Human Anatomy & Physiology

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Human Anatomy & Physiology 
Sixth Edition 
131831 
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! Elaine N. Marieb, R.N., Ph.D. 
~ Holyoke Community College 
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San Francisco Boston. New York 
Cape Town Hong Kong London Madrid Mexico City 
Montreal Munich Paris Singapore Sydney Tokyo Toronto 
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Contents 
anization of the Body 
1 The Human Body: An Orientatiolil 
An Overview of Anatomy and Physiology 2 
1 
Topics of Anatomy • Topics of Physiology • Complementarity 
of Structure and Function 
Levels of Structural Organization 3 
Maintaining Life 4 
Necessary Life Functions • Survival Needs 
Homeostasis 9 
Homeostatic Control Mechanisms • Homeostatic Imbalance 
The Language of Anatomy 12 
Anatomical Position and Directional Terms • Regional Terms 
• Anatomical Variability • Body Planes and Sections • Body 
Cavities and Membranes • Abdominopelvic Regions and 
Quadrants 
A CLOSER LOOK Medicallmaging: Illuminating the Body 20 
2 Chemistry Comes Alive '25 
PART 1: Basic Chemistry 26 
Definition of Concepts: Matter and Energy 26 
Matter • Energy 
Composition of Matter: Atoms and Elements 27 
Atomic Structure • Identifying Elements • Radioisotopes 
How Matter Is Combined: Molecules and Mixtures 31 
Molecules and Compounds • Mixtures • Distinguishing 
Mixtures from Compounds 
Chemical Bonds 32 
The Role of Electrons in Chemical Bonding • Types of 
Chemical Bonds 
Chemical Reactions 37 
Chemical Equations • Patterns of Chemical Reactions 
• Energy Flow in Chemical Reactions • Reversibility of 
Chemical Reactions • Factors InfluenCing the Rate of 
Chemical Reactions 
PART 2: Biochemistry 40 
Inorganic Compounds 40 
Water • Salts • Acids and Bases 
Organic Compounds 44 
Carbohydrates • Lipids • Proteins • Nucleic Acids (DNA 
and RNA) • Adenosine Triphosphate (ATP) 
63 3 Cells: The Living Units 
Overview of the Cellular Basis of Life 64 
The Plasma Membrane: Structure 65 
The Fluid Mosaic Model • Specializations of the Plasma 
Membrane 
The Plasma Membrane: Functions 69 
Membrane Transport • Generating and Maintaining a Resting 
Membrane Potential· Cell-Environment Interactions 
The Cytoplasm 85 
Cytoplasmic Organelles • Cellular Extensions 
The Nucleus 96 
Nuclear Envelope • Nucleoli • Chromatin 
Cell Growth and Reproduction 98 
The Cell Life Cycle • Protein Synthesis 
Extracellular Materials 110 
Developmental Aspects of Cells 111 
A CLOSER LOOK DNA Fingerprinting: Cracking Our Genetic 
"Barcode" 95 
4 Tissue: The Living Fabric 117 
Epithelial Tissue 118 
Special Characteristics of Epithelium • Classification 
of Epithelia • Glandular Epithelia 
Connective Tissue 126 
Common Characteristics of Connective Tissue • Structural 
Elements of Connective Tissue • Types of Connective Tissue 
Covering and Lining Membranes 138 
Cutaneous Membrane • Mucous Membranes • Serous 
Membranes 
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Nervous Tissue 140 
Muscle Tissue 140 
Tissue Repair 142 
Steps of Tissue Repair • Regenerative Capacity of Different 
Tissues 
Developmeiltal Aspects of Tissues 144 
A CLOSER LOOK Cancer-The Intimate Enemy 145 
5 The Integumentary System 
The Skin 152 
Epidermis • Dermis • Skin Color 
151 
Appendages of the Skin 157 
Sweat (Sudoriferous) Glands' Sebaceous (Oil) Glands' Nails 
• Hairs and Hair Follicles 
Functions of the Integumentary System 164 
Protection • Body Temperature Regulation • Cutaneous 
Sensation • Metabolic Functions • Blood Reservoir 
• Excretion 
Homeostatic Imbalances of Skin 166 
Skin Cancer • Burns 
Developmental Aspects of the Integumentary System 169 
A CLOSER LOOK 1IIuminating the Skin 162 
MAKING CONNECTIONS 170 
6 Bones and Skeletal Tissues 
Skeletal Cartilages 176 
175 
Basic Structure, Types, and Locations • Growth of Cartilage 
Classification of Bones 176 
Functions of Bones 178 
Bone Structure 179 
Gross Anatomy • Microscopic Anatomy of Bone • Chemical 
Composition of Bone 
Bone Development 183 
Formation of the Bony Skeleton • Postnatal Bone Growth 
Bone Homeostasis: Remodeling and Repair 187 
Bone Remodeling • Bone Repair 
Homeostatic Imbalances of Bone 193 
Osteomalacia and Rickets • Osteoporosis • Paget's Disease 
Developmental Aspects of Bones: Timing of Events 196 
A CLOSER LOOK Them Bones, Them Bones Goin' to Walk 
Around-Clinical Advances in Bone Repair 194 
MAKING CONNECTIONS 197 
7 The Skeleton 202 
PART 1: The Axial Skeleton 203 
The Skull 203 
Contents 
Overvie~'of Skull Geography' Cranium' Facial Bones 
• Special Characteristics of the Orbits and Nasal Cavity 
• Paranasal Sinuses • The Hyoid Bone 
The Vertebral Column 219 
General Characteristics • General Structure of Vertebrae 
• Regional Vertebral Characteristics 
The Bony Thorax 226 
Sternum • Ribs 
PART 2: The Appendicular Skeleton 228 
The Pectoral (Shoulder) Girdle 228 
Clavicles • Scapulae 
The Upper Limb 233 
Arm • Forearm • Hand 
The Pelvic (Hip) Girdle 237 
xv 
Ilium • Ischium • Pubis • Pelvic Structure and Childbearing 
The Lower Limb 241 
Thigh • Leg • Foot 
Developmental Aspects of the Skeleton 247 
8 Joints 252 
Classification of Joints 253 
Fibrous Joints 253 
Sutures • Syndesmoses • Gomphoses 
Cartilaginous Joints 254 
Synchondroses • Symphyses 
Synovial Joints 255 
General Structure • Bursae and Thndon Sheaths • Factors 
Influencing the Stability of Synovial Joints • Movements 
Allowed by Synovial Joints' Types of Synovial Joints 
• Selected Synovial Joints 
Homeostatic Imbalances of Joints 272 
Common Joint Injuries' Inflammatory and Degenerative 
Conditions 
Developmental Aspects of Joints 275 
A CLOSER LOOK Joints: From Knights in Shining Armor to 
Bionic Humans 274 
9 Muscles and Muscle Tissue 279 
Overview of Muscle Tissues 280 
Types of Muscle Tissue • Functional Characteristics of Muscle 
Tissue • Muscle Functions 
Chapter 9 continues 
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xvi Contents 
Chapter 9, continued 
Skeletal Muscle 281 
Gross Anatomy of a Skeletal Muscle • Microscopic Anatomy 
of a Skeletal Muscle Fiber • Sliding Filament Model of 
Contraction· Physiology of a Skeletal Muscle Fiber 
• Contraction of a Skeletal Muscle • Muscle Metabolism 
• Force of Muscle Contraction • Velocity and Duration of 
Contraction • Effect of Exercise on Muscles 
Smooth Muscle 309 
Microscopic Structure of Smooth Muscle Fibers • Contraction 
of Smooth Muscle • Types of Smooth Muscle 
Developmental Aspects of Muscles 318 
A CLOSER LOOK Athletes Looking Good and Doing Better with 
Anabolic Steroids? 308 
MAKING CONNECTIONS 316 
1 0 The Muscular System 324 
Interactions of Skeletal Muscles in the Body 325 
Naming Skeletal Muscles 325 
Muscle Mechanics: Importance of Fascicle Arrangement 
and Leverage 326 
Arrangement of Fasicles • Lever Systems: Bone-Muscle 
Relationships 
Major Skeletal Muscles of the Body 330 
Table 10.1 Muscles ofthe Head, Part I: Facial 
Expression 335 
Table 10.2 Muscles ofthe Head, Part 11: Mastication and 
Tongue Movement 338 
Table 10.3 Muscles of the Anterior Neck and Throat: 
Swallowing 340 
Table 10.4 Muscles of the Neck and Vertebral Column: 
Head and Trunk Movements 342 
Table 10.5 Muscles of the Thorax: Breathing 346 
Table 10.6 Muscles of the Abdominal Wall: Trunk 
Movements and Compression of' Abdominal Viscera 348 
Table 10.7 Muscles of the Pelvic Floor and Perineum: 
Support of Abdominopelvic Organs 350 
Table 10.8 Superficial Muscles of the Anterior and Posterior 
Thorax: Movements of the Scapula 352 
Table 10.9 Muscles Crossing the Shoulder Joint: 
Movements of the Arm 354 
Table 10.10 Muscles Crossing the Elbow Joint: Flexion and 
Extension of theForearm 357 
Table 10.11 Muscles of the Forearm: Movements of the 
Wrist, Hand, and Fingers 358 
Table 10.12 Summary of the Actions of Muscles Acting on 
);-he""Arm~ Forearm, and Hand 362 
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I Thbf;{lV.13 Intrinsic Muscles of the Hand: Fine Movements 
of the Fingers 364 
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Table 10.14 Muscles Crossing the Hip and Knee Joints: 
Movements of the Thigh and Leg 367 
Table 10.15 Muscles of the Leg: Movements of the Ankle 
and Toes 373 
Table 10.16 Summary of Actions of Muscles Acting on the 
Thigh, Leg, and Foot 379 
Table 10.17 Intrinsic Muscles of the Foot: Toe Movement 
and Arch Support 381 
UNIT THREE) Regulation and Integration 
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11 Fundamentals of the Nervous System and Nervous Tissue 387 
Organization of the Nervous System 388 
Histology of Nervous Tissue 389 
Neuroglia • Neurons 
Neurophysiology 397 
Basic Principles of Electricity • The Resting Membrane 
Potential • Membrane Potentials That Act as Signals • The 
Synapse • Postsynaptic Potentials and Synaptic Integration 
• Neurotransmitters and Their Receptors 
Basic Concepts of Neural Integration 421 
Organization of Neurons: Neuronal Pools • Types of Circuits 
• Patterns of Neural Processing 
Developmental Aspects of Neurons 423 
A CLOSER LOOK Pleasure Me, Pleasure Me! 424 
1 2 The Central Nervous System 
The Brain 431 
430 
Embryonic Development • Regions and Organization 
• Ventricles • Cerebral Hemispheres • Diencephalon 
• Brain Stem· Cerebellum· Functional Brain Systems 
Higher Mental Functions 456 
Brain Wave Patterns and the EEG • Consciousness 
• Sleep and Sleep-Awalze Cycles • Memory 
Protection of the Brain 463 
Meninges· Cerebrospinal Fluid· Blood-Brain Barrier 
• Homeostatic Imbalances of the Brain 
The Spinal Cord' 469 
Embryonic Development • Gross Anatomy and Protection 
• Cross-Sectional Anatomy • Spinal Cord Trauma and 
Disorders 
Diagnostic Procedures for Assessing CNS 
Dysfunction 480 
Developmental Aspects of the Central Nervous 
System 480 
A CLOSER LOOK Stem Cells: A Medical Miracle? 482 
