Seeley's Anatomy & Physiology

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An Interactive Cadaver my my Course Content

y
Dissection Experience g Maximize efficiency by studying
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designed to help you master human g Your instructor selects the content
anatomy and physiology with: that’s relevant to your course.
g Content customized Dissection
to your course
g Peel layers of the body to reveal
g Stunning cadaver specimens structures beneath the surface.
g Vivid animations
Animation
g Lab practical quizzing g Over 150 animations make anatomy
and physiology easier to visualize
and understand.
Histology
g Study interactive slides that
simulate what you see in lab.
Imaging
g Correlate dissected anatomy
with X-ray, MRI, and CT scans.
Quiz
g Gauge proficiency with customized
quizzes and lab practicals that
cover only what you need for
your course.

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 Brief
Contents

PART 1 PART 4
Organization of the Human Body Regulation and Maintenance
1 The Human Organism 1 19 Cardiovascular System: Blood 637
2 The Chemical Basis of Life 24 20 Cardiovascular System: The Heart 665
3 Cell Biology 56 21 Cardiovascular System: Blood Vessels and Circulation 709
4 Tissues 101 22 Lymphatic System and Immunity 769
23 Respiratory System 811

PART 2 24 Digestive System 858

Support and Movement 25 Nutrition, Metabolism, and Temperature Regulation 912

5 Integumentary System 139 26 Urinary System 946

6 Skeletal System: Bones and Bone Tissue 163 27 Water, Electrolyte, and Acid–Base Balance 988

7 Skeletal System: Gross Anatomy 191

8 Joints and Movement 239 PART 5
9 Muscular System: Histology and Physiology 265 Reproduction and Development
10 Muscular System: Gross Anatomy 309 28 Reproductive System 1016
29 Development, Growth, Aging, and Genetics 1063

PART 3
Integration and Control Systems Appendices
A Periodic Table of the Elements A-1
11 Functional Organization of Nervous Tissue 361
B Scientific Notation A-2
12 Spinal Cord and Spinal Nerves 400
C Solution Concentrations A-3
13 Brain and Cranial Nerves 429 D pH A-4
14 Integration of Nervous System Functions 461 E Answers to Review and Comprehension Questions A-5
F Answers to Critical Thinking Questions A-6
15 The Special Senses 500
G Answers to Predict Questions A-23
16 Autonomic Nervous System 547
17 Functional Organization of the Endocrine System 569
18 Endocrine Glands 594

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 Seeley’s
Anatomy&
Physiology
Cinnamon VanPutte
SoutHwestern Illinois College

Jennifer Regan
university of southern mississippi

Andrew Russo
UniverSIty of Iowa

Rod Seeley
Idaho State University

Trent Stephens
Idaho State University

Philip Tate
Stevens college
TM

van03636_ch00_FM.indd 1 12-10-12 11:03 AM

 TM

SEELEY’S ANATOMY & PHYSIOLOGY, TENTH EDITION

Published by McGraw-Hill, a business unit of The McGraw-Hill Companies, Inc., 1221 Avenue of the Americas, New York,
NY 10020. Copyright © 2014 by The McGraw-Hill Companies, Inc. All rights reserved. Printed in the United States of America.
Previous editions © 2011, 2008, and 2006. No part of this publication may be reproduced or distributed in any form or by any
means, or stored in a database or retrieval system, without the prior written consent of The McGraw-Hill Companies, Inc.,
including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning.

Some ancillaries, including electronic and print components, may not be available to customers outside the United States.

This book is printed on acid-free paper.

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ISBN 978–0–07–340363–2
MHID 0–07–340363–6

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All credits appearing on page or at the end of the book are considered to be an extension of the copyright page.

Library of Congress Cataloging-in-Publication Data

Seeley, Rod R.
[Anatomy & physiology]
Seeley’s anatomy & physiology. — 10th ed. / Rod Seeley, Cinnamon VanPutte, Jennifer Regan, Andrew Russo.
   p. cm.
Includes index.
ISBN 978–0–07–340363–2 — ISBN 0–07–340363–6 (hard copy : alk. paper) 1. Human physiology. 2. Human anatomy.
I. VanPutte, Cinnamon L. II. Regan, Jennifer. III. Russo, Andrew. IV. Title. V. Title: Seeley’s anatomy and physiology.
QP34.5.S4 2014
612–dc23
2012028548

The Internet addresses listed in the text were accurate at the time of publication. The inclusion of a website does not
indicate an endorsement by the authors or McGraw-Hill, and McGraw-Hill does not guarantee the accuracy of the
information presented at these sites.

www.mhhe.com

van03636_ch00_FM.indd 2 12-10-12 11:03 AM

 About thE
Authors

Cinnamon L. VanPutte Andrew F. Russo

Associate Professor of Biology Jennifer L. Regan
Instructor Professor of Molecular
Southwestern Illinois College Physiology and Biophysics
University of Southern Mississippi
Cinnamon has been teaching biology and human University of Iowa
anatomy and physiology for almost two decades. For over ten years, Jennifer has taught introduc-
tory biology, human anatomy and physiology, Andrew has over 20 years of classroom experi-
At Southwestern Illinois College she is a full-time
and genetics at the university and community ence with human physiology, neurobiology,
faculty member and the coordinator for the
college level. She has received the Instructor of molecular biology, and cell biology courses at
anatomy and physiology courses. Cinnamon is
the Year Award at both the departmental and the University of Iowa. He is a recipient of the
an active member of several professional societies,
college level while teaching at USM. In addition, Collegiate Teaching Award and is currently the
including the Human Anatomy & Physiology
she has been recognized for her dedication to course director for Medical Cell Biology and
Society (HAPS). Her Ph.D. in zoology, with an
teaching by student organizations such as the Director of the Biosciences Graduate Program.
emphasis in endocrinology, is from Texas
Alliance for Graduate Education in Mississippi He is also a member of several professional
A&M University. She worked in Dr. Duncan
and Increasing Minority Access to Graduate societies, including the American Physiological
MacKenzie’s lab, where she was indoctrinated
Education. Jennifer has dedicated much of her Society and the Society for Neuroscience.
in the major principles of physiology and the
career to improving lecture and laboratory Andrew received his Ph.D. in biochemistry
importance of critical thinking. The critical
instruction at her institutions. Critical thinking from the University of California at Berkeley.
thinking component of Seeley’s Essentials of
and lifelong learning are two characteristics His research interests are focused on the molec-
Human Anatomy & Physiology epitomizes
Jennifer hopes to instill in her students. She ular neurobiology of migraine. His decision to
Cinnamon’s passion for the field of human
appreciates the Seeley approach to learning join the author team for Seeley’s Essentials of
anatomy and physiology; she is committed to
and is excited about contributing to further Human Anatomy & Physiology is the culmina-
maintaining this tradition of excellence.
development of the textbook. She received her tion of a passion for teaching that began in
Cinnamon and her husband, Robb, have two
Ph.D. in biology at the University of Houston, graduate school. He is excited about the oppor-
children: a daughter, Savannah, and a son, Ethan.
under the direction of Edwin H. Bryant and tunity to hook students’ interest in learning by
Savannah is very creative and artistic; she loves
Lisa M. Meffert. She is an active member of sev- presenting cutting-edge clinical and scientific
to sing, write novels and do art projects. Robb
eral professional organizations, including the advances. Andy is married to Maureen, a physical
and Ethan have their black belts in karate and
Human Anatomy and Physiology Society. During therapist, and has three daughters Erilynn,
Ethan is one of the youngest black belts at his
her free time, Jennifer enjoys spending time Becky, and Colleen, now in college and graduate
martial arts school. Cinnamon is also active in
with her husband, Hobbie, and two sons, Patrick school. He enjoys all types of outdoor sports,
martial arts and is a competitive Brazilian Jiu-Jitsu
and Nicholas. especially bicycling, skiing, ultimate Frisbee and,
practitioner. She has competed at both the Pan
before moving to Iowa, bodyboard surfing.
Jiu-Jitsu Championship and the World Jiu-Jitsu
Championship.

This text is dedicated to the students of human anatomy and physiology. Helping students develop a working knowledge
of anatomy and physiology is a satisfying challenge, and we have a great appreciation for the effort and enthusiasm of
so many who want to know more. It is difficult to imagine anything more exciting, or more important, than being
involved in the process of helping people learn about the subject we love so much.

iii

van03636_ch00_FM.indd 3 12-10-12 11:03 AM

 wHAt SetS
Seeley
APArt?

Seeley’s Anatomy & Physiology is written for the two-semester anatomy and physiology course. The writing is
comprehensive enough to provide the depth necessary for those courses not requiring prerequisites, and yet117
CHAPTER 4 Tissues is
presented with such clarity that it nicely balances the thorough coverage. Clear descriptions and exceptional
illustrationsmesenchyme.
combine to Thehelp students
mucous develop
connective a firm
tissue helps understanding
support the of the
as dendritic cells,concepts of anatomy
which look very and physiology
much like reticular cells but are
umbilical cord blood vessels between the mother and the child. cells of the immune system; macrophages; and blood cells (see
and to teachAfter
them how to use that information.
birth, the mucous connective tissue can also be a rich source chapter 22).
of stem cells.
Dense Connective Tissue

