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Dokumen - Pub - The Concise Human Body Book An Illustrated Guide To Its Structure Function and Disorders True PDF Retailnbsped 1465484698 978 1465484697 PDF
Dokumen - Pub - The Concise Human Body Book An Illustrated Guide To Its Structure Function and Disorders True PDF Retailnbsped 1465484698 978 1465484697 PDF
Dokumen - Pub - The Concise Human Body Book An Illustrated Guide To Its Structure Function and Disorders True PDF Retailnbsped 1465484698 978 1465484697 PDF
CONCISE
HUMAN
BO DY
BOOK
THE
CONCISE
HUMAN
BO DY
BOOK
S T E V E PA R K E R
PROJECT EDITORS Ann Baggaley, Abhijit Dutta, ILLUSTRATORS
Philip Morgan, Martyn Page, Mark Silas, Kate Taylor, CREATIVE DIRECTOR Rajeev Doshi
Megan Douglass 3-D ARTISTS Olaf Louwinger, Gavin Whelan,
PROJECT ART EDITORS Mandy Earey, Monica Taddei
Rupanki Arora Kaushik, Ted Kinsey
SENIOR EDITOR Simon Tuite
SENIOR ART EDITOR Vicky Short ADDITIONAL ILLUSTRATORS Peter Bull Art Studio,
MANAGING EDITOR Angeles Gavira, Julie Oughton Kevin Jones Associates, Adam Howard
MANAGING ART EDITOR Louise Dick, Michael Duffy The Concise Human Body Book provides information
ASSOCIATE PUBLISHER Liz Wheeler on a wide range of medical topics, and every effort has
PUBLISHER Jonathan Metcalf been made to ensure that the information in this book
ART DIRECTOR Karen Self, Bryn Walls is accurate. The book is not a substitute for medical
advice, however, and you are advised always to consult
JACKET DESIGNER Duncan Turner a doctor or other health professional on personal
PRODUCTION EDITORS Joanna Byrne, Maria Elia health matters
PRE-PRODUCTION MANAGER Balwant Singh The Concise Human Body Book has been adapted
PRODUCTION CONTROLLER Sophie Argyris from The Human Body Book, first published in
DTP DESIGNER Bimlesh Tiwari Great Britain in 2007 by Dorling Kindersley Limited
INDEXER Hilary Bird This American edition published in 2019
PROOFREADER Katie John First American edition published in the United States
MEDICAL CONSULTANT Dr. Penny Preston, in 2009 by DK Publishing,
Dr. Kristina Routh 1450 Broadway, Suite 801, New York, NY 10018, USA
Copyright © 2009, 2019
For The Human Body Book: DK, a Division of Penguin Random House LLC
PROJECT EDITOR Rob Houston 19 20 21 22 23 10 9 8 7 6 5 4 3 2 1
PROJECT ART EDITOR Maxine Lea 001 – 315374 – Jul/2019
EDITORS Ruth O’Rourke, Rebecca Warren, All rights reserved.
Mary Allen, Kim Bryan, Tarda Davidson-Aitkins, Without limiting the rights under the copyright
Jane de Burgh, Salima Hirani, Miezan van Zyl reserved above, no part of this publication may be
reproduced, stored in or introduced into a retrieval
DESIGNERS Matt Schofield, Kenny Grant,
system, or transmitted, in any form, or by any means
Francis Wong, Anna Plucinska (electronic, mechanical, photocopying, recording,
MANAGING EDITOR Sarah Larter or otherwise), without the prior written permission
MANAGING ART EDITOR Philip Ormerod of the copyright owner.
PUBLISHING MANAGER Liz Wheeler Published in Great Britain by
REFERENCE PUBLISHER Jonathan Metcalf Dorling Kindersley Limited
A catalog record for this book
ART DIRECTOR Bryn Walls
is available from the Library of Congress
PICTURE RESEARCHER Louise Thomas ISBN 978-1-4654-8469-7
JACKET DESIGNER Lee Ellwood DK books are available at special discounts when
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EDITORIAL ASSISTANTS Tamlyn Calitz, DK Publishing Special Markets,
Manisha Thakkar 1450 Broadway, Suite 801, New York, NY 10018, USA
or SpecialSales@dk.com
INDEXER Hilary Bird
PROOFREADER Andrea Bagg Color reproduction by
GRB Editrice s.r.l. in London, UK
CONTRIBUTORS Mary Allen, Andrea Bagg, Printed and bound in China
Jill Hamilton, Katie John, Janet Fricker,
Jane de Burgh, Claire Cross
A WORLD OF IDEAS:
SEE ALL THERE IS TO KNOW
MEDICAL CONSULTANTS Dr. Sue Davidson,
Dr. Penny Preston, Dr. Ian Guinan www.dk.com
CONTENTS
INTEGRATED BODY 8
INTRODUCTION 10
IMAGING THE BODY 12
BODY SYSTEMS 14
SUPPORT AND MOVEMENT 18
INFORMATION PROCESSING 20
THE FLUID BODY 21
EQUILIBRIUM 22
BODY SYSTEMS TO CELLS 24
THE CELL 26
DNA 30
THE GENOME 34
SPECIALIZED CELLS AND TISSUES 36
SKELETAL SYSTEM 38
SKELETON 40
BONE STRUCTURE 42
JOINTS 44
SKULL 48
SPINE 50
RIBS AND PELVIS 52
HANDS AND FEET 54
BONE AND JOINT DISORDERS 56
MUSCULAR SYSTEM 62
MUSCLES OF THE BODY 64
MUSCLES OF THE FACE, HEAD, AND NECK 68
MUSCLES AND TENDONS 70
MUSCLE AND TENDON DISORDERS 74
NERVOUS SYSTEM 76
NERVOUS SYSTEM 78
NERVES AND NEURONS 80
NERVE IMPULSE 84
BRAIN 86
BRAIN STRUCTURES 90
THE PRIMITIVE BRAIN 94
SPINAL CORD 98
PERIPHERAL NERVES 102
AUTONOMIC NERVOUS SYSTEM 106
MEMORIES, THOUGHTS, AND EMOTIONS 110
SMELL, TASTE, AND TOUCH 112
EARS, HEARING, AND BALANCE 116
EYES AND VISION 120
NERVOUS SYSTEM DISORDERS 124
ENDOCRINE SYSTEM 130 INFLAMMATORY RESPONSE 198
ENDOCRINE ANATOMY 132 FIGHTING INFECTIONS 202
HORMONE PRODUCERS 134 IMMUNE SYSTEM DISORDERS 208
HORMONAL ACTION 138
ENDOCRINE DISORDERS 140 DIGESTIVE SYSTEM 210
DIGESTIVE ANATOMY 212
CARDIOVASCULAR SYSTEM 144 MOUTH AND THROAT 214
CARDIOVASCULAR ANATOMY 146 STOMACH AND SMALL INTESTINE 218
BLOOD AND BLOOD VESSELS 148 LIVER, GALLBLADDER, AND PANCREAS 220
HEART STRUCTURE 150 LARGE INTESTINE 224
HOW THE HEART BEATS 154 DIGESTION 228
CARDIOVASCULAR DISORDERS 156 NUTRIENTS AND METABOLISM 232
DIGESTIVE TRACT DISORDERS 234
RESPIRATORY SYSTEM 160
RESPIRATORY ANATOMY 162 URINARY SYSTEM 240
LUNGS 164 URINARY ANATOMY 242
GAS EXCHANGE 166 KIDNEY STRUCTURE 244
BREATHING AND VOCALIZATION 168 URINARY DISORDERS 248
RESPIRATORY DISORDERS 172
REPRODUCTION AND LIFE CYCLE 250
SKIN, HAIR, AND NAILS 176 MALE REPRODUCTIVE SYSTEM 252
SKIN, HAIR, AND NAIL STRUCTURE 178 FEMALE REPRODUCTIVE SYSTEM 256
SKIN AND EPITHELIAL TISSUES 182 CONCEPTION TO EMBRYO 260
SKIN DISORDERS 188 FETAL DEVELOPMENT 264
PREPARING FOR BIRTH 266
LYMPH AND IMMUNITY 190 LABOR 268
LYMPH AND IMMUNE SYSTEMS 192 DELIVERY 270
IMMUNE SYSTEM 194 AFTER THE BIRTH 272
GROWTH AND DEVELOPMENT 276
PUBERTY 280
AGING 284
INHERITANCE 286
PATTERNS OF INHERITANCE 290
MALE REPRODUCTIVE DISORDERS 294
FEMALE REPRODUCTIVE DISORDERS 296
SEXUALLY TRANSMITTED INFECTIONS 298
INFERTILITY DISORDERS 300
PREGNANCY AND LABOR DISORDERS 302
INHERITED DISORDERS 304
CANCER 305
X-RAY
ANGIOGRAM X-rays are similar to light waves, but of very
In this type of
short wavelength. When passed through
X-ray, a contrast
medium (colored the body they create shadow images on
red here) has been photographic film. Dense structures such
injected into the as bone show up white; soft tissues appear
arteries of the in shades of gray. To show hollow or
shoulder, neck, and fluid-filled structures, these are filled with
lower head. Bones a substance that absorbs X-rays (a contrast
show up white.
medium). Fluoroscopy uses X-rays to gain
real-time moving images of body parts, for
instance to investigate swallowing.
X-RAY OF
THE BREAST
A plain X-ray of the female
breast (mammogram) is used
as a routine screening test for
breast cancer, which may
show up as an unusually
white area. This mammogram
shows a healthy breast.
12
MRI AND CT SCANNING
The exact number and extent of the body’s support. Most systems have some
systems is debated—the muscles, bones, “general” body tissues, such as the
and joints are sometimes combined as the connective tissues, which delineate,
musculoskeletal system, for instance. support, and cushion many organs.
Although these systems can be described All the systems except—somewhat
as separate entities, each depends on all of ironically—the reproductive system are
the others for physical and physiological essential for our basic survival.
SKELETAL MUSCULAR
EXPLORED ON PAGES 38–61 EXPLORED ON PAGES 62–75
MALE
15
INTEGRATED BODY
SKIN, HAIR, LYMPH AND
RESPIRATORY AND NAILS IMMUNITY
EXPLORED ON PAGES 160–175 EXPLORED ON PAGES 176–189 EXPLORED ON PAGES 190–209
The respiratory tract and its The skin, hair, and nails form The immune system’s intricate
movements, powered by the body’s outer protective interrelationships of physical,
breathing muscles, carry air covering, and are together cellular, and chemical defenses
into and out of the lungs. termed the integumentary provide vital resistance to
Deep inside the lungs, gases system. They repel hazards many threats, including
are exchanged. On inhalation, such as physical injury, infectious diseases and
life-giving oxygen is absorbed microorganisms, and radiation. malfunctions of internal
from air, while carbon dioxide The skin also regulates body processes. The slowly
waste is passed into the air, temperature through sweating circulating lymph fluid helps
to be expelled from the body and hair adjustment. A layer of distribute nutrients and collect
on exhalation. A secondary fat under the skin acts as an waste. It also delivers
function of the respiratory insulator, an energy store, and immunity-providing white
system is vocalization. a shock absorber. blood cells when needed.
16
BODY SYSTEMS
DIGESTIVE URINARY REPRODUCTIVE
EXPLORED ON PAGES 210–239 EXPLORED ON PAGES 240–249 EXPLORED ON PAGES 250–305
The digestive tract’s 30 feet The formation of urine by the Unlike any other system, the
of tubing, which runs from kidneys eliminates unwanted reproductive system differs
the mouth to the anus, has a substances from the blood, dramatically between female
complex range of functions. It helping maintain the body’s and male; it functions only for
chops and chews food, stores correct balance of fluids, salts, part of the human lifespan and
and then digests it, eliminates and minerals. Urine production is not vital for maintaining life.
waste, and passes the nutrients is controlled by hormones and The production of sperm in
to the liver, which processes or influenced by blood flow and the male is continual while the
stores the various digestive pressure, intake of water and female production of ripe
products. Healthy digestion nutrients, fluid loss (through eggs is cyclical. In the male,
depends on the proper sweating, for instance), external both sperm and urine use the
functioning of the immune temperature, and body cycles urethra as an exit tube, but at
and nervous systems. such as sleeping and waking. different times.
MALE MALE
17
CENTRAL COLUMN
The vertebrae form the “tower”
of the spinal column. This is not
only the body’s central support
structure; it also flexes and
bends to move the head and
torso at different angles.
SUPPORT AND MOVEMENT
The body’s muscular system is never SPECIALIZED CELLS AND TISSUES 36–37
still. Even as the body sleeps, breathing SKELETAL SYSTEM 38–61
continues, the heart beats, the intestines MUSCULAR SYSTEM 62–75
squirm, and skeletal muscles contract
SKIN, HAIR, AND NAILS 176–189
occasionally to shift the body into
a new position. Sensory cortex
Part of brain that monitors
sensory information from
MUSCLE TEAMWORK the body
Most movements are the result of multiple
muscle contractions. A smile, for example,
Sensory nerve
involves 20 facial muscles; writing utilizes Muscle-stretch
more than 60 muscles in the arm, hand, Biceps muscle information
and wrist. Muscles work in pairs: as one Moves arm to a travels to brain
contracts to pull on a bone and initiate flexed position
ELECTRICAL AND
CHEMICAL PATHWAYS
The “language” of the nervous system is
tiny electrical impulses. Every second,
millions pass through the body’s nerve
network, conveying information to and
from the brain. Information from the
senses flows to the brain, where it is BRAIN ACTIVITY
analyzed. Decisions are reached, and This image is a three-dimensional functional MRI
scan showing brain activity during speech. Red
command messages—also in the form of
indicates areas of high activity, yellow indicates
electrical impulses—travel along motor medium activity, and green indicates low activity.
nerves to the muscles to stimulate and
coordinate their contractions. In addition, Different information carriers called
microreceptors monitor conditions inside hormones are secreted by endocrine
the body and feed data about it to the glands into the bloodstream to stimulate
unconscious part of the brain, which distant tissues to action. More than 50
automatically evaluates the data and sends hormones circulate in the bloodstream.
out impulses to various parts of the body The specific molecular structure of each
to keep the internal environment at the hormone stimulates only those cells that
optimum for body functioning. have suitable receptors on their surface,
instructing the cells to carry out certain
SELECTIVE FOCUS
processes. In general, nerves work
The nose sends quickly— within fractions of a second.
streams of “smell” Most hormones function over longer time
nerve signals to periods—minutes, days, or even months.
the brain. We can Long-lasting effects, as in growth hormone
choose to ignore
these or to focus on
for example, occur because the hormone
them, as part of the is continuously secreted over a period
mind’s selective of many years; an individual dose would
awareness. last only a few days.
20
THE FLUID BODY
EQUILIBRIUM
THE BODY’S CELLS AND TISSUES FUNCTION WELL ONLY IF ALL ASPECTS OF THEIR
ENVIRONMENT ARE KEPT STABLE AND IN EQUILIBRIUM. SEVERAL BODY SYSTEMS
MAINTAIN A BALANCED INTERNAL ENVIRONMENT, A PROCESS CALLED HOMEOSTASIS.
EACH SYSTEM CAN BE SEEN AS A HIERARCHY. THE SYSTEM ITSELF IS AT THE TOP OF
THE HIERARCHY; NEXT ARE ITS ORGANS; THEN THE TISSUES THAT MAKE UP THE
ORGANS; AND AT THE BOTTOM ARE THE CELLS FROM WHICH TISSUES ARE MADE.
A body system is usually regarded The main parts of a system are its organs
as a collection of organs and parts designed and tissues. Most organs are composed of
for one important task. The systems are different tissues. The brain, for example,
integrated and interdependent, but each contains nervous, connective, and
has its own epithelial (covering or lining) tissues. A
identifiable tissue is a group of cells that are similar in
components. structure and carry out the same function.
Mouth
Esophagus 1 SYSTEM
The digestive system is one of the most
clearly defined in the body. It consists of
(gullet)
a long passageway—the digestive tract—and
associated glands. These include the liver and
pancreas, which are connected to the main
tract by ducts, and empty their products, such
Liver as enzymes, into the tract.
Gallbladder Aorta
Liver
Inferior vena cava lobule
Pancreas
Hepatic artery
Small
intestine Left lobe
Hepatic vein
Large
intestine
Right lobe
2 ORGAN
The liver is the body’s largest internal
organ, with an average adult weight of 31/3 lb
Arteriole
Venule
Cell membrane
Nucleus
Mitochondrion
MICRO-SECTION OF LIVER
In this magnified section of liver
tissue, the cells (pink) and their nuclei
(dark purple) are visible. Blood cells
lie in the lighter areas between the
5 CELL
The fundamental living unit of all
body tissues, a typical cell is capable of
cells (hepatic sinusoids). obtaining energy and processing nutrients.
The hepatocytes of the liver are examples
4
Kupffer cell TISSUE of body cells, containing most types of the
Also known as a The unique tissue of the liver miniature structures known as organelles
hepatic macrophage, a consists of branching sheets, or inside them.
Sinusoid
type of white blood cell laminae, of liver cells (hepatocytes)
Bile canaliculus A blood vessel
specific to the liver that arranged at angles. These are
Smallest branch with many
engulfs and digests old permeated by fluids and microscopic
of bile duct; pores that allow
worn-out blood cells branches of two main kinds of tubes:
snakes between for the
and other debris blood vessels and bile ducts.
hepatocytes exchange
of oxygen and
nutrients
Hepatocyte
Bile duct
Collects bile
fluid, made by
hepatocytes,
from canaliculi
Branch of
hepatic portal
vein
Branch of
hepatic artery
Lymph vessel
Central vein
Fat-storing cell
25
INTEGRATED BODY Nucleolus Nucleus Nuclear membrane Cytoskeleton
Central region The cell’s control A two-layered membrane Internal framework of
of the nucleus; center, containing with pores through which the cell, consisting
Vacuole plays a role in chromatin and substances can pass of microfilaments
A sac that stores ribosome most of the cell’s and microtubules
and transports production DNA Nucleoplasm
ingested materials, The fluid within the Microfilament
wastes, and water nucleus Provides support
for the cell
Mitochondrion
Site of fat and Cytoplasm
sugar digestion in the Jellylike fluid that
cell; produces energy contains organelles
Microtubule
Part of cytoskeleton;
aids movement of
substances in the
cytoplasm
Centriole
Two cylinders of
tubules;
essential for
reproduction
Microvilli
Projections found
on some cells;
they increase the
cell’s surface area
Ribosome
Involved in
Released secretions
protein assembly
Secretions are released
by exocytosis; a vesicle Cell membrane
merges with the cell Encloses cell contents;
membrane and releases regulates inflow and
its contents outflow of substances
THE CELL
THE CELL IS THE BASIC UNIT OF THE BODY. IT IS THE SMALLEST PART CAPABLE OF THE
PROCESSES THAT DEFINE LIFE, SUCH AS REPRODUCTION, MOVEMENT, RESPIRATION,
DIGESTION, AND EXCRETION—ALTHOUGH NOT ALL CELLS HAVE ALL THESE ABILITIES.
CELL ANATOMY
Most cells are microscopic—a typical cell cells (myofibers), which may be more than
is 20-30 µm in diameter, which means 40 12 in (30 cm) long. Most cells have an
in a row would stretch across a period. Very outer flexible “skin”: the cell, or plasma,
specialized, long, thin cells include membrane. Inside are structures known as
neurons (nerve cells) and muscle fiber organelles, each with a characteristic shape,
size, and function. These organelles do not
float around at random. The cell is highly
organized, with interior compartments
linked by sheets and membranes and held
in place by a flexible, latticelike “skeleton”
of even tinier tubules and filaments.
EMBRYONIC STEM CELL
Stem cells are unspecialized “beginner” cells
that can develop into specialized cells. Stem cells
in the embryo can develop into any of the
200-plus types of specialized cells in the body.
CELL TYPES
Cells come in many shapes and sizes, depending on physical abrasion and wear and which must
their specialized functions within tissues. Speed of cell continually replace themselves. It is slow or even
division also varies. It is most rapid in epithelial nonexistent in some cells that are structurally
(covering and lining) cells, which are subjected to complex, such as nerve cells (neurons).
Epithelial cells
These cells form skin, cover most Smooth muscle cell
organs, and line hollow cavities The large, elongated, spindlelike cells of smooth
such as the intestinal tract. muscle contract by sliding strands of protein inside.
PERMEABLE BILAYER
The typical cell membrane
is characterized by a double
layer of phospholipids with
embedded proteins.
Protein within
Protein membrane
Glycoprotein
Head of
phospholipid Tails of phospholipid
Each has two tails
SURFACE ORGANELLES
Some cells in the body have
SPERM
specialized structures projecting
The thin tail (flagellum)
from their surface. Cells lining the
that extends from a
small intestine have small, human sperm cell is
fingerlike projections called used like a propeller
microvilli, which increase the to help the sperm
surface area for absorption of swim up the female
nutrients. Some cells in the genital tract.
female reproductive tract have
small, hairlike cilia that wave to
CILIATED CELLS
move the ovum along the
Some of the cells
oviduct; similar ciliated cells in lining the fallopian
the respiratory tract move small tubes have hairlike
particles out of the airways. The cilia (colored pink in
sperm is unique in the human this micrograph) that
body in having a long, whiplike brush an egg along
flagellum, used for propulsion. toward the uterus.
28
THE CELL
MEMBRANES OF ORGANELLES
Membranes divide the cytoplasm into sections and control the passage
of materials between these regions, act as attachment points and storage
areas, and shape channels along which substances move.
TRANSPORT
The transfer of materials through the must cross by facilitated diffusion. When
cell membrane occurs by one of three substances (such as minerals and nutrients)
processes. Small molecules, such as water, are at lower concentration on the outside
oxygen, and carbon dioxide, cross the of the cell than on the inside, they can
membrane by diffusion. Molecules that only be conveyed into the cell by active
cannot cross the phospholipid layer transport, which requires energy.
Fluid Cell Cell Carrier Cell Molecule at Protein forms
membrane interior protein interior receptor site channel
BASE PAIRS
The four bases can pair in Phosphate
only two configurations
due to their chemical C G Three bonds
structures. Adenine and join G and C
thymine each have two T A
positions for forming Two bonds
hydrogen bonds and so fit G C join A and T
together, while guanine and
A T
cytosine each have three
Sugar
hydrogen-bond locations.
30
DNA
COILS AND SUPERCOILS
DNA’s coiled structure allows an COILED Chromosomes
incredible length to be packed in cell nucleus
into a tiny space. If unwound, Nucleosomes
the DNA in a chromosome would
stretch about 2 in (5 cm). There are
46 chromosomes in the nucleus of
each cell (except mature red blood
Nondividing cell
cells, which have no nucleus or
DNA). When cells are not dividing, DNA double
the DNA (wrapped around protein helix Coiled chromatin in nucleus
to form what is called chromatin) is
Visible chromosome
relatively loosely coiled. This allows SUPERCOILED
portions to be available for protein
assembly and other functions. As a Coiled chromatin
cell prepares to divide, its DNA coils
into supercoils, which are shorter Cell prepared
and denser, and visible as the Supercoiled for division
typical chromosome “X” shapes. chromatin
Cytosine
Guanine–
cytosine link
Guanine always
forms a pair with
cytosine
Adenine
Guanine
31
INTEGRATED BODY
HOW DNA WORKS
One of DNA’s key functions is to provide to protein assembly units called ribosomes.
the information to build proteins. Some In the translation phase, the mRNA acts
proteins are the body’s major structural as a template for the formation of units
molecules, while others form enzymes or of protein, known as amino acids. There
hormones, which control chemical reactions are about 20 different amino acids. Their
within the body. Manufacture of proteins order is specified by lengths of mRNA
occurs in two main phases: transcription three bases long, called triplet codons. The
and translation. In transcription, order of bases in each codon is the code
information is taken from the DNA and for a particular amino acid (hence the
copied to an intermediate type of molecule term “genetic code”). The mRNA carries
called mRNA (messenger ribonucleic acid). instructions to make a specific protein
The mRNA moves out of the cell’s nucleus from a sequence of amino acids.
tRNA
disengages
Amino for reuse
acid
Unattached
RNA nucleotide
Codon on
tRNA matches
Protein gains
three-dimensional
2 TRANSLATION
In the cell’s cytoplasm, the mRNA
attaches to a ribosome. Individual tRNA
structure
Amino acid
(transfer ribonucleic acid) molecules have chain
specific amino acids attached. They can
slot onto the mRNA only if the order of Chain twists
their bases matches, ensuring they bring and folds into
the correct amino acid. As the ribosome finished protein
moves along the mRNA, the tRNAs bring
the correct amino acid sequence, which COMPLETED
fit together to construct a protein. PROTEIN
32
DNA
WHAT ARE GENES?
A gene is generally regarded as a unit of
DNA needed to construct one protein. It
consists of all the sections of DNA that
code for all the amino acids for that protein.
Usually one gene is located on one
chromosome. However, it may have several
sections on different regions of the DNA
molecule, each containing the code for one
portion of the protein. Typically, lengths of
DNA called introns and exons (see below)
are both transcribed to form immature
mRNA. The parts of mRNA made from the
introns are then stripped out by the cell’s
molecular machinery, leaving mature
mRNA for translation. There are also
EYE COLOR
regulatory DNA sequences that code for Iris color is affected by at least 15 genes,
their own proteins, affecting the rate of including OCA2 and HERC2, both sited on
gene transcription. chromosome 15.
PARTS OF A GENE
Regions called introns and Regulatory
exons both transcribe to sequence Introns Exons
form mRNAs for different
portions of a protein. The
lengths made from introns
are then spliced out
chemically, to leave
exon-only portions, which
go on to make the protein. Gene
CELLULAR DIFFERENTIATION
GENETIC CONTROL OF CELLS The first cells produced by divisions
Not all genes are active in all cells. The process by which of a fertilized egg are “generalized”
a gene is able to make its protein is called gene expression. stem cells. As they multiply,
The expression of each gene is controlled according to preprogrammed instructions begin
exposure to chemicals such as growth factors and regulators— to act. Intercellular contacts and the
chemical environment inform cells in
products of other genes. Some genes are “switched on” and
certain parts of an embryo to
express themselves in most cells. These are concerned with differentiate into tissues such as
basic processes such as utilizing glucose for energy. Other nerves, muscle, and skin.
genes are “switched off” unless they are needed; these are for
PRECURSOR CELL
making specialized products, such This can become any of a
as hormones. As cells’ genes are PRECURSOR CELL variety of cells. Some lines of
switched on and off in different offspring cells retain the ability
to generalize, while others go
circumstances they differentiate, on to become specialists
or become different.
SPERM CELL MUSCLE CELL NERVE CELL EPITHELIAL CELL FAT CELL
Packed with Long, thin cells Extreme specialization Programmed to Stores energy in case
mitochondria with contractile in both shape and multiply rapidly diet does not meet
to supply fuel proteins connections and then die energy requirements
35
36 INTEGRATED BODY
Connective
LOOSE CONNECTIVE TISSUE dermal tissue
ELASTIC CARTILAGE
Connects dermis
Some connective tissue is made of skin (pictured) A sample of cartilage from the
up of cells loosely embedded in to underlying epiglottis reveals round cells
fibers. The dark spots seen here organs LARYNX (chondrocytes) in fibers of elastin,
are the nuclei of fibroblast cells. which make it light and flexible.
Longitudinal
layer of
smooth muscle
SKELETAL
MUSCLE
SMOOTH MUSCLE TISSUE SKELETAL MUSCLE TISSUE
The long fibers in smooth muscle SMALL Each bundle of contractive
tissue contract involuntarily. They INTESTINE filaments (seen here as stripes)
are found in many tubular internal is sheathed by white connective
parts, such as the intestines. tissue. The dark spots are nuclei.
Tendon
SPONGY BONE TISSUE DENSE CONNECTIVE TISSUE
Spongy bone has a lightweight, TENDONS OF This strong, dense tissue is found
honeycomb-like structure that THE HAND in ligaments, tendons, and, as
accommodates bone marrow shown above, in the lower layer
STRUCTURE OF
in its large open spaces. A LONG BONE Dermis of the skin (dermis).
Lower Sweat gland
layer of Part of
WHITE skin epithelial tissue
BLOOD CELL of skin
SKELETON
THE SKELETON MAKES UP ALMOST ONE-FIFTH OF THE Cranium
Skull
BODY’S WEIGHT. WITHOUT THIS INNER FRAMEWORK,
Mandible
ALL OTHER PARTS AND TISSUES WOULD COLLAPSE. Jawbone
Tibia
A LONG BONE Shinbone
(FEMUR)
Fibula
Calf bone
Medial
malleolus
A SESAMOID Rounded
BONE Lateral malleolus
prominence
(PATELLA) Rounded prominence at
at end of tibia
end of fibula
Talus
Navicular
Tarsals Cuneiform bones
Talus Ankle bones
A SHORT BONE Cuboid bone
Calcaneus Metatarsals
(CALCANEUS)
Heel bone Phalanges
41
SKELETAL SYSTEM
BONE STRUCTURE
BONE IS A TYPE OF CONNECTIVE TISSUE THAT IS AS STRONG AS STEEL BUT AS LIGHT
AS ALUMINUM. IT IS MADE OF SPECIALIZED CELLS AND PROTEIN FIBERS. NEITHER
IMMOBILE NOR DEAD, BONE CONSTANTLY BREAKS DOWN AND REBUILDS ITSELF.
and ossification occur. Cartilage cells (see Old cartilage cells die
right) multiply here and form columns Osteoblasts (specialized bone cells)
toward the bone shaft. As the cartilage attach to the calcified tissue
cells enlarge and die, the space they New blood vessels and
occupied is filled by new bone cells. bone tissue form
42
BONE STRUCTURE
Blood vessel CARTILAGE
Haversian Cartilage is a tough, adaptable form of
canal connective tissue. It consists of a gel-like
Arteriole matrix containing many chemicals, such as
proteins and carbohydrates. Various types
of fibers are embedded in this tissue, as
well as chondrocytes cells, which make
and maintain the whole tissue. There
Venule
are several kinds of cartilage, including
Lamellae Lacuna hyaline cartilage, fibrocartilage, and elastic
cartilage, a springy material found at sites
OSTEON
such as the outer ear flap and larynx.
This rod-shaped unit is the building
block of compact bone. Its central HYALINE CARTILAGE
(Haversian) canal, containing blood Dense collagen fibers
vessels and nerves, is surrounded by make this cartilage
concentric layers of tissue (lamellae). extra tough and
Gaps (lacunae) in the tissue contain resistant. It covers
osteocytes, which maintain bones. bone ends in joints
Bone marrow and attaches ribs to
Tissue filling a bone’s central the sternum, and is
cavity; at first, long bones also found in the
have red marrow—later this trachea and nose.
Osteon turns into yellow marrow
Vein
Spongy bone Epiphysis
Artery Latticework structure Expanded head of bone
consisting of bony spikes containing mainly
(trabeculae), arranged along spongy bone tissue
lines of greatest stress
Bone shaft
Mostly compact
bone and marrow
FIBROCARTILAGE
This is mostly dense bundles of collagen
fibers, with little gel-like matrix. It is found in
the jaw, knee joints, and intervertebral disks.
43
SKELETAL SYSTEM
JOINTS
THE SITE AT WHICH TWO BONES MEET IS CALLED A JOINT OR AN ARTICULATION.
JOINTS CAN BE CLASSIFIED ACCORDING TO THEIR STRUCTURE AND BY THE TYPES OF
MOVEMENT THEY ALLOW. THE BODY HAS MORE THAN 300 DIFFERENT JOINTS.
FIXED JOINT
The adult skull’s suture
joints show up as wiggling
lines. In infancy, these
Gliding joint
joints are loosely attached The bone surfaces that meet in a gliding joint are almost
to allow for expansion of flat and slide over one another. Movement is limited by
Suture the rapidly growing brain. ligaments. Some joints between the tarsals of the ankle
and between the carpals in the wrist move in this way.
SEMIMOVABLE JOINT
In partly flexible joints,
bones are linked by Tarsals
fibrous tissue or
cartilage, as in the
Gliding
pubic symphysis.
joints
Pubic symphysis
Metatarsals
44
Clavicle
JOINTS
Scapula
Humerus
Saddle joint
Each bone’s joint surface has both
concave and convex areas, like a horse
saddle, which allow the bones to slide
back and forth and from side to side,
but with limited rotation. There is a
saddle joint at the base of the thumb.
Trapezium
Hinge joint (wrist bone)
First
metacarpal
of thumb
Ellipsoidal joint
An ovoid (egg-shaped) bone end
nestles in an ellipsoidal cavity, such as
where the forearm’s radius bone meets
the wrist’s scaphoid bone. This type of
joint can be flexed and moved from
side to side, but rotation is limited.