1 3 The Peripheral Nervous System and Reflex Activity 489 
PART 1: Sensory Receptors and Sensation 490 
Sensory Receptors 490 
Classificatiop. by Stimulus Type • Classification by 
Location • Classification by Structural Complexity 
Overview: From Sensation to Perception 493 
General Organization of the Somatosensory System 
PART 2: Transmission Lines: Nerves and Their 
Structure and Repair 497 
Nerves and Associated Ganglia 497 
Structure and Classification • Regeneration of Nerve Fibers 
Cranial Nerves 499 
Spinal Nerves 508 
General Features • Innervation of Specific Body Regions 
PART 3: Motor Endings and Motor Activity 518 
Peripheral Motor Endings 518 
Innervation of Skeletal Muscle • Innervation of Visceral 
Muscle and Glands 
Overview of Motor Integration: From Intention to 
Effect 519 
Levels of Motor Control 
PART 4: Reflex Activity 520 
The Reflex Arc 520 
Components of a Reflex Arc 521 
Spinal Reflexes 521 
Stretch and Golgi Tendon Reflexes 
Developmental Aspects of the Peripheral Nervous 
System 526 
A CLOSER LOOK Pain: Sound the Alarm, But Pain Me Not! 494 
1 4 The Autonomic Nervous System 
Introduction 532 
531 
Comparison of the Somatic and Autonomic Nervous Systems 
• ANS Divisions 
ANS Anatomy 534 
Parasympathetic (Craniosacral) Division· Sympathetic 
(Thoracolumbar) Division • Visceral Reflexes 
ANS Physiology 541 
Neurotransmitters and Recepiors • The Effects of Drugs 
• Interactions of the Autonomic Divisions • Control of 
Autonomic Functioning 
Homeostatic Imbalances of the ANS 547 
Developmental Aspects of the ANS 550 
MAKING CONNECTIONS 548 
Contents xvii 
1 5 The Special Senses 554 
The Chemical Senses: Taste and Smell 555 
Taste Buds and the Sense of Taste • The Olfactory Epithelium 
and the Sense of Smell • Homeostatic Imbalances of the 
Chemical Senses 
The Eye and Vision 560 
Accessory Structures of the Eye • Structure of the Eyeball 
• Physiology of Vision 
The Ear: Hearing and Balance 581 
Structure of the Ear • Physiology of Hearing • Homeostatic 
Imbalances of Hearing • Mechanisms of Equilibrium and 
Orientation 
Developmental Aspects of the Special Senses 596 
Taste and Smell • Vision • Hearing and Balance 
1 6 The Endocrine System 603 
The Endocrine System: An Overview 604 
Hormones 605 
The Chemistry of Hormones • Mechanisms of Hormone 
Action • Target Cell Specificity • Half-Life, Onset, and 
Duration of Hormone Activity • Interactions of Hormones at 
Target Cells • Control of Hormone Release 
Major Endocrine Organs 611 
The Pituitary Gland (Hypophysis) • The Thyroid Gland 
• The Parathyroid Glands· The Adrenal (Suprarenal) Glands 
• The Pancreas • The Gonads • The Pineal Gland • The 
Thymus 
Other Hormone-Producing Strl:lctures 636 
Developmental Aspects of the Endocrine System 636 
A CLOSER LOOK Sweet Revenge: Can Biotechnology Tame the 
DM Monster? 634 
MAKING CONNECTIONS 638 
17 Blood 644 
Overview: Blood Composition and Functions 645 
Components • Physical Characteristics and Volume 
• Functions 
Blood Plasma 646 
Formed Elements 647 
Erythrocytes • Leukocytes • Platelets 
xviii Contents 
Chapter 17, continued 
Hemostasis 661 
Vascular Spasms • Platelet Plug Formation • Coagulation 
• Clot Retraction and Repair • Fibrinolysis • Factors Limiting 
Clot Growth or Formation • Disorders of Hemostasis 
Transfusion 'and Blood Replacement 667 
Transfusion of Whole Blood • Plasma and Blood Volume 
Expanders 
Diagnostic Blood Tests 671 
Developmental Aspects of Blood 671 
A CLOSER LOOK Concocting Blood: Artificial Blood 
Substitutes 666 
8 The Cardiovascular System: The Heart 675 
Heart Anatomy 676 
Size, Location, and Orientation • Coverings of the Heart 
• Layers of the Heart Wall • Chambers and Associated Great 
Vessels • Pathway of Blood Through the Heart • Coronary 
Circulation • Heart Valves 
Properties of Cardiac Muscle Fibers 687 
Microscopic Anatomy • Mechanism and Events of 
Contraction • Energy Requirements 
Heart Physiology 690 
Electrical Events • Heart Sounds • Mechanical Events: The 
Cardiac Cycle • Cardiac Output 
Developmental Aspects of the Heart 703 
A CLOSER LOOK From "Oh, What a Beautiful Morning" to 
Heart Boosters, Retreads, and 
Replacements 704 
19 The Cardiovascular System: Blood Vessels 711 
PART 1: Overview of Blood Vessel Structure and 
Function 712 
Structure of Blood Vessel Walls 712 
Arterial System 714 
Elastic (Conducting) Arteries • Muscular (Distributing) 
Arteries • Arterioles • Capillaries 
Venous System 720 
Venules • Veins 
Vascular Anastomoses 721 
PART 2: Physiology of Circulation 721 
Introduction to Blood Flow, Blood Pressure, and 
Resistance 721 
Definition of Terms • Relationship Between Blood Flow, Blood 
Pressure, and Resistance 
Systemic Blood Pressure 722 
Arterial Blood Pressure • Capillary Blood Pressure • Venous 
Blood Pressure 
Maintaining Blood Pressure 724 
Short-Term Mechanisms: Neural Controls' Short-Term 
Mechanisms: Chemical Controls' Long-Term Mechanisms: 
Renal Regulation • Monitoring Circulatory Efficiency 
• Alterations in Blood Pressure 
Blood Flow Through Body Tissues: Tissue Perfusion 732 
Velocity of Blood Flow • Autoregulation: Local Regulation of 
Blood Flow • Blood Flow in Special Areas • Blood Flow 
Through Capillaries and Capillary Dynamics • Circulatory 
Shock 
PART 3: Circulatory Pathways: Blood Vessels of the 
Body 740 
Developmental Aspects of the Blood Vessels 740 
Table 19.3 Pulmonary and Systemic Circulations 744 
Table 19.4 The Aorta and MajorArteries of the Systemic 
Circulation 746 
Table 19.5 Arteries of the Head and Neck 748 
Table 19.6 Arteries of the Upper Limbs and Thorax 750 
Table 19.7 Arteries of the Abdomen 752 
Table 19.8 Arteries of the Pelvis and Lower Limbs 756 
Table 19.9 The Venae Cavae and the Major Veins of the 
Systemic Circulation 758 
Table 19.10 Veins ofthe Head and Neck 760 
Table 19.11 Veins of the Upper Limbs and Thorax 762 
Table 19.12 Veins of the Abdomen 764 
Table 19.13 Veins ofthe Pelvis and Lower Limbs 766 
A CLOSER LOOK· Atherosclerosis?Get Out the Cardiovascular 
Drano 716' 
MAKING CONNECTIONS 742 
20 The Lymphatic System 
Lymphatic Vessels 772 
771 
Distribution and Structure of Lymphatic Vessels • Lymph 
Transport 
Lymphoid Cells and Tissues 775 
Lymphoid Cells • Lymphoid Tissue 
Lymph Nodes 776 
Structure of a Lymph Node • Circulation in the Lymph Nodes 
Other Lymphoid Orga~s 777 
Spleen • Thymus • Tonsils • Aggregates of Lymphoid 
Follicles 
Developmental Aspects of the Lymphatic System 782 
MAKING CONNECTIONS 780 
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21 The Immune System: Innate and Adaptive Body Defenses 786 
PART 1: Innate Defenses 787 
Surface Barriers: Skin and Mucosae 787 
Internal D'afenses: Cells and Chemicals 788 
Phagocytes • Natural Killer Cells • Infla=ation: Tissue 
Response to Injury • Antimicrobial Proteins • Fever 
PART 2: Adaptive Defenses 796 
Antigens 797 
Complete Antigens and Haptens • Antigenic Determinants 
• Self-Antigens: MHC Proteins 
Cells of the Adaptive Immune System: An Overview 798 
Lymphocytes • Antigen-Presenting Cells 
Humoral Immune Response 801 
Clonal Selection and Differentiation of B Cells 
• I=unological Memory • Active and Passive Humoral 
Immunity • Antibodies 
Cell-Mediated Immune Response 807 
Clonal Selection and Differentiation of T Cells • Specific T 
Cell Roles • Organ Transplants and Prevention of Rejection 
Homeostatic Imbalances of Immunity 818 
Immunodeficiencies • Autoi=une Diseases 
• Hypersensitivities 
Developmental Aspects of the Immune System 823 
A CLOSER LOOK Too Clean for Our Own Good? 822 
22 The Respiratory System 828 
Functional Anatomy of the Respiratory System 829 
The Nose and Paranasal Sinuses • The Pharynx • The Larynx 
• The Trachea • The Bronchi and Subdivisions: The Bronchial 
Tree • The Lungs and Pleurae 
Mechanics of Breathing 844 
Pressure Relationships in the Thoracic Cavity • Pulmonary 
Ventilation: Inspiration and Expiration • Physical Factors 
Influencing Pulmonary Ventilation • Respiratory Volumes and 
Pulmonary Function Tests • Nomespiratory Air Movements 
Basic Properties of Gases 852 
Dalton's Law of Partial Pressures • Henry's Law 
Composition of Alveolar Gas 853 
Gas Exchange Between the Blood, Lungs, and 
Tissues 853 
External Respiration: Pulmonary Gas Exchange • Internal 
Respiration: Capillary Gas Exchange in the Body Tissue~ 
Transport of Respiratory Gases by Blood 856 
Oxygen Transport • Carbon Dioxide Transport 
Control of Respiration 861 
Neural Mechanisms and Generation of Breathing Rhythm 
• Factors Influencing Breathing Rate and Depth 
Contents xix 
Respiratory Adjustments 868 
Adjustments During Exercise • Adjustments at High Altitude 
Homeostatic Imbalances of the Respiratory System 869 
Chronic Obstructive Pulmonary Disease • Asthma 
• Tuberculosis • Lung Cancer 
Developmental Aspects of the Respiratory System 871 
A CLOSER LOOK Dangerous Raptures ofthe Deep 866 
MAKING CONNECTIONS 874 
23 The Digestive System 881 
PART 1: Overview of the Digestive System 882 
Digestive Processes 883 
Basic Functional Concepts 884 
Digestive System Organs: Relationship and Structural 
Plan 885 
Relationship of the Digestive Organs to the Peritoneum 
• Blood Supply: The Splanchnic Circulation • Histology of the 
Alimentary Canal • Enteric Nervous System of the Alimentary 
Canal 
PART 2: Functional Anatomy of the Digestive 
System 888 
The Mouth, Pharynx, and Esophagus 888 
The Mouth and Associated Organs • The Pharynx • The 
Esophagus • Digestive Processes Occurring in the Mouth, 
Pharynx, and Esophagus 
The Stomach 897 
Gross Anatomy • Microscopic Anatomy • Digestive Processes 
Occurring in the Stomach 
The Small Intestine and Associated Structures 907 
The Small Intestine • The Liver and Gallbladder • The 
Pancreas • Digestive Processes Occurring in the Small 
Intestine, 
The Large Intestine 920 
Gross Anatomy • Microscopic Anatomy • Bacterial Flora 
• Digestive Processes Occurring in the Large Intestine 
