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Copyright, ii
Text and Illustration Team, iii
Preface, v
Acknowledgments, xix
1. Foundations: An Introduction to Anatomy, 1
Microscopic Anatomy, 2
Gross Anatomy, 3
Other Perspectives on Anatomy, 3
Levels of Organization, 4
Clinical Note: Disease, Pathology, and Diagnosis, 4
An Introduction to Organ Systems, 6
Clinical Note: The Diagnosis of Disease, 6
The Language of Anatomy, 13
Superficial Anatomy, 14
Anatomical Landmarks, 14
Anatomical Regions, 15
Anatomical Directions, 16
Sectional Anatomy, 16
Planes and Sections, 17
Body Cavities, 18
Clinical Note: The Visible Human Project, 18
Clinical Note: Sectional Anatomy and Clinical Technology, 21
Clinical Terms, 23
2. Foundations: The Cell, 26
The Study of Cells, 27
Light Microscopy, 27
Electron Microscopy, 28
Cellular Anatomy, 29
The Plasmalemma, 31
Membrane Permeability: Passive Processes, 32
Membrane Permeability: Active Processes, 32
Extensions of the Plasmalemma: Microvilli, 35
The Cytoplasm, 35
The Cytosol, 36
Organelles, 36
Nonmembranous Organelles, 36
The Cytoskeleton, 36
Centrioles, Cilia, and Flagella, 36
Ribosomes, 38
Membranous Organelles, 38
Mitochondria, 38
The Nucleus, 38
The Endoplasmic Reticulum, 40
The Golgi Apparatus, 41
Lysosomes, 42
Peroxisomes, 42
Membrane Flow, 43
Intercellular Attachment, 43
The Cell Life Cycle, 45
Interphase, 45
DNA Replication, 46
Mitosis, 46
Clinical Note: Cell Division and Cancer, 47
Clinical Terms, 48
3. Foundations: Tissues and Early Embryology, 51
Epithelial Tissue, 52
Functions of Epithelial Tissue, 53
Specializations of Epithelial Cells, 53
Maintaining the Integrity of the Epithelium, 54
Intercellular Connections, 54
Attachment to the Basal Lamina, 54
Epithelial Maintenance and Renewal, 54
Classification of Epithelia, 55
Squamous Epithelia, 55
Cuboidal Epithelia, 56
Columnar Epithelia, 57
Pseudostratified and Transitional Epithelia, 57
Glandular Epithelia, 58
Types of Secretion, 59
Gland Structure, 59
Modes of Secretion, 60
Connective Tissues, 61
Classification of Connective Tissues, 62
Connective Tissue Proper, 62
Cells of Connective Tissue Proper, 62
Connective Tissue Fibers, 63
Ground Substance, 64
Embryonic Tissues, 64
Loose Connective Tissues, 64
Dense Connective Tissues, 66
Clinical Note: Liposuction, 66
Fluid Connective Tissues, 68
Supporting Connective Tissues, 68
Cartilage, 69
Clinical Note: Cartilages and Knee Injuries, 69
Bone, 71
Membranes, 72
Mucous Membranes, 72
Serous Membranes, 72
Clinical Note: Problems with Serous Membranes, 73
The Cutaneous Membrane, 74
Synovial Membranes, 74
The Connective Tissue Framework of the Body, 74
Muscle Tissue, 75
Skeletal Muscle Tissue, 75
Cardiac Muscle Tissue, 75
Smooth Muscle Tissue, 75
Neural Tissue, 77
Tissues, Nutrition, and Aging, 77
Clinical Note: Tumor Formation and Growth, 78
Embryology Summary: The Formation of Tissues, 79
Embryology Summary: The Development of Epithelia, 80
Embryology Summary: Origins of Connective Tissues, 81
Embryology Summary: The Development of Organ Systems, 82
Clinical Terms, 84
4. The Integumentary System, 88
Clinical Note: Examination of the Skin, 89
Integumentary Structure and Function, 90
The Epidermis, 90
Layers of the Epidermis, 91
Stratum Germinativum, 91
Stratum Spinosum, 91
Stratum Granulosum, 91
Stratum Lucidum, 92
Stratum Corneum, 92
Clinical Note: Disorders of Keratin Production, 92
Thick Skin and Thin Skin, 93
Epidermal Ridges, 93
Skin Color, 93
Clinical Note: Transdermal Drug Administration, 93
The Dermis, 95
Dermal Organization, 95
Wrinkles, Stretch Marks, and Lines of Cleavage, 95
Other Dermal Components, 96
Clinical Note: Skin Cancers, 96
The Blood Supply to the Skin, 97
The Nerve Supply to the Skin, 97
The Subcutaneous Layer, 97
Accessory Structures, 98
Hair Follicles and Hair, 98
Hair Production, 98
Follicle Structure, 98
Functions of Hair, 98
Types of Hairs, 100
Hair Color, 100
Growth and Replacement of Hair, 100
Glands in the Skin, 100
Sebaceous Glands, 100
Sweat Glands, 102
Clinical Note: Acne and Seborrheic Dermatitis, 102
Control of Glandular Secretions, 103
Other Integumentary Glands, 103
Nails, 103
Clinical Note: Repairing Injuries to the Skin, 104
