Hole's 123 Anatomy

Holes essentials of
Human
Anatomy
Physiology
eleventh edition
David Shier
Washtenaw Community College
Reinforced Binding
What does it mean? Jackie Butler
Since high schools frequently adopt textbooks for several Grayson County College
years durability is important. To ensure that this textbook
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HOLES ESSENTIALS OF HUMAN ANATOMY & PHYSIOLOGY, ELEVENTH EDITION

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Library of Congress Cataloging-in-Publication Data

Shier, David.
Holes essentials of human anatomy & physiology / David Shier, Jackie Butler, Ricki Lewis. 11th ed.
p. cm.
Includes index.
ISBN 9780076593460 ISBN 0076593460 (hard copy : alk. paper) 1. Human physiology. 2. Human
anatomy. I. Butler, Jackie. II. Lewis, Ricki. III. Title.
[DNLM: 1. Anatomy. 2. Physiology. QS 4]
QP34.5.S49 2012
612--dc22
2010034043
www.mhhe.com
Brief Contents
Unit 1 Unit 4
Levels of Organization Transport
1 Introduction to Human 12 Blood 318

Anatomy and Physiology 1 13 Cardiovascular System 340
2 Chemical Basis of Life 30 14 Lymphatic System and
3 Cells 50 Immunity 377
4 Cellular Metabolism 76
5 Tissues 94
Unit 5
Absorption and Excretion
Unit 2 15 Digestive System and

Support and Movement Nutrition 400
6 Integumentary System 116 16 Respiratory System 442
7 Skeletal System 132 17 Urinary System 467
8 Muscular System 178 18 Water, Electrolyte, and

Acid-Base Balance 489
Unit 3 Unit 6
Integration and Coordination
The Human Life Cycle
9 Nervous System 213
19 Reproductive Systems 505
10 The Senses 262
20 Pregnancy, Growth,
11 Endocrine System 291 Development, and
Genetics 536
iii
About the Authors
David Shier Jackie Butler Ricki Lewis

David Shier has more than Jackie Butlers professional Ricki Lewiss career
thirty years of experience background includes work communicating science
teaching anatomy and at the University of Texas began with earning a Ph.D.
physiology, primarily to Health Science Center in genetics from Indiana
premedical, nursing, dental, and allied health conducting research about the genetics of University in 1980. It quickly blossomed into
students. He has effectively incorporated bilateral retinoblastoma. She later worked writing for newspapers and magazines, and
his extensive teaching experience into at Houstons M. D. Anderson Hospital writing the introductory textbook Life. Since
another student-friendly revision of investigating remission in leukemia patients. then she has taught a variety of life science
Holes Essentials of Human Anatomy and A popular educator for more than twenty- courses and published the textbook Human
Physiology and Holes Human Anatomy and five years at Grayson County College, Jackie Genetics: Concepts and Applications, an essay
Physiology. David has published in the areas teaches microbiology and human anatomy collection, and a novel about stem cells.
of renal and cardiovascular physiology, and physiology for health science majors. Since 1984 Ricki has been a genetic
the endocrinology of fluid and electrolyte Her experience and work with students counselor for a large ob/gyn practice. She is
balance, and hypertension. A faculty of various educational backgrounds have active with the American Society of Human
member in the Life Science Department contributed significantly to another revision Genetics, and teaches an online course in
at Washtenaw Community College, he is of Holes Essentials of Human Anatomy and Genethics at Albany Medical College.
actively involved in a number of projects Physiology and Holes Human Anatomy and
dealing with assessment, articulation, Physiology. Jackie Butler received her B.S. and
and the incorporation of technology into M.S. degrees from Texas A&M University,
instructional design. David holds a Ph.D. in focusing on microbiology, including courses
physiology from the University of Michigan. in immunology and epidemiology.
A Note from the Authors

To the Student To the Teacher
Welcome! As you read this (with your eyes) and under- We are authors, but first and foremost we are teachers,
stand it (with your brain), perhaps turning to the active in the classroom. What we and our reviewers do in
next page (with muscle actions of your fingers, hand, class is reflected in this new edition. Students have always
forearam, and arm), you are using the human body to come first in our approach to teaching and textbook
do so. In this eleventh edition of Holes Essentials of authoring, but we now feel more excited than ever about
Human Anatomy and Physiology, our goal is to pro- the student-oriented, teacher-friendly quality of this text.
vide you with an interesting and readable introduction Along with updated versions of the extra resources
to how all of this works! It is not simple, and there are that students and teachers alike have found so helpful
times when it may not seem easy, but it is always fasci- over the years (Anatomy and Physiology Revealed ,
nating, and understanding how your body works can text websites, and so on), we are especially pleased to
be fun! present the new Learn, Practice, Assess approach. Each
Many of you are on a path toward a career in health chapter opens with Learning Outcomes, contains many
care, athletics, science, or education. We understand opportunites to Practice throughout, and closes with
that many of you face the challenges of balancing fam- Assessments that are closely tied to the learning out-
ily, work, and academics. Always remember that your comes. Students can use this new feature not only to
course is not so much a hurdle along your way as it is a focus their study efforts, but also to take an active role
stepping stone. We have written this book to help you in monitoring their own progress toward mastering the
succeed in your coursework and to help prepare you to material. All of these resources are described in more
make that journey. detail in the Chapter Preview beginning on page xviii.
David Shier, Jackie Butler, Ricki Lewis
iv
iv
New to this Edition
Global Changes
End-of-chapter Integrative Assessments/Critical Thinking questions include reference to previous chapters.
Practice Questions are added to the legends of selected figures.
Clinical Terms are on the book website.
Complex figures include the legend content in the artwork, paralleling the text.
Many new vignettes and small boxes.
All boxed material updated, with a more clinical focus.
Specific Changes At-a-Glance

Chapter Topic Change Rationale
1 Head cavities (fig. 1.9) Improved depth Accuracy

1 Directional terms (fig. 1.13) Rewritten Clarity
1 Anatomical terms (fig. 1.14) Rewritten Clarity, consistency
1 Anatomical terms Rewritten Clarity, consistency
2 Matter and mass Rewritten Clarity
2 Ionically-bonded substances Dissociate, not dissolve Accuracy
3 Reprogrammed cells New vignette Update
3 Gene expression New material Update
3 Cell membrane (fig. 3.3) Lipid bilayer inset added Clarity
3 Osmosis Rewritten Clarity
3 Organelles Functions added Update, balance
4 Enzyme-substrate complex New fig. 4.5 Clarity
4 Fate of pyruvic acid Redrawn Clarity
4 Catabolism of macronutrients (fig. 4.9) Redrawn Update
4 DNA replication (fig 4.11) Redrawn Accuracy, detail
5 Tissues (figs. 5.1c, d; 5.2; 5.3; 5.4; 5.5; 5.6; 5.7; 5.13; Many new micrographs and Clarity, an attempt to more
5.14; 5.15; 5.16; 5.17; 5.18; 5.19; 5.20; 5.21; 5.22; corresponding line art closely resemble the microscope
5.23; 5.24) slides the students will be
observing in lab
5 Extracellular matrix Clinical Application Rewritten, new figure Update, more clinical approach
6 Itching New vignette New information
6 Skin (figs. 6.1; 6.2; 6.5; 6.7) Many new micrographs and Clarity
corresponding line art
6 Skin cancer Rewritten Update, more clinical approach
6 Fingerprints Rewritten Clarity, update
6 Burns Rule of nines added to More clinical approach
Clinical Application
Continued next page
v
New to this Edition
Specific Changes At-a-Glance Continued
6 Botox New small box More clinical approach

7 Skeletal system (figs. 7.1; 7.9; 7.38; 7.39; 7.40) Many figures improved Update, clarity
7 Joint movements Photos of people added More clinical approach
7 Arthritis Box expanded into Clinical Update, more clinical approach
Application
8 Thick and thin muscle filaments Figs. 8.1 and 8.2 redone Accuracy, clarity
8 Motor end plate, motor units, and recruitment Reorganized and rewritten Clarity
9 Vegetative brain Vignette rewritten Update
9 Nerve impulse conduction and synaptic Distinguished better Clarity, consistency
transmission
9 Relationship of CNS/PNS, sensory/motor Fig. 9.2 redone Clarity
9 Membrane and action potentials Figs. 9.12 and 9.13 Clarity
9 Meninges Figs. 9.21 and 9.22 redone Clarity
9 Nerve impulse, nerve tract, axons, fibers, nerve fibers Redundancy eliminated Clarity, consistency
9 Lateral horn New micrograph and line art Clarity
9 Sensory and motor speech areas Rewritten Update
10 Sensation and perception Rewritten Clarity
10 Sound volume perception in terms of action Rewritten Clarity
potentials
10 Clinical Applications on synesthesia and migraines Rewritten Update
11 Hormone secretion regulation Rewritten Accuracy
11 Clinical Application on diabetes A1c testing, new glucose Update, more clinical
monitoring methods approach
12 Collection and centrifugation of blood sample Photos added to fig. 12.1 Update, clarity
12 Blood components Fig. 12.12 moved up Clarity
12 Genetics Connection Factor V Leiden replaces Accuracy, update
ITP, which is not genetic;
also includes coagulation
disorders
12 Blood cell formation (fig. 12.4), rbc life cycle Reworked Update
(fig. 12.6), platelet plug (fig. 12.13)
12 Artery cross section (fig. 12.15) New micrographs Clarity
13 Human heart and major vessels New photo for fig. 13.3 Clarity
13 Tachycardia/bradycardia New small box More clinical information
13 SA node and depolarization pathway Fig. 13.11 redrawn Clarity
13 Blood color Fig. 13.21 lightened Clarity