PART 3: Physiology of Chemical Digestion and 
Absorption 925 
Chemical Digestion 925 
Mechanism of Chemical Digestion: Enzymatic Hydrolysis 
• Chemical Digestion of Specific Food Groups 
Absorption 929 
Absorption of Specific Nutrients • Malabsorption of Nutrients 
Developmental Aspects of the Digestive System 932 
MAKING CONNECTIONS 934 
i' 
xx Contents 
24 Nutrition, Metabolism, and Body Temperature Regulation 941 
Nutrition 942 
Carbohydrates • Lipids • Proteins • Vitamins • Minerals 
MetaboJism 955 
Overview • Carbohydrate Metabolism • Lipid Metabolism 
• Protein Metabolism • Catabolic-Anabolic Steady State of the 
Body • Absorptive and Postabsorptive States • The Metabolic 
Role of the Liver 
Energy Balance 982 
Regulation of Food Intake • Metabolic Rate and Heat 
Production • Regulation of Body Temperature 
Developmental Aspects of Nutrition and Metabolism 989 
A CLOSER LOOK Obesity: Magical Solution Wanted 980 
25 The Urinary System 
Kidney Anatomy 997 
996 
Location and External Anatomy • Internal Anatomy • Blood 
and Nerve Supply • Nephrons 
Kidney Physiology: Mechanisms of Urine Formation 1006 
Step 1: Glomerular Filtration • Step 2: Tubular Reabsorption 
• Step 3: Tubular Secretion • Regulation of Urine 
Concentration and Volume • Renal Clearance 
Urine 1022 
Physical Characteristics • Chemical Composition 
Ureters 1023 
Urinary Bladder 1025 
Urethra 1025 
Micturition 1025 
Developmental Aspects of the Urinary System 1027 
A CLOSER LOOK Chronic Renal Disease: A National Health 
Crisis in the Making 1020 
26 Fluid, Electrolyte, and Acid-Base Balance 1033 
Body Fluids 1034 
Body Water Content • Fluid Compartments • Composition of 
Body Fluids • Fluid Movement Among Compartments 
Water Balance and ECF Osmolality 1036 
Regulation of Water Intal<:e • Regulation of Water Output 
• Influence of ADH • Disorders of Water Balance 
Electrolyte Balance 1041 
The Central Role of Sodium in Fluid and Electrolyte Balance 
• Regulation of Sodium Balance • Regulation of Potassium 
Balance • Regulation of Calcium and Phosphate Balance 
• Regulation of Anions 
Acid-Base Balance 1048 
Chemical Buffer Systems • Respiratory Regulation of H+ • 
Renal Mechanisms of Acid-Base Balance • Abnormalities of 
Acid-Base Balance 
Developmental Aspects of Fluid, Electrolyte, and Acid-Base 
Balance 1058 
A CLOSER LOOK Sleuthing: Using Blood Values to Determine 
the Cause of Acidosis or Alkalosis 1055 
MAKING CONNECTIONS 1056 
UNIT 
1063 27 The Reproductive System 
Anatomy of the Male Reproductive System 1064 
The Scrotum • The Testes • The Penis • The Male Duct 
System • Accessory Glands • Semen 
Physiology of the Male Reproductive System 1070 
Male Sexual Response • Spermatogenesis • Hormonal 
Regulation of Male Reproductive Function 
Anatomy of the Female Reproductive System 1079 
The Ovaries • The Female Duct System • The External 
Genitalia • The Ma=ary Glands 
Physiology of the Female Reproductive System 1088 
Oogenesis • The Ovarian Cycle • Hormonal Regulation of 
the Ovarian Cycle· The Uterine (Menstrual) Cycle 
• Extrauterine Effects of Estrdgens and Progesterone • Female 
Sexual Response 
Sexually Transmitted Diseases 1096 
Gonorrhea • Syphilis • Chlamydia • Genital Warts 
• Genital Herpes 
Developmental Aspects of the Reproductive System: 
Chronology of Sexual Development 1097 
Embryological and FetalEvents • Puberty • Menopause 
A CLOSER LOOK Erectile Dysfunction and Passion Pills 1077 
MAKING CONNECTIONS 1103 
2 8 Pregnancy and Human Development 1109 
From Egg to Embryo 1110 
Accomplishing Fertilization • Preembryonic Development 
Events of Embryonic Development 1118 
Formation and Roles of the Embryonic Membranes 
• Gastrulation: Germ Layer Formation • Organogenesis: 
Differentiation of the Germ Layers 
Events of Fetal Development 1129 
Effects of Pregnancy on the Mother 1129 
Anatomical Changes • Metabolic Changes • Physiological 
Changes 
Parturition (Birth) 1131 
Initiation of Labor • Stages of Labor 
Adjustments of the Infant to Extrauterine Life 1133 
Taking the First Breath • Occlusion of Special Fetal Blood 
Vessels and Vascular Shunts • The Transitional Period 
Lactation 1134 
A CLOSER LOOK Contraception: To Be or Not to Be 1124 
29 Heredity 1139 
The Vocabulary of Genetics 1140 
Gene Pairs (Alleles) • Genotype and Phenotype 
Sexual Sources of Genetic Variation 1141 
Chromosome Segregation and Independent Assortment 
• Crossover of Homologues and Gene Recombination 
• Random Fertilization 
Types of Inheritance 1143 
Dominant-Recessive Inheritance .• Incomplete Dominance 
• Multiple-Allele Inheritance • Sex-Linked Inheritance 
• Polygene Inheritance 
Contents xxi 
Environmental Factors in Gene Expression 1147 
Nontraditional Inheritance 1147 
Genomic Imprinting • Extrachromosomal (Mitochondrial) 
Inheritance 
Genetic Screening, Counseling, and Therapy 1147 
Carrier RecOgnition • Fetal Testing • Human Gene Therapy 
Appendices 
A The Metric System 1153 
B The Amino Acids 1155 
C Two Important Metabolic Pathways 1156 
D Periodic Table of the Elements 1159 
E Reference Values for Selected Blood and Urine 
Studies 1160 
F Answers to Clinical Connections, Multiple Choice, and 
Matching Questions 1165 
Glossary 1168 
Text, Photography, and Illustration Credits 1189 
Index 1193 
Index 
Note: Page numbers in boldface indicate a definition. A t following a page number indicates 
tabular material, an I indicates an illustration, and a b indicates boxed material. 
A (adenine), 55-57, ,561, 99, Accessory glands, male, 10641, Acidemia, 1048 
1001 10681, 1069 Acid group of amino acids, 49, 
A bands (dark bands), 284, Accessory hemiazygos vein, 491 
2851,314t 7621, 7631, 763t . Acid hydrolases, 89 
ABCD rule, 166-167 Accessory nerves (XI), 4481, Acid mantle 
Abdomen, 141 4491,451,500, 5001, 5101 of skin, 164, 793t 
arteries, 7461, 7471, 752-755t muscles served by; 342t, 352t of vagina, 793t 
blood flow, at rest/during origin/course/functions, 507t Acidosis, 58, 1048 
exercise, 7321 Accessory oculomotor effects of, 1054-1055, 1054t 
innervation, 510, 5381, 540 (Edinger-Westphal) nuclei, metabolic, 1054, 1054t 
muscles, 330,...3311, 348t, 536 respiratory, 1050, 1054t 
3491 Acclimatization, 868-869 using blood values to 
veins, 7581, 7591, 764t, 7651 Accommodation, 572, 5721 diagnose, 1055b 
Abdominal aortic plexus, 5381, Accommodation pupillary Acids, 41-42 
540 reflex, 572 metabolic (fixed), 1051 
Abdominal cavity; 17, 171 ACE (angiotensin converting pH scale, 431 
Abdominal reflexes, 526 enzyme), 840, 10081, strong'wealz, 43, 1048, 10491 
Abdominal wall 1009 volatile, 1050-1051 
innervation, 510 Acetabularlabrum, 270, 2701 Acinar cells, 631, 6311 
muscles, 348t, 3491 Acetabulum, 237, 2381, 2441 Acinar exocrine glands, 126 
Abdominopelvic cavity; IS, 17, in female vs. male, 240t Acini,917 
171 Acetic acid, 967 Acne, 158 
regions/quadrants, 18, 191 Acetylcholine (ACh), 415, 416t Acoustic (auditory) meatus 
Abducens nerves (VI), 4481, in autonomic vs. somatic external, 2061, 207, 2081, 
450, 499, 5001, 504t, 564 nervous systems, 533, 2091,217t 
Abduction (movement), 261, 5331 internal, 2061, 2081, 209, 
2621 in gastric secretion 217t, 504t, 505t 
of lower limbs, 379-380t, regulation, 904 Acquired immune deficiency 
3801 neuromuscular junctions syndrome (AIDS), 818 
of upper limbs, 362-363t, and, 2891, 290 Acromegaly; 614, 616t 
3631 released by ANS neurons, Acromial end, of clavicle, 229, 
Abductor digiti minimi 541-542, 543t 2301,2351 
muscle, 364t, 3651, 381t, Acetylcholine (ACh) receptors, Acromial region, 141 
3821 2891,290 Acromioclavicular joint, 2301, 
Abductor hallucis muscle, Acetylcholinesterase (AChE), 232,258t 
381t, 3821 289t 290,415, 518 Acromion, 2301, 232, 2351, 
Abductor pollicis muscles, ANS and, 544t 2571,2691 
360t, 3611, 364t, 3651 Acetyl coenzyme A (acetyl Acrosomal reaction, 1111, 
actions of (summary), 362t CoA), 9561, 960, 9611 11121 
ABO blood groups, 668-669, Achalasia, 551 ACTH (adrenocorticotropic 
668t AChE. See hormone), 615, 616t, 
inheritance and, 1145, Acetylcholinesterase 627,6271 
1146t Achilles (calcaneal) tendon, stress response and, 6301 
Abortion, 1135 243,3331,3771,3781, Actin, 52t, 91, 921, 286,2861 
ABP (androgen-binding 3821 globular, 286 
protein), 1078, 10781 rupture of, 384 Actin (thin) ffiaments, 140, 
Absence seizures, 457 Achondroplasia, 199, 1144 282t, 286, 2861 
Absolute refractory period, ACh. See Acetylcholine in cardiac/skeletal/smooth 
406,4061 Acid-base balance, 1048 muscles, 31St 
in cardiac muscle abnormalities, 1053-1055, Action potentials (APs), 289, 
contraction, 688-689, 1058 402 
6891 aging and, 1058-1059 all-or-none phenomenon, 
Absorption, 882, 883, 8831, buffer systems 406 
929 chemical, 1048-1050, autorhythmic cardiac cells 
flowchart, 9261 10491 and, 690-691, 6901 
functions overview, 911t physiological, 1050 conduction velocities of, 407 
malabsorption of nutrients, renal, 1050-1053 generation of, 290, 2911, 
931-932 respiratory; 1050 402-404, 4031 
of specific nutrients, developmental aspects, homeostatic imbalance in, 
929-931 1058-1059 408-409 
small intestine adaptations renal compensations, 1054t, neurons and, 397, 402-409 
fOl; 908-910, 9091, 9101 lOSS, 1055b, 1058 postsynaptic potentials vs., 
Absorptive cells, 910, 9101 respiratory compensations, 414t 
Absorptive (fed) state, 971, 1054t, lOSS, 1055b, . propagation of, 404-405, 
972-974, 9721 1058 4051 
Index 1193 
refractory periods, 406, 4061 
skeletal muscle cells and, 
290, 2911, 402 
stimulus intensity and, 406, 
4061 
Activation energy; 54, 541, 551 
Active humoral immunity, 
802-804, 8031 
Active membrane transport, 
71, 75-80, 761 
in tubular reabsorption, 
10111, 1012 
summary; 81-82t 
Active sites, 52, 531, 541 
Acute hypersensitivities, 
820-821, 8211 
AD (Alzheimer's disease), 468 
Adam's apple, 8341, 835 
Adaptation, 496 
dark,578 
light, 577-578 
olfactory; 559-560 
Adaptive immune system, 796. 