Local Control of Integumentary Function, 105
Aging and the Integumentary System, 105
Clinical Case: Anxiety in the Anatomy Laboratory, 106
Clinical Terms, 108
5. The Skeletal System: Osseous Tissue and Skeletal Structure, 111
Structure of Bone, 112
The Histological Organization of Mature Bone, 112
The Matrix of Bone, 112
The Cells of Mature Bone, 112
Compact and Spongy Bone, 113
Structural Differences between Compact and Spongy Bone, 113
Functional Differences between Compact and Spongy Bone, 115
The Periosteum and Endosteum, 116
Bone Development and Growth, 117
Intramembranous Ossification, 117
Clinical Note: Rickets, 117
Endochondral Ossification, 118
Clinical Note: Heterotopic Bone Formation, 118
Increasing the Length of a Developing Bone, 119
Increasing the Diameter of a Developing Bone, 120
Formation of the Blood and Lymphatic Supply, 123
Bone Innervation, 123
Factors Regulating Bone Growth, 123
Clinical Note: Congenital Disorders of the Skeleton, 123
Bone Maintenance, Remodeling, and Repair, 124
Remodeling of Bone, 124
Injury and Repair, 125
Aging and the Skeletal System, 125
Anatomy of Skeletal Elements, 126
Classification of Bones, 126
Clinical Note: Osteoporosis and Age-Related Skeletal Abnormalities, 126
Bone Markings (Surface Features), 127
Clinical Note: A Classification of Fractures, 129
Integration with Other Systems, 130
Clinical Terms, 130
6. The Skeletal System: Axial Division, 133
The Skull and Associated Bones, 135
Bones of the Cranium, 142
Occipital Bone, 142
Parietal Bones, 142
Frontal Bone, 142
Temporal Bones, 145
Sphenoid, 146
Ethmoid, 147
The Cranial Fossae, 148
Bones of the Face, 148
The Maxillae, 148
The Palatine Bones, 150
The Nasal Bones, 150
The Inferior Nasal Conchae, 150
The Zygomatic Bones, 151
The Lacrimal Bones, 151
The Vomer, 151
The Mandible, 151
The Orbital and Nasal Complexes, 151
The Orbital Complex, 151
The Nasal Complex, 152
The Hyoid Bone, 154
Clinical Note: Sinus Problems, 154
Clinical Note: Problems with Growth of the Skull, 155
The Skulls of Infants, Children, and Adults, 158
The Vertebral Column, 158
Spinal Curves, 159
Vertebral Anatomy, 161
The Vertebral Body, 161
The Vertebral Arch, 161
Clinical Note: Kyphosis, Lordosis, and Scoliosis, 161
The Articular Processes, 162
Vertebral Articulation, 162
Vertebral Regions, 162
Cervical Vertebrae, 163
Thoracic Vertebrae, 164
Lumbar Vertebrae, 166
Clinical Note: Spina Bifada, 167
The Sacrum, 168
The Coccyx, 168
The Thoracic Cage, 168
The Ribs, 169
The Sternum, 170
Clinical Note: Cracked Ribs, 170
Clinical Note: The Thoracic Cage and Surgical Procedures, 170
Clinical Terms, 171
7. The Skeletal System: Appendicular Division, 174
The Pectoral Girdle and Upper Limb, 176
The Pectoral Girdle, 176
The Clavicle, 176
The Scapula, 176
The Upper Limb, 179
The Humerus, 179
The Ulna, 179
The Radius, 181
The Carpal Bones, 184
The Metacarpal Bones and Phalanges, 184
Clinical Note: Scaphoid Fractures, 184
The Pelvic Girdle and Lower Limb, 186
The Pelvic Girdle, 186
The Hip Bones, 186
The Pelvis, 187
The Lower Limb, 193
The Femur, 193
The Patella, 196
The Tibia, 196
The Fibula, 196
The Tarsal Bones, 198
The Metatarsal Bones and Phalanges, 199
Individual Variation in the Skeletal System, 200
Clinical Note: Problems with the Ankle and Foot, 201
Clinical Terms, 202
8. The Skeletal System: Articulations, 205
Classification of Joints, 206
Synarthroses (Immovable Joints), 206
Amphiarthroses (Slightly Movable Joints), 206
Diarthroses (Freely Movable Joints), 206
Synovial Fluid, 207
Accessory Structures, 208
Strength versus Mobility, 208
Articular Form and Function, 208
Clinical Note: Dislocation of a Synovial Joint, 208
Describing Dynamic Motion, 209
Types of Movements, 209
Linear Motion (Gliding), 209
Angular Motion, 209
Rotation, 211
Special Movements, 211
A Structural Classification of Synovial Joints, 212
Representative Articulations, 213
The Temporomandibular Joint, 214
Intervertebral Articulations, 214
The Intervertebral Discs, 214
Intervertebral Ligaments, 215
Vertebral Movements, 215
The Sternoclavicular Joint, 215
Clinical Note: Problems with the Intervertebral Discs, 216
The Shoulder Joint, 217