13 Venous valves Fig. 13.23 colors lightened Arrows more visible
13 Varicose veins Rewritten and moved to Clarity
veins section
13 Major vein figures show paired veins Figs. 13.33 and 13.35 redone Accuracy, clarity
14 Lymphatic vessel valve Micrograph in fig 14.3 replaced Clarity
14 Lymphatic pathway Detail added to fig. 14.5 Clarity, update
14 Thymus and spleen New micrographs for figs. Clarity
14.9b and 14.10b
vi
Specific Changes At-a-Glance Continued
14 T cell/B cell activation Fig. 14.13 redone and Clarity

corresponding text rewritten
14 Complement Agglutination and More information
neutralization added
14 Primary and secondary immune response Graphs in fig. 14.16 separated Clarity
15 Gut microbiome Vignette expanded Update
15 Gastric gland cells and hepatic lobules New micrographs for figs. Clarity
15.12b and 15.17c
15 Movements in alimentary canal (fig. 15.4), mouth Redrawn Clarity
(fig. 15.6), skull (fig. 15.7), salivary glands (fig. 15.10)
and stomach (fig. 15.11)
15 Inflammatory bowel disease Clinical Application rewritten Update
16 Mechanics of inspiration Rewritten Clarity
16 Spirometry Cannot measure residual Clarity
volume
16 Basic breathing rhythm Figs. 16.16 and 16.17 redone and Update
corresponding text rewritten
16 Cystic fibrosis Clinical Application rewritten Update
17 Hemolytic uremic syndrome Vignette rewritten Update
17 Macula densa Location, new fig. 17.7 Accuracy
17 Afferent and efferent arterioles Anatomical differences Accuracy, clarity
moved to part on glomerular
filtration
17 Net filtration pressure Fig. 17.10 matches fig. 13.21 Consistency
on capillary filtration
18 Heatstroke New vignette More clinical approach
18 Water intoxication New information in Clinical Update
Application
19 Seminiferous tubules New micrograph in fig. 19.2c Clarity
19 Spermatogonia and sperm New micrograph in fig. 19.4 Clarity
19 Prostate cancer Clinical Application rewritten Update
19 Uterus Fundus added More information
19 Breast cancer Clinical Application rewritten Update
19 Contraceptives Fig. 19.15 redone Update
19 Sexually transmitted diseases Changed to sexually Update, accuracy
transmitted infections
20 Postmortem sperm retrieval New vignette Update
20 Critical period Added to discussion, new More information
orange box
20 Teratogens Clinical Application 20.2 Update
rewritten
20 Aging Added More information
ppendix B
A Metrics New Students need help making
conversations to/from metric
measurements.
Appendix E Figure Questions Answers New Provides answers to the new
figure questions
vii
10
TheSenses
Learn, Practice,
The sound of music. ThebandNirvanaandsingerToriAmoshave
eachrecordedthesongSmellsLikeTeenSpirit.IntheoriginalNirvana
version,KurtCobainsvoiceisloudandbrash,asistheinstrumentation;
incontrast,ToriAmosssongisslowandsubdued.Yetitiseasytotell
thatthesearethesamesongs.Whatisnteasyisfiguringouthowthe
braincantellthis.
Someneuronsintheauditorycortexsenseacertainrangeoffre-
Assess!
quenciesofincomingsoundwaves,butothersarepitch-sensitive,
whichmeansthattheycanrecognizethesamenote,whetheritcomes
fromanoboeoranelephant.Thispropertyofsound,calledpitch,isa
vibrationfrequencyfromobjectsthatvibrateperiodically.Thevibra- Experiments in which monkeys listened to music suggest how the human
tioniscomplexpluckingastringonaninstrumentvibratestheentire brain processes pitch.
string,butalsovibratespartsofit,creatingacomplexsound.Pitch-
sensitiveneuronsrecognizethefundamentalvibration,whichisthe
lowestonecomingfromtheentirevibratingobject,correspondingto brainswereinthesamepartoftheauditorycortexthatisdamaged
pluckingtheentirestring. inhumanswholosetheabilitytodistinguishpitchesaftersufferinga
Inexperimentstoidentifyandlocalizepitch-sensitiveneurons, stroke.However,wedontyetknowhowthebrainlearnsandmatches
researchersplacedelectrodesovertheauditorycorticesofmarmoset thetemporalcombinationofnotesthatmakeupamelodywhichis
monkeys,whohearthesamerangeofsoundsashumans.Whenthe howweperceivethatKurtCobainandToriAmossangthesamesong.
monkeyslistenedtosoundsthatsharedthefundamentalvibration, Presumablymemoryispartofthepicture,whichmayexplainwhywe
eventhoughdifferentsourcesmadethesounds,thesameneuronsfired canrememberlyricstoasongmanyyearsafterlasthearingitbutmay
actionpotentials.Moreover,thepitch-sensitiveneuronsinthemonkey notrememberwhatwelearnedinaclassjustadayago.
Learn
Learning Outcomes
After studying this chapter, you should be able to do the following:
10.1 Introduction 10.4 Special Senses 10.8 Sense of Equilibrium

1. Distinguishbetweengeneralsensesand 6. Identifythelocationsofthereceptorsas- 11. Distinguishbetweenstaticanddynamic
specialsenses.(p.263) sociatedwiththespecialsenses.(p.267) equilibrium.(p.275)
10.2 Receptors, Sensations, 10.5 Sense of Smell 10.9 Sense of Sight
Learning Outcomes open chapters, 2.

and Perception
Namefivekindsofreceptors,andexplain
theirfunctions.(p.263)
7.
8.
Explaintherelationshipbetweenthe
sensesofsmellandtaste.(p.267)
Explainthemechanismforsmell.(p.268)
12.
13.
Explainthefunctionofeachpartofthe
eye.(p.277)
Explainhowtheeyerefractslight.(p.284)
and are closely linked to Chapter 3. Explainhowasensationarises.(p.263)
10.3 General Senses

10.6 Sense of Taste
9. Explainthemechanismfortaste.(p.270)
14. Describethevisualnervepathway.(p.286)
Assessments and Integrative Assess- 4. Describethereceptorsassociatedwith

thesensesoftouch,pressure,tempera-
ture,andpain.(p.264)
10.7 Sense of Hearing
10. Explainthefunctionofeachpartofthe Module 7: Nervous System
ments/Critical Thinking questions 5. Describehowthesenseofpainispro-

duced.(p.265)
ear.(p.270)
262 Learn Practice Assess

found at the end of each chapter.
Learning tools to help you succeed. . .

Check out the Chapter Preview, Foundations for
10
TheSenses
Success, on page xviii. The Chapter Preview was
specifically designed to help you LEARN how
to study. It provides helpful study tips.
NEW! for this edition is a section on learning styles!
The sound of music. ThebandNirvanaandsingerToriAmoshave
Vignettes lead into chapter content. They connect

eachrecordedthesongSmellsLikeTeenSpirit.IntheoriginalNirvana
version,KurtCobainsvoiceisloudandbrash,asistheinstrumentation;
incontrast,ToriAmosssongisslowandsubdued.Yetitiseasytotell
thatthesearethesamesongs.Whatisnteasyisfiguringouthowthe
braincantellthis.
Someneuronsintheauditorycortexsenseacertainrangeoffre-
quenciesofincomingsoundwaves,butothersarepitch-sensitive,
you to many areas of health care including
whichmeansthattheycanrecognizethesamenote,whetheritcomes
fromanoboeoranelephant.Thispropertyofsound,calledpitch,isa
vibrationfrequencyfromobjectsthatvibrateperiodically.Thevibra- Experiments in which monkeys listened to music suggest how the human
technology, physiology, medical conditions, historical
perspectives, and careers.
tioniscomplexpluckingastringonaninstrumentvibratestheentire brain processes pitch.
string,butalsovibratespartsofit,creatingacomplexsound.Pitch-
Reference Plates The Human Organism 27
sensitiveneuronsrecognizethefundamentalvibration,whichisthe
lowestonecomingfromtheentirevibratingobject,correspondingto brainswereinthesamepartoftheauditorycortexthatisdamaged
pluckingtheentirestring. inhumanswholosetheabilitytodistinguishpitchesaftersufferinga
NEW! Anatomy and Physiology Revealed (APR)

Common carotid a. Inexperimentstoidentifyandlocalizepitch-sensitiveneurons,
Larynx stroke.However,wedontyetknowhowthebrainlearnsandmatches
researchersplacedelectrodesovertheauditorycorticesofmarmoset
Trachea thetemporalcombinationofnotesthatmakeupamelodywhichis
Right subclavian a.
monkeys,whohearthesamerangeofsoundsashumans.Whenthe howweperceivethatKurtCobainandToriAmossangthesamesong.
Left subclavian a.
icon at the beginning of each chapter tells you which

Brachiocephalic a.
monkeyslistenedtosoundsthatsharedthefundamentalvibration, Presumablymemoryispartofthepicture,whichmayexplainwhywe
eventhoughdifferentsourcesmadethesounds,thesameneuronsfired Arch of aorta canrememberlyricstoasongmanyyearsafterlasthearingitbutmay
Superior vena cava actionpotentials.Moreover,thepitch-sensitiveneuronsinthemonkey notrememberwhatwelearnedinaclassjustadayago.
Pulmonary a.
Pulmonary trunk
Right atrium
Right ventricle
Learning Outcomes
Pulmonary v.
Left atrium
Lung
system in APR applies to this chapter.
Left ventricle
10.1 Introduction 10.4 Special Senses 10.8 Sense of Equilibrium
Aids to Understanding Words help you remember

Lobes of liver Diaphragm
1. Distinguishbetweengeneralsensesand 6. Identifythelocationsofthereceptorsas- 11. Distinguishbetweenstaticanddynamic
specialsenses.(p.263) sociatedwiththespecialsenses.(p.267)
Spleen equilibrium.(p.275)
Gallbladder
Cystic duct 10.9 Sense of Sight
10.2 Receptors, Sensations, 10.5 Sense of Smell
Stomach
Duodenum 2.
and Perception
Namefivekindsofreceptors,andexplain
theirfunctions.(p.263)
7.
8.
Explaintherelationshipbetweenthe
sensesofsmellandtaste.(p.267)
Explainthemechanismforsmell.(p.268)
12.
13.
Explainthefunctionofeachpartofthe
eye.(p.277)
Explainhowtheeyerefractslight.(p.284)
scientific word meanings. Examine root words,
stems, prefixes, suffices, pronunciations, and build a
3. Explainhowasensationarises.(p.263) Transverse colon 14. Describethevisualnervepathway.(p.286)
Ascending colon 10.6 Sense of Taste
Jejunum (cut)
10.3 General Senses 9. Explainthemechanismfortaste.(p.270)
Descending colon
solid anatomy and physiology vocabulary.