Gliding
joint
Radius
Scaphoid
45
SKELETAL SYSTEM INSIDE A SYNOVIAL JOINT
INSIDE A JOINT A mere film of synovial fluid
The bone ends in a synovial joint separates bone ends. There
are covered by a smooth, slightly are just 3/100–7/100 fl oz (1–2 ml)
compressible tissue called articular of this liquid in the knee joint.
cartilage. Surrounding the joint is the
Bone marrow
joint capsule, which is made of strong
connective tissue and is attached to Bone
the bone ends. Its delicate inner
lining, the synovial membrane, Joint capsule
Protective sac that
secretes viscous synovial fluid into encloses joint and
the synovial cavity to keep the joint reduces friction
well oiled. The fluid also nourishes Synovial membrane
the cartilage with fats and proteins, Synovial fluid
and is constantly reabsorbed. Articular cartilage
Fibrous thickenings of the capsule,
called ligaments, are anchored to
the bones at each end and prevent
unnatural movement of the joint. Ligaments
Muscles around the joint, which are
connected to the bones by tendons,
provide stability and produce movement.
CARTILAGE AS
A SHOCK ABSORBER
The articular cartilage that coats the
bone ends in a synovial joint is also
known as hyaline cartilage (see p.43).
If sudden blows or vibrations jolt the
joint, this cartilage works as a shock
absorber to dissipate the force of the
impact and prevent jarring damage
to the much more rigid bones. In
certain joints, the cartilage has
especially tough fibers. Examples
include the fibrocartilaginous pads,
called intervertebral disks, that act
as cushions between the vertebrae
of the backbone. Fibrocartilage also
occurs in the jaw and wrist joints and
the menisci in the knee.
SPINAL CARTILAGE
The fibrocartilage disks (blue) between
the vertebrae help stabilize and
cushion the spinal column.
46
INTERIOR OF THE KNEE
JOINTS
The meeting of the femur and
tibia forms the body’s largest joint
(articulation), the knee.
Cruciate ligaments
Form a cross shape from
back to front of joint to
provide stability
Mevniscus
One of two wedges
of cartilage that help
distribute weight across
the knee joint
Muscle
Nerve
Patellar tendon
Crosses over patella,
which is embedded in it
Femur
Bone of the upper leg;
also called the thigh bone
Synovial membrane
Produces synovial fluid
Patella
Protective disk of bone
and cartilage, also called
the kneecap
Pad of fat
Acts as cushion between
patella and knee,
especially when kneeling
Articular cartilage
Artery
Ligament
Vein
Attachment of patellar
tendon to tibia
Tibia
Also called the shinbone; larger
of the two lower leg bones
SKULL
Two groups of bones make up the skull. The upper set
of eight bones forms the domelike cranium (cranial
skull or cranial vault), which encloses and protects
the brain. The other 14 bones make the skeleton
of the face. During growth in childhood, 21 of the
22 bones become strongly fused at faint joint lines,
SKULL SUTURES
Lines on the skull’s surface,
known as sutures. The lower jaw, or mandible,
highlighted here, are the fused remains unfixed and is linked to the rest of the
margins of the skull bones. skull at the two jaw, or temporomandibular, joints.
SKULL AND HEAD REGIONS
Two sets of bones form the
SINUSES
structure of the skull. The eight
The four pairs of sinuses, known as paranasal bones that enclose the brain are
sinuses, are air-filled cavities within the skull bones. called the cranial vault.
They are named after the bones in which they are
located: maxillary, frontal, sphenoidal, and Parietal bone Lacrimal bone Frontal bone
ethmoidal sinuses. The first three pairs have fairly
Temporal bone Ethmoid bone Nasal bone
well-defined shapes. The ethmoidal sinuses are
more honeycomb-like and variable.
Frontal
sinus
Sphenoidal Maxillary Ethmoidal sinuses
sinus sinus
RESONANT WEIGHT-SAVERS
Occipital bone Sphenoid bone
The sinuses help lighten the skull’s overall weight,
and also act as resonating chambers to give each
person’s voice an individual character. Zygomatic bone Mandible
Maxilla
48
Occipital bone
SKULL
Parietal bone
Frontal bone
Temporal bone
Sphenoid bone
Zygomatic
bone
Lacrimal bone
Vomer
Ossicles Stapes
of the Malleus
middle ear
Incus
Palatine bone
Inferior nasal
concha
Ethmoid bone
Nasal bones
Maxilla
SPINE FUNCTION
The spine consists of 33 ringlike bones called vertebrae.
The bottom nine vertebrae are fused into two larger
bones termed the sacrum and the coccyx. The 26
movable components of the spine are linked by a series of
mobile joints. Between the bones of each joint is an
intervertebral disk—a springy pad of tough, fibrous
cartilage that squashes slightly under
pressure to absorb shocks. Ligaments FLEXIBLE COLUMN
Owing to the shape of
and muscles around the spine
the vertebrae, the
provide stability and help control spine can bend farther
movement. The spinal column also forward than back,
protects the spinal cord (see p.98). and twist on its axis.
Intervertebral disk
Composed of
tough, flexible
fibrocartilage with
jellylike core
SPINAL JOINTS
LOCATION Spinal joints do not have a
The hyoid bone sits within wide range of movement,
the curve of the lower jaw; but they still allow the spine
it has two pairs of small great flexibility, letting it arch
hornlike projections near back, curve forward, and
the front. twist. Two facet joints help
prevent slippage and torsion.
50
Atlas Transverse process
SPINE
Cervical Winglike structure
Axis
vertebrae (7) that attaches
to muscles
Vertebral foramen
Opening through Posterior tubercle
Thoracic which the spinal
vertebrae (12) cord passes ATLAS
Transverse foramen
Body Carries vertebral
SPINE STRUCTURE artery to brain
The spine has five main
regions, each with its own type Spinous process
of vertebrae: seven cervical
CERVICAL VERTEBRA
vertebrae (C1–C7) in the neck;
12 thoracic vertebrae (T1–T12)
in the chest; five lumbar Body
vertebrae (L1–L5) in the Hollow for rib
lower back; five fused
sacral vertebrae in the
sacrum; and four fused Spinous process
coccygeal vertebrae. THORACIC VERTEBRA
Body
Much enlarged to Articular process
support extra weight Slots into vertebra
above
Lumbar
vertebrae (5) Transverse process Spinous process
LUMBAR VERTEBRA
BASE OF SPINE
The wedge-shaped sacrum Sacrum
consists of five vertebrae fused
at faint grooves called Coccyx
Manubrium
Body Sternum
Xiphoid
True ribs process
Attach directly
to sternum
Left lung
Costal cartilage
Diaphragm
Liver
Coccyx
Pubis
Pubic
symphysis
Ischium
Narrow
Wide pelvic inlet pelvic inlet
Pisiform
Interphalangeal
joint Hamate Triquetral
Capitate Lunate
Ulna
Metacarpophalangeal
joint
Scaphoid
Trapezoid
Trapezium
Phalanges Carpometacarpal Radius
joint
Carpals
HAND BONES
The three major skeletal
groups in the hand are the
carpus (wrist); metacarpus
(palm); and phalanges
(digits or fingers).
Metacarpals
54
HANDS AND FEET
ANKLE AND FOOT
The ankle and foot have a similar bone LIGAMENTS
arrangement to the wrist and hand, except Ligaments are strong bands or straps of fibrous
that there are only seven tarsal (ankle) bones. tissue that provide support to the bones and
The build of the ankle and foot bones is link bone ends together in and around joints.
heavier, for strength and weight-bearing Ligaments are made of collagen–a tough,
elastic protein. A large number of ligaments bind
stability. The sole is supported by the five
together the complex wrist and ankle joints. Each
metatarsal bones. The hallux (first digit or
ligament is named after the bones it links; for
big toe) has two phalanges example, the calcaneofibular ligament links the
(toe bones), and the calcaneus (“heel bone”) and the fibula.
others have three each.
Fibula
The bony prominence Tibia
commonly called the Calcaneofibular
ligament Tibiofibular
“heel bone” is formed ligament
by the calcaneus.
Calcaneus
Calcaneus
ANKLE LIGAMENTS
Talus More than a dozen
ligaments bind the tarsal Ligaments
Cuboid bones to each other, and connecting
ligaments run from the tarsals and
Navicular metatarsals
tarsals to the fibula, tibia,
Lateral and metatarsals.
cuneiform
Intermediate
cuneiform WALKING PRESSURE
Medial cuneiform With each step, the weight of the body moves
from the rear to the front of the foot. The heel
bears the initial pressure as the foot is put down.
The force passes along the arch, which transfers
energy and pressure to the ball of the foot, and
finally to the big toe for the push-off.
Tarsals
Metatarsals
FOOT BONES
The three main bone groups LOAD AREAS ON THE FOOT
in the foot are the tarsus Phalanges These footprint impressions show (from left to
(ankle); metatarsus (sole); and right) how the body’s weight transfers from the
phalanges (digits or toes). heel to the ball to the big toe when walking.
55
SKELETAL SYSTEM
BONE AND JOINT DISORDERS
BONES AND JOINTS ARE VULNERABLE TO INJURIES SUCH AS FRACTURES AND, DUE TO CONSTANT
WEAR, TO DISORDERS SUCH AS OSTEOARTHRITIS. BONES MAY BE WEAKENED BY OSTEOPOROSIS,
AND JOINTS MAY BE AFFECTED BY INFLAMMATORY CONDITIONS SUCH AS RHEUMATOID ARTHRITIS.
FRACTURE
Fractures may be caused by a sudden impact, by as coughing, may cause a fracture. Nutritional
compression, or by repeated stress. A displaced deficiencies or certain chronic diseases such as
fracture occurs when the broken surfaces of bone osteoporosis, which can weaken bone, may
are forced from their normal positions. There are increase the likelihood of fractures. If a broken
various types of displaced fracture, depending on bone remains beneath the skin, the fracture is
the angle and strength of the blow. A compression described as closed or simple, and there is a low
fracture occurs when spongy bone, such as in risk of infection. If the ends of the fractured
the vertebrae, is crushed. Stress fractures are bone project out through the skin, the injury is
caused by prolonged or repeated force straining described as open or compound, and there
the bone; they occur in long-distance runners and is a danger of dirt entering the bone tissue and
in the elderly, in whom minor stress, such causing microbial contamination.
Spinal
nerve
IMMEDIATE RESPONSE AFTER SEVERAL DAYS
Fibroblast cells construct Vertebra Spinal cord
Blood leaks from the
blood vessels and clots. new fibrous tissue across NORMAL DISK
White blood cells gather the break. The limb is The outer casing (capsule) of the intervertebral disk is
at the area to scavenge immobilized, usually in intact and encloses its gelatinous core. The disk sits
damaged cells and debris. a plaster cast or splint. between the bodies (centra) of adjacent vertebrae.
Talus
Anterior
cruciate Calcaneus
ligament
Tibia
Fibula
TORN CARTILAGE
The knee joint contains padlike, curved
“disks” of cartilage called menisci.
These are almost C-shaped and made
Femur
of tough fibrous cartilage. The disks are
Intact lateral meniscus
situated between the lower end of the
femur and upper end of the tibia, with Torn medial meniscus
End of
knuckle SITES OF
OSTEOARTHRITIS
Knee In large, weight-
bearing joints,
osteoarthritis is often
due to erosion of the
OSTEOARTHRITIS OF THE HIP articular cartilage with
The right hip, on the left of this X-ray, is badly age. In smaller joints,
eroded by osteoarthritis. The head of the osteoarthritis tends to
Base of
femur, which is normally round, is flattened. big toe be due to a familial
susceptibility.
Tight, thickened
Inflamed synovial
Bone capsule
membrane
Inflamed synovial
Joint capsule Osteophyte membrane
Wrist
Middle
knuckle
SITES OF RHEUMATOID
ARTHRITIS
Smaller joints, especially
Knee
those in the hands, are
often affected first,
JOINT INFLAMMATION usually on both sides of
In this X-ray, the middle knuckles of the hands the body at the same
are severely damaged by rheumatoid arthritis time. The inflammation
(red). Inflammation of the joints causes Ankle may then transfer or
abnormal bending of the fingers. “flit” to other, larger
Toe joints, such as the wrist.
Rectus abdominis
External intercostal Flexes spine and draws
Elevates ribs pelvis forward
Internal intercostal
Pulls adjacent ribs together
Iliopsoas
Tensor fasciae latae
Flexes thigh at hip
Helps keep knee straight
Sartorius
Pectineus Flexes thigh at hip and leg at knee
Flexes and draws thigh in joint; turns thigh outward
toward body
Rectus femoris
Adductor brevis Flexes thigh at hip; with other
Rotates and draws thigh in quadriceps muscles, extends knee
toward body
Vastus lateralis
Adductor longus Plays a part in extending knee
Rotates and draws thigh in
toward body
Vastus medialis
Peroneus brevis Plays a part in extending knee
Flexes foot downward; stops
it from turning inward Tibialis anterior
Flexes foot upward and inward;
Peroneus longus supports arch of foot
Flexes foot downward;
turns it outward Gastrocnemius
Flexes foot downward
Extensor digitorum longus Soleus
Extends outer toes; helps Flexes foot downward; aids forward
flex foot upward propulsion when walking or running
65
66 MUSCULAR SYSTEM
67
MUSCULAR SYSTEM
MUSCLES OF THE FACE, HEAD, AND NECK
THE MUSCLES OF THE FACE, HEAD, AND NECK INTERACT TO STEADY AND MOVE THE
HEAD AND TO MOVE THE FACIAL FEATURES. THE MUSCULATURE INVOLVED IS HIGHLY
COMPLEX, MAKING POSSIBLE A HUGE RANGE OF FACIAL EXPRESSIONS.
FACIAL MUSCLES
Some facial muscles are anchored to
bones. Others are joined to tendons or
to dense, sheetlike clusters of fibrous
connective tissue called aponeuroses. This
means that some facial muscles are joined
to each other. Many of these muscles have
their other end inserted into deeper layers
of the skin. The advantage of this complex
system is that even a slight degree of
muscle contraction produces movement
NERVE–MUSCLE JUNCTION
of the facial skin, which reveals itself as a
In this microscope image, a nerve cell (top left) joins
a facial muscle fiber. At the point of contact between show of expression or emotion. Almost all
the two is the motor end plate (center), an area of facial muscles are controlled by the facial
highly excitable muscle fiber. nerve called cranial VII (see p.102).
Procerus
Pulls eyebrows down
and together
Orbicularis oculi
Closes eyelid
Levator labii superioris
Raises and pushes
out upper lip
Compressor naris
Closes nostrils
Dilator naris
Opens and flares
nostrils
Masseter
Zygomaticus minor
Lifts lower jaw
Raises upper lip
(mandible) as
when chewing,
Zygomaticus major
and closes
Pulls corner of
mouth
mouth up and out
Risorius
Sternocleidomastoid Pulls corner of
Twists and tilts mouth outward
neck
Orbicularis oris
Scalenus
Narrows mouth and
Aids breathing
purses lips
and neck
flexion Mentalis
Raises lower lip and
wrinkles chin
Depressor labii
inferioris
Pulls down lower lip
M band
Connects
neighboring
strands of myosin
MUSCLE STRUCTURE
Skeletal (striated or voluntary) muscle
consists of densely packed groups of
hugely elongated cells called myofibers.
These are grouped into bundles (fascicles).
A typical myofiber is 3/4 –11/5 in (2–3 cm)
long and 1/500 in (0.05 mm) in diameter and
is composed of narrower structures called
myofibrils. These contain thick and thin
myofilaments made up mainly of the
proteins actin and myosin. Numerous
capillaries keep the muscle supplied Thick myofilament
Main component is the
with the oxygen and glucose needed protein myosin;
to fuel contraction. molecules have round
Actin heads and long tails
Thin myofilament
Consists of twisted Tropomyosin
strands of actin and
tropomyosin (protein that
inhibits contraction), plus
occasional troponin
complexes
Tail of myosin
molecule
Head of myosin
molecule
70
Fascicle Perimysium
Sarcolemma
Plasma membrane
surrounding myofiber
Sarcoplasm
Cytoplasm of muscle
cell, containing many
nuclei
Sarcomere
Basic unit of contraction of
a muscle fiber, which
Muscle fibril extends from one Z band
(myofibril) to the next
Each muscle
fibril is made up
of both thick
(myosin) and thin
(actin) contractile
filaments HOW MUSCLES CONTRACT
In muscle that is relaxed, the Z band
myofilaments only partly
overlap. When a muscle
contracts, the myosin filaments
slide between the actin M band
filaments, shortening the
myofibrils and the entire muscle
fiber. The more shortened
muscle fibers there are, the
greater the contraction in the
RELAXED CONTRACTED
muscle as a whole. MUSCLE MUSCLE
71
MUSCULAR SYSTEM
BODY PARTS AS LEVERS
Body movements employ the mechanical TENDONS
principles of applying a force to one part Tendons are tough, fibrous cords of connective
of a rigid lever, which tilts at a pivot point tissue that link skeletal muscles to bones. Within
(fulcrum) to move a weight (load) that is them, Sharpey’s fibers pass through the bone
elsewhere on the lever. The muscles apply covering (periosteum) to embed in the bone.
Tendons in the hands and feet are enclosed in
force, bones serve as levers, and joints
self-lubricating sheaths to protect them from
function as fulcrums. The various lever
rubbing against the bones. From the hand bones,
systems in the body allow a wide range tendons extend up to muscles near the elbow.
of movement as well as making it possible
to lift and carry things. Muscle
Collagen fibers
Trapezius of tendon
Movement
muscle of load
Fulcrum
Direction of force Periosteum
Tendon
Transverse
ligament
Cross-braces
Direction the tendons
of force Fulcrum
THIRD-CLASS LEVER
Tendon sheath
The most common type of lever in the body; the Protects digital
force is applied between the load and the fulcrum. tendons
An example is flexing the elbow joint (the fulcrum)
by contracting the biceps brachii muscle.
72
MUSCLES AND TENDONS
HOW MUSCLES WORK BENDING THE ELBOW
The chief agonist is the biceps
TOGETHER brachii muscle, which runs from
Muscles can only pull, not push, and the scapula to the radius
so are arranged in pairs that act in bone in the lower arm.
opposition to one other. The movement
produced by one muscle can be reversed
by its opposing partner. When a muscle Contracted
contracts to produce biceps brachii
movement, it is called the muscle
TORN HAMSTRING
Clavicle Supraspinatus
The hamstring muscles (collarbone) muscle
(rear of the thigh) may
be torn by vigorous Inflamed
movements, such as supraspinous
tendon
the rapid acceleration
common in sports. Humerus
Pelvis
Femur Acromion process
of shoulder blade
Tendon
Semitendinosus
muscle TENOSYNOVITIS
Inflammation
The complex, weight-bearing nature
of the foot makes it susceptible to Tendon
Biceps femoris sheath
tendon damage. Activities such as
muscle
running, kicking, or dancing may
cause inflammation.
Site of tear
Tendon
sheaths
Vastus lateralis
muscle Tendons
74
MUSCLE AND TENDON DISORDERS
RUPTURED TENDON Calf
Playing sports and lifting heavy weights may muscle
result in torn, or ruptured, tendons. Examples
are tearing of the tendons attached to the biceps
brachii muscle in the upper arm, or of the Achilles
tendon
quadriceps tendon at the front of the thigh that
stretches over the knee. A sudden impact that
bends a fingertip toward the palm may snap Tibialis
anterior Ruptured
the extensor tendon on the back of the finger. In tendon tendon
severe cases, the tendon may be torn away from
the bone. Symptoms include a snapping sensation,
pain, swelling, and impaired movement.
Tendon
sheath Tendon
sheath
Tendon
Carpal
ligament CROSS SECTION OF CARPAL TUNNEL
(flexor The carpal tunnel is situated between the carpal
retinaculum) ligament (flexor retinaculum) and the carpal bones
of the wrist. Tendons in their sheaths slide through
Tendons this passageway, adjacent to the median nerve.
75
IN SOME WAYS, THE HUMAN BRAIN RESEMBLES A
COMPUTER. HOWEVER, IN ADDITION TO LOGICAL
PROCESSING, IT IS CAPABLE OF COMPLEX DEVELOPMENT,
LEARNING, SELF-AWARENESS, EMOTION, AND CREATIVITY.
EVERY SECOND, MILLIONS OF CHEMICAL AND ELECTRICAL
SIGNALS TRAVEL AROUND THE BRAIN AND THE BODY’S
INTRICATE NERVE NETWORK. NERVOUS TISSUE IS DELICATE
AND NEEDS PHYSICAL PROTECTION AND A RELIABLE
BLOOD SUPPLY. IF NERVES ARE DAMAGED, REPAIR MAY
BE SLOW OR IMPOSSIBLE.
NERVOUS
SYSTEM
78 NERVOUS SYSTEM
NERVOUS SYSTEM
CONSTANTLY ALIVE WITH ELECTRICITY, THE EXTENSIVE
AND COMPLEX NERVOUS SYSTEM IS THE BODY’S PRIME
COMMUNICATION AND COORDINATION NETWORK.
Brain
The body’s nervous system has three
parts. The central nervous system, or
Auriculotemporal nerve
CNS, is made up of the brain and spinal
Axillary nerve Facial nerve
cord. The peripheral nervous system, or
Supraclavicular nerve
PNS, comprises 12 pairs of nerves from Phrenic nerve
Extends to
the brain and 31 pairs from the cord. diaphragm
Brachial plexus
These branching nerves go to each part
Vagus nerve
of the body, relaying information to and
from the CNS, which has the roles of Lateral pectoral nerve
coordination and decision-making. The Deltoid nerve
autonomic nervous system, or ANS, Ulnar nerve
has nerve pathways in the CNS and
Musculocutaneous nerve
PNS. Its work is primarily “automatic”:
it deals with activities such as heart
rate adjustment and blood pressure
Intercostal nerves
control, of which we are rarely aware.
Medial cutaneous branches
of intercostal nerves
Spinal ganglion
One of many nodules that send sensory Dorsal branches of
information to brain via spinal cord intercostal nerves
Subcostal nerve
Spinal cord
Part of central nervous system, Median nerve
extends from brain down the back, Radial nerve
protected by vertebral column
Ulnar nerve
Sympathetic ganglia chain Obturator nerve
Part of sympathetic nervous system, also called Iliohypogastric nerve
paravertebral ganglia; conveys stress signals to
body
Gluteal nerve Filum terminale
Fibrous tissue connecting
Pudendal nerve
spinal cord to coccyx
Femoral nerve
Muscular branch
of femoral nerve
Common palmar digital nerve
Muscular branches
of sciatic nerve
Deep branch of ulnar nerve
Anterior cutaneous
branches of femoral nerve
Sciatic nerve
Sciatic nerve
Common
peroneal nerve
Common peroneal nerve
Tibial nerve
Tibial nerve
Infrapatellar branch
of saphenous nerve
Intermediate dorsal
cutaneous nerve Medial dorsal
cutaneous nerve
79
NERVOUS SYSTEM
NERVES AND NEURONS
NERVE CELLS, OR NEURONS, ARE HIGHLY
SPECIALIZED IN THEIR STRUCTURE, FUNCTION, Axon
terminal fiber
AND COMMUNICATION LINKS.
NEURON STRUCTURE
Like all other cells, a typical neuron has
Schwann cell
a main cell body with a nucleus. But a Produces myelin
neuron also has long, wirelike processes
that connect the neuron to others, allowing Schwann cell
nucleus
messages to be passed at junctions called
synapses. These processes are of two main
kinds. Dendrites receive messages from
Dendrite
other neurons, or from nervelike cells in process
sense organs, and conduct them toward Receives
messages
the cell body of the neuron. The axon from other
conveys messages away from the cell body, neurons
to other neurons or to muscle or gland
cells. Dendrites tend to be short and have Axon process
Transmits
many branches, while axons are usually messages
longer and branch less along their length. from the
Neurons in the brain and spinal cord are nerve cell
body to
protected and nurtured by supporting other tissues
nerve cells known as glial cells.
MICROSCOPE VIEW
Nerve cells under the microscope
display their cell bodies with
nuclei (left) and processes (right).
Mitochondrion
Involved in cell respiration
and production of energy
Nucleus
Located toward the middle
of the cell body
Cell body
80
NERVES AND NEURONS
Node of Ranvier
Gap between
segments of myelin
sheath on an axon
Myelin sheath
Series of fatty wrappings along an
axon; insulates axons to prevent
short-circuiting and speeds up the
transmission of nerve impulses
NEURONAL NETWORK
The snaking dendrites and axons of a
neural net, which are reaching out to
communicate, are clearly visible in this
image. These neurons are of the
multipolar type, which are found especially
in the cortex of the brain. A single neuron
can correspond via its processes with tens
of thousands of others.
MYELINATED NERVES
The axons of most nerve fibers are wrapped in thin layers
of a white, fatty substance called myelin. These create a
sheath of insulation that allows nerve impulses to be
conducted quickly along the length of the nerve fiber.
Synaptic knob
End of an axon fiber Schwann cell
Myelin layer
Axon
SCHWANN CELL
The myelin sheath
that insulates a
nerve fiber in the
peripheral nervous
system is produced
by a Schwann cell,
which is wrapped
spirally around the
body of the axon.
81
NERVOUS SYSTEM
TYPES OF NEURON
Neuron cell bodies vary greatly in size and
Axon
shape, as do the type, number, and length branch
of their projections. Neurons can be
unipolar, bipolar, or multipolar. Unipolar
neurons are found mainly in the sensory Axon
nerves of the PNS. Bipolar neurons exist branch
UNIPOLAR NEURON
mostly in the embryo, but adults have some A single short process, an axon,
in the retina of the eye and the olfactory extends from the nerve cell body
nerve in the nose. Most neurons in the and splits into two.
brain and spinal cord are multipolar.
Dendrite
Dendrite
Axon Axon
branch branch
INSIDE A NERVE
NERVES Bundles of nerve fibers are embedded
Nerves, which resemble ropelike within tough connective tissue to Myelin sheath
cords, pass between and branch protect them from damage.
Axon
into the body’s organs and tissues. A fiber or axon
They are composed of bundles of may end some
distance from
communication strands—the Nerve fascicle Perineurium
its cell body
A bundle or group Sheathlike
elongated axons or nerve fibers of nerve fibers wrapping
of neurons. Each bundle is known for a fascicle
as a fascicle. Most nerves carry
two types of fiber. Sensory, or
afferent, fibers bring messages
from receptors in the sense organs
and other structures to the spinal
cord and brain. Motor, or efferent,
fibers convey signals from the
brain or spinal cord to a muscle or
gland. Some nerves contain
just sensory fibers, such as the
optic nerve, while others have
solely motor fibers.
Epineurium
Strong, protective outer
covering for the whole nerve Blood vessels
82
NERVES AND NEURONS
NERVE
REGENERATION Cell Cut nerve fiber
Myelin
Peripheral nerve fibers that body sheath
have been crushed or partly
cut may slowly regenerate if
the cell body is undamaged. Degenerating
The damaged section of fiber fiber
degenerates, leaving the INJURED NERVE
myelin sheath hollow. The
healthy remaining fiber begins
to grow along the empty
Nerve fiber sprouts
sheath at a rate of 1/25–2/25 in
(1–2 mm) daily. Natural
regeneration is much less
likely in the nerve fibers of
Empty myelin sheath
the brain and spinal cord,
where the neurons are so ATTEMPTED REPAIR
specialized that generally they
cannot replicate themselves
or recreate their highly New nerve
developed connections. fiber
REGROWTH
The stump end of a damaged
nerve fiber sends out several
sproutlike growths. One of these
finds the empty but intact myelin NERVE FUNCTION RESTORED
sheath and grows inside it.
SUPPORT CELLS
Supporting nerve cells, known ASTROCYTE
as glial cells or neuroglia, protect Named for their starlike
and nourish the neurons. There appearance, they provide
are several types of glial cell. support and nutrition.
The smallest are microglia, which
destroy microorganisms, foreign
particles, and cell debris from
disintegrating neurons.
Ependymal cells line cavities that
are filled with cerebrospinal fluid,
which surrounds both the brain
and spinal cord (see p.89). Other OLIGODENDROCYTE
glial cells insulate the axons and These cells provide a support
dendrites or regulate the flow framework, and produce
of cerebrospinal fluid. and nourish myelin sheath
segments for certain axons.
83
NERVE IMPULSE
NERVOUS SYSTEM
Postsynaptic
membrane
Membrane of
receiving cell’s
dendrite
Neurotubule
Specialized
microtubule that
conveys synaptic
vesicles from the
cell body to the
axon terminal
Synaptic knob
Enlarged end of
axon terminal
Positive ion
Receptor
Site in membrane channel into
which neurotransmitters slot,
letting in charged ions
Dendrites Neuron cell body Axon Neurofibral Myelin sheath
NERVE IMPULSE
Projections of Main part of Main nerve fiber node Also called neurilemma or
neuron; collect the neuron, of the neuron, Also called node Schwann sheath; spiraling
nerve impulses containing the conveying of Ranvier; structure of fatty myelin that
from other nucleus and cell impulses away portion of axon helps speed an impulse and
neurons or components from the cell not covered by prevent it from fading or leaking
sensory nerve body myelin
endings
Schwann cell
Sheetlike cell that grows around
a portion of axon (fiber) to form
the myelin sheath
IMPULSE MOVEMENT
WITHIN A NERVE CELL
A nerve impulse is based chiefly
on movement of positively
charged sodium and potassium
ions through the neuron’s cell
membrane. Impulses travel at
speeds of between 3–400 ft/s
(1–120 m/s), depending on the
type of nerve. Movement is
faster in myelin-coated axons.
Excess of Direction of nerve Excess of positive ions Positive ions pumped out
positive ions impulse produces positive across membrane,
outside charge inside restoring resting potential
cell membrane Positive ions membrane
pumped in Extracellular fluid
outside axon
Resting
potential Intracellular
across fluid within
membrane; axon
inside is Membrane
negatively of axon
charged with
respect to
outside
REPOLARIZATION
DEPOLARIZATION Positively charged potassium ions
RESTING POTENTIAL Positive ions rush in through ion flow in the opposite direction,
There are more positive ions channels. The membrane is first restoring the charge balance. This
outside the cell and more negative depolarized, then its polarity is stimulates an adjacent area of
ions inside, producing a “resting reversed, resulting in an “action membrane, and the next, and the
potential” of -70 millivolts. potential” of +30 millivolts inside. impulse moves along like a wave.
85
NERVOUS SYSTEM
BRAIN
THE BRAIN, TOGETHER WITH THE SPINAL CORD, REGULATES NONCONSCIOUS
PROCESSES AND COORDINATES MOST VOLUNTARY MOVEMENT. IT IS THE SITE
OF CONSCIOUSNESS, ALLOWING HUMANS TO THINK AND LEARN.
BRAIN STRUCTURE
The largest part of the brain is the cerebrum,
which has a heavily folded surface—the pattern of
which is unique in each person. The grooves are
called sulci when shallow and fissures when deep.
Fissures and some of the large sulci outline four
functional areas, called lobes: frontal, parietal,
occipital, and temporal (see p.90). A ridge on the
surface of the brain is called a gyrus. The center of
the brain contains the thalamus, which acts as the
brain’s information relay station. Surrounding
this is a group of structures known as the limbic
CEREBELLUM
system (see p.94), which is involved in survival
The cerebellum (section shown above)
instincts, behavior, and emotions. Closely linked contains billions of neurons that link up
with the limbic system is the hypothalamus (see with other regions of the brain and spinal
p.95, which receives sensory information. cord to facilitate precise movement.
BRAIN
Meninges Corpus callosum
A section down the middle of the brain reveals Three membranes Largest of several bundles
its inner structures. Although these structures that surround and of nerve fibers that connect
look very different in the diagram below, they are protect the brain and the two brain hemispheres
all made up of brain tissue, which is composed of spinal cord; made of
billions of neurons. There are two types of brain connective tissue
tissue—gray matter and white matter.
