Preface xvii

Chemical 3
Organelle 3
Cell 3
Tissue 3
Organ 3
Organ System 3
Organism 3

Characteristics of Life 8
Biomedical Research 9

Negative Feedback 10
Positive Feedback 11

Directional Terms 13
Planes 14
Body Regions 14
Body Cavities 15
Serous Membranes 17

Matter, Mass, and Weight 24
Elements and Atoms 24
Electrons and Chemical
Bonding 26
Molecules and Compounds 29
Intermolecular Forces 30

Synthesis Reactions 32
Decomposition Reactions 32
Oxidation-Reduction Reactions 33
Reversible Reactions 34
Rate of Chemical Reactions 35

Electrical Energy 36
Electromagnetic Energy 36
Chemical Energy 36
Mechanical Energy 37
Heat Energy 37

Water 38
Solution Concentrations 38
Acids and Bases 38
Oxygen 40
Carbon Dioxide 40

Carbohydrates 41
Lipids 43
Proteins 46
Nucleic Acids: DNA and RNA 50
Adenosine Triphosphate 52

Cytosol 63
Organelles 64

Diffusion 74
Osmosis 75
Filtration 77
Mediated Transport
Mechanisms 78
Endocytosis and Exocytosis 81

Transcription 87
Translation 88
Regulation of Protein
Synthesis 88

Interphase 90
DNA Replication 91
Cell Division 92
Mitosis 92
Cytokinesis 92

Classification of Epithelium 103
Glands 111

Connective Tissue Cells 113
Protein Fibers of the Matrix 113
Other Matrix Molecules 113
Classification of Connective
Tissue 113
Matrix with Fibers as the Primary
Feature 113
Matrix with Both Protein Fibers and Ground Substance 122
Predominantly Fluid Matrix 123

Dermis 137
Epidermis 137
Thick and Thin Skin 140
Skin Color 141

Hair 144
Muscles 146
Glands 146
Nails 147

Protection 148
Temperature Regulation 148
Vitamin D Production 149
Sensation 149
Excretion 149

Bone Shapes 158
Structure of a Long Bone 158
Structure of Flat, Short, and Irregular Bones 160

Bone Matrix 161
Bone Cells 161
Woven and Lamellar Bone 163

Intramembranous
Ossification 164
Endochondral Ossification 166

Growth at the Epiphyseal Plate 167
Growth at Articular Cartilage 169
Other Bone Growth 170
Factors Affecting Bone
Growth 171

Skull 184
Vertebral Column 203
Thoracic Cage 208

Upper Limb 210
Lower Limb 214

Fibrous Joints 225
Cartilaginous Joints 226
Synovial Joints 229

Angular Movements 230
Circular Movements 232
Special Movements 232
Combination Movements 236

Temporomandibular Joint 236
Shoulder Joint 236
Hip Joint 238
Knee Joint 239
Ankle Joint 242
Arches of the Foot 242

Ligands and Membrane-Bound Receptors 249
Ligands and Intracellular Receptors 254

Concentration Differences Across the Plasma Membrane 257
The Resting Membrane
Potential 259
Electrically Excitable Cells 262

Connective Tissue 277
Muscle Fibers 278

Neuromuscular Junction 282
Excitation-Contraction Coupling 283
Energy Requirements for Muscle Contraction 286
Muscle Relaxation 288

Muscle Twitch 288
Stimulus Strength and Muscle Contraction 288
Stimulus Frequency and Muscle Contraction 290
Types of Muscle Contraction 292
Length Versus Tension 293
Fatigue 293
Physiologic Contracture and Rigor Mortis 295
Energy Sources 295
Oxygen Debt 296
Slow and Fast Fibers 296
Effects of Exercise 297
Heat Production 298

Types of Smooth Muscle 299
Electrical Properties of Smooth Muscle 299
Functional Properties of Smooth Muscle 301
Regulation of Smooth Muscle 301

Muscle Shapes 309
Nomenclature 309
Movements Accomplished by Muscles 311
Muscle Anatomy 312

Head Movement 312
Facial Expression 312
Mastication 319
Tongue Movements 319
Swallowing and the Larynx 321
Movements of the Eyeball 324

Muscles Moving the Vertebral Column 325
Thoracic Muscles 328
Abdominal Wall 329
Pelvic Floor and Perineum 330

Scapular Movements 330
Arm Movements 335
Forearm Movements 338
Wrist, Hand, and Finger Movements 338

Thigh Movements 341
Leg Movements 343
Ankle, Foot, and Toe Movements 344

Neurons 362
Types of Neurons 363
Neuroglia 364
Axon Sheaths 366

Receptor Molecules in Synapses 370
Neurotransmitters and
Neuromodulators 370
Excitatory and Inhibitory Postsynaptic Potentials 372
Presynaptic Inhibition and Facilitation 372
Spatial and Temporal Summation 373