See also Immune system 
Adaptive relaxation, 904 
Addison's disease, 626t, 628, 
1041, 1043 
Adduction (movement), 261, 
2621 
of lower limbs, 379-380t, 
3801 
of upper limbs, 362-363t, 
3631 
Adductor hiatus, 7561, 756t, 
7571 
Adductor muscles 
of foot, 3831,383t 
of hand, 364t, 3651 
of thigh, 3301, 3311, 3331, 
367,3681, 369t, 3711 
summary of actions of, 
379-380t, 3801 
Adductor tubercle, 2411, 242, 
2441 
Adenine (A), 55-57, 561, 99, 
1001 
Adenocarcinoma, 147,871 
Adenohypophysis, 612. See 
also Pituitary gland 
hormones of, 613-616, 
616-617t 
Adenoidectomy 
(adenotonsillectomy), 876 
Adenoids (pharyngeal tonsil), 
782, 8321, 833 
Adenoma, 147 
Adenosine deaminase (ADA), 
818 
Adenosine diphosphate (ADP), 
38, 381, 571, 58 
during muscle activity; 301, 
3011 
role in blood clotting, 662 
Adenosine monophosphate 
(AMP), 571, 58 
1194 Index 
Adenosine triphosphate (ATPL 
26. See also ATP 
Adenylate cyclase, 606, 606f 
Adherence, in phagocytosis, 
788, 789f 
Adhesions, 144 
ADH. See Antidiuretic 
hormone 
Adipocytes, 132, 132f 
Adipose capsule of kidneys, 
998,998f 
Adipose tissue, 132, 132fas loose connective tissue, 
127f 
as source of blood glucose, 
975 
hormones secreted by, 636 
in skin, 153f 
preferred energy source of, 
975t 
sympathetic effects, 545t 
ADP. See Adenosine 
diphosphate 
Adrenal glands, 604f, 
624-630, 626f 
adrenal cortex, 624-625, 
625f 
hormones of, 48t, 
625-629, 626t 
adrenal medulla, 624, 625f, 
629 
ANS fibers/effects, 538f, 
541,545t 
hormones, 626t, 
629-630, 629f, 726 
arterial supply, 746f 
kidneys in relation to, 997 
stress response and, 
629-630, 630f 
Adrenergic fibers, 542 
Adrenergic receptors, 542, 
543t 
Adrenocorticotropic hormone 
(ACTHL 615, 616t, 627, 
627f 
stress response and, 630f 
Adrenocorticotropic hormone 
(corticotropinL 615, 616t 
Adult celiac disease, 931-932 
Adult respiratory distress 
syndrome (ARDSL 876 
Adventitia 
esophageal, 887, 895f 
tracheal, 837, 837f 
ureter, 1023, 1024f 
vaginal, 1084 
Aerobic (cellular) respiration, 
86, 301f, 302 
in cardiac/skeletal/smooth 
muscle, 315t 
Aerobic endurance, 302-303 
exercise, 307, 309 
Afferent arterioles, nephron, 
1002, 1003f-1005f 
Afferent pathway; 9f, 10 
Afferent (sensory) division of 
PNS, 388, 389f 
Afferent (sensory) nerves, 497 
Afferent (sensory) neurons, 
395,397t 
Afterbirth, 1133 
Afterhyperpolarization, 404 
Afterload, 698f, 699 
Age-related macular 
degeneration (ARMDL 
598 
Ageusia, 598 
Agglutination, 806, 807f 
Agglutinins, 669 
Agglutinogens, 668 
Aggregated lymphoid follicles, 
910 
''Aging pigment", 392 
Agonist (prime mover) muscle, 
325 
Agranulocytes, 655, 657-658, 
657f 
percentages in normal blood, 
655f 
summary, 656t 
Agrin, 318 
AHF (antihemophilic factor), 
661f,667 
AIDS (acquired immune 
deficiency syndrome), 818 
Air-blood barrier, 840 
Air cells (mastoid sinusesL 
207 
Airway resistance, 847-848, 
848f 
Alae 
illium, 237, 238f 
of nasal cavity, 829, 831f 
sacral, 225, 225f 
Alar plate, 469, 469f 
Albinism, 172, 1145 
Albumin, 52t, 646, 647t 
Albuminuria, 1022t 
Alcohol 
blood pressure and, 728 
fetus and, 1129 
nervous system and, 417t, 
456, 480, 482 
Aldosterone, 625-628, 729, 
729f 
blood pressure regulation 
and,728t 
blood volume and, 728t 
cardiac output and, 728t 
electrolyte balance and, 
1043, 1043f, 1047 
peripheral resistance and, 
728t 
regulation of, 627-628, 627f 
summary; 626t 
Aldosteronism, 626t, 627 
primary, 1059 
Alertness (consciousness 
stateL 458 
Alimentary canal, 88.2-883, 
882f. See also 
Castrointestinal (Cl) tract 
histology of, 886-887, 886f 
Alkalemia, 1048 
Alkaline phosphatase, 188 
Alkaline reserve, 1049, 1052 
Allcaline solutions, 42 
Allcaline tide, 904 
Allcalosis, 58, 1048 
effects of, 1054-1055, 1054t 
metabolic, 1054, 1054t 
respiratory, 1050 
using blood values to 
diagnose, 1055b 
Allantois, 1116f, 1119 
Alleles, 1140 
Allergic contact dermatitis, 
822 
Allergies (hypersensitivities L 
820-822, 821f 
hygiene hypothesis of, 
822-823b 
Allografts, 816 
All-or-none phenomenon, 406 
All-trans isomer, 575, 576, 
576f-578f 
Alopecia, 164 
Alpha-blocker drugs, 544 
Alpha cells, 630, 630f, 631, 
631f 
Alpha efferent fibers, 522, 522f 
Alpha globulins, in blood 
plasma, 647t 
Alpha helix, 50, 51f 
Alpha interferon, 794, 813t 
Alpha motor neurons, 522, 
522f,523f 
Alpha particles, 30-31 
Alpha receptors, 542, 543t 
Alpha waves, 456, 457f 
ALS (amyotrophic lateral 
sclerosisL 480 
Altitude (highL breathing and, 
868-869 
Alveolar ducts, 839f, 840 
Alveolar macrophages, 840 
Alveolar margin, 206f, 212, 
212f, 213, 215f 
Alveolar pores, 839f, 840 
Alveolar sacs, 839f, 840 
Alveolar ventilation rate 
(AVRL 851, 851t 
Alveoli 
breast, 1086, 1086f 
dental, 218t 
respiratory, 829, 830f, 836t, 
839f,840 
composition of gas in, 
853, 853t 
dead space, 851 
ventilation in, 851, 851t, 
855-856, 855f 
Alzheimer'S disease (ADL 468 
Amacrine cell, 567f 
Amenorrhea, 1094 
AMH (anti-Mullerian 
hormone), 1098 
Amino acids, 49-50, 49f 
as neurotransmitters, 417t, 
418 
chemical digestion and, 927 
essential, 944t, 945, 945f 
hormones based on, 
605-608 
in absorptive state, 972t 
973 ' 
metabolism of, 969-970 
970f ' 
nutrient pool, 970, 971f 
oxidation of, 969, 969f 
Aminopeptidase, 928, 928t 
Amitotic cells, 391 
Ammonia, 42, 969, 969f 
Ammonium salts, in blood 
plasma, 647t 
Amniocentesis, 1149, 1149f 
Amnion, 1116f, 1117f, 1118 
Amniotic fluid, 1118 
Amoeboid motion, 80, 655 
AMP (adenosine 
monophosphateL 57f, 58 
Amphiarthroses, 253, 256t, 
258t, 259t 
Amphipathic molecules, 48 
Amphoteric molecules, 1050 
Amplitude, 587f, 588 
Ampulla 
of ear; 584, 585f 
of uterine tube, 1081, 1082f 
of vas deferens, 1064f, 1067t 
Amygdala, 443, 444f, 454, 
455f 
memory and, 461, 462f 
Amylase, 918 
Amyotrophic lateral sclerosis 
(ALS), 480 
Anabolic hormones, 946 
Anabolic processes, 38, 38f 
Anabolic steroids, 308b 
Anabolism, 8, 955, 956f 
Anaerobic glycolysis, 302, 302t 
Anaerobic mechanisms, 301, 
301f 
Anaerobic threshold, 302-303, 
302f 
Anagen phase (hair growth 
cycle),162 
Anal canal, 882f, 921t, 923 
Anal columns, 921f, 923 
AnalgeSia, 495b, 527 
Anal sinuses, 921f, 923 
Anal sphincters, 350t, 351t, 
921f,923 
Anaphase, of mitosis, 101, 
103f 
Anaphylactic shock, 820 
Anaphylaxis, 820, 821t 
Anaplasia, 113 
Anastomoses 
arterial, 721, 756f 
cardiac, 683f 
vascular, 721 
Anatomical dead space, 
850-851 
Anatomical neck of humerus, 
232f,233 
Anatomical position, 12, 14, 
14f 
Anatomical terminology, 3, 
12-19,22 
abdorninopelvic 
regions/quadrants, 18, 
19f 
Index 1195 
body cavities/membranes, Antacid, 1059 self-antigens and, 797-798 pelvic girdle and lower 
15,17-18, 17f, 22, 22f Antagonism of hormones, 610 T cells and, 809-812 limbs, 237-247, 246t 
body planes/sections, IS, 16f Antagonist muscles, 325 T-cell dependent! Appendix, vermiform, 777f, 
directional/orientation, 12, Antebrachial region, 14f independent, 813 782, 882f, 921, 921f 
13t, 14 Antebrachial veins, 762f, 762t, Antihemophilic factor (AHF), Appetite, 991 
regional, 14-15, 14f 763f 661f,667 regulation of, 982-984 
Anatomy; 2 Antebrachium, 233. See also Antimicrobial proteins, Appositional growth, 176, 187, 
Anchoring junctions, 68, 69f Forearm 793-796, 793t 188f 
Anconeus muscle, 356f, 357t, Antecubital region, 14f Anti-mwlerian hormone APs. See Action potentials 
361f,362t Anterior (ventral) body region, (AMH), 1098 Aquaporins (AQP), 73, 1012 
Androgen-binding protein 14f Antioncogenes (tumor Aqueous humor, 568-569, 
(ABP), 1078, 1078f Anterior (ventral) horns, 471, suppressor genes), 145b 569f 
Androgenital syndrome, 626t, 472f,473f Antioxidants, 946, 950 Arachnoid mater 
629 Anterior (ventral) orientation Antiport pump system, 76f, 77 cerebral, 463f, 464, 465f 
Androgens, 628 or direction, 13t Antirachitic factor. See spinal, 469, 470f, 471f, 472f 
hair growth and, 160, 162 Anterograde amnesia, 461-462 VitaminD Arachnoid. See Arachnoid 
summary of regulation! Anterolateral pathways, 474, Antisense agents, 717b mater 
effects, 626t 475f,476t Antisterility factor (vitamin E), Arachnoid villi, 463f, 464, 
Androstenedione, 308b, 628 Antibodies, 52t, 657, 804-807 48t, 947t 465f 
Anemias, 653-654, 654f classes of, 80S, 805t Antithrombin Ill, 665 Arbor vitae, 445f, 453 
pernicious, 653, 902 complement activation and, Antrum, 1089, 1090f Arches 
siclde-cell, 653-654, 654f, 794 Anucleate cells, 96, 647 of atlas (Cl), 223, 223f 
1145 functions in immune Anuria, 1010 of foot, 245-247, 245f, 383t 
Anemic hypoxia, 859 response (summary), Anus, 882f, 921f, 923, 1064f of vertebrae, 221, 221f 
Anencephaly; 480-481 813t Anvil (incus) bone, 583f, 584, Arcuate arteries, 747f, 756f, 
Anergy;798, 811 mechanisms of action, 806, 584f 756t, 757f, 999f, 1000, 
Aneurysm, 741 807f Aorta, 680f, 681, 681f, 683f, 1003f, 1084, 1084f 
ANF (atrial natriuretic factor). mechanisms of diversity, 746t Arcuate line, 239 
See Atrial natriuretic 805-806 abdOminal, 746t, 747f, 752f, Arcuate popliteal ligament, 
peptide monoclonal, 806-807 755f 266 
Angina pectoris, 684 preformed, 669 ascending, 679f, 746t, 747f Arcuate veins, 999f, 1000, 
Angiogenesis, 734 structure, 804-805, 804f blood flow velocity in, 733f 1003f 
Angiogram, 741 Antibody-mediated (humoral) blood pressure in, 723f ARDS (adult respiratory 
cerebral, 480 immunity, 796 descending (thoracic), 746t, distress syndrome), 876 
Angiotensin converting Antibody monomer, 804, 804f 747f Areola, 1086, 1086f 
enzyme (ACE)' 840, Anticoagulant drugs, 665 heart and, 680f, 681, 681f, Areolar connective tissue, 
1008f, 1009 Anticodon, 108 683f 127f, 130, 131f 
Angiotensin I, 1008f, 1009 Antidiuretic hormone (ADH), Aortic arch, 679f, 746t, 747f Arm 
Angiotensin Il, 627, 627f, 728, 617t, 618 Aortic bodies, 726, 865, 865f arteries, 750f, 750t, 751f, 
728t, 729, 729f, 1008f, body's water balance and, Aortic plexus, 537, 538f 751t 