What Makes this Text

Adult connective tissue consists of three types: connective tissue
proper (loose and dense), supporting connective tissue (cartilage Dense connective tissue has a relatively large number of protein
and bone), and fluid connective tissue (blood). fibers, which form thick bundles and fill nearly all of the extracellular

a Market Leader?
space. Most of the cells of developing dense connective tissue are
Connective Tissue Proper spindle-shaped fibroblasts. Once the fibroblasts become completely
surrounded by matrix, they are fibrocytes. Dense connective tissue
Loose Connective Tissue
can be subdivided into two major groups: regular and irregular.
Loose connective tissue (table 4.8) consists of relatively few protein
Dense regular connective tissue has protein fibers in the
Seeley Learning System—Emphasis on
fibers that form a lacy network, with numerous spaces filled with
ground substance and fluid. Three subdivisions of loose connec-
extracellular matrix that are oriented predominantly in one direction.
Dense regular collagenous connective tissue (table 4.9a) has abun-
Critical Thinking
tive tissue are areolar, adipose, and reticular. Areolar (ă-r ē′ō-lăr)
tissue is the “loose packing” material of most organs and other
dant collagen fibers, which give this tissue a white appearance. Dense
regular collagenous connective tissue forms structures such as ten-
tissues; it attaches the skin to underlying tissues (table 4.8a). It con-
An emphasis on critical thinking is integrated dons, whichthroughout
connect muscles thistotextbook.
bones (seeThis approach
chapter can be
9), and most
tains collagen, reticular, and elastic fibers and a variety of cells. For
found in questions starting each ligaments,
chapter and which connect
embedded bonesthe
within to bones (see chapter
narrative; in 8). The
clinical col-
material
example, fibroblasts produce the fibrous matrix; macrophages
that is bacteria designed lagen fibers of dense connective tissue resist stretching and give
move through the tissue, engulfing andtocell bridgedebris; concepts
mast explained in the text with real-life applications and scenarios;
the tissue considerable strength in the direction of the fiber orien-
cells contain chemicals that help in end-of-chapter
mediate inflammation; questions and lym- that go beyond rote memorization; and in a visual program that
tation. Tendons and most ligaments consist almost entirely of thick
phocytes are involved in immunity. presents The material
loose packing in understandable,
of areolar relevant
bundles of images.
densely packed parallel collagen fibers with the orientation
tissue is often associated with the other loose connective tissue
of the collagen fibers in one direction, which makes the tendons
types, adipose and reticular tissue. ▶ Problem-solving perspective from the book’s inception
and ligaments very strong, cablelike structures.
Adipose tissue and reticular ▶ tissue
Pedagogy are connective builds student tissues with comprehension from knowledge
The general structures of to application
tendons (Predict
and ligaments arequestions,
similar,
special properties. Adipose tissue (table Critical 4.8b)Thinking
consists of adipocytes, questions, andbut Learn To Predict Answer)
they differ in the following respects: (1) The collagen fibers of
which contain large amounts of lipid. Unlike other connective tis-
ligaments are often less compact, (2) some fibers of many ligaments
sue types, adipose tissue is composed of large cells and a small
are not parallel, and (3) ligaments are usually more flattened than
amount of extracellular matrix, which consists of loosely Predict arrangedQuestions challenge
tendons and formstudents
sheets orto use their
bands understanding of
of tissues.
collagen and reticular fibers with some scattered elastic fibers.
new concepts to solve aDense problem.regular elastic connective
Answers tissue (table
to the questions 4.9b) consists of
are provided
Blood vessels form a network in the extracellular matrix. The adi-
at the end of the parallel
book, bundlesstudents
allowing of collagen
to fibers and their
evaluate abundant elastic and
responses fibers.toThe
pocytes are usually arranged in clusters, or lobules, separated from
elastin in elastic ligaments gives them a slightly yellow color. Dense
one another by loose connective tissue. Adipose tissue understand
functions as the logic used to arrive at the correct answer. All Predict question
regular elastic connective tissue forms some elastic ligaments, such
an insulator, a protective tissue, and a site of energyanswers storage. Lipids have been as rewritten in teaching
those in the vocal foldsstyle format
and the nuchalto(noo′kăl;
model the backanswer
of the neck)
take up less space per calorie than either carbohydrates or proteins
for the student. Helps students learn how to think critically.
ligament, which lies along the posterior of the neck, helping hold
and therefore are well adapted for energy storage.
the head upright. When elastic ligaments are stretched, they tend to
Adipose tissue exists in both yellow and brown forms. Yellow
636 PART 3 Integration and Control Systems shorten to their original length, much as an elastic band does.
adipose tissue is by far the most abundant. Yellow adipose tissue
CRiTiCAL THiNkiNGappears white at birth, but it turns yellow with age because of
Predict 4
1. The hypothalamohypophysialthe portal accumulation
system connects the hypothala- of pigments,
6. An anatomy such as carotene,
and physiology instructor asks two a plant
students pigment
to predict
mus with the anterior pituitary. Why is such a special circulatory sys- explain the advantages of having elastic ligaments that extend from vertebra
tem advantageous? that humans can metabolize asperson
claims the a source
would suffer offrom vitamin
hypocalcemia. The A.otherInstudent
a patient’s response to chronic vitamin D deficiency. One student
humans,
to vertebra in the vertebral column and why it would be a disadvantage if
brown
2. A patient exhibits polydipsia (thirst), adipose
polyuria (excess tissue is found
urine production),
and urine with a low specific gravity (contains few ions and no glucose).
inlowspecific areas of the wouldbody,
claims the calcium levels would remain within their normal range,
although at the end, and that bone reabsorption occur to such
tendons, which connect skeletal muscles to bone, were elastic.
as thewould
If you wanted to reverse the symptoms,
glucagon, ADH, or aldosterone? Explain.
axillae (armpits),
you administer insulin, the neck, and near the kidneys. The brown
the point that advanced osteomalacia might occur. With whom do
you agree, and why?

3. A patient complains of headachescolor results

and visual from
disturbances. the cytochrome
A casual
7. A patient arrives pigments
at the emergency room in inthe tissue’s
an unconscious numer-
condi-

ous mitochondria
glance reveals enlarged finger bones, a heavy deposition of bone over
tion. A medical emergency bracelet reveals that he has diabetes. The
and itspatient
abundant blood
is in either diabetic coma orsupply.
insulin shock. ItHowis candifficult
you tell to Dense irregular connective tissue contains protein fibers
the eyes, and a prominent jaw. The doctor determines that the head-

distinguish brown
aches and visual disturbances result from increased pressure within
adipose
which, and what treatment do you recommend for each condition?
from
8. Predict some ofyellow adipose
the consequences of exposurein babies
to intense because
and pro-
arranged as a meshwork of randomly oriented fibers. Alternatively,
the skull and that the presence of a pituitary tumor is affecting hor-
the color difference
mone secretion. Name the hormone causing the problem, and explain
is not
longed stress.
great. Brown adipose fat is specialized the fibers within a given layer of dense irregular connective tissue
why increased pressure exists within the skull.
4. Most laboratories are able to to generate heat
TSH, T as
9. Katie was getting nervous. At 16, she was the only one in her group of
, anda result of oxidative metabolism of lipid mol-
can be oriented in one direction, whereas the fibers of adjacent
Critical Thinking
friends who had not started menstruating. Katie had always dreamed

oriented at these innovative exercises

that layer.encourage
determine blood levels of
3
T . Given that ability, design a method of determining whether hyper-
4
thyroidism in a patient results ecules in mitochondria.
from a pituitary abnormality or from
of having three beautiful children someday and she was worried. Her
Itmother
can play a significant role in regulating
took her to see Dr. Josephine, who ordered several blood tests. layers are nearly right angles to Dense irregu-
the production of a nonpituitary thyroid stimulatory substance.
When the results came back, Dr. Josephine gently explained to Katie
students
lar to apply
connective chapter
tissue concepts
forms sheets to
of solve a problem.
connective tissue these
that have
body temperature in newborns and may also play a role in adult
and her mother that Katie would never be able to have children and
5. Over the past year, Julie has gradually gained weight. The increase in
metabolism (see
adipose tissue is distributed over her trunk, face, and neck, and her
chapter
would never menstruate. Dr. Josephine then asked Katie to wait in the
25).
outer room while she spoke privately to her mother. She explained to strength
questions in
help many
build directions
student'sbut less strength
knowledge ofin any
anatomysingle & direction
muscle mass appears to be decreased. Julie also feels weak and bruises
Reticular tissue forms
easily. Her physician suspects Cushing syndrome and orders a series
Katie’s mom that Katie has androgen insensitivity syndrome. Though
the framework of lymphatic tissue physiology
Katie is genetically male and her gonads produce more of the male than doeswhile regular connectivereasoning
developing tissue. and critical thinking skills.
of blood tests. The results reveal elevated blood levels of cortisol and reproductive hormone, testosterone, than the female reproductive
(table 4.8c), such
ACTH. There is no evidence of an extrapituitary source of ACTH.
as in the spleen
hormone, estrogen,and
Katie didlymph nodes,
not reflect the tissue changesas well
expected. as in
iv
Predict the cause of Julie’s condition and the treatments that are likely
to be recommended. bone marrow and the liver.
What malfunction in Katie’s body would cause this? Why does Katie’s
body lookIt is characterized
feminine if she is genetically male? by a network of Predict 5
Answers in Appendix F
reticular fibers and reticular cells. Reticular cells produce the reticular Scars consist of dense irregular connective tissue made of collagen fibers.
fibers and remain closely attached to them. The spaces between Vitamin C is required for collagen synthesis. Predict the effect of scurvy, which
is a nutritional disease caused by vitamin C deficiency, on wound healing.
the reticular fibers can contain a wide variety of other cells, such
Visit this book’s website at www.mhhe.com/seeley10 for chapter quizzes, interactive learning exercises, and other study tools.

anatomy & physiology

van03636_ch00_FM.indd 4 12-10-12 11:03 AM
 800 PART 4 Regulation and Maintenance

Clinical Acquired immunodeficiency Syndrome

IMPACT

A
cquired immunodeficiency syndrome numbers of helper T cells. Nonetheless, over a RNA from producing viral DNA. AZT can delay
(AIDS) is a life-threatening disease caused period of years the HIV numbers gradually the onset of AIDS but does not appear to
by the human immunodeficiency virus increase, and helper T cell numbers decrease. increase the survival time of AIDS patients.
(HIV). HIV is transmitted from an infected Normally, approximately 1200 helper T cells are However, the number of babies who contract
person to a noninfected person in body fluids, present per cubic millimeter of blood. An HIV- AIDS from their HIV-infected mothers can be
such as blood, semen, or vaginal secretions. infected person is diagnosed with AIDS when one dramatically reduced by giving AZT to the
The major methods of transmission are through or more of the following conditions appear: mothers during pregnancy and to the babies
unprotected sexual contact, through contami- The helper T cell count falls below 200 cells/mm3, following birth.
nated needles used by intravenous drug users, an opportunistic infection occurs, or Kaposi Protease inhibitors are drugs that inter-
through tainted blood products, and from a sarcoma develops. fere with viral proteases. The current treatment
pregnant woman to her fetus. Evidence indicates Opportunistic infections involve organisms for suppressing HIV replication is highly active
that household, school, and work contacts do that normally do not cause disease but do so antiretroviral therapy (HAART). This therapy
not result in transmission. Reduced exposure to when the immune system is depressed. Without uses drugs from at least two classes of antivirals.
HIV is the best prevention for its transmission. helper T cells, cytotoxic T and B cell activation Treatment may involve combining three drugs,
Practices such as abstinence, the use of latex is impaired, and adaptive resistance is sup- such as two reverse transcriptase inhibitors and
condoms, monogamy, and avoiding sharing pressed. Examples of opportunistic infections one protease inhibitor, because HIV is unlikely
needles are effective ways to reduce exposure include pneumocystis (noo-mō-sis′tis) pneu- to develop resistance to all three drugs. This
to HIV. Medical professionals should also use monia (caused by an intracellular fungus, strategy has proven very effective in reducing
care when handling body fluids, such as wear- Pneumocystis carinii), tuberculosis (caused by the death rate from AIDS and partially restoring
ing latex gloves. an intracellular bacterium, Mycobacterium health in some individuals.