Skull
Cerebrum
Largest part of brain,
with connections to all
parts of the body
Hypothalamus
Functions include
regulating body
temperature and
controlling
autonomic
nervous system
Pituitary gland
Known as the “master gland”;
controls many other glands
Thalamus
Area that relays nerve
signals to cerebral cortex
Brainstem
Regulates vital functions such as
heartbeat and respiration
Cerebellum
Second largest part of the brain;
responsible for balance and
posture; situated behind
brainstem
87
NERVOUS SYSTEM
PROTECTION
The brain has several forms of protection. Protection also comes from the
First and foremost is the skull (see p.48). cerebrospinal fluid (see opposite) in the
Between the skull and the gray matter of subarachnoid space, between the arachnoid
the cerebrum lie three protective membrane and the pia mater. It absorbs and
membranes that also protect the spinal disperses excessive mechanical forces that
cord (see p.98). The dura mater lines the might otherwise cause serious injury.
inside of the skull, where it is attached to Analyses of its chemical constituents and
the bones; it is a thick, inelastic layer that flow pressure have offered vital clues for
provides support and protection. The diagnosing diseases and disorders of the
arachnoid membrane lies beneath the brain and spinal cord, such as meningitis.
dura, and was named for its resemblance
to a spider’s web. The pia mater adheres to
the convolutions of the cerebrum, and Skull
Cerebrum
Skull
Arachnoid
Pia mater
88
BRAIN
CEREBROSPINAL FLUID FLOW
The tissue of the brain floats in cerebrospinal lymphocytes that guard against infection.
fluid (CSF) within the skull. CSF is a clear CSF is produced by the choroid plexuses
liquid, which is renewed four to five times in the lateral ventricles, and drains into the
a day. CSF protects and nourishes the brain third ventricle. It then flows into the fourth
and spinal cord as it flows around them. It ventricle, which is located in front of the
contains proteins and glucose that provide cerebellum. Circulation of the fluid is aided
energy for brain cell function, as well as by pulsations of the cerebral arteries.
2 Direction of flow
Fluid moves from the brain’s
lateral ventricles into the third
and fourth ventricles. The fluid
then flows up the back of the
brain, down around the spinal
cord, and up to the front
of the brain, as indicated
by the arrows.
Lateral
ventricle
Dura
mater
Third
ventricle
Cerebellum
Fourth
ventricle
Spinal Skull
cord
Central
3 Circulation around
spinal cord
CSF ebbs and flows
canal
Parietal
occipital
fissure
Fissure (deep
groove) that
demarcates
border
between
parietal and
occipital lobes
Right
hemisphere Cerebellum
Longitudinal
fissure Brainstem
Left
hemisphere
Interventricular Lateral
foramen ventricles
Opening through
which fluid drains
from lateral to
third ventricle
would cover about the same area as a interior, is composed mainly of nerve fibers.
Caudate
nucleus
White matter
Contains both
projection and
Cranial nerves association fibers
PROJECTION PATTERN
The projection fibers pass Internal capsule
through the upper part of the A region of compact
brainstem, then fan out and bands of nerve fibers
travel to the cerebral cortex.
Thalamus
THE THALAMUS AND
BRAINSTEM
The thalamus sits on top of the brainstem,
and is shaped like two eggs placed side
by side. It lies almost at the “heart” of the
Midbrain
brain, and acts as a major relay station that
monitors and processes incoming
information before this is sent to the
upper regions of the brain. The brainstem
Pons
contains centers that regulate several Brainstem
functions vital for survival: these functions
include the heartbeat, respiration, blood
pressure, and some reflex actions, such
Medulla
as swallowing and vomiting.
BRAINSTEM
The three main regions of the Spinal
brainstem are the midbrain, cord
pons, and medulla.
93
NERVOUS SYSTEM
THE PRIMITIVE BRAIN
IN TIMES OF STRESS OR CRISIS, DEEP-SEATED INSTINCTS WELL UP FROM WITHIN US
AND TAKE OVER OUR AWARENESS. SUCH EVENTS INVOLVE THE “PRIMITIVE BRAIN,”
WHICH IS BASED MAINLY IN A SERIES OF PARTS KNOWN AS THE LIMBIC SYSTEM.
Mammillary body
Relay station for
information Midbrain
between fornix Topmost part of
and thalamus; brainstem;
helps process limbic areas here
memories link to the cortex
and thalamus,
and to clusters
of nerve cell
bodies known as
basal ganglia
Pituitary
gland
Hippocampus
Olfactory bulbs Involved with learning,
The brain’s “smell recognizing new experiences,
processors”; they and short-term memory
are “hard-wired”
into the limbic Pons Amygdala
system, which Part of the Involved in emotions such as
helps explain why brainstem; not part anger, and drives such as thirst,
the sense of of the limbic system hunger, and sexual desire
smell can evoke
such strong Parahippocampal gyrus
memories and Modifies expression of forceful
emotional emotions; forms and recalls
responses memories of scenes and views
94
THE PRIMITIVE BRAIN
THE HYPOTHALAMUS
The hypothalamus, which literally means also has complex associations with the rest
“below the thalamus,” is about the size of of the limbic system around it, and with
a sugar cube and contains numerous tiny the autonomic parts of the general nervous
clusters of neurons called nuclei. It forms system. Functions of the hypothalamus
an important part of the relationship include monitoring and regulating vital
between the brain and the body, and is internal conditions such as nutrient levels,
usually regarded as the vital integrating body temperature, water–salt balance,
center of the limbic system. A stalk below blood flow, the sleep–wake cycle, and the
links it to the pituitary gland (see p.134), levels of hormones such as sex hormones.
which helps regulate the activity of the The hypothalamus also initiates feelings,
endocrine system, including the thyroid actions, and emotions such as hunger,
and adrenal glands. The hypothalamus thirst, rage, and terror.
HYPOTHALAMIC NUCLEI
The roles played by all the nuclei in the hypothalamus
are not fully known. However, some roles have been
identified. For example, the ventromedial nucleus is
responsible for feelings of fullness after eating.
Damage to this area causes overeating.
Dorsal
Paraventricular Anterior hypothalamic Dorsomedial
nucleus nucleus area nucleus
LOCATOR
Posterior
nucleus
Lateral Lateral
preoptic hypothalamic
nucleus area
Ventromedial
nucleus
Medial preoptic
nucleus Mammillary
body
Lateral
Suprachiasmatic
tuberal
nucleus
nuclei
Site of the “body
clock” that Oculomotor
generates nerve nerve
activity on a
circadian, or
24-hour, cycle, and
influences many
body rhythms Infundibulum
Supraoptic
nucleus
Pituitary gland
95
NERVOUS SYSTEM
THE RETICULAR FORMATION
The reticular formation is a structure passes on nerve signals at the tiny
containing various clusters of neurons junctions, or synapses, between neurons).
(nuclei) together with a series of long, slim One of the reticular formation’s many
nerve tracts that are located in much of the functions is to operate an arousal system,
length of the brainstem (see p.93). Its fibers known as the reticular activating system
extend to the cerebellum behind, the (RAS), that keeps the brain awake and alert.
diencephalon above, and the spinal cord The reticular formation also includes the
below. The reticular formation comprises cardioregulatory and respiratory centers that
several distinct neural systems, each with control heart rate and breathing, and other
its own neurotransmitter (the chemical that essential centers.
Radiating signals
The RAS sends activating Activating signals
signals up through the Nerve signals arrive at the
midbrain to regions cerebral cortex to maintain
of the cerebral cortex, the state of wakeful readiness
while other nerve fibers so that the mind remains
return feedback conscious and alert
Cerebral cortex
Diencephalon
Contains
VISUAL IMPULSES thalamus,
Sensory input to the RAS hypothalamus,
and epithalamus
travels along the optic
nerves from the eyes,
alerting the brain to
possible danger. Reticular
formation
Medulla
Excitatory
area
Inhibitory
area
Impulses from
spinal cord
AWAKE
REM
STAGE OF SLEEP
NREM STAGE 1
NREM STAGE 2
NREM STAGE 3
NREM STAGE 4
0 1 2 3 4 5 6 7 8 9
HOURS OF SLEEP
SLEEP STAGES
EEG traces show different waveforms of brain activity
for each sleep stage. As the body reaches the deeper
NREM SLEEP: STAGE 3 stages, body temperature, heart rate, breathing rate,
and blood pressure all reduce. During REM sleep, these
functions increase slightly and most dreaming occurs.
97
NERVOUS SYSTEM
SPINAL CORD
THE NERVE FIBERS OF THE SPINAL CORD LINK THE BRAIN WITH THE TORSO, ARMS,
AND LEGS. THE CORD IS MORE THAN A PASSIVE CONDUIT FOR NERVE SIGNALS. WHEN
NECESSARY, IT CAN BYPASS THE BRAIN: FOR EXAMPLE, IN REFLEX ACTIONS.
Sensory
Motor nerve root
rootlets (ventral) ganglion
Bundles of fibers Cluster of
that emerge from the nerve cell
front (ventral side) of bodies on a
spinal cord spinal nerve
Pia mater
Anterior fissure
Deep groove along Arachnoid
front of spinal cord
Dura mater
Subarachnoid space
Meninges
Three layers
that protect
FRONT OF BODY spinal cord
98
SPINAL GRAY MATTER
SPINAL CORD
This microscopic view of a cross section
through the spinal cord shows a brown-
stained “wing” of the butterfly-shaped
gray matter, which lies at the cord’s center.
NERVE CROSSOVER
Bundles of nerve fibers (axons) in the left and right touch center (somatosensory cortex) on the right
sides of the spinal cord do not all pass straight up side of the brain. Likewise, motor signals from the
into the left and right sides of the brain. In the right motor cortex in the brain and the right side of
uppermost portion of the spinal cord and the lower the cerebellum travel to the muscles on the left side
brainstem (the part called the medulla; see p.93), of the body. Different major bundles, or tracts, of
many of the fibers cross over, or decussate, fibers decussate at slightly different levels. About
to the other side—left to right, and right to left. This one-tenth of those that cross over do so in the
means that nerve signals about, for example, touch upper spinal cord, and the remainder cross over
sensations on the left side of the body reach the in the medulla.
Spinal nerve
Spinal cord
Spinal nerve root
Intervertebral
disk REAR OF BODY
99
NERVOUS SYSTEM
PROTECTION OF THE SPINAL
CORD of fat and connective tissue. The epidural
The spinal cord is located inside the spinal tissues lie between the periosteum (the
canal, which is a long tunnel within the membrane that lines the bone of the spinal
aligned column of backbones (vertebrae). canal) and the dura mater, the outer layer of
This vertebral column, along with its the meninges.
strengthening ligaments and muscles, bends
and flexes the cord, but also guards it from INSIDE THE SPINAL CANAL
A cross section of the vertebral column in the neck
direct knocks and blows. Within the spinal
(cervical) region shows how the spinal cord nestles in
canal, the circulating cerebrospinal fluid the well-padded bony cavity. Although the vertebrae
(see p.89) acts as a shock-absorber and the shift position as the trunk of the body moves, the
epidural space provides a cushioning layer spinal cord remains well supported and protected.
REAR OF BODY
Subarachnoid space Pia mater
Arachnoid
Periosteum
Epidural space Tough membrane that
Cushions spinal cord; covers bones and lines
contains connective cavities within them
tissue and blood vessels
Cerebrospinal fluid
Dura mater
Fills subarachnoid
space between middle
and inner meninges
Motor
nerve
rootlets
FRONT OF BODY
Cerebrum
Spinal cord
Filum
terminale
Extension of
pia mater
ASCENDING TRACTS
These ascending tracts are bundles of nerve fibers that
relay impulses about body sensations, and inner sensors
such as pain, up the spinal cord to the brain.
Sacrum DESCENDING TRACTS
These descending tracts convey motor signals from the
brain to the skeletal muscles of the torso and limbs in
Coccyx order to bring about voluntary movements.
101
NERVOUS SYSTEM
PERIPHERAL NERVES
THE BODY’S NETWORK OF PERIPHERAL NERVES COMMUNICATES WITH THE BRAIN
AND SPINAL CORD. SENSORY FIBERS CARRY MESSAGES FROM SENSE AND INTERNAL
ORGANS, WHILE MOTOR FIBERS CONTROL MUSCLE AND GLAND ACTIVITY.
CRANIAL NERVES
The 12 pairs of cranial nerves connect to of stretch and tension in the muscles they
the brain directly, not via the spinal cord. serve, as part of the proprioceptive sense
Some perform sensory functions for organs (see p.73). Most of the cranial nerves are
and tissues in the head and neck, while named according to the body parts they
others have motor functions. The nerves serve, such as the optic nerves (eyes). By
with predominantly motor fibers also convention, the nerves are also identified
contain some sensory fibers that convey by Roman numerals, so the trigeminal
information to the brain about the amount nerve, for example, is cranial V (five).
Olfactory nerve
(I, sensory)
I
Relays information
about smells from the
olfactory epithelium
inside the nose, via
the olfactory bulbs
and tracts, to the
brain’s limbic centers.
Trigeminal nerve
(V, two sensory and
one mixed branch)
Ophthalmic and
maxillary branches V
send signals from the
eye, face, and teeth;
mandibular fibers
control chewing and
send sensory signals
from the lower jaw.
Facial nerve
(VII, mixed)
Sensory branches
come from the taste
buds of the front
two-thirds of the VII
tongue; motor fibers
run to the muscles of
facial expression and
to the salivary and
lacrimal glands.
PERIPHERAL NERVES
The optic nerve sends visual messages
from the rod and cone cells in the Vestibulocochlear
retina of the eye to the visual cortex in Oculomotor, trochlear, and abducens nerve (VIII, sensory)
the brain; parts of the two nerves cross nerves (III, IV, VI, mainly motor) The vestibular branch sends
at the optic chiasm (see p.122), where These three nerves regulate the voluntary nerve signals from the inner
they form bands of nerve fibers, called movements of the eye muscles, to move ear about head orientation
optic tracts. Each nerve consists of a the eyeball and eyelids; the oculomotor and balance; the cochlear
bundle of about one million sensory also controls pupil constriction by the iris branch brings signals from
fibers—it carries the most information muscles and focusing changes in the lens the ear concerning sound
of any cranial nerve. by the ciliary muscles. and hearing.
III
II IV VI
VIII
IX
X XII
Glossopharyngeal and
hypoglossal nerves
XI (IX, XII, both mixed)
Motor fibers of these
nerves are involved in
tongue movement and
swallowing, while sensory
fibers relay information
Spinal accessory nerve Vagus nerve (X, mixed) about taste, touch, and
(XI, mainly motor) The longest and most branched cranial nerve, temperature from the
This nerve controls muscles and the vagus has sensory, motor, and autonomic tongue and pharynx.
movements in the head, neck, fibers that pass to the lower head, throat, neck,
and shoulders. It also stimulates the chest, and abdomen; they are involved in many
muscles of the pharynx and larynx, vital body functions, including swallowing,
which are involved in swallowing. breathing, and heartbeat.
103
NERVOUS SYSTEM
SPINAL NERVES
The 31 pairs of peripheral spinal nerves
emerge from the spinal cord through
spaces between the vertebrae (see p.99).
Each nerve divides and subdivides into a
number of branches; the dorsal branches
serve the rear portion of the body, while
the ventral branches serve the front and
sides. The branches of one spinal nerve
may join with other nerves to form meshes
called plexuses, where nerves merge and
intersect. Nerves leaving each plexus
then go on to carry signals to and from
that particular area of the body. SPINAL NERVE GANGLION
This microscope image shows a section through a
cluster of spinal nerve cells (ganglia), where nerve
impulses are coordinated. Each neuron (purple) is
surrounded by support cells (light blue).
SPINAL REGIONS
The organization and naming of the four main
spinal nerve regions reflect the regions of the
spine itself—cervical or neck, thoracic or chest,
lumbar or lower back, and sacral or base of spine.
104
FRONT VIEW REAR VIEW
PERIPHERAL NERVES
DERMATOMES V1 C2
A dermatome is a region or C3
V2
zone of skin supplied by the V3 C4
dorsal (rear, sensory) nerve C2 C5
C3 C6
roots of one pair of spinal C4
nerves. The nerve branches T2 to T1 to T12
carry sensory information T12
C7
about touch, pressure, heat, C5 C8
cold, and pain from the skin L1
microsensors within the zone, C6 L2
along the sensory fibers of the T1 L3
spinal nerve, to the nerve root L4
and then into the spinal cord.
C7
A “skin map” delineates these C8
S1
zones, or dermatomes. In real S5
L2
life, the distribution of nerve S4
roots, and so of sensations, L1 S3
overlaps slightly. S2 L5
S3 L1
L2
L3
DERMATOME MAP
L3
Spinal nerve C1 has no sensory fibers L4
L4
from the skin, so it is omitted; the face L5 S1
and forehead send signals via the three S1 S2
branches of the trigeminal cranial (V)
nerve, coded here as V1–V3. L5
SPINAL REFLEXES
A spinal reflex is a rapid, Sensory nerve fiber
involuntary response to a Each sensory nerve
stimulus. A circuit of impulse is sent
directly to the
sensory nerve fibers feeds spinal cord
information to the spinal
cord and then connects
to motor nerve fibers. The Nerve
Motor rootlets
resulting instructions for Stimulus nerve fiber
movement go out directly Spinal
from the cord cord
Thigh
to the relevant muscles. muscle Fiber ends of Cell body of
(rectus sensory neurons motor neuron
femoris) Pass impulses to Initiates impulses and
motor neurons sends them to muscle
Kidney
TWO DIVISIONS decreases
There are two divisions in urine output
the ANS: the sympathetic
Stomach
and parasympathetic. The produces less
ganglia of the sympathetic of the digestive
division are arranged into enzymes
two ganglion chains, one
on each side of the spinal Intestine slows
its movement
column (only one is shown
of food SYMPATHETIC
here). The ganglia of the
GANGLION
parasympathetic ANS are Bladder CHAIN
inside organs (see sphincter
diagram). Only skin and muscle
blood vessels receive constricts
nerve messages from all Blood vessels
positions on the cord. dilate
106
AUTONOMIC NERVOUS SYSTEM
KEY
Parasympathetic
division
Sympathetic
division
PARASYMPATHETIC
DIVISION Lacrimal glands
Preganglionic
produce tears
axons
Pupil constricts
as inner muscles Postganglionic
of iris contract;
axons
lens focuses on
nearby objects
Synapses
Nasal glands
produce
mucus
Terminal
Salivary glands ganglion
secrete thin
saliva
Collateral
ganglia
Pancreas secretes
insulin and enzymes
Bladder sphincter
muscle relaxes
SPINAL
CORD Sexual organs are stimulated,
causing increased lubrication and
erection of the clitoris in females
and erection of penis in males
107
NERVOUS SYSTEM
INVOLUNTARY RESPONSES
There are two main types of involuntary, nerve tracts to the lower autonomic regions
or automatic, responses, which do not of the brain, particularly parts of the limbic
usually involve conscious awareness. system and the hypothalamus. These
One involves reflex actions (see p.105). regions analyze and process the information
Reflexes mainly affect muscles normally received, and then use the autonomic
under voluntary control. The other type pathways to send out motor impulses,
of response includes autonomic motor which are instructions for the involuntary
actions. The initial nerve pathways for muscles and the glands. Response signals
these responses run along spinal nerves for the parasympathetic and sympathetic
into the spinal cord, then up ascending systems have separate pathways.
Cerebral cortex
Receives sensory data from
cerebellum, compares it
with what has just been
sent as instructions, and
modifies the next batch of
instructions accordingly
Basal ganglia
Plan and initiate complex
movements, receive sensory
data from the cerebellum, and
relay information to the
cerebral cortex above
Cerebellum
Receives all sensory information
from the muscles and the joints;
Sensory nerve impulse coordinates and relays instructions
to produce precise movements
VOLUNTARY RESPONSES
Nerve signal pathways for voluntary actions
include a continually active feedback loop.
Motor nerve impulses travel to the muscles
involved, while sensory nerve impulses return to
the cerebellum to report on the progress of the
action and make any fine adjustments necessary Spinal
for smooth movements. cord
109
NERVOUS SYSTEM
MEMORIES, THOUGHTS, AND EMOTIONS
MANY MENTAL FACULTIES ARE NOT CONTROLLED BY JUST ONE AREA OF THE
BRAIN. FOR EXAMPLE, THERE IS NO SINGLE “MEMORY CENTER.” THOUGHTS, FEELINGS,
EMOTIONS, AWARENESS, AND MEMORY INVOLVE MANY PARTS OF THE BRAIN.
Primary visual
cortex
Analyzes visual
nerve signals
Broca’s area from the eyes
Controls speech
production and clear
articulation of words Wernicke’s area
Analyzes
Primary auditory cortex language;
Analyzes hearing nerve signals controls the
from the ears comprehension
of spoken words
Auditory association cortex
Integrates auditory data with memories,
emotions, and other senses
110
MEMORIES, THOUGHTS, AND EMOTIONS
MEMORY AND RECALL
Memories are the brain’s information store. These processes depend on the significance
No single region of the brain processes and time span of the memory, its depth of
them as they are being established, nor emotional impact, and its association with
acts as a storage site for all memories. specific senses such as eyesight.
Putamen Cortex
Stores “subconscious” Stores parts of a memory associated
memories, such as motor skills with specific senses and motor
gained by repetition actions in their relevant areas
AREAS INVOLVED IN
Prefrontal cortex MEMORY STORAGE
Controls grasp of Various areas of the brain
passing situations, are involved in memory.
such as visual– The hippocampus, for
spatial awareness
example, helps transfer
of current
surroundings immediate thoughts
and sensory data into
short- and long-term
stores. If it is damaged,
Amygdala a person can recall
Recalls powerful Hippocampus
emotions Establishes long-term
events from long ago,
associated with memories and Temporal lobe before the damage, but
memorable events, knowledge linked with Stores language, words, not what happened a
such as fear spatial awareness vocabulary, and speech few hours previously.
THOUGHT IN ACTION
The real-time scanning method fMRI which areas of the brain are busy during
(functional magnetic resonance imaging) well-defined mental activities, such as
reveals tiny localized increases in blood studying the visual details of an image,
flow. As a result, the scans can pinpoint or listening to and understanding speech.
PLANNING A MOVEMENT
The subject of this fMRI scan was asked to
think about performing a task during the
scan. The image shows activity in both the
left and right prefrontal areas and also in
both the left and right auditory cortex.
SMELL
Smell is a sense that can detect chemical
molecules known as odorants floating in
the air. Specialized epithelial tissue provides
a smelling zone, known as the olfactory
epithelium, on the roof of the nasal cavity.
In humans, smell is more sensitive than taste
and may be able to distinguish millions
of odors. Smell is important for warning of
dangers, such as smoke and poisonous gas,
and for appreciating food and drink. The
NASAL LINING
sense of smell tends to deteriorate with age,
Epithelial cells in the lining of the nasal chamber
so young people are able to distinguish a have tufts of hairlike cilia, which wave germ- and
wider range of odors and experience them odorant-trapping mucus toward the back of the
more vividly than older people. chamber to be swallowed.
HOW WE SMELL
Odor molecules dissolve in the
mucus lining the nasal chamber. Dura mater Olfactory bulb
In the roof of the chamber, they
touch the cilia (microscopic,
hairlike endings of olfactory Glomerulus
receptor cells). If the correct
molecule slots into the same- Nerve fiber
shaped receptor on the cilial OLFACTORY
membrane, like a key in a lock, a Ethmoid EPITHELIUM
bone When odor
nerve impulse is generated. The
impulses are partly processed Mucus- molecules
by intermediate neurons called secreting make contact
gland with cilia on
glomeruli in the olfactory bulb.
olfactory
Basal cell
receptor cells in
Olfactory the olfactory
receptor cell epithelium,
Supporting nerve impulses
cell travel along
Airflow nerve fibers to
glomeruli in the
Odor molecules Cilia olfactory bulb.
LOCATION
112
NASAL CHAMBER
NERVE PATHWAYS FOR SMELL A 3-D CT scan shows
AND TASTE the three shelves
Both smell (olfactory) and taste (gustatory) of bone known as
sensations pass along cranial nerves directly to the the conchae on
brain. Smell signals travel from the olfactory bulbs both sides of the
along the olfactory nerve, which is made up of nasal chamber.
groups of nerve fibers, to a patch of the cortex
located in the temporal lobe. Taste sensations
travel along branches of the glossopharyngeal and
facial nerves to the gustatory center in the cortex.
Cerebral cortex
Helps integrate smell
and taste sensation with
memory and emotion
Gustatory cortex
“Taste center” for reception
and analysis of gustatory
(taste) nerve signals
Pathway of impulses
from trigeminal nerve
Pathway of
impulses from
glossopharyngeal
nerve
Thalamus
Receives taste signals
from the medulla and
sends them to the
gustatory cortex
Olfactory bulb
Outgrowth of brain;
processes smell signals
before passing them
to the brain
Nasal chamber
Trigeminal nerve
Branches gather Medulla
sensory impulses from Taste signals
the front two-thirds of from cranial
the tongue nerves reach
the medulla to
be relayed to
Glossopharyngeal nerve
the thalamus
Branches collect taste
impulses from the rear
third of the tongue
NERVOUS SYSTEM
TASTE
Taste works in a similar way to smell. Its buds, but with age, their numbers may fall
gustatory cell (taste) receptors detect to under 5,000. They are located mainly on
specific chemicals dissolved in saliva by a and between the pimplelike papillae that
“lock-and-key” method (see p.112). dot regions of the tongue’s upper surface.
Groups of receptor cells are known as There are also some taste buds on the palate
taste buds. A child has about 10,000 taste (roof of the mouth), throat, and epiglottis.
Taste pore
Taste hair
Gustatory
receptor cell
Supporting
cell
TASTE RECEPTORS
Epithelium
A scanning electron microscope
of tongue
image shows two different types
Nerve fiber of papillae. The purple conical
structures are filiform papillae.
The circular pink structure is a
fungiform papilla.
114
SMELL, TASTE, AND TOUCH
TOUCH
The sense of touch comes from microscopic of receptors detect a range of stimuli, such
sensory receptors (specialized endings of as light touch, heat, cold, pressure, and
nerve cells) in the skin or in deeper tissues pain. The receptors relay their signals via the
(see p.182). Some receptors are enclosed in spinal cord and lower brain to a strip curving
capsules of connective tissue, while others around the cerebral cortex, known as the
are uncovered. Different shapes and sizes somatosensory cortex, or “touch center.”
Lips
Tongue
TOUCH MAP
Each part of the somatosensory cortex
(above) receives touch messages from
skin around the body, as mapped on this
vertical cross section of the brain (right).
115
NERVOUS SYSTEM
EARS, HEARING, AND BALANCE
THE EARS PROVIDE THE SENSE OF HEARING. THEY ALSO DETECT HEAD POSITION
AND MOTION, SO THEY ARE ESSENTIAL TO BALANCE. THE FUNCTION OF BOTH
HEARING AND BALANCE IS BASED ON THE ACTIVITY OF “HAIR CELL” RECEPTORS.
OUTER EAR
Pinna (ear flap) The vaguely trumpet-shaped pinna
Skin-covered helps funnel sound waves into the
flap with outer ear canal. The lining of the canal
subcutaneous continuously secretes wax to trap dirt and
fat, cartilage, and
germs. It slowly flakes off and works its way
connective tissue
out, helped by movements of the jaw.
116
MIDDLE AND INNER EAR
Tympanic chamber
(middle-ear cavity)
Tympanum, or
tympanic
membrane Tympanic
(eardrum) canal
Resembles
thin skin Cochlea
Contains organ
Canal lining of hearing;
Secretes wax, spirals for 23/4
which traps turns
unwanted debris
Malleus Incus Stapes Oval Round Eustachian tube Vestibule
(hammer) (anvil) (stirrup) window window Runs to an Contains the
Membrane Pressure relief opening in the utricle and
in cochlea membrane that side of the upper saccule, organs
wall; receives allows cochlear throat, level with of balance
Ear ossicles vibrations fluid to bulge the soft palate
from stapes with vibrations
117
NERVOUS SYSTEM
HOW WE HEAR
Ears act as energy converters, changing Hair cell
pressure differences in air, known as sound
waves, into electrochemical nerve impulses.
Sound waves usually occur as a complex Hairs of
pattern of frequencies, and they vibrate the hair cell
eardrum in that same pattern. The vibrations
are conducted along the ossicle chain, which HAIR CELLS
Within the organ of Corti, with the tectorial
rocks like a bent lever and forces the membrane removed on the right, each hair cell
footplate of the stapes to act like a piston, is seen to have 40–100 hairs arranged in a curve.
pushing and pulling at the flexible oval Nerve fibers run from the cell bases.
window of the cochlea. The motions set off Organ of Corti Hair cells
waves through the perilymph fluid inside Central spiral element of Generate nerve signals
the cochlea. These, in turn, transfer their the cochlea, composed in response to motion
of tectorial and basilar of basilar and tectorial
vibrational energy to the organ of Corti, membranes linked by membranes
which coils within the cochlea. sensitive hair cells
Cochlear nerve
Carries nerve
Path of Malleus Incus Stapes Vestibular canal signals to brain
incoming Transmits vibrations
sound to basilar membrane
AMPULLA ACTION
SEMICIRCULAR CANALS
Cupula
Each semicircular canal has a
bulge near one end, called the Hairs of hair cells
ampulla. This houses a low mound Mound of hair cells
of hair cells, their hair ends set into (crista ampullaris)
a taller, jellylike mound, the
cupula. As the head moves, fluid in Ampulla
the canal lags behind, swirls past Fluid swirls due to head motion
the cupula, and bends it. This pulls
the hairs and triggers their cells Cupula bends
to fire nerve signals.
Hair cells stimulated
119
NERVOUS SYSTEM
EYES AND VISION
EYESIGHT PROVIDES THE BRAIN WITH MORE INPUT THAN ALL OTHER
Sclera
SENSES COMBINED—MORE THAN HALF OF THE INFORMATION IN THE Tough, white
protective outer
CONSCIOUS MIND IS ESTIMATED TO ENTER THROUGH THE EYES. sheath of eyeball
Optic nerve
Conveys nerve
signals to brain
Lateral rectus
Small muscle that swivels
the eye to look out
to the side
Point of focus
Flatter lens
bends light less
DISTANT VISION
Light rays from distant objects are almost parallel
and require less refracting power to focus, so the
ciliary muscle relaxes to make the lens bulge less.
Iris
Ring of muscle that changes size of pupil to
regulate amount of light entering the eye
Anterior chamber
Between cornea and iris, filled
with aqueous humor (fluid)
Pupil
Hole in iris that becomes wider in dim light
Cornea
Domed, transparent “window” at front of eye
Conjunctiva
Lens Delicate, sensitive covering of
Transparent disk cornea and eyelid lining
Ciliary muscle of tissue that
Ring of muscle that changes shape for
alters lens shape near or far vision
121
NERVOUS SYSTEM
VISUAL PATHWAYS
Nerve signals conducted along the left and Likewise, fibers from the right side of each
right optic nerves converge at a crossover retina form the right optic tract and go to
junction, called the optic chiasm, at the the right visual cortex. Because the eyes
base of the brain. Here, fibers carrying are set apart, each sees a slightly different
signals from the left side of each retina join view of an object. The combination of
and proceed as the left optic tract to the the views of both eyes into a single image
left visual cortex at the back of the brain. is called binocular vision.
View as
seen by Final image
left eye
View as seen
by right eye
Lacrimal sac
Channels tears
toward nose
Nasolacrimal
duct
Opens into
nasal cavity
Lateral
Medial
TEAR APPARATUS rectus
rectus
The tear (lacrimal) gland is under the soft tissues
of the outer part of the upper eyelid. It produces Inferior Inferior
1/ 2/
3 – 3 fl oz (1–2 ml) of fluid daily. oblique rectus
123
NERVOUS SYSTEM
NERVOUS SYSTEM DISORDERS
DISORDERS OF THE NERVOUS SYSTEM CAN DEVELOP FOR VARIOUS REASONS, SUCH AS PROBLEMS
WITH THE BRAIN’S BLOOD SUPPLY, THE DETERIORATION OF BRAIN CELLS, ABNORMAL
DEVELOPMENT IN THE WOMB, TISSUE INFECTION, CELL DAMAGE, AND THE AGING PROCESS.
Common
carotid artery
Embolus
A piece of material
called an embolus
may travel in the
blood and block a
cerebral artery,
causing a stroke
MIGRAINE Dilated
blood
About 1 in 10 people has migraine, with episodes of severe headache vessels
often associated with visual disturbances, nausea, and vomiting.
The underlying cause of a migraine is unknown, but changes in the
diameter of the blood vessels in the scalp and brain are known to occur.
Current research indicates that migraines are linked to abnormal
function of nerve pathways and a disturbance in the activity of brain
chemicals. Triggers for a migraine attack include stress, missed
meals, lack of sleep, and certain foods, such as cheese or chocolate.
In many women, migraines are associated with menstruation.
HEADACHE PHASE
During migraine, severe, throbbing pain may affect half
or all of the head as blood vessels in the scalp and brain
widen (dilate). These vascular changes are thought to be
secondary to nerve pathway abnormalities.