1009 1039,1039f Aortic reflex, 726 bone, 229f, 231t, 232f, 233, 
Angiotensinogen, 627, 627f, in blood pressure regulation, Aortic semilunar (SL) valve, 235f 
1008f,1009 728, 728t 681f, 684, 685f, 695f innervation, 510-513, 512t, 
Angular movements, 260-262, in formation of concentrated Aortic valve. See Aortic 513f 
260-262f urine, 1017-1018, semilunar (SL) valve muscles acting on, 
Anion,34 1018f APCs (antigen-presenting 354-356t, 356f 
Anlde Antidiuretic substances, 618 cells), 798, 799-801, 813t actions of (su=ary), 
articulations of, 243, 246t, Antigen-antibody (immune) Apical foramen, 893f, 894 362-363t, 363f 
259t, 261, 261f complexes, 806, 806f Apical surface of epithelia, veins, 762f, 762-763t, 763f 
bone (talus), 243, 245f, 246t Antigen-binding site, 804-805, 118, 119f ARMD (age-related macular 
muscles acting on, 373-378t 804f Aplastic anemia, 653 degeneration),598 
actions of (summary), Antigen challenge, 801 Apnea, 865 Arrector pili muscles, 153f, 
379-380t Antigenic determinants, 797, sleep, 460 160 
Ankyloglossia, 889 797f Apneustic breathing, 862 parasyrnpathetic/syrnpathetic 
Anlcylosing spondylitis, 276 Antigen-presenting cells Apocrine sweat glands, 126, effects, 545t 
Anlcylosis, 273f, 275 (APCs), 798, 799-801, 158 Arrhythmias, 692 
Annular ligament, 271, 271f 813t Apoenzyme, 53 Arterial anastomoses, 721, 
Annular ring, 563, 563f Antigens, 775, 797-798 Aponeuroses, 284, 349f, 459f, 756f 
Annulus fibrosus, 220, 220f B cells and, 801-802 1065f Arterial blood pressure, 
Anopsias, 502t binding, 809, 811 Apoptosis, 112, 798 722-723, 723f 
Anosmia, 501t complete, 797 Appendages, 15 Arteries, 712-720, 713f 
Anosmias, 560 endogenous, 809, 810f Appendicitis, 921, 923 blood flow velocity in, 733f 
ANP. See Atrial natriuretic exogenous, 809, 810f Appendicular region, 14, 15 blood pressure in, 723f 
peptide functions in immune Appendicular skeleton, 176, blood transport and, 645 
Ansa cervicalis, 340t, 51 Of, response (su=ary), 177f,228-247 compared to other blood 
511t 814t developmental aspects, vessels, 714t 
ANS. See Autonomic nervous incomplete (hapten), 797 247-248 elastic (conducting), 714, 
system in skin's biological barrier; pectoral girdle and upper 714t,715f 
165 limbs, 228-237, 231t 
continues 
1196 Index 
r Arteries, continued Asystole, 708 Atrioventricular (AV) bundle major effects of (summary) 
lymphatic vessels in relation Atelectasis, 845 (Bundle of His), 691t, 692 545t ' i 
to, 772, 773t Atherosclerosis, 707, Atrioventricular (AV) node, neurotransmitters released 
major, of systemic 716-717b 691-692,691t by; 541-542, 543t 
circulation, 746t, Atherosclerotic (fibrous) Atrioventricular (AV) valves, origin sites/major organs 
746-747t, 747t plaques, 716-717b 684, 685t, 686t, 695, 695t served, 535t 
of pulmonary circulation, Athlete's anemia, 653 Atrioventricular groove, 678, parasympathetic division 
744t, 744-745t Atlantoaxial joint, 258t 679t, 680t 389, 534. See also ' 
veins vs., 740 Atlanto-occipital joint, 258t Atrium, embryonic, 703, 703t Parasympathetic 
Arterioles, 712, 714t, 715, Atlas (Cl), 223, 223t, 224t, Atrophy, 112 division 
715t 258t disuse, 309 physiology; 541-547 
blood flow velocity in, 733t Atmospheric pressure, 8-9, Attenuated vaccines, 802 CNS regulation of, 
blood pressure in, 723t 844,845t Auditory (acoustic) meatus 546-547 
of nephron capillary beds, gas partial pressures vs., external, 206t, 207, 208t, interactions of divisions 
1002,1003t 853t 209t,217t 543-546 ' 
Arteriosclerosis, 717b Atomic mass unit, 27 internal, 206t, 208t, 209, neurotransmitters, 
Arteriovenous anastomoses, Atomic number, 29 217t, 504t, 505t 541-542 
715t, 721 Atomic symbol, 27 Auditory association area, receptors, 542, 543t 
Arthritis, 273, 275 Atomic weight, 30 437t, 440 PNS in relation to, 490t 
Arthrology, 276 Atoms, 3, 4t, 27-29, 29t Auditory canal, 582, 583t receptors, 542, 543t 
Arthroscopic surgery, 272 Atonic bladder, 551 Auditory cortex, 437t, 440, somatic nervous system vs., 
Articular capsule, 255-256, Atopy; 821 591,591t 532-534, 533t 
255t ATP, 26, 57 c Auditory nerve. See spinal cord controls of, 546t 
of elbow joint, 271, 271t active membrane transport Vestibulocochlear nerve 547 ' 
of hip joint, 270t and, 81-82t Auditory (pharyngotympanic) sympathetic division, 388, 
of knee joint, 267t as chemical energy; 26 tube, 582, 583t, 584t, 534. See also 
of shoulder joint, 269t as exchange reaction, 38, 38t 831t, 832t, 833t Sympathetic division 
Articular cartilage, 137, 176, as neurotransmitter, 417t, Aura, 457 vasomotor tone and, 544 
177t, 180t, 186 419 olfactory; 560 visceral reflexes, 541, 541t 
in synovial joints, 255, 255t as pain-causing chemical, Auricles Autopsy, 147 
Articular discs (menisci), 176, 494b ear, 582, 583t Autoregulation of blood floW; 
177t, 256, 258t cellular work driven by; 58t heart, 678, 679t, 680t 733-734 
in knee joint, 259t, 266, glucose and, 10 Auricular nerve, SlOt, 51lt Autorhythmic cells, 690-691, 
267t, 268, 268t in active transport processes, Auricular surface, 225, 238t, 690t 
Articular processes 71 239,244t Autorhythrnicity, 688-689 
sacrum, 225, 225t in muscle contraction, Auricular veins, 760t, 761t Autosomes, 1097, 1140 
vertebral, 221, 221t, 222t, 300-303,301t Auscultatory method, 730 AV (atrioventricular) node, 
222t, 224t of smooth muscle, 312 Autocrines, 605 691-692, 691t 
Articular surfaces, joint metabolism and, 8 Autografts, 816 AV (atrioventricular) valves, 
stability and, 257 mitochondria as supplier of, Autoimmune diseases, 275, 684, 685t, 686t, 695, 695t 
Articulations, 253. See also 85-86 819-820 Aveolar exocrine glands, 
Joints motor molecules and, 93t Autoimmunity; 819 125-126, 125t 
Artificial bone, 195b nutrients and, 942 Autologous transfusions, 670 Avogadro's number, 32 
Artificial joint, 27 4b regeneration methods, AutolYSis, 90 AVR (alveolar ventilation rate), 
Arytenoid cartilage, 834t, 835 300-302,301t Automaticity, 688 851, 85lt 
Ascending (sensory) tracts role in carbohydrate Automatic memory, 460t, 461 Axial region, 14-15 
major pathwaysltracts, 475t, functions, 46 Autonomic ganglion, 532, 533t Axial skeleton, 176, 177t, 
476t solute pumps and, 77 Autonomic nervous system 203-228,204t 
nonspecific/specific sports activities and, (ANS), 388-389, 532-553 bony thorax, 226-228 
pathways, 474-476 302-303 aging and, 550 developmental aspects, 
types of neurons in, stored,300 antagonistic interactions of, 247-248 
473-474,475t structure of, 57-58, 57t 543 skull, 203-218 
ASCites, 936 synth~sis, 57-58, 957-958, biofeedback's influence on, vertebral column, 219-226 
Ascorbic acid (vitamin Cl, 948t 957t, 958t 547 Axillary artery, 747t, 749t, 
Aspartate, 418 calcium'srole in, 293 brain stem controls, 546t, 750t, 750t 
Aspartic acid, 49t summary; 964-965, 965t 547 Axillary lymph nodes, 774t 
Aspiration, 876 ATP synthases, 957t, 958, cooperative effects within, Axillary nerve, 511, 512t, 513t 
Aspiration pneumonia, 247 962t, 963, 964t 544 muscles served by; 355t 
Aspirin, 665 Atria, 678, 679t, 680t, 681t, developmental aspects, 550 Axillary region, 14t 
Association areas, 440 682t, 683t drugs that influence, Axillaryveins, 759t, 762t, 
Association fibers, 442t, 443 Atrial (Bainbridge) reflex, 700 542-543, 543t 762t, 763t 
Association neurons Atrial muscle, 691t homeostatic imbalances, Axis (C2), 223, 223t, 224t, 
(interneurons), 395, 397, Atrial natriuretic peptide 547, 550 258t 
397t (ANP), 627-628, 627t, hypothalamic regulation of, Axoaxonic synapses, 408t, 409 
Asters, 102t 636,637t 446, 546, 547 Axodendritic synapse, 408t, 
Asthma, 822b, 870 blood pressure regulation interactions of divisions of, 409 
acute, 848 and, 726, 728t 543-546 Axolemma, 393 
Astigmatism, 574 electrolyte balance and, limbic system's control of, Axonal terminals, 289t, 292t, 
Astrocytes, 390-391, 390t 1045-1046, 1045t 546 392t, 393, 410, 518 
Index 1197 
Axon collaterals, 393 Bases, 42 Bilirubin, 652, 652/,916 oxygenation in pulmonary 
Axon hillock, 392/, 393 strong/weak, 43 Bilirubinuria, 1022t capillaries, 854-855, 
Axons, 392, 392/, 393-394 Basic electrical rhythm (BERL Bilopancreatic diversion (BPD), 854/ 
action potentials and, 906 981b percentage of body weight, 
402-409 Basilar artery, 748/, 748-749t, Biochemistry, 40-58 646 
compared, by neuron type, 749/ inorganic compounds, physical characteristics, 646 
396t Basilar membrane, 585, 586/ 40-44 plasma, 645/, 646, 647t 
growth cone of, 4Q4 Basilic veins, 759/, 762/, 762t, organic compounds, 44-58 protective functions of, 646 
neuromuscular junctions 763/ Biofeedback, 547 regulatory functions of, 646 
an~289-290, 289/ Basophils, 657, 657/ Biogenic amines, 415, 415/, respiratory gases transport 
regeneration of, 498-499, formation of, 659/ 416t, 418 and, 856-861 
499/ in anaphylaxis, 820, 821/ Biological clock, 446/, 447, substitutes, 666-667b 
Schwann cells and, percentages in normal blood, 459,635-636 typing, 670, 670/ 
394-395, 394/ 655/ Biological colloids, 40 viscosityj 648, 654, 721-722 
Axosomatic synapses, 408/, summary, 656t Biologic response modifiers, volume, 646, 670 
409 Batista procedure, 705b 275 Blood-brain barrier, 466-467 
Azygos system, 745/, 762f B cells (B lymphocytesL 657, BiopsYi 145b structural basis, 718 
762-763t, 763/ 775,775/ Biosynthetic centers, 391-392, Blood chemistry tests, 671 
Azygos vein, 762/, 762t, 763/ immunocompetency and, 392/ Blood clotting, 662-664 
lymphatic vessels and, 774/ 798-799 Biotin, 949t ANS and, 545t 
in immune response, Biotransformation, liver'S role as positive feedback 
Babinski's sign, 526 798-807 in, 978t mechanism, 11-12, 12/ 
Baby (deciduous) teeth, 892, summary, 813t Bipennate fascicle pattern, disorders, 666-667 
892/ Bell's palsYi 504t 326,327/ factors limiting normal, 
Back Benign neoplasm, 145b Bipolar cells, retinal, 566, 567/ 664-665 
innervation of, 510 BER (basic electrical rhythm), Bipolar neurons, 395, factors (procoagulants), 