Mesentery 4. Describethereceptorsassociatedwith
thesensesoftouch,pressure,tempera- 10.7 Sense of Hearing
Ureter Module 7: Nervous System
lleum (cut) ture,andpain.(p.264) 10. Explainthefunctionofeachpartofthe
Cecum 5. Describehowthesenseofpainispro- ear.(p.270)
Sigmoid colon
Appendix duced.(p.265)
Rectum
Common iliac a. 262 Learn Practice Assess
Uterus
Ovary
Tensor fasciae latae m.
Uterine tube
Round ligament of uterus
Femoral a.
Femoral v. Urinary bladder
Adductor longus m.
Great saphenous v.
Reference Plates offer vibrant

Rectus femoris m.
Gracilis m.
Vastus lateralis m.
Vastus medialis m. Sartorius m.
PLATE FIVE
Human female torso with the lungs, heart, and small intestine sectioned and the liver reflected (lifted back).
(a. stands for artery, m. stands for muscle, and v. stands for vein.)
detail of body structures.
viii
stable internal environment. peri- [around] pericardial membrane:
Membrane that surrounds the heart.
Practice
268 Unit Three Integration and Coordination
1.1 IntrOdUctIOn Practice
1. What factors probably stimulated an early interest in the
Modern medicine began with long-ago observations human body?
Practice with a question or series of questions after
Clinical Application 10.1 on the function, and malfunction, of the human body.
The study of the human body probably began with our
2. What kinds of activities helped promote the development
of modern medical science?
Synesthesia: Connected Senses
major sections. They will test your understanding of the earliest ancestors, who must have been curious about
The song was full of glittering orange diamonds.
how their bodies worked, as we are today. At first their
and physicist Richard Feynman, who used to include the
284
material. The paint smelled blue.
The sunset was salty.
The pickle tasted
Unit Three Integration and Coordination like a rectangle. interests
hues with which he visualized chemical equations on the
most
chalkboard, to thelikely
amusement ofconcerned
his students. One of theinjuries
co- and illnesses,
authors of this book has itto her, days are colors. The earliest
About 1 in 2,000 people have a condition called synesthesia
(joined sensation), in which sensation and perception mix,
because healthy
recorded bodies
mention of synesthesia demand
is an essay from John Locke little attention from
in 1690. More and more people with synesthesia are recog-
so that the brain perceives a stimulus to one sense astheir coming owners. Early
nizing that their peculiar talenthealers
has a name, thanks relied
to Internet heavily on supersti-
Interesting applications help you practice and apply their knowledge. . .

from another. Most commonly, letters, numbers, or periods groups devoted to the condition.
of time evoke specific colors. These associations aretions involun- and notions
Researchers hypothesize about magic.
that mixed senses are presentHowever, as healers
tary, are very specific, and persist over a lifetime. For example, in all babies, but synesthesia develops in individuals who do
Artery a person might report that 3 is always mustard yellow, tried or to not help
prune as manythesynapsessick, as othersthey
as they age.began(A loss of to discover useful
Thursday a very dark, shiny brown. 20 billion synapses a day is normal for adults.) Imaging stud-
Synesthesia runs in families, and geneticists have waysassoci- of ies examining
and animal experiments and treating
have localized the neurons the that human body. They
ated the condition with inheriting variants in any of four dif- convey synesthetic connections to the general area where
Veins one. Creative NEW! individuals areAnatomy

ferent genes. Female synesthetes outnumber males
overrepresented among those
observed
healed,
and
six to
timesPhysiology
theparietal,
the temporal,
and Macula
referred
effects
examined
oflobes
and occipital
cadavers
Revealed
injuries,
meet. Once some-
to as a learning disability, synesthesia
noticed how wounds
to determine causes of
is instead Q: NEW! Figure Questions allow an additional
icons Mayer,found inLiszt, figure legends. and a fuller These of enjoying ouricons
sensual worlds. indicate
with the condition. They include musicians Syd Barrett, John now increasingly
luteaviewed as an enhancement to learning
Tori Amos, and Franz architect Frank Lloyd
death.
Wright,
They wayalso found that certain herbs and potions assessment. Found on key figures throughout
that there is a direct link couldtosometimes APR available
Fovea be used to treat coughs, headaches,
centralis in the the chapter.
Optic
eBook
disc provided with fevers, Connect and other common signs of illness.
Plus for this title!
Over time, people began to believe that humans Semicircular
Auricle canals
could understand forces that caused natural events. Incus Stapes Cochlea
Artery
They began observing the world around them more Malleus Vestibulocochlear
(a) closely, asking questions and seeking answers. This nerve
Figure 10.23
Veins set the stage Maculafor the development of modern medical Oval window (under stapes)
Round window
The retina. (a) Major features of the retina. science.
Nerve fibers within (b) Nerve fibers lutea Tympanic cavity
leave the retina of the eye in the area of the optic disc (arrow) to
the olfactory bulb
form the optic nerve in this magnified view of the retina (53). As techniques Fovea for
Olfactory Olfactory
making
(b)
Cribriform
accurate observations
centralis
Optic and performing tract
careful experiments evolved, knowl-
bulb plate
Olfactory area of
disc
edge of the human body expanded rapidly (fig. 1.1). At nasal cavity
Eardrum
(tympanic
membrane)
the same time, earlyLight medical
Superior nasal
concha
Refraction providers coined many
The fovea centralis of the human eye hasnew 150,000terms cones to name body parts, describe their loca-Nasal cavity External acoustic
meatus
Auditory tube Nasopharynx
Cilia Olfactory Columnar Cribriform
per square millimeter. In contrast, a bird of preys eye has When afunctions person sees and an object, either the object is giving
about
(a) a million cones per square
receptor cells
millimeter. tions, and
epithelial cells plate
explain their interactions.
off light, or it is reflecting light waves from Figure another
10.6 source.
Figure
(a)
10.23 These terms, most ofThese (b)

which light originated
waves enter from Greek
the eye, and
andMajor
anparts Figure stapes) and 1.1
of the ear. The outer ear includes the auricle, external acoustic meatus, and eardrum. The middle ear includes the auditory
image ofandthe
Figure 10.4 ossicles (malleus, incus, the oval window. The inner ear includes the semicircular canals and the cochlea.
Just
Olfactory
The retina. medial to
receptors convey
(a) Major the
the
features sensefovea
of centralis
of smell. (a)
the Columnar
retina. Latin
(b) is an
epithelial
Nerve words,
cells area
support
fibers formed
called
olfactory the
receptor cells,object basis
which have isciliafocusedfor
at their distalthe language
on the of anat-
retina. Focusing
Q: How bends thepotentials
do the action light generated along auditory pathways compare with those on taste and smell pathways?
ends. The actual olfactory receptors, which are proteins, are on the cilia. Binding of odorants to these receptors in distinctive patterns The study of the human body has a long history, as evidenced
the optic
leave the retina
conveys disc
the (optik
of the
information eyethein
that disk) (fig.of
theinterprets
brain area the
an omy
as10.23). (b)Here,
optic
odor. and
Thedisc nerve physiology
(arrow)
olfactory area fibers
to
is associated thatnasalpersists
waves,
with the superior a phenomenon
concha. today.called
(Therefraction
names of(re-frakshun).
Answer can be found in Appendix E on page 568.
form (b) Refraction occurs when light waves pass by this illustration from the second book of De Humani Corporis
fromthethe optic nerveleave
retina in this the magnifiedeye and viewjoinof thethe
some retinaoptic
modern (53). nerve. medical and applied sciences are listed at an
oblique angle from a medium of one optical
Fabrica by Andreas Vesalius, Auditory
density into
issued in 1543. (Note the similarity to
A central artery and vein also pass through the optic disc. Middle Ear Tube
These vessels are continuous with the capillary networks
on pages 1719.) a medium of a different optical density. the anatomical position, described
Thisear,happens
The middle or tympanic cavity, is an air-filled space
later in this chapter on page 14.)
An auditory tube (awdi-tore tub) (eustachian tube)
in the temporal bone. It contains three small bones connects each middle ear to the back of the nasal cav-
of the retina, and along with vessels in the underlying at the curved surface between the air and the cornea
Light
and at Refraction
called auditory ossicles (awdi-tore osi-klz): the mal- ity (nasopharynx). This tube conducts air between the
choroid
The fovea
layer.
coat,
Because
per square
theyofsupply
centralis the human
the optic
millimeter.
blood
disc region
In contrast,
to the
eye has
a bird oflacks
cells
150,000 of the inner
cones
preysphotoreceptors,
eye has
Facts of Life provides interesting bits of anatomy and physiology
the curved surface of the lens itself.
convexa surface (as inanthe
leus, theAincus,
eye) causes
lensandwith a (fig. 10.7). Tiny ligaments
the stapes
attach them to the wall of the tympanic cavity, and they
light waves to con-
tympanic cavity and the outside of the body by way of
When person sees object, either the object