125
NERVOUS SYSTEM
BRAIN INFECTIONS SITES OF INFECTION
Infectious organisms can affect the brain itself, the
Infection of brain tissue or its protective layers can
three membranes (meninges) that surround the brain,
be caused by a variety of viruses, bacteria, and or both. Infections can reach the brain through the
tropical parasites. Infection of the brain, or blood, but can also spread from a nearby infection
encephalitis, is a rare complication of a viral (such as an ear infection) or through a skull wound.
infection, such as mumps or measles. It can be
fatal, with babies and elderly people being most Brain tissue
Infection of brain tissue, known as
at risk. encephalitis, is often mild, but is
occasionally life-threatening;
MENINGITIS features include headache,
fever, and nausea
Inflammation of the meninges is usually caused
by a virus or bacterium. Initially, meningitis Skull
may cause vague flulike symptoms. More
pronounced symptoms may also develop, Dura mater
such as headache, fever, nausea, vomiting,
stiff neck, and a dislike of bright light. In Arachnoid
meningitis due to Meningococcus
bacteria, there is a distinctive reddish Pia mater
purple rash. If meningitis is suspected,
immediate admission to a hospital is
necessary for tests. If bacterial meningitis is Meninges
Of the three meninges,
confirmed, treatment in intensive care is the arachnoid and pia
often required, and a complete recovery mater are affected more
may take weeks or months. It can be fatal severely by meningitis
than the outermost layer,
despite treatment. Recovery from viral meningitis the dura mater.
usually takes up to two weeks. No specific
treatment is needed.
BRAIN ABSCESS
An abscess is a collection of pus.
Brain abscesses are rare, and are
usually caused by bacteria that
have spread to the brain from an
infection in nearby tissues in the
skull. Treatment consists of high
doses of antibiotics and possibly
corticosteroids to control swelling
of the brain. Surgery may be
needed to drain pus through a hole
drilled in the skull. If given early
treatment, many people with a BRAIN ABSCESS TESTING A MENINGITIS RASH
This MRI scan of the brain shows an In meningococcal meningitis,
brain abscess recover. However,
abscess (blue area) due to a fungal bacteria in the blood may cause
some have persistent problems, infection in a person who has AIDS. dark-red or purple spots that turn
such as seizures, slurred speech, People with AIDS are at increased into blotches. The rash does not
or weakness of a limb. risk of developing a brain abscess. fade when pressed with a glass.
126
NERVOUS SYSTEM DISORDERS
SPINA BIFIDA
There are three main forms of spina bifida: paralysis or weakness in the legs, and lack of bladder
spina bifida occulta, meningocele, and and bowel control. Children with this form will have
myelomeningocele. Spina bifida occulta may a permanent disability and may need extra support
require surgery to avoid serious neurological during their lives. Folic acid helps prevent spina bifida,
complications later in life. Meningoceles and women are advised to take supplements when
usually have a good prognosis after surgery. planning to conceive and during the first 12 weeks
Myelomeningocele has effects that may include of pregnancy.
Malformed Hairy Spinal Skin and Cerebro- Spinal Skin Cerebro- Abnormal
vertebra patch cord meninges spinal cord spinal spinal
Vertebra on skin fluid fluid cord
should
enclose
spinal cord
GLUE EAR
PERFORATED EARDRUM A persistent collection
A tear or hole in the eardrum of fluid in the middle
may occur due to pressure from ear, which occurs more
a buildup of pus or fluid in the commonly in children,
middle ear during an infection. can cause difficulty in
It may also occur due to unequal hearing. Fluid buildup is
pressures between the middle caused by a blockage of
and outer ear, as may happen the Eustachian tube, which
when flying. Healing usually Gluelike ventilates the middle ear, often
takes about a month. fluid as a result of infection.
128
FOCUSING
Farsightedness (hypermetropia)
and nearsightedness (myopia)
result from the eyeball being
either too short or too long (see
right). In astigmatism, vision is Light Light
Lens rays Lens rays
blurred because the cornea is UNCORRECTED UNCORRECTED
irregularly curved, and the lens FARSIGHTEDNESS NEARSIGHTEDNESS
cannot focus all light rays on the Convex Concave
retina. Aging often affects near lens lens
vision because the lens loses its
elasticity and cannot easily adjust
its shape. Refractive errors can
usually be corrected by glasses or
contact lenses, or by surgical
techniques such as laser-assisted CORRECTED CORRECTED
FARSIGHTEDNESS NEARSIGHTEDNESS
in-situ keratomileusis (LASIK)
and photorefractive keratectomy FARSIGHTEDNESS NEARSIGHTEDNESS
(PRK). In LASIK, the middle In farsightedness, the eyeball is In nearsightedness, the eyeball is
layers of the cornea are reshaped too short, so the cornea and lens too long, so the cornea and lens
focus light rays behind the retina, focus light rays in front of the
by a laser, while in PRK, areas
and the image is blurred. Convex retina, and the image is blurred.
of the cornea’s surface are lenses make the light rays Concave lenses are required, which
shaved away by a laser to alter converge so that they are focused make the light rays diverge so that
its shape. on the retina, correcting vision. they are focused on the retina.
GLAUCOMA
Glaucoma occurs when there is an abnormally Blocked
trabecular
high pressure inside the eyeball that is caused meshwork
by a buildup of fluid. The pressure may
permanently damage nerve fibers in the retina
or the optic nerve, affecting vision. In acute LOCATION
ENDOCRINE ANATOMY
THE BODY’S CHEMICAL MESSENGERS, HORMONES, ARE
PRODUCED BY ENDOCRINE GLANDS. HORMONES TARGET
CERTAIN TISSUES TO REGULATE THEIR ACTIVITIES.
Thymus gland
Produces hormones involved in development
of white blood cells, called T cells, that are
part of the immune system
Heart
Produces a hormone called atriopeptin that
reduces blood volume and pressure and
helps regulate fluid balance
Adrenal gland
Outer layer manufactures steroid hormones that
regulate metabolism and maintain fluid balance;
inner layer produces epinephrine
Kidney
Secretes erythropoietin,
which stimulates
production of red blood
cells in bone marrow
Stomach
Makes hormones that
stimulate production or
release of digestive
enzymes
Pancreas
Contains clusters of cells
that produce the hormones
insulin and glucagon, which
control blood glucose levels
Intestines
Like the stomach, make
TESTES hormones that stimulate
production or release of
In males, the two testes produce digestive enzymes
androgens: male sex hormones,
including testosterone. Androgens
stimulate the growth and
development of the male sexual Ovary
Makes the female sex
organs and the production of sperm,
hormones estrogen
and influence secondary sexual and progesterone,
characteristics, such as facial hair which regulate the
and deepening of the voice. menstrual cycle
133
ENDOCRINE SYSTEM
HORMONE PRODUCERS
HORMONES CARRY THE CHEMICAL DATA THAT CONTROL THE RATE AT WHICH
GLANDS AND ORGANS WORK. HORMONE-PRODUCING CELLS ARE FOUND ALL
AROUND THE BODY, MANY IN GLANDS THAT HAVE SPECIALIZED FUNCTIONS.
THYROID
Thyrotropin-releasing hormone
from the hypothalamus controls
the release of thyroid-stimulating
hormone (TSH). This encourages
the thyroid to become more active
Vein
and affects metabolism.
Testis Ovary
BONE AND GENERAL GROWTH SEX GLANDS
Growth hormone (GH) acts on the Luteinizing hormone (LH) and
whole body to promote protein follicle-stimulating hormone (FSH)
manufacture, bone growth, and trigger the sex glands to make
building of new tissues throughout their own hormones, and also to
life, but is especially important for produce ripe egg cells in females
development in children. and mature sperm cells in males.
134
HORMONE PRODUCERS
Neurosecretory cell
Specialized nerve cells
in the hypothalamus
produce antidiuretic
hormone (ADH) and
oxytocin; these hormones
flow through cell fibers
(axons) to the posterior
lobe of the pituitary
Hypothalamus
KIDNEY TUBULES
Axon Antidiuretic hormone (ADH), also
known as vasopressin, controls the
amount of water removed from
Pituitary stalk
the blood by the microfilters
(nephrons) in the kidneys. It also
helps constrict small arteries when
blood pressure falls.
Artery
PITUITARY VESSELS AND NERVES
The pituitary attaches to the hypothalamus by a short
stalk. The anterior lobe receives a blood supply from
the hypothalamus, while the posterior receives blood
directly from the heart. Interaction between the
hypothalamus and pituitary links the nervous and
endocrine systems. This diagram shows the targets
Posterior lobe for pituitary hormones.
of pituitary
Stores hormones produced
by neurosecretory cells in KEY TO ARROWS
hypothalamus, and releases
them as needed Melanocyte-stimulating
hormone (MSH)
Adrenocorticotropic
hormone (ACTH)
Thyroid-stimulating
hormone (TSH)
Growth hormone (GH)
UTERINE MUSCLES AND Luteinizing hormone (LH) and
MAMMARY GLANDS follicle-stimulating hormone (FSH)
Oxytocin stimulates
contractions during labor Oxytocin
and—together with prolactin Antidiuretic hormone (ADH)
from the anterior pituitary—
triggers the release of milk Prolactin
from the mammary glands.
135
ENDOCRINE SYSTEM
PANCREAS
The pancreas is a dual-purpose gland. It Another hormone, glucagon, is produced by
produces digestive enzymes in cells called alpha cells and has opposing actions, raising
acini, but also has an endocrine function. blood glucose levels. Delta cells make
Within the acinar tissues are cell clusters somatostatin, which regulates the alpha and
known as islets of Langerhans, which beta cells.
produce hormones involved in controlling Delta Beta
glucose (blood sugar), the body’s main cell cell Duct
energy source. Beta cells make the hormone
insulin, which promotes glucose uptake by
body cells and speeds conversion of glucose
into glycogen for storage in the liver. In this
way, insulin lowers blood glucose levels.
PANCREAS
PANCREATIC ISLETS
Surrounded by enzyme-producing acini cells, the tiny
pancreatic islets contain three types of cells: alpha,
beta, and delta. The secretions of the latter help Islet of Alpha Acini cells
regulate insulin and glucagon production. Langerhans cell
Blood
ADRENAL GLANDS vessel
The inner layer (medulla) and
Cortex
outer layer (cortex) of the adrenal
gland secrete different hormones.
Medulla
The cortical hormones are
steroids (see p.139) and include Pad of
fat
glucocorticoids, such as cortisol,
Kidney
which affect metabolism;
mineralocorticoids, such as
aldosterone, which influence
salt and mineral balance; and
gonadocorticoids, which act
on the ovaries and testes. The
medulla functions as a separate
ADRENAL ANATOMY
gland. Its nerve fibers link to the Each adrenal gland is shaped like a cone or pyramid and sits
sympathetic nervous system, on top of the kidney, cushioned by a pad of fat. The glands
and it makes the fight-or-flight consist of two parts: the cortex, with three layers, and the
hormones, such as epinephrine. medulla, containing nerve fibers and blood vessels.
136
FRONT VIEW BACK VIEW
HORMONE PRODUCERS
THYROID AND
PARATHYROID GLANDS
The thyroid is located in the front
of the neck, and has four tiny
parathyroid glands embedded
Thyroid Superior
at the back. The hormones it cartilage parathyroid
produces have wide-ranging effects glands
on body chemistry, including the Thyroid
gland
maintenance of body weight, the
rate of energy use from blood
Inferior
glucose, and heart rate. Unlike other parathyroid
glands, the thyroid can store its Trachea glands
hormones. The parathyroids make
parathormone (PTH), which
increases the levels of calcium in THYROID PARATHYROIDS
the blood. PTH acts on bones to The thyroid wraps around the The small parathyroid glands
upper windpipe (trachea). It are set into the rear corners
release their stored calcium, on
produces two hormones of the thyroid’s lobes, at the
the intestines to increase calcium that regulate the body’s back of the trachea. There are
absorption, and on the kidneys metabolism: thyroxine (T4) usually four, but their number
to prevent calcium loss. and triiodothyronine (T3). and exact locations vary.
HORMONAL TRIGGERS
Various stimuli cause an endocrine gland hormone (ACTH), released by the pituitary
to release more of its hormone. In some on cue from the hypothalamus, and
cases, the gland responds to the level of by nerve impulses direct from the
a certain substance in the blood, using hypothalamus. The pea-sized pineal gland,
a feedback loop (see opposite). In near the center of the brain, is triggered by
other cases, there is an intermediate darkness to release the sleep hormone
mechanism, such as the hypothalamus– melatonin. Pineal activity is inhibited by
pituitary complex. The adrenal gland is light, which is detected by the eye and sent
controlled both by adrenocorticotropic to the gland as a series of nerve impulses.
Hypothalamus
Receives information
Blood vessel from monitoring cells
Blood calcium that track levels of
level detected sex hormones; produces
gonadotropin-releasing
Thyroid hormones
Calcitonin lowers
blood calcium
Parathyroid
Parathormone raises Pituitary
blood calcium Stimulated
to release
gonadotropins
Hormone release
Nucleus
Action
Complex affects
inside cell
genes that
Biochemical
produce enzymes
action triggered
DNA
FEEDBACK MECHANISMS
Hormone levels are controlled by feedback complex (as with the thyroid hormones,
mechanisms, or loops. The amount of a see below). If a hormone level is too
hormone in the blood is detected and high, the control unit reduces hormone
passed on to a control unit, which in many production. If the level is too low, the
cases is the hypothalamus–pituitary control unit stimulates production.
Hypothalamus
Receives messages Hypothalamus
about blood levels of Detects rising blood
thyroid hormones, levels of thyroid
makes TRH hormones; produces
less TRH for pituitary
PITUITARY TUMORS
The central role of the pituitary in the endocrine
PROLACTINOMAS
system is reflected in the problems caused by a About 40 percent of pituitary tumors are
pituitary tumor, which may grow in any part of prolactinomas—slow-growing, noncancerous
the gland; those in the anterior lobe are more tumors that cause the anterior lobe to secrete
likely to be benign (noncancerous). One result excessive prolactin. Normally this hormone
promotes breast development and milk
may be excess growth hormone, which causes
production in pregnancy. Symptoms of excess
enlargement of certain bones, such as those in
prolactin include irregular periods and lowered
the face, hands, and feet, and of some tissues,
fertility in women; breast enlargement and
such as the tongue, as well as the development impotence in men; and fluid leakage from the
of coarse body hair and deepening of the voice. nipples, along with reduced sexual desire. In
This condition is known as acromegaly. Some most cases, medication helps shrink the tumor
tumors cause excessive prolactin secretion and reduce prolactin output; otherwise, surgery
or overstimulate the adrenal cortex. or radiation therapy may be necessary.
PITUITARY TUMOR
An enlarging tumor may press
on the optic nerves that pass just
above it, causing headaches and
visual disturbances, such as losing
part of the visual field.
Anterior cerebral
artery
Compressed
optic nerve
Pituitary
gland
NORMAL ABNORMAL
Exophthalmos
Eyeball is forced
forward; appears
unusually
Normal eye
prominent
Eyeball sits
neatly in
socket
Normal eye
position
Swollen tissue
Causes eyeball
to protrude
HYPOTHYROIDISM
In hypothyroidism, the thyroid hormones, tri- considerably as a lump, or goiter, in the neck.
iodothyronine and thyroxine, are underproduced. A less common cause of hypothyroidism is a lack
Because these hormones govern the speed of of the mineral iodine—needed to make the
many metabolic processes, a lack of them leads thyroid hormones—in the diet. A rarer possibility
to a slowing of bodily functions. Symptoms is damage to the pituitary gland by a tumor.
of hypothyroidism include fatigue, weight gain,
GOITER
slow bowel activity and constipation, swollen face,
A swollen
puffy eyes, thickened skin, thinned hair, hoarse thyroid (goiter)
voice, and inability to cope with cold. may be due to
The most common cause of hypothyroidism thyroiditis,
is inflammation of the thyroid gland due to hyperthyroidism,
hypothyroidism,
an autoimmune condition called Hashimoto’s
thyroid nodules,
thyroiditis, in which antibodies mistakenly or cancer of the
damage the gland. The thyroid gland may swell thyroid.
141
DIABETES MELLITUS
ENDOCRINE SYSTEM
THE MAIN ENERGY SOURCE FOR CELLS IS GLUCOSE, WHICH THE CELLS ABSORB FROM THE BLOOD
WITH THE HELP OF THE HORMONE INSULIN. IN DIABETES MELLITUS, THIS PROCESS DOES NOT
WORK PROPERLY. THERE ARE TWO MAIN TYPES OF DIABETES MELLITUS: TYPE 1 AND TYPE 2.
TYPE 1 DIABETES
Type 1 diabetes mellitus is an autoimmune hunger, frequent urination, fatigue, blurred vision,
disorder. It occurs when the immune system and weight loss. If untreated, the disorder can
misidentifies beta cells in the islets of Langerhans cause ketoacidosis, in which toxic chemicals
in the pancreas as foreign and destroys them. called ketones build up in the blood. Affected
The cause is unknown, but the disease may be people need urgent medical attention; otherwise
triggered by a viral infection or inflammation in they can fall into a coma. There can also be
the pancreas. It usually develops in childhood or long-term complications (see Type 2 diabetes,
adolescence. Symptoms include thirst, dry mouth, opposite). Treatment involves insulin injections.
Beta cells
Insulin-producing
cells Damaged
beta cells
Insulin-
producing cells
destroyed
DAMAGED BETA CELLS
If the beta cells are damaged, they cannot produce Capillary
insulin. As a result, body cells cannot take up glucose, No insulin
and blood glucose levels rise too high. The lack of is secreted
into capillaries
insulin allows the alpha cells to produce more
glucagon, which raises blood glucose levels
still further.
Receptor
Insulin binds to
receptor, Resistant
“unlocking” cell receptor
Cell receptors
Signal do not allow
Passes to cell insulin to bind
nucleus, to them
triggering
transporters
Nucleus
CARDIOVASCULAR ANATOMY
THE CIRCULATORY (OR CARDIOVASCULAR) SYSTEM DELIVERS
OXYGEN AND NUTRIENTS TO VIRTUALLY ALL BODY CELLS, AND
REMOVES CARBON DIOXIDE AND OTHER WASTES FROM THEM.
Cerebral vein, or
The circulatory system comprises sagittal sinus
the heart, blood vessels, and blood. Angular vein
Temporal artery
Working as a pump, the heart beats Superficial temporal vein
regularly to send oxygen-rich blood Maxillary artery
into tough, elastic tubes called Facial vein
arteries, which convey the blood Facial artery
Internal jugular vein
around the body. The arteries divide Common carotid
External jugular vein
into tiny capillaries, the walls of artery
Thyroid vein
which are so thin that oxygen, Axillary artery
nutrients, and other substances can Subclavian vein
Pulmonary
Axillary vein
pass through to surrounding cells veins (red)
Superior vena cava
and tissues. Waste products flow Aorta
Brachial
from the tissues and cells into the artery Cephalic vein
blood for disposal. The capillaries Pulmonary
Gastric arteries (blue)
join and enlarge to form veins, which artery
take blood back to the heart. In the Heart
Common
figure shown here, vessels carrying hepatic artery Brachial veins
oxygenated blood (usually arteries) Descending aorta
Common iliac
appear red and those carrying artery
deoxygenated blood (usually veins) Renal artery
are blue. This intricate network is Ulnar artery Inferior vena cava
some 90,000 miles (150,000 km) Basilic vein
long—almost equivalent to four Radial artery Superior
times the circumference of the mesenteric artery
Interosseous
Earth. arteries Ulnar veins
Radial veins
Common iliac vein
Dorsal carpal artery Venous
Palmar carpal arteries network
of the hand
Palmar arches
Palmar
venous arch
Venous network
Perforating arteries
of the knee
Popliteal vein
Descending
genicular artery Perforating veins
Popliteal artery
Peroneal veins
147
CARDIOVASCULAR SYSTEM
BLOOD AND BLOOD VESSELS
BLOOD IS A COLLECTION OF SPECIALIZED CELLS SUSPENDED IN A STRAW-COLORED
LIQUID CALLED PLASMA. FLOWING AROUND THE BODY, BLOOD CARRIES OXYGEN
AND NUTRIENTS, COLLECTS WASTE, DISTRIBUTES HORMONES, AND SPREADS HEAT.
WHAT IS BLOOD?
An adult has about 11 pints (5 liters) of Gamma globulins are mostly the disease-
blood. Roughly 50–55 percent of blood fighting substances known as antibodies.
is plasma, 90 percent of which is water. The remaining 45-50 percent of blood is
Plasma contains dissolved substances made up of three types of specialized cells.
such as glucose (blood sugar), hormones, Red blood cells or erythrocytes carry
enzymes, and also waste products such as oxygen; various white blood cells,
urea and lactic acid. Plasma also contains known as leukocytes, are part of the
proteins such as albumins, fibrinogen defense system; and platelets or
(important in clotting), and globular thrombocytes, which are tiny
proteins or globulins. Alpha and beta fragments of much larger
globulins help transport lipids, which are cells, are involved in the
fatty substances such as cholesterol. process of clotting.
Free oxygen molecule Cytoplasm Cell
(dissolved in blood plasma) membrane
Heme molecule,
including iron atom
Blood travels
to lungs
OXYHEMOGLOBIN
DEOXYHEMOGLOBIN
Globin
chain of
protein
VEINS
A vein is more flexible than an artery and
its walls are thinner. The blood inside a vein
is under relatively low pressure, and flows
slowly and smoothly. Many larger veins,
particularly the long veins in the legs, contain
valves that prevent the backflow of blood,
a job helped by muscles
Outer layer around the veins that
contract during movement.
Inner lining
VEIN SECTION
Valve cusp, The muscle layer of a vein is thin
or leaflet
and enclosed by two layers; the
White blood cell innermost layer of some veins has
Also called Muscle layer valves at regular intervals.
leukocytes, white
blood cells are a
vital part of the
body’s defense CAPILLARY BED
system CAPILLARIES Capillaries link small
The smallest and most arteries (arterioles)
Platelet numerous of the blood to veins (venules).
Tiny, short-lived cell
fragment that has an vessels, capillaries convey Arteriole
important role in the blood between arteries and Carries blood Capillary
clotting of blood rich in oxygen
veins. A typical capillary Venule
Contains blood
Red blood cell
is about 1/2,500 in (0.01 mm) low in oxygen
Red blood cells in diameter, only slightly
(erythrocytes) have Capillary wall
wider than a red blood cell.
a lifespan of about Cell nucleus
3 months Many capillaries enter
tissue to form a capillary CAPILLARY WALL
Blood vessel wall The thin capillary
The thickness of the bed, where oxygen and
wall allows easy
wall is dependent other nutrients are released, movement of
on the pressure of
blood flowing
and where waste matter substances between
through it passes into the blood. surrounding tissues.
149
CARDIOVASCULAR SYSTEM
HEART STRUCTURE
THE HEART IS A POWERFUL ORGAN ABOUT THE SIZE OF A CLENCHED FIST. LOCATED
JUST TO THE LEFT OF CENTER BETWEEN THE LUNGS, IT OPERATES AS TWO
COORDINATED PUMPS THAT SEND BLOOD AROUND THE BODY.
HEART STRUCTURE
vena cava The largest artery in the
Vein carrying body; carries oxygenated
deoxygenated blood to organs and tissues
blood from the
upper body Pulmonary artery
Divides into the right and
left pulmonary arteries
PULMONARY
ARTERY
This is an inside view
of the pulmonary
artery, which carries
deoxygenated blood
to both lungs.
Left pulmonary
veins
Left atrium
Aortic valve
Controls flow from
left ventricle into
systemic circulation
Pulmonary valve
Controls blood flow
from right ventricle
Mitral valve
The left
Right atrioventricular valve,
pulmonary veins with two cusps
Carry oxygen-
rich blood from Left ventricle
the lungs to the
left atrium Septum
Muscular partition
Right atrium between the heart’s
two sides
Tricuspid valve
The right Myocardium
atrioventricular valve, Layer of cardiac
with three cusps muscle responsible
for the heart’s
Right ventricle contractions
Pericardium
Chordae tendinae Two-layered
membrane that
INSIDE THE HEART
Also known as
surrounds and The heart has four chambers. The lower
heart strings
protects the heart two (the ventricles) have thicker muscle
Inferior vena cava walls than the upper two (the atria).
One of the body’s Descending aorta
The septum, also mostly muscle, divides
two largest veins; Takes freshly
carries oxygen- oxygenated blood the heart’s two sides. The atria receive
depleted blood to the lower body blood from all parts of the body; the
from the lower body and legs ventricles pump blood into circulation.
151
CARDIOVASCULAR SYSTEM
HEART VALVES
The heart has four valves to control blood counterpart, the tricuspid valve, has three.
flow. Each has the same basic structure, The two semilunar valves are at the exits
although they differ in certain details. The from the ventricles: the pulmonary valve
two atrioventricular valves lie between the between the right ventricle and the
atria and ventricles. The mitral valve, on pulmonary artery, and the aortic valve
the left side, has two cusps, while its right between the left ventricle and the aorta.
Superior vena Pulmonary
cava Aorta artery
Left
atrium
Pulmonary
valve Left
ventricle
TWO CUSPS THREE CUSPS
Aortic
valve
PULMONARY
Right
VALVE
atrium
This valve lies
Mitral between the right
valve ventricle of the heart
and the pulmonary
Tricuspid
valve artery. It opens as
the right ventricle
Right contracts and
ventricle
forces blood out
of the heart toward
FUNCTION OF HEART VALVES the lungs.
The tricuspid valve controls blood flow from the
right atrium to the right ventricle; the pulmonary Direction of Blood at high
Blood
valve, from the right ventricle into the pulmonary blood flow pressure
pushes Blood
artery; the mitral valve, from the left atrium to the Valve cusp against Valve cusp at low
left ventricle; and the aortic valve, from the left open valve shut pressure
ventricle into the aorta.
MITRAL VALVE
This image of a
healthy human
heart valve shows
the heart strings
(chordae tendinae)
and valve cusps.
The mitral valve lies
between the left
atrium and the
left ventricle.
HEART VALVE OPEN HEART VALVE CLOSED
Cusp
The flexible cusps are Back pressure causes
forced apart by the the cusps to close and
Chordae pressure of blood as seal at their edges, to
tendinae
the heart contracts. stop reverse blood flow.
152
HEART STRUCTURE
CARDIAC MUSCLE
The walls of the heart are made of a
special type of muscle known as cardiac
muscle, which is found only in the heart.
Unlike other types of muscle, cardiac CARDIAC
muscle can contract repeatedly without MUSCLE TISSUE
Cardiac muscle is a
becoming tired. However, to maintain this
type of involuntary
constant activity, the muscle requires a muscle, with short,
continuous, ample supply of oxygenated branched, striated
blood, provided by the coronary arteries. muscle fibers.
Network of blood
vessels in right lung
Gas exchange takes place
in the lungs’ capillary
network: oxygen passes
into the blood, and
carbon dioxide passes out
Portal vein
Conveys
nutrient-rich
BLOOD FLOW AROUND THE BODY blood from
The body’s circulatory system consists intestines to liver
of two linked parts: the pulmonary
circulation to and from the lungs,
and the systemic circulation around Blood vessels Blood vessels Blood vessels in
the rest of the body. in liver in lower body digestive system
153
HOW THE HEART BEATS
CARDIOVASCULAR SYSTEM
The heart’s two lower chambers (ventricles) the heart relaxes and refills with blood;
have thick, muscular walls that contract to in the second phase (systole), it contracts,
squeeze blood into the arteries. The upper forcing the blood out. The whole cycle
chambers (atria) have thinner walls and act takes, on average, less than a second.
partly as reservoirs for blood entering from During activity or stress, both the beating
the main veins. Each heartbeat has two rate and the volume of blood pumped
main phases: in the first phase (diastole), out of the heart increase greatly.
Blood forced from Aortic valve opened Pulmonary valve Aortic valve closed
right ventricle into by ventricular closed by back- by back-pressure
pulmonary artery pressure pressure from artery from artery
Pulmonary
valve opened
by ventricular
pressure
Left atrium
relaxed
Atrium Blood forced
relaxes but from contracting Mitral
pressure rises ventricle into aorta valve open
due to the
contracting Right atrium
ventricle relaxed
pressing
Mitral valve forced shut
against its
by ventricular pressure
wall
Tricuspid
valve forced Tricuspid
shut by valve open
ventricular
pressure
Left
Taut heart ventricle Right ventricle
strings contracts relaxed
(chordae Right ventricle contracts from base Left ventricle
tendinae) from base upward upward relaxed
3 CONTRACTION OF THE
VENTRICLES (VENTRICULAR SYSTOLE)
During this most active and powerful stage of
4 RELAXATION (EARLY DIASTOLE)
The walls of the ventricles begin to relax,
causing ventricular pressure to reduce. The
the heartbeat, the thick cardiac muscle in the pressure of the recently ejected blood in the
ventricle walls contracts, stimulated by electrical main arteries is now high, so both the aortic
impulses relayed by the atrioventricular node. and pulmonary valves close. This prevents
This causes a rise in ventricular pressure, which backflow into the ventricles. As ventricular
opens the aortic and pulmonary valves at the pressure on the atrioventricular valves relaxes,
exits of the ventricles. Blood is forced out into the valves open. This reduces pressure in the
the main arteries, making the atrioventricular atria, allowing blood to enter once again from
valves snap shut. the main veins.
155
CARDIOVASCULAR SYSTEM CARDIOVASCULAR DISORDERS
DISORDERS OF THE CARDIOVASCULAR SYSTEM MAY AFFECT THE HEART ITSELF, CAUSING
STRUCTURAL DAMAGE OR DISRUPTING HEART RHYTHM. BLOCKAGES IN BLOOD VESSELS CAN
STARVE TISSUES OF OXYGEN, LEADING TO SERIOUS PROBLEMS ANYWHERE IN THE BODY.
HEART ATTACK
A heart attack (myocardial infarction) is the result must be restored to the damaged cells as quickly
of coronary artery disease due to atherosclerosis as possible. A heart attack usually occurs
(see opposite), and the subsequent formation of suddenly, with little or no warning. The chest pain
a blood clot, or thrombus. Once formed, the clot is usually severe, is not necessarily brought on by
can completely block blood flow to an area of exertion, and persists despite resting. A heart
heart muscle, starving it of oxygen and eventually attack can also cause sweating, shortness
causing tissue death. If possible, the blood flow of breath, nausea, and loss of consciousness.
Aorta Blood clot CORONARY THROMBOSIS
Superior Roughened Fat deposits (plaques) collect and
vena cava plaque may become roughened. Blood
Damaged
cells stick to the area, triggering
Pulmonary clot formation.
artery muscle
ENZYME RELEASE
Right
Narrowed The affected
coronary artery
artery Damaged muscle releases
Left main muscle enzymes that, if
coronary artery Enzymes measured by a
released blood test, indicate
Site of the extent of the
blockage damage.
MYOCARDIAL
INFARCTION DAMAGED
When a coronary Blood
HEART MUSCLE
artery becomes supply Cells deprived
blocked, cells of the blocked of oxygen and
heart muscle supplied nutrients rapidly
by that artery begin degenerate. If the
to die from lack of Necrotic blood supply is not
oxygen and nutrients (dead) muscle fibers restored quickly,
and the accumulation of the heart tissue
poisonous waste products. dies (necrosis).
ANGINA
Angina is caused by a temporarily inadequate large meal. An attack of angina typically begins
supply of blood to the heart muscle, usually with a heavy, constricting pain behind the
because of arterial narrowing as a result of breastbone. This can spread into the throat and
atherosclerosis (see opposite). The pain most often jaw, and down into the arms, especially the left
occurs when the heart’s workload is increased, for one. The pain usually subsides within about 10-15
example with exercise, and fades with rest. Other minutes. People with angina often take medication
triggers of angina are stress, cold weather, or a to dilate (widen) the coronary arteries.
156
CARDIOVASCULAR DISORDERS
ATHEROSCLEROSIS
The process that leads to atherosclerosis begins fatty cores within the arterial wall, covered by
with abnormally high levels of excess fats and fibrous caps. The plaques narrow the space within
cholesterol in the blood. These substances the artery, restricting the overall flow of blood to
infiltrate the lining of arteries, forming deposits tissues beyond the site. They also cause
known as atheroma. This can happen in any turbulence that disrupts the flow of blood, and
of the body’s arteries, including those supplying the eddies over the plaque surface make the blood
the brain with blood, when the result may be a more likely to clot. The major risk factors for
stroke. The atheromatous deposits gradually form atherosclerosis include smoking, a diet high in
raised patches known as plaques. These consist of saturated fats, lack of exercise, and excess weight.
Fibrous cap
Narrowed
arterial channel
Outer protective
layer of artery RESTRICTED BLOOD FLOW
Atherosclerosis can occur anywhere in the main coronary
Muscle layer arteries or their branches. However, plaque usually builds up at
of artery
points where the arterial wall is subject to turbulent flow, such
Inner lining as where an artery divides. The arterial wall at the site often
of artery becomes thickened as new muscle cells grow into the plaque.