Convergent Pathways 376
Divergent Pathways 376
Oscillating Circuits 377

Medulla Oblongata 385
Pons 386
Midbrain 386
Reticular Formation 388

Thalamus 390
Subthalamus 390
Epithalamus 390
Hypothalamus 390

Cerebral Cortex 391
Basal Nuclei 398
Limbic System 399

General Structure 402
Cross Section 403

Stretch Reflex 404
Golgi Tendon Reflex 406
Withdrawal Reflex 408

Ascending Pathways 409
Descending Pathways 417

Meninges 420
Ventricles 422
Cerebrospinal Fluid 423

Cervical Plexus 445
Brachial Plexus 445
Lumbar and Sacral Plexuses 451
Coccygeal Plexus 457

Olfactory Epithelium and Bulb 466
Neuronal Pathways for Olfaction 467

Histology of Taste Buds 468
Function of Taste 468
Neuronal Pathways for Taste 470

Accessory Structures 470
Anatomy of the Eye 473
Functions of the Complete Eye 477
Structure and Function of the Retina 479
Neuronal Pathways for Vision 484

Auditory Structures and
Their Functions 486
Auditory Function 493
Neuronal Pathways for Hearing 498
Balance 499
Neuronal Pathways for Balance 502

Sympathetic Division 509
Parasympathetic Division 513

Neurotransmitters 514
Receptors 514

Membrane-Bound Hormone
Receptors 537
Intracellular Hormone Receptors 542

Structure of the Pituitary Gland 547
Posterior Pituitary, or
Neurohypophysis 547
Anterior Pituitary, or
Adenohypophysis 548

Posterior Pituitary Hormones 548
Anterior Pituitary Hormones 552

Histology 555
Thyroid Hormones 556
Calcitonin 558

Histology 562
Hormones of the Adrenal
Medulla 563
Regulation 563
Hormones of the Adrenal Cortex 563

Histology 566
Effect of Insulin and Glucagon on Their Target Tissues 568
Regulation of Pancreatic Hormone Secretion 569

Transportation 583
Maintenance 583
Protection 583

Production of Formed Elements 584
Erythrocytes 586
Leukocytes 593
Platelets 594

Vascular Spasm 594
Platelet Plug Formation 594
Coagulation 595
Control of Clot Formation 598
Clot Retraction and Dissolution 598

ABO Blood Group 599
Rh Blood Group 601

Type and Crossmatch 601
Complete Blood Count 601
White Blood Cell Differential
Count 603
Clotting 603
Blood Chemistry 603

Pericardium 610
Heart Wall 610
External Anatomy 611
Heart Chambers and Valves 614

Heart Skeleton 618
Cardiac Muscle 618
Conducting System 619

Action Potentials 620
Autorhythmicity of Cardiac
Muscle 621
Refractory Period of Cardiac
Muscle 623
Electrocardiogram 623

Events Occurring During Ventricular Systole 625
Events Occurring During Ventricular Diastole 630
Heart Sounds 630
Aortic Pressure Curve 631

Intrinsic Regulation 632
Extrinsic Regulation 633

Effect of Blood Pressure 635
Effect of pH, Carbon Dioxide, and Oxygen 636
Effect of Extracellular Ion Concentration 637
Effect of Body Temperature 637

Capillaries 647
Structure of Arteries and Veins 648
Nerves 651
Aging of Arteries 651

Aorta 652
Coronary Arteries 652
Arteries to the Head and the Neck 652
Arteries of the Upper Limb 656
Thoracic Aorta and Its Branches 658
Abdominal Aorta and Its Branches 659
Arteries of the Pelvis 659
Arteries of the Lower Limb 660

Veins Draining the Heart 663
Veins of the Head and Neck 663
Veins of the Upper Limb 664
Veins of the Thorax 666
Veins of the Abdomen and Pelvis 666
Veins of the Lower Limb 670

Thoracic Duct 672
Right Lymphatic Duct 672

Laminar and Turbulent Flow in Vessels 674
Blood Pressure 674
Rate of Blood Flow 675
Poiseuille's Law 675
Viscosity 675
Critical Closing Pressure and LaPlace's Law 676
Vascular Compliance 676

Cross-Sectional Area of Blood Vessels 676
Pressure and Resistance 677
Pulse Pressure 677
Capillary Exchange 679
Functional Characteristics of Veins 679
Blood Pressure and the Effect of Gravity 680

Local Control of Blood Flow by the Tissues 680
Nervous and Hormonal Regulation of Local Circulation 683

Short-Term Regulation of Blood Pressure 686
Long-Term Regulation of Blood Pressure 689