are covered byismucous
giving membrane. These bones bridge
about a million cones per square millimeter.
it is commonly known as the blind spot of the eye. information, adding a touch of wonder to chapter topics.
verge
off (fig.
light, or 10.24).
it is reflecting light waves from the eardrum
another andsource.
the inner ear, transmitting vibrations
between these parts. Specifically, the malleus attaches to
The space bounded by the lens, ciliary body, and These The convex
light wavessurface
enter the of eye,
the cornea
andtheaneardrum, refracts
image andof when
light
the the eardrum vibrates, the mal-
Incus
retinaJustis medial
the largest compartment
to the fovea centralis of theiseye an and
areaiscalled
called wavesisfrom
object outside
focused objects.
on the retina.The convex
Focusing surface
leus vibrates
bends oflight
in unison.
the the
The malleus causes the incus to
vibrate, and the incus passes the movement on to the
the posterior
the optic disccavity
(optik(see fig.(fig.
disk) 10.17). It is Here,
10.23). filled with
nervea fibers
trans- lens and,
waves, to a lesser extent,
a phenomenon calledthe surfaces
refraction stapes. ofLigaments
the fluids
(re-frakshun). hold the in stapes to an opening in the Malleus
Clinical Application 10.1 cavity called the oval window,
parent,
from thejellylike fluid the
retina leave eyevitreous
called and join humor the optic(vitre-us
nerve. the Refraction
chambers ofoccurs the eyewhenthen refract
light the wall
waves light
of theagain.
passtympanic
at an
Boxed information applies ideas and
which leads into the inner ear. Vibration of the stapes at
humor), which along with collagenous
A central artery and vein also pass through the optic disc. fibers forms the oblique angle from a medium of one optical the oval density
Synesthesia:
window movesintoConnected
a fluid in the inner Sensesear, which
Stapes
vitreous
These body.are
vessels The vitreous with
continuous bodythe supports
capillary thenetworks
internal a medium of a different optical density. stimulates the hearing receptors.
This happens
facts in the narrative to clinical situations.
parts
of theof the eye
retina, and and helpswith
along maintain
vessels its in
shape.
the underlying at the curved surface between the airof vibrations
The
and
auditory
The song
the
The paint
The sunset
was fullossicles
as cornea
smelled
theyblue.
help
of glittering increase
orange (amplify) the
diamonds.
pass from the eardrum to hues
was salty.to transmitting vibrations. The vibra-
force
and physicist Richard Feynman, who used to include the
the oval
with which he visualized chemical equations on the
window, in addition
choroid coat, they supply blood to the cells of the inner and at the curved surface of the lens itself. tionalTheApickle
force
lens
tasted with
like aLight
concentrates
a
rectangle.
as it moves from the outer
chalkboard, to the amusement of his students. One of the co-
to the
authors of this book has itto her, days are colors. The earliest Chapter Eight Muscular System 193
layer.As aBecause
person ages,the tiny,
optic discclumps
dense regionoflacks
gel or photoreceptors,
deposits of convex surface (as in the eye) causes Aboutlight
1inner waves
ear
in 2,000 because
people tothe
have con-
wave
ossiclescalled
a condition transmit vibrations from
synesthesia recordedthemention of synesthesia is an essay from John Locke
(joinedrelatively
sensation),large surface
in which of the
sensation andeardrum
perceptiontomix,
a muchinsmaller
1690. More and more people with synesthesia are recog-
it iscrystal-like
commonly known form
substances as the blind
in the spot humor.
vitreous of the eye.
When verge (fig. 10.24). so that the
areabrain
at perceives
the ovala stimulus
window. to one
As sense as coming
a result, the nizing(per
that their peculiar talent has a name, thanks to Internet
Genetics Connection 8.1pressure Figure 10.7
The clumps
these space cast bounded
shadowsby on the lens, the
the retina, ciliary
person body,
sees and The convex surface of the cornea from another. refracts
squareMost commonly,
millimeter) light
letters,
that
Airthe
numbers, or periods
stapes applies groups
on the oval devoted to the condition.
win- The auditory ossiclesthe malleus, incus, and stapesare bones
of time dow
evoke isspecific
manycolors.
timesThese associations
greater than the are pressure
involun- that sound Researchers hypothesize that mixed senses are present
retina is the largest compartment of the eye and is called
small, moving specks in the field of vision, called floaters. waves from outside objects. The convex tary, arewaves surface
very specific,
exertand of
on persist the Inherited
over a lifetime.
the eardrum. For example,Diseases ofbut
in all babies,
that bridge the eardrum and the inner ear (2.5) (see fig. 10.6).
Muscle
synesthesia develops
Comparison to a penny in individuals
emphasizeswho dotiny size.
their
Convex
lens and, to a lesser extent, the surfaces a person might report that 3 is always mustard yellow, or
of the fluids in not prune as many synapses as others as they age. (A loss of
the posterior cavity (see fig. 10.17). It is filled with a trans- surface Thursday a very dark, shiny brown.Glass A variety of inherited conditions 20 billionaffect
synapses a day is normal
muscle actin infor
theadults.)
cell to Imaging stud-in the cell membrane, which
glycoproteins
parent, jellylike fluid called vitreous humor (vitre-us the chambers of the eye then refract the light
Synesthesia runsagain.
in families, and geneticists
tissue.have
Theseassoci-
disorders ies andinanimal
differ experiments
the nature of have
helpslocalized
attach thethecell
neurons
to thethat
extracellular matrix. Missing or
ated the condition with inheriting variantsthe in any of four
genetic dif- the convey
defect, type of synesthetic
protein thatconnections
is to thedystrophin
abnormal general area or where
the glycoproteins cause muscular
humor), which along with collagenous fibers forms the ferent genes. Female synesthetes
abnormaloutnumber
in form ormales six toand thethe
function, temporal,
particular parietal,
muscles in and occipital lobesThese
dystrophies. meet.illnesses
Once some-vary in severity and age of onset,
Practice
vitreous body. The vitreous body supports the internal one. Creative individuals are the
overrepresented among those
body that are impaired.
with the condition. They include musicians Syd Barrett, John
times referred to as a learningbut
now increasingly viewed as fat
disability,
an and
synesthesia
in all cases,
enhancement
connective
muscles
to
is instead
weaken and degenerate. Eventually,
learning
tissue replace muscle.
Converging Mayer, Tori Amos, and Franz Liszt,
parts
30. of the eye and helps maintain its and
shape.
NEW! Clinical Applications present
Explain the source of aqueous humor, trace its path Thearchitect
Muscular FrankDystrophiesMissing
Lloyd Wright, and a fullerProteins
way of enjoying our sensual worlds.muscular dystrophy (DMD) is the most
Duchenne
light waves A muscle cell is packed with filaments of actin and myosin. severe type of the illness (fig. 8B). Symptoms begin by age
through the eye. Much less abundant, but no less important, is a protein called five and affect only boys. By age thirteen, the person cannot
Light
Figure to
disorders, physiological responses 10.24
31. How does the pupil respond to changes in light intensity? dystrophin. It holds skeletal muscle cells together by linking
wave
walk, and by early adulthood he usually dies from failure of
As a person ages, tiny, dense clumps of gel or deposits of the respiratory muscles. In DMD, dystrophin is often miss-
32. Describesubstances
the structure ofin
the retina. A lens with a convex surface causes light waves to converge. The ing. In Becker muscular dystrophy, symptoms begin in early
crystal-like form the vitreous humor. When
environmental factors, and other topics of
these clumps cast shadows on the retina, the person sees
lens of the eye functions the same way.
Air
adulthood,
of dystrophin.
are less severe, and result from underproduction
general interest.
small, moving specks in the field of vision, called floaters.
Convex
Charcot-Marie-Tooth Disease
A Duplicate Gene
surface Glass Charcot-Marie-Tooth disease causes a slowly progress-
ing weakness in the muscles of the hands and feet and a
Practice
Genetics Connections explore the decrease in tendon reflexes in these parts. In this illness, an
extra gene impairs the insulating sheath around affected
nerve cells, so that nerve cells cannot adequately stimulate
molecular underpinnings of familiar as wellConverging

30. Explain the source of aqueous humor, and trace its path light waves
Nerve fibers within
the olfactory bulb
muscles. Physicians perform two testselectromyography
and nerve conduction velocityto diagnose Charcot-Marie-
through the eye. Olfactory Tooth disease. It Cribriform
is also possible to test for the gene mutation
as not so familiar illnesses. Read about
10.24 such
Olfactory
tract tobulb
confirm a diagnosis
plate based on symptoms.
Figure
31. How does the pupil respond to changes in light intensity? Olfactory area of
Hereditary Idiopathic Dilated
topics as ion channel disorders,A lensmuscular
nasal cavity
32. Describe the structure of the retina. with a convex surface causes light waves to converge. The CardiomyopathyA Tiny Glitch
Superior nasal
lens of the eye functions the same way. This very rare inherited
concha form of heart failure usually begins
dystrophy, and cystic fibrosis. Cilia Olfactory Columnar

receptor cells epithelial cells plate
Cribriform
in a persons forties and is lethal in 50% of cases within five
years of diagnosis, Nasal cavity a heart transplant can be per-
unless
formed. The condition is caused by a tiny genetic error in a
form of actin found only in cardiac muscle, where it is the
Figure 8B predominant component of the thin filaments. The mutation
(a) (b)
This young man has Duchenne muscular dystrophy. The disturbs actins ability to anchor to the Z lines in heart muscle
Figure 10.4 condition has not yet severely limited his activities, but he
shows the hypertrophied (overdeveloped) calf muscles that cells, preventing actin from effectively transmitting the force
Olfactory receptors convey the sense offrom
result (a)inability
smell.his Columnar epithelial
to rise from acells support
sitting olfactory
position of contraction.
receptor cells,
the usual As at
which have cilia a result, the heart chambers enlarge and
their distal
ends. The actual olfactory receptors, whichearly
wayan are proteins, areillness.
sign of the on the cilia. Binding of odorants to these receptors in distinctive
eventually fail. patterns
conveys the information that the brain interprets as an odor. (b) The olfactory area is associated with the superior nasal concha.
Since students often find it helpful to think of move-

ments in terms of the specific actions of the muscles
Interaction of Skeletal Muscles
involved, we may also describe flexion and extension in
these terms. Thus, the action of the biceps brachii may be
Skeletal muscles almost always function in groups. Con-
sequently, a particular body movement requires more ix
described as flexion of the forearm at the elbow, and the than contracting a single muscle; instead, after learning
action of the quadriceps group as extension of the leg at to make a particular movement, the person initiates the
the knee. We believe this occasional departure from strict movement consciously, and the nervous system stimu-
anatomical terminology eases understanding and learning. lates the appropriate group of muscles.
10.7 Sense of Hearing (p. 270) and an inner (nervous) layer.
1. Outer ear (1) The outer layer is protective, and its transparent anterior
The outer ear collects sound waves of vibrating objects. portion (cornea) refracts light entering the eye.
2. Middle ear (2) The middle layer is vascular and contains melanin that keeps
Auditory ossicles of the middle ear conduct sound waves from the the inside of the eye dark.
eardrum to the oval window of the inner ear. (3) The inner layer contains the photoreceptors.
3. Auditory tube b. The lens is a transparent, elastic structure. Ciliary muscles
Auditory tubes connect the middle ears to the nasopharynx and control its shape.
help maintain equal air pressure on both sides of the eardrums. c. The lens must thicken to focus on close objects.
4. Inner ear d. The iris is a muscular diaphragm that controls the amount of
a. The inner ear is a complex system of connected tubes and light entering the eye.
chambersthe osseous and membranous labyrinths. e. Spaces within the eye are filled with fluids that help maintain
b. The spiral organ contains hearing receptors that are stimulated its shape.
by vibrations in the fluids of the inner ear. 3. Light refraction
c. Different frequencies of vibrations stimulate different sets of The cornea and lens refract light waves to focus an image on
receptor cells. the retina.
5. Auditory nerve pathways 4. Photoreceptors
a. Auditory nerves carry impulses to the auditory cortices of the a. Photoreceptors are rods and cones.
b. Rods are responsible for colorless vision in dim light, and cones
Learn, Practice, Assess!

temporal lobes.
b. Some auditory nerve fibers cross over, so that impulses arising provide color vision.
from each ear are interpreted on both sides of the brain. 5. Photopigments
a. A light-sensitive pigment in rods decomposes in the presence
10.8 Sense of Equilibrium (p. 275) of light and triggers a complex series of reactions that initiate
1. Static equilibrium nerve impulses.
Static equilibrium maintains the stability of the head and body b. Color vision comes from three sets of cones containing different
when they are motionless. light-sensitive pigments.
2. Dynamic equilibrium 6. Visual nerve pathways
a. Dynamic equilibrium balances the head and body when they a. Nerve fibers from the retina form the optic nerves.
are moved or rotated suddenly. b. Some fibers cross over in the optic chiasma.
b. Other structures that help maintain equilibrium include the c. Most of the fibers enter the thalamus and synapse with others
eyes and mechanoreceptors associated with certain joints. that continue to the visual cortex in the occipital lobes.
Assess Chapter Assessments

10.1 Introduction
1. Distinguish between general senses and special senses. (p. 263)
3. Explain the difference between a sensation and a perception.
(p. 263)
4. Explain the projection of a sensation. (p. 263)
10.2 Receptors, Sensations, and Perception
5. You fill up the tub to take a hot bath, but the water is too hot
Tools to help you make the