Clinical Emphasis—Case Studies

HIV infection begins when a protein on tuberculosis), syphilis (caused by a sexually Still in the research stage are integrase
the surface of the virus, called gp120, binds to transmitted bacterium, Treponema pallidum), inhibitors, which prevent the insertion of viral
a CD4 molecule on the surface of a cell. The candidiasis (kan-di-dī′ă-sis; a yeast infection of DNA into the host cell’s DNA. Another advance
CD4 molecule is found primarily on helper T the mouth or vagina caused by Candida albicans), in AIDS treatment is a test for measuring viral
cells, and it normally enables helper T cells to and protozoans that cause severe, persistent load, which measures the number of viral
adhere to other lymphocytes—for example,
during antigen presentation. Certain mono-
cytes, macrophages, neurons, and neuroglia
diarrhea. Kaposi sarcoma is a type of cancer
that produces lesions in the skin, lymph nodes,
and visceral organs. AIDS symptoms resulting
RNA molecules in a milliliter of blood. The
actual level of HIV is one-half the RNA count
because each HIV has two RNA strands. Viral
Bring Relevance to the Reader
also have CD4 molecules. Once attached to the from the effects of HIV on the nervous system load is a good predictor of how soon a person
CD4 molecules, the virus injects its genetic include motor retardation, behavioral changes, will develop AIDS. If viral load is high, the

▶ NEW! Chapter opening photos and scenarios have been

material (RNA) and enzymes into the cell and progressive dementia, and possibly psychosis. onset of AIDS is likely to occur sooner than if
begins to replicate. Copies of the virus are A cure for AIDS has yet to be discovered. the viral load is low. It is also possible to detect
manufactured using the organelles and materi- Management of AIDS can be divided into two developing viral resistance by an increase in
als within the cell. Replicated viruses escape
from the cell and infect other cells.
categories: (1) management of secondary infec-
tions or malignancies associated with AIDS
viral load. In response, a change in drug dose
or type may slow viral replication. Current correlated to provide a more complete story and begin
critical thinking from the start of the chapter
Following infection by HIV, within 3 weeks and (2) control of HIV replication. In order for treatment goals are to keep viral load below
to 3 months, many patients develop mono- HIV to replicate, the viral RNA is used to make 500 RNA molecules per milliliter of blood.
nucleosis-like symptoms, such as fever, sweats, viral DNA, which is inserted into the host cell’s Effective treatment for AIDS is not the
fatigue, muscle and joint aches, headache, sore DNA. The inserted viral DNA directs the pro- same as a cure. Even if viral load decreases to
throat, diarrhea, rash, and swollen lymph nodes.
Within 1–3 weeks, these symptoms disappear as
duction of new viral RNA and proteins, which
are assembled to form new HIV. Key steps in
the point that the virus is undetected in the
blood, the virus still remains in cells through-
▶ UPDATED! Learn to Predict and chapter Predict questions
the immune system responds to the virus by
producing antibodies and activating cytotoxic
the replication of HIV require viral enzymes.
The enzyme reverse transcriptase promotes
out the body. The virus may eventually mutate
and escape drug suppression. The long-term with unique Learn to Predict Answers
T cells that kill HIV-infected cells. However, the the formation of viral DNA from viral RNA, and goal for deterring AIDS is to develop a vaccine
immune system is not able to eliminate HIV
completely, and by about 6 months a kind of
integrase (in′te-grās) inserts the viral DNA into
the host cell’s DNA. A viral protease (prō′tē-ās)
that prevents HIV infection.
Because of improved treatment, people with ▶ Clinical Impact boxes (placed at key points in the text)
“set point” is achieved in which the virus con- breaks large viral proteins into smaller proteins, HIV/AIDS can now live for many years. Thus,

▶ Case Studies
tinues to replicate at a low but steady rate. This which are incorporated into the new HIV. HIV/AIDS is being viewed increasingly as a
chronic stage of infection lasts, on average, Blocking the activity of HIV enzymes can chronic disease, not a death sentence. Working
8–10 years, and the infected person feels good inhibit the replication of HIV. The first effec- together, a multidisciplinary team of occupa-
and exhibits few, if any, symptoms. tive treatment of AIDS was the drug azidothy- tional therapists, physical therapists, nutrition-
Although helper T cells are infected and
destroyed during the chronic stage of HIV
midine (AZT; az′i-dō-thī′mi-dēn), also called
zidovudine (zī-dō′voo-dēn). AZT is a reverse
ists/dieticians, psychologists, infectious disease
physicians, and others can help patients with
▶ UPDATED! Clinical Genetics essays have been updated
infection, the body responds by producing large transcriptase inhibitor, which prevents HIV HIV/AIDS have a better quality of life.
and streamlined for accuracy and impact
▶ UPDATED! Diseases and Disorders tables
Clinical Impact boxes these in-depth boxed essays explore relevant ▶ UPDATED! Systems Pathologies with System Interactions
topics of clinical interest. Subjects covered include pathologies, current
van03636_ch22.indd 800 12-09-10 12:36 PM

research, sports medicine, exercise physiology, and pharmacology.

804 PART 4 Regulation and Maintenance CHAPTeR 22 Lymphatic System and Immunity 805

Systems
PATHOLOGY Systemic Lupus erythematosus SKELETAL MUSCULAR
Arthritis, tendinitis, and death Destruction of muscle tissue
INTEGUMENTARY of bone tissue can develop. and muscular weakness occur.
Background information Skin lesions occur frequently and
Systemic lupus erythematosus (SLE) is an autoimmune disease, mean- are made worse by exposure
to the sun. Hair loss results in
ing that tissues and cells are damaged by the body’s own immune sys-
diffuse thinning of the hair.
tem. The name describes the skin rash that is characteristic of the dis- NERVOUS
ease (figure 22A). The term lupus means “wolf ” and originally referred Memory loss, intellectual deterioration,

Name:
Lucy
: Female
to eroded (as if gnawed by a wolf) lesions of the skin. Erythematosus
refers to redness of the skin resulting from inflammation.
Systemic disorientation, psychosis, reactive depression,
headache, seizures, nausea, and loss of appetite
Gender
Age:
30 In SLE, a large variety of antibodies are produced that recognize
self-antigens, such as nucleic acids, phospholipids, coagulation factors, URINARY Lupus can occur. Stroke is a major cause of dysfunction
and death. Cranial nerve involvement results in

ts
Commen rced mother
red blood cells, and platelets. The combination of the antibodies with
self-antigens forms immune complexes that circulate throughout
Renal lesions and glomerulonephritis
can result in progressive kidney failure. Erythematosus facial muscle weakness, drooping of the eyelid,
and double vision. Central nervous system
vo
Lucy, a di been working
excess proteins are lost in the urine, lesions can cause paralysis.
the body and are deposited in various tissues, where they stimulate Symptoms
s resulting in lower than normal blood
of two, ha e past few inflammation and tissue destruction. Thus, SLE can affect many proteins, which can produce edema. (Highly variable)
ll- tim e th body systems, as the term systemic implies. For example, the most
fu cided • Skin lesions, particularly on face
t has de
years bu e her nursing common antibodies act against DNA released from damaged cells.
• Fever
et ENDOCRINE
to compl lupus when Normally, the liver removes the DNA, but sometimes DNA and
• Fatigue
sed with d stress of antibodies form immune complexes that tend to be deposited in the Sex hormones may play a role in SLe
s diagno • Arthritis
Lucy wa the adde kidneys and other tissues. Approximately 40–50% of individuals DIGESTIVE because 90% of the cases occur in
degree. ew that worsen. • Anemia
25 and kn her condition to ce and with SLE develop renal disease. In some cases, the antibodies can females, and females with SLe have
she was ca us e ndan bind to antigens on cells, causing the cells to lyse. For example,
Ulcers develop in the oral cavity and
reduced levels of androgens.
could her atte r Treatment
ratic as he
pharynx. Abdominal pain and vomiting
college id te rm
gh, by m ts was er antibodies binding to red blood cells cause hemolysis and anemia. are common, but no cause can be found. • Anti-inflammatory drugs
Sure enou ce on assignmen te alterna
ted The cause of SLE is unknown. The most popular hypothesis Inflammation of the pancreas and • Anti-malarial drugs
perform
an
an d em otional sta e end of the suggests that a viral infection disrupts the function of regulatory occasionally an enlarged liver and minor
el ar th d
energy lev ghs and lows. Ne on her face an T cells, resulting in loss of tolerance to self-antigens. The picture abnormalities in liver function occur. CARDIOVASCULAR
hi rash
between e developed a ing Lucy
’s is probably more complicated, however, because not all SLE
m. Know
Inflammation of the pericardium (pericarditis)
r sh
semeste lesion on her ar ested she receive patients have reduced numbers of regulatory T cells. In addition, with chest pain can develop. Damage to heart
d gg
a large re r instructor su coursework later some patients have decreased numbers of the helper T cells valves, inflammation of cardiac tissue, tachycardia,
he e
situation, ete and finish th that normally stimulate regulatory T-cell activity.
RESPIRATORY
arrhythmias, angina, and myocardial infarction can
pl Genetic factors probably contribute to the development
an incom er.
also occur. Hemolytic anemia and leukopenia can be
m m of the disease. The likelihood of developing SLE is much Chest pain may be caused by inflammation of the present (see chapter 19). Antiphospholipid antibody
that su higher if a family member also has it. In addition, family pleural membranes; fever, shortness of breath, and syndrome, through an unknown mechanism,
members of SLE patients who do not have SLE are much more hypoxemia may occur due to inflammation of the increases coagulation and thrombus formation,
lungs; alveolar hemorrhage can develop. which increases the risk for stroke and heart attack.
likely to have DNA antibodies than the general population does.
Approximately 1 of every 2000 individuals in the United States has
SLE. The first symptoms usually appear between 15 and 25 years of age
and affect women approximately nine times as often as men. A low-grade
fever is present in most cases of active SLE. The progress of the disease is potent therapies as conditions warrant. Aspirin and nonsteroidal anti-
unpredictable, with flare-ups followed by periods of remission. The sur- inflammatory drugs are used to suppress inflammation. Antimalarial drugs
Predict 8
vival after diagnosis is greater than 90% after 10 years. The most frequent are prescribed to treat skin rash and arthritis in SLE, but the mechanism of The red lesion Lucy developed on her arm is called purpura (pŭ r′poo-ră ),
causes of death are kidney failure, central nervous system dysfunction, action is unknown. Patients who do not respond to these drugs and those and it is caused by bleeding into the skin. The lesions gradually change
Figure 22A Systemic infections, and cardiovascular disease. who have severe SLE are helped by glucocorticoids. Although glucocorti- color and disappear in 2–3 weeks. Explain how SLE produces purpura.
Lupus erythematosus No cure for SLE exists, nor is there one standard of treatment, because coids effectively treat inflammation, they can produce undesirable side
The butterfly rash results from the course of the disease is highly variable and patient histories differ widely. effects, including suppression of normal adrenal gland functions. In patients
inflammation in the skin. Treatment usually begins with mild medications and proceeds to increasingly with life-threatening SLE, very high doses of glucocorticoids are used.