Functions of the Lymphatic
System 703
Lymphatic Organs 703

Mechanical Mechanisms 708
Chemical Mediators 708
Cells 710
Inflammatory Response 713

Origin and Development of Lymphocytes 714
Activation of Lymphocytes 715
Inhibition of Lymphocytes 719
Antibody-Mediated Immunity 720
Cell-Mediated Immunity 724

Active Natural Immunity 729
Active Artificial Immunity 729
Passive Natural Immunity 729
Passive Artificial Immunity 729

Nose and Nasal Cavity 738
Pharynx 739
Larynx 739
Trachea 740
Tracheobronchial Tree 743
Lungs 745
Thoracic Wall and Muscles of Respiration 745
Pleura 747
Blood Supply 749
Lymphatic Supply 749

Pressure Differences and
Air Flow 751
Pressure and Volume 751
Air Flow into and out of Alveoli 751
Changing Alveolar Volume 752

Compliance of the Lungs and the Thorax 754
Pulmonary Volumes and Capacities 755
Minute Ventilation and Alveolar Ventilation 755

Partial Pressure 755
Diffusion of Gases Through Liquids 758
Diffusion of Gases Through the Respiratory Membrane 758
Relationship Between Ventilation and Pulmonary Capillary
Blood Flow 760

Oxygen Diffusion Gradients 761
Carbon Dioxide Diffusion Gradients 761
Hemoglobin and Oxygen Transport 763
Transport of Carbon Dioxide 765

Respiratory Areas in the Brainstem 767
Generation of Rhythmic Ventilation 768

Cerebral and Limbic System Control 768
Chemical Control of Ventilation 768
Hering-Breuer Reflex 771
Effect of Exercise on Ventilation 771
Other Modifications of Ventilation 772

Mucosa 783
Submucosa 783
Muscularis 783
Serosa or Adventitia 783

Ingestion 784
Mastication 784
Propulsion 784
Mixing 784
Secretion 784
Digestion 784
Absorption 784
Transportation 786
Elimination 786
Regulation 786

Oral Cavity 786
Pharynx 790
Esophagus 791
Stomach 791
Small Intestine 793
Liver 794
Gallbladder 798
Pancreas 798
Large Intestine 798
Peritoneum 799

Functions of the Oral Cavity 803
Deglutition 803
Stomach Functions 805
Functions of the Small Intestine 811
Liver Functions 812
Functions of the Gallbladder 813
Functions of the Pancreas 814
Functions of the Large Intestine 816

Carbohydrates 818
Lipids 819
Proteins 821
Water 822
Ions 822

Nutrients 832
Kilocalories 832
Carbohydrates 833
Lipids 835
Proteins 836
Vitamins 836
Minerals 838

Glycolysis 840
Anaerobic Respiration 843
Aerobic Respiration 844

Basal Metabolic Rate 853
Thermic Effect of Food 853
Muscular Activity 853

Kidneys 861
Arteries and Veins of the Kidney 864
Ureters and Urinary Bladder 864

Filtration 868
Tubular Reabsorption 871
Tubular Secretion 877
Urine Concentration Mechanism 877

Hormonal Mechanisms 884
Autoregulation 886
Effect of Sympathetic Stimulation on Kidney Function 886

Urine Flow Through the Nephron and the Ureters 892
Micturition Reflex 893

Sodium Ions 901
Chloride Ions 904
Potassium Ions 905
Calcium Ions 907
Phosphate Ions 909

Acids and Bases 913
Buffer Systems 913
Mechanisms of Acid-Base Balance Regulation 914

Scrotum 923
Perineum 923
Testes 923
Ducts 927
Accessory Glands 932

Regulation of Sex Hormone Secretion 934
Puberty 935
Effects of Testosterone 935
Male Sexual Behavior and the Male Sex Act 936

Ovaries 937
Uterine Tubes 941
Uterus 941
Vagina 942
External Genitalia 942
Perineum 943
Mammary Glands 943

Puberty 944
Menstrual Cycle 944
Female Sexual Behavior and the Female Sex Act 948
Female Fertility and Pregnancy 949
Menopause 950

Fertilization 962
Early Cell Division 962
Morula and Blastocyst 962
Implantation of the Blastocyst and Development of the Placenta 963
Formation of the Germ Layers 964
Neural Tube and Neural Crest Formation 964
Somite Formation 966
Formation of the Gut and Body Cavities 967
Limb Bud Development 968
Development of the Face 968
Development of the Organ Systems 970
Growth of the Fetus 980

Circulatory Changes 985
Digestive Changes 985
Apgar Scores 986

Chromosomes 991
Genes 992
Genetic Disorders 995
Genetic Counseling 997

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