2. Match each sensory receptor to the type of stimulus to which it to the touch. You try a second and third time, and within a few
is likely to respond. (p. 263) seconds it feels fine. Which of the following is the most likely
(1) chemoreceptor A. Approaching headlights explanation? (p. 263)
(2) pain receptor B. A change in blood pressure a. The water has cooled down unusually quickly.
connection and master anatomy

(3) thermoreceptor C. The smell of roses b. Your ability to sense heat has adapted.
(4) mechanoreceptor D. An infected tooth c. Your nervous system is suddenly not functioning properly.
(5) photoreceptor E. A cool breeze d. Your ability to sense cold has adapted.
& physiology!
e. All of the above.
290 unit three Integration and Coordination
Integrative Assessments/critical thinking

OutcOmes 6.2, 9.14, 10.2, 10.9 information is needed to use this association to prevent or treat
Chapter Assessments check your understanding 1. PET (positron emission tomography) scans of the brains of people
who have been blind since birth reveal high neural activity in the
visual centers of the cerebral cortex when these people read Braille.
these diseases?
4. Describe how the taste of a medicine might be modified from sour
to sweet, so that children would be more willing to take it.
of the chapters learning outcomes. However, when sighted individuals run their fingers over the raised
letters of Braille, the visual centers do not show increased activity.
OutcOmes 10.2, 10.7, 10.8
5. People who are deaf due to cochlear damage do not suffer from
Explain these experimental results.
motion sickness. Why not?
Integrative Assessments/Critical Thinking

OutcOmes 6.2, 10.2, 10.3
OutcOmes 10.2, 10.8
2. Why are some serious injuries, like a bullet entering the abdomen,
6. Labyrinthitis is an inflammation of the inner ear. What symptoms
relatively painless, but others, such as a burn, considerably more
would you expect in a patient with this disorder?
questions allow you to connect and apply painful?

OutcOmes 10.2, 10.5
information from previous chapters as well as

3. Loss of the sense of smell often precedes the major symptoms
of Alzheimer disease and Parkinson disease. What additional
information within the current chapter. Chapter Ten The Senses 287
Web ConneCtions apr
Visit the text website at www.mhhe.com/shieress11 for additional Anatomy & Physiology REVEALED includes cadaver photos that
quizzes, interactive learning exercises, and more. allow you to peel away layers of the human body to reveal structures
Chapter Summary Outlines help you review the

nasal half of the left eye and the temporal half of the
right eye form the right optic tract, and fibers from the
nasal half of the right eye and the temporal half of the
nerve pathways called optic radiations, which lead to
the visual cortex of the occipital lobes.
beneath the surface. This program also includes animations, radiologic
imaging, audio pronunciation, and practice quizzing. To learn more
visit www.aprevealed.com.
chapters main ideas.
left eye form the left optic tract.
Practice
Just before the nerve fibers reach the thalamus, a
35. Distinguish between the rods and cones of the retina.
few of them enter nuclei that function in various visual
reflexes. Most of the fibers, however, enter the thala- 36. Explain the roles of visual pigments.
mus and synapse in its posterior portion (lateral genicu- 37. Trace a nerve impulse from the retina to the visual cortex.
late body). From this region, the visual impulses enter
Summary Outline
10.1 Introduction (p. 263) (4) Within the brain, pain impulses pass through the reticular
Sensory receptors sense changes in their surroundings. formation before being conducted to the cerebral cortex.
d. Regulation of pain impulses
10.2 Receptors, Sensations, and Perception (p. 263) (1) Awareness of pain occurs when pain impulses reach
1. Types of receptors the thalamus.
a. Each type of receptor is most sensitive to a distinct type
of stimulus.
b. The major types of receptors are chemoreceptors, pain receptors,
(2) The cerebral cortex determines pain intensity and locates
its source.
(3) Impulses descending from the brain stimulate neurons to
o rgan i z ation
o r g a n i z at i o n
thermoreceptors, mechanoreceptors, and photoreceptors.
2. Sensations
a. A sensation is the awareness that sensory stimulation
release pain-relieving neuropeptides, such as enkephalins.
10.4 Special Senses (p. 267)

Illustrations
has occurred.
b. A particular part of the cerebral cortex interprets every impulse
reaching it in a specific way.
Special senses have receptors within large, complex sensory organs
of the head. found at the end of selected
c. The cerebral cortex projects a sensation back to the region
of stimulation.
3. Sensory adaptation may involve receptors becoming unresponsive
10.5 Sense of Smell (p. 267)
1. Olfactory receptors
a. Olfactory receptors are chemoreceptors that are stimulated by
Skeletal System chapters conceptually link
or inhibition along the CNS pathways leading to the sensory
regions of the cerebral cortex.
chemicals dissolved in liquid.
b. Olfactory receptors function with taste receptors and aid in
food selection. Integumentary System Lymphatic System
the highlighted body
10.3 General Senses (p. 264)
General senses are associated with receptors in the skin, muscles, joints,
and viscera.
2. Olfactory organs
a. Olfactory organs consist of receptors and supporting cells in the
nasal cavity.
Vitamin D, activated
in the skin, plays a
role in calcium
absorption and
Cells of the immune
system originate in
the bone marrow.
system to every other
1. Touch and pressure senses
a. Free ends of sensory nerve fibers are receptors for the sensation
of itching.
b. Olfactory receptor cells are bipolar neurons with cilia.
3. Olfactory nerve pathways
Nerve impulses travel from the olfactory receptor cells through the
availability for
bone matrix. system and reinforce the
b. Tactile corpuscles are receptors for the sensation of light touch.
c. Lamellated corpuscles are receptors for the sensation of
heavy pressure.
olfactory nerves, olfactory bulbs, and olfactory tracts to interpreting
centers in the temporal and frontal lobes of the cerebrum.
4. Olfactory stimulation Muscular System Digestive System
dynamic interplay among
2. Temperature senses
Temperature receptors include two sets of free nerve endings that
are warm and cold receptors.
a. Olfactory impulses may result when odorant molecules bind
cell surface olfactory receptors on cilia of receptor cells. The
binding pattern encodes a specific odor, which is interpreted in
Muscles pull on
bones to cause
movement.
Absorption of
dietary calcium
provides material
for bone matrix.
systems. These illustrations
3. Sense of pain
a. Pain receptors are free nerve endings that tissue damage stimulates.
b. Visceral pain
the brain.
b. The sense of smell adapts rapidly. help you review chapter
(1) Pain receptors are the only receptors in viscera that
provide sensations.
(2) Pain sensations produced from visceral receptors may feel
10.6 Sense of Taste (p. 269)
1. Taste receptors
a. Taste buds consist of taste (receptor) cells and supporting cells. Nervous System Respiratory System
concepts and reinforce the
as if they are coming from some other body part, called
referred pain.
b. Taste cells have taste hairs.
c. Taste hair surfaces have receptors to which chemicals bind,
stimulating nerve impulses.
Proprioceptors
sense the position of
body parts. Pain
Ribs and muscles
work together in
breathing.
big picture in learning and
(3) Visceral pain may be referred because sensory impulses from
applying the principles of
receptors warn of
the skin and viscera travel on common nerve pathways. 2. Taste sensations trauma to bone.
a. The five primary taste sensations are sweet, sour, salty, bitter, Bones protect the
c. Pain nerve fibers brain and spinal cord.
(1) The two main types of pain fibers are acute pain fibers and and umami.
chronic pain fibers.
(2) Acute pain fibers conduct nerve impulses rapidly. Chronic
b. Various taste sensations result from the stimulation of one or
more types of taste receptors.
Endocrine System Urinary System
anatomy and physiology.
pain fibers conduct impulses more slowly. c. A single taste receptor cell detects only one of the five tastes,
(3) Pain impulses are processed in the gray matter of the spinal but receptors corresponding to different tastes are scattered on Some hormones The kidneys and
act on bone to help bones work together
cord and ascend to the brain. the tongue. regulate blood to help regulate blood
calcium levels. calcium levels.
Cardiovascular System Reproductive System