Thrombotic
Embolus embolus
traveling to lung A fragment (embolus)
composed of blood
Pulmonary artery clot (thrombotic)
material may arise
anywhere, but veins
of the legs and pelvis
Path of embolus are common sites
THROMBOSIS
Thrombosis is the blockage of a blood
vessel by a blood clot. It is most likely
to occur where normal blood flow is
disrupted, which may be due to plaques of fatty
atheromatous tissue in the walls of an artery (see
p.157) or inflammation of the blood vessel. The Thrombus
clot eventually narrows or blocks the passage for blocking artery;
Fibrin thrombi can also
blood so that the tissues beyond are deprived of strands form in veins
oxygen and nutrients.
Lining
Platelet
Damage
THROMBUS from
FORMATION atheroma
Thrombosis can occur (plaque)
in arteries and veins,
but commonly
1 When an artery lining is
INTERNAL DAMAGE
happens at a site of
atherosclerosis in an damaged by rupture of a plaque, 2The chemicals help convert
CLOT FORMATION
artery wall, which platelets in the area clump fibrinogen into insoluble fibrin
disrupts the normal together and release chemicals strands, which trap blood cells,
blood flow. that begin the clotting process. escalating clot formation.
158
CARDIOVASCULAR DISORDERS
ARRHYTHMIA
An arrhythmia is a heart rate that is unusually slow These signals are relayed by the atrioventricular
or fast, or erratic. A normal heartbeat is initiated by (AV) node along nervelike fibers through the
specialized cells in the natural “pacemaker,” the septum (central dividing wall) and into the thick
sinoatrial (SA) node, at the top of the right atrium. muscle tissue of the ventricle walls. A fault in the
They send electrical impulses out through the system can lead to various arrhythmias, including
atrial muscle tissue, stimulating it to contract. those described here.
Circular
impulses
AV node Variable
blockage at Slowed
AV node conduction
through
SA node
damaged
Irregular area
impulses
Atrium
through Damaged
Ventricle atria heart
muscle
Very fast heartbeat Extremely rapid and Rapid heartbeat
irregular heartbeat
HYPERTENSION
Blood is under pressure as the heart pumps it to hypertension include certain genetic
around the circulation. In hypertension, this influences and diet and lifestyle factors, such
pressure is persistently above normal limits. as being overweight, drinking excessive amounts
There are no symptoms of hypertension at first, of alcohol, smoking, and having a high-salt diet.
but despite this, over time it increases the risk of Hypertension is most common in middle-aged
many serious disorders, such as stroke, heart and elderly people. A stressful lifestyle may
disease, and kidney failure. Contributing factors aggravate the condition.
RESPIRATORY ANATOMY
THE RESPIRATORY SYSTEM, IN CLOSE CONJUNCTION WITH THE CIRCULATORY SYSTEM, IS
RESPONSIBLE FOR SUPPLYING ALL BODY CELLS WITH ESSENTIAL OXYGEN AND REMOVING
POTENTIALLY HARMFUL CARBON DIOXIDE FROM THE BODY.
163
RESPIRATORY SYSTEM
LUNGS
THE TWO SPONGELIKE LUNGS FILL MOST OF THE CHEST CAVITY AND ARE PROTECTED
BY THE RIBS. THEIR ESSENTIAL FUNCTION IS GAS EXCHANGE—TAKING
IN VITAL OXYGEN FROM THE AIR AND EXPELLING WASTE CARBON DIOXIDE.
LUNG STRUCTURE
Air enters the lungs from the trachea, Right lung
which branches at its base into two main Like left lung, has ten
bronchopulmonary
airways, the primary bronchi. Each primary segments
bronchus enters its lung at a site called
the hilum, which is also where the main
blood vessels pass in and out of the lung. Superior lobe
The primary bronchus divides into Contains three
bronchopulmonary
secondary bronchi, and these subdivide segments
into tertiary bronchi, all decreasing in
diameter. Many subsequent divisions form
the narrowest airways: the terminal and Horizontal fissure
Between superior
then respiratory bronchioles, which and middle lobes
distribute air to the alveoli. of right lung
ALVEOLI
The lungs’ microscopic air sacs, known as alveoli, are
elastic, thin-walled structures arranged in clumps at
the ends of respiratory bronchioles. Around the alveoli
are networks of capillaries. Oxygen passes from the air
in the alveoli into the blood by diffusion through the
alveolar and capillary walls (see p.166). Carbon
dioxide diffuses from the blood into the alveoli. There
are more than 300 million alveoli in both lungs,
providing a huge surface area for
gas exchange.
Terminal
bronchiole
Single
alveolus
Smooth muscle
Group of alveoli
fiber
Consists of partly
merged alveoli
Respiratory
bronchiole
Pulmonary arteriole
Brings used, oxygen-poor
Elastic fiber blood to alveoli
Secondary
(lobar) bronchus
One of two
airways, each
supplying a
lobe of left lung
Tertiary
(segmental)
bronchus
One of ten smaller
airways; aerates a
bronchopulmonary
segment
Pulmonary arteries
Bring deoxygenated
blood from heart
Pulmonary veins
Send oxygenated,
bright red blood
to heart
Terminal bronchioles
Tiny airways—about
30,000 in each lung;
next-to-last divisions
of segmental bronchi
Base
Middle lobe Pleural membranes Upcurved to
Contains two Two membranes that accommodate
bronchopulmonary cover each lung: visceral diaphragm below
segments pleura wraps directly
around lung; parietal Cardiac notch
pleura lines chest; Space taken Superior Oblique Inferior
separated by fluid up by heart lobe fissure lobe
GAS EXCHANGE
RESPIRATORY SYSTEM
THE BODY CANNOT STORE OXYGEN AND NEEDS CONTINUING SUPPLIES. IT ALSO
CONSTANTLY PRODUCES CARBON DIOXIDE AS A WASTE PRODUCT. GAS EXCHANGE
SWAPS OXYGEN AND CARBON DIOXIDE IN THE LUNGS AND TISSUES.
Deoxygenated Oxygen is
Oxygen is drawn into the body blood returns drawn into
by the expanding lungs. When from tissues trachea
it reaches the end of the lungs’ to heart
2
Heart pumps Oxygen-rich
Oxygen
deoxygenated blood returns
enters blood into
Blood to heart
Fluid-lined blood plasma lungs
alveolus capillary inside capillary
(air sac) Oxygen-rich blood
leaves heart
4 Carbon dioxide
diffuses out of blood
plasma and enters air in
5 Oxygenated blood
leaves heart along
the aorta (the body’s
alveolus main artery) and
circulates to body tissues
Cell of capillary wall
Cell of alveolar wall
GAS EXCHANGE
THE BODY TISSUES
Oxygen levels are higher in the
blood than in surrounding BRONCHIOLE AND ALVEOLI
tissues. The difference in levels This microview shows a cross-
forces oxygen to break its bonds sectioned bronchiole (red)
to the hemoglobin in red blood surrounded by alveoli that have
cells and diffuse out of the been cut through, so that they
blood into the adjacent cells. resemble air bubbles in a sponge.
The reverse applies to carbon
dioxide, which diffuses from the
tissue into the blood plasma.
7 Arriving red blood
cells are rich in
oxygen, which is bound
8 Oxygen leaves the
hemoglobin within
the blood cells, and
9 Carbon
dioxide
diffuses out of
to hemoglobin in the diffuses across capillary tissue cells, across
body of each cell walls and into tissue cells wall of blood
6 Oxygenated blood is
carried through tissues in
capillaries thinner than hair
capillary, and into
blood plasma
Capillary
Red blood
cell
Capillary
bed running
through
tissue
RESPIRATORY SYSTEM
BREATHING AND VOCALIZATION
THE MOVEMENTS OF BREATHING, ALSO KNOWN AS RESPIRATION, BRING FRESH
AIR CONTAINING OXYGEN DEEP INTO THE LUNGS AND THEN REMOVE STALE AIR
CONTAINING THE WASTE PRODUCT CARBON DIOXIDE.
BREATHING INHALATION
The movement of air into and out of The chief muscles used in respiration at rest
the lungs is generated by differences in are the diaphragm at the base of the chest
pressure within the lungs compared to the and the external intercostals between the
surrounding atmospheric pressure. These ribs. For forceful inhalation, additional
differences are produced by forcefully muscles assist in moving the ribs and
expanding the lungs by muscular sternum to expand the chest further and
action, and then passively allowing stretch the lungs even more.
them to return to their former
size. The rate and depth of Sternocleidomastoid
Pulls collarbone (clavicle)
breathing can be consciously and sternum up to enlarge
modified. However, the upper chest cavity
underlying need to breathe
is controlled by an area of Scalenes
the brain where responses Three scalene muscles
help elevate the
to regulate the breathing uppermost two ribs
muscles occur according
to the levels of carbon
Pectoralis minor
dioxide and oxygen Pulls up the third,
in the blood. fourth, and fifth ribs
Lung
Expands as
diaphragm pulls
down and ribs
move up and out
External
intercostals
Narrow the
gaps between
ribs, making
them swing
up and out
Diaphragm
Contracts and
becomes flatter
to stretch lungs
downward
Ribs
Tilt up and
out to expand
chest
168
Chest cavity expands as
DIAPHRAGM MOVEMENT
The abdominal contents (dark area
at the bottom of this X-ray) are
flattened by the diaphragm muscle
during inhalation (left) and then rise
up during exhalation (right).
EXHALATION
Breathing out is largely passive.
Like a stretched elastic band,
the enlarged lungs recoil and
shrink when the diaphragm,
intercostals, and other inhalation
muscles relax, and abdominal Trachea
Stiff cartilage rings keep
pressure pushes the diaphragm
airways open under
upward. Forced expiration brings negative pressure
further muscles into play, to
actively compress the lungs Sternum
Moves down
beyond their usual and inward as
resting volume. ribs return to
resting position
Lung
Shrinks with
diminishing
chest cavity
volume Internal
intercostals
Pull ribs
down for
forced
exhalation
Diaphragm Ribs
Relaxes and Are drawn in
pushes up and tilt down
into dome
shape
Rectus
abdominis
Pulls on ribs
five to seven
and sternum,
to depress rib
cage and assist
expiration
169
RESPIRATORY SYSTEM
VOLUME AND PRESSURE
Breathing alters the volume of the chest and volume increase automatically if
(thoracic cavity). The lungs “suck” onto the body needs more oxygen, as during
the inner chest wall, so that as the cavity exercise. Then forced inspiration can suck
expands, they also become larger. The in an extra 70 fl oz (2 liters), and forced
main expanding forces are provided by expiration expels almost as much, leading
the diaphragm and intercostal muscles. to a total air shift, or vital capacity, of more
At rest, the diaphragm carries out most of than 150 fl oz (4.5 liters) in a large, healthy
the work, as 17 fl oz (0.5 liters) of air—the adult. The breathing rate can triple,
tidal volume—shifts in and out with each producing a total air exchange more
breath (12 to 17 times every minute). Rate than 20 times greater than at rest.
Sternum Sternum
rises lowers
Lung Lung
volume volume
increases decreases
Ribs move
up and out
Ribs move
down and in
Diaphragm
flattens
Diaphragm
rises
INHALING EXHALING
The diaphragm contracts to become less domelike, The diaphragm relaxes, and the elastic, stretched
while the ribs swing upward and outward with a lungs recoil to become smaller again, allowing the
“bucket handle” action to raise the sternum. sternum and ribs to move down and inward.
Thoracic Thoracic
space space
increases decreases
Pressure Pressure
inside inside
falls rises
Diaphragm Diaphragm
lowers rises
COMMON COLD
The common cold is one of the most discharge that may later become
frequently experienced illnesses but thicker and greenish yellow, a
also generally one of the less serious. headache, slightly raised temperature,
At least 200 different and highly and perhaps a sore throat, cough, and
contagious types of virus can cause the reddened eyes. Antibiotic drugs are
problem. They spread in fluid that ineffective because they do not work
floats through air, in tiny droplets of against viruses. Cold viruses change
mucus coughed or sneezed out by (mutate) so rapidly that even if
people with colds, and also in films of antiviral drugs could be made to tackle
moisture transferred from person to existing strains, they would be
person by close contact, such as ineffective against the new ones. Most SPREADING INFECTION
shaking hands, or via shared objects, cold remedies, such as decongestants Coughs and sneezes can
rapidly spread common
such as cups. Symptoms involve and inhalants, treat the symptoms
cold viruses by spraying
frequent sneezing, a runny nose, while the body’s immune system them up to 10ft (3 m) in
which at first runs with a clear, thin attacks the invading microbes. mucous droplets.
1 VIRUS
INVADES CELLS 2 WHITE CELLS
ARRIVE Lymphocyte
Virus particles in air Defensive white (white blood
land on and invade blood cells squeeze cell)
the cells lining the out of capillaries
nose and throat. toward the infected Red
They rapidly lining cells, which blood
replicate, killing are producing cell
their host cells. Multiplied virus particles thin mucus.
B-cell
releases
3 ANTIBODY
PRODUCTION
antibodies 4 Other white
CLEARING UP
Phagocyte engulfs
White blood cells blood cells called dead viruses
known as B-cells phagocytes engulf
produce antibodies, virus particles,
which immobilize the damaged nasal
virus; other white Antibody lining cells, and
blood cells destroy T-cell releases other debris. The Phagocyte
infected cells. defensive chemicals cold subsides. engulfs cell debris
172
RESPIRATORY DISORDERS
INFLUENZA ACUTE BRONCHITIS
Influenza is primarily an upper respiratory tract Bronchitis is inflammation of the larger airways
infection, but it also has body-wide symptoms: (bronchi) in the lungs. The disorder may be a
raised temperature, sensations of being hot complication of a respiratory infection. Its
and sweaty and then cold with shivers, muscle acute form develops rapidly, with symptoms
aches, and exhaustion. Even after the main including a sputum-producing cough, tight
infection has cleared up, there may be chest, wheezing, and mild fever. Healthy
lingering depression and fatigue. The influenza adults usually recover in a few days.
viruses are coded A, B, and C and are very Lumen Lining Stiff, cartilaginous Thick
contagious. Influenza A tends to produce (inner tissue tissue mucus
regular outbreaks and can also affect domestic space) Narrowed Inflamed
Mucus lumen lining
animals such as pigs, horses, and fowl.
Influenza B usually causes more sporadic
outbreaks in places where many people gather
and interact. Influenza C is less likely to
produce serious symptoms. The type A virus is
most likely to change or mutate. People at risk
of dangerous complications, such as the very
young or elderly, can be vaccinated before the NORMAL BRONCHUS INFLAMED BRONCHUS
The airway lining secretes The airway lining swells
main risk time of the winter season. Because a thin layer of mucus. The and produces excess
the virus can mutate, new vaccines are passageway (lumen) mucus, which may be
prepared annually. allows free air flow. coughed up.
ASTHMA
Asthma is an inflammatory lung disease that The narrowing is worsened by the secretion of
causes recurrent attacks of breathlessness and excess mucus. Most cases develop in childhood
wheezing due to narrowed airways. Some people and may be linked to allergy-based problems
have the occasional slight episode; others are prone such as eczema. In many children, the trigger
to severe and even life-threatening attacks. The for an attack is an allergic reaction to a foreign
muscle in the walls of the airways contracts substance, such as inhaled particles of pollen,
spasmodically, causing constriction of the tubes. animal hair, or house dust mite droppings.
Relaxed Contracted
Blood smooth Blood smooth
vessel muscle vessels muscle
widen
Mucus
Inflammation
Increased and swelling
mucus
SPREADING
CANCER CELLS Brain
Tiny airborne metastasis
carcinogenic particles
lodge in the airways
and contribute to
the development of
Primary Lymph node
cancerous cells.
tumor metastasis
Some of these cells
may break away and
travel in the blood
or lymph to trigger
secondary tumors. Bone
metastasis
Adrenal
White gland
blood cell metastasis
Liver
metastasis
CHRONIC BRONCHITIS
In chronic bronchitis, the main airways leading is troublesome mostly in damp, cold months but
to the lungs, the bronchi, become inflamed, then persists throughout the year. Symptoms such
congested, and narrowed due to irritation caused as hoarseness, wheezing, and breathlessness also
by tobacco smoke, frequent infections, or develop. Eventually a person becomes short of
prolonged exposure to pollutants. The inflamed breath even at rest. If a secondary respiratory
airways begin to produce too much mucus infection develops, the sputum may change
(sputum), resulting in a typical cough that at first appearance from clear or white to yellow or green.
EMPHYSEMA
In emphysema, the air sacs (alveoli) become reduced. Most people affected by emphysema
overstretched. They rupture and merge, which are long-term heavy smokers, although a rare
reduces their oxygen-absorbing surfaces and makes inherited condition called alpha1-antitrypsin
gas exchange less efficient. Air also becomes deficiency can also cause the disorder. The lung
trapped inside them, the lungs over-inflate, and the damage is usually irreversible, but giving up
volume of air moving in and out of the lungs is smoking may slow the progression of the disease.
SKIN STRUCTURE
The skin is not just a thin, waterproof
covering but a complex organ consisting of
a variety of specialized cells. The skin’s
thickness varies from about 1/50 in (0.5 mm)
on delicate areas such as the eyelids, to
1/
5 in (5 mm) or more on areas of wear and
tear, such as the soles of the feet. Skin has
two main layers: the outer epidermis, the
main function of which is protection, and
the underlying dermis. The dermis
contains thousands of sensors that are
sensitive to touch. It also contains sweat
glands and blood vessels, which play a
vital role in temperature regulation. Under
SKIN SECTION
This micrograph shows three hair follicles and the dermis is a layer known as subcutaneous
globules of sebum in the dermis (blue), with fat. This acts as a buffer and provides
the thin epidermis (purple) on top. insulation against extreme heat and cold.
SKIN RENEWAL
The epidermis continually renews and
replaces itself. The basal layer consists Surface layer cell
of boxlike cells that multiply quickly and Dead, flattened
cell completely
are gradually pushed up to the surface filled with keratin
by new cells forming below. As the cells
Granular cell
move upward, they develop tiny prickles A cell containing
that bind them together. They then flatten granules of the
and fill with a waterproofing protein called protein keratin
keratin. Finally, the cells die, and reach
the surface resembling interlocking roof Prickle cell
tiles. As they flake away with wear and A many-sided
cell that binds
tear, more cells arrive to replace them. closely with its
neighbors
EPIDERMAL LAYERS
The procession of skin cells from base to surface
Basal cell
creates four layers (five in areas of great friction, A specialized cell
such as the palms and soles) in the epidermis. that multiplies
As each cell moves upward, it fills with keratin. continually
178
STRUCTURE OF SKIN
Epidermis
Outer protective
layer consisting
of tough,
flat cells
Dermis
Layer
containing
blood vessels,
glands, and
nerve endings
Subcutaneous fat
Acts as an insulator,
shock absorber,
and energy store
Hair bulb Hair follicle Sebaceous gland Sweat gland Arteriole Venule
Lowest part Pouch of Produces sebum Coiled knot of Supplies Carries
of hair, where epidermis at that protects hair tubes secreting oxygenated away
growth occurs root of hair and lubricates skin watery sweat blood waste
179
SKIN, HAIR, AND NAILS
SKIN REPAIR
If the skin surface is breached, contents Tissue-forming fibroblast cells collect
leak from damaged cells and stimulate in the area, as do white cells called
the repair process. Platelets in the blood neutrophils, which ingest cell debris and
and the blood-clotting protein fibrinogen foreign matter such as dirt and germs. The
together form a mesh of fibers that traps clot gradually hardens and expels fluid to
red cells as the beginning of a clot. become a scab, as the skin heals.
Epidermis
their contents. These components attract a clot. Fibroblasts multiply and migrate to
various defense and repair cells. the damaged area.
Scab
Plug of
Scar
fibrous
tissue
New
tissue
within the clot, which contracts and shrinks. which eventually detaches. A scar may remain,
New tissue begins to form beneath. but usually fades with time.
TEMPERATURE REGULATION
One of the skin’s functions is to help sweat, which evaporates, drawing away body
maintain a constant body temperature. heat. If the body is cold, the skin’s blood
If the body is too hot, blood vessels in the vessels narrow (vasoconstrict) to minimize
dermis widen (vasodilate) to allow extra heat loss, and sweating is reduced. Tiny
blood flow so more heat can be lost from hairs are pulled upright by the arrector pili
the surface, and sweat glands produce more muscles to trap an insulating layer of air.
Hair stands
more upright
Skin puckers to
form goose pimple Hair lies flatter
Minimal
Increased
sweating
sweating
Arrector pili
muscle Arrector pili
contracts muscle relaxes
DEEP-PRESSURE SENSOR
Pacinian corpuscles have a multilayered structure
and are the largest skin receptors, in some areas
being more than 1/25 in (1 mm) long.
182
SKIN AND EPITHELIAL TISSUES
SKIN MICRORECEPTORS TYPES OF SENSOR
Deformation of the layers within a receptor, and Each type of microsensor is set at a particular
expansion or contraction as a result of depth in the dermis that best suits its function. The
temperature changes, generate nerve impulses. largest receptors, Pacinian corpuscles, are located
The impulses travel along the receptor’s nerve at the deepest level, near the base of the dermis.
Sensors for light touch are located near or just
fiber, which joins with bundles of other fibers in
within the epidermal layer.
the deep dermis or tissue layers below. Most
receptors “fire” nerve signals infrequently and Free nerve endings
irregularly when not stimulated, increasing their Branching, usually
firing rate when the skin is touched. unsheathed sensors
of temperature, light
touch, pressure, and
pain. They are found
all over the body and
in all types of
connective tissue.
Ruffini corpuscle
Dermis Encapsulated receptor
Mix of collagen, elastin, in the skin and deeper
and other connective tissue that reacts to
tissue; houses most of continuous touch and
the touch receptors pressure. In joint
capsules, it responds
to rotational
movement.
Blood vessel
Brings nutrients and
Pacinian corpuscle
oxygen to the skin layers
Large, covered
and touch receptors
receptor located deep
in the dermis, as well
as in the bladder wall,
Nerve fiber and near joints and
Receptors’ nerve fibers muscles. It senses
gather into bundles; stronger, more
these convey signals sustained pressure.
to the main nerves
183
SKIN, HAIR, AND NAILS
EPITHELIUM
Epithelial tissue, also called epithelium, is membranes and are specialized for
an important structural element that acts protection, absorption, or secretion. They
as a lining or covering for other body do not contain blood vessels, and their
tissues. Epithelium can be classified cells are usually anchored to, and
according to the shape and layout pattern stabilized by, a basement membrane.
of individual cells (see opposite), and also There may be other cell types present,
by the arrangement of cells into one or such as goblet cells that secrete blobs of
more layers. Most epithelial tissues form mucus for release onto the surface.
PSEUDOSTRATIFIED
EPITHELIUM
This type of columnar epithelium Surface of
seems to be arranged in vertical layers. Cilia goblet cell
However, it actually consists of a
single layer of cells of varying shapes
and heights. The nuclei (control
centers) of the different cell types are
also at different levels, creating a
layered (stratified) effect. Taller cells TRACHEAL LINING
may be specialized into mucus-making The electron micrograph
shows cilia (green strands)
goblet cells or ciliated cells that trap
projecting from the epithelial
foreign particles. This type of cells of the trachea
epithelium occurs in the airway (windpipe). Mucus-secreting
linings, and in the excretory and male goblet cells between the cilia
reproductive passages and ducts. possess tiny microvilli (yellow-
brown).
Retina
EPITHELIUM IN THE EYE
The eye contains two types of
epithelium: simple epithelium
Cornea in the pigmented layer of the
retina, and stratified squamous
epithelium in the domed front
“window” of the cornea.
Features: Cells allow Features: Substances Features: Protect and Features: Layers of these
selective diffusion, or absorbed from one side of separate other tissues; cells may be infolded to
permeability, allowing the layer can be altered as may be topped with form pits, pockets,
certain substances to they pass through the cilia for movement of grooves, or ducts, as
pass, owing to thinness cytoplasm of the cuboidal fluid outside the cell or in sweat glands.
of the layer. cells, before leaving. microvilli for absorption.
185
SKIN, HAIR, AND NAILS
SKIN AND HAIR
DEFENSIVE FUNCTIONS
Skin is the body’s first line of defense SCALP HAIR
against potential harm. As such, it is well Head hairs help keep
equipped to prevent physical damage due rainwater from the scalp,
absorb or deflect some
to its supple, cushioned qualities. The
of the energy in impacts
epidermal cells that form skin’s outermost and blows, and shield
layers are tightly knit together but allow a the head from extremes
certain amount of pliability. The cells are of temperature.
almost entirely full of the tough protein
keratin, which resists attack by many
kinds of chemicals. The natural secretion
of sebum from the millions of sebaceous
glands, each associated with a hair follicle,
is slightly oily at body temperature and
spreads easily. It furnishes the skin with
partially water-repellent and antibiotic
qualities, inhibiting the growth of certain
microorganisms, and prevents hairs from
becoming too brittle.
Thick epidermis
THICKENED SKIN
Areas of skin subjected to Basal cell layer
regular pressure respond by
thickening their epidermis
for greater protection and
Dermis
buffering, as in this magnified
image of skin from the foot.
186
SKIN AND EPITHELIAL TISSUES
ULTRAVIOLET DEFENSES
The Sun’s rays include a spectrum of color
wavelengths, as well as infrared or IR rays and Surface Melanin
ultraviolet, UV, rays. Both UV-A and UV-B Dead, flat cells granules
wavelengths are invisible, but exposure to the latter, Disperse in cell;
in particular, is linked to skin cancers. Skin’s defense cell flattens and
fills with keratin
is its dark pigment, melanin. This forms
a screen in the upper epidermis and shields the Dendrite
multiplying cells in the base of the epidermis. Cell projection
distributes
MELANIN PRODUCTION melanosomes
to nearby cells
Melanocytes are melanin-producing cells in the
base of the epidermis. They make parcels of Melanocyte
melanin granules, known as melanosomes, which Cell body makes
pass into surrounding cells. melanosomes
SKIN PIGMENTATION
Skin color depends on the type and pigment granules within organelles
quantity of two melanin pigments— called melanosomes. These move along
reddish pheomelanin and brown-black the dendrites and into nearby cells. Darker
eumelanin—in the epidermis, and on the skin has larger melanocytes with more
way the pigment granules are distributed. melanosomes. Lighter skin has smaller
Each melanocyte has fingerlike dendrites melanocytes and fewer melanosomes.
that touch surrounding cells (basal Exposure to UV rays stimulates the
keratinocytes). The melanocyte produces melanocytes so that the skin darkens.
COLOR VARIATION
Darker skin tends to have
larger melanin-making cells
with denser melanosomes, in DARK INTERMEDIATE LIGHT
comparison to lighter skin.
The former release their
Surface
pigment granules, while the Tilelike cells
latter’s granules stay clumped.
Upper
keratinocytes
Upper Contain little
keratinocytes spread-out
Have evenly melanin
spread melanin Melanosomes
Stay intact
Melanosomes
Release melanin Basal
granules keratinocytes
Basal keratinocytes Take up
Take up more fewer, lighter
melanosomes melanosomes
Melanocyte Melanocyte
Has many dendrites Has few
and is active dendrites; not
very active
187
SKIN, HAIR, AND NAILS SKIN DISORDERS
SKIN CONTAINS SOME OF THE FASTEST-MULTIPLYING CELLS IN THE BODY. SEVERAL OF ITS
DISORDERS, SUCH AS MOLES, RESULT FROM PROBLEMS IN THIS SELF-RENEWAL SYSTEM. THE SKIN
IS ALSO SUSCEPTIBLE TO INJURY, ALLERGIC REACTION IN THE FORM OF RASHES, AND INFECTIONS.
RASHES
Some skin rashes are localized, while others are It is often linked to allergic conditions such as
more widespread. Often, the cause of a rash is not asthma and rhinitis (hay fever). Impetigo is a
clear. The condition may affect quality of life and blistering of the skin caused by bacterial infection,
require long-term control with self-help measures typically through a cut, a cold sore (Herpes simplex
and medication. Psoriasis is a widespread, patchy virus), or scratched, weeping eczema. In vitiligo,
rash that flares up at intervals. Episodes may be the body makes antibodies that attack the skin’s
triggered by infection, injury, stress, or as a pigment-making cells, or melanocytes. It occurs in
side effect of drug treatment. Eczema is one of patchy areas over the body; in about one-third of
the most common rashes, especially in children. cases, the pigmentation spontaneously returns.
PSORIASIS ECZEMA
There are several types of psoriasis, mostly A typical eczema rash is inflamed and itchy, with small
characterized by intermittently itchy patches of red, fluid-filled blisters or episodes of dry, scaly, thickened,
thickened, scaly skin, as dead epidermal cells and cracked skin. Common sites are the hands and
accumulate. Common sites are the knees, elbows, creased areas of skin, such as the wrists, elbows, and
lower back, scalp, and behind the ears. knees. The condition is also known as dermatitis.
IMPETIGO VITILIGO
This bacterial infection is common on the face, most Depigmented patches of skin develop over months
often around the nose and mouth. The skin develops or years, especially on the face and hands. The
fluid-filled blisters, which burst. This stage is followed areas are more distinct in people with dark skin.
by redness, weeping, and crusting that may itch. They do not carry any medical risks to health.
188
SKIN DISORDERS
ACNE
In acne vulgaris, the sebaceous glands produce comedone, or pale, as a whitehead. A combination
an excessive amount of the oily-waxy secretion of trapped sebum, dead skin cells, and bacterial
sebum. This reacts in contact with air and forms infection inflame the area, and a pustule develops.
a plug in the skin pore, which may appear dark Acne is a common problem at puberty, when
with pigmentation (not dirt), as a blackhead or hormone surges cause increased sebum output.
Dark,
Hair pigmented
plug Plug
Sebum
Sebum Bacteria
flow
builds up build up
Sebum Sebum Sebum
Sebaceous Sebaceous Sebaceous
gland gland gland
Follicle Follicle Follicle
MOLE CYST
A mole, or nevus, is a localized overproduction The most common type of cyst is a sebaceous
and aggregation of the skin’s pigment cells cyst that forms in a hair follicle. A cyst contains
(melanocytes), with increased amounts of sebaceous secretions and dead cells, which are
melanin pigment. Moles are very common—most restrained in a strong, baglike capsule. Its surface
adults have 10–20 moles by the age of mound is usually smooth, and some cysts have
30 years. They can occur almost anywhere on the a paler or darker central region. Common sites
body and are variable in size, but usually less include the scalp, face, trunk, and genitals,
than 2/5 in (1 cm) across. Rarely, moles become although they can occur just about anywhere.
malignant (cancerous); any change in size or Treatment may be needed if the cyst becomes
appearance, itching, or bleeding should be enlarged, unsightly, painful, or infected.
discussed with a doctor.
Raised Cyst—collection of
epidermis sebum and dead cells
193
LYMPH AND IMMUNITY
IMMUNE SYSTEM
THE COMPLEXITIES OF THE IMMUNE SYSTEM CREATE THE CONDITION OF IMMUNITY,
IN WHICH, AFTER THE FIRST ATTACK BY A PARTICULAR TYPE OF MICROORGANISM,
THE BODY IS PROTECTED OR RESISTANT TO FUTURE INVASIONS.
LYMPH NODES
The lymph nodes produce and harbor (vessels) bring lymph to a node, while a
lymphocytes that protect the body from larger vessel carries it away. The nodes filter
disease. They are scattered throughout and clean the lymph, which then drains into
the body and are also concentrated in the venous bloodstream. Lymph vessels
groups (see p.192). Small lymphatics have valves so the fluid flows only one way.
INSIDE A NODE Incoming lymph Trabecula
A lymph node, or vessel Divides the
gland, is a mass of One of several node into
segmented lymphatic vessels that transport segments
tissue covered in a lymph into the node
fibrous capsule. It Capsule
contains sinuses, Dense meshwork of
where many fibers that surrounds
scavenging white node
blood cells, called
macrophages, ingest
Germinal center
bacteria as well as Lymphocytes multiply
other foreign matter. and partly mature here
Lymph nodes vary
in diameter from Sinus
1
/25 to 1 in (1–25 mm), Wide channel where
although they lymph slows so Incoming blood
can swell during macrophages can attack supply artery
infection or illness. intruders
Outgoing lymph vessel Vein for
Filtered lymph is carried outgoing blood
away by only one vessel
Capillary Skin wound Microbes White cells Defense chemicals White cell
attempt to squeeze out diffuse from capillary engulfs microbes
invade and of capillary
multiply
LOCAL INFECTION
If harmful microbes enter body especially if the surrounding tissues Pus Cavity
tissues, both the inflammatory have no flexibility—for example, Abscess
and immune responses act swiftly in a dental abscess.
to limit their spread. White blood
cells, fluids, microbes, toxins, and
DENTAL ABSCESS
debris accumulate as pus. An
Microbes enter through a region
abscess forms if the pus gathers
of decayed enamel and dentine,
in a localized area, putting
infect the pulp, and spread into
pressure on surrounding the root, where pus collects. As
structures. This may cause pus presses on the pulp nerves,
discomfort and pain, it causes the pain of toothache.