The ability to produce monoclonal antibodies may result in effective antigens of a particular type than normal cells, resulting in greater are modified to resemble human antibodies. This approach has then lysed by natural killer cells. Herceptin slows disease progression

Systems Pathologies boxes

treatments for tumors. If an antigen unique to tumor cells can be
found, monoclonal antibodies can deliver radioactive thesetreatment
isotopes, drugs, spreads
age, explore
be better able toarecover
specifi
from the c condition or
delivery. Tumor cells may also be more susceptible to dam-
or normal cells may treatment. disorder related
antibodiesto a tumors
particular
allowed monoclonal antibodies to sneak past the immune system.
Some uses of monoclonal to treat are yield- body system.
Many other immunotherapy Presented
approaches are being instudied,
a simplifi
and increases survival time, but it is not a cure for breast cancer.
and ed
toxins, enzymes, or cytokines that kill the tumor cell directly or activate One problem with monoclonal antibody delivery systems is ing promising results. For example, monoclonal antibodies with more treatments that use the immune system are sure to be developed.
case study
the immune systemformat, each Systems
to kill the cell. Unfortunately, so far researchers Pathology vignette
that the immune system recognizes thebegins withasaa patientradioactive
monoclonal antibody history iodinefollowed byregression
( I) have caused the background
of B-cell lym- information about the featured topic.
131

have found no antigen on tumor cells that is not also present on nor- foreign antigen. After the first exposure, a memory response quickly phomas with few side effects. Herceptin, a monoclonal antibody,
mal cells. Nonetheless, this approach may be useful if damage to normal destroys the monoclonal antibodies, rendering the treatment inef- ASSeSS YOuR PROgReSS
binds to a growth factor that is overexpressed in 25–30% of pri-
cells is minimal. For example, tumor cells may have more surface fective. In a process called humanization, the monoclonal antibodies mary breast cancers. The antibodies “tag” cancer cells, which are 63. What is immunotherapy? Give some examples.

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 Exceptional Art—Always created from the student perspective
A picture is worth a thousand words—especially when you’re learning anatomy
and physiology. Because words alone cannot convey the nuances of anatomy or
the intricacies of physiology, Seeley’s Anatomy & Physiology employs a dynamic
program
430
of full-color illustrations and photographs that support and further clarify
PART 3 Integration and Control Systems

the textual explanations:

▶13.1 Development
UPDATED! of the CNS
Fundamental Figures teamed
fromwith special
the neural online
crests and give rise support and now
to sensory, autonomic, and linked to APR
enteric neurons of the peripheral nervous system. They also give
UPDATED!
▶ LEARNING OUTCOMESHomeostasis figures were revised toanddraw a correlation from the
rise to all the pigmented cells of the body, the adrenal medulla, the
facial bones, the dentin of the teeth.
CHAPTER 26 Urinary System 949

text description of feedback

After reading this section, you should be able to
system
A. Describe the development of the neural tube and name
componentsA series ofto the
pouches fi gure.
develops Maintains
in the anterior part of the neural
tube, forming three brain regions in the early embryo (figure 13.3a):
Renal capsule

consistency throughout each organ thatsystem

Cortex
the embryonic pouches and the adult brain structures a forebrain, or prosencephalon (pros-en-sef′ă-lon); a midbrain, or Medulla
they become. mesencephalon (mez-en-sef′ă-lon); and a hindbrain, or rhomben- Artery and vein
in the renal sinus

▶ NEW! All figures were visually linked to create consistency throughout the
Segmental artery
B. Explain the origin of the ventricles of the brain. cephalon (rom-ben-sef′ă-lon). The pouch walls become the various Renal sinus
portions of the adult brain (table 13.2). The forebrain divides into the (space) Hilum (indentation)

Thetext.
brain isTh
the e same
part colors
of the central aresystem
nervous always (CNS)used
that is for the same type of arrow, cytoplasm
telencephalon (tel-en-sef′ă-lon), which becomes the cerebrum, and Renal artery
contained within the cranial cavity (figure 13.1). It consists of the the diencephalon (dī-en-sef′ă-lon). The midbrain remains a single
Renal pyramid

in a cell,
brainstem, symbols
the cerebellum, for ions,and
the diencephalon, and molecules, etc.
the cerebrum structure as in the embryo, the mesencephalon, but the hindbrain Renal vein

(table 13.1). The brainstem includes the medulla oblongata, the divides into the metencephalon (met′en-sef′ă-lon), which becomes the Renal papilla

▶ Step-by-step Process figures

pons, and the midbrain. We begin our study of the brain and the pons and cerebellum, and the myelencephalon (mī′el-en-sef′ă-lon), Minor calyx Renal pelvis

cranial nerves by describing how the CNS develops in the fetus. which becomes the medulla oblongata (figure 13.3b,c). Major calyx

▶ Atlas-quality cadaver images The pouch cavities become fluid-filled ventricles (ven′tri-klz).
Renal column
The CNS forms from a flat plate of ectodermal tissue (see Ureter

chapter 4), the neural plate, on the dorsal surface of the embryo, The ventricles are continuous with each other and with the central
Medullary rays

(a)
which is influenced in part by the underlying rod-shaped notochord canal of the spinal cord. The neural tube develops flexures that cause
▶ Illustrated tables
(figure 13.2). The lateral sides of the neural plate become elevated the brain to be oriented almost 90 degrees to the spinal cord.
as waves, forming neural folds. The crest of each fold is called a
▶ Photos side-by-side with illustrations
Renal capsule

neural crest, and the center of the neural plate becomes the neural
ASSESS YOUR PROGRESS Cortex

groove. The neural folds move toward each other in the midline,
▶ NEW! Color saturation of art makes the art more engaging
and the crests fuse to create a neural tube (figure 13.2). The cephalic 1. Name the five pouches of the neural tube and the part of the
adult brain that each division becomes.
Renal sinus
Medulla

portion of the neural tube becomes the brain, and the caudal portion (space)

becomes the spinal cord. Neural crest cells are cells that separate
▶ Macro-to-micro art 2. What do the cavities of the neural tube become in the adult brain?

Hilum
Renal pyramid (indentation)
Renal papilla
Renal column Renal artery

Renal vein

FUNDaMeNTal Figure Major calyx

Minor calyx
Renal pelvis
Ureter

(b)

Anterior
FiguRE 26.3 Frontal Section of the Kidney and ureter
(a) A frontal kidney section shows that the cortex forms the outer part of the kidney, and the medulla forms the inner part. A central cavity called the renal sinus
contains the renal pelvis. The renal columns of the kidney project from the cortex into the medulla and separate the pyramids. (b) Photograph of a longitudinal
section of a human kidney and ureter.

Corpus callosum Cerebrum

Thalamus
Diencephalon Posterior
Hypothalamus van03636_ch26.indd 949 12-09-18 11:34 AM

Midbrain
454 PART 3 Integration and Control Systems

Brainstem Pons
Table 13.5 Cranial Nerves and Their Functions—Continued
Cerebellum
Medulla
Consequences of
oblongata
Cranial Nerve Foramen or Fissure* Function Lesions to Nerve
Medial view
X. Vagus Jugular foramen Sensory, motor,† and Difficulty swallowing
parasympathetic and/or hoarseness;
FIGURE 13.1 Regions of the Brain Left vagus nerve uvula deviates away from
Sensory from inferior
Medial view of a mid-saggital section of the right half of the brain. Pharyngeal pharynx, larynx, thoracic side of the dysfunction
branch Superior vagal and abdominal organs; sense
Right vagus ganglion
of taste from posterior tongue
nerve Larynx Inferior vagal
ganglion Motor to soft palate, pharynx,
Superior laryngeal intrinsic laryngeal muscles
branch (voice production), and an
extrinsic tongue muscle
(palatoglossus)
van03636_ch13.indd 430 Left recurrent
12-09-10 12:22 PM
Right recurrent Proprioceptive from
laryngeal branch
laryngeal branch those muscles
Cardiac branch
Parasympathetic to thoracic
Cardiac
branch Lung and abdominal viscera

Pulmonary plexus
Heart
Clearly labeled photos of dissected human Esophageal plexus

cadavers provide detailed views of anatomical

Liver Stomach
Celiac plexus
Spleen
structures, capturing the intangible characteristics
of actual human anatomy that can be appreciated
only when viewed in human specimens. Kidney
Colon Pancreas
Small
intestine

XI. Accessory Foramen magnum Motor† Difficulty elevating the

Jugular foramen Motor to sternocleidomastoid scapula or rotating the neck
and trapezius
Accessory nerve

vi
Spinal roots of accessory nerve

Accessory nerve

Cervical
spinal
nerves
van03636_ch00_FM.indd 6 12-10-12 11:03 AM
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Thinking Questions
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 tentH edItIon
Changes

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The tenth edition of Seeley’s Anatomy & Physiology is the result of extensive analysis of the text and
evaluation of input from instructors who have thoroughly reviewed chapters. The outcome is a retention
of the beloved features which foster student understanding, with an emphasis on a sharper focus within
many sections, affording an even more logical flow within the text. Throughout every chapter the writing
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information available
cHAPTeR 14 Integration of Nervous System Functions 475