Blood transports The pelvis helps
nutrients to bone support the uterus
cells. Bone helps during pregnancy.
regulate plasma Bones provide a
calcium levels, source of calcium
important to heart during lactation.
function.
Bones provide support, protection, and movement and also play a role in calcium balance.
Shier
McGraw-Hill Higher Education Group
Essentials of Human
Anatomy & Physiology
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y
Dissection Experience g Maximize efficiency by studying
This unique multimedia tool is exactly whats required.
designed to help you master human g Your instructor selects the content
anatomy and physiology with: thats 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 processes 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.
W W W. A P R E V E A L E D.C O M
xii
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xiii
Acknowledgments
We would like to acknowledge the valuable contributions Leba Sarkis, Aims Community College
of the reviewers for the eleventh edition who read either Jennifer Sieszputowski, Kirtland
portions or all of the text, and who provided detailed criti- Community College
cisms and ideas for improving the narrative and the illustra-
Daniel A Slutsky, American River College
tions. They include the following:
Marty Stickle, Asheville Buncombe Technical
Diana Alagna, Branford Hall Career Institute Community College
Barbara Banning, Augusta Technical College John F. Tarpey, City College of San Francisco
Dan Bickerton, Ogeechee Technical College Rita F Waller, Augusta Technical College
Russell L. Blalock, Central Georgia Technical College Kara Young, Baltimore School of Massage-
York Campus
Jocelyn Cash, Central Piedmont Community College
Yu (Joy) Zhao, American River College
Barbara A. Coles, Wake Technical Community College
Cynthia Conaway Mavroidis, Northwest State And thanks to those who prepared ancillary materials:
Community College
Simone Brito, College of Southern Nevada
George Ealy, Keiser University
LuAnne Clark, Lansing Community College
Christine M. Enz, Everest Institute Rochester
Jason LaPres, Lone Star College
Bridget A. Falkenstein, Sierra College
Sheri Martin, Central Georgia Technical College
Maria Florez, Lone Star College-CyFair
Patrice Parsons, Grayson County College
Deborah Furbish, Wake Technical Community College
Greg Reeder, Broward College
Linda Gerlock, Middle Georgia Technical College
Melanie Waite-Altringer, AnokaRamsey
Brent M. Graves, Northern Michigan University
Community College
Mark E. Grigsby, Northeastern Oklahoma A&M College
Martie Heath-Sinclair, Hawkeye Community College Any textbook is the result of hard work by a
Jean Helgeson, Collin County Community College large team. Although we directed the revision,
many behind-the-scenes people at McGraw-Hill
Shannon E. Henninger, Augusta Technical College
were indispensable to the project. We would like
Eugenia Ilisei, IIA College to thank our editorial team of Jim Connely, Marty
Mary Jane Keith, Wichita State University Lange, and Fran Schreiber; our production team,
Sara Lanier, Augusta Technical College which included Jayne Klein, Sandy Ludovissy, Tara
McDermott, John Leland, and Stacy Patch; copyedi-
Dean V. Lauritzen, City College of San Francisco
tor Wendy Nelson and freelance photo researcher
M. Reading-Martin, Western Nebraska Community College Toni Michaels; and most of all, John Hole, for giv-
Kevin E. Morkel, Bohecker College - Columbus ing us the opportunity and freedom to continue his
Lisa Nagle, Augusta Technical College classic work. We also thank our wonderfully patient
families for their support.
Brent Odson, Bohecker College-Columbus
Susan Rohde, Triton College David Shier
Jackie Butler
Jimmy Rozell, Tyler Junior College
Ricki Lewis
Amy Fenech Sandy, Columbus Technical College
xiv
Contents
Chapter Preview: Foundations for Success xviii
Unit 1
Levels of Organization
Chapter 1 Chapter 3
Introduction to Human Anatomy Cells 50
and Physiology 1
3.1 Introduction 51
1.1 Introduction 2 3.2 Composite Cell 52 Chapter 5
1.2 Anatomy and Physiology 3 3.3 Movements Through Cell Tissues 94
1.3 Levels of Organization 3 Membranes 60
1.4 Characteristics of Life 4 3.4 The Cell Cycle 67 5.1 Introduction 95
1.5 Maintenance of Life 5 5.2 Epithelial Tissues 95
1.6 Organization of the Human Body 8 Chapter 4 5.3 Connective Tissues 102
1.7 Anatomical Terminology 14 5.4 Types of Membranes 110
Cellular Metabolism 76
5.5 Muscle Tissues 110
Reference Plates
The Human Organism 22 4.1 Introduction 77 5.6 Nervous Tissues 111
4.2 Metabolic Reactions 77
Chapter 2 4.3 Control of Metabolic Reactions 79
Chemical Basis of Life 30 4.4 Energy for Metabolic Reactions 80
4.5 Metabolic Pathways 82
2.1 Introduction 31 4.6 DNA (Deoxyribonucleic Acid) 83
2.2 Structure of Matter 31 4.7 Protein Synthesis 85
2.3 Chemical Constituents of Cells 39
Unit 2
Support and Movement
Chapter 6 7.3 Bone Development and Growth 135
Integumentary System 116 7.4 Bone Function 137
7.5 Skeletal Organization 142
6.1 Introduction 117 7.6 Skull 144
Chapter 8
6.2 Skin and Its Tissues 117 7.7 Vertebral Column 149
6.3 Accessory Structures of the Skin 122 7.8 Thoracic Cage 153 Muscular System 178
6.4 Regulation of Body Temperature 125 7.9 Pectoral Girdle 155 8.1 Introduction 179
6.5 Healing of Wounds 125 7.10 Upper Limb 155 8.2 Structure of a Skeletal Muscle 179
7.11 Pelvic Girdle 158 8.3 Skeletal Muscle Contraction 182
Chapter 7 7.12 Lower Limb 161 8.4 Muscular Responses 187
Skeletal System 132 7.13 Joints 164 8.5 Smooth Muscle 191
Reference Plates 8.6 Cardiac Muscle 191
7.1 Introduction 133 Human Skull 175
8.7 Skeletal Muscle Actions 192
7.2 Bone Structure 133
8.8 Major Skeletal Muscles 194
xv
xvi Contents
Unit 3
Integration and Coordination
Chapter 9 9.15 Peripheral Nervous System 246
Nervous System 213 9.16 Autonomic Nervous System 250
9.1 Introduction 214 Chapter 10

9.2 General Functions of the Nervous Chapter 11
System 215
The Senses 262
Endocrine System 291
9.3 Neuroglia 216 10.1 Introduction 263
9.4 Neurons 216 10.2 Receptors, Sensations, and 11.1 Introduction 292
9.5 The Synapse 221 Perception 263 11.2 General Characteristics of the
9.6 Cell Membrane Potential 222 10.3 General Senses 264 Endocrine System 292
9.7 Nerve Impulses 227 10.4 Special Senses 267 11.3 Hormone Action 293
9.8 Synaptic Transmission 228 10.5 Sense of Smell 267 11.4 Control of Hormonal
Secretions 296
9.9 Impulse Processing 228 10.6 Sense of Taste 269
11.5 Pituitary Gland 297
9.10 Types of Nerves 230 10.7 Sense of Hearing 270
11.6 Thyroid Gland 301
9.11 Nerve Pathways 231 10.8 Sense of Equilibrium 275
11.7 Parathyroid Glands 303
9.12 Meninges 232 10.9 Sense of Sight 276
11.8 Adrenal Glands 304
9.13 Spinal Cord 234
11.9 Pancreas 306
9.14 Brain 236
11.10 Other Endocrine Glands 309
11.11 Stress and Health 311
Unit 4
Transport
Chapter 12 13.3 Heart Actions 347

Blood 318 13.4 Blood Vessels 353
13.5 Blood Pressure 359
12.1 Introduction 319 13.6 Paths of Circulation 363 14.3 Tissue Fluid and Lymph 380
12.2 Blood Cells 319 13.7 Arterial System 363 14.4 Lymph Movement 381
12.3 Blood Plasma 327 13.8 Venous System 369 14.5 Lymph Nodes 381
12.4 Hemostasis 330 14.6 Thymus and Spleen 382
12.5 Blood Groups and Transfusions 333 Chapter 14 14.7 Body Defenses Against
Lymphatic System and Infection 384
Chapter 13 Immunity 377 14.8 Innate (Nonspecific) Defenses 384
Cardiovascular System 340 14.9 Adaptive (Specific) Defenses, or
14.1 Introduction 378 Immunity 386
13.1 Introduction 341 14.2 Lymphatic Pathways 378
13.2 Structure of the Heart 342
Contents xvii
Unit 5
Absorption and Excretion
Chapter 15 Chapter 16
Digestive System and Respiratory System 442
Nutrition 400
16.1 Introduction 443
15.1 Introduction 401 16.2 Organs of the Respiratory System 443 Chapter 18
15.2 General Characteristics of the 16.3 Breathing Mechanism 450 Water, Electrolyte, and
Alimentary Canal 401 16.4 Control of Breathing 456 Acid-Base Balance 489
15.3 Mouth 403 16.5 Alveolar Gas Exchanges 459
15.4 Salivary Glands 408 18.1 Introduction 490
16.6 Gas Transport 460
15.5 Pharynx and Esophagus 408 18.2 Distribution of Body Fluids 490
15.6 Stomach 410 18.3 Water Balance 492
Chapter 17
15.7 Pancreas 413 18.4 Electrolyte Balance 493
Urinary System 467 18.5 Acid-Base Balance 497
15.8 Liver 415
15.9 Small Intestine 420 18.6 Acid-Base Imbalances 500
15.10 Large Intestine 424 17.2 Kidneys 468
15.11 Nutrition and Nutrients 428 17.3 Urine Formation 472
17.4 Urine Elimination 481
Unit 6
The Human Life Cycle
Chapter 19 Chapter 20
Reproductive Systems 505 Pregnancy, Growth, Development,
and Genetics 536
19.2 Organs of the Male Reproductive 0.1
2 Introduction 537 Appendix C
System 506 20.2 Pregnancy 537 Periodic Table of Elements 566
19.3 Hormonal Control of Male 20.3 Prenatal Period 541 Appendix D
Reproductive Functions 513 20.4 Postnatal Period 553 Changes Occurring in the Heart During
19.4 Organs of the Female Reproductive 20.5 Aging 555
a Cardiac Cycle 567
System 516 Appendix E
20.6 Genetics 556
19.5 Hormonal Control of Female FIGURE QUESTION ANSWERS 568
Reproductive Functions 522
Appendix A Glossary 569
19.6 Mammary Glands 525
19.7 Birth Control 526
Aids to Understanding Words 564 Credits 585
19.8 Sexually Transmitted Infections 530 Application Index 587
Appendix B
METRIC MEASUREMENT SYSTEM AND Subject Index 589
CONVERSIONS 565
Chapter
The Chapter Preview not only provides great study tips
to offer a foundation for success, but it also offers tips
on how to utilize this particular text.
Preview
Foundations for
Success
OPENING VIGNETTE
Beginning each chapter is a vignette that discusses current
events or research news relating to the subject matter in the A photo on the opening page for each chapter generates interest.
chapter. These vignettes demonstrate applications of the
concepts learned in the study of anatomy and physiology.
It is a beautiful day. You cant help but stare wistfully out the win- a flash of fear grips your chestbut you soon realize what has hap-
dow, the scent of spring blooms and sound of birds making it impos- pened and recover.
sible to concentrate on what the instructor is saying. Gradually, the The message is clear: pay attention. So you do, tuning out the
lecture fades as you become aware of your own breathing, the beat- great outdoors and focusing on the lecture. In this course, you will learn
ing of your heart, and the sweat that breaks out on your forehead in all about the events that you have just experienced, including your
response to the radiant heat from the glorious day. Suddenly your rev- response to the sudden stimulation of the instructors wake-up call. This
erie is cut shortthe instructor has dropped a human anatomy and is a good reason to learn about how to stay focused in the course.
physiology textbook on your desk. You jump. Your heart hammers and
Learning Outcomes
P.1 Introduction 3. Identify student activities that enhance

Each chapter begins with a list of 1. Explain the importance of an individual- classroom experience.
outcomes indicating the knowledge ized approach to learning. 4. List and describe several study techniques
you should gain as you work through that can facilitate learning new material.
the chapter. (Note the blue learn P.2 Strategies for Your Success
arrow.) These outcomes are intended 2. Summarize what you should do before
to help you master the similar attending class.
outcomes set by your instructor.
The outcomes will be tied directly to
assessments of knowledge gained.
xviii Learn Practice Assess