195
LYMPH AND IMMUNITY
SPECIFIC RESPONSE CELL-MEDIATED IMMUNITY
The two main types of specific defense—cell- Once a T cell recognizes an antigen, it multiplies
mediated and antibody-mediated immunity— rapidly and its offspring form several types. Killer
may accompany nonspecific reactions T cells attack and destroy infected cells, which have
such as inflammation, or follow if infection the antigen on their surface. Helper T cells activate
persists. Both depend on the actions of B both B cells to help antibody-mediated immunity and
and T lymphocytes. B cells make protein macrophages to engulf debris. Suppressor (regulatory)
antibodies known as gammaglobulins, which T cells dampen down the body’s immune response
react against antigens (foreign proteins). after the infection has been dealt with.
Types of T cells multiply and attack cells
infected by pathogens. Presentation
Macrophage
Memory cell presents
Some T cells retain antigens
memory of the antigen from microbe
for future defense to T cell
Killer T cell
Squeezes into
bloodstream and travels
to site of infection
Proliferation Recognition
Line, or clone, of Preprogrammed Helper T cell
T lymphocytes, specific to the T cell recognizes Stimulates
antigen, multiplies and the antigen, even antibody-
differentiates into helper, killer, if it is their first mediated
suppressor, and memory cells encounter immunity
by B cells
Lymphokines
Proteins toxic to microbes Macrophage
made by killer T cells Attracted to site
by lymphokines
Phagocytosis
Macrophage
engulfs antigens
COMPLEMENT SYSTEM
More than 25 proteins and related substances in the
blood form the complement system, which joins the
fight against invading microbes. Once a complement
reaction begins, it carries on in a “cascade,” with one
protein activating the next, and so on. It generally
LYSED BACTERIUM
helps destroy microbes and prevent them from
Complement dissolves, or lyses,
invaders such as bacteria by attacking body cells, encourages the activity of white
disrupting their outer membranes cells, widens blood vessels, and clears away the
(cell shown on right). antigen–antibody complexes.
196
Phagocytosis Invading microbe ANTIBODY-
IMMUNE SYSTEM
Macrophage engulfs Pathogenic (harmful)
microorganisms and microorganisms such MEDIATED
their antigens as bacteria IMMUNITY
Transport to B cells produce Y- or
lymph node T-shaped antibodies, and
Macrophages each type acts against a certain
travel in blood
and lymph microorganism or “non-self”
material by attaching to antigens
Lymph node
Macrophages on its surface. The presence of antigens triggers B
engulf microbes cells to multiply. Some develop into plasma cells,
and debris and
present antigens
which are the main antibody-producing cells. As
to T cells with cell-mediated immunity,
Proliferation memory cells are made, which
B cells specific can recognize the same
to the antigen antigen and initiate
multiply into
new cells defense many years later.
Memory B cell
Some B cells retain
memory of the
antigen from a
previous infection
Plasma cell
Recognition Produces antibodies
Preprogrammed B specific to antigen
cell recognizes the protein
antigen, even if it is
their first encounter Antibodies
Float in blood
and other fluids
Macrophage
Presentation Engulfs antibody–
Macrophage presents antigens antigen complex
from microbe to B cell
Antibody–antigen reaction
Antibodies stick to antigen sites on
microbe, forming antibody–antigen
complexes (immune complexes)
Complement protein
binds to complex
Complement attaches to
antibody–antigen complex
Membrane breached of an invading microorganism
Complement proteins
break outer membrane Complement cascade
Sequence of complement
reactions produces more
complement proteins
Additional help
The complement pathways can destroy Swelling and bursting
microbes by disrupting their membranes Fluid rushes into microbe,
in a process called lysis (see p.200) which expands and bursts
197
INFLAMMATORY RESPONSE
LYMPH AND IMMUNITY
SITE OF
DAMAGE
The trachea, or
windpipe, is the
body’s main airway 3 PHYSICAL DAMAGE
Sharp particles can
fracture the epithelial cells,
rupturing the delicate cell
membranes.
CAUSE OF INFLAMMATION
The respiratory system is under constant threat from
tiny inhaled particles of dust and debris and attack by Tufts of cilia
Hairlike projections
infecting microbes. Here, the lining (epithelium) of the borne by some cells
trachea (windpipe) mounts an inflammatory response of the tracheal
to dust and bacteria. In reality, this process usually lining; the cilia
“beat” to remove
occurs alongside the specific immune response (see protective mucus
p.196), which targets individual foreign substances. covering the cells
198
INFLAMMATORY RESPONSE
DEFENSIVE CELLS
Various types of white blood cell (leukocytes) immature when they leave the blood vessels
become involved in inflammation, including and enter the tissues. However, they rapidly
the defensive cells called neutrophils and develop into active cells called
monocytes (see p.194). The monocytes are macrophages that replace neutrophils.
NEUTROPHILS MACROPHAGE
Among the first cells A single macrophage,
to take action, these which means “big
are small but capable eater,” can consume
of engulfing several up to 100 bacteria or
pieces of damaged similar-sized items
tissue and bacteria. before dying.
2 PHYSICAL DAMAGE
As the air current slows,
the particles are trapped in
4 INITIAL SPREAD
Messenger substances, such
as histamine and kinins, leak
protective mucus secreted from ruptured cells, especially Histamine
by epithelial cells of the “mast cells” scattered
tracheal lining. throughout the tissue.
Surface of epithelium
Foreign particle
Kinins
Lung airways
A network of air passages
that supply the lungs
199
LYMPH AND IMMUNITY PHAGOCYTOSIS
Various kinds of white blood cells can surround, Bacterium Neutrophil
engulf, and ingest smaller items, such as bacteria
and cellular debris, in a process known as
phagocytosis (“cell eating”). The cell exploits its
ability to change shape and move, using the
intracellular components of microtubules and
microfilaments (see p.26) that form its flexible,
mobile, internal scaffolding. The ingestion
usually takes less than one second, and the
consumed material is gradually broken down by
enzymes and other chemicals within the cell.
1 ENGULFING STAGE
The white cell extends pseudopods
(“false feet”) toward and around the
unwanted item—here a bacterium.
The pseudopods merge to engulf it.
2 LYSIS STAGE
Any unwanted items are trapped in phagocytic
vesicles. Together with enzyme-containing lysosomes,
3 EXOCYTOSIS STAGE
Harmless waste products of cell-eating are
expelled through the membrane of the white blood
these digestive vesicles form phagolysosomes, in cell, or in tiny, membrane-bound, exocytic vesicles,
which lysis (breaking down) occurs. to the extracellular fluid.
200
1 CAPILLARIES DILATE
2 FLUID LEAKAGE
INFLAMMATORY RESPONSE
Histamine stimulates widening Increased blood flow produces redness and
of capillaries (vasodilation). As their heat. Plasma (blood’s liquid component, pictured
walls stretch and become thinner, as yellow) leaks into the space between the cells,
narrow gaps appear and make carrying various proteins such as fibrinogen, which
them more permeable to fluids. helps blood clot when the skin is broken.
3 FLUID ACCUMULATION
Plasma and escaped fluids from damaged cells
gather in tissue spaces, causing swelling. This presses
on nerve endings, which helps cause the fourth sign
of inflammation—pain.
4 NEUTROPHILS
ARRIVE
Neutrophils press
on the inner lining of
capillaries, a
stage called
margination. They
squeeze through
the capillary walls
in a process called
diapedesis, as they
leave the blood and
enter the tissues.
Foreign particle
Bacterium
VIRUSES
Viruses are the smallest microbes; millions means they must have living cells, or host
would cover the head of a pin. Many types cells, in order to replicate themselves. The
of viruses can stay inactive for long periods typical virus particle has a single or double
and survive freezing, boiling, and chemical strand of genetic material (nucleic acid—
attack. Yet they can activate suddenly when either DNA or RNA) surrounded by a
an opportunity of invading a living cell shell-like coat of protein (capsid), and
arises. Viruses are obligate parasites, which sometimes a protective outer envelope.
LIFE CYCLE OF
A VIRUS 2 INSERTION OF VIRUS
Viral surface proteins
attach to specific receptor
4 NUCLEIC ACID
REPLICATION
The host cell makes many
Viruses have very few sites on the host cell’s surface. copies of the viral RNA
genes (typically After attaching itself, part or molecule and the viral
100–300) and cannot all of the virus penetrates protein coat, using its raw
the host cell. materials and its enzymes.
process nutrients. To
build copies of itself,
a virus takes over a
host cell’s machinery, 3 NUCLEIC ACID
INSERTION
Viral RNA enters the nucleus
causing the cell to die and joins the host’s nucleic
or malfunction. acid. It then replicates itself
in great numbers before
is capable of independent
survival and then infection.
Genetic material
Influenza carries its
genetic material as
RNA rather than DNA
and arranges it on
eight segments
5 BUDDING VIRUS
The nucleic acid (RNA)
strands and protein-coat
subunits join to form new virus
particles. These form buds in
the host cell membrane, using
part of the membrane as their
outer protective envelope.
6 RELEASE
The buds separate as free
virus particles, ready to spread
and infect more cells. All eight
separate segments of genetic
material (RNA) must be present
for the virus to successfully carry
the infection further.
Replication complete
Duplicated viral RNA escapes
through nuclear envelope
203
LYMPH AND IMMUNITY
BACTERIA
The microorganisms known as bacteria are BACTERIAL SHAPES
present almost everywhere—in soil, water, There are several typical shapes for bacteria, and
air, food, drink, and on and in our own these, along with the way they are colored by
bodies. Many types of bacteria are laboratory stains, are important for classification
harmless; indeed, those present naturally and determination of their origins and relationships.
Many thousands of bacterial types are known, with
in the human intestines, the “gut flora,”
more discovered each year.
have a beneficial effect in helping extract
nutrients from food. However, hundreds Cocci
of types of bacteria can cause infections, Generally spherical, may Dividing cocci
exist in clumps, chains, bacteria
ranging from mild to lethal. Bacteria are or pairs. Examples
simpler than other single-cell organisms in include Staphylococcus
that their genetic material (DNA) is free and Streptococcus.
Bacilli
in the cell, rather than contained in a Oval, or rodlike, with or
membrane-bound nucleus. without surface hairs or
Pili (hairs)
flagella. Examples include
Streptobacillus. on surface
STRUCTURE OF A BACTERIUM
A typical rod-shaped bacterium (bacillus) has Spirilla
a cell membrane enclosing cytoplasm and Spiral or, more accurately, Open coils
organelles, such as ribosomes, which are helical (corkscrewlike) in
shape. Examples include
distributed in it. Unlike animal cells, it has a
Leptospira and Treponema.
semi-rigid cell wall outside its cell membrane.
Cytoplasm
Complex fluid
containing many
dissolved
substances
Cell membrane
Surrounds cytoplasm;
controls movement of
chemicals, water, and
waste from cell
Flagellum
Whiplike Pilus Plasmid
projection that Rigid, tiny, hairlike structure; anchors Small loop of
is swished for to surfaces and takes part in genetic extra genetic
movement exchange with other bacteria material (DNA)
204
FIGHTING INFECTIONS
HOW BACTERIA CAUSE DAMAGE
Disease-causing bacteria can enter the body in
several ways: via the airways or digestive tract,
during sexual contact, or through broken skin. Released toxins
Some bacteria adhere to and invade body cells.
Others produce poisonous substances called Clot forming
bacteriotoxins, or toxins, which may disrupt
Bacterium
cell function. For example, the diphtheria toxin
from the bacterium Corynebacterium diphtheriae
damages heart muscle by inhibiting protein
LEAKING VESSELS
production. Some toxins are highly dangerous. A Some bacteria release toxins that cause blood
bucket of nerve toxin from Clostridium botulinum to clot in small blood vessels, depriving tissues
could kill everyone in the world. and organs of their normal blood supply.
RESISTANCE TO ANTIBIOTICS
1
Drug-inactivating
ROLE OF PLASMIDS
enzyme Many bacteria become resistant to antibiotics by
A plasmid may cause
a bacterium to make changing (mutating) into new strains. Their most
enzymes against effective mechanism is the transfer of plasmids—
antibiotics, or to alter its fragments of the genetic material DNA–between
surface receptors, where
antibiotics bind. Then the
bacteria. The gene for antibiotic resistance crops
plasmid duplicates itself. Duplicated plasmid up by accident, and the bacterium possessing it
can pass it to others.
2 PLASMID TRANSFER
Plasmid transfer takes place during a process
known as conjugation. The plasmid copy is passed
3 DRUG-RESISTANT STRAINS
Recipient bacteria inherit the resistant
gene. Plasmid transfer produces populations
from the donor, through a pilus, to of bacteria resistant to a range of antibiotics.
the recipient bacterium. Drug-inactivating
Pilus enzymes
Plasmid transfer
DONOR RECIPIENT
SUPERBUGS
Some bacteria pass through their life cycle in less
MRSA
than 20 minutes. Fast reproduction, coupled with
Staphylococcus
the incredible numbers of bacteria and rapid
aureus bacteria
transfer of genetic information, gives great scope
that are resistant
for mutation (see above). Many strains of bacteria to the antibiotic
resistant to wide-acting, or broad-spectrum, meticillin are
antibiotics have appeared. These so-called known as MRSA,
“superbugs” may not be resistant to more and are a cause of
specialized, narrow-spectrum, antibiotics. concern in hospitals.
205
PROTISTS (PROTOZOA)
LYMPH AND IMMUNITY
Liver cell
Sporozoites
enter liver cell
and multiply
Gametocyte
Merozoites form
Parasite change male and female
Sporozoites Multiplication reproductive-
develop into Merozoites stage cells, or
another form of multiply in red gametocytes
the parasite, blood cells
merozoites
FUNGAL INFECTIONS
Various relatively minor
fungal infections affect
different body parts.
ALLERGIES
When first exposed to an allergen, such as nuts
2 When the
ANTIBODIES Mast cell
allergen returns,
or pollen, the immune system makes antibodies the antibodies are
to fight it. The antibodies coat the surface of triggered into action.
mast cells in the skin, stomach lining, lungs, and If the allergen links
two or more
upper airways. If the allergen enters the body
antibodies together,
again, these cells mount an allergic response. the cell bursts. Allergen Antibody
Histamine
1 The first time an 3 As the cell bursts,
EXPOSURE HISTAMINE Bursting
Mast cell mast cell
allergen enters the it releases histamine,
body, antibodies which causes an
bind to the surface inflammatory response.
of mast cells. These This irritates body
cells contain histamine, tissues and produces
Allergen
which normally causes Cell nucleus all the symptoms Histamine Allergen bound
inflammation. Antibody of an allergy. released to antibodies
IMMUNIZATION
The process of becoming resistant or immune to a but the illness does not develop. If urgent protection
particular microbe as a result of infection is known as is needed, or if an immune system is weak, passive
natural immunization. Resistance can also be immunization can be used by injecting ready-made
developed artificially. In active immunization, dead or antibodies. These antibodies provide swift resistance
weakened versions of the microbe or its toxic against the microbes, but they gradually degenerate
products are injected into the body. The immune and are not replaced. The body has no memory for
response occurs, with the production of antibodies, making them again.
Pathogen attack
Trachea Invading microbes in mucus
Full strength Vaccine (windpipe) droplet in trachea
Normal, injected
harmful Accurate dose Invasion
microbes of vaccine Some pathogens
Reduced invade tissues
danger Immune action
Weakened Antibodies made Instant response
or disabled by body attack Antibodies launch
microbes vaccine antigens defense against
pathogens
3 REVERSE TRANSCRIPTION
The virus releases reverse
transcriptase into the cell. The
enzyme copies the single strands of Double-
viral RNA as double-stranded DNA. stranded
DNA
5 CREATION OF PROTEINS
In the cytoplasm the mRNA is “read”
and chains of HIV proteins and viral
Cytoplasm mRNA
RNA are made. These molecules become
the components of new HIV particles. Viral constituents Infected
collect at cell wall CD4+
6 NEW HIV CREATED
HIV constituents gather
at the cell wall. An immature
Mature HIV
lymphocyte
particle
virus forms and breaks away
from the cell. Enzymes within
Immature virus particle
the virus bring about changes
resulting in a mature virus. Mature HIV particle
PEOPLE ARE PROBABLY MORE AWARE OF THEIR DIGESTIVE
SYSTEM THAN OF ANY OTHER SYSTEM BECAUSE OF ITS
FREQUENT MESSAGES. HUNGER, THIRST, GAS, AND
BOWEL MOVEMENTS ALL AFFECT DAILY LIFE. EATING
WELL AND REGULAR EXERCISE ARE THE BEDROCKS OF
GOOD DIGESTIVE HEALTH. PLENTY OF FRESH VEGETABLES
AND FRUIT, ADEQUATE FIBER, AND A LOW INTAKE OF
ANIMAL FATS AND SALT ARE SIMPLE GUIDELINES FOR
MAINTAINING THE WELL-BEING NOT JUST OF THE
DIGESTIVE SYSTEM BUT OF THE WHOLE BODY.
DIGESTIVE
SYSTEM
212 DIGESTIVE SYSTEM
DIGESTIVE ANATOMY
THE DIGESTIVE TRACT AND ITS ASSOCIATED ORGANS, INCLUDING
THE LIVER, GALLBLADDER, AND PANCREAS, BREAK DOWN FOOD,
EXTRACT NUTRIENTS, AND DISPOSE OF WASTE MATERIALS.
Liver
Large organ that processes
absorbed nutrients, detoxifies
harmful substances, and
produces bile
Esophagus
Gallbladder
Stores bile produced
by liver
Liver
Stomach Pancreas (behind stomach)
Parietal Secretes digestive enzymes,
peritoneum which pour along a duct into
first part of small intestine
Visceral
peritoneum
(mesenteries) Small intestine
Major site of digestion and
Duodenum absorption of nutrients
Transverse
colon Large intestine
Omentum Absorbs water from food residue,
and forms and stores feces
Jejunum
Ileum Appendix
Sigmoid Also called the vermiform
colon appendix; dead-end tube
whose function, if it has one,
Bladder
is as yet unknown
Uterus Rectum
Rectum Stores waste matter until
it can be excreted
THE PERITONEUM conveniently
The two layers of the peritoneum make a fluid to
Anus
reduce friction between organs. The parietal
Short, tubelike,
peritoneum lines the abdominal wall, and the muscular valve that
organs hang from the visceral peritoneum within relaxes to let out
the abdomen. The omentum is a specialized digestive waste
fatty peritoneum hanging from the stomach.
213
DIGESTIVE SYSTEM
MOUTH AND THROAT
DIGESTION STARTS AT THE MOUTH, WHERE FOOD IS
CHEWED, LUBRICATED WITH SALIVA, TURNED INTO A
SOFT, MOIST MASS CALLED A BOLUS, AND SWALLOWED.
Nasal cavity
Rearmost part joins
ANATOMY OF THE to the nasopharynx
region of the throat
MOUTH AND THROAT
The interior of the lips, cheeks, and
oral cavity is lined with a tough, firmly
anchored mucous membrane and a
type of tissue called nonkeratinized
squamous epithelium. Cells here Uvula
multiply rapidly to replace those
Soft palate
rubbed away by biting, chewing, and
swallowing. The front underside Tongue
Moves food around
of the tongue has a fleshy central when chewing, contains
ridge, the frenulum, which connects taste buds, and helps
to the floor of the mouth. The form distinct words in speech
tongue is the body’s most flexible Teeth
muscle. Within it are three pairs of Bite off and chew food
into a moist, soft pulp, ready
intrinsic muscles; and outside, three to be swallowed
pairs of extrinsic muscles run from
Sublingual duct
the tongue to other parts of the
throat and neck. The root of the Sublingual gland
tongue anchors to the lower jaw Produces viscous saliva,
which contains enzymes
(mandible) and to the curved hyoid
bone in the neck. The rear of the Submandibular duct
mouth leads to the middle part of Submandibular gland
the throat, the oropharynx. The
whole throat or pharynx, from its Mandible
(lower jawbone)
nasal to laryngeal regions, is about
5 in (13 cm) long in a typical adult. Epiglottis
Cartilaginous flap that
blocks off the larynx entrance
NOSE, MOUTH, AND THROAT during swallowing
The roof of the mouth, or oral cavity, is formed
by shelves of the maxillary and palatine
bones of the skull (see p.49), together known
as the hard palate. This extends rearward as
the soft palate, which contains skeletal muscle
fibers that allow it to flex when swallowing. The
central posterior part of the soft palate
extends into a small “finger,” the uvula,
which can be seen through the open
mouth, dangling down from the back,
where it helps direct food downward.
214
MOUTH AND THROAT
SALIVARY GLANDS
Parotid (Stensen’s) duct
Saliva is made by three pairs of salivary
Opens into cheek lining, next to glands: the parotid glands, positioned
the upper second molar tooth in front of and just below each ear; the
Accessory Parotid gland
submandibulars, on the inner sides of
parotid Largest of three the lower jawbone (mandible); and the
gland paired salivary sublinguals, in the floor of the mouth,
glands; produces
watery saliva
below the tongue. In addition, many
small accessory glands are found in the
mucous membranes lining the mouth
and tongue. Although it is composed
of 99.5 percent water, saliva also
contains important solutes such as
amylase, a digestive enzyme that
begins the breakdown of starches, and
salts. Saliva lubricates food to make
chewing and swallowing easier, and
it keeps the mouth moist between
periods of eating.
Trachea (windpipe)
215
DIGESTIVE SYSTEM
TEETH
There are four types of teeth, each of which absorbs shock. At the center of the tooth,
has a different role. The incisors, at the the soft dental pulp contains blood vessels
front, are chisel-shaped, with sharp edges and nerves. Below the gum, bonelike
for cutting food. The pointed canines, cementum and periodontal ligament
known as “eye teeth,” are designed for tissues secure the tooth in the jawbone.
tearing food. The premolars, with their
two ridges, and the flatter molars, which
are the largest and strongest teeth, crush
and grind food. The crown is the part of
the tooth above the gum, while the root is
embedded in the jawbone; and where
these two meet, at the gum or gingival
surface, is the neck of the tooth. The outer
layer of the crown is made of a bonelike
enamel, which is the hardest substance in
the body. Beneath it is a layer of softer but
still strong tissue called dentine, which
ENAMEL SURFACE
This microscope image of enamel shows U-shaped
enamel prisms packed with the crystalline mineral
Molars Premolars Canine Incisors
substance hydroxyapatite.
Enamel
Gum
Pulp
Dentine
Cementum
Hard palate
Soft palate
Food bolus BREATHE OR SWALLOW
Pharynx The pharynx is a dual-purpose passageway: for air
Tongue when breathing, and food, drink, and saliva when
Epiglottis swallowing. Nerve signals from the brain operate
Larynx the muscles of the mouth, tongue, pharynx, larynx,
and upper esophagus to prevent food from
Trachea
entering the trachea. If food is inhaled, irritation of
Esophagus
the airway triggers the coughing reflex, which
1 PHARYNGEAL STAGE
Before the food bolus reaches the back of the
mouth, the epiglottis is raised in its normal position.
expels the inhaled particles and prevents choking.
The complex muscle movements involved in
swallowing are a voluntary reflex, and they also
occur when solid matter contacts touch sensors at
Soft palate
Closes nasal
the back of the mouth.
cavity
Tongue Air flow
Pharynx
Food bolus
Epiglottis
Folds down to Epiglottis
cover larynx
Larynx Trachea
Esophagus
DUAL INTAKE
2 ESOPHAGEAL STAGE
The larynx rises to meet the tilted epiglottis, closing
the trachea. The soft palate lifts to close the nasal
Breathing occurs through the nose or the mouth.
The passageways of both meet at the throat,
and air flows into the trachea.
cavity. The bolus is pushed down the esophagus.
217
DIGESTIVE SYSTEM
STOMACH AND
SMALL INTESTINE
THE STOMACH DIGESTS FOOD CHEMICALLY AND Longitudinal
PHYSICALLY. THE SMALL INTESTINE CONTINUES THE Circular
Longitudinal
Serosa
Muscularis
Submucosa
Mucosa
Villus
Fingerlike extension of mucosa
up to 1/25 in (1 mm) long
SECTION OF SMALL INTESTINE
Central vein
STRUCTURE AND FUNCTION Cross
section of
OF THE LIVER lobule
Weighing about 31/3 lb (1.5 kg), the dark red
Exterior of
liver is composed of lobules; these are made lobule
up of sheets of liver cells (hepatocytes), tiny
branches of the hepatic artery and vein, and
bile ducts. Nutrient-rich blood arrives from
the intestines via the hepatic portal system
(see p.222) and filters through the lobules.
The liver has many functions, the most
important of which are storing and releasing
blood glucose for energy; sorting and
processing vitamins and minerals; breaking
down toxins into less harmful substances;
and recycling old blood cells. Artery Bile duct
Vein
LIVER FUNCTIONS
LIVER LOBULES
Most of the liver’s tasks are concerned with The six-sided lobules of the liver nestle together,
the process of metabolism. They include each supplied with a central vein and blood vessels
breaking down, storing, and circulating and bile-collecting vessels around them.
Left liver
lobe
Stomach
Hepatic artery
Branch of celiac
artery from main
aorta; brings
Gallbladder one-fifth of liver’s
Storage bag for total blood supply
liver’s bile fluid Transverse
colon
Hepatic portal vein Pancreas
Supplies blood from Hidden behind lower stomach
intestinal tract to liver and transverse colon
LIVER ARCHITECTURE
In this electron micrograph at a
magnification of around 300 times,
sheets of hepatocytes can be seen
radiating from the central canal. This
canal contains the central vein.
221
DIGESTIVE SYSTEM
THE HEPATIC PORTAL
CIRCULATION the rest of the body. It also helps regulate
The liver receives two blood supplies. The the levels of many other substances in the
hepatic artery delivers oxygen-rich blood bloodstream. Veins from several organs,
to the liver. In addition, the hepatic portal including the intestines, pancreas,
vein supplies the liver with the oxygen- stomach, and spleen, drain into the
poor, nutrient-rich blood that comes from hepatic portal vein. It is around 3 in (8 cm)
the digestive tract, before this blood long and supplies up to four-fifths
returns to the heart and is pumped of the blood into the liver. The flow-rate
throughout the body. This hepatic portal increases after a meal, but falls during
circulation enables the liver to stop toxins physical activity as blood is diverted from
absorbed in the intestines from reaching the abdominal organs to skeletal muscles.
Esophagus
Liver
Stomach
Spleen
Gallbladder
Hepatic
portal vein
Large
intestine
HEPATIC PORTAL
SYSTEM
Veins from almost
every part of the
digestive tract, even
the lower esophagus,
converge to form the
hepatic portal vein,
which enters the liver.
In this view, some
organs have been
removed to reveal
the blood vessels.
Appendix
Rectum
222
LIVER, GALLBLADDER, AND PANCREAS
BILE TRANSPORT Left and right
Bile assists the breakdown of hepatic ducts
THE PANCREAS
The head end of this gland nestles in a of digestive juice containing various
loop of the duodenum, its main body enzymes that break down proteins,
lies behind the stomach, and its tapering carbohydrates, and lipids. The fluid flows
tail sits above the left kidney, below into the main and accessory pancreatic
the spleen. Each day, the pancreas ducts, which empty the juices into
produces around 2 2/3 pints (1.5 liters) the duodenum.
Pancreatic
duct
PANCREATIC
STRUCTURE
The pancreas is up
to 6 in (15 cm) long,
soft and flexible, and
gray-pink in color.
GUT FLORA
Trillions of microorganisms, mainly bacteria, live in the BACTERIA IN THE COLON
intestinal tract—chiefly in the large intestine. They are This electron microscope image
known as gut flora (or gut microbiota) and have a vital (magnified over 2,000 times) shows
role in human health and disease. They produce clusters of rodlike bacteria (purple) on
enzymes that break down certain food components, the lining of the colon.
such as cellulose, which human enzymes cannot digest.
The gut flora also produce vitamins K and B, and
hydrogen, carbon dioxide, hydrogen sulfide, and
methane. They help control harmful microbes in
the digestive system and promote the formation of
antibodies and the activity of lymphoid tissue in the
colonic lining. Overall, the gut flora and the body
exist in a mutually beneficial partnership (symbiosis).
At least one-third of the weight of excreted feces is
composed of these bacteria.
224
LARGE INTESTINE
Ascending colon
Section of colon
rising up right side
of abdomen Transverse colon
Highest section of colon,
just below stomach, passing
across upper abdomen
Haustra
Pouches that give colon its
puckered appearance
Descending colon
Section of colon that passes
down left side of abdomen
SEGMENTATION
A series of ringlike
contractions occurs
at regular intervals.
These churn and mix
feces but do not
propel them along
the colon.
PERISTALTIC
CONTRACTIONS
Small waves of
movement called
peristaltic contractions
(see p.218) propel
feces toward the
rectum. The muscles
Cecum
behind the contents
contract, while those
Appendix
in front relax.
MASS MOVEMENTS
These extra-strong
peristaltic waves move
from the middle of the
transverse colon. They
happen two
or three times a day
and drive feces
into the rectum. THE RECTUM
The rectum is a passageway
for feces and is normally
empty, except just before and
during defecation.
226
LARGE INTESTINE
RECTUM, ANUS, AND DEFECATION
The rectum is around 5 in (12 cm) long. Below
it is the anal canal, about 11⁄2 in (4 cm) long.
In the walls of the anal canal, there are two sets
of strong muscles—the internal and external
Transverse
sphincters. During defecation, peristaltic waves
colon in the colon push feces into the rectum, which
triggers the defecation reflex. Contractions push
the feces along, and the anal sphincters relax to
allow them out of the body through the anus.
The defecation reflex may be aided by voluntary
contraction of the abdominal muscles, or
overridden by conscious control.
Rectum Plicae
Wide passageway transversales
Bladder
at the end of Shelves of tissue
the colon in wall of rectum
Descending
colon Prostate gland
Present only
in males
Feces Sigmoid
colon
1 IN THE STOMACH
The stomach lining has gastric pits that make various
substances: hydrochloric acid to kill microbes in swallowed food;
the enzyme gastric lipase to begin breaking down fat; mucus to
protect the stomach from digestive enzymes and acid; and pepsin
to digest proteins. Pepsin on its own could digest the stomach wall,
so it is first released in an inactive form (pepsinogen), then
activated by the stomach’s acid.
Peptide Pepsin
Protein-digesting Gastric lipase
Protein enzyme Fat-digesting
enzyme
Gastric
mucosa Hydrochloric acid
Stomach
lining Mucus
Pepsin
enzyme
PEPSIN IN ACTION
Pepsin is activated
when it meets the DIGESTIVE JOURNEY
acid of the stomach’s As it travels from the
interior. It splits protein mouth to the small
Gastric pit
molecules into shorter Makes enzymes, intestine, food is broken
amino acid chains hydrochloric acid, down into smaller and
called peptides. and mucus smaller particles.
228
Bile salt
2 IN THE DUODENUM
DIGESTION
Chyme is squirted into the duodenum
and mixed with bile and secretions from the
Smaller
pancreas. These include alkalis, such as
fat droplet
bicarbonates, that neutralize stomach acid,
and about 15 enzymes, which work on
BILE FUNCTION carbohydrates, proteins, and fats (lipids).
Bile contains salts
that emulsify large fat Wall of
droplets, to create an duodenum Bile duct from
Lined with gallbladder
emulsion of tiny fat droplets
fingerlike villi
Fat droplet with a large surface area
Containing fat (lipid) for enzyme action. Pancreatic
duct from
pancreas
Ampulla
of Vater
Villus
Protease
enzymes
Bile salts
Lipase
Peptide
Triglyceride Monoglyceride Amylase
lipid
Fat molecule
Fatty
Lipase acid
Protein
Protease
enzyme
FAT (LIPID)
BREAKDOWN
Lipase
fat-digesting
enzymes break down
PROTEIN
triglyceride fat (lipid) units
BREAKDOWN
to form two fatty acids and
Protease enzymes
a monoglyceride. Starch split proteins into
Amylase enzyme short-chain
peptides and
amino acids.
CARBOHYDRATE BREAKDOWN
Pancreatic amylase enzyme breaks
long-chain carbohydrates, such as
starch, into disaccharide (double-sugar)
pieces, especially maltose sugar. Maltose sugar
229
3 IN THE SMALL INTESTINE
DIGESTIVE SYSTEM
After the duodenum, the remainder of the small
intestine is the site for the final breakdown of food
substances and their absorption into the blood and lymphatic
fluids. The pancreatic juices and bile fluids continue to work,
but the small intestine releases few further enzymes into its
inner passage, the lumen. Instead, its enzymes act within the
lining cells, and on their surfaces. These enzymes include
lactase and maltase, which break down the double
(disaccharide) sugars, lactose and maltose, into single-unit
glucose and galactose. Intestinal peptidases convert short
peptide chains (originally from proteins) into their subunits,
amino acids. The fingerlike villi of the intestine lining have
surface cells bearing smaller projections of their own
(microvilli), where some of these final changes occur.
