.3d Spinal Cord 270
Gray Matter of the Spinal Cord and Spinal Roots
White Matter of the Spinal Cord
7.4 Peripheral Nervous System 273
7.4a Structure of a Nerve 273
7.4b Cranial Nerves 274
7.4c Spinal Nerves and Nerve Plexuses 274
7.4d Autonomic Nervous System 274
Somatic and Autonomic Nervous Systems Compared
Anatomy of the Parasympathetic Division • Anatomy
of the Sympathetic Division • Autonomic Functioning
7.5 Developmental Aspects of the Nervous
System 285
Summary 289
Review Questions 292
Critical Thinking And Clinical Application Questions 293
A Closer Look The “Terrible Three” 268
A Closer Look Tracking Down Cns Problems 287
Systems In Sync 288
8 Special
Senses 294
PART I: THE EYE AND VISION 295
8.1 Anatomy of the Eye 295
8.1a External and Accessory Structures 295
8.1b Internal Structures: The Eyeball 297
Layers Forming the Wall of the Eyeball • Lens
8.2 Physiology of Vision 303
8.2a Pathway of Light through the Eye and
Light Refraction 303
8.2b Visual Fields and Visual Pathways to the
Brain 304
8.2c Eye Reflexes 306
PART II: THE EAR: HEARING AND
BALANCE 306
8.3 Anatomy of the Ear 307
8.3a External (Outer) Ear 307
8.3b Middle Ear 308
8.3c Internal (Inner) Ear 308
8.4 Hearing 308
8.5 Equilibrium 311
8.5a Static Equilibrium 311
8.5b Dynamic Equilibrium 312
8.5c Hearing and Equilibrium Deficits 313
PART III: CHEMICAL SENSES:
SMELL AND TASTE 314
8.6 Olfactory Receptors and the Sense of Smell 314
8.7 Taste Buds and the Sense of Taste 315
PART IV: DEVELOPMENTAL ASPECTS OF THE SPECIAL SENSES 317
Summary 319
Review Questions 321
Critical Thinking And Clinical Application Questions 323
A CLOSER LOOK Visual Pigments—The Actual
Photoreceptors 301
A CLOSER LOOK Bringing Things into Focus 305
FOCUS ON CAREERS Physical Therapy
Assistant 313
9 The Endocrine System 324
9.1 The Endocrine System and Hormone
Function—An Overview 325
9.1a The Chemistry of Hormones 325
9.1b Hormone Action 325
Direct Gene Activation • Second-Messenger System
9.1c Stimuli for Control of Hormone Release 327
Hormonal Stimuli • Humoral Stimuli • Neural Stimuli
9.2 The Major Endocrine Organs 328
9.2a Pituitary Gland and Hypothalamus 329
9.2b Pineal Gland 332
9.2c Thyroid Gland 333
9.2d Parathyroid Glands 335
9.2e Thymus 336
9.2f Adrenal Glands 336
Hormones of the Adrenal Cortex • Hormones of the Adrenal Medulla
9.2g Pancreatic Islets 340
9.2h Gonads 341
Hormones of the Ovaries • Hormones of the Testes
9.3 Other Hormone-Producing Tissues and
Organs 345
9.4 Developmental Aspects of the Endocrine
System 345
Summary 348
Review Questions 351
Critical Thinking And Clinical Application Questions 352
A CLOSER LOOK Potential Uses for Growth
Hormone 332
SYSTEMS IN SYNC 347
10 Blood 353
10.1 Composition and Functions
of Blood 353
10.1a Components 354
10.1b Physical Characteristics and
Volume 354
10.1c Plasma 354
10.1d Formed Elements 354
Erythrocytes • Leukocytes • Platelets
10.1e Hematopoiesis (Blood Cell
Formation) 360
Formation of Red Blood Cells • Formation of White
Blood Cells and Platelets
10.2 Hemostasis 362
10.2a Phases of Hemostasis 363
10.2b Disorders of Hemostasis 364
10.3 Blood Groups and Transfusions 365
10.3a Human Blood Groups 365
10.3b Blood Typing 366
10.4 Developmental Aspects
of Blood 368
Summary 369
Review Questions 370
Critical Thinking And Clinical Application Questions 372
FOCUS ON CAREERS Phlebotomy
Technician 367
11 The Cardiovascular
System 373
11.1 The Heart 374
11.1a Anatomy of the Heart 374
Size, Location, and Orientation • Coverings and Walls
of the Heart
11.1b Chambers and Associated Great
Vessels 375
11.1c Heart Valves 378
Cardiac Circulation
11.1d Physiology of the Heart 381
Intrinsic Conduction System of the Heart: Setting the