Chapter Preview xix
Aids to Understanding Words (Appendix A on page 564 has a complete list of Aids to Understanding Words.)
This section introduces building blocks of words that your instructor may assign. Learning them is a good investment of your time, because
they can be used over and over and apply to many of the terms you will use in your career. Appendix A (p. 564) has a comprehensive list of
these prefixes, suffixes, and root words.
ana- [up] anatomy: the study of breaking up the multi- [many] multitasking: performing several physio- [relationship to nature] physiology: the
body into its parts. tasks simultaneously. study of how body parts function.
P.1 Introduction and kinesthetic learners will appreciate real-life examples

and applications to relate to their own activities.
Each chapter begins with an overview that tells you what to After each major section, a question or series of questions
expect and why the subject matter is important. tests your understanding of the material and enables you
to practice using the information. (Note the green practice
arrow.) If you cannot answer the question(s), you should
reread that section, being particularly on the lookout for the
Studying the human body can be overwhelming at times. answer(s).
The new terminology, used to describe body parts and
how they work, can make it seem as if you are studying a
foreign language. Learning all the parts of the body, along
with the composition of each part, and how each part fits
with the other parts to make the whole requires memori- Check Your Recall
zation. Understanding the way each body part works indi- 1. List some difficulties a student may experience when
vidually, as well as body parts working together, requires studying the human body.
a higher level of knowledge, comprehension, and appli- 2. List the ways that people learn.
cation. Identifying underlying structural similarities, from
the macroscopic to the microscopic levels of body organi-
zation, taps more subtle critical thinking skills. This chap-
ter will catalyze success in this active process of learning. P.2 Strategies for Your Success
(Remember that while the skills and tips discussed in this
chapter relate to learning anatomy and physiology, they
can be applied to other subjects.) Major divisions within a chapter are called A-heads. They
Learning occurs in different ways or modes. Most are numbered sequentially in very large, purple type and
identify major content areas.
students use several modes (multimodal), but are more
comfortable and use more effectively one or two learn-
ing styles. Some students prefer to read the written word
to remember it and the concept it describes or to actu- Many strategies for academic success are common
ally write the words; others learn best by looking at visual sense, but it might help to review them. You may
representations, such as photographs and drawings. Still encounter new and helpful methods of learning.
others learn most effectively by hearing the information
or explaining it to someone else. For some learners, true Before Class
understanding remains elusive until a principle is revealed
in a laboratory or clinical setting that provides a memo-
The major divisions are subdivided into B-heads, which are
rable context and engages all of the senses. identified by large, black type. These will help you organize
This text is balanced among the learning styles; read- the concepts upon which the major divisions are built.
write learners will appreciate the lists, definitions (glos-
sary), and tables; visual learners will discover in the pages
of text many diagrams, flow charts, and figures, all with Before attending class, prepare by reading and outlining
consistent and purposeful use of color (in figures where or taking notes on the assigned pages of the text. If out-
bones are color-coded, for example, a particular bone is lining, leave adequate space between entries to allow
always the same color); auditory learners will find pro- room for note-taking during lectures. Or, fold each page
nunciations whenever new scientific terms are intro- of notes taken before class in half so that class notes can
duced, so that they may sound out the new vocabulary; be written on the blank side of the paper across from
xx Chapter Preview
the reading notes on the same topic. This introduces the

topics of the next class lecture, as well as new terms. Health-care workers repeatedly monitor patients vital
signsobservable body functions that reflect essential
Some students team a vocabulary list with each chap-
metabolic activities. Vital signs indicate that a person is
ters notes. The outline or notes from the reading can
alive. Assessment of vital signs includes measuring body
be taken to class and expanded during the lecture. At a temperature and blood pressure and monitoring rates and
minimum, the student should at least skim through the types of pulse and breathing movements. Absence of vital
text, reading A-heads, B-heads, and the summary out- signs signifies death. A person who has died displays no
line to become acquainted with the topics and vocabu- spontaneous muscular movements, including those of the
lary in advance of class attendance. breathing muscles and beating heart. A dead body does not
respond to stimuli and has no reflexes, such as the knee-jerk
reflex and the pupillary reflexes of the eye. Brain waves cease
with death, as demonstrated by a flat electroencephalogram
As you read, you may feel the need for a study break or to (EEG), which signifies a lack of electrical activity in the brain.
chill out. Other times, you may just need to shift gears. Try the
following. Throughout the book are shaded boxes that present
sidelights to the main text. Indeed, some of these may cover
topics that your instructor chooses to highlight. Read them!
They are interesting, informative, and a change of pace. The skeleton of an average 160-pound body weighs
about 29 pounds.
Genetics Connection 16.1
Cystic Fibrosis
Woe to that child which when kissed on the fore- The gene that is mutant in CF normally encodes a pro-
head tastes salty. He is bewitched and soon must tein called the cystic fibrosis transmembrane regulator,
die. So went a seventeenth-century British say- or CFTR for short. It is an ion channel that controls chloride
ing about a child with cystic fibrosis (CF). Until recently, salty transport out of cells. In severe CF, the chloride channel is
skin, foul stools, and poor weight gain (failure to thrive) were missing one crucial amino acid, and is so deformed that it
typically the first symptoms of CF. Today most new cases are fails to function. The abnormal handling of chloride ions
detected before birth, using genetic tests. The disease, inher- thickens the mucus. Organs become clogged.
ited from two carrier parents, affects about 30,000 people in Discovery of the most common CFTR mutation in 1989
the United States and 70,000 worldwide. It isnt known how enabled development of more targeted treatments. Some
many people have mild forms of the disease, merely with drugs allow more chloride to leave the cells lining the lungs.
symptoms of frequent respiratory infection. More than 1,000 Two new drugs, still experimental, are small molecules that
mutations can cause CF, so severity varies widely. escort abnormal CFTR protein to the cell surface, where it
In 1938, physicians first described CF as a defect in chan- apparently functions. The drugs act as correctors, saving
nels leading from certain glands. This causes formation of the errant CFTR proteins from being dismantled before
extremely thick, sticky mucus, which encourages infections they can reach the cell surface.
by microorganisms not otherwise common in the lungs. Life with severe CF is difficult. One little girl did not mind
A clogged pancreas prevents digestive juices from reaching the twice-daily vibrating vest, or even the feeding tube
the intestines and thus impairs absorption of nutrients. she needed at night to pack in nutrients. But she hated the
In the 1930s, life expectancy for a child with CF was five measures to avoid respiratory infections, especially in sum-
years, but by 1960 it became possible to treat the symptoms. mertime. She had to stay away from hoses, which harbor
Antibiotics control the respiratory infections, and daily bron- lung-loving Pseudomonas bacteria. Bonfires or cookouts
chial drainage exercises shake the stifling mucus free from could expose her to lung-clogging particulates in the air. She
the lungs of infants. Older children and adults wear a vibrat- couldnt even go into a pooltoo little chlorine would invite
ing vest for half-hour stretches two to four times a day to bacterial infections, and too much would irritate her lungs.
shake the mucus free. Some people multitask, taking daily But unlike children of a generation ago, her disease is con-
antibiotics in a nebulizer as they wear the vest. Digestive trolled enough that she will likely live well into adulthood.
enzymes mixed into soft foods enhance nutrient absorption.
Chapter Preview xxi
Clinical Application 15.1
Dental Caries
Sticky foods, such as caramel, lodge between Dental caries can be prevented in several ways:
the teeth and in the crevices of molars, feed- 1. Brush and floss teeth regularly.
ing bacteria such as Actinomyces, Streptococcus 2. Have regular dental exams and cleanings.
mutans, and Lactobacillus. These microorganisms metabolize 3. Talk with your dentist about receiving a fluoride treat-
carbohydrates in the food, producing acid by-products that ment. Fluoride is added to the water supply in many
destroy tooth enamel and dentin. The bacteria also produce communities. Fluoride is incorporated into the enamels
sticky substances that hold them in place. chemical structure, strengthening it.
If a person eats a candy bar but does not brush the 4. The dentist may apply a sealant to childrens and ado-
teeth soon afterward, the acid-forming bacteria may lescents teeth where crevices might hold onto decay-
decay tooth enamel, creating a condition called dental car- causing bacteria. The sealant is a coating that keeps
ies. Unless a dentist cleans and fills the resulting cavity that acids from eating away at tooth enamel.
forms where enamel is destroyed, the damage will spread to
the underlying dentin.
Remember when you were very young and presented with a substantial book for the first time? You were likely intimidated by its
length, but were reassured that there were a lot of pictures. This book has many illustrations too, all designed to help you master the
material and become that person who you would want treating you.
Photographs and Line Art Because line art can present different positions, layers,
or perspectives, it can provide a unique view.
The heading above this box is a C-head. Sometimes
subdivisions have so many parts that the book goes to this
Crista galli
third level of organization. This heading is presented in a Ethmoid
slightly smaller, italicized font. Cribriform plate bone
Frontal bone
Photographs provide a realistic view of anatomy.
Sphenoid bone
Sella turcica
Coronal suture
Frontal bone Temporal bone

Parietal bone
Sphenoid bone
Squamous suture
Ethmoid bone
Temporal bone Nasal bone Parietal bone
Lambdoid suture Lacrimal bone
Zygomatic process
Occipital bone of temporal bone
Zygomatic bone Foramen magnum
External acoustic
meatus Maxilla
Mastoid process Occipital bone
Temporal process
of zygomatic bone
Mandibular condyle
Mandible
xxii Chapter Preview
Macroscopic to Microscopic Anatomical Structures

Many figures show anatomical structures in a manner Some figures illustrate the locations of anatomical structures.
that is macroscopic to microscopic (or vice versa).
Osteon Trapezius
Sternocleidomastoid
t
Central canal
c
n e pa
containing blood
bo om
Endosteum vessels and nerves
C
Pectoralis minor Deltoid
ne gy
bo pon
Periosteum
Internal intercostal
S
Nerve Pectoralis major

External intercostal
Blood Pores
Central Serratus anterior
vessels
canal
Perforating
canal
Compact Nerve Linea alba
Rectus abdominis
bone (band of connective tissue)
Blood
vessels
Internal oblique External oblique
Nerve Transversus abdominis