Active site
PEPSIN
A computer model
of this digestive
enzyme shows the
active site as the VAST SURFACE AREA
gap at the top. A The internal lining of
protein molecule the folded and looped
will slot in here small intestine has a
and break apart. vast surface area for
absorbing nutrients.
230
Lumen
DIGESTION
Fluid-filled space inside small
intestine
Villus
Capillary of villus
Epithelial (lining)
cell of small
intestine wall
Glucose
Short-chain Peptidase
fatty acid enzyme
EXTREME CLOSE-UP Splits peptides
Simply diffuses
OF CELL MEMBRANE across cell into amino acids
Enzymes that complete membrane
digestion are embedded Amino acids
in the membrane of the Pass through protein
epithelial cells (right). Small intestine channel in twos and
lumen threes
The resulting sugars and
amino acids pass through
dedicated protein Epithelial cell Epithelial cell
channels, while fatty membrane interior
acids diffuse across.
231
DIGESTIVE SYSTEM
NUTRIENTS AND METABOLISM
THE BODY’S INTERNAL BIOCHEMICAL REACTIONS, CHANGES, AND PROCESSES ARE
TERMED METABOLISM. DIGESTION PROVIDES THE NUTRIENTS AS RAW MATERIALS,
WHICH ENTER METABOLIC PATHWAYS IN ALL CELLS AND TISSUES.
CECUM
Each day about 31/2–17 fl oz (100–500 ml)
of digestive fluids, undigested leftovers,
Vitamin K
rubbed-off intestinal linings, and other
Manufactured
matter enters the first chamber of the by symbiotic
large intestine, the cecum. bacteria
INTERPLAY
Metabolism is a complex interplay of
construction and destruction, with many COMPLEX
ENERGY
molecules being recycled as they pass MOLECULES
between the two processes.
PEPTIC ULCERS
Esophagus Fundus
Most peptic ulcers are associated with
Helicobacter pylori bacteria. These damage
the mucous lining that normally protects Lesser curvature
against the powerful acidic juices in the
stomach and first part of the duodenum. Duodenal bulb Body
Mucosa Mucosa
Submucosa Submucosa
Muscle Muscle
layer layer
Erosion
In the early stages the Blood vessel Deepening ulcer
lining is only partly Bleeding (hemorrhage) can penetrates
destroyed, producing a result if a vessel is breached muscle layer
shallow area of damage by a deepening ulcer
EARLY ULCER PROGRESSIVE ULCERATION
If the protective mucous barrier coating the stomach A true ulcer penetrates the entire lining (mucosal layer)
lining breaks down, gastric juices containing strong acid as well as the submucosa and muscle layers. In severe
and enzymes come into contact with mucosal cells. cases, it can perforate the stomach or duodenal wall.
234
DIGESTIVE TRACT DISORDERS
GASTRITIS
Inflammation of the stomach lining, called gastritis, causes
discomfort or pain, as well as nausea and vomiting. Gastritis
that comes on suddenly, known as sudden onset (acute)
gastritis, may be caused by overindulging, especially in
alcohol consumption, or by taking medications known for
their effect on the stomach lining, such as aspirin. Chronic
gastritis develops over the longer term and may be due to
repeated insult to the lining by alcohol, tobacco, or drugs.
COMMON CULPRIT
Another common cause is the bacterium Helicobacter pylori. At least 50 percent of people have H. pylori
Gastritis usually gets better with medication and by removing in their stomach lining. If the bacteria cause
the underlying cause. symptoms, antibiotics can eradicate them.
HIATUS HERNIA
The esophagus passes through a taut gap (hiatus) in through this gap. Any symptoms of a hiatus
the muscular sheet of the diaphragm, which lies hernia are those of heartburn (gastric reflux).
between the abdomen and the chest cavity. The There are two types of hiatus hernia: sliding
hiatus helps the esophageal sphincter (ring and paraesophageal. Sliding hernias usually have
of muscle at the lower end of the esophagus) no symptoms, and it is estimated that they are
prevent acidic stomach contents from passing up present in around a third of all people over 50.
into the lower esophagus. In a hiatus hernia, the In rare cases, however, paraesophageal hernias can
upper section of the stomach protrudes up cause severe pain and require surgery.
Esophageal
sphincter Esophageal
sphincter
Duodenum
Duodenum
Stomach Stomach
Damaged tissue
Scar tissue
Liver
Stomach
Enlarged
spleen
Varicose
veins
Blood from
spleen
Portal
Gallbladder vein
OBSTRUCTED BLOOD FLOW
The portal vein takes blood to the liver from the
digestive tract and other organs. Cirrhosis in the
Blood from stomach
liver blocks blood flow and increases the pressure
in the portal vein. Back pressure causes veins
“upstream,” and in the esophagus, to distend.
237
DIGESTIVE SYSTEM
GALLSTONES Common
In developed countries, the majority of Cystic duct hepatic duct
gallstones consist primarily of cholesterol,
Gallstone
a fatty substance processed in the liver impacted in
Gallbladder
and stored in the gallbladder as one of the cystic duct
constituents of bile. Gallstones can develop
if the normal “mix” of bile is altered and
the cholesterol content is high. They are far Bile
more common in women and are unusual
before the age of 30. Most people have no
symptoms. If there are symptoms, they Common
begin when a stone lodges in one of bile duct
the ducts leaving the gallbladder. The
main symptom is pain, which varies
in intensity and often develops
Gallstones
after a fatty meal. For
symptomatic gallstones,
the treatment is usually STONE IN CYSTIC DUCT
Cystic If a gallstone becomes lodged
cholecystectomy, duct in the cystic duct, it can prevent
(often by laparoscopic the gallbladder from emptying
Gallbladder
surgery) to remove and cause an inflammatory
the gallbladder. Bile reaction called cholecystitis.
Common
bile duct STONE IN COMMON BILE DUCT
Stones that block the flow of bile from
the gallbladder or liver to the
Gallstones Gallstone impacted duodenum can cause varying degrees
in common bile duct of pain and discomfort, and may
cause jaundice. This pain is known as
biliary colic and is usually the first sign
that a gallstone is present.
PANCREATITIS
Pancreatitis is a serious inflammation of the There are many causes of acute pancreatitis, the
pancreas, and can be either acute or chronic. most common of which are gallstones (see above),
In both types, the inflammation is triggered by excessive intake of alcohol, some drugs, and certain
the enzymes that the pancreas itself normally infections, such as mumps. Chronic pancreatitis
manufactures to aid the digestion of food when is usually associated with long-term alcoholism.
it enters the duodenum. In pancreatitis, these In both types, the main feature is pain. In acute
enzymes become activated while they are still pancreatitis, this is particularly severe and may
inside the pancreas, and begin to digest the tissue. be accompanied by nausea and vomiting.
238
DIGESTIVE TRACT DISORDERS
DIVERTICULAR DISEASE Hard, dry feces Wall of colon
In diverticular disease, patches of
the colon wall bulge outward into 1 HARD FECES
Soft, bulky feces are
able to pass easily along
pouches called diverticula. Most
the colon. If feces are
people with diverticular disease hard and dry, usually
are over 50 in age and have eaten due to lack of fiber or
a low-fiber diet for many years, “roughage” in the diet,
with consequent straining as they the contractions of the
smooth muscle layers of
pass hard stools. The problem
the colon must increase
becomes more common with in force, putting pressure Blood vessel
increasing age. The lowest part on the walls of the colon.
of the colon, known as the sigmoid
Hard, dry feces Pouches can
colon (see p.227), is most become
commonly affected, but the whole
colon can be involved. About 95
inflamed
2 Eventually, the
POUCHES FORM
increased pressure
percent of people with diverticular pushes small areas of
disease do not show symptoms, colon lining through
points of weakness in
but some people have abdominal
the muscle of the
pain and irregular bowel habits. In wall, often near a
diverticulitis, the pouches become blood vessel. The
inflamed, causing severe pain, pea- to grape-sized
fever, and constipation. pouches that form
easily trap bacteria
The pain is often in the lower left
and may become
abdomen, and may fade after Diverticula push inflamed.
passing gas or stools. through wall
URINARY ANATOMY
THE URINARY SYSTEM IS COMPOSED OF TWO KIDNEYS, TWO URETERS, A
BLADDER, AND A URETHRA. IT REGULATES THE VOLUME AND COMPOSITION
OF BODY FLUIDS AND EXPELS WASTE AND EXCESS WATER FROM THE BODY.
Kidney
Each is about 4–5 in (10–12.5 cm) long, and
contains about 1 million filtering units
Renal pelvis
Funnel-shaped chamber in which urine
collects before passing down the ureter
Renal artery
Renal vein
Ureters
Vessels conveying urine from kidneys to bladder; a
muscular layer in their walls contracts to propel urine
to the bladder, and a mucosal layer secretes mucus to
prevent its cells from coming into contact with urine
Opening of ureter
Bladder lining
Secretes mucus to isolate body tissues from
urine; contains many folds when bladder is
empty; these smooth out as bladder fills
Bladder wall
Contains three indistinct layers of muscle
fiber, jointly called the detrusor muscle
Femoral artery
Urethra
Bladder outlet
Prostate gland
Involved in semen
production as part of
the reproductive system;
encircles the urethra
Membranous part
of urethra
Spongy part of
urethra
Penis
MALE URETHRA
A male’s urethra
conveys both semen
and urine along the
length of the penis.
243
URINARY SYSTEM
KIDNEY STRUCTURE
THE KIDNEYS ARE A PAIR OF ORGANS SITUATED EITHER SIDE OF THE SPINAL COLUMN
AND AT THE UPPER REAR OF THE ABDOMINAL CAVITY. THEY FILTER WASTE PRODUCTS
FROM THE BLOOD AND EXCRETE THEM, ALONG WITH EXCESS WATER, AS URINE.
Superior Aorta
mesenteric Renal Loop of
artery Coeliac trunk medulla Henle
NEPHRON
Each microfiltering unit, urine-collecting ducts
or nephron, spans the are in the cortex. The
Right cortex and medulla. medulla contains mainly
renal
artery Left The glomerulus, capsule, the long tubule loops of
renal proximal and distal Henle and the larger
artery tubules, and the smaller urine-collecting ducts.
GLOMERULUS
This microscope
Right ureter Left ureter
image shows the
tangled system
BLOOD SUPPLY TO of a glomerulus
THE KIDNEYS (pink). A filtrate
The left and right renal aorta just below the fluid oozes from
arteries are branches of superior mesenteric the glomerulus
the aorta, which carries artery. The renal arteries and is collected
blood directly from the form a branching by the cuplike
heart. The arteries leave network that supplies Bowman’s
the celiac trunk of the blood to the kidneys. capsule (brown).
244
KIDNEY CROSS SECTION Renal cortex
KIDNEY STRUCTURE
This cutaway shows the kidney’s main Outer region of kidney;
layers: the cortex and the medulla, which packed with microscopic
structures called glomeruli,
forms segments known as renal pyramids.
which make it look granular
The renal artery and vein circulate huge
amounts of blood—about 21/2 pints per
min (1.2 liters per min) at rest, which is up
to one-quarter of the heart’s total output.
Renal medulla
Region of capillaries around
loops of tubules
Renal artery
Supplies blood to
kidney; branches
from the aorta
Renal column
Tissue between
renal pyramids
Renal pyramid
Cone-shaped
region of renal
medulla Renal vein
Removes cleaned
Major calyx blood, which
Several minor then drains into
calyces merge inferior vena cava
to form a
major calyx Renal hilus
Junction where
Minor calyx renal blood
Cuplike cavity vessels and ureter
that receives pass into kidney
urine from the
renal papilla
Renal pelvis
Funnel-shaped
tube into which
the major
calyces merge
Renal capsule
Thin covering of
white fibrous
tissue around the
whole kidney
Interlobular
artery
Distributes blood
from arcuate
artery to afferent Proximal
arterioles convoluted
tubule
Efferent Carries filtrate
arterioles away from
Convey blood Bowman’s capsule
from glomerulus Peritubular
to the capillary capillary
networks around Surrounds the
the tubule tubule for much
Distal of its length
convoluted
tubule
Carries almost- Interlobular
formed urine to vein
the collecting
duct
Arcuate artery
Arcuate vein
Urine-collecting
duct
Capillary network
around loop of Henle
Descending
limb
Ascending limb
BLOOD FILTRATION
The renal tubule filters the blood between
a cup-shaped membrane, Bowman’s
capsule, around the glomerulus and a
urine-collecting tubule. All of a kidney’s Loop of Henle
tubules laid end to end would stretch Positioned in the
50 miles (80 km). renal medulla
246
Afferent Glomerulus Fenestration BOWMAN’S
KIDNEY STRUCTURE
arteriole to Knot of capillaries (pore) CAPSULE
glomerulus acting as a filter The tangled system of
Juxtaglomerular capillaries forming the
apparatus glomerulus oozes a
filtrate fluid that is
collected by Bowman’s
Proximal capsule. The capsule is
convoluted about 1/125 in (0.2 mm)
tubule in diameter. The filtrate
Glomerular leaves the capsule and
capillary enters the proximal
convoluted tubule.
Podocyte
Filtration slit
Between podocytes
Efferent
arteriole Distal
from convoluted Bowman’s capsule
glomerulus tubule
KIDNEY
Urinary output
due to increased Urinary output due
aldosterone to increased ADH
Urinary output due to
reduced aldosterone Urinary output due
to reduced ADH
Pyelonephritis
An acute infection of the
urine-collecting system of the kidney
Diabetic nephropathy
Changes to capillaries in the kidneys,
which may lead to kidney failure;
caused by long-term diabetes mellitus
Glomerulonephritis
Inflammation of the filtering units of
the kidney (glomeruli); often related
to an autoimmune process
Reflux
Forcing of urine up the ureters by
back pressure; can be caused by
a blockage of the urethra
CYSTITIS
This micrograph shows
cystitis affecting a
bladder lining.
Bacteria (yellow
rods) colonize
the lining’s
inner surface
(blue), causing
inflammation.
248
URINARY DISORDERS
INCONTINENCE
A tendency to leak urine, incontinence most different types, such stress incontinence (see below).
commonly occurs in women, elderly people, and In urge incontinence, irritable bladder muscle causes
those with brain or spinal cord damage. Women the bladder to contract and expel all its urine. In total
after childbirth may be susceptible because their incontinence, a nervous system disorder such as
pelvic floor muscles may be weak. There are multiple sclerosis causes total loss of bladder function.
Uterus Contracted
bladder
wall
Stretched
bladder Relaxed
wall sphincter
muscle
Urine in
bladder
Contracted Urethra
sphincter
muscle
Weakened
Pelvic floor pelvic floor
muscle muscle
Bladder
Cartilage of
pubic
symphysis
Joint at
midpoint of
front of pelvis
Corpus
cavernosum
Spongy erectile
tissue within penis
Corpus
spongiosum
Spongy erectile
tissue within penis
Urethra
Conveys sperm from
testes, or urine from
bladder
Glans penis
Sensitive, enlarged
fleshy end of
the penis
Prepuce Rectum
(foreskin)
Loosely fitting Anus
skin sheath that
protects the Seminal vesicle
glans penis Produces bulk of seminal
fluid, including energy
sources for sperm
Testis
Produces sperm Prostate gland Ejaculatory duct
continuously, about Surrounds Conveys sperm and
50,000 per minute ejaculatory seminal vesicle
Scrotum Epididymis ducts and first secretions to urethra
Skin pouch that Coiled tube in which portion of
suspends sperm mature for urethra;
testes away from about 1–3 weeks produces fluid
body and keeps for semen
them cool
253
REPRODUCTION AND LIFE CYCLE
ACCESSORY GLANDS
The seminal vesicles and the prostate and prostaglandins. Prostate secretions account
bulbourethral glands are together termed for about 30 percent of semen, and include
the accessory glands. Their secretions are enzymes, fatty acids, cholesterol, and salts
added to sperm during ejaculation. Fluids to adjust the semen’s acid-alkali balance.
from the seminal vesicles makes up about Secretions from the bulbourethral glands
60 percent of semen by volume, and make up 5 percent of semen, and neutralize
contain sugar (fructose), vitamin C, and the acidity of urine traces in the urethra.
Ureter
Bladder
REAR VIEW
Vas deferens
OF GLANDS
Seminal vesicle
Ejaculatory duct
Prostate gland
Urethra
Bulbourethral gland
SEMINIFEROUS TUBULE
This cross section of a seminiferous
tubule shows sperm and their long
tails as they move toward the center.
Tail Midpiece
MAKING SPERM
Each testis is a mass of more than 800 tightly
looped and folded seminiferous tubules. Head
Here, sperm begin as bloblike cells called
spermatogonia lining the inner wall. As they Mitochondrion
mature, they develop tails and move steadily Energy-providing
toward the middle of the tubule. Thousands structure (organelle)
Vein
Nerve
Dorsal penile
artery
Artery
Corpus
cavernosum
Corpus
spongiosum PENILE ERECTION
During arousal, large
quantities of arterial
blood enter the corpus
spongiosum and corpus
cavernosum, compressing
the veins. As a result,
Urethra blood cannot drain from
the penis and it becomes
hard and erect.
SEMEN
Seminal fluid, or semen, is sperm
mixed with fluid added by the accessory
glands (see opposite), including the
prostate gland. The prostate secretes
fluid through tiny ducts to mix with
sperm as they are ejaculated down the
urethra. The final mix has around
300–500 million sperm in 1/15–1/6 fl oz
(2–5 ml) of fluid.
PROSTATE GLAND
This microscopic view of a section
of prostate gland tissue shows a
number of secretory ducts (orange
and white).
255
REPRODUCTION AND LIFE CYCLE
FEMALE
REPRODUCTIVE SYSTEM
THE FEMALE REPRODUCTIVE ORGANS RELEASE AN
EGG AT REGULAR INTERVALS AND, IF IT IS FERTILIZED,
PROTECT AND NOURISH THE EMBRYO AND FETUS.
REPRODUCTIVE TRACT
The female reproductive glands (ovaries) lie
within the abdomen. From puberty, they
mature and release the female sex cells
(gametes), known as egg cells or ova. This
release occurs roughly once a month as part
of the menstrual cycle (see p.283). The
ripe egg travels along the fallopian tube
to the uterus, the muscular sac in
which, if fertilized, it develops into an
embryo and then a fetus. Unfertilized
eggs and the uterine lining are shed
via the vagina. The ovaries also make
the female sex hormone estrogen.
REPRODUCTIVE ORGANS
A cross section through the female
lower abdomen reveals the reproductive
structures and organs. The ovaries sit
against the abdominal wall. The
fallopian tubes arch from them,
opening into the muscular, thick-walled
womb (uterus).
ENDOMETRIUM
This electron micrograph shows the
thick, folded, glandular endometrium
(the lining of the uterus). The tissue Rectum
shown is very rich in blood and ready Last section of
to receive a fertilized egg. large intestine
256
FALLOPIAN TUBE LINING
Fallopian tube
Also called the oviduct, or egg tube;
carries ripe eggs from ovary to uterus
Fimbriae
Fingerlike flaps that embrace ovary;
they oscillate to guide the ovulated
egg into the fallopian tube
Ovary
Produces a ripe egg with each
menstrual cycle
Uterus
Also called the womb; protects
and nourishes the developing
baby before birth
Bladder
Pushes uterus up
slightly as it fills
with urine
Pubic symphysis
Cartilage forming
the junction of the
two pubic bones
Cervix
Narrow, protruding,
collarlike neck of
the uterus
Clitoris
Urethra
Carries urine from
bladder to outside; opens
into front part of vulva
Vagina
Receptacle for sperm, exit
for menstrual blood, and
passageway for the baby
257
REPRODUCTION AND LIFE CYCLE
VULVA
The external genital parts of the female are
Clitoris
together known as the vulva. They are sited
under the mons pubis, a mound of fatty Labia majora
tissue that covers the junction of the two
pubic bones, the pubic symphysis. On the Urethra
outside are the flaplike labia majora, and
Labia minora
the smaller, foldlike labia minora lie within
Vagina
them. The labia majora contain sebaceous
glands, smooth muscle, and sensory nerve
Anus
endings. At puberty, their exposed surfaces
begin to grow hairs. Within the vulva are
the openings to the vagina and the urethra. EXTERNAL GENITALS
At the front end of the labia minora is the The external genitals have a protective role,
clitoris. Like the male penis, it is sensitive preventing infection from reaching the urethra
and engorges with blood when aroused. or vagina, but allowing urine to exit.
Egg
258
FEMALE REPRODUCTIVE SYSTEM
BREASTS
Breasts contain modified sweat glands called
mammary glands, which produce milk at childbirth.
A breast contains 15–20 lobes of compound areolar
glands, each lobe resembling a bunch of grapes on
a long stalk. The cells of the glands secrete milk,
which flows along merging lactiferous ducts
toward the nipple. The breast also contains
a widespread drainage system of lymph
vessels (see p.192).
Blood vessel
Lobule
One of the groups
of milk-producing
glands
Lactiferous
ampulla (sinus)
Widened portion
of lactiferous duct
that stores milk
Nipple
Contains
connective tissue,
smooth muscle,
15–20 lactiferous
duct openings,
and nerve endings
Areola
Dark area around
the nipple
Lactiferous
ducts
Carry milk from
glandular tissue
to nipple
Pectoral muscle
First cleavage
Large zygote
splits itself into Ovarian
two cells ligament
Cilia
Microhairs waft
the zygote
along
Goblet cells
Secrete fluid
into tube
Ovum (egg cell)
2 ZYGOTE
The fertilized egg passes along the
Up to 1/250 in (0.1 mm) across
(huge compared to other
fallopian tube. Within 24–36 hours it has cells); contains 23 maternal
chromosomes
divided into two cells, then 12 hours later
into four cells, and so on. This process is Corona cell
known as cleavage. At each stage the Secretes chemicals to aid
resulting cells become smaller, gradually egg development
approaching normal body cell size.
Tail of sperm
Lashes to propel sperm
toward egg
1 FERTILIZATION
Fertilization takes place in the
fallopian tube, when the head of the
Sperm head
Contains 23 paternal
sperm cell, or spermatozoon, penetrates chromosomes
the much larger ripe egg cell, or mature
Acrosome
ovum. This forms a single cell—the “Cap” of sperm head,
fertilized egg, or zygote, which contains which penetrates egg
23 pairs of chromosomes (see p.286). cell membrane
260
4 BLASTOCYST
CONCEPTION TO EMBRYO
About six days
after fertilization, the Blastocyst
cell cluster forms a
hollow cavity known as Blastocoele
Inner cell mass
a blastocyst. It floats Fluid-filled
Develops into the
within the uterus for cavity
embryonic body
around 48 hours
before landing on
the thick uterus Uterine
lining (endometrium), gland
Endometrium
which softens to
(uterine lining)
aid implantation
(burrowing of the Trophoblast
blastocyst into the Burrows into the
endometrium). The Maternal blood endometrium and
inner group of cells vessels forms placenta
will become the
embryo itself.
SEXUAL INTERCOURSE
Myometrium During sexual intercourse, more than 300
million sperm are ejaculated into the vagina.
Fewer enter the cervix; fewer still reach the
Endometrium
(lining of the fallopian tubes. A few hundred may reach the egg,
uterus) but only one can fertilize it.
Fallopian Female Female pubic Male pubic Vas
Cervix tube bladder cartilage cartilage deferens
Ovary Male
Vagina Uterus bladder
Cervix Seminal
vesicle
Clitoris
Ejaculatory
Penis duct
Prostate
Vagina gland
Labia Testis Male urethra
261
REPRODUCTION AND LIFE CYCLE
EMBRYONIC DISK EARLY DEVELOPMENT
Within the inner cell mass, an embryonic disk forms. This As soon as implantation has
taken place in the lining of
separates the cell cluster into the amniotic cavity, which the uterus, development
develops into a sac that will fill with fluid and fold around begins. The embryonic disk
to cover the embryo, and the yolk sac, which helps forms the three germ layers,
transport nutrients to the embryo during the second and and the placenta starts to
third weeks. The disk develops three circular sheets called form from the trophoblast.
the primary germ layers−ectoderm, mesoderm, and
endoderm−from which all body structures will derive. Endometrium
Blood-rich uterine lining
Maternal blood sinus
Loose, saclike space filled with
the mother’s blood
Trophoblast
Mass of embryonic cells that extends into
uterine lining to become the placenta
Endoderm
Forms linings of digestive,
respiratory, and urogenital tracts, Yolk sac
some glands such as thyroid, and
the ducts of liver and pancreas Embryonic disk
Amniotic cavity
Ectoderm
Develops into skin epidermis, Implantation
hair, nails, tooth enamel, central scar
nervous system, and sense
organ receptor cells
Mesoderm
Forms skin dermis, bone,
muscle, cartilage, connective
tissue, heart, cells and
vessels of blood and lymph,
also spleen and some glands
262
CONCEPTION TO EMBRYO
GROWING EMBRYO
In general, development is from the head down: the brain and head
take shape early, then the body, arms, and lastly the legs. Eight
weeks after fertilization, all major organs and body parts have Face
formed
formed. From this time on, the baby is known as a fetus.
Placenta
Amnion Developing
ear
Embryo
Limb able
to move
Brain
Yolk
sac
Heart
Arm
bud Developing
eye
Umbilical Umbilical
Neural tube stalk cord
Maternal blood
Maternal chamber
blood sinus (lacuna)
Chorionic
Chorionic
villus
villus
Fetal artery
Umbilical cord
Fetal vein vessel
Umbilical cord
Immunological, nutritional, and
hormonal link with the mother
Amnion
Strong, transparent sac within the
chorion; it encloses amniotic fluid
Amniotic fluid
Shock-absorbing liquid in
which the fetus “floats”
Chorion
Main protective sac
around the fetus
Cervical plug
Plug of thick mucus
that blocks the cervix
to prevent infection
36 WEEKS
Cervix
The fetus is
Lower part of the
now somewhat uterus that extends
restricted by the into the vagina; it stays
uterus. The side tightly closed until
of the placenta birth is near
facing the fetus
is smooth and Vagina
circular in outline, Birth canal
with the umbilical
cord attached at
the center.
264
FETAL DEVELOPMENT
HOW THE PLACENTA WORKS
Chorionic villi Oxygen, nutrients, and antibodies pass from the
Wisps of placental tissue; bunches mother to the fetus in the umbilical veins; fetal waste
of villi create large area for gas,
passes to the mother in the umbilical arteries.
nutrient, and waste exchange
Maternal
Maternal lacunae artery Maternal
Pools of maternal blood that vein
surround the chorionic villi Lining of Deoxygenated
uterus maternal
Fetal blood vessels
Umbilical arteries that blood, carrying
Pool of
branch in placenta to wastes
maternal
the chorionic villi blood Flow of
(lacuna) wastes
Maternal
blood vessel
Permeates uterine Flow of Umbilical
lining near the oxygen and artery
placenta nutrients
Knees Knees
straight bent
CERVIX SOFTENING
As labor nears, the cervix
tissues lose their firm
consistency. They become
softer and more spongy,
affected by natural
substances in the blood
Lower segment of uterus
called prostaglandins.
Cervix
CERVIX THINNING
The cervix becomes wider
and thinner, and merges
smoothly into the uterus
wall above. The process of
softening and thinning is Cervix merging with uterus
known as effacement.
Cervix thinned
CONTRACTIONS
The shortening of uterine muscles, with painful, and longer lasting. The main area of
the eventual aim of expelling the fetus, are contraction is in the muscles of the uterine
called contractions, which are regular and fundus (upper uterus), which stretches,
become steadily more frequent, more causing the lower uterus and cervix to thin.
Evenly spaced Contractions increase
Occasional, irregular Regular, mild
CONTRACTION
CONTRACTION
INTENSITY OF
INTENSITY OF
0 10 20 MINUTES 0 10 20 MINUTES
PREGNANCY 20TH WEEK PRE-LABOR 36TH WEEK
Approaching labor
Interval between
CONTRACTION
INTENSITY OF
contractions decreases
PROGRESS OF CONTRACTIONS
Gentle, partial contractions occur through much of
pregnancy. True contractions begin late in pregnancy.
At first, they are occasional and relatively weak. As
labor intensifies, they are more frequent and last 0 10 20 MINUTES
longer, putting more downward pressure on the baby. EARLY LABOR 40TH WEEK
267
REPRODUCTION AND LIFE CYCLE
LABOR
LABOR USUALLY MEANS THE FULL PROCESS OF GIVING BIRTH. IT CAN BE DIVIDED
INTO THREE PHASES OR STAGES: ONSET OF CONTRACTIONS TO FULL DILATION OF
THE CERVIX; DELIVERY OF THE BABY; AND DELIVERY OF THE PLACENTA (AFTERBIRTH).
ENGAGEMENT
Toward the end of pregnancy, the part of baby lowers the upper uterus, relieving the
the baby that will emerge first−usually the pressure on the diaphragm and making it
head−descends into the pelvic cavity. This easier for the mother to breathe. Engagement
is called engagement. Many women feel a usually takes place at about 36 weeks during
sensation of dropping and “lightening” as a first pregnancy and at the onset of labor
it happens because the movement of the during subsequent pregnancies.
Head sits above Uterus Cervix Pelvic inlet
pelvic cavity
CERVICAL DILATION
Labor begins with the onset of regular, and cervix. For a first baby, the cervix dilates
painful contractions, which dilate the at about 1⁄2 in (1 cm) per hour on average;
cervix. These occur mainly in the upper progress is usually quicker for subsequent
uterus, which shortens and tightens, babies. In most women, the cervix is fully
pulling and stretching the lower uterus dilated when it opens to around 4 in (10 cm).
3/
4 in 21/3 in 4 in
(2 cm) (6 cm) (10 cm)
dilated dilated dilated
INITIAL DILATION CERVIX WIDENS FULLY DILATED
268
Amniotic Uterus Placenta
LABOR
SIGNS OF EARLY LABOR fluid
Every woman’s personal experience of
childbirth is different, but generally there
are three particular signs that labor is
starting. First there is a “show,” followed
by contractions, and finally the water
breaks. Before labor begins (usually
less than 3 days), the mucous plug in
the cervix, which has been acting as
a seal during pregnancy, is passed as
a blood-stained or brownish discharge (the
“show”). As the contractions of the uterus
become stronger and more regular, the
membranes that retain the amniotic fluid
Mucous plug
rupture (break), allowing the fluid (water) Protects the
to leak out via the birth canal. entrance to
the uterus
Fundus
1 For most of the time during a pregnancy, the
THE “SHOW”
Continuing
contractions
2 Coordinated muscular contractions are generated 3 The amniotic sac (membrane) around the baby
CONTRACTIONS WATER BREAKS
in the upper part of the uterus, called the fundus. This ruptures, or breaks, allowing colorless amniotic
helps gradually open, or dilate, the cervix. fluid to pass out through the birth canal.
269
REPRODUCTION AND LIFE CYCLE
DELIVERY
THE CULMINATION OF PREGNANCY AND LABOR, DELIVERY OF THE BABY AND THE
PLACENTA, INVOLVES A COMPLEX SEQUENCE OF EVENTS THAT ULTIMATELY SEPARATES
CHILD FROM MOTHER, ALLOWING THE START OF THEIR INDEPENDENT RELATIONSHIP.
NORMAL
THREE STAGES OF CHILDBIRTH DELIVERY
During the first stage, the cervix dilates Newborn babies
and the water breaks (see p.269). The are usually covered
second stage, delivery, sees uterine with a combination
contractions synchronize with shifts in the of blood, mucus,
and vernix (the
baby’s position as it fits its large head into greasy covering
the birth canal and then travels along it to that protected the
the outside world. In the third stage, the fetus in the uterus).
placenta, or “afterbirth,” is delivered, often This baby’s
with the help of an obstetrician or a umbilical cord has
not yet been
midwife gently pulling on the cord. clamped and cut.
1 When the cervix is fully dilated, the baby turns so 2 The top of the baby’s head appears (“crowning”).
DILATION OF THE CERVIX DESCENT THROUGH THE BIRTH CANA
that the widest part of its skull aligns with the widest Usually, the baby faces the mother’s anus, allowing
part of the mother’s pelvis. As the baby tucks in its the emerging head to negotiate the bend in the fully
chin, it starts moving out of the uterus. stretched vagina. Birth is usually imminent at this point.
270
DELIVERY
PELVIC SHAPES
A woman’s pelvis is adapted to child-bearing has a generous capacity, and usually results
and delivery, but it varies greatly in shape. in few problems. A pelvis that is more like a
Some shapes make childbirth easier than man’s (android) is less spacious and can
others. The classic “female pelvis” (gynecoid) cause difficulties at childbirth.
