TheHumanBodyinHealthandIllness

SIXTHEDITION

BarbaraHerlihy,BSN,MA,PhD(Physiology),RNProfessorofBiology,UniversityoftheIncarnateWord,SchoolofMathematics,Science,andEngineering,SanAntonio,Texas

TableofContents

Coverimage

Titlepage

Copyright

Dedication

Acknowledgments

TotheInstructor

TotheStudent

Chapter1.IntroductiontotheHumanBody

AnatomyandPhysiology:WhatTheyAre

WhyDoINeedtoKnowThis?

TheBody’sLevelsofOrganization

MajorOrganSystems

Homeostasis:StayingtheSame

AnatomicalTerms:TalkingAbouttheBody

AnatomicalPosition

RelativePositions

PlanesoftheBody

RegionalTerms

CavitiesoftheBody

DorsalCavity

VentralCavity

Chapter2.BasicChemistry

Matter,Elements,andAtoms

Elements

Atoms

ChemicalBonds

IonicBonds

CovalentBonds

HydrogenBonds

Polarity

Ions

IonFormation

Ionization

MoleculesandCompounds

Compounds

SomeImportantCompoundsandMolecules

ChemicalReactions

AcidsandBases

Acids

Bases

NeutralizationofAcidsandBases

Measurement:ThepHScale

Energy

FormsofEnergy

ConversionofEnergy

EnergyTransfer:TheRoleofAdenosineTriphosphate

Mixtures,Solutions,Suspensions,andPrecipitates

Mixtures

Solutions

Suspensions

Precipitates

Chapter3.Cells

TypicalCell

CellMembrane

InsidetheCell

OntheCellMembrane

MovementAcrosstheCellMembrane

PassiveTransportMechanisms

ActiveTransportMechanisms

CellDivision

CellCycle

CellDifferentiation

StemCells

Order,Disorder,andDeath

Chapter4.CellMetabolism

Metabolism

Carbohydrates

Monosaccharides

Disaccharides

Polysaccharides

UsesofGlucose

TheBreakdownofGlucose

TheMakingofGlucose

Lipids(Fats)

UsesofLipids

Proteins

AminoAcids

UsesofProteins

ProteinSynthesisandDNA

DNAStructure

StepsinProteinSynthesis

Chapter5.MicrobiologyBasics

WhatIsDisease?

TypesofPathogens

Microorganisms(Microbes)

Other(Multicellular)Disease-CausingOrganisms

LaboratoryIdentificationofPathogens

TheSpreadofInfection

PortalsofEntryandExit

FiveGerm-LadenStories

Dr.SemmelweisScreams,“WashThoseMitts!”

FloraandHerVaginalItch

Rick,Nick,andtheSickTick

WhyTyphoidMaryNeededtoLoseHerGallbladder

APoxNewsAlert!

Chapter6.TissuesandMembranes

EpithelialTissue

WhatDoesItDo?

WhatIsItLike?

Classification

SimpleEpithelia

StratifiedEpithelia

GlandularEpithelia

ConnectiveTissue

WhatDoesItLookLike?

TypesofConnectiveTissue

NervousTissue

Neurons

MuscleTissue

SkeletalMuscle

SmoothMuscle

CardiacMuscle

TissueRepair

Membranes

Chapter7.IntegumentarySystemandBodyTemperature

FunctionsoftheIntegumentarySystem

StructureoftheSkin

LayersoftheSkin

SkinColor

AccessoryStructuresoftheSkin

Hair

Nails

Glands

BodyTemperature

HeatProduction

HeatLoss

Regulation

WhenSkinIsBurned

ANoteAboutSkinCare

Chapter8.SkeletalSystem

ArrangementandFunctionsofBones

TheSkeletalSystem:WhatItDoes

ManySizesandShapesofBones

BoneTissueandBoneFormation

CompactandSpongyBone

LongBones

Ossification

GrowingBones

DivisionsoftheSkeletalSystem

AxialSkeleton

AppendicularSkeleton

Joints(Articulations)