Trabeculae Aponeurosis of external oblique
Bone matrix
Canaliculus
Osteocyte
Lacuna
(space)
Flow Charts Other figures illustrate the functional relationships

of anatomical structures.
Flow charts depict sequences of related events, steps of
pathways, and complex concepts, easing comprehen-
sion. Other figures may show physiological processes.
Pulmonary
Aortic Pulmonary
Control center valve closed
Beta cells secrete valve closed valve open
insulin
RA
LA
Atrial systole
Receptors Effectors
Beta cells detect a rise Insulin
in blood glucose Promotes movement of
glucose into certain cells
Stimulates formation of
glycogen from glucose Tricuspid LV
and mitral Tricuspid
Ventricular
Stimulus Response valves open RV and mitral
diastole
Rise in blood glucose Blood glucose drops toward valves close
normal (and inhibits insulin
secretion)
(a) (b)
too high
Normal
blood glucose
concentration
Pulmonary
Aortic Pulmonary
valve closed
valve closed valve open Aortic
too low
valve open
RA
Stimulus Response
LA
Drop in blood glucose Blood glucose rises toward Atrial systole
normal (and inhibits glucagon Atrial diastole
secretion)
Receptors Effectors
Ventricular
Tricuspid Alpha cells detect a drop LV
Glucagon systole
and mitral in blood glucose Stimulates cells to break down Tricuspid
Ventricular
valves open RV
glycogen into glucose and mitral
Stimulates cells to convert diastole
noncarbohydrates into glucose valves closed
(a) (b)
Control center
Alpha cells secrete
glucagon
Chapter Preview xxiii
Organizational Tables points and major topics make them stand out, which
eases both daily reviews and studying for exams.
Organizational tables can help put it all together, but
are not a substitute for reading the text or having good Lists
lecture notes.
Organizing information into lists or categories can mini-
mize information overload, breaking it into manageable
Table 5.6 Muscle and Nervous Tissues chunks. For example, when studying the muscles of the
Type Function Location thigh it is easier to learn the insertion, origin, action,
and nerve supply of the four muscles making up the
Skeletal muscle Voluntary movements Muscles usually quadriceps femoris as a group, because they all have
tissue (striated) of skeletal parts attached to bones
the same insertion, action, and nerve supply . . . they
Smooth muscle Involuntary Walls of hollow differ only in their origins.
tissue (lacks movements of internal organs
striations) internal organs
Mnemonic Devices
Cardiac muscle Heart movements Heart muscle
tissue (striated) Another method for remembering information is the
Nervous tissue Sensory reception Brain, spinal cord, mnemonic device. One type of mnemonic device is
and conduction of and peripheral a list of words, forming a phrase, in which the first let-
electrical impulses nerves ter of each word corresponds to the first letter of each
word that must be remembered. For example, Frequent
parade often tests soldiers endurance stands for the
skull bones frontal, parietal, occipital, temporal, sphe-
It is critical that you attend class regularly, and be on noid, and ethmoid. Another type of mnemonic device is a
timeeven if the instructors notes are posted on the word formed by the first letters of the items to be remem-
Web, and the information is in the textbook. For many bered. For example, ipmat represents the stages in the
learners, hearing and writing new information is a better cell cycle: interphase, prophase, metaphase, anaphase,
way to retain facts than just scanning notes on a com- and telophase.
puter screen. Attending lectures and discussion sections
also provides more detailed and applied analysis of the Study Groups
subject matter, as well as a chance to ask questions.
Forming small study groups helps some students.
Together the students review course material and com-
During Class pare notes. Working as a team and alternating leaders
allows students to verbalize the information. Individual
Be alert and attentive in class. Take notes by adding
students can study and master one part of the assigned
to either the outline or notes taken while reading.
material, and then explain it to the others in the group,
Auditory learners benefit from recording the lectures
which incorporates the information into the memory
and listening to them while driving or doing chores.
of the speaker. Hearing the material spoken aloud also
This is called multitaskingdoing more than one
helps the auditory learner. Be sure to use anatomical
activity at a time.
and physiological terms, in explanations and everyday
Participate in class discussions, asking questions of
conversation, until they become part of your working
the instructor and answering questions he or she poses.
vocabulary, rather than intimidating jargon. Most impor-
All of the students are in the class to learn, and many
tant of allthe group must stay on task, and not become
will be glad someone asked a question others would
a vehicle for social interaction. Your instructor may have
not be comfortable asking. Such student response can
suggestions or guidelines for setting up study groups.
alert the instructor to topics that are misunderstood or
not understood at all. However, respect class policy.
Due to time constraints and class size, asking questions Flash Cards
may be more appropriate after a large lecture class or Flash cards may seem archaic in this computer age, but
during tutorial (small group) sessions. they are still a great way to organize and master com-
plex and abundant information. The act of writing or
drawing on a note card helps the tactile learner. Master
After Class a few new cards each day, and review cards from pre-
In learning complex material, expediency is critical. vious days, and use them all again at the end of the
Organize, edit, and review notes as soon after class as semester to prepare for the comprehensive final exam.
possible, fleshing out sections where the lecturer got They may even come in handy later, such as in study-
ahead of the listener. Highlighting or underlining (in ing for exams for admission to medical school or grad-
color, for visual learners) the key terms, lists, important uate school. Divide your deck in half and flip half of
xxiv Chapter Preview
the cards so that the answer rather than the question Daily repetition is helpful, so scheduling several
is showing. Mix and shuffle them. Get used to identify- short study periods each day can replace an end-of-
ing a structure or process from a description as well as semester crunch to cram for an exam. This does not
giving a description when provided with a process or take the place of time to prepare for the next class.
structure. This is more like what will be expected of Thinking about these suggestions for learning now can
you in the real world of the health-care professional. maximize study time throughout the semester, and,
hopefully, lead to academic success. A working knowl-
Manage Your Time edge of the structure and function of the human body
provides the foundation for all careers in the health
For each hour in the classroom, most students will spend
sciences.
at least three hours outside of class studying. Many of you
have important obligations outside of class, such as jobs
and family responsibilities. As important as these are, you
still need to master this material on your path to becom-
ing a health-care professional. Good time management Check Your Recall
skills are therefore essential in your study of human anat- 3. Why is it important to prepare before attending class?
omy and physiology. In addition to class, lab, and study 4. Name two ways to participate in class discussions.
time, multitask. Spend time waiting for a ride, in a doc- 5. List several aids for remembering information.
tors office, or on line reviewing notes or reading the text.
Summary Outline
b. Macroscopic to microscopic show increase in detail.
A summary of the chapter provides an outline to review c. Flow charts depict sequences and steps.
major ideas and is a tool for organizing thoughts. d. Figures of anatomical structures show locations.
e. Organizational charts/tables summarize text.
2. During class
Take notes and participate in class discussions.
P.1 Introduction (page xix)
3. After class
Try a variety of methods to study the human body. a. Organize, edit, and review class notes.
P.2 Strategies for Your Success (page xix) b. Mnemonic devices aid learning.
(1) The first letters of the words to remember begin words of an
While strategies for academic success seem to be common sense, you easily recalled phrase.
might benefit from reminders of study methods. (2) The first letters of the items to be remembered form a word.
1. Before class c. Small study groups reviewing and vocalizing material can
Read the assigned text material prior to the corresponding class divide and conquer the learning task.
meeting. d. Making flash cards helps the tactile learner.
a. Photographs give a realistic view and line art shows different e. Time management skills encourage scheduled studying,
perspectives. including daily repitition instead of cramming for exams.
Chapter Assessments
c. taking notes on the assigned reading.
Chapter assessments that are tied directly to the learning d. making a vocabulary list.
outcomes allow you to assess your mastery of the material. e. all of the above.
(Note the purple assess arrow.)
3. Describe how you can participate in class discussions. (p. xxiii)
4. Forming the phrase I passed my anatomy test to remember
P.1 Introduction the cell cycle (interphase, prophase, metaphase, anaphase,
telophase) is a ____________ device. (p. xxiii)
1. Explain why the study of the human body can be
overwhelming. (p. xix) 5. Name a benefit and a drawback of small study groups. (p. xxiii)
6. Explain the value of repetition in learning and preparation for
P.2 Strategies for Success
exams. (p. xxiv)
2. Methods to prepare for class include: (p. xix)
a. reading the chapter.
b. outlining the chapter.
Chapter Preview xxv
Integrative Assessments/Critical Thinking
A textbook is inherently linear. This text begins with Chapter 1 and ends with Chapter 20. Understanding physiology and the
significance of anatomy, however, requires you to be able to recall previous concepts. Toward this end, we have included in the
Integrative Assessments/Critical Thinking section references to sections from earlier chapters. Making connections is what it is all
about!
Outcome P.1 Outcomes P.1, P.2

1. Which study methods are most successful for you? 2. Design a personalized study schedule.
Check out the text website at www.mhhe.com/shieress11 for additional

study tools. There is also information about the applicable Anatomy &
Physiology Revealed CD-ROM.
Web Connections apr

Visit the text website at www.mhhe.com/shieress11 for Anatomy & Physiology REVEALED includes cadaver photos that
additional quizzes, interactive learning exercises, and more. allow you to peel away layers of the human body to reveal structures
beneath the surface. This program also includes animations, radiologic
imaging, audio pronunciations, and practice quizzing. To learn more
visit www.aprevealed.com.

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What are some study strategies discussed in the text?

What are some study strategies discussed in the text?

What are some benefits of small study groups according to the text?

What are some benefits of small study groups according to the text?

Holes essentials of

HOLES ESSENTIALS OF HUMAN ANATOMY & PHYSIOLOGY, ELEVENTH EDITION

Library of Congress Cataloging-in-Publication Data

1 Introduction to Human 12 Blood 318

Unit 2 15 Digestive System and

6 Integumentary System 116 16 Respiratory System 442

7 Skeletal System 132 17 Urinary System 467

8 Muscular System 178 18 Water, Electrolyte, and

David Shier Jackie Butler Ricki Lewis

A Note from the Authors

David Shier, Jackie Butler, Ricki Lewis

Specific Changes At-a-Glance

1 Head cavities (fig. 1.9) Improved depth Accuracy

Continued next page

6 Botox New small box More clinical approach

13 Blood color Fig. 13.21 lightened Clarity

Chapter Topic Change Rationale

14 T cell/B cell activation Fig. 14.13 redone and Clarity

10.1 Introduction 10.4 Special Senses 10.8 Sense of Equilibrium

10.2 Receptors, Sensations, 10.5 Sense of Smell 10.9 Sense of Sight

Learning Outcomes open chapters, 2.

and are closely linked to Chapter 3. Explainhowasensationarises.(p.263)

10.3 General Senses

Assessments and Integrative Assess- 4. Describethereceptorsassociatedwith

ments/Critical Thinking questions 5. Describehowthesenseofpainispro-

262 Learn Practice Assess

Learning tools to help you succeed. . .

Vignettes lead into chapter content. They connect

NEW! Anatomy and Physiology Revealed (APR)

icon at the beginning of each chapter tells you which

Aids to Understanding Words help you remember

solid anatomy and physiology vocabulary.

Femoral v. Urinary bladder

Reference Plates offer vibrant

Vastus medialis m. Sartorius m.

Interesting applications help you practice and apply their knowledge. . .

Veins one. Creative NEW! individuals areAnatomy

10.23 These terms, most ofThese (b)

When person sees object, either the object

molecular underpinnings of familiar as wellConverging

dystrophy, and cystic fibrosis. Cilia Olfactory Columnar

Since students often find it helpful to think of move-

Learn, Practice, Assess!

Assess Chapter Assessments

Tools to help you make the

connection and master anatomy

Integrative Assessments/critical thinking

Integrative Assessments/Critical Thinking

questions allow you to connect and apply painful?

information from previous chapters as well as

Chapter Summary Outlines help you review the

10.4 Special Senses (p. 267)

Cardiovascular System Reproductive System

Book Website www.glencoe.com/shier11 Laboratory Manual for Holes

McGraw-Hills ConnectPlusTM Anatomy &