Ligaments, 217
Skeletal Muscles and Tendons, 217
Bursae, 219
The Elbow Joint, 219
The Radioulnar Joints, 219
The Joints of the Wrist, 219
Stability of the Wrist, 219
Clinical Note: Shoulder Injuries, 219
The Joints of the Hand, 221
The Hip Joint, 223
The Articular Capsule, 223
Stabilization of the Hip, 223
The Knee Joint, 225
The Articular Capsule, 225
Supporting Ligaments, 225
Locking of the Knee, 225
The Joints of the Ankle and Foot, 228
The Ankle Joint, 228
Clinical Note: Knee Injuries, 228
The Joints of the Foot, 229
Aging and Articulations, 229
Bones and Muscles, 231
Clinical Case: The Road to Daytona, 231
Clinical Terms, 233
9. The Muscular System: Skeletal Muscle Tissue and Muscle Organization, 237
Functions of Skeletal Muscle, 238
Anatomy of Skeletal Muscles, 238
Gross Anatomy, 238
Connective Tissue of Muscle, 238
Nerves and Blood Vessels, 239
Microanatomy of Skeletal Muscle Fibers, 240
Clinical Note: Fibromyalgia and Chronic Fatigue Syndrome, 240
Myofibrils and Myofilaments, 243
Sarcomere Organization, 243
Muscle Contraction, 245
The Sliding Filament Theory, 245
The Start of a Contraction, 246
The End of a Contraction, 246
The Neural Control of Muscle Fiber Contraction, 246
Muscle Contraction: A Summary, 246
Motor Units and Muscle Control, 248
Clinical Note: Rigor Mortis, 248
Muscle Tone, 249
Muscle Hypertrophy, 249
Muscle Atrophy, 249
Types of Skeletal Muscle Fibers, 249
Distribution of Fast, Slow, and Intermediate Fibers, 250
The Organization of Skeletal Muscle Fibers, 251
Parallel Muscles, 251
Convergent Muscles, 251
Clinical Note: Delayed-Onset Muscle Soreness, 251
Pennate Muscles, 252
Circular Muscles, 252
Muscle Terminology, 253
Origins and Insertions, 253
Actions, 253
Names of Skeletal Muscles, 254
Levers and Pulleys: A Systems Design for Movement, 254
Classes of Levers, 254
Anatomical Pulleys, 255
Aging and the Muscular System, 256
Clinical Note: Trichinosis, 257
Clinical Terms, 257
10. The Muscular System: Axial Musculature, 261
The Axial Musculature, 262
Muscles of the Head and Neck, 263
Muscles of Facial Expression, 264
Extra-ocular Muscles, 266
Muscles of Mastication, 268
Muscles of the Tongue, 269
Muscles of the Pharynx, 269
Clinical Note: What’s New?, 269
Anterior Muscles of the Neck, 271
Muscles of the Vertebral Column, 273
The Superficial Layer of the Intrinsic Back Muscles, 273
The Intermediate Layer of the Intrinsic Back Muscles, 274
The Deep Layer of the Intrinsic Back Muscles, 274
Spinal Flexors, 274
Obligue and Rectus Muscles, 276
The Diaphragm, 279
Muscles of the Perineum and the Pelvic Diaphragm, 279
Clinical Note: Hernias, 279
Clinical Terms, 282
11. The Muscular System: The Appendicular Musculature, 284
Factors Affecting Appendicular Muscle Function, 285
Muscles of the Pectoral Girdle and Upper Limbs, 286
Muscles That Position the Pectoral Girdle, 286
Muscles That Move the Arm, 288
Clinical Note: Sports Injuries, 292
Muscles That Move the Forearm and Hand, 293
Muscles That Move the Hand and Fingers, 295
Extrinsic Muscles of the Hand, 295
Intrinsic Muscles of the Hand, 296
Clinical Note: Carpal Tunnel Syndrome, 297
Muscles of the Pelvic Girdle and Lower Limbs, 302
Muscles That Move the Thigh, 302
Clinical Note: Intramuscular Injections, 305
Muscles That Move the Leg, 307
Muscles That Move the Foot and Toes, 309
Extrinsic Muscles of the Foot, 309
Intrinsic Muscles of the Foot, 311
Fascia, Muscle Layers, and Compartments, 318
Compartments of the Upper Limb, 318
Clinical Note: Compartment Syndrome, 319
Compartments of the Lower Limb, 321
Clinical Case: Grandma’s Hip, 323
Clinical Terms, 324
12. Surface Anatomy and Cross-Sectional Anatomy, 327
A Regional Approach to Surface Anatomy, 328
The Head and Neck, 328
The Thorax, 330
The Abdomen, 331
The Upper Limb, 332
The Arm, Forearm, and Wrist, 333
The Pelvis and Lower Limb, 334
The Leg and Foot, 335
Cross-Sectional Anatomy, 336
Level of the Optic Chiasm, 336
Cross Section of the Head at the Level of C₂, 337
Cross Section at the Level of Vertebra T₂, 337
Cross Section at the Level of Vertebra T₈, 338
Cross Section at the Level of Vertebra T₁₀, 338
Cross Section at the Level of Vertebra T₁₂, 339