JointClassification

NamingJoints

MovingSynovialJoints

Clinically“Big”SynovialJoints

Chapter9.MuscularSystem

TypesandFunctionsofMuscles

SkeletalMuscle

SmoothMuscle

CardiacMuscle

StructureoftheWholeMuscle

LayersofConnectiveTissue

MuscleAttachments

StructureandFunctionofaSingleMuscleFiber

HowMusclesContract

TheRoleofCalciumandAdenosineTriphosphate

SkeletalMusclesandNerves

TheMotorUnit

TheNeuromuscularJunction

MuscleResponses

EnergySourceforMuscleContraction

MuscleFatigue

MuscleTerms

PrimeMover,Synergist,andAntagonist

MuscleOveruseandUnderuseTerms

HowSkeletalMusclesareNamed

Size

Shape

OrientationofFibers

Location

NumberofOrigins

OriginandInsertion

MuscleAction

MusclesFromHeadtoToe

MusclesoftheHead

MusclesoftheNeck

MusclesoftheTrunk

MusclesoftheShoulder(Pectoral)GirdleandArm

MusclesThatMovetheForearm

MusclesThatMovetheWrist,Hand,andFingers

MusclesThatMovetheThigh,Leg,andFoot

MusclesThatMovetheLeg

MusclesThatMovetheFoot

Chapter10.NervousSystem:NervousTissueandBrain

TheNervousSystem:StructureandFunction

DivisionsoftheNervousSystem

FunctionsoftheNervousSystem

CellsThatMakeUptheNervousSystem

Neuroglia

Neuron

WhiteMatterVersusGrayMatter

TheNeuronCarryingInformation

TheNerveImpulse:WhatItIs

TheNerveImpulse:WhatCausesIt

TheNerveImpulse:WhatCausesIttoMove

TheNerveImpulse:WhatCausesIttoMoveQuickly

SynapseAcrossNeurons

PartsofaSynapse

EventsattheSynapse

Brain:StructureandFunction

Cerebrum

Diencephalon

BrainStem

Cerebellum

StructuresAcrossDivisionsoftheBrain

ProtectingtheCentralNervousSystem

Bone:FirstLayerofProtection

Meninges:SecondLayerofProtection

CerebrospinalFluid:ThirdLayerofProtection

Blood–BrainBarrier:FourthLayerofProtection

Chapter11.NervousSystem:SpinalCordandPeripheralNerves

WhattheSpinalCordIs

GrayontheInside,WhiteontheOutside

WhattheSpinalCordDoes

Reflexes

TheReflexArc

Many,ManyReflexes

PeripheralNervousSystem

Nerves

ClassifyingthePeripheralNervousSystem

SpinalNervesAttachedtotheSpinalCord

Chapter12.AutonomicNervousSystem

Autonomic(Visceral)Reflexes

Pathway

OrganizationandFunctionoftheAutonomicNervousSystem

AutonomicToneandVasomotorTone

AutonomicNervousSystemNeurons

NeuronsoftheSympatheticNervousSystem

NeuronsoftheParasympatheticNervousSystem

NamingFibersandNeurotransmitters

Neurotransmitters:TerminationofActivity

ReceptorsoftheAutonomicNervousSystem

CholinergicReceptors

AdrenergicReceptors

AutonomicTerminology:“Doing”AutonomicPharmacology

Chapter13.SensorySystem

ReceptorsandSensation

SensationandPerception

ExperiencingaSensation

TheGeneralSenses

Pain

TouchandPressure

Temperature

Proprioception

TheSpecialSenses

SenseofSmell:TheNose

SenseofTaste:TheTongue

SenseofSight:TheEye

SenseofHearing:TheEar

SenseofBalance:TheEar

Chapter14.EndocrineSystem

EndocrineGlands

ClassificationofHormones

Targets

HormoneReceptors

ControlofHormoneSecretion

PituitaryGlandandtheHypothalamus

AnteriorPituitaryGland

PosteriorPituitaryGland

ThyroidGland

ThyroidFollicle

WhatThyroidHormones(T3andT4)Do

RegulationofSecretion

TheNeedforIodine

Calcitonin

ParathyroidGlands

PTHDeficiencyandHypocalcemicTetany

AdrenalGlands

AdrenalMedulla

AdrenalCortex

Pancreas

Insulin

Glucagon

Gonads

ThymusGland

PinealGland

OtherHormones

Prostaglandins

AdiposeTissueHormones

Chapter15.Blood

WhatBloodDoes

CompositionofBlood

BloodHasTwoParts

OriginofBloodCells

BoneMarrowWoes:TooLittle,TooMuch

BloodCells

WhiteBloodCells

Platelets

BloodCounts

Hemostasis:PreventionofBloodLoss

BloodVesselSpasm

FormationofaPlateletPlug

BloodCoagulation

BloodTypes

AntigensandBloodTypes

AntibodiesandBloodType

Antigen–AntibodyInteraction

CompatibilityandIncompatibilityofBloodTypes

RhClassificationSystem

Chapter16.AnatomyoftheHeart

Function,Location,andSizeoftheHeart

LayersandCoveringoftheHeart

Endocardium

Myocardium

Epicardium

Pericardium

ADoublePumpandTwoCirculations

TheHeart’sChambersandGreatVessels

RightAtrium

RightVentricle

LeftAtrium

LeftVentricle

GreatVesselsoftheHeart

HeartValves

AtrioventricularValves

SemilunarValves

HeartSounds

PathwayofBloodFlowThroughtheHeart

BloodSupplytotheMyocardium

IschemiaandInfarction

CardiacEnzymesandLeakyCells

CardiacConductionSystem

PartsoftheCardiacConductionSystem

AutomaticityandRhythmicity

Electrocardiogram

Chapter17.FunctionoftheHeart

TheCoordinatedandAdaptablePump

AutonomicControloftheHeart

HeartTalk

HeartTalk:ReceptorLanguage

TheFailingHeart:WhentheHeartCan’tPump

LeftHeartFailure

RightHeartFailure

Chapter18.AnatomyoftheBloodVesselsandSpecialCirculations

Circles,Circuits,andCirculations

BloodVessels

BloodVesselWalls:TheLayeredLook

BloodVessels:WhatTheyDo

MajorArteriesoftheSystemicCirculation

Aorta

BranchesoftheAorta

MajorVeinsoftheSystemicCirculation

VenaeCavae

SpecialCirculations

BloodSupplytotheHeadandBrain

BloodSupplytotheLiverandtheHepaticPortalCirculation

FetalCirculation

Pulse

WhatCanYouLearnAboutaPatientbyFeelingthePulse?

Chapter19.FunctionsoftheBloodVessels

BloodVesselsDeliver

BloodVesselsRegulateBloodPressure

BloodPressureinDifferentBloodVessels

WhatDeterminesBloodPressure?

HowBloodPressureStaysWithinNormalLimits

BloodVesselsActasExchangeVessels

WhatIsanExchangeVessel?

WhyCapillariesAreGoodExchangeVessels

CapillaryForces:Exchange

BloodVesselsDistributeBlood

BloodVesselsRegulateBodyTemperature

Chapter20.LymphaticSystem

LymphandLymphaticCirculation

LymphaticVessels

WhatCausesLymphtoMove?

LymphaticTissue

LymphaticOrgans

LymphNodes

ThymusGland

Spleen

LymphaticNodules

Chapter21.ImmuneSystem

ClassificationoftheImmuneSystem

NonspecificImmunity

SpecificImmunity:ThirdLineofDefense

TypesofImmunity

GeneticImmunity

AcquiredImmunity

OtherImmuneResponses

AllergicReactions

Chapter22.RespiratorySystem

Structure:OrgansoftheRespiratorySystem

NoseandNasalCavities

Pharynx

Larynx

Trachea

BronchialTree:Bronchi,Bronchioles,andAlveoli

Lungs

PleuralMembranes

CollapsedandExpandedLungs

WhyLungsCollapse

WhyLungsExpand

SayingItAnotherWay:Compliance

RespiratoryFunction

AmountsofAir

ControlofBreathing

Chapter23.DigestiveSystem

OverviewoftheDigestiveSystem

DigestionandAbsorption

LayersandMembranesoftheDigestiveTract

StructuresandOrgans

Pharynx

Esophagus

Stomach

SmallIntestine

LargeIntestine

AccessoryDigestiveOrgans

Liver

Gallbladder

Pancreas

DigestionandAbsorption

CarbohydratesandCarbohydrate-SplittingEnzymes

ProteinsandProtein-SplittingEnzymes

Fats,Bile,andFat-SplittingEnzymes

Nutrition:ConceptstoKnow

Carbohydrates

Proteins

Fats(Lipids)