Basic Rhythm • Cardiac Cycle and Heart Sounds
Cardiac Output
11.2 Blood Vessels 387
11.2a Microscopic Anatomy of Blood
Vessels 388
Tunics • Structural Differences in Arteries, Veins, and
Capillaries
11.2b Gross Anatomy of Blood Vessels 391
Major Arteries of the Systemic Circulation • Major
Veins of the Systemic Circulation • Special Circulations
11.2c Physiology of Circulation 396
Arterial Pulse • Blood Pressure • Capillary Exchange
of Gases and Nutrients • Fluid Movements at
Capillary Beds
11.3 Developmental Aspects of the
Cardiovascular System 405
Summary 409
Review Questions 411
Critical Thinking And Clinical Application Questions 413
A CLOSER LOOK Electrocardiography: (Don’t) Be
Still My Heart 384
A CLOSER LOOK Atherosclerosis? Get Out the
Cardiovascular Plumber’s Snake! 403
SYSTEMS IN SYNC 408
12 The Lymphatic
System and Body
Defenses 414
PART I: THE LYMPHATIC SYSTEM 414
12.1 Lymphatic Vessels 415
12.2 Lymph Nodes 416
12.3 Other Lymphoid Organs 418
PART II: BODY DEFENSES 419
12.4 Innate Body Defenses 420
12.4a Surface Membrane Barriers: First Line of
Defense 420
12.4b Cells and Chemicals: Second Line of
Defense 422
Natural Killer Cells • Inflammatory Response
Phagocytes • Antimicrobial Proteins • Fever
12.5 Adaptive Body Defenses 427
12.5a Antigens 428
12.5b Cells of the Adaptive Defense System:
An Overview 428
Lymphocytes • Antigen-Presenting Cells
12.5c Humoral (Antibody-Mediated) Immune
Response 431
Active and Passive Humoral Immunity • Antibodies
12.5d Cellular (Cell-Mediated) Immune
Response 436
12.5e Organ Transplants and Rejection 438
12.5f Disorders of Immunity 443
Part Iii: Developmental Aspects Of The Lymphatic System And Body Defenses 446
Summary 449
Review Questions 451
Critical Thinking And Clinical Application Questions 453
A CLOSER LOOK COVID-19: A Global
Pandemic 440
A CLOSER LOOK AIDS: An Ongoing
Pandemic 446
SYSTEMS IN SYNC 448
13 The Respiratory
System 454
13.1 Functional Anatomy of the Respiratory
System 454
13.1a The Nose 455
13.1b The Pharynx 456
13.1c The Larynx 457
13.1d The Trachea 458
13.1e The Main Bronchi 458
13.1f The Lungs 459
The Bronchial Tree • Respiratory Zone Structures and
the Respiratory Membrane
13.2 Respiratory Physiology 463
13.2a Mechanics of Breathing 463
Inspiration • Expiration
13.2b Respiratory Volumes and Capacities 466
Nonrespiratory Air Movements • Respiratory Sounds
13.2c External Respiration, Gas Transport, and
Internal Respiration 467
External Respiration • Gas Transport in the Blood
Internal Respiration
13.2d Control of Respiration 470
Neural Regulation: Setting the Basic Rhythm
Nonneural Factors Influencing Respiratory Rate and
Depth
13.3 Respiratory Disorders 472
13.4 Developmental Aspects of the
Respiratory System 475
Summary 477
Review Questions 480
Critical Thinking And Clinical Application Questions 481
A Closer Look Too Clean For Our Own Good? 474
Systems In Sync 476
14 The Digestive
System and Body
Metabolism 482
Part I: Anatomy And Physiology Of The Digestive System 482
14.1 Anatomy of the Digestive System 482
14.1a Organs of the Alimentary Canal 483
Mouth • Pharynx • Esophagus • Stomach • Small
Intestine • Large Intestine
14.1b Accessory Digestive Organs 492
Teeth • Salivary Glands • Pancreas • Liver and
Gallbladder
14.2 Functions of the Digestive System 496
14.2a Overview of Gastrointestinal Processes
and Controls 496
14.2b Activities Occurring in the Mouth,
Pharynx, and Esophagus 498
Food Ingestion and Breakdown • Food Propulsion—
Swallowing and Peristalsis
14.2c Activities of the Stomach 500
Food Breakdown • Food Propulsion
14.2d Activities of the Small Intestine 502
Chyme Breakdown and Absorption • Chyme Propulsion