Cross Section at the Level of Vertebra L₅, 339
13. The Nervous System: Neural Tissue, 340
An Overview of the Nervous System, 341
Cellular Organization in Neural Tissue, 342
Clinical Note: The Symptoms of Neurological Disorders, 343
Neuroglia, 344
Neuroglia of the CNS, 344
Neuroglia of the PNS, 346
Neurons, 349
Neuron Classification, 350
Neural Regeneration, 352
Clinical Note: Demyelination Disorders, 352
The Nerve Impulse, 353
Synaptic Communication, 354
Vesicular Synapses, 354
Nonvesicular Synapses, 355
Neuron Organization and Processing, 355
Anatomical Organization of the Nervous System, 356
Clinical Terms, 357
14. The Nervous System: The Spinal Cord and Spinal Nerves, 361
Gross Anatomy of the Spinal Cord, 362
Spinal Meninges, 362
The Dura Mater, 362
The Arachnoid Mater, 365
The Pia Mater, 365
Clinical Note: Spinal Taps, Myelography, Spinal Anesthesia, and Caudal Anesthesia, 366
Sectional Anatomy of the Spinal Cord, 367
Organization of Gray Matter, 367
Organization of White Matter, 367
Clinical Note: Spinal Cord Injuries, 367
Spinal Nerves, 369
Peripheral Distribution of Spinal Nerves, 369
Nerve Plexuses, 370
The Cervical Plexus, 372
The Brachial Plexus, 373
The Lumbar and Sacral Plexuses, 376
Clinical Note: Peripheral Neuropathies, 377
Reflexes, 380
Clinical Note: Disorders of the Spinal Cord and Spinal Nerves, 380
Classification of Reflexes, 382
Spinal Reflexes, 382
Higher Centers and Integration of Reflexes, 382
Clinical Terms, 383
15. The Nervous System: The Brain and Cranial Nerves, 386
An Introduction to the Organization of the Brain, 387
Embryology of the Brain, 387
Major Regions and Landmarks, 387
The Cerebrum, 387
The Diencephalon, 387
The Mesencephalon, 389
The Pons and Cerebellum, 389
The Medulla Oblongata, 389
Gray Matter and White Matter Organization, 389
The Ventricles of the Brain, 389
Protection and Support of the Brain, 389
The Cranial Meninges, 391
The Dura Mater, 391
The Arachnoid Mater, 391
The Pia Mater, 391
The Blood–Brain Barrier, 391
Clinical Note: Traumatic Brain Injuries, 391
Cerebrospinal Fluid, 394
Formation of CSF, 394
Circulation of CSF, 394
Clinical Note: Epidural and Subdural Hemorrhages, 394
The Blood Supply to the Brain, 395
The Cerebrum, 396
The Cerebral Hemispheres, 396
The Cerebral Lobes, 396
Motor and Sensory Areas of the Cerebral Cortex, 398
Clinical Note: Hydrocephalus, 398
Association Areas, 400
Integrative Centers, 400
The Central White Matter, 400
The Basal Nuclei, 401
Functions of the Basal Nuclei, 401
The Limbic System, 401
The Diencephalon, 405
The Epithalamus, 405
The Thalamus, 405
Functions of Thalamic Nuclei, 406
The Hypothalamus, 406
Functions of the Hypothalamus, 406
The Mesencephalon, 410
The Pons, 410
Clinical Note: The Substantia Nigra and Parkinson’s Disease, 410
The Cerebellum, 412
The Medulla Oblongata, 414
Clinical Note: Cerebellar Dysfunction, 414
The Cranial Nerves, 416
The Olfactory Nerve (N I), 418
The Optic Nerve (N II), 419
The Oculomotor Nerve (N III), 420
The Trochlear Nerve (N IV), 420
The Trigeminal Nerve (N V), 421
The Abducens Nerve (N VI), 422
The Facial Nerve (N VII), 422
Clinical Note: Tic Douloureux, 422
The Vestibulocochlear Nerve (N VIII), 423
Clinical Note: Bell’s Palsy, 423
The Glossopharyngeal Nerve (N IX), 424
The Vagus Nerve (N X), 424
The Accessory Nerve (N XI), 425
The Hypoglossal Nerve (N XII), 426
A Summary of Cranial Nerve Branches and Functions, 426
Clinical Note: Cranial Reflexes, 427
Clinical Terms, 427
16. The Nervous System: Pathways and Higher-Order Functions, 431
Sensory and Motor Pathways, 432
Sensory Pathways, 432
The Posterior Column Pathway, 432
The Spinothalamic Pathway, 435
The Spinocerebellar Pathway, 435
Motor Pathways, 436
The Corticospinal Pathway, 437
The Medial and Lateral Pathways, 438
Clinical Note: Cerebral Palsy, 438
The Basal Nuclei and Cerebellum, 440
Clinical Note: Amyotrophic Lateral Sclerosis, 440
Levels of Somatic Motor Control, 441
Clinical Note: Anencephaly, 441
Higher-Order Functions, 443
Integrative Regions of the Cerebral Cortex, 443
The General Interpretive Area, 443
The Speech Center, 444
The Prefrontal Cortex, 444
Brodmann Areas and Cortical Function, 444