Vitamins

Minerals

HealthandaBalancedDiet

Chapter24.UrinarySystem

Excretion

UrinarySystemOrgans

UrinarySystemTerms

Kidneys

Structure

BloodSupply

NerveSupply

FunctionsoftheKidneys

UrineMaking:TheNephronUnit

UrineFormation

HormonesThatWorkontheKidneys

Aldosterone

AntidiureticHormone

NatriureticPeptides

ParathyroidHormoneandCalcitonin

CompositionofUrine

UremiaandDialysis

YourPlumbing

Ureters

UrinaryBladder

Urination

Urethra

AnAutonomicMoment

Chapter25.Water,Electrolyte,andAcid–BaseBalance

BodyFluids:DistributionandComposition

CompositionofBodyFluids

WaterBalance

WaterIntake

WaterOutput

WaterImbalances

WhyDoesFluidShift?

FluidSpacing—inOtherWords

ElectrolyteBalance

QuickReference:Electrolytes

MostImportantIons

Acid–BaseBalance

QuickReference:AcidsandBases

WheretheAcidComesFrom

HowtheBodyRegulatespH

Buffers

Lungs

RespiratoryActivityastheCauseofChangesinpH

RespiratoryActivityastheCorrectionforChangesinpH

Acid–BaseImbalances

Acidosis

Alkalosis

Chapter26.ReproductiveSystems

MaleReproductiveSystem

Testes

GenitalDucts

AccessoryGlands

Semen

ExternalGenitals

MaleSexualResponse:Erection,Emission,Ejaculation,andOrgasm

MaleSexHormones

FemaleReproductiveSystem

Ovaries

GenitalTract

ExternalGenitals

FemaleSexualResponse

HormonalControloftheReproductiveCycles

TwoReproductiveCycles

FemaleBreastandLactation

MethodsofBirthControl

Chapter27.HumanDevelopmentandHeredity

Fertilization

WhenFertilizationOccurs

WhereFertilizationOccurs

HowFertilizationOccurs

HumanDevelopment

PrenatalDevelopment

EarlyEmbryonicPeriod

EmbryonicPeriod

FetalPeriod

ChangesintheMother’sBodyDuringPregnancy

Birth

PostnatalChangesandDevelopmentalStages

DevelopmentasaLifelongProcess

Heredity

DNA,Genes,andChromosomes

It’saBoy;It’saGirl:HowtheSexoftheChildIsDetermined

CongenitalandHereditaryDisease

AnswerstoReviewYourKnowledgeandGoFigureQuestions

Glossary

Index

Copyright

3251RiverportLaneSt.Louis,Missouri63043

THEHUMANBODYINHEALTHANDILLNESS,SIXTH

EDITION ISBN:978-0-323-49844-9Copyright©2018,ElsevierInc.Previouseditionscopyrighted2014,2011,2007,2003,2000

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Names:Herlihy,BarbaraL.,author.Title:Thehumanbodyinhealthandillness/BarbaraHerlihy.Description:Sixthedition.|St.Louis,Missouri:Elsevier,[2018]|Includesbibliographicalreferencesandindex.Identifiers:LCCN2017031809|ISBN9780323498449(paperback:alk.paper)Subjects:|MESH:PhysiologicalPhenomena|PathologicProcesses|HealthClassification:LCCQP34.5|NLMQT104|DDC612--dc23LCrecordavailableathttps://lccn.loc.gov/2017031809

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Dedication

Toallwholivecompassionately,seeingthedivineineachother,ourfurfriends,andMotherEarth.Weareallconnectedinlife.

Love,

Barbara

Acknowledgments

Thepublishingandrepublishingofananatomyandphysiologytextrequirethecombinedeffortsofvariouspersonswithdiversetalents.IhavebeenblessedtoworkwithmanygenerousandtalentedindividualsatElsevierandoffermygratefulthanks,especiallytoElizabethKilgore,KellieWhite,andAnneKonopka.Liz,yourpatience,kindness,organizationalskills,andmotivational“encouragements”aremuchappreciated.

ManythanksalsotomystudentsandfriendsattheUniversityoftheIncarnateWord.Theyhavegraciouslysupportedmethroughallsixeditions.AspecialthankstoDr.BonnieMcCormick,thewisestandkindestof“bosses”attheUniversityoftheIncarnateWord.Thankstomyhusband,Jerry;hehascontributedmuchtothistextbyconstructingtables,proofreading,andofferingmanyhelpfulhints;he,too,isaphysiologist.ThankstomydaughterKellie,aclinicalnursespecialist,whoproofread,rewrote,andphotocopiedinthemidstofbeingamomtothreeadorabletoddlers.Whew!Thankstomychildren,grandchildren,andracquetballbuddiesfortheirinsistenceonleisureandplay;theyareinchargeofmymentalhealth.Ihighlyrecommend“grannyhood”;itisbeyondjoyandgetsbetter!

ThankstomyfurbabiesAnnieandLucy(woofandwoof)andMinky(purr)forthehourstheyhoveredaroundmeandmylaptop.Asusual,aspecialacknowledgmenttomybeloveddachshund,Pretzyl,wholaboredsohardonthefirsttwoeditions.Fourotherfurryhelpers—Julia,Kenner,Cajun,andZeke—aremissedbutcertainlynotforgotten.Awell-fedferalcatpopulationhasbeenadded,andwiththecompletionofthisedition,Iwillrewardmyselfwitha“rescue”dachshund…ortwo.Toallofyouwhohumormeaboutmypetcollectionanddevotion,many,manythanksforunderstanding.

Lastbutcertainlynotleast,manythankstothosewhousedpreviouseditionsandwerekindenoughtoforwardcommentsandsuggestions.Yourassistanceissoappreciated.Keepthecommentscoming!