14.2 control of Skeletal muscles 30% of upper motor neurons are located in the primary motor
cortex. Another 30% are in the premotor area, and the rest are in
the primary somatic sensory cortex.
LeARning OuTcOmeS 146 PART 2 Support and Movement
The cortical functions of the primary motor cortex are arranged
After reading this section, you should be able to topographically according to the general body plan—similar to the
topographic arrangement of the primary somatic sensory cortex
A. Describe the primary motor area of the cerebral cortex Clinical (figureSkin Cancer
14.13). The neuron cell bodies controlling motor functions
GeNeTICS
and discuss how it interacts with other parts of the
of the feet are in the most superior and medial portions of the
frontal lobe.
S
kin cancer is the most common type of Genetics, “Genetic Changes in Cancer Cells,” exposed to sunlight, such as the face, neck,
cancer. Most skin cancersprecentral gyrus,
result from in chapter 3). whereas those ears, forandthe dorsumface areandinhand.the
of the forearm A inferior
B. Distinguish between upper and lower motor neurons, damage caused by the ultraviolet (UV)
region.
radiation in sunlight. Some skin
The amount of protective melanin in the physician should be consulted if skin cancer
cancers are Muscle groups
skin affects the likelihood ofwith many
developing motor
skin is suspected. units are represented by
and between direct and indirect tracts. induced by chemicals, x-rays, depression of cancer. Fair-skinned individuals, who have less There are three types of skin cancer: basal
relatively
the immune system, or inflammation,
others are inherited.
large
whereas melanin, areas
are at of
an increased the
risk primary
of develop- motor
cell carcinoma, squamouscortex. For
cell carcinoma,
ing skin cancer compared with dark-skinned melanoma (figure 5A). Basal cell carcinoma,
and example,

c. explain how the basal nuclei and the cerebellum regulate

UV radiation damages the genes (DNA) individuals, who have more melanin. Long- the most common type, affects cells in the stra-
motor function. in epidermal cells, producing mutations. If term or intense exposure to UV radiation also tum basale. Basal cell carcinomas have a varied
hose controlling ASSeSS YOuR PROgReSS a mutation is not repaired, the mutation is
passed to one of the two daughter cells when
increases the risk. Thus, individuals who are
older than 50, who have engaged in repeated
appearance. Some are open sores that bleed,
ooze, or crust for several weeks. Others are
of which has a The motor
12. Compare system
upper motor of thewith
neurons brain andmotor
lower spinalneurons.
cord is responsible for
ing oncogenes
a cell divides by mitosis. If mutations affect-
and tumor suppressor genes in
recreational or occupational exposure to the
sun, or who have experienced sunburn are
reddish patches; shiny, pearly, or translucent
bumps; or scarlike areas of shiny, taut skin.
unit summation maintaining the body’s posture and balance; for moving
division and the
epidermal cells accumulate, uncontrolled cell
skin cancer can result (see Clinical
at increased risk. Most skin cancers develop
on the parts of the body that are frequently
Removal or destruction of the tumor cures
most cases.
traction of these 13. Where are the primary motor, premotor, and prefrontal areas
trunk, head, limbs, and eyes; and for communicating through
of the cerebral cortex located? Explain the sequential nature
me are recruited. facial expressions and speech. Reflexes mediated through the spinal
Trunk
r

Hip
Arm
w
Shoulde

of their functions.
Elbo

rm

ted by relatively cord (see chapter 12) and the brainstem (see chapter 13) are respon- Knee
rea

Mi Rin le finand t
Lit HWris

14. Why sible

are some
for areas
someofbody
the body represented as larger
arethan other
Ind dle fin ger

e muscles inner- movements. These called involuntary

ex fin ger
Fo

fin ger

areas on the topographic map of the primary motor cortex? Ankle

r

ntrolling move- movements because they occur without conscious thought.

ge
g

b
t

wer motor units Voluntary movements, on the other hand, are consciously activated Toes um
Th
d

more and much motor toPathways

achieve a specific goal, such as walking or typing. Although (a) Basal cell carcinoma (b) Squamous cell carcinoma (c) Melanoma
Ne
ck
muscles are less Motor pathways,
consciously or tracts,
activated, descending
are the pathways
details of containing
most voluntary FiguRE 5A Cancer of the Skin
movements all
yeb
otor unit stimu- axons thatoccur
carry automatically
action potentials from
once regionsThus,
learned. of theacerebrum
toddler who or is just nd e
y e lid a jaw
E and
cerebellum to the brainstem
learning to walk mustor spinal cord. Theon
concentrate names
everyof step.
descending
However, once Lips
ace
primary motor viiipathwaysthe are toddler
based onstarts
theirwalking,
origin and he termination.
or she does not Much havelike
tothe
think
parallel toabout
the cleavage lines is less likely to gap than an incision
5.3 Subcutaneous Tissue F
made across them. The development of infections and the forma-
motor functions names ofthe ascending pathways, thecontrol
moment-to-moment prefix of
indicates a pathway’s
every muscle because neural
tion of scar tissue are reduced in wounds where the edges are
closer together. Tongue
ry motor cortex. origin, and the suffix
circuits in the indicates
reticularitsformation
destination.
andFor example,
spinal the If the skin is overstretched, the dermis may rupture and
cord automatically LEARNiNg OuTCOME
After reading this section, you should be able to
leave lines that are visible through the epidermis. These lines
e neurons of the corticospinal tractthe
control is alimbs.
motorAfter
pathway that originates
learning a complex in the
task,cerebral
suchofas scar typing,
tissue, called stretch marks, can develop on the abdo- A. Describe the structure and functions of the subcutaneous
tissue underlying the skin.
ation is made in cortex andpeople
terminates in the spinal
can perform cord (figure
it relatively 14.14).
automatically. men and breasts of a woman during pregnancy or on the skin
of athletes who have quickly increased muscle size by intense
Phary
nx
Just as a house rests on a foundation, the skin rests on subcutaneous
ntract, in what The descending
van03636_ch00_FM.indd 8 Voluntarymotormovements
fibers are divided
dependintoontwo groups:
upper anddirect
lower motor
weight training.
tissue, which attaches it to underlying bone and muscle and supplies 12-10-12 11:03 AM
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practice quizzing

FUNDAMeNTAL Figure Fundamental Figures—

1 Foreign proteins or
self-proteins within the cytosol
Integrated with special
ConnectPlus® assets!
are broken down into fragments Antigens
that are antigens. (protein
2 Antigens are transported into 3
fragments) 2
the rough endoplasmic MHC class I
reticulum. molecule
3 Antigens combine with MHC Stimulates cell
class I molecules. 1 MHC class I/ destruction
4 The MHC class I/antigen antigen complex

▶ NEW! Special icons now link Fundamental Figures

complex is transported to the
Golgi apparatus, packaged into 5
a vesicle, and transported to 4
the plasma membrane. Foreign antigen

with corresponding modules within APR

Membrane Lumen
5 Foreign antigens combined Protein
with MHC class I molecules MHC class I
stimulate cell destruction. Rough molecule
6 Self-antigens combined with endoplasmic

▶ Additional online ConnectPlus® resources support

MHC class I molecules do not reticulum Self-antigen
stimulate cell destruction. Golgi
apparatus 6

these important figures

Normally does not
stimulate cell
(a) destruction

1 A foreign antigen is ingested by

endocytosis and is within a
vesicle.
Vesicle
containing
▶ Grouped together, the Fundamental Figures
represent an excellent summary and study tool
2 The antigen is broken down into MHC class II
fragments to form processed molecules
foreign antigens.
3 The vesicle containing the
processed foreign antigens fuses 2
with vesicles produced by the
Golgi apparatus that contain MHC 3
1
class II molecules. Processed
foreign antigens and MHC Vesicle
class II molecules combine. containing
4 The MHC class II/antigen processed
complex is transported to the foreign antigens
plasma membrane. Foreign 4
5 The displayed MHC class antigen MHC class II
II/antigen complex can molecule
stimulate immune cells. MHC class II/
antigen complex
Processed
5 foreign antigen

Stimulates
(b) immune cells

PROCeSS FiguRe 22.15 Antigen Processing

(a) Foreign proteins, such as viral proteins, or self-proteins in the cytosol are processed and presented at the cell surface by MHC class I molecules.
(b) Foreign antigens are taken into an antigen-presenting cell, processed, and presented at the cell surface by MHC class II molecules.

a response from a B cell or a T cell. In many cases, costimulation

Predict 4 by additional signals is also required. Costimulation is accomplished
Antibodies bind to a foreign antigen, resulting in removal of that foreign by cytokines released from cells and by molecules attached to the
antigen from the body. explain what happens to antibody production as
surfaces of cells (figure 22.16a). Cytokines produced by lympho-
the foreign antigens decrease.
cytes are often called lymphokines (lim′fō-kīnz). Table 22.4 lists
important cytokines and their functions.
Costimulation Certain pairs of surface molecules can also be involved in
The combination of an MHC class II/antigen complex with an costimulation (figure 22.16b). When the surface molecule on one
antigen receptor is usually only the first signal necessary to produce cell combines with the surface molecule on another, the combination

788
ix
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 b
Helping students learn
odybuilding is a popular
Clinical
IMPaCT
Learn to Predict and Learn to Predict Answer—
sport how
worldwide.to think
Its participants combine diet and specific
weight training to develop maximum mus-
cle mass and minimum body fat, with the goal of
achieving a complete, well-balanced physique.
Bodybuilding

Skill, training, and concentration are required to

10
cHAPTeR 10 Muscular System

learn to Predict
357

While weight training, Pedro strained his

back and damaged a vertebral disk. The
build a well-proportioned, muscular body and to

Muscular System
bulged disk placed pressure on the left side
know which exercises develop a large number of
of the spinal cord, compressing the third
muscles and which are specialized to build up cer-
tain parts of the body. An uninformed, untrained lumbar spinal nerve, which innervates the
GROSS aNaTOMY
muscle builder can build some muscles and ig-
nore others; the result is a disproportioned body.
following muscles: psoas major, iliacus,
pectineus, sartorius, vastus lateralis,
Is the old adage “no pain, no gain” correct? vastus medius, vastus intermedius, and
Not really. Overexercising can cause soreness
rectus femoris. as a result, action potential