muscles, 342-344t, 343f 906 396-397t 647t, 661t, 662 
345/ Beta amyloid peptide core, 468 Birth canal. See Vagina intrinsic/extrinsic/common 
superficial, 332/, 333/ Beta-blocker drugs, 543 Birth control, 1124-1125b pathways, 662-664, 
Bainbridge (atrial) reflex, 700 Beta-carotene, 946 Birthmarks, 162-163b 663/ 
Balance sense. See Equilibrium Beta cells, 631, 631/ Birth (parturitionL 1131 Blood doping, 654 
Baldness, 164 Beta endorphin, 418 Bitter taste sensation, 555-557 Blood flow, 721 
Ball-and-socket joints, 256t, Beta globulins, in blood Blackhead, 158 at rest/during exercise, 732, 
258t, 259t, 265/, 266 plasma, 647t Bladder. See Urinary bladder 732/ 
Balloon angioplasty, 71 7b Beta interferons, 813t Blanching (pallor), 157 blood pressure and, 724 
"Bandage muscle", 343t Beta Oxidation, 967, 967/, 970t Blastocyst, 1114, 1114/ in brain, 735 
Band cell stage of leukopoiesis, Beta particles, 30-31 implantation, 1115-1116, in heart, 736 
658,659/ Beta receptors, 542, 543t 1115/ in lungs, 735-736 
Baroreceptors, 725, 726, 727/ Beta waves, 456, 457/ Bleaching of the pigment, 576, in skeletal muscles, 
cardiovascular, 1044-lO45, Biaxial movement, 260 577/ 734-735 
lO44/ Bicarbonate, in blood Bleeding disorders, 665, in skin, 735 
Barrett's esophagus, 936 plasmalIFIICF, lO36/ 666-667 local regulation of, 733-734 
Barrier methods of Bicarbonate buffer system, Blepharitis, 598 velocity o( 733, 733/ 
contraception, 1125b 1048-1049, 1052 Blindness, 440, 502t, 580 Blood fraction, 671 
Basal bodies, 94, 94/ Bicarbonate ions, 42,859, night, 578 Blood glucose 
Basal cell carcinoma, 166, 167/ 860/ Blind spot (optic discL 565/, influence of glucagon on, 
Basal cells Bicarbonate reabsorption, 566, 567l 568/ 976/ 
of olfactory epithelium, 559 1052-1053 Blisters, 156 in postabsorptive state, 
of taste buds, 555, 556/ Biceps brachii muscle, 330/, Blood, 138, 138/, 644-674, 975-976, 975t 
Basal ganglia. See Basal nuclei 331/, 356/, 357t 645 regulation of, 10, 11f 
Basal lamina, 118-119 actions of (summaryL aging and, 671 631-632, 632/ 
Basal layer (stratum basaleL 362-363t, 363/ artificial, 666-667b sources of, 975, 975t 
153-154, 154/ tendon, 271/, 359/ as connective tissue, 126, Blood groups, 668-669 
Basal metabolic rate (BMRL Biceps femoris muscle, 332/, 127/ ABO, 668-669, 668t, 1145, 
984-985 333/,371/, 372t, 379t changes in arterial pH, and 1146t 
thyroid hormone's effects Bicipital (intertubercular) breathing rate/rhythm, Rh,669 
on, 620t, 985 groove, 232/, 233 866-867 Blood islands, 671, 740 
Basal nuclei, 442/, 443, 444/ Bicuspid (mitral) valve, 681/, chemistry profile, 671 Blood plasma, 138, 138/, 
embryonic development, 684,685/ components, 645-646, 645/ 645-646, 645/, 647t 
431,432/,433 Bile, 915-916 developmental aspects, 671 as communicating medium 
role in motor hierarchYi 519, in urine, 1022t diagnostic tests, 671 between cells, 1036, 
519/,520 secretion o( 916/ distribution functions of, 1037/ 
Basal plate, 469, 469/ Bile canaliculi, 915 646 electrolyte composition o( 
Basa:l surface of epithelia, 118, Bile duct, 912, 912, 913/, 914/ doping, in athletiCS, 654 1036/ 
119/ Bile salts, 48t, 915-916, 916/ formed elements, 647-661, in ECF compartment, 1034, 
Basement membrane, 69/, role in fat emulsification, 647/ 1035/ 
119, 122/-124/ 929/ erythrocytes, 647-654 plasma expanders, 670 
in capillaries, 718, 718/ Biliary calculi (gallstones), 917 influence of carbon dioxide potassium concentration 
on, 861 and, 1046 
1198 Index 1 Blood pressure (BP), 721, in hypovolemic shock, 738, Bohr effect, 858 Bony thorax (thoracic cage) 722-724 739/ Boils, 172 226-228, 227/ ' ! 
aging and, 741 pressure diuresis and, 1044 Bolus of food, 889, 897/ Boutons, ~93. See also Axonal 
arterial, 722-723, 723/ B lymphocytes (B cells), 657, Bone marrow biopsy, 671 termmals 
capillary, 723, 723/, 737 775,775/ Bone morphogenic protein Bowman's capsule (glomerular 
chemical (hormonal) immunocompetency and, (BMP),195b capsule), 1000, 
controls, 726, 728, 728t 798-799 Bone (osseous tissue), 1001/-1005/ 
disorders, 729-732 in immune response, 137-138, 137/ Boyle's law, 845 
in hypovolemiccshock, 738, 798-807 aging and, 193, 196 BPD (bilopancreatic diversion) 
739/ summary, 813t artificial, 195b 981b ' 
maintaining, 724-729, 725/, BMI (body mass index), 980b as connective tissue, 126, B-pleated sheet, 50, 51/ 
727/,728t BMP (bone morphogenic 127/ BP. See Blood preSSure 
factors causing increase protein), 195b bending stress and, 190, Brachial arteries, 747/, 750/ 
in, 730/ BMR. See Basal metabolic rate 190/ 750t ' 
sodium, water balance Body cavities, 15, 17, 17/,22, calcified cartilage vs.,176 pulse rate and, 731/ 
and, 1044-1045, 22/ calcium and, 188-190, 189/ Brachialis muscle, 331/, 333/, 
1044/ Body defenses. See also chemical composition, 356/,357t 
measuring, 730-731 Immune system 182-183 actions of (summary), 
neural controls, 725-726 adaptive, 796-824 classification of, 176-178, 362-363t, 363/ 
pulse rate and, 729-730, innate, 787-796 177/, 178/ Brachial plexus, 508/, 
731/ role of globular proteins in, collar, 180, 184/, 185, 185/ 510-513, 512t, 513/ 
renal regulation, 728-729, 52t demineralization of, 190 Brachial region, 14/ 
729/ Body fluids, 110-111. See also deposit, 187-188 Brachial veins, 759/, 762/, 
skeletal muscle contraction Fluids developmental aspects, 196 762t, 763/ 
and, 724, 724/ composition of, 1034-1035, disorders, 193-196, 193/ Brachiocephalic artery, 679/ 
systemic, 722, 723/ 1036/ endochondral (cartilage Brachiocephalic trunk, 746t, 
venous, 723-724, 723/ continuous mixing of, 1037/ bone), 184 747/, 749/ 
Blood pressure cuff, 730 Body heat. See also Body formation of Brachiocephalic veins, 227/, 
Blood reservoirs, 720 temperature embryonic skeleton, 758/-763/, 758t, 762t 
Blood sugar. See Blood glucose basal metabolic rate and, 184-186 lymphatic vessels and, 774/ 
Blood-testis barrier, 1074 984-985, 985/ postnatal growth, Brachioradialis muscle, 331/, 
Blood-thymus barrier; 779 core and shell temperatures, 186-187 333/, 356/, 357t, 359/, 
Blood transfusions, 667-670 986 fracture repair; 191-193, 360,361/ 
Blood values, using to dietary thermogenesis, 985 191/, 192t actions of (summary), 
determine cause of generated by muscle functions of, 178-179 362-363t, 363/ 
acidosis/ allcalosis, 10 5 5b contraction, 281, 303 growth, 183-184 tendon, 359/ 
Blood vessels, 711-770, 712 mechanisms of heat body proportions and, Brachytherapy, 71 7b 
aging and, 741 exchang~ 986-987 247,248/ Bradycardia, 702 
anatomy of (summary), 714t receptors, 490, 492t hormonal regulation of, Bradykinin, 735, 791t 
arteries, 714-715, 718. See thyroid hormone's role in, 187 Brain, 388, 389/, 431-456 
also Arteries 619,620t postnatal, 186-187, 186/, arteries, 748/, 748t, 749/, 
blood pressure in various, Body mass index (BMI), 980b 187/ 749t 
723/ Body membranes, 17-18, 18/ markings, 179, 179t ascending pathways to, 
circulation physiology; Bodyplanes/sections, 15, 16/ membrane, 184 473-476 
721-740 Body temperature Pagetic, 195 blood flow, 735 
damage to. See Blood ANS responses to heat, parathyroid hormone's at rest/during exercise, 
clotting 545-546 influence on, 1047 732/ 
developmental aspects, basal metabolic rate and, remodeling, 187-190, disorders, 467-469 
740-741 984-985 187/-189/,193/ embryonic development, 
diameter of, resistance and, core and shell temperatures, hormonal controls, 431,431/,432/,433, 
722 986 188-190,189/ 1119, 1121/ 
fetal, 1126, 1127/, 1134 eating behavior and, 983 response to mechanical preferred energy source, 975t 
length of, resistance and, fever and, 793t, 796, 989 stress, 190, 190/ protection of, 463-467 
722 heat exchange mechanisms, repair, 191-193, 191/, 192t blood-brain barrier, 
lymphatic vessels in relation 986-987 clinical advances in, 466-467 
to, 712, 715/, 772, 773/ heat-loss mechanisms, 194-195b cerebrospinal fluid, 
sympathetic effects, 545t 988-989, 988/ response to mechanical 464-466 
vasomotor tone and, heat-promoting stress, 190, 190/ meninges, 463-464 
543-544 mechanisms, 987-988, structure skull bones. See Skull 
veins, 720-721. See also 988/ chemical, 182-183 regions of, 433, 433/ 
Veins hypothalamus and, 987 gross, 179-181 brain stem, 448-452 
wall structure, 712-713, normal,8 microscopic, 181-182 cerebellum, 452-454 
713/ regulation of, 985-989 substitutes for, 194-195b cerebral hemispheres, 
Blood volume by hypothalamus, 446 textures, 179, 180/, 181/ 434-443 
blood pressure maintenance effects of thyroid hormone Bony (hard) callus, 191 diencephalon, 443-448 
and, 724-732 on, 620t Bony (osseous) labyrinth, 584 traumatic injury to, 467 
influence of hormones on mechanisms of Bony pelvis, 237,238/ veins, 758/, 759/, 760/, 
blood pressure, 728t (summary), 988/ Bony spur, 199 760t, 761/ 
skin and, 171b, 987, 988/ vesicles, 431, 432/, 433 
I': 
Index 1199 li ,. , 
r 
I' 
Brain attacks. See respiratory rhythm and} protein} 1049-1050 salts} calcification and} 176 r 
Cerebrovascular accidents 862-863} 862/ Buffy coat} 645} 645/ Calculus} 894 I 
Brain death} 457} 458 Breech presentation (birth)} Bulbar (ocular) conjunctiva} Callus} 152} 191} 191/ !: Brain stem} 433} 435/} 1133 561/} 562} 569/ Calmodulin} 293} 312} 315t} I' 
448-452 Broad ligament} 1080} 1080/} Bulbospongiosus muscle} 350t} 60n 608 
autonomic functions 1082/ 351/ Caloric intake} protein 
regulated by} 546-547} Broca}s area} 437/} 439 Bulbourethral duct} 1024/} synthesis and} 946 
546/ Brodma= areas} 436} 438/ 1068/ Calorigenic effect of thyroid 
diencephalon in relation to} Bronchi} 829} 830/ Bulbourethral glands} 1024/} hormone} 619} 620t 
448-449/ primary} 838-840} 838/} 1064} 1064/} 1068/} 1069 Calorimeter} 984 
embryonic development} 842/ Bulbus cordis} 703} 703/ Calsequestrin} 293 
431} 432/} 433 secondary (lobarL 838-840} Bulimia} 936 Calvaria} 203 
