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.