W
and small tears in muscles. Torn muscles are
weaker, and ithout
it maymuscles,
take up towe humans
3 weeks would be little more than department store man-
to repair conduction to these muscles was reduced.
the damage, nequins—unable
even though the soreness to walk, maytalk,
last blink our eyes, or even hold this book. But Using your new knowledge about the
only 5–10none days. of these inconveniences would bother us for long because we would histology and physiology of the muscular
Historically, although bodybuilders had a
also not be able to breathe. system from chapter 9 and combining it
lot of muscle mass, they were not “in shape.”
One of the major characteristics of living human beings is our ability to move
However, today bodybuilders exercise aerobi-
with the information about gross muscle
about.
cally inBut we also
addition to use our skeletal
“pumping iron.” muscles when we areFiGuRe not “moving.” Postural muscles
10A Bodybuilders anatomy in this chapter, predict Pedro’s
are constantly contracting to keep
A current topic of discussion for modern us sitting or standing upright. Respiratory muscles symptoms and which movements of his
are constantlyisfunctioning
bodybuilders to keep usshort-
whether bodybuilding breathing, even evidence
whelming while weat are
this asleep.
time showsCommuni-
that the Bodybuilders
lower limb also
were have their other
affected, own lan-
than
ens their
cation lifekinds
of all span. For instance,
requires scientifi
skeletal c evi- life
muscles, span offor
whether active peopletyping,
writing, is longerorthan that of
speaking. guage. Thwalking
ey refer to
on“lats,”
a flat “traps,”
surface.and
What“delts”
types of
dence has shown that restricted-calorie diets sedentary people,
Even silent communication using hand signals or facial expressions requires skeletal even when the activity is ex- rather than latissimus dorsi, trapezius, and del-
daily tasks would be difficult for Pedro
increase life span, yet some bodybuilders con- treme. As bodybuilders age and reduce the in- toids. The exercises have special names, such as
muscle function. to perform?
sume at least 4500 calories a day when in the tensity of their workouts, their muscle mass “lat pulldowns,” “preacher curls,” and “triceps
This chapter
“bulking” phase offocuses
training.on the anatomy
Others claim thatof the major but
decreases, named skeletal
not at muscles; cardiac
a porportionally higher extensions.”
▶ muscle
Part ofthethe is considered
training
overall process in more
of lift
critical depth
ing extremely
thinking in later chapters. The physiology
rate thanthat
heavyquestions
Predict other of skeletal
people with a lower
appear andactivity
smooth Photographs of bodybuilders are very use-
muscle was described
weights,
throughout such
each chapter,in
as squat-lift
aingchapter 9, including
500 pounds
special Learn the effects
in se- level.
to Predict of aging
In chapter
question 9, see on
now the
opensskeletal muscle.
section “Eff ects of ful in the study of anatomy because they allow
ries of repetitions, and carrying the extra Aging on Skeletal Muscle” for more informa- us to identify the surface anatomy of muscles
every poundage
chapter. of Ththeir
is specifi
acquired cally written
muscle scenariotion
mass causes takes knowledge
on the acquired
effects of reduced muscle mass as thatPhoto:
cannotThe
usually be seen in untrained people
man in this photo has clearly defined muscles.
from previous
their heart chapters, and However
to work harder. ties it into contentpeople
the over- in theage.
current chapter. (figure 10A).
Which muscles can you identify?

Module 6

Answer
Muscular System

learn to Predict From page 309

The description of Pedro’s injury provided specific information about We read in chapter 10 that the muscles affected by Pedro’s injury
the regions of the body affected: the left hip and thigh. In addition, we (psoas major, iliacus, pectineus, sartorius, vastus lateralis, vastus medius, 309
are told that the injury affected action potential conduction to the mus- vastus intermedius, and rectus femoris) are involved in flexing the
cles of these regions. These facts will help us determine Pedro’s symp- hip, the knee, or both. Therefore, we can conclude that movements
toms and predict the movements that may be affected by his injury. involving hip and knee flexion, such as walking up and down stairs,
Chapter 9 described the relationship between action potential would be affected. any tasks that require Pedro to walk up and down
van03636_ch10.indd conduction
309 and the force of muscle contractions. The reduction in stairs would be more difficult for him. Sitting and standing may also 12-09-07 3:35 PM
action potential conduction to the muscles of the hip and thigh reduced be affected, but the weakness in Pedro’s left hip and thigh may be
the stimulation of these muscles, reducing the contraction force. as a compensated for by increased muscle strength on his right side.
result of his injury, we can predict that Pedro experienced weakness
in his left hip and thigh, limiting his activity level. Answers to the rest of this chapter’s Predict questions are in Appendix G.

▶ The Learn to Predict Answer box at the end of each chapter teaches
students step-by-step how to answer the chapter-opening critical
thinking question. This is foundational to real learning and is a
crucial part of helping students put facts together to reach that
van03636_ch10.indd 357 12-09-07 3:37 PM
“Aha” moment of true comprehension.

van03636_ch00_FM.indd 10 12-10-12 11:04 AM

 Specialized Figures Clarify Tough Concepts
Studying anatomy and physiology does not have to be an intimidating task mired in
memorization. Seeley’s Anatomy & Physiology uses two special types of illustrations to
help students not only learn the steps involved in specific processes, but also apply the
knowledge as they predict outcomes in similar situations. Process Figures organize the
key occurrences of physiological processes in an easy-to-follow format. Homeostasis
figures summarize the mechanisms of homeostasis by diagramming how a given
system regulates a parameter within a narrow range of values.

CHAPTER 12 Spinal Cord and Spinal Nerves 407

Step-by-Step Process
Intense stretch of a skeletal muscle results in: To brain
Figures Process figures break
1 Golgi tendon organs detect tension applied to a tendon.
down physiological processes
2 Sensory neurons conduct action potentials to the spinal cord.
3 into a series of smaller steps,
3 Sensory neurons synapse with inhibitory interneurons Sensory
that synapse with alpha motor neurons. neuron allowing readers to build their
4 Inhibition of the alpha motor neurons causes muscle relaxation, 2
understanding by learning each
relieving the tension applied to the tendon. Note: The muscle that
relaxes is attached to the tendon to which tension is applied.
4 Inhibitory
interneuron important phase. numbers
Alpha motor
neuron are placed carefully in the art,
Muscle contraction
increases tension
permitting students to zero right
applied to tendons. In
response, action 1
in to where the action described
potentials are conducted
to the spinal cord. in each step takes place.
Sensory
neuron Hamstring
muscles
(flexor)
Golgi
tendon
organ

Golgi
tendon
Tendon Muscle reflex

Golgi tendon organ

3 4

PROCESS FIGURE 12.7 Golgi Tendon Reflex Actions Reactions

The effectors (the heart and

spindles causes them to be less sensitive to stretch. Sensitivity is great amount of tension to the tendon stimulates the sensory neu- Chemoreceptors in the medulla
blood vessels) respond:
oblongata detect an increase in blood
maintained because, while alpha motor neurons are stimulating the rons of the Golgi tendon organs. The sensory neurons stimulate the pH (often caused by a decrease in
Vasodilation decreases
peripheral resistance,
blood CO ). An increase in pH inhibits and heart rate and stroke
muscle to contract, gamma motor neurons are stimulating the muscle interneurons to release inhibitory neurotransmitters, which inhibit
2
the vasomotor and cardioregulatory volume decrease,
centers. reducing blood flow to the
spindles to contract. The contraction of the muscle fibers at the ends the alpha motor neurons of the associated muscle and cause it to lungs, which increases
blood CO2.
of the muscle spindles pulls on the center part of the muscle spindles relax. The sudden relaxation of the muscle reduces the tension
and maintains the proper tension. The activity of the muscle spindles applied to the muscle and tendons. This reflex protects muscles and
NEW Correlated With APR! Homeostasis
helps control posture, muscle tension, and muscle length. tendons from damage caused by excessive tension. For example, a
2
weight lifter who suddenly drops a heavy weight after straining toBlood
liftpH increases:
5
Blood pH decreases:

Figures with in-art explanations and Homeostasis Disturbed Homeostasis Restored

Golgi Tendon Reflex it does so, in part, because of the effect of the Golgi tendon reflex.
organ icons
The Golgi tendon reflex prevents contracting muscles from applying The muscles and tendons of the legs sustain tremendous1

amounts of tension, particularly in athletes. Frequently, an athlete’s

6

excessive tension to tendons. Golgi tendon organs are encapsulated

(normal range)
(normal range)

Golgi tendon reflex is inadequate to protect muscles and tendons

Blood pH
Blood pH

nerve endings that have at their ends numerous branches with small Start here

▶bundles
swellings adjacent to These specialized
of collagen flowcharts
fibers in tendons. Golgi ten- illustrating
from excessivethetension. For example, the large muscles and sudden
movements of football players and sprinters can make them vul-
mechanisms that body systems nerable
don organs are located near the muscle-tendon junction (figure 12.7).
As a muscle contracts, the attached tendons stretch, resulting in
employ to
to relatively frequent hamstring pulls and calcaneal
maintain homeostasis have been refined and
increased tension in the tendon. The increased tension stimulates (Achilles) tendon injuries. Blood pH decreases:
Homeostasis Disturbed
Blood pH increases:
Homeostasis Restored
action potentials in the sensory neurons from the Golgi tendon
improved
organs. Golgi tendon organs have a highin the tenth
threshold edition. Withdrawal Reflex
and are sensitive
only to intense stretch. The function of the withdrawal reflex, or flexor reflex, is to remove Actions
▶ More
The sensory neurons of the succinct
Golgi tendon explanations
organs pass through a limb or another body part from a painful stimulus. The sensory
Reactions

the dorsal root to the spinal cord and enter the posterior gray matter, receptors are pain receptors (see chapter 15). Following painful
where they branch▶andSmallsynapse icon illustrations included in boxes
sensory depict
The effectors (the heart and
with inhibitory interneurons. The stimuli, neurons conduct action potentials through the Chemoreceptors in the medulla
blood vessels) respond:
oblongata and the carotid and aortic

the organ or structure

muscle to which the Golgi tendon organ is attached. Applying a
being
interneurons synapse with alpha motor neurons that innervate the
discussed.
dorsal root to the spinal cord, where the sensory neurons synapse
with excitatory interneurons, which in turn synapse with alpha
bodies detect a decrease in blood pH
(often caused by an increase in blood
CO ). A decrease in pH stimulates the 2
Vasoconstriction
increases peripheral
resistance and heart rate
vasomotor and cardioregulatory centers. and stroke volume

▶ All homeostasis figures were revised to draw a increase, increasing blood

flow to the lungs, which
decreases blood CO2.

correlation from the text description of feedback

system components to the figure. Maintains
consistency throughout each organ system. HOmeOSTASiS FiguRe 21.43 Summary of the effects of pH and gases on Blood Pressure
(1) Blood pH is within its normal range. (2) Blood pH increases outside the normal range, which causes homeostasis to be disturbed. (3) Chemoreceptors detect the
van03636_ch12.indd 407 12-09-10 12:17
increase in blood pH. The cardioregulatory PM
and vasomotor centers in the brain are inhibited. (4) Nervous and hormonal changes alter the activity of cardiac muscle
of the heart and smooth muscle of the blood vessels (effectors), causing heart rate and stroke volume to decrease and blood vessels to dilate, reducing blood flow to
the lungs, which increases blood CO2. (5) These changes cause blood pH to decrease. (6) Blood pH returns to its normal range, and homeostasis is restored. Observe
the responses to a decrease in blood pH outside its normal range by following the red arrows. For more information on the chemoreceptor reflex, see figure 21.42;
for the central nervous system ischemic response, see the text.