Clinical Note: Damage to the Integrative Centers, 444
Hemispheric Specialization, 445
Memory, 445
Clinical Note: Disconnection Syndrome, 445
Consciousness: The Reticular Activating System, 446
Clinical Note: Levels of Consciousness, 446
Aging and the Nervous System, 447
Clinical Note: Alzheimer’s Disease, 447
Clinical Note: Cerebrovascular Diseases, 448
Clinical Terms, 448
17. The Nervous System: Autonomic Division, 451
A Comparison of the Somatic and Autonomic Nervous Systems, 452
Subdivisions of the ANS, 452
Sympathetic (Thoracolumbar) Division, 452
Parasympathetic (Craniosacral) Division, 452
Innervation Patterns, 452
The Sympathetic Division, 453
The Sympathetic Chain Ganglia, 454
Functions of the Sympathetic Chain, 454
Anatomy of the Sympathetic Chain, 454
Collateral Ganglia, 456
Functions of the Collateral Ganglia, 456
Anatomy of the Collateral Ganglia, 456
Clinical Note: Hypersensitivity and Sympathetic Function, 456
The Suprarenal Medullae, 458
Effects of Sympathetic Stimulation, 458
Sympathetic Activation and Neurotransmitter Release, 458
Plasmalemma Receptors and Sympathetic Function, 459
Alpha and Beta Receptors, 459
Sympathetic Stimulation and ACh, 459
A Summary of the Sympathetic Division, 459
The Parasympathetic Division, 460
Organization and Anatomy of the Parasympathetic Division, 460
General Functions of the Parasympathetic Division, 462
Parasympathetic Activation and Neurotransmitter Release, 462
Plasmalemma Receptors and Responses, 462
A Summary of the Parasympathetic Division, 462
Relationships between the Sympathetic and Parasympathetic Divisions, 463
Anatomy of Dual Innervation, 463
A Comparison of the Sympathetic and Parasympathetic Divisions, 464
Integration and Control of Autonomic Functions, 464
Visceral Reflexes, 464
Higher Levels of Autonomic Control, 465
Clinical Note: Diabetic Neuropathy and the ANS, 465
Clinical Terms, 467
18. The Nervous System: General and Special Senses, 470
Receptors, 471
Interpretation of Sensory Information, 471
Central Processing and Adaptation, 471
Sensory Limitations, 472
The General Senses, 472
Nociceptors, 472
Thermoreceptors, 473
Mechanoreceptors, 473
Tactile Receptors, 473
Clinical Note: Acute and Chronic Pain, 473
Baroreceptors, 475
Proprioceptors, 475
Chemoreceptors, 475
Olfaction (Smell), 477
Olfactory Receptors, 477
Olfactory Pathways, 477
Olfactory Discrimination, 478
Gustation (Taste), 478
Gustatory Receptors, 478
Gustatory Pathways, 479
Gustatory Discrimination, 479
Equilibrium and Hearing, 480
The External Ear, 480
The Middle Ear, 480
The Auditory Ossicles, 482
The Inner Ear, 482
Clinical Note: Otitis Media and Mastoiditis, 482
The Vestibular Complex and Equilibrium, 483
Clinical Note: Nystagmus, 485
Hearing, 486
The Cochlea, 486
Clinical Note: Vertigo, Motion Sickness, and Ménière’s Disease, 487
Sound Detection, 490
Auditory Pathways, 490
Clinical Note: Hearing Loss, 490
Vision, 491
Accessory Structures of the Eye, 491
Eyelids, 491
The Lacrimal Apparatus, 492
The Eye, 493
The Fibrous Tunic, 493
The Vascular Tunic, 495
The Neural Tunic, 496
Clinical Note: Conjunctivitis, 496
The Chambers of the Eye, 498
Clinical Note: Corneal Transplants, 498
The Lens, 499
Visual Pathways, 499
Clinical Note: Glaucoma, 499
Clinical Note: Cataracts, 499
Cortical Integration, 500
The Brain Stem and Visual Processing, 500
Clinical Case: What Did You Say, Doc?, 502
Clinical Terms, 503
19. The Endocrine System, 507
An Overview of the Endocrine System, 508
The Hypothalamus and Endocrine Regulation, 509
The Pituitary Gland, 510
The Neurohypophysis, 510
The Adenohypophysis, 510
The Hypophyseal Portal System, 512
Hormones of the Adenohypophysis, 512
Clinical Note: Diabetes Insipidus, 512
The Thyroid Gland, 513
Thyroid Follicles and Thyroid Hormones, 513
The C Thyrocytes of the Thyroid Gland, 515
The Parathyroid Glands, 515
The Thymus, 515
The Suprarenal Glands, 516
The Cortex of the Suprarenal Gland, 516
The Zona Glomerulosa, 516
The Zona Fasciculata, 517
The Zona Reticularis, 517
The Medulla of the Suprarenal Gland, 518
Endocrine Functions of the Kidneys and Heart, 518
The Pancreas and Other Endocrine Tissues of the Digestive System, 518