functions of} 452t 838/} 842/ Bundle branches} 691l 692 Calyces} major/minor} 999} 
important nuclei} 450-451/ tertiary (segmentalL Bundle of His (Atrioventricular 999/ 
regions 838-840} 838/} 842/ (AV) bundleL 691/} 692 CAMs (cell adhesion 
medulla oblongata} Bronchial arteries} 746/} 751t} Burns} 167-169} 168/ moleculesL 67/} 83-84 
450-452 843 Bursae} 256-257} 257/ Canaliculi} 182} 183/ 
midbrain} 449-450 Bronchial tree (respiratory Bursitis} 272-273 Canal of Schlemm (scleral 
pons} 450 tree)} 838-840} 839 venous sinusL 565/} 568} 
Brain-testicular axis} 1078} conducting zone} 838-840} Cadherins (linker proteins)} 569/ 
1078/ 838/ 68} 69/} 83-84 Cancellous (spongy) bone} 
Brain waves} 456-457} 457/ description/functions} 836t Calcaneal (Achilles) tendon} 179} 180/} 181l182} 183/ 
Branchial groove} 597 respiratory zone} 829} 839/} 243} 333/} 377/} 378/} as co=ective tissue} 127/ 
Braxton Hicks contractions} 840 382/ Cancer} 145-146b 
1131-1132 Bronchial veins} 763t rupture of} 384 bladder} 1029 
Breasts Bronchioles} 838-839} 839/ Calcaneal region} 14/ breast} 1087} 1087/ 
cancer} 1087} 1087/ respiratory} 839/} 840 Calcaneus bone} 243} 246t} carcinoma} 147} 166} 167/ 
mammary glands} terminal} 839} 840/ 377/} 378/ colon} 146/ 
1086-1087} 1086/ ventilation -perfusion Calcarine sulcus} 437/} 440 genetic factors in} 145b 
Breathing} 844 coupling and} 855-856 Calcification} metastatic} 624 lung} 870-871 
adjustments during exercise} Bronchitis} 869-870 Calcification front} 188 ovarian} 1105 
868 Bronchomediastinal trunks} Calcified cartilage} 176} skin} 166-167 
apneustic} 862 773} 774/ 185-186} 186/ testicular} 1067 
at high altitude} 868-869 Bronchopulmonary dysplasia} Calcitonin} 623 Canines (teethL 892/} 893 
breathing rate and depth} 849 in bone remodeling} Canthi} 560} 561/ 
863-867 Bronchopulmonary segments} 189-190} 189/ Capacitance current} 401 
chemical factors influencing} 840} 842} 843/ Calcitriol} 624} 636 Capacitance vessels} 715/} 720 
864-867 Bronchoscopy, 876 Calcium Capacitated sperm} 1111 
summary} 867 Bronze diabetes} 936 absorption of} 931 Capillaries} 712} 713l 715 
cortical controls} 864 Bronzing of skin} 157 blood levels of} hormonal blood flow through} 
disorders} 869-871 Brown fat} 132 controls on} 189-190} 736-738} 736/ 
first breath} 1133-1134 Browning reactions} 990 189/ blood flow velocity in} 733} 
hypothalamic controls} 864 Bruises} 157} 672 bone remodeling and} 733/ 
inflation reflex} 863 Bru=er}s glands} 125/ 188-190} 189/ blood pressure in} 723/ 
I mechanics of Brush border} 118} 909} 909/} calcitonin and} 1047 blood transport and} 645 
airway resistance} 910/ calcium ions} 421 compared to other blood847-848} 848/ of renal tubules} 1002 in blood clotting} 661t} vessels} 714t 
alveolar surface tension Brush border enzymes} 909 662-663} 663/ exchanges of respiratory 
forces in} 848-849 Bruxism} 936 cha=els} information gases/nutrients in} 
alveolar ventilation} 851} Buboes} 777 transfer across} 410 736-738} 737/} 854/} 
851t Buccal cavity. See Oral cavity deficits of} 951t 856 
dead space} 850-851 (mouth) dietary sourceslRDAs/ fluid flows at} 737-738} 737/ 
lung compliance} 849 Buccal glands. See Salivary importance to body, hydrostatic pressure} 
pressure relationships} glands 951t 737-738} 737/ 
844-845} 845/ Buccal nerve} 504-505t electrolyte balance and} lymphatic} 715/} 772} 773/ 
pulmonary function tests} Buccal phase} of swallowing} 1042t} 1047 pulmonary, 744/} 744t} 841/} 
851 896-897} 897/ excesses o( 951t 843 
respiratory capacities} Buccal region} 14/ functions in body, 28t skeletal muscle fibers and} 
849-850} 850/ Buccinator muscles} 336t} in blood plasma/lFIlCF} 281} 281/ 
respiratory volumes} 337/} 338} 339/} 341/} 889 1036/ structure} 715} 718} 718/ 
849-851} 850/ Buffers} 42-44} 43 muscle contraction and} transport mechanisms} 
muscles of} 346t} 347/ plasma proteins as} 52t 287} 289/} 290-295} 736-737} 736/ 
neural controls o( 861-867 Buffer systems 292/} 293/ types of} 718-719} 718/ 
nomespiratory air bicarbonate} 1048-1049 in cardiac/skeletal/smooth Capillary beds} 682/} 719-720} 
movements} 852} 852t carbonic acid-bicarbonate} muscles} 312} 315t 719/ 
phrenic nerve and} 510 43-44} 861 parathyroid hormone and} nephron} 1002} 1003/ 
pulmonary irritant reflexes} phosphate} 1049 1047 Capillary plexus} 612/} 613 
863 physiological} 1050 role in ATP synthesis} 293 Capitate bone} 231t} 236} 236/ 
1200 Index f 
I 
I 
Capitulum, 232/, 233 Cardiac muscle, 687-690 nervous system and, 548b Cavernous sinuses, 464/, 760/ 
Capsular hydrostatic pressure, anatomy (microscopic), reproductive system and, 760t,761/ ' 
1007, 1007/ 687-688, 688/ 1103b Cavities, of eye, 564, 565/ 
Capsular (intrinsic) ligaments, body location, 314t respiratory system and, Cavities (dental caries), 894 
256 bundles, 678, 678/ 874b, 875b CBC (complete blood count) 
Capsular space, 1000, 1001/, contraction mechanisms, skeletal system and, 197b 671 ' 
1004/, 1005/ 688-690, 689/ urinary system and, 1056b, CCK (cholecystokinin), 418t, 
Caput medusae,c 915 energy requirements of, 690 1057b 637t, 899, 904, 905t, 
Carbaminohemoglobin, 648, fibrosis of, 707 Carina, 830/, 838 916/, 917 
859,860/ innervation of, 518 Carotene, 156 C (cytosine), 55-57, 56/, 99 
Carbohydrates, 44-46 parasympathetic! Carotid arteries, 746t, 747/, 100/ ' 
deficits of, 944t sympathetic effects, 748/, 748t, 749/ CD4 cells (T4 cells), 807-808 
dietary sources! 545t common, 227/, 506t, 679/ 808/ ' 
requirements, 942-943 preferred energy source of, pulse rate and, 731/ CD8 Cells (T8 cells), 808, 
digestion/absorption, 926/, 975t Carotid bodies, 726, 748, 865, 808/, 811, 811/ 
927,929 properties of, 687-690, 688/ 865/ Cdks (cyclin-dependent 
excesses of, 944t skeletal muscle vs., Carotid canal, 208/, 209, 217t kinases), 104, 104/ 
fat substitutes, 944 314-315t, 688-689 Carotid sinus, 506t, 726, 727/, Cecum, 882/, 921, 921/ 
food sources of, 944t smooth muscle vs., 748 Celiac disease, 931-932 
in absorptive state, 973 314-315t Carotid sinus reflex, 726 Celiac ganglia, 540 
metabolism of, 958-966 tissue, 140, 141/, 142, 280 Carpal bones, 229/, 231t, 236, Celiac plexus, 536/, 537 
liver's role in, 978t Cardiac notch, 840, 842/ 236/ Celiac trunk, 746/, 747/, 752/, 
summary, 970t Cardiac orifice, 895 articulations of, 258t 753/, 753t, 755/ 
molecular structure, 45/ Cardiac output (CO), Carpal region, 14/ , Cell adhesion molecules 
nutrient pools, 970, 971/ 698-703, 698/, 701/ Carpal tunnel syndrome, 237 (CAMs), 67/, 83-84 
uses in body, 943 blood pressure and, 724-732 Carpometacarpal joint, 258t Cell adhesion proteins, 
Carbon disorders of, 702-703 Carpus, 236. See also Wrist 127-128 
functions in body, 28t influence of hormones on Carrier proteins, 67, 72-73, Cell body (neuron), 390/, 
in methane gas formation, blood pressure, 728t 72/ 391-392, 392/, 395, 396t 
35,35/ major factors enhanCing, Carriers, genetic, 1145 Cell differentiation 
isotopes, 30 725/ screening, 1148 glycoproteins, 807, 808/ 
percentage of body weight, Cardiac plexuses, 536/, 537, Cartilage, 135. See also Cell division, 101-104, 
27 538/ specific type 102-103/ 
Carbon dioxide Cardiac region (cardia), of as connective tissue, 126, Cell life cycle, 98-101, 99/ 
blood transport of, 647t, stomach, 898, 898/ 127/ Cell membrane. See Plasma 
859-861, 860/ Cardiac reserve, 698, 707 calcified, 176, 185-186, membrane 
influence on breathing Cardiac tamponade, 676 186/ Cells, 3, 4/, 63-116, 64. See 
depth/rate, 864-865, Cardiac veins, 679/, 680/, growth of, 176 also individual cell 
864/ 683/, 684, 759/ injuries to, 272, 272/ structures 
molecular structure, 36, 36/ Cardioacceleratory center, 693, Cartilaginous joints, 254-255, aging of, 112 
Carbonic acid-bicarbonate 693/, 727/ 254/ anucleate, 96 
buffer system, 43-44 Cardiogenic shock, 740 structure/functions, 256t, as basis of life (overview), 
blood pH shifts and, 861 Cardioinhibitory center, 693, 258t, 259t 64-65 
Carbonic anhydrase, 859 693/, 727/ Cascades, 11 developmental aspects, 
Carbon monoxide Cardiomyoplasty; 705b Catabolic processes, 38, 38/ 111-112 
as neurotransmitter, 418t, Cardiovascular center, 451, 725 Catabolism, 8, 955, 956/ differentiation in, 112 
419 Cardiovascular physiology, 3 Catagen phase (hair growth environmental interactions, 
poisoning, 859 Cardiovascular system, 6/, cycle), 162-163 83-85 
Carboxypeptidase, 918, 918/, 675-770 Catalysts, 40. See also extensions, 70t, 93-94 
928,928/ blood vessels, 711-770, 712. Enzymes extracellular materials, 
Carbuncles, 172 See also Blood Vessels Catalytic proteins, 84 110-111 
Carcinogenesis, 145b circulatory physiology; Cataract, 569-570, 570/ growth and reproduction, 
Carcinogens, 145b 721-740 CAT (computerized axial 98-110 
Carcinoma, 147 digestive system and, 934b, tomography). See cell division, 10 1-1 04 
basal cell, 166 935b Computed tomography cell life cycle, 98-101 
small cell, 871 during pregnancy; 1131 Catecholamines, 415, 626t, protein synthesis, 
squamous cell, 166, 166, effects of thyroid hormone 629-630,630/ 104-110 
167/,871 on, 620t Cathelicidins, 164 membrane of, 65. See also 
Cardia (cardiac region), of endocrine system and, 638b Catheterization, cardiac, 708 Plasma membrane 
stomach, 898, 898/ heart, 675-710, 676. See Cation, 34 multinucleate, 96 
Cardiac catheterization, 708 also Heart Cauda equina, 470/, 471, 471/, programmed death of, 112 
Cardiac centers, medullary; integumentary system and, 508,508/ secretions of, III 
451, 547, 693, 693/ 170b, 171b Caudal (inferior) structures of, 69-98 
Cardiac conduction system, interrelationships with other orientation/direction, 13t cytoplasm, 85-94 
690-693, 691/ systems, 742b, 743b Caudate nucleus, 442, 443, generalized composite, 65/ 
Cardiac cycle, 696-698, 697/ lymphatic system/immunity 444/,462/ nucleus, 96-98 
Cardiac (gastroesophageal) and,780b Caveoli, 80, 80/, 311/, 314t plasma membrane, 65. 