TotheInstructor

Heresheis…thesixtheditionofTheHumanBodyinHealthandIllness…older,wiser,stillsmilingandeagertowalkwithyouonyourjourneyintothehealthprofessions.It’sanexcitingjourneyforall,andwewishyouallthebest.

TheHumanBodyinHealthandIllnesstellsthestoryofthehumanbodywithallitspartsandthewaythesepartsworktogether.Itisastorythatwehavetoldmanytimesinourclasses.Itisalsoastorythatgetsbetterwitheachtellingasthebodycontinuestorevealitsmysteriesandhowmarvelouslyithasbeencreated.IhopethatyouenjoytellingthestoryasmuchasIdo.

TheHumanBodyinHealthandIllnessisabasicanatomyandphysiologytextaddressedtothestudentpreparingforacareerinthehealthprofessions.Itiswrittenforstudentswithminimalpreparationinthesciences;nopriorknowledgeofbiology,chemistry,orphysicsisrequired.Thetextprovidesallthebackgroundscienceinformationneededforanunderstandingofanatomyandphysiology.

ThebasicprinciplesofchemistryandbiochemistryarepresentedinChapters2and4,andtheysetthestageforanunderstandingofcellularfunction,fluidandelectrolytebalance,endocrinefunction,anddigestion.Chapter5,MicrobiologyBasics,presentsclinicallyrelevantmicrobiologicaltopics.Checkoutthestories“Rick,Nick,andtheSickTick”and“Dr.SemmelweisScreams:‘WashThoseMitts!’”Thelatterisanamusingpresentationofasadtaleinthehistoryofmedicineandcorrespondstothecurrentemphasisonhandhygieneandhealthcare–associatedinfection.

Theanatomyandphysiologycontentispresentedinatraditionalorder,fromsimpletocomplex.Thetextbeginswithadescriptionofasinglecellandprogressesthroughthevariousorgansystems.Therearetwokeythemesthatrunthroughoutthetext:(1)therelationshipbetweenstructureandfunction—thestudentmustunderstandthatanorganisanatomicallydesignedtoperformaspecificphysiologicalfunction,and(2)homeostasis—therolethateachorgansystemplaysinsustaininglifeandwhathappenswhenthatdelicatebalanceisdisturbed.

Thetextaddressestwoconcernsabouttheselectionofcontent.Thefirsthastodowiththeamountofcontent.Thefieldofanatomyandphysiologyishuge;thereforetheremustbeaselectionofcontentthatcanbemasteredintheshortperiodoftimethatasemester(oreventwo)allows.Thistextfocusesonthephysiologythatisbasicandmostclinicallyrelevant.Pathophysiologyisintroducedprimarilytoclarifyphysiologicalfunction.Forinstance,thedifferenttypesofanemiasillustratethevariousstepsinthemakingoftheredbloodcell.Asecondconcernhastodowiththerecognitionthatwearenotpreparingphysiologists;instead,wewantthestudenttobeabletousethephysiologytounderstandclinicallyrelevantcontentsuchaspathophysiology,physicalassessment,diagnostics,andpharmacology.Anunderstandingofphysiologyiscrucialforadvancementinthemedicallyrelatedsciences.

TextbookStrengths•Anatomyandphysiologyareclearlyandsimplyexplained.Ameticulouslypreparedsetofillustrations—completewithamusingcartoons—supportsthetext.Infact,thestoryofthebodyistoldasmuchthroughtheartasthroughthewrittenword.

•Thetexttrulyintegratespathophysiology;itisnotmerelyboxedinortackedonattheend.Theintegratedpathophysiologyisusedprimarilytoamplifythenormalanatomyandphysiology.TheexpandedMedicalTerminologyandDisorderstablesandfrequentreferencestocommonmedicalterminologyallowthetexttobeusedforanintroductorycourseinpathophysiologyandmedicalterminology.

•Inadditiontothepathophysiology,othertopicsareliberallyintegratedthroughoutthetext.Theseincludecommondiagnosticproceduressuchasbloodcount,lumbarpuncture,urinalysis,andelectrocardiography.Pharmacologicaltopicsarealsointroducedand,likethepathophysiology,areusedtoamplifythenormalanatomyandphysiology.Forinstance,thediscussionoftheneuromuscularjunctionisenhancedbyadescriptionoftheeffectsoftheneuromuscularblockingagents.Becauseoftheeffortofthetexttomakeclinicalcorrelations,itsetsthestageforthemoreadvancedhealthsciencecourses,includingpharmacologyandmedical-surgicalnursing.

•Re-Thinkboxesareliberallydistributedthroughouteachchapterandencouragestudentstomasterthatcontentbeforeprogressingthroughthechapter.RampItUp!boxesdevelopselectedclinicallyrelevanttopicsthataresimplytooadvancedtobeincludedinthetextasbasicinformation.Theseboxedfeaturescontainneworadvancedcontentcommonlyusedintheclinicalsettingandallowinstructorstoscaletheircoverageinamannerappropriatetothecourse.Theyofferstudentsthechancetomakefurtherconnectionsbetweenthetextandtheirfuturecareers.(SeetheTotheStudentprefaceonpageixfordescriptionsandexamplesofeachofthechapterfeatures.)

•Medicalterminologyisintroduced,defined,andusedthroughoutthetext.Commonclinicaltermssuchashyperkalemia,vasodilation,hypertension,anddiagnosisaredefinedandreusedsothatthestudentgraduallybuildsupasubstantialmedicalvocabulary.TheexpandedMedicalTerminologyandDisorderstablesweredeliberatelyconstructedtomaximizetheuseof

commonmedicaltermsanddisorders.Tohelpfosterabroaderunderstandingofmedicalterminology,wordpartsandtheirmeaningsareincludedfornearlyeverytermpresented.Repetitionofthesehelpsstudentsgaingreatergroundinunderstandingtheveryspecificmedicallanguagetheywillbelearningtouseforafutureinthehealthprofessions.Adescriptionisalsoprovided,whichgivesthedefinitionorotherpertinentinformationonthetopic.