The Pancreas, 518
Endocrine Tissues of the Reproductive System, 520
Testes, 520
Clinical Note: Diabetes Mellitus, 520
Ovaries, 521
The Pineal Gland, 521
Clinical Note: Endocrine Disorders, 522
Hormones and Aging, 523
Clinical Case: Why Can’t I Keep Up Anymore?, 524
Clinical Terms, 526
20. The Cardiovascular System: Blood, 530
Functions of the Blood, 531
Composition of the Blood, 531
Clinical Note: Transfusions, 531
Plasma, 533
Differences between Plasma and Interstitial Fluid, 533
The Plasma Proteins, 533
Clinical Note: Plasma Expanders, 533
Formed Elements, 534
Red Blood Cells (RBCs), 534
Structure of RBCs, 534
RBC Life Span and Circulation, 535
Clinical Note: Anemia and Polycythemia, 535
RBCs and Hemoglobin, 536
Blood Types, 536
Clinical Note: Elevating Hemoglobin Levels, 536
Clinical Note: Sickle Cell Anemia, 537
Leukocytes, 538
Granular Leukocytes, 539
Agranular Leukocytes, 539
Platelets, 540
Hemopoiesis, 541
Clinical Note: Hemophilia, 541
Erythropoiesis, 543
Stages in RBC Maturation, 543
Leukopoiesis, 543
Clinical Note: Synthetic Blood, 543
Clinical Note: Blood Doping, 544
Clinical Terms, 544
21. The Cardiovascular System: The Heart, 547
An Overview of the Cardiovascular System, 548
The Pericardium, 548
Structure of the Heart Wall, 550
Cardiac Muscle Tissue, 550
The Intercalated Discs, 550
The Fibrous Skeleton, 550
Orientation and Superficial Anatomy of the Heart, 552
Internal Anatomy and Organization of the Heart, 554
The Right Atrium, 554
The Right Ventricle, 554
Clinical Note: Infection and Inflammation of the Heart, 554
The Left Atrium, 556
The Left Ventricle, 556
Structural Differences between the Left and Right Ventricles, 556
The Structure and Function of Heart Valves, 556
Valve Function during the Cardiac Cycle, 556
Coronary Blood Vessels, 558
The Right Coronary Artery, 558
The Left Coronary Artery, 558
The Cardiac Veins, 558
Clinical Note: Mitral Valve Prolapse, 558
Clinical Note: Coronary Artery Disease, 560
The Cardiac Cycle, 561
The Coordination of Cardiac Contractions, 561
The Sinoatrial and Atrioventricular Nodes, 562
The Conducting System of the Heart, 562
Clinical Note: Cardiac Arrhythmias, Artificial Pacemakers, and Myocardial Infarctions, 564
The Electrocardiogram (ECG), 566
Autonomic Control of Heart Rate, 566
Clinical Terms, 568
22. The Cardiovascular System: Vessels and Circulation, 571
Histological Organization of Blood Vessels, 572
Distinguishing Arteries from Veins, 573
Arteries, 573
Elastic Arteries, 574
Clinical Note: Arteriosclerosis, 574
Muscular Arteries, 575
Arterioles, 575
Capillaries, 575
Capillary Beds, 575
Veins, 577
Venules, 577
Medium-Sized Veins, 577
Large Veins, 577
Venous Valves, 577
The Distribution of Blood, 578
Blood Vessel Distribution, 579
The Pulmonary Circuit, 579
The Systemic Circuit, 579
Systemic Arteries, 579
Systemic Veins, 592
Cardiovascular Changes at Birth, 600
Clinical Note: Congenital Cardiovascular Problems, 602
Aging and the Cardiovascular System, 603
Clinical Case: The Complaining Postal Carrier, 603
Clinical Terms, 605
23. The Lymphoid System, 608
An Overview of the Lymphoid System, 609
Functions of the Lymphoid System, 609
Structure of Lymphatic Vessels, 610
Lymphatic Capillaries, 610
Valves of Lymphatic Vessels, 611
Major Lymph-Collecting Vessels, 612
The Thoracic Duct, 612
The Right Lymphatic Duct, 613
Lymphocytes, 613
Types of Lymphocytes, 613
T Cells, 613
B Cells, 613
NK Cells, 614
Lymphocytes and the Immune Response, 614
Distribution and Life Span of Lymphocytes, 615
Lymphopoiesis: Lymphocyte Production, 615
Lymphoid Tissues, 616
Lymphoid Organs, 617
Lymph Nodes, 617
Clinical Note: Infected Lymphatic Nodules, 617
Distribution of Lymphoid Tissues and Lymph Nodes, 620
The Thymus, 622
Clinical Note: Lymphadenopathy and Metastatic Cancer, 622
Clinical Note: Lymphomas, 622
The Spleen, 623
Surfaces of the Spleen, 623
Histology of the Spleen, 624
Aging and the Lymphoid System, 625
Clinical Case: I Feel Like I am Going to Suffocate! What’s Happening to Me?, 625
Clinical Terms, 626
24. The Respiratory System, 629
An Overview of the Respiratory System, 630
Functions of the Respiratory System, 631
The Respiratory Epithelium, 631