758

van03636_ch21.indd 758 12-09-10 12:35 PM

xi

van03636_ch00_FM.indd 11 12-10-12 11:04 AM

 teACHIng And
Learning
Supplements

McGraw-Hill Connect® Anatomy & Physiology—

www.mcgrawhillconnect.com

anatomy & physiology

McGraw-Hill Connect® Anatomy & Physiology provides online

presentation, assignment, and assessment solutions. It connects your
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With Connect Anatomy & Physiology you can deliver
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mance—by question, assignment, or in relation to the class overall—
with detailed grade reports. Integrate grade reports easily with Learn-
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McGraw-Hill ConnectPlus® Anatomy & Physiology pro-
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McGraw-Hill LearnSmart™ is available as an integrated
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www.mhlearnsmart.com

xii

van03636_ch00_FM.indd 12 12-10-12 11:04 AM

 An Interactive Cadaver my my Course Content
y
Dissection Experience g Maximize efficiency by studying
This unique multimedia tool is exactly what’s required.
designed to help you master human g Your instructor selects the content
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xiii

van03636_ch00_FM.indd 13 12-10-12 11:04 AM

 Other Resources Available Correlated Website
The website that accompanies Seeley’s Essentials of Anatomy &
Physiology at www.mhhe.com/seeley10 allows instructors to
browse, select, and export files containing artwork from the text in
®

multiple formats to create customized classroom presentations,

My Lectures–McGraw-Hill Tegrity visually based tests and quizzes, dynamic course website content,
www.tegrity.com or printed support materials. The digital assets on the website are
all available for teaching presentations:
McGraw-Hill Tegrity® records and distributes your class lecture,
with just a click of a button. Students can view anytime/anywhere ▶ Art Full-color digital files of all the illustrations in the book
via computer, iPod, or mobile device. It indexes as it records your and unlabeled versions of the same artwork can be readily
PowerPoint® presentations and anything shown on your computer incorporated into lecture presentations, exams, or custom-made
so students can use keywords to find exactly what they want to classroom materials. In addition, all files are pre-inserted into
study. Tegrity is available as an integrated feature of McGraw-Hill blank PowerPoint slides for easy lecture presentations.
Connect Anatomy & Physiology or as standalone. ▶ Photos Digital files of instructionally significant photographs
from the text can be reproduced for multiple classroom uses.
Physiology Interactive Lab Simulations (Ph.I.L.S) 4.0 ▶ Tables Every table that appears in the text is available to
Ph.I.L.S. 4.0 is the perfect way to reinforce instructors in electronic form.
key physiology concepts with powerful lab ▶ Animations Numerous full-color animations illustrating
experiments. Created by Dr. Phil Stephens physiological processes are provided. Harness the visual
at Villanova University, this program offers impact of processes in motion by importing these files into
42 laboratory simulations that may be used classroom presentations or online course materials.
to supplement or substitute for wet labs. All
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book. Each exercise demonstrates the First, a student’s knowledge is adaptively leveled on core learning
anatomical and physiological facts and outcomes: Questioning reveals knowledge deficiencies that are
principles presented in the textbook by corrected by the delivery of content that is conditional on a student’s
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provide better lab prep, improve student performance, or make
your online experience one that rivals the real world, LabSmart
accomplishes it all.
Learn more at www.mhlabsmart.com

xiv

van03636_ch00_FM.indd 14 12-10-12 11:04 AM

 Acknowledgments

A great deal of effort is required to produce a heavily illustrated Designer Tara McDermott, and Media Project Manager Tammy Juran,
textbook like Seeley’s Anatomy & Physiology. Many hours of work we thank you for your time spent turning our manuscript into a book
are required to organize and develop the components of the textbook and its accompanying website. The McGraw-Hill employees with
while also creating and designing illustrations, but no text is solely the whom we have worked are excellent professionals. They have been
work of the authors. It is not possible to adequately acknowledge consistently helpful and their efforts are truly appreciated. Their
the support and encouragement provided by our loved ones. They commitment to this project has clearly been more than a job to them.
have had the patience and understanding to tolerate our absences Finally, we sincerely thank the reviewers and instructors who’ve
and our frustrations. They have also been willing to provide assistance provided us time and time again with remarkable feedback. We wish
and unwavering support. we could pay you what you’re really worth to us! To conscientiously
Many hands besides our own have touched this text, guiding it review a textbook requires a true commitment and dedication to
through various stages of development and production. We wish to excellence in teaching. Your helpful criticisms and suggestions for
express our gratitude to the staff of McGraw-Hill for their help and improvement were significant in revising the ninth edition. Our advi-
encouragement. We appreciate the guidance and tutelage of Director sory board was a special group of exceptional reviewers to whom
James Connely. We are sincerely grateful to Developmental Editor we could turn to at any time during the development of this text for
Mandy Clark for her careful scrutiny of the manuscript, her creative almost immediate valuable input. To those of you who’ve participated
ideas and suggestions, and her tremendous patience and encourage- in focus groups, we’d like to recognize the time you spent away from
ment. Special thanks are also offered to Copyeditor Deb DeBord for family and students in order to provide us with significant informa-
her attention to detail and for carefully polishing our words. A special tion about the future of anatomy and physiology at your institution.
acknowledgement of gratitude is owed to Project Manager Jayne We gratefully acknowledge all of you who played a part in this edition
Klein for her patience and detail-tracking abilities. Content Licensing by name in the next section.
Specialist John Leland, Production Supervisor Sandy Ludovissy,
Cinnamon VanPutte
Jennifer Regan
Andy Russo
Rod Seeley

Reviewers
Jerry M. Allen James Davis Ewa Gorski
KCTCS Somerset Community College University of Southern Maine Community College of Baltimore Cantonsville
Timothy A. Ballard Kathryn A. Durham Edwin Griff
University of North Carolina Wilmington Lorain County Community College University of Cincinnati at Cincinnati
David M. Bastedo Clair B. Eckersell Richard S. Groover
San Bernadino Valley College Brigham Young University Idaho J. Sargeant Reynolds Community College
Mary L. Bonine Angela M. Edwards Robert F. Halliwell
Northeast Iowa Community College–Peosta Trident Technical College TJL School of Pharmacy & Health Sciences
Nishi Sood Bryska Jeffrey G. Edwards Clare Hays
University of North Carolina Charlotte Brigham Young University Metro State College of Denver
Ronald A. Canterbury Maria Florez Christopher W. Herman
University of Cincinnati at Cincinnati Lone Start College–CyFair Eastern Michigan University
Claire Michelle Carpenter Purti Gadkari William Huber
Yakima Valley Community College Wharton County Junior College St. Louis Community College Forest Park

xv

van03636_ch00_FM.indd 15 12-10-12 11:04 AM

 xvi Acknowledgments

Jason Hunt Betsy Peitz Clare Hays

Brigham Young University Idaho California State University, Los Angeles Metropolitan State College of Denver
Susanne Kalup Raffaelle Pernice Chris Herman
Westmoreland County Community College Hudson County Community College Eastern Michigan University

Kamal Kamal Terri Pope Kristopher Kelley

Valencia Community College West Cuyahoga Community College University of Louisiana at Monroe

Helen M. Rarick Allart Kok

L. Henry Kermott
Wilbur Wright College Community College of Baltimore County
St. Olaf College
Marilyn Shannon Cynthia Littlejohn
April Kilgore The University of Southern Mississippi
KCTCS Somerset Community College Indiana University/Purdue University
Fort Wayne Karen McLellan
Tyjuanna R. S. LaBennett Indiana University/Purdue University
Jeff Simpson
North Carolina Central University Fort Wayne
Metropolitan State College of Denver
Steven D. Leidich Margaret Ott
Jason Tasch
Cuyahoga Community College Tyler Junior College
Cuyahoga Community College Metro
Jerri K. Lindsey Josephine Rogers
Janis G. Thompson
Tarrant County College NE University of Cincinnati
Lorain County Community College
Mary Katherine Lockwood Tim Roye
Corinne Ulbright San Jacinto College
University of New Hampshire Indiana University/Purdue University
Indianapolis Fadi N. Salloum
Karen K. McLellan
J. Sargeant Reynolds Community College
Indiana University/Purdue University Anthony J. Uzwiak
Fort Wayne The College of New Jersey Marilyn M. Shannon
Indiana University/Purdue University
Kenneth Michalis Charles Wright III Fort Wayne
San Bernadino Valley College Community College of Baltimore County–
Denise Slayback–Barry
Claire A. Miller Essex
Indiana University/Purdue University
Community College of Denver Indianapolis
William R. Millington Accuracy Checkers Eric L. Sun
Albany College of Pharmacy Nishi Bryska Macon State College
Dan Miska UNC Charlotte
Corinne Ulbright
Wright State University Lois Brewer Borek Indiana University/Purdue University
J. Jean Mitchell Georgia State University Indianapolis
Okaloosa–Walton College; University Ronald A. Canterbury MaryJo A. Witz
of Florida University of Cincinnati Monroe Community College
Ramzi A. Ockaili Ethel Cornforth Dwight Wray
J. Sargeant Reynolds Community College San Jacinto College South Brigham Young University–Idaho
Sidney L. Palmer Emily Y. F. González Martin Zahn
Brigham Young University Northern Essex Community College Thomas Nelson Community College

van03636_ch00_FM.indd 16 12-10-12 11:04 AM

 Contents

4.3 epithelial tissue 103

PART 1
4.4 Connective tissue 113
4.5 muscle tissue 124
4.6 nervous tissue 127
Organization of the Human Body 4.7 tissue membranes 129
4.8 tissue damage and Inflammation 130