14.2e Activities of the Large Intestine 504
Nutrient Breakdown and Absorption • Propulsion of
Food Residue and Defecation
14.2f The Microbiota 505
PART II: NUTRITION AND METABOLISM 507
14.3 Nutrition 507
14.3a Dietary Recommendations 507
14.3b Dietary Sources of the Major
Nutrients 508
Carbohydrates • Lipids • Proteins • Vitamins • Minerals
14.4 Metabolism 510
14.4a Carbohydrate, Fat, and Protein
Metabolism in Body Cells 510
Carbohydrate Metabolism • Fat Metabolism • Protein
Metabolism
14.4b The Central Role of the Liver in
Metabolism 513
General Metabolic Functions • Cholesterol Metabolism
and Transport
14.4c Body Energy Balance 516
Regulation of Food Intake • Metabolic Rate and Body
Heat Production • Body Temperature Regulation
Part III: Developmental Aspects Of The Digestive System And Metabolism 521
Summary 524
Review Questions 530
Critical Thinking And Clinical
Application Questions 532
A CLOSER LOOK Peptic Ulcers: “Something Is
Eating at Me” 506
A CLOSER LOOK Obesity: Magical Solution
Wanted 522
SYSTEMS IN SYNC 523
15 The Urinary
System 533
15.1 Kidneys 534
15.1a Location and Structure 534
Kidney Structure • Blood Supply
15.1b Nephrons 535
15.1c Urine Formation and Characteristics 538
Glomerular Filtration • Tubular Reabsorption • Tubular
Secretion • Nitrogenous Wastes • Characteristics of Urine
15.2 Ureters, Urinary Bladder, and
Urethra 542
15.2a Ureters 542
15.2b Urinary Bladder 543
15.2c Urethra 544
15.2d Micturition 544
15.3 Fluid, Electrolyte, and Acid-Base
Balance 546
15.3a Maintaining Water Balance of
Blood 546
Body Fluids and Fluid Compartments • The Link
between Water and Electrolytes • Regulation of Water
Intake and Output
15.3b Maintaining Electrolyte Balance 549
15.3c Maintaining Acid-Base Balance of
Blood 551
Blood Buffers • Respiratory Mechanisms • Renal
Mechanisms
15.4 Developmental Aspects of the Urinary
System 553
Summary 557
Review Questions 559
Critical Thinking And Clinical
Application Questions 561
A CLOSER LOOK Renal Failure and the Artificial
Kidney 545
FOCUS ON CAREERS Licensed Practical
Nurse (LPN) 554
SYSTEMS IN SYNC 556
16 The Reproductive
System 562
16.1 Anatomy of the Male Reproductive
System 563
16.1a Testes 563
16.1b Duct System 563
Epididymis • Ductus Deferens • Urethra
16.1c Accessory Glands and Semen 565
Seminal Vesicles • Prostate • Bulbourethral Glands Semen
16.1d External Genitalia 566
16.2 Male Reproductive Functions 567
16.2a Spermatogenesis 567
16.2b Testosterone Production 569
16.3 Anatomy of the Female Reproductive
System 571
16.3a Ovaries 571
16.3b Duct System 571
Uterine Tubes • Uterus • Vagina
16.3c External Genitalia and Female
Perineum 574
16.4 Female Reproductive Functions and
Cycles 575
16.4a Oogenesis and the Ovarian Cycle 575
16.4b Hormone Production by the Ovaries 577
16.4c Uterine (Menstrual) Cycle 578
16.5 Mammary Glands 578
16.6 Pregnancy and Embryonic
Development 581
16.6a Accomplishing Fertilization 582
16.6b Events of Embryonic and Fetal
Development 583
16.6c Effects of Pregnancy on the Mother 587
Anatomical Changes • Physiological Changes
16.6d Childbirth 589
Initiation of Labor • Stages of Labor
16.7 Developmental Aspects of the
Reproductive System 591
Summary 595
Review Questions 599
Critical Thinking And Clinical
Application Questions 601
A CLOSER LOOK Contraception: Preventing
Pregnancy 592
SYSTEMS IN SYNC 594
Appendixes
Appendix A: Answers to Did You Get It?
Questions and Multiple Choice Review Questions 603
Appendix B: Word Roots, Prefixes, and Suffixes 610
Appendix C: Periodic Table of the Elements 612
Appendix D: Key Information about Vitamins and
Many Essential Minerals 613
Glossary 617
Credits 630
Index 631