The Upper Respiratory System, 632
The Nose and Nasal Cavity, 632
Clinical Note: Cystic Fibrosis, 632
The Pharynx, 634
The Nasopharynx, 634
The Oropharynx, 634
The Laryngopharynx, 634
The Lower Respiratory System, 634
The Larynx, 634
Cartilages of the Larynx, 634
Laryngeal Ligaments, 636
The Laryngeal Musculature, 636
The Trachea, 637
Clinical Note: Tracheal Blockage, 637
The Primary Bronchi, 638
The Lungs, 638
Lobes of the Lungs, 638
Lung Surfaces, 640
The Pulmonary Bronchi, 640
Branches of the Right Primary Bronchus, 640
Branches of the Left Primary Bronchus, 640
Branches of the Secondary Bronchi, 640
The Bronchopulmonary Segments, 640
The Bronchioles, 643
Alveolar Ducts and Alveoli, 643
Clinical Note: COPD: Asthma, Bronchitis, and Emphysema, 643
The Alveolus and the Respiratory Membrane, 646
The Blood Supply to the Lungs, 646
The Pleural Cavities and Pleural Membranes, 646
Clinical Note: Lung Cancer, 646
Respiratory Muscles and Pulmonary Ventilation, 647
Respiratory Muscles, 647
Clinical Note: Respiratory Distress Syndrome (RDS), 647
Respiratory Movements, 648
Respiratory Changes at Birth, 649
Respiratory Centers of the Brain, 649
Aging and the Respiratory System, 650
Clinical Case: How Is This All Related, Doc?, 650
Clinical Terms, 652
25. The Digestive System, 655
An Overview of the Digestive System, 656
Histological Organization of the Digestive Tract, 656
The Mucosa, 656
The Submucosa, 656
The Muscularis Externa, 657
The Serosa, 657
Muscularis Layers and the Movement of Digestive Materials, 657
Peristalsis, 659
Segmentation, 659
The Peritoneum, 660
Mesenteries, 660
Clinical Note: Peritonitis, 660
The Oral Cavity, 662
Anatomy of the Oral Cavity, 662
The Tongue, 662
Salivary Glands, 663
Regulation of the Salivary Glands, 664
The Teeth, 664
Clinical Note: Mumps, 664
The Pharynx, 666
The Swallowing Process, 666
Clinical Note: Achalasia, Esophagitis, and GERD, 666
The Esophagus, 667
Histology of the Esophageal Wall, 667
The Stomach, 668
Anatomy of the Stomach, 668
Mesenteries of the Stomach, 671
Blood Supply to the Stomach, 671
Musculature of the Stomach, 671
Histology of the Stomach, 671
Gastric Secretory Cells, 673
Regulation of the Stomach, 673
The Small Intestine, 673
Clinical Note: Gastritis and Peptic Ulcers, 673
Regions of the Small Intestine, 674
The Duodenum, 674
The Jejunum, 674
The Ileum, 674
Support of the Small Intestine, 674
Histology of the Small Intestine, 674
The Intestinal Epithelium, 674
Intestinal Crypts, 674
The Lamina Propria, 676
Regional Specializations, 676
Regulation of the Small Intestine, 677
The Large Intestine, 677
The Cecum, 677
The Colon, 677
Regions of the Colon, 679
The Rectum, 679
Histology of the Large Intestine, 679
Regulation of the Large Intestine, 680
Accessory Glandular Digestive Organs, 680
The Liver, 680
Anatomy of the Liver, 681
Histological Organization of the Liver, 681
The Gallbladder, 683
The Pancreas, 684
Histological Organization of the Pancreas, 685
Clinical Note: Problems with Bile Storage and Secretion, 685
Pancreatic Enzymes, 686
The Regulation of Pancreatic Secretion, 686
Aging and the Digestive System, 687
Clinical Case: China Was Great But . . ., 687
Clinical Terms, 689
26. The Urinary System, 693
The Kidneys, 694
Superficial Anatomy of the Kidney, 694
Sectional Anatomy of the Kidney, 694
The Blood Supply to the Kidneys, 696
Innervation of the Kidneys, 696
Histology of the Kidney, 698
An Introduction to the Structure and Function of the Nephron, 698
The Renal Corpuscle, 699
The Proximal Convoluted Tubule, 700
The Nephron Loop, 703
The Distal Convoluted Tubule, 703
The Collecting System, 703
Structures for Urine Transport, Storage, and Elimination, 704
The Ureters, 704
Histology of the Ureters, 704
The Urinary Bladder, 704
Clinical Note: Advances in the Treatment of Renal Failure, 704
Histology of the Urinary Bladder, 705
The Urethra, 706
Clinical Note: Problems with the Conducting System, 707
Histology of the Urethra, 708
The Micturition Reflex and Urination, 708
Aging and the Urinary System, 708
Clinical Note: Urinary Tract Infections, 708
Clinical Case: How Come She Got Really Sick and I Didn’t?, 709