•TheReviewYourKnowledgesectionhasbeenexpandedtoincludequestionsthatrequireananalyticalresponse.TheGoFigurequestionsarebasedonthestorytoldbytheartwork.Thequestionscanonlybeansweredbyanalyzingtheartand/ortheinformationpresentedinthetables.Thisexerciseencouragesthestudenttoseebeyondthe“prettypictures”andrealizethatapictureistrulyworthathousandwords.Iwouldencourageyoutoassistyourstudentstoseethattheartandthetextareconveyingthesamemessage.

•Thetextissupportedbymanyactivities,exercises,puzzles,andgames(e.g.,BodyBingo)onEvolve(http://evolve.elsevier.com/Herlihy).Theseactivitiesemphasizethefocusofthistext—clinicallyrelevantanatomyandphysiology.

•Last,thetextincorporatesmanyamusinganecdotesfromthehistoryofmedicine.Althoughthehumanbodyisperfectlylogicalandpredictable,wehumansthink,do,andsaysomestrangethings.Talesfromthemedicalcryptprovidesomegoodlaughsandmuchhumility.

ClassroomResourcesMaterialsfromtheStudyGuideandEvolveInstructorLearningResourcescanbeusedto:

1.Remediatestudentswhoarehavingdifficultyingraspingthecontent.2.Remediatestudentswhohavemissedclass(es).3.Providereviewforstudentsengagedinpathophysiologyandpharmacologywhosememoriesneedtoberefreshedinthephysiology.

StudyGuideTheStudyGuideforTheHumanBodyinHealthandIllnessofferssomethingforstudentsatalllevelsoflearningandisaready-maderesourceforinstructorslookingforhomeworkassignments.Eachchapterincludestwoparts:PartI,MasteringtheBasics,withmatching,labeling,andcoloringexercises;andPartII,PuttingItAllTogether,containingmultiple-choicequestions,casestudies,andwordpuzzles.Textbookpagereferencesareincludedwiththequestions,andtheanswerkeyisavailableontheEvolvewebsite,onlytoinstructors.

EvolveInstructorLearningResourcesTheEvolvewebsiteforTheHumanBodyinHealthandIllness(http://evolve.elsevier.com/Herlihy)includesalloftheStudentResources,aswellasthefollowingInstructorResources:

•AnswerKeyfortheStudyGuide,AudienceResponseSystemquestions,ImageCollection,andExamViewTestBanksthatincludeover2300questions!

•Instructor’sChapterExams,ClassroomActivities—includingBingo,Line‘EmUp,Sorting,andWordPuzzles—andtheTEACHInstructorResource.

TEACHInstructorResourceonEvolveInstructorswhoadoptthetextbookwillalsoreceiveaccesstotheTEACHInstructorResource,whichlinksallpartsoftheHerlihyeducationalpackagewithcustomizableLessonPlansbasedonobjectivesdrawnfromthetext.TheTEACHLessonPlansarebasedonthechapter-by-chapterorganizationofTheHumanBodyinHealthandIllnessandcanbemodifiedorcombinedtomeet

yourcurriculum’sschedulingandteachingneeds.

TEACHhasbeencompletelyupdatedandrevisedforthisedition.TheTEACHLessonPlanshelpinstructorsprepareforclassandmakefulluseofthericharrayofancillariesandresourcesthatcomewiththetextbook.Thecontentcoveredineachtextbookchapterisdividedacrossoneormorelessonplans,eachdesignedtooccupy50minutesofclasstime.Lessonplansareorganizedintoeasilyunderstandablesectionsthatareeachtiedtothechapterlearningobjectives:

•InstructorPreparationThissectionprovidesachecklistofallthethingsyouneedtodotoprepareforclass,includingalistofalltheitemsyouneedtobringtoclasstoperformanyactivityordemonstrationincludedinthelessonplan.

•StudentPreparationTextbookreadings,studyguideexercises,onlineactivities,andotherapplicablehomeworkassignmentsforeachlessonareprovidedhere,alongwithanoverallestimatedcompletiontime.

•The50-MinuteLessonPlanAlectureoutlinethatreflectsthechapterlectureslidesthatcomeaspartofTEACHisincluded,aswellasclassroomactivitiesandonlineactivities,oneormorecriticalthinkingquestions,andtimeestimatesfortheclassroomlectureandactivities.

•AssessmentPlanToensurethatyourstudentshavemasteredalltheobjectives,theTEACHInstructorResourceincludesaseparateAssessmentPlansection.Aneasy-to-usetablemapseachassessmenttooltothelessonplansandchapterobjectivessothatyoucanseeallyourassessmentoptions—bychapter,bylesson,andbyobjective—andchooseaccordingly.

TotheStudent

Thisbookwilltakeyouonanamazingjourneythroughthehumanbody.Youwilllearnmanybodypartsand,moreimportantly,howtheyworkinanintegratedmannertokeepyougoing.Youwillusethisinformationinyourclinicalpracticewhenpatientsbecomeillwithdisordersofthosestructures.Thefollowingspecialfeatureswerecreatedtohelpmakelearningenjoyableandfun.

TextbookFeaturesKeyTermsKeytermsarelistedatthebeginningofeachchapter,alongwithapagereference.Eachis(1)presentedinthetextinblueprint,(2)accompaniedbyapronunciationguide,(3)thoroughlyexplainedwithinthechapter,and(4)definedintheglossary.

ObjectivesNumberedobjectivesidentifythegoalsforeachchapter.

IllustrationsOriginalillustrationsandfull-colorcartoonshelpyoumakesenseofanatomyandphysiologyusinghumor,clarity,andinsight.

DoYouKnow…Mostoftheseboxedvignettesrefertoclinicalsituations;othersrelatetointerestingandamusinghistoricaleventsrelatedtoanatomyandphysiology.

RampItUp!Thesefeatureschallengeyouwithmoreadvancedanatomyandphysiologytopics.

Re-ThinkThesequestionsareliberallyplacedthroughoutthechaptertohelpreinforceimportantconcepts.

AsYouAgeTheseboxedfeaturescontainnumberedlistsdescribinghowtheagingprocessaffectshumananatomyandphysiology.