1 The Human Organism

1.1 Anatomy and Physiology 2
1

1.2 Structural and functional organization of

4.9
4.10
tissue repair 130
effects of Aging on tissues 133

the Human body 4

1.3 Characteristics of life 4
1.4 biomedical research 6 PART 2
1.5 Homeostasis 9
1.6 terminology and the body Plan 12

Support and Movement

2 The Chemical Basis of Life
2.1
2.2
basic Chemistry 25
24

Chemical reactions and energy 32 5 Integumentary System

5.1
139
functions of the Integumentary System 140
2.3 Inorganic Chemistry 36 5.2 Skin 140
2.4 organic Chemistry 39 5.3 Subcutaneous tissue 146
5.4 Accessory Skin Structures 148

3 Cell Biology
3.1
3.2
56
functions of the Cell 57
How we See Cells 59
5.5
5.6
Physiology of the Integumentary System 153
effects of Aging on the Integumentary
System 158
3.3 Plasma membrane 59
3.4
3.5
3.6
membrane lipids 61
membrane Proteins 62
movement through the Plasma
6 Skeletal System: Bones and Bone
Tissue 163
6.1 functions of the Skeletal System 164
membrane 67
6.2 Cartilage 164
3.7 Cytoplasm 76
6.3 bone Histology 165
3.8 the nucleus and Cytoplasmic organelles 77
6.4 bone Anatomy 169
3.9 genes and gene expression 86
6.5 bone development 172
3.10 Cell life Cycle 91
6.6 bone growth 176

4
6.7 bone remodeling 180
Tissues 101 6.8 bone repair 181
4.1 tissues and Histology 102 6.9 Calcium Homeostasis 183
4.2 embryonic tissue 102 6.10 effects of Aging on the Skeletal System 186

xvii

van03636_ch00_FM.indd 17 12-10-12 11:04 AM

 7 Skeletal System: Gross Anatomy 191 11.3 Cells of the nervous System 365
11.4 organization of nervous tissue 370
7.1 Skeletal Anatomy overview 192
11.5 electrical Signals 371
7.2 Axial Skeleton 194
11.6 the Synapse 383
7.3 Appendicular Skeleton 222
11.7 neuronal Pathways and Circuits 393

8 Joints and Movement

8.1
8.2
Classes of Joints 240
types of movement 246
239

12 Spinal Cord and Spinal Nerves

12.1 Spinal Cord 401
400

12.2 reflexes 404

8.3 range of motion 250
12.3 Spinal nerves 410
8.4 description of Selected Joints 250
8.5 effects of Aging on the Joints 260

9 Muscular System: Histology and

Physiology 265
13 Brain and Cranial Nerves
13.1
13.2
development of the CnS 430
brainstem 433
429

9.1 functions of the muscular System 266 13.3 Cerebellum 435

9.2 general Properties of muscle 266 13.4 diencephalon 436
9.3 Skeletal muscle Structure 267 13.5 Cerebrum 438
9.4 Physiology of Skeletal muscle fibers 273 13.6 meninges, Ventricles, and Cerebrospinal
9.5 Physiology of Skeletal muscle 285 fluid 441
9.6 muscle fatigue 291 13.7 blood Supply to the brain 447
9.7 energy Sources 291 13.8 Cranial nerves 448
9.8 Slow-twitch and fast-twitch fibers 294
9.9
9.10
9.11
Heat Production 296
Smooth muscle 296
Cardiac muscle 300
14 Integration of Nervous System
Functions 461
14.1 Sensation 462
9.12 effects of Aging on Skeletal muscle 300 14.2 Control of Skeletal muscles 475
14.3 brainstem functions 482

10 Muscular System: Gross Anatomy

10.1 general Principles of Skeletal muscle
Anatomy 310
309 14.4
14.5
Higher brain functions 484
effects of Aging on the nervous System 490

10.2 Head and neck muscles 313

10.3 trunk muscles 326
10.4 upper limb muscles 334
15 The Special Senses
15.1
15.2
olfaction 501
taste 504
500

10.5 lower limb muscles 345

15.3 Visual System 507
15.4 Hearing and balance 526
15.5 effects of Aging on the Special Senses 540
PART 3

Integration and Control Systems

16 Autonomic Nervous System
16.1 overview of the Autonomic nervous
System 548
547

16.2 Contrasting the Somatic and Autonomic

11
nervous Systems 548
Functional Organization of Nervous 16.3 Anatomy of the Autonomic nervous
Tissue 361 System 550
11.1 functions of the nervous System 362 16.4 Physiology of the Autonomic nervous
11.2 divisions of the nervous System 362 System 556

xviii

van03636_ch00_FM.indd 18 12-10-12 11:04 AM

 16.5 regulation of the Autonomic nervous 20.3 Anatomy of the Heart 667
System 562 20.4 route of blood flow through the Heart 675
16.6 functional generalizations About the 20.5 Histology 675
Autonomic nervous System 564 20.6 electrical Properties 678

17
20.7 Cardiac Cycle 684
Functional Organization of the 20.8 mean Arterial blood Pressure 691
Endocrine System 569 20.9 regulation of the Heart 692
17.1 Principles of Chemical Communication 570 20.10 the Heart and Homeostasis 695
17.2 Hormones 572 20.11 effects of Aging on the Heart 702
17.3 Control of Hormone Secretion 577

21
17.4 Hormone receptors and mechanisms of
Action 580
Cardiovascular System: Blood Vessels
and Circulation 709

18 Endocrine Glands
18.1
18.2
594
overview of the endocrine System 595
Pituitary gland and Hypothalamus 595
21.1
21.2
21.3
functions of the Circulatory System 710
Structural features of blood Vessels 710
Pulmonary Circulation 716
21.4 Systemic Circulation: Arteries 716
18.3 thyroid gland 605
21.5 Systemic Circulation: Veins 725
18.4 Parathyroid glands 611
21.6 dynamics of blood Circulation 738
18.5 Adrenal glands 612
21.7 Physiology of the Systemic Circulation 743
18.6 Pancreas 618
21.8 Control of blood flow in tissues 749
18.7 Hormonal regulation of nutrient
utilization 622 21.9 regulation of mean Arterial Pressure 753
18.8 Hormones of the reproductive System 626
18.9
18.10
Hormones of the Pineal gland 627
other Hormones and Chemical
messengers 628
22 Lymphatic System and Immunity
22.1
22.2
functions of the lymphatic System 770
Anatomy of the lymphatic System 770
769

18.11 effects of Aging on the endocrine

22.3 Immunity 778
System 629
22.4 Innate Immunity 780
22.5 Adaptive Immunity 784
PART 4 22.6 Acquired Adaptive Immunity 799
22.7 overview of Immune Interactions 801
22.8 Immunotherapy 801
22.9 effects of Aging on the lymphatic System
Regulation and Maintenance and Immunity 806

19 Cardiovascular System: Blood

19.1 functions of blood 638
637
23 Respiratory System 811
23.1 functions of the respiratory System 812
23.2 Anatomy and Histology of the respiratory
19.2 Composition of blood 638
System 812
19.3 Plasma 638
23.3 Ventilation 827
19.4 formed elements 639
23.4 measurement of lung function 832
19.5 Hemostasis 649
23.5 Physical Principles of gas exchange 834
19.6 blood grouping 655
23.6 oxygen and Carbon dioxide transport in
19.7 diagnostic blood tests 659 the blood 836

20
23.7 regulation of Ventilation 843
Cardiovascular System: The Heart 665 23.8 respiratory Adaptations to exercise 848
20.1 functions of the Heart 666 23.9 effects of Aging on the respiratory
20.2 Size, Shape, and location of the Heart 667 System 848

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 24 Digestive System 858 27.4 regulation of Specific electrolytes in the
extracellular fluid 997
24.1 Anatomy of the digestive System 859
27.5 regulation of Acid-base balance 1005
24.2 functions of the digestive System 859
24.3 Histology of the digestive tract 861
24.4 regulation of the digestive System 863 PART 5
24.5 Peritoneum 864
24.6 oral Cavity 864
24.7 Swallowing 871
24.8 Stomach 873 Reproduction and Development

28
24.9 Small Intestine 881
24.10 liver 883 Reproductive System 1016
24.11 gallbladder 889 28.1 functions of the reproductive System 1017
24.12 Pancreas 889 28.2 Anatomy of the male reproductive
24.13 large Intestine 892 System 1017
24.14 digestion and Absorption 896 28.3 Physiology of male reproduction 1030
24.15 effects of Aging on the digestive System 903 28.4 Anatomy of the female reproductive
System 1034

25
28.5 Physiology of female reproduction 1043
Nutrition, Metabolism, and Temperature
28.6 effects of Aging on the reproductive
Regulation 912 System 1054
25.1 nutrition 913

29
25.2 metabolism 921 Development, Growth, Aging, and
25.3 Carbohydrate metabolism 922 Genetics 1063
25.4 lipid metabolism 930
29.1 Prenatal development 1064
25.5 Protein metabolism 932
29.2 Parturition 1086
25.6 Interconversion of nutrient molecules 934
29.3 the newborn 1088
25.7 metabolic States 935
29.4 lactation 1091
25.8 metabolic rate 937
29.5 first year After birth 1092
25.9 body temperature regulation 938
29.6 Aging and death 1093

26
29.7 genetics 1095
Urinary System 946
26.1 functions of the urinary System 947
Appendices
26.2 Kidney Anatomy and Histology 947
A Periodic table of the elements A-1
26.3 urine Production 955
26.4 regulation of urine Concentration and B Scientific notation A-2
Volume 968 C Solution Concentrations A-3
26.5 Plasma Clearance and tubular maximum 976 D pH A-4
26.6 urine movement 977 E Answers to review and Comprehension
26.7 effects of Aging on the Kidneys 981 Questions A-5
F Answers to Critical thinking Questions A-6

27 Water, Electrolytes, and Acid–Base

Balance 988
27.1 body fluids 989
G

Glossary
Answers to Predict Questions

g-1
A-23

27.2 regulation of body fluid Concentration

and Volume 990 Credits C-1
27.3 regulation of Intracellular fluid
Composition 996 Index I-1

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