Clinical Terms, 711
27. The Reproductive System, 714
Organization of the Reproductive System, 715
Anatomy of the Male Reproductive System, 715
The Testes, 715
Descent of the Testes, 715
The Spermatic Cords, 715
Structure of the Testes, 718
Histology of the Testes, 718
Spermatogenesis and Meiosis, 719
Spermiogenesis, 719
Nurse Cells, 719
Anatomy of a Spermatozoon, 721
Clinical Note: Testicular Cancer, 721
The Male Reproductive Tract, 722
The Epididymis, 722
The Ductus Deferens, 723
The Urethra, 723
The Accessory Glands, 723
The Seminal Glands, 723
The Prostate Gland, 723
The Bulbo-urethral Glands, 725
Semen, 725
The Penis, 725
Anatomy of the Female Reproductive System, 727
The Ovaries, 727
The Ovarian Cycle and Oogenesis, 727
Clinical Note: Ovarian Cancer, 727
Age and Oogenesis, 732
The Uterine Tubes, 732
Histology of the Uterine Tube, 733
The Uterus, 733
Suspensory Ligaments of the Uterus, 733
Internal Anatomy of the Uterus, 733
Clinical Note: Uterine Cancers, 733
The Uterine Wall, 734
Blood Supply to the Uterus, 734
Histology of the Uterus, 734
The Uterine Cycle, 735
The Vagina, 736
Histology of the Vagina, 737
The External Genitalia, 738
The Mammary Glands, 739
Development of the Mammary Glands during Pregnancy, 739
Clinical Note: Breast Cancer, 739
Pregnancy and the Female Reproductive System, 740
Aging and the Reproductive System, 741
Menopause, 741
The Male Climacteric, 741
Clinical Case: Is This Normal for Someone My Age?, 741
Clinical Terms, 743
28. The Reproductive System: Embryology and Human Development, 747
An Overview of Development, 748
Fertilization, 748
The Oocyte at Ovulation, 748
Pronucleus Formation and Amphimixis, 748
Prenatal Development, 749
The First Trimester, 750
Clinical Note: Complexity and Perfection, 750
Cleavage and Blastocyst Formation, 751
Clinical Note: Teratogens and Abnormal Development, 751
Implantation, 752
Placentation, 755
Embryogenesis, 755
The Second and Third Trimesters, 757
Labor and Delivery, 760
Stages of Labor, 760
The Dilation Stage, 760
The Expulsion Stage, 760
The Placental Stage, 762
Premature Labor, 762
The Neonatal Period, 763
Clinical Note: Forceps Deliveries and Breech Births, 763
Clinical Note: Evaluating the Newborn Infant, 763
Embryology Summary: The Development of the Integumentary System, 764
Embryology Summary: The Development of the Skull, 766
Embryology Summary: The Development of the Vertebral Column, 768
Embryology Summary: The Development of the Appendicular Skeleton, 770
Embryology Summary: The Development of the Muscles, 772
Embryology Summary: The Development of the Nervous System, 774
Embryology Summary: The Development of the Spinal Cord, Part I, 775
Embryology Summary: The Development of the Spinal Cord, Part II, 776
Embryology Summary: The Development of the Brain, Part I, 777
Embryology Summary: The Development of the Brain, Part II, 778
Embryology Summary: The Development of Special Sense Organs, Part I, 779
Embryology Summary: The Development of Special Sense Organs, Part II, 780
Embryology Summary: The Development of the Endocrine System, Part I, 781
Embryology Summary: The Development of the Endocrine System, Part II, 782
Embryology Summary: The Development of the Heart, 783
Embryology Summary: The Development of the Cardiovascular System, 784
Embryology Summary: The Development of the Lymphoid System, 786
Embryology Summary: The Development of the Respiratory System, Part I, 787
Embryology Summary: The Development of the Respiratory System, Part II, 788
Embryology Summary: The Development of the Digestive System, Part I, 789
Embryology Summary: The Development of the Digestive System, Part II, 790
Embryology Summary: The Development of the Urinary System, Part I, 791
Embryology Summary: The Development of the Urinary System, Part II, 792
Embryology Summary: The Development of the Reproductive System, 793
Clinical Terms, 796
Answers to Concept Check and Review Questions, 799
Appendix, 819
Weights and Measures, 820
Foreign Word Roots, Prefixes, Suffixes, and Combining Forms, 822
Eponyms in Common Use, 823
Glossary of Key Terms, 825
Photo Credits, 845
Index, 847

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