SumItUp!Thesefeaturesappearregularlythroughoutthechaptersandhelpyousynthesizekeyconcepts.

MedicalTerminologyandDisordersTablesThesetablesdescribemedicaltermsandspecificdisordersrelatedtoindividualbodysystems,withafocusondevelopingastrongworkingmedicalvocabulary,whichisnecessaryforacareerinthehealthprofessions.

End-of-ChapterFeaturesSummaryOutlineAdetailedoutlineattheendofeachchaptersummarizeskeyconceptsandservesasanexcellentreviewofthechaptercontent.Useitasastudytooltoreviewyourreadingandprepareforexams.

ReviewYourKnowledgeThematchingandmultiple-choicequestionsinthissectioncoverthemajorpointsofthechapterandallowyoutotestyourcomprehension.

GoFigureThisreviewsectionasksyoutointerpretthefiguresinthechapterandreinforcestheimportanceoftheconceptspresented.

AnswerstoReviewYourKnowledgeandGoFigureQuestionsTheAppendixcontainsanswerstoallReviewYourKnowledgeandGoFigurequestionsfoundinthetextbook.

GlossaryTheglossaryincludesapronunciationguideandabriefdefinitionofallkeytermsandmanyotherwordsinthetext.

StudyGuideEnhanceyourlearningofthetextbookcontentwiththeaccompanyingStudyGuideforTheHumanBodyinHealthandIllness.TheStudyGuidehassomethingtoofferstudentsatalllevelsoflearning,fromlabelingandcoloringexercisestomultiple-choicepracticetestsandcasestudies.

CHAPTER1

IntroductiontotheHumanBody

OBJECTIVES

1.Definethetermsanatomyandphysiology.2.Listthelevelsoforganizationofthehumanbody.3.Describethe12majororgansystems.4.Definehomeostasis.5.Describetheanatomicalposition.6.Listcommontermsusedforrelativepositionsofthebody.7.Describethethreemajorplanesofthebody.8.Listanatomicaltermsforquadrantsandregionsofthebody.9.Describethemajorcavitiesofthebody.

KEYTERMS

abdominopelviccavity(p.10)anatomicalposition(p.6)anatomy(p.1)cranialcavity(p.10)dorsalcavity(p.9)frontalplane(p.7)homeostasis(p.6)mediastinum(p.10)organs(p.2)

pericardialcavity(p.10)physiology(p.1)pleuralcavities(p.10)quadrants(p.10)sagittalplane(p.7)spinal(vertebral)cavity(p.10)thoraciccavity(p.10)transverseplane(p.7)ventralcavity(p.9)viscera(p.9)http://evolve.elsevier.com/HerlihyThehumanbodyisawonderfulcreation.Millionsofmicroscopicpartsworktogetherinacoordinatedfashiontokeepyougoingforabout75years.Mostofusarecuriousaboutourbodies—howtheywork,whytheydonotwork,whatmakesustick,andwhatmakesussick.Asyoulearnmoreaboutthebody,youwillsometimesfeellikethiscartooncharacter:“Whatisthis?WhydoIneedit?Howdoesitwork?Whydon’tIhaveone?”Asyoustudyanatomyandphysiology,youwilllearntheanswerstothesequestions.

AnatomyandPhysiology:WhatTheyAreWhat’sItMean?Anatomy(ah-NAT-o-mee)isthebranchofsciencethatstudiesthestructureofthebody.Forexample,anatomydescribeswhattheheartlookslike,howbigitis,whatitismadeof,howitisorganized,andwhereitislocated.ThewordanatomycomesfromtheGreekwordmeaningtodissect.Thescienceofanatomyarosefromobservationsmadebyscientistscenturiesagoastheydissectedbodiesthatwereusuallystolenfromthelocalgraveyard.Physiology(fiz-ee-OL-o-jee)isthebranchofsciencethatdescribeshowthe

bodyfunctions.Forexample,physiologydescribeshowtheheartpumpsbloodandwhythepumpingofbloodisessentialforlife.Pathophysiology(path-o-fiz-ee-OL-o-jee)isthebranchofsciencethatdescribestheconsequencesoftheimproperfunctioningofthebody—thatis,howabodypartfunctionswhenapersonhasadisease.Pathophysiologydescribeswhathappensduringaheartattackandwhentheheartfunctionspoorlyornotatall.

FIG.1.1 Structureandfunctionarecloselyrelated.

WhyDoINeedtoKnowThis?Whystudyanatomyandphysiologyaspartofyourprofessionalcurriculum?Unlessyougainagoodunderstandingofnormalanatomyandphysiology,youcannotunderstandthediseasesanddisordersexperiencedbyyourpatients,norcanyouunderstandthebasisforthevariousformsoftreatment,suchasdrugtherapyandsurgicalprocedures.Youwanttogiveyourpatientsthebestpossiblecare,soyoumusthaveasoundunderstandingofthehumanbody.Anatomyandphysiologyarecloselyrelated.Structureandfunctiongo

together.Whenyouexaminetheanatomyofabodypart,askyourselfhowitsstructurerelatestoitsfunction.Forexample,thestructureofthehandisrelatedtoitsfunction:itsabilitytograspanobject(Fig.1.1).Theheartpumpsblood,andthelong,strong,flexibletailofthemonkeyallowsittohangfromthetree.Structureandfunctionarerelated.

Re-Think

1.Whatisthedifferencebetweenanatomyandphysiology?2.Usinganyhouseholditem,explainwhatismeantby“structureandfunctionarerelated.”

DoYouKnow...WhyThisGraveIsBeingRobbed,andWhytheGraveRobberIsinBig,BigTrouble?Dissectionofthehumanbodyduringmedievaltimeswasnotallowed.Thus,theonlywaythatearlyanatomistswereabletoobtainhumanbodiesfordissectionwastorobgraves.Medievalscientistshiredpeopletorobgraves.Punishmentforrobbinggraveswasswiftandsevere.Thisladwillbeinbig,bigtroubleifheiscaught,anditlooksasifhewillbe.Surprisingly,graverobbingwascommonearlyinthiscenturyandinthiscountry.Manyamedicalstudentwhoenrolledinthemostprestigiousmedicalschoolshadto“get”hisowncadaver.