sphincter, 895, 897/ muscular system and, 316b, Caveolin-coated vesicles, 80, See also Plasma 
317b 80/,82t membrane 
Index 1201 
summary, by part, 70-71t retina, 5651, 5671, 568 Cerebral peduncles, 4481, 449, 
Chemical digestion. See 
theory of, 64 Centrioles, 651, 70t, 92, 931, 450" 4781 
Digestion 
types of, 64 94, 1021 Cerebral vein, 4651 
Chemical energy, 26 
Cellular respiration, 8,955, Centromere, 1021 Cerebral white matter, 4421,
 Chemical equations, 37-38 
9561 Centrosome, 651, 91, 92, 931 443,4441 
Chemical equilibrium, 39 
aerobic, 86,3011,302, 315t Centrum (body) of vertebra, Cerebrospinal fluid (CSn Chemicalgradie
nts, 398 
as oxidation-reduction 221,2211 464-466,4651 
Chemical level of structural 
reaction, 39 Cephalic (reflex) phase, of Cerebrovascular accidents organization, 3, 41 
energy yield during, 9651 gastric secretion, 9021, (CVAsL 467-468 Chemically-gate
d channel-
in carbohydrate metabolism, 903 Cerebrum, 433. See also 
linked receptors, 84-85 
970t Cephalic region, 141 Cerebral hemispheres 
Chemically-gated ion 
sites of ATP formation Cephalic veins, 7591, 7621, Cerumen, 582 
channels, 398, 3981 
during, 9581 762t, 7631 Ceruminous glands, 158, 582 C
hemical (nonshivering) 
Cellulose, 46 Cephalin, 48t Cervical branch, of facial 
thermogenesis, 987 
Cementum (tooth), 893, 8931 Cephalization, 431 nerve, 504t, 5051 Chemical reac
tions, 37-40 
Central artery, retina, 5651, Cerebellar hemispheres, 453 Cervical canal, 10821, 1083
 chemical equations in, 
5671,568 Cerebellar peduncles, 4481, Cervical (cardinal) ligaments, 37-3
8 
Central canal 449,4491,450,4501, 10821,1083 
energy flow in, 39 
of brain, 4321, 4341 4511,454 Cervical curvature, 219, 2
191 factors influencing rate of, 
of spinal cord, 4651, 4721 Cerebellum, 4351, 4451, 4471, Cervical enlargement, 508
1 39-40 
Central (Haversian) canal, 452-454, 4531, 4651 of spinal cord, 4701, 471 patterns of, 
38-39, 381 
182, 1831 ascending spinal cord tracts Cervical ganglia, 5381, 540 
reversibility of, 39 
Central nervous system (CNSL and,4751 Cervical lymph nodes, 7741 Chemical sens
es, 555-560. 
388, 3891, 431-484 cognitive functioning of, 454 Cervical nerve, 504t 
See also Smell; Taste 
aging and, 481-482 descending spinal cord tracts Cervical plexus, 5081,510, 
developmental aspects, 596 
ANS in relation to, and,4781 5101, 511t 
Chemical signaling between 
388-389, 3891, 5321, embryonic development, Cervical region, 141 
cells, 84-85, 84f 
546-547, 5461 431, 432f, 433 Cervical spinal nerves, 4701, Chemical synapses, 
409-411, 
arrangement of graylwhite equilibrium and, 595, 5961 5081 
4111 
matter in, 433, 4331 functions of, 452t muscles served by, 340t, 
excitatory; 411-412, 4121 
brain, 388, 3891, 431-456. motor activity processing of, 341t, 342t, 343t, 3
53t Chemiosmotic process, 
See also Brain 454 Cervical vertebrae, 219, 2191, 
957-958 
developmental aspects, role in motor hierarchy; 519, 223, 2231 
Chemistry, 25-62 
480-482 5191,520 articulated, 2241 
atoms and elements, 27-31 
disorders Cerebral angiogram, 480 as part of axial skeleton, 
chemical bonds, 32-36 
diagnostic procedures, Cerebral aqueduct, 4321, 434, 2041 
chemical reactions, 37-40 
480 4341, 4451, 449, 4501, first and second, 223, 2231 
energy and matter, 26-27 
of brain, 467-469 4651 regional characteristics, 22
3, inorganic compounds, 
of spinal cord, 479-480 Cerebral arteries, 7481, 748t, 2241 
. 40-44 
effects of thyroid hormone 7491,749t Cervix, 10801, 10821, 1083 
molecules and mixtures, 
on, 620t Cerebral cortex, 436-443. See Cesarean (C-)section, 1133 31-32 
glial cells in, 390-391, 3901 also Mental functions CF (cystic fibrosisL 872, 932, organic com
pounds, 44-58 
mental functions ascending spinal cord tracts 990, 1145 
Chemoreceptors, 490, 555 
brain wave patterns, and, 4751 CFTR protein, 872 
blood pressure and, 725, 726 
456-457 autonomic functions Chadwick's sign, 1129 b
reathing and, 864-865, 8651 
consciousness, 458 regulated by; 546-547, Chain (paravertebral) ganglia, Chemotactic agent
s, 792 
memory, 460-463 5461 537 
Chemotaxis, 7901, 792 i: 
sleep, 458-460 embryonic development, pathways with synapses in
, positive, 655 
nuclei of, 392 431, 4321, 433 539-540, 5391 
Chemotherapy, 146b 11 
PNS in relation to, 388, functional regions of Chalazion, 562 
Chewing. See Mastication 
3891, 490, 4901 association areas, Chambers 
Cheyne-Stokes breathing, 876 
" 
regeneration of nerve fibers 440-441 of eye, 568, 5691 
CHF (congestive heart failure), ", ~ 
in,499 lateralization and, 441, of heart, 678, 681, 6811 
702-703 i! 
spinal cord, 388, 3891, 443 Channel-linked receptors,
 Chiasma, of homologues, 
469-480. See also motor areas, 436-439 419-420, 4201 
1142-1143, 11431 
I 
!l 
Spinal cord sensory areas, 439-440 Channel proteins, 67, 721, 73 
Chiasmatic groove, 210, 2101 i: 
stem cell research and, Cerebral dominance, 441 Chaperonins (molecular Chief cells, 623, 
6231, 899, !' 
482-483b Cerebral edema, 467 chaperonesL 52-53, 52t 900
1 
Central pattern generators Cerebral hemispheres, Charley horse, 384 
Childbirth (parturitionL 1131 
(CPGsL 519, 5191 434-443,4351 Chemical bonds, 32-36 pelvic stru
cture and, 239 
Central process, of unipolar basal nuclei, 443 covalent, 34-36, 35, 351 
Chin, 141 
neurons, 395, 396t cerebral cortex, 436-443 hydrogen, 36, 371 
Chiropractic, 249 
Central sulcus, 434, 4351, 436, descending spinal cord tracts intramolecular, 36 
Chlamydia, 1097 
4371 and,4781 ionic, 33-34, 341 
Chloasma, 1129 
Central tendon embryonic development, role of electrons in, 3
2-33 Chloride 
of diaphragm, 3471 431, 4321, 433 Chemical buffer systems,
 electrolyte balance and, 
of perineum, 3501, 3511 functions of, 452t 1048-1050, 10491 
1042t, 1048 
Central vein white matter, 443 Chemical composition of b
one, continues 
liver, 912, 9131, 915 Cerebral palsy; 480 182-183 
1202 Index 
Chloride, continued 
in blood plasmaJIFIICF, 
1036f 
ions, in resting membrane 
potential, 399-400, 399f 
Chloride shift, 859 
Chlorine 
dietary sourceslRDAs/ 
importance in body, 
951t 
functions in body, 28t 
Choanae (nasal apertures), 
830, 832f 
Chokes, 866b 
Cholecalciferol, 636, 637t 
Cholecystitis, 932 
Cholecystokinin (CCKL 418t, 
637t, 899,904, 905t, 
916f,917 
Cholesterol, 48, 977 
blood level regulation, 
977-979, 979f, 982 
formation of, 47f 
in plasma membrane, 66, 
66f 
location/function in body; 
48t 
metabolism of, 968-969, 
977 
transport, 977-979 
Choline acetyltransferase, 415 
Cholinergic fibers, 542 
Cholinergic receptors, 542, 
543t 
Chondroblasts, 12n 129, 135 
Chondrocytes, 127f, 135, 135f, 
136f 
in skeletal cartilage, 176, 
177f 
Chondroitin, 128, 128f 
Chondromalacia patellae, 276 
. Chordae tendineae, 681f, 684, 
685f,686f 
Chorda tympani, 504t, 557 
Chorea, 469 
Chorion, 1116, 1116f, 1119 
Chorionic villi sampling 
(CVSL 1149-1150, 1149f 
Choroid, 564, 565f, 567f 
Choroid plexuses, 445f, 448f, 
449f, 451" 464-466, 465f 
Christmas factor, 661t 
Chromaffin cells, 629 
Chromatids, 98f, 100f, 101, 
102f 
sister, 102f 
Chromatin, 65f, 96, 98, 98f 
condensed, 97f, 98, 102f 
extended, 97f, 98 
structure/function of, 71t 
Chromatophilic substance 
(Nissl bodiesL 391, 392f 
Chromium, 28t, 953t 
Chromosomes, 98, 98f 
independent assortment, 
1141-1142, 1141f 
in mitosis, 102f 
recombinant, 1142, 1143f 
Chronic obstructive 
pulmonary disease 
(COPDL 869-870, 869f 
Chorionic villi, 1116, 1116f 
Chronotropic factors, 700 
Chyle, 772 
Chylomicrons, 930, 966 
Chyme, 898 
Chymotrypsin, 918, 918f, 
928,928f 
Chymotrypsinogen, 918 
Cilia, 70t, 93-94, 94f 
as protective mechanism, 
793t 
of epithelia, 118, 122f 
Ciliary body, 564-565, 565f, 
569f 
Ciliary ganglia, 502t, 536, 
536f 
Ciliary glands, 561 
Ciliary muscles, 565, 565f, 
569f 
Ciliary processes, 565, 565f, 
569f 
Ciliary vein, 569f 
Cingulate gyrus, 43 n 454, 
454,455f 
Circadian rhythm, 459 
Circle of Willis, 749f, 749t 
Circuit level processing (neural 
integrationL 493, 496, 
496f 
Circuits in neuronal pools, 
421-422, 422f 
Circular fascicle pattern, 326, 
327f 
Circular folds (plicae 
circulares), 908, 909f 
Circular layer, muscularis, 
895f, 897f, 898f, 900f 
Circulating hormones, 605 
Circulation 
coronary, 683-684, 683f 
of blood. See Circulation