TheBody’sLevelsofOrganizationThebodyisorganizedfromtheverysimpletothecomplex,fromthemicroscopicatomtothecomplexhumanorganism.NotetheprogressionfromsimpletocomplexinFig.1.2.Tinyatomsformmolecules.These,inturn,formlargermolecules.Thelargermoleculesareeventuallyorganizedintocells,thebasicunitoflife.Specializedgroupsofcellsformtissues.Tissuesarethenarrangedintoorgans,suchastheheart,stomach,andkidney.Groupsoforgans,inturn,createorgansystems.Eachorgansystemhasafunction,suchasdigestion,excretion,orreproduction.Alltheorgansystemstogetherformthehumanorganism.Fromsimpletocomplex,thebodyisbuiltfromthetinyatomtothehumanbeing.

MajorOrganSystemsTwelvemajororgansystemsmakeupthehumanbody.Eachperformsspecificfunctionsthatenablethehumanbodytooperateasacoordinatedwhole.RefertoFig.1.3andidentifythelocationanddistributionoftheorgansofeachsystem.•Theintegumentary(in-teg-yoo-MEN-tar-ee)systemconsistsoftheskinandrelatedstructures,suchashairandnails.Theintegumentarysystemformsacoveringforthebody,helpsregulatebodytemperature,andcontainssomeofthestructuresnecessaryforsensation.

FIG.1.2 Levelsoforganization,fromatomstohumanorganism.

•Theskeletalsystemformsthebasicframeworkofthebody.Itconsistsprimarilyofbones,joints,andcartilage.Theskeletonprotectsandsupportsbodyorgansandenablesustomovearound.

•Themuscularsystemhasthreetypesofmuscles.Skeletalmusclesattachtothebonesandareresponsibleformovementoftheskeletonandthemaintenance

ofbodyposture.Smoothandcardiacmusclesarefoundinvariousorgansandtubes;contractionandrelaxationofthesemuscleshelptheorgansystemscarryouttheirfunctions.

•Thenervoussystemismadeupofthebrain,spinalcord,nerves,andsenseorgans.Sensorynervesreceiveinformationfromtheenvironmentandbringittothespinalcordandbrain,whereitisinterpreted.Decisionsmadebythebrainandspinalcordaretransmittedalongmotornervestovariousbodystructures.

•Theendocrine(EN-doh-krin)systemcontainsnumerousglandsthatsecretehormonesandchemicalsubstancesthatregulatebodyactivitiessuchasgrowth,reproduction,metabolism,andwaterbalance.

•Thecirculatory(SER-kyoo-lah-tor-ee)systemconsistsoftheblood,heart,andbloodvessels.Thissystempumps(heart)andtransports(bloodvessels)bloodthroughoutthebody.Bloodcarriesnutrientsandoxygentoallthebody’scellsandalsocarriesthewasteawayfromthecellstotheorgansofexcretion.

•Thelymphatic(lim-FAT-ik)systemismadeupofthelymphnodes,lymphaticvessels,lymph,andotherlymphaticorgans.Lymphandlymphaticstructuresplayanimportantroleinfluidbalanceandinthedefenseofthebodyagainstpathogensandotherforeignmaterial.

•Theimmunesystemisanelaboratedefensesystemthatprotectsthebodynotonlyfrompathogens,butalsofromallergens,suchaspollens,beevenom,andsomeofourowncellsthathavegoneawry(cancercells).Theimmunesystemiswidelydistributedthroughoutthebody(itisnotshowninFig.1.3).

•Therespiratorysystemcontainsthelungsandotherstructuresthatconductairtoandfromthelungs.Oxygen-richairmovesintothelungs;theoxygenispickedupbythebloodanddistributedthroughoutthebody.Carbondioxide–richairmovesoutofthelungs,therebyriddingthebodyofwaste.

•Thedigestivesystemiscomprisedoforgansdesignedtoingestfoodandbreakitdownintosubstancesthatcanbeabsorbedbythebody.Foodthatisnotabsorbediseliminatedaswaste.

•Theurinarysystemcontainsthekidneysandotherstructuresthathelpexcretewasteproductsfromthebodythroughtheurine.Moreimportantly,theurinarysystemhelpscontrolwater,electrolyte,andacid–basebalanceinthebody.

FIG.1.3 Majororgansystemsofthebody.

•Thereproductivesystemismadeupoforgansandstructuresthatenablehumanstoreproduce.

Homeostasis:StayingtheSameHomeostasis(ho-me-o-STAY-sis)literallymeansstaying(stasis)thesame(homeo).Thetermreferstothebody’sabilitytomaintainastableinternalenvironmentinresponsetoachangingenvironment.Forexample,inahealthyperson,bodytemperaturestaysaround98.6°F(37°C),evenwhenroomtemperatureincreasesto100°Fordecreasesto60°F.Theamountofwaterinyourcellsstaysthesamewhetheryoudrink2,3,or4liters(L)ofwaterperday.Yourbloodsugarremainswithinnormallimitswhetheryouhavejusteatenaturkeydinnerorhavefastedfor6hours.Mechanismsthathelpmaintainhomeostasisarecalledhomeostaticmechanisms.Homeostaticimbalanceresultsindiseaseordysfunction.

SumItUp!

Anatomyandphysiologydescribethestructureandfunctionofthebody.Thebodyisconstructedfromsimpletocomplex(atomstomoleculestocellstotissuestoorganstoorgansystemstothehumanorganism).The12majororgansystemsareshowninFig.1.3.Homeostaticmechanismsenablethebodyto“staythesame”despitechanginginternalandexternalenvironments.

AnatomicalTerms:TalkingAbouttheBodySpecialtermsdescribethelocation,position,andregionsofbodyparts.Becausethesetermsareusedfrequently,youshouldbecomefamiliarwiththemnow.Peopleinthemedicalfieldareoftenaccusedofspeakingtheirownlanguage.Indeed,wedo!Wealwaysusethesetermsasifthebodywerestandinginitsanatomicalposition.

AnatomicalPositionInitsanatomicalposition,thebodyisstandingerect,withthefaceforward,thearmsatthesides,andthetoesandpalmsofthehandsdirectedforward(Fig.1.4).

RelativePositionsSpecifictermsdescribethepositionofonebodypartinrelationtoanotherbodypart.Thesearedirectionalterms.Theyarelikethemorefamiliardirectionsofnorth,south,east,andwest;however,whereasdescribingCanadaasbeinglocatednorthoftheUnitedStateswouldbecorrect,describingtheheadas“northofthechest”wouldsoundstrange.Therefore,inlocatingbodyparts,weuseotherterminology.Thetermscomeinpairs.Notethatthetwotermsineachpairaregenerallyopposites.Remember,thereferencesarevalidonlyforthebodyinitsanatomicalposition.

FIG.1.4 Anatomicalposition.

•Superiorandinferior.Superiormeansthatapartisaboveanotherpartorisclosertothehead.Forexample,theheadissuperiortothechest.Inferiormeansthatapartislocatedbelowanotherpartorisclosertothefeet.Thechest,forexample,isinferiortothehead.

•Anteriorandposterior.Anteriormeanstowardthefrontsurface(thebellysurface).Posteriormeanstowardthebacksurface.Forexample,theheartisanteriortothespinalcord,buttheheartisposteriortothebreastbone.Anotherwordforanteriorisventral,andanotherwordforposteriorisdorsal.Considerthedorsalfinofafish.Itisthedorsalpartofthesharkthatcanbeseenmovingeffortlesslyandveryquicklytowardyoursurfboard!

•Medialandlateral.Imaginealinedrawnthroughthemiddleofyourbody,dividingitintorightandlefthalves.Thisisthemidline.Medialmeanstowardthemidlineofthebody.Thenose,forexample,ismedialtotheears.Lateralmeansawayfromthemidlineofthebody.Forexample,theearsarelateraltothenose.Intheanatomicalposition,thehandisclosertothelateralthighthantothemedialthigh.

•Proximalanddistal.Proximalmeansthatthestructureisnearertothepointofattachment,oftenthetrunkofthebody.Becausetheelbowisclosertothepointofattachmentthanisthewrist,theelbowisdescribedasproximaltothewrist.Thewristisproximaltothefingers,meaningthatthewristisclosertothetrunkthanarethefingers.Distalmeansthatapartisfartherawayfromthepointofattachmentthananotherpart.Forexample,thewristisdistaltotheelbow,andthefingersaredistaltothewrist.

FIG.1.5 Planesofthebody.(A)Sagittal.(B)Frontal(coronal).(C)Transverse.

•Superficialanddeep.Superficialmeansthatapartislocatedonornearthesurfaceofthebody.Theskinissuperficialtothemuscles.Deepmeansthatthebodypartisawayfromthesurfaceofthebody.Thebones,forexample,aredeeptotheskin.

•Centralandperipheral.Centralmeansthatthepartislocatedinthecenter.Peripheralmeansawayfromthecenter.Theheart,forexample,islocatedcentrally,whereasthebloodvesselsarelocatedperipherally(awayfromthecenterandextendingtowardthelimbs).Thebrainandspinalcordarecalledthecentralnervoussystem,andthenervesarecalledtheperipheralnervoussystem.

Re-Think

1.Usethetermsproximalanddistaltodescribetherelationshipofthewristtotheelbow.

2.Usethetermsproximalanddistaltodescribetherelationshipofthefingerstothewrist.

3.Usethetermsmedialandlateraltodescribethepartsofthethigh.Dothe

samewiththeeye.

PlanesoftheBodyWhenwerefertotheleftsideofthebody,thetophalfofthebody,orthefrontofthebody,wearereferringtotheplanesofthebody.Eachplanedividesthebodywithanimaginarylineinonedirection.Fig.1.5showsthefollowingthreeimportantplanes:1.Sagittalplane(seeFig.1.5A).Thesagittalplanedividesthebodylengthwiseintorightandleftportions.Ifthecutismadeexactlydownthemidlineofthebody,therightandlefthalvesofthebodyareequal.Thisdivisionisamidsagittalsection.2.Frontalplane(seeFig.1.5B).Thefrontalplanedividesthebodyintoanterior(ventral)andposterior(dorsal)portions.Thisplanecreatesthefrontpartofthebodyandthebackpartofthebody.Thefrontalplaneisalsocalledthecoronalplane.Coronalmeans“crown,”sotheimaginarylineforthecoronalplaneismadeacrossthepartoftheheadwhereacrownwouldsitandthendownwardthroughthebody.3.Transverseplane(seeFig.1.5C).Thetransverseplanedividesthebodyhorizontally,creatinganupper(superior)andalower(inferior)body.Whenthebodyoranorganiscuthorizontallyortransversely,itiscalledacrosssection.

FIG.1.6 Regionalterms.(A)Anteriorview.(B)Posteriorview.

RegionalTermsSpecifictermsdescribethedifferentregionsorareasofthebody.Fig.1.6illustratesthetermsusedtoidentifytheregionsontheanteriorandposteriorsurfacesofthebody.Ontheanteriorsurface,identifythefollowingregions:

Abdominal:anteriortrunkjustbelowtheribsAntecubital:areainfrontoftheelbowAxillary:armpitBrachial:armBuccal:cheekarea;cavitybetweenthegumandcheekCephalic:headCervical:neckregionCranial:nearertotheheadDigital:fingers,toesFemoral:thighareaFlank:fleshyareaalongeachsidebetweenthelowerribsandthetopofthehipbones

Inguinal:areawherethethighmeetsthetrunkofthebody;oftencalledthegroinOral:mouthOrbital:areaaroundtheeyePatellar:frontofthekneeoverthekneecapPedal:footPlantar:soleofthefootPubic:genitalareaSternal:middleofthechest(overthebreastbonearea)Umbilical:navelOntheposteriorsurface,identifythefollowingregions:Caudal:neartothelowerregionofthespinalcolumn(nearthetailbone)Deltoid:roundedareaoftheshoulderclosesttothearmGluteal:buttocks

FIG.1.7 Majorbodycavities.