Pelvic inlet 51/8 in (13 cm) Pelvic inlet 43/4 in (12 cm)
3 The obstetrician checks the cord is not around the 4 The uterus mildly contracts soon after the baby is
DELIVERY OF THE BABY DELIVERY OF THE PLACENTA
baby’s neck, and clears mucus from its nose and mouth. born, sealing any bleeding blood vessels. The placenta
The baby rotates again so the shoulders can slip out separates from the uterus and is eased out by gently
easily, one shoulder quickly followed by the other. pulling the cord while pressing on the lower abdomen.
271
REPRODUCTION AND LIFE CYCLE
AFTER THE BIRTH
OVER 40 WEEKS, THE FERTILIZED EGG HAS CHANGED FROM EMBRYO TO NEWBORN
BABY. ALL ORGAN SYSTEMS ARE IN PLACE—SOME QUICKLY ADAPT TO LIFE WITHOUT
AN UMBILICAL CORD, WHILE OTHERS DO NOT DEVELOP FULLY UNTIL ADOLESCENCE.
NEWBORN ANATOMY
Special features in a baby’s anatomy help Cartilage in the joints and at the end of
it grow and develop outside the uterus. long bones allows the skeleton to grow
Fontanelles allow the skull to expand as rapidly. In the fetus, the liver produced
the brain grows; they become bone by all the red blood cells, but this task is
the time the child is about six years old. now taken over by the bone marrow.
Jaw
Contains fully formed
Fontanelle primary (milk) teeth
Flexible, fibrous joint within jawbone; in most
between skull bones; cases, teeth do not start
fontanelles allow changes to erupt until the baby is
in skull shape, facilitating six months old
the passage of the baby
through the birth canal
Heart
Changes in structure
at birth to enable
blood to circulate
Thymus gland through the lungs
Part of the immune rather than through
system; is large at the placenta
birth, because the
immune system is Lung
maturing rapidly With the first
breath, the baby’s
Liver
lungs fill with air,
Relatively large
expand, and
at birth since it is
regular breathing
the major site of
(respiration) begins
blood production
in the fetus
Intestines
Pelvis Excrete the first fecal material
Primarily made of as a thick, sticky, greenish-
cartilage at birth; black mixture of bile and
hardens to bone mucus, called meconium
tissue (ossifies)
during childhood Femur
Long bone of the thigh;
only the shaft has hardened
into bone at birth; the ends
Genitals are still cartilage to allow
Large in both for growth
sexes; girls may
have a slight Foot
vaginal discharge At birth, most of the bones in
the foot are cartilage, and the
foot may be turned in or out
depending on baby’s position
in the uterus
272
AFTER THE BIRTH
CHANGES IN THE MOTHER
Many physiological changes take place newborn from allergies and respiratory
in the mother after birth, for which her and gastrointestinal infections), water,
body has prepared during pregnancy. protein, and minerals. After the birth,
The process of enhancing breast tissue colostrum supplies a breast-fed baby
in anticipation of breastfeeding begins with nutrition until the mother’s milk
early in pregnancy: the breasts enlarge begins to flow several days later. Soon
visibly, and the alveoli in each of the after birth, the uterus begins to shrink
milk-producing glands (lobules) swell to its prepregnancy size—a process
and multiply. From three months into that is helped by breastfeeding.
the pregnancy, the breasts
can produce colostrum,
a fluid rich in antibodies
(which help protect a Uterus,
one week
after
childbirth
UTERUS SHRINKS
After delivery of the baby
and the placenta in the Uterus, six
second and third stages weeks after
of labor, hormones in the childbirth
mother’s body cause her
uterus and vagina to
shrink back to their
normal size and position
in her body.
Stretched
vagina
returns to
normal
LACTATION
During pregnancy, lobules
(milk-producing glands)
increase in size and
number in preparation for
breastfeeding the baby.
By the end of the first
trimester, they can
produce colostrum, the
yellow fluid that provides
antibodies to protect
against allergies and Lobule New and
gastrointestinal and enlarged
respiratory infections in lobule
the newborn. BEFORE DURING PREGNANCY
PREGNANCY AND LACTATION
273
REPRODUCTION AND LIFE CYCLE
CIRCULATION IN THE UTERUS
As the placenta provides oxygen and nutrients, foramen ovale, to the left atrium (mostly
the fetal circulation has anatomical variations bypassing the right ventricle) and onward
(“shunts”) that bypass the not-yet-functioning to the body. Any blood that enters the right
liver and lungs. The ductus venosus shunts ventricle passes into the pulmonary artery
incoming blood through the liver to the right but is shunted into the aorta by the ductus
atrium, which shunts it through a gap, the arteriosus, thus bypassing the lungs.
Aorta
Lung
Right atrium
Ductus arteriosus
Foramen ovale Allows umbilical blood
Window between to bypass lungs
atria, which forms a
shortcut for blood
passing from
placenta to fetus
Left ventricle
Pulmonary artery
Ductus venosus
Connects umbilical Heart
vein to inferior
vena cava
Descending aorta
Umbilical vein
Carries all
nourishment and
dissolved gases Inferior vena cava
from the placenta
Placenta
Links blood
supplies of
mother and baby
Umbilical arteries
FETAL CIRCULATION Take waste products
Much of the fetal blood and deoxygenated
supply is a mixture of blood back to
oxygenated and placenta
deoxygenated blood.
Vessels carrying mixed
blood are indicated in
purple on this Blood supply to
illustration. lower body parts
274
AFTER THE BIRTH
CIRCULATION AT BIRTH
At birth, the baby takes its first breaths and blood returning from the lungs into the
the umbilical cord is clamped. This forces the left atrium forces shut the foramen ovale
circulatory system into a monumental response: between the two atria, thus establishing
to convert itself immediately to obtain its oxygen normal circulation. The ductus arteriosus, the
supply via the lungs. Blood is sent to the lungs ductus venosus, and the umbilical vein and
to retrieve oxygen, and the pressure of this arteries close up and become ligaments.
Blood supply from
upper body parts
Ductus arteriosus
closes
Pulmonary
artery Increased blood
flow to lungs
Pulmonary
veins
More oxygen-
rich blood enters
left atrium than
Right atrium in fetal
circulation
Heart
Liver
Descending
aorta
Inferior
vena cava
NEWBORN CIRCULATION
After birth, all the arteries carry
blood from the heart, and all veins
carry it back to the heart. Thus
most arteries carry oxygenated
blood, with the exception of the
pulmonary arteries, which carry
deoxygenated blood to the lungs.
The circulations do not mix, so all
vessels on this illustration are
either red, denoting oxygenated
blood, or blue, indicating Blood supply to
deoxygenated blood. lower body parts
275
REPRODUCTION AND LIFE CYCLE
GROWTH AND DEVELOPMENT
YOUNG CHILDREN DEVELOP BASIC PHYSICAL SKILLS AND THEN BECOME MORE AGILE,
WITH INCREASED INTELLECTUAL ABILITIES. PHYSICAL GROWTH RATE IS RAPID DURING
INFANCY, AND THEN IS FAIRLY STEADY UNTIL IT SPEEDS UP AGAIN AT PUBERTY.
BONE GROWTH
Body growth depends on the increasing (ossification) that starts before birth at
size of the skeleton. The long leg bones primary centers in the bone shafts. After
provide most of the increase in height. birth, secondary centers develop near the
Many long bones develop from cartilage bone ends. Growth ceases once ossification
precursors, by a sequence of changes is complete, at 18–20 years of age.
Blood vessel
Growth Shaft
plate
Epiphysis LONG BONE OF
Bone end, made A NEWBORN
of cartilage The shaft turns to hard
1 YEAR bone from the primary
ossification center, and
has a marrow cavity.
The head is all
Marrow cavity cartilage, and is
Periosteum
relatively soft.
LONG BONE OF
Secondary A CHILD
3 YEARS
ossification
center
A secondary ossification
center inside the end
begins to change the
Growth plate surrounding cartilage to
Produces new hardened, mineralized
cartilage bone. An elongating
Epiphyseal line growth area (growth
Ossifies during late plate) forms between
adolescence, signifying the the shaft and the end.
20 YEARS end of bone lengthening
HEAD–BODY PROPORTIONS
3/
4 If the body’s height at different
ages is superimposed onto a
grid, the changes in head–
1/
2 body proportions that take
place from birth to adulthood
are clearly shown. The overall
1/
4
growth trend is for the head to
lead, growing first and fastest.
Then the other regions of the
0 body catch up: first the torso,
BIRTH 2 6 12 18 followed by the arms, and
AGE IN YEARS finally the legs.
Cranium Suture
Brain
Suture Facial
bone
Cranium Fontanelle
Brain Suture
with one or more teeth. pattern with its mental intention Can roll over
Primary teeth loosen and to make the movement. Muscles Can stand by hoisting
fall out as the adult, or gradually become coordinated up own weight
permanent, dentition as the brain learns to combine
patterns of movements by Can sit unsupported
erupts through the gums. reinforcing and linking the neural
This usually starts at about pathways that control them. Can crawl
six years of age. The set of
32 permanent teeth is VISION AND MANUAL Holds hands together
complete once the third DEXTERITY
molars (known as wisdom A new baby can focus clearly on Plays with feet
objects up to a yard away. After
teeth) appear in the late
six months, items several yards Reaches out for a rattle
teens or early twenties. In away are clear. The eyes are
some people, however, the more coordinated, rather than Can pick up a
small object
third molars never make an occasionally squinting. Hand–
appearance above the gum. eye coordination soon develops
Can grasp an object
as the baby watches its fingers with finger and thumb
and senses what they touch.
AGE IN YEARS
2 3 4 5
14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60
AGE IN MONTHS
279
REPRODUCTION AND LIFE CYCLE
PUBERTY
AT PUBERTY, A NUMBER OF HORMONAL CHANGES STIMULATE PHYSICAL GROWTH
AND THE DEVELOPMENT OF THE SEX ORGANS. IN BOTH SEXES, EMOTIONAL,
BEHAVIORAL, AND PSYCHOLOGICAL CHANGES ALSO OCCUR.
MALE PUBERTY
In boys, the physical changes of puberty and oily skin. The sign of sexual
start later than in girls, around age 12 or maturation for boys is ejaculation.
13. Most show signs of development by age Although they are capable of having an
14, and complete the changes of puberty by erection from birth, boys only produce
age 17 or 18. The testes and penis get bigger sperm when testosterone begins
first, then hair grows in the pubic area and circulating in their bodies. It is then that
armpits. Muscles increase in bulk, and they are able to ejaculate for the first time.
some breast tissue might also develop. The
hormone testosterone causes cartilage in Adult height
the voice box to grow larger and thicker,
which results in the vocal cords getting
longer and thicker. This causes the cords Facial hair
Starts as a light
to vibrate at a lower frequency, so down, becoming
the voice becomes deeper. Finally, coarser
facial hair appears, which Broadened chest
may be accompanied by
acne. Boys are more likely
than girls to experience Chest hair
problems with perspiration Continues growing
until age 30; some
men have little or
no chest hair
Pubic hair
Enlarged genitals
MATURING SPERM
This cross section through several
seminiferous tubules in the testis
shows maturing sperm with tails in
the center (blue).
HYPOTHALAMUS
HYPOTHALAMUS
Progesterone
Preparation for
possible pregnancy
Gonadotropin-releasing hormone
Stimulates release of LH and FSH
PITUITARY GLAND
Ovulation
Mature follicle leaves
the ovary; corpus
Luteinizing hormone luteum develops
Causes the mature follicle to
CORPUS LUTEUM
rupture and release the egg
OVARY
Follicle development
Follicle-stimulating hormone One follicle ripens Estrogen
Acts on the ovary to stimulate into a mature egg Development of female
the growth of follicles sexual characteristics
282
PUBERTY
THE MENSTRUAL CYCLE
For a few days each month, the lining of random. If fertilized, the embryo is implanted
the uterus is shed and blood passes out into the uterine wall, and signals its presence
through the vagina. The lining thickens by releasing human chorionic gonadotropin
again to prepare for the implantation of a (HCG), the hormone measured in pregnancy
fertilized egg. This is the menstrual cycle. tests. This signal maintains the corpus
It starts when the pituitary gland releases luteum and enables it to continue
FSH (see opposite), which stimulates egg producing progesterone. In the absence
follicles in the ovary. The follicles secrete of a pregnancy and without HCG, the
estradiol, a form of estrogen. This triggers corpus luteum dies and progesterone
the release of LH, which matures the egg levels fall. Progesterone withdrawal leads
and weakens the follicle wall, allowing the to menstrual bleeding and, as FSH levels
release of the mature egg (ovum). Whether rise, a new crop of follicles is formed—the
the right or left ovary ovulates is entirely cycle begins again.
Estrogen Progesterone
FSH LH
Produced by Produced by empty
Causes egg Triggers ovulation
developing eggs; egg follicle to thicken
HORMONES
lining
to proliferate
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1 2 3 4
DAYS OF MENSTRUAL CYCLE
283
REPRODUCTION AND LIFE CYCLE
AGING
THE BRAIN, MUSCLES, JOINTS, EYES, AND OTHER ORGANS ALL DECLINE WITH AGE,
BUT CHANGES ARE USUALLY SMALL UNTIL AFTER THE AGE OF 60. GENETICS AND
LIFESTYLE ARE MAJOR CONTRIBUTORS TO A PERSON’S LIFESPAN.
CELLULAR DETERIORATION
Cells divide a fixed number of times
and then stop functioning properly.
Connective tissue becomes increasingly
stiff, making the organs, blood vessels,
Epidermis
and airways more rigid. Changes in Thick layer
cell membranes impede the delivery confers strength
of oxygen and nutrients and the
Dermis
removal of carbon dioxide and wastes, Well supplied
causing an increase in pigments and with elastic and
fatty substances inside cells. How collagen fibers
YOUNG SKIN
A thick top layer, many elastic
Liver spots and collagen fibers in the deeper
Pigmentation patches in
layers, good layers of supporting
areas exposed to sun
fat, and plenty of sebaceous glands
Wrinkles
producing oil all help maintain the
Creased, sagging skin smoothness and suppleness
that gives a lined of young skin.
appearance
Dermis
Thinner; contains fewer
collagen fibers, causing
reduced elastic recoil
Fatty layer
Thicker relative to
dermis, although may
also be thinner with age
HEARING VISION
More than half of people over 60 have hearing Older people are susceptible to a number of
difficulties. Problems are caused by changes in the visual disorders (see p.129). In a cataract, for
cochlea in the inner ear (see p.117). At birth, example, the normally transparent lens of the
there are about 15,000 hair cells in the inner ear, eye becomes cloudy. Meanwhile, macular
but they gradually reduce with age, and the body degeneration can affect the retina, causing
is unable to generate new cells. detailed vision to deteriorate.
0 Age 20
HEARING LOSS (DECIBELS)
10
Age 30 Lens degeneration
20 Lens usually thickens
and loses ability to
30 Age 50 focus (presbyopia),
and a cloudy lens
40 (cataract) can lead
Age 70
to poor vision.
50
60
400 3,000 20,000
FREQUENCY (HERTZ)
MENOPAUSE
Menopause results from
decreased production of sex
hormones. Symptoms include hot
flashes, insomnia, night sweats, Ovaries Vaginal lining Ovaries Vaginal lining
produce is thick and produce less or becomes thin
and headaches. Falling estrogen
estrogen moist no estrogen and dry
levels can also cause depression.
Vaginal Fluids are Less secretion The vagina
Menstruation may be irregular
walls secreted of fluids narrows
for several years up to are elastic during sex during sex and shortens
menopause, which is complete
once a woman has not had a PREMENOPAUSAL POST MENOPAUSAL
period for one year. The average VAGINA VAGINA
Before menopause, the vaginal Declining estrogen levels cause
age for menopause in developed
lining is thick and well lubricated; a reduction in vaginal mucus
countries is 51 years. the walls stretch easily and mucous production; the vagina walls lose
fluids are secreted. some elasticity and become thinner.
285
REPRODUCTION AND LIFE CYCLE
INHERITANCE
THE PASSING OF GENETIC INFORMATION FROM PARENT TO CHILD IS KNOWN AS
INHERITANCE. THE INFORMATION IS CONTAINED IN CHEMICAL CODES CARRIED
BY DEOXYRIBONUCLEIC ACID (DNA) IN THE SEX CELLS (EGGS AND SPERM).
INHERITANCE OF GENES
Everything that specifies a person is found to produce a complex trait, such as athletic
in the genes. Each gene carries a “blueprint” ability. Simple features controlled by single
to make a particular product, some of which genes are inherited in predictable patterns
affect appearance or biology—skin pigment, (see pp.290–93). However, complex traits,
for instance. Other gene products combine such as height, are controlled by many genes.
CELL
The genetic information of DNA is based
in the cell’s nucleus. Almost every type of
body cell carries DNA, but a few
specialized types, such as red blood
cells, lose it as they mature.
Sex
chromosome Y
Sex
chromosome
X
Chromosome
pair 22
Nucleus
GENOME
The full complement of genetic
instructions, known as the human
genome, is carried by 23 pairs of
chromosomes (see p.34). They represent
about 20,000 protein-coding genes—a
relatively low number for an organism as
Chromosome 12
complex as the human being. The tiny Contains 4–4.5%
fruit fly Drosophila, long used for genetic of total genomic DNA;
experiments, has 13,600 genes. carries 1,000–1,300 genes
286
INHERITANCE
SEQUENCING THE GENOME
By 2003, the Human Genome Project identified all 3 billion base
pairs in the full set of human DNA. In 2012, it was realized that a
large portion of the DNA instructs for building RNA rather than
proteins. A major technique used in DNA sequencing is gel
electrophoresis. DNA is extracted from cells, purified, and
broken into smaller fragments of known length by chemicals
known as restriction enzymes. The DNA fragments are separated
out and stained with dye, showing up as dark stripes, like bar
codes (see right). Computers can read these bar codes and
reveal the sequences of base pairs.
CHROMOSOME
Each chromosome is an immensely long,
thin molecule of DNA. When ready for
cell division, it duplicates itself as a double-
chromosome consisting of two identical
Chromatids sister chromatids, in which the DNA is
Replicated twins coiled, looped, and folded into one
generally cross-shaped structure.
Centromere
Links chromatids;
attaches to spindle
during cell division
Chemical
bases T G C T G
G
A A C
C C G
Base pair
C–G
2 Free nucleotides, each one a base combined with 3 More nucleotides join, linked by a new backbone.
BASES JOIN TWO STRANDS FORM
a portion of DNA backbone, join to the two sets of Each strand now has a new “mirror-image” partner,
exposed bases. This can only happen in the correct giving two double helices, which are identical to
order, since A always pairs with T, and C with G. each other and to the original.
MUTATIONS
DNA replication usually works well. However, factors exactly. This change is a mutation. The new base
such as radiation or certain chemicals may cause a sequence may produce a different protein, which
fault, where one or more base pairs do not copy could cause a problem in the body.
1 DNA replicates
PREPARATION Nuclear
membrane
Centromere
2 A spindle fiber holds
ALIGNMENT Centromere
1 DNA strands
PREPARATION
2 The matching
PAIRING
Spindle Chromosome
Nucleus
6 FOUR OFFSPRING
5 The double-
SECOND SEPARATION The four sex cells
differ from each other
chromosome splits, each and the parent cell in
half moving to one end Single their genetic
of the dividing cell. chromosome composition.
289
REPRODUCTION AND LIFE CYCLE
PATTERNS OF INHERITANCE
GENES ARE PASSED FROM ONE GENERATION TO THE NEXT, IN A VAST SEQUENCE
OF INHERITANCE. THEY ARE RESHUFFLED AT EACH STAGE SO THAT OFFSPRING ARE
UNIQUE, BUT THERE ARE PATTERNS IN THE MODE OF INHERITANCE.
VERSIONS OF GENES
Each cell in a body contains a double set two versions of every gene in the set−one
of genetic material, in the form of 23 pairs maternal and one paternal. These versions
of chromosomes. One chromosome of of genes are called alleles. Inheritance
each pair, and the genes on it, come from patterns vary depending on how these two
the mother. The other chromosome is versions interact, because they may be
from the father. So there are, in effect, identical or slightly different.
TWO BY TWO
Chromosome pairs have the
same sets of genes. But the
individual allele on one
chromosome may differ slightly
from its equivalent allele on the
other chromosome.
290
PATTERNS OF INHERITANCE
GENERATIONAL SEQUENCE
The two versions of the genes (alleles) are grandparent. The child’s inherited features
mixed, or reshuffled, as they are inherited at strongly resemble a mixture of those from
each generation. In effect, a child inherits his or her parents, but the features from the
one-quarter of its total genes from each grandparents appear to be less marked.
GRANDPARENTS MIXED, BUT
NOT BLENDED
MATERNAL MATERNAL PATERNAL PATERNAL
GRANDMOTHER GRANDFATHER GRANDMOTHER GRANDFATHER Genes are “units” of
inheritance that are
shuffled at each
generation into
different
combinations.
Individual genes
do not blend with
each other to create
new versions.
INHERITANCE OF GENDER
Gender depends on which sex A woman’s egg cells all contain an X,
chromosome−an X or a Y−is inherited. whereas half a man’s sperm cells contain an
Females have two X chromosomes; males X and the other half a Y. Thus, the gender of
have an X and a smaller Y, with male genes. offspring is always determined by the father.
MOTHER FATHER Y chromosome
X chromosome
BOY OR GIRL?
Gender is determined
X X X Y by the inheritance of
the sex chromosomes,
X and Y (the other 22
chromosome pairs are
not shown here).
X X X Y X X X Y
DAUGHTER SON DAUGHTER SON
291
REPRODUCTION AND LIFE CYCLE
RECESSIVE AND DOMINANT
GENES
Each gene in a cell exists in two versions, results. One allele may be dominant and
one inherited from each parent. In some “overpower” the other, which is recessive.
cases these gene versions, or alleles, are An example is eye color, although this is
different, and produce slightly different not as simple as depicted below.
BLUE EYES
Recessive allele
for blue eyes
RECESSIVE AND RECESSIVE
Each parent has two alleles for eye
color. Here, both parents have only
“blue” alleles. When both alleles are
the same, the individual is said to
be “homozygous.” Their children
can only inherit “blue” alleles, so
all have blue eyes.
ALL INDIVIDUALS HAVE BLUE EYES
BLUE EYES BROWN EYES
Recessive Dominant
allele for allele for
blue eyes brown eyes
RECESSIVE AND MIXED
One parent has two “blue”
alleles; the other, one “blue”
and one “brown” allele.
“Brown” is dominant and takes
over when it occurs with “blue.”
So the chance is 1 in 2 that each
offspring has brown eyes. BLUE EYES BROWN EYES BLUE EYES BROWN EYES
X X X Y COLOR-BLIND FATHER
AND UNAFFECTED MOTHER
Sex chromosomes combine in four
possible ways, governed by chance.
Here, any daughter will inherit the
color-impairment allele, and will be
a carrier, but she also has the normal
allele on her other X chromosome, to
X X X Y X X X Y give normal vision. No sons can be
affected, nor can they be carriers.
CARRIER UNAFFECTED CARRIER UNAFFECTED
DAUGHTER SON DAUGHTER SON
MULTIPLE-GENE INHERITANCE
Some body traits follow clear single-gene a trait may be influenced by more than one gene.
inheritance patterns. However, the situation These two situations mean that a trait can be
becomes more complex in two ways. First, there governed by multiple genes, and for each of these
may not be only two alleles of a gene with a simple genes, by multiple alleles of the gene—added to
dominant–recessive interaction between them. which, the genes may interact in different ways,
There may be three alleles or more in existence in according to which alleles are present in each of them.
the general population, although each person can In such cases, the numbers of possible combinations
have only two of them. An example is the blood multiply, consequently making multi-gene inheritance
group system, with alleles for A, B, and O. Second, exceptionally difficult to unravel.
293
REPRODUCTION AND LIFE CYCLE
MALE REPRODUCTIVE DISORDERS
DISORDERS AFFECTING THE EXTERNAL PARTS OF THE MALE REPRODUCTIVE TRACT ARE USUALLY
APPARENT AT AN EARLY STAGE; THOSE AFFECTING INTERNAL PARTS, SUCH AS THE PROSTATE GLAND,
MAY NOT BE NOTICED UNTIL LATER, WHEN SUCCESSFUL TREATMENT MAY BE HARDER TO ACHIEVE.
PROSTATE DISORDERS
Bladder
Conditions that affect the prostate gland
range from inflammation and benign
enlargement to serious disorders such Prostate
gland
as cancer. Prostate disorders are very
common and tend to occur in the middle Urethra
and later years of a man’s life. Prostate
cancer, although potentially life- Cancerous
tumor
threatening, tends to occur most
commonly in elderly men, in whom it
often grows slowly and may not cause PROSTATE CANCER
symptoms. New diagnostic techniques A cancerous tumor of this size on the prostate gland is unlikely
are detecting the condition in much to cause immediate problems, but as it grows it may press on
the urethra, and may spread to other parts of the body.
younger men, who do need treatment.
Enlargement of the prostate is extremely NORMAL PROSTATE ENLARGED PROSTATE
common and is considered part of the
aging process; most men over age 50
have it to some degree. If the enlarged
gland constricts the urethra, it can cause Enlarged
prostate
distressing urinary symptoms, including presses on
frequent urination, delay in starting to urethra
urinate, weak flow, dribbling, and a
feeling of incomplete bladder emptying. ENLARGED PROSTATE
Prostatitis (see below) is a common A normal prostate gland fits snugly around the urethra and
condition, often caused by infection. abuts the bladder; enlargement can squash the urethra.
PROSTATITIS
Inflammation of the prostate gland, or prostatitis, can CAUSATIVE BACTERIUM
be acute or chronic. The acute type is less common; This electron micrograph shows the bacterium
severe symptoms such as fever and pain in the Enterococcus faecalis, implicated in prostatitis. It
lower back come on suddenly, but usually clear up is a normal, harmless inhabitant of the human gut.
quickly. Chronic prostatitis features long-standing
but often mild symptoms that are difficult to treat,
such as groin and penis pain, pain on ejaculation,
blood in semen, and painful urination. Possibly
caused by a bacterial infection from the urinary
tract, both types are most common in men
between 30 and 50 years old.
294
MALE REPRODUCTIVE DISORDERS
TESTICULAR CANCER
Cancer of the testis is one of the most commonly treatment of the cancer is vital and has a very high
occurring cancers in men between the ages of 20 cure rate, all men should regularly examine their
and 40. Although it is curable if discovered early, testes; any swellings or changes in the scrotal skin
the cancer can spread to lymph nodes and to other should be reported immediately. Soft lumps or
parts of the body if not treated. Symptoms of painful swellings are likely to be caused by a cyst or
testicular cancer include a hard, painless lump in infection, but should still be checked.
the testis; a change in the size and appearance of
the testis; or a dull ache in the scrotum. There
are two main types of testicular cancer, seminoma
and non-seminoma. They develop from the
sperm-producing cells of the testis. As early
TUMOR ON TESTIS
A tumor of this size on Tumor
the outer wall of the testis Tiny growth
would be clearly felt on the testis
through the thin outer skin
Scrotum
and layers of the scrotum.
HYDROCELE
Each testis is surrounded by a double-layered the condition often gets better without the need for
membrane, which under normal conditions treatment. However, if the condition is causing
contains a small amount of fluid. In a hydrocele, discomfort, the hydrocele may be surgically
an excessive amount of fluid forms, causing the removed or, for those who are not fit enough for
testis to appear swollen. The condition occurs surgery, the fluid may be drained from the area
most frequently in infants and elderly people. The using a needle and syringe.
cause of hydrocele is not usually known, although
infection, inflammation, or injury to the testis are
possible triggers. A hydrocele does not usually
cause any pain, but may result in a dragging
sensation due to the increased size and weight of
the scrotum. In younger people with hydrocele,
SWOLLEN TESTIS
A hydrocele is the result Scrotum
of excess fluid filling the
double-layered membrane Testis
that surrounds the testis; Fluid
it causes the scrotum to Fluid accumulates
appear swollen. around the testis
295
REPRODUCTION AND LIFE CYCLE
FEMALE REPRODUCTIVE DISORDERS
MANY FEMALE REPRODUCTIVE DISORDERS ARE HARMLESS, AND SOME ARE EVEN SYMPTOMLESS.
HOWEVER, WIDE HORMONAL FLUCTUATIONS AND PHYSIOLOGICAL STRESSES CAN LEAD TO
MORE SERIOUS DISORDERS, INCLUDING VARIOUS TYPES OF CANCER.
BREAST LUMPS
A breast lump is a solid or swollen an overgrown lobule, and a more defined one
area that can be felt or seen in the may be a cyst. Only a small percentage of lumps
tissue of the breast. General lumpiness are a symptom of breast cancer. All women
is common as breasts change shape should familiarize themselves with the shape
during puberty, pregnancy, and prior to of their breasts during the menstrual cycle, so
menstruation. Nonspecific lumpiness that they can look and feel for abnormal changes,
usually relates to the hormonal and immediately report them to their doctor.
fluctuations of the menstrual From the age of around 50, women are invited to
cycle. A single lump may be attend regular screening.
Fibroadenoma
A common
noncancerous
BREAST CANCER
breast lump Cancer of the breast is the most
Cyst common female cancer. The risk
One or more increases with age, doubling every 10
fluid-filled sacs years. The causes are unclear, but risk
within breast
factors have been identified. Women
with higher exposure to estrogen—for
Fatty tissue example, through having an early
puberty, late menopause, or no
children—have a higher risk. Age
Nonspecific is significant, with many more cases
lumpiness occurring over the age of 50. Faulty
Usually related to
genes are also a known cause. A breast
menstruation;
often called lump, usually painless, is often the first
fibrocystic sign of breast cancer.
disease
ENDOMETRIOSIS
Endometriosis is a common condition, affecting many of endometrial tissue grow outside the uterus, most
women of childbearing age. It can cause debilitating commonly on the ovaries and in the pelvis. These
pain and very heavy periods; in severe cases, the pieces of tissue respond to hormonal changes and
condition can lead to fertility problems. The bleed during menstruation. Since the blood cannot
endometrium, the lining of the uterus, is shed leave the body through the vagina, its normal exit, it
approximately once every month as part of the irritates nearby tissues, causing pain and eventually
menstrual cycle. Endometriosis is when small areas forming scars. The cause of the disorder is unknown.
296
FEMALE REPRODUCTIVE DISORDERS
FIBROIDS
Fibroids are very common, occurring in Intracavity Subserous Fallopian
polyp tube
about one third of women of childbearing
age. They can occur singly or in groups, and
can be the size of a pea or as large as a
grapefruit. Small fibroids are unlikely to
cause any problems. Larger ones may result
in prolonged and heavy menstrual bleeding,
Intramural
and increasingly severe period pain. Large
fibroids can distort the uterus, which may Submucosal
cause infertility, or put pressure on other Ovary
organs, such as the bladder or rectum.
Uterus
SITES AND TYPES OF FIBROIDS Cervical
Fibroids can occur in any part of the uterus
wall and are named according to their site—
for example, in the cervix—or in the tissues
they occupy, such as submucosal fibroids.
PROLAPSED UTERUS
Prolapse of the uterus is more likely to occur The uterus protrudes down into the vagina, and
after menopause, when low estrogen levels affect in severe cases may reach as far as the vulva.
the ability of the ligaments to retain the uterus. Symptoms may include a feeling of fullness in
Childbirth, obesity, and straining while coughing the vagina, pain in the lower back, and difficulty
or opening the bowels are contributing factors. urinating or passing feces.
Prolapsed
uterus
Pelvic brim
Cervix
Levator
Deep ani
muscle Weakened Weakened
transverse Obturator internus
muscle muscle
perineal muscle muscle
GONORRHEA
Although gonorrhea tends to be more
prevalent among males, it can also affect
women. The main sites of infection are
the urethra and, in women, the cervix. The
symptoms often do not appear, but if they
do they commonly include a discharge of
pus from the penis or vagina and pain on
urination. Women may also experience
lower abdominal pain and irregular vaginal
bleeding. Occasionally, the infection spreads
to other parts of the body, such as the joints
(via the bloodstream). If the disease is left
untreated, it can cause infertility in women.
GONORRHEA BACTERIA
An electron micrograph of Neisseria
gonorrhoeae, which is responsible
for the STI gonorrhea.
INFECTED PARTS
The fallopian tube and ovary on
the right of the image are inflamed Inflamed Inflamed
and swollen as a result of PID. ovary fallopian tube
298
SEXUALLY TRANSMITTED INFECTIONS
NONGONOCOCCAL URETHRITIS
Nongonococcal urethritis (NGU) is one of the most chlamydial infection. Other possible causes of NGU
common STIs affecting men. Typically, it features include the bacterium Ureaplasma urealyticum; the
inflammation of the urethra, with or without a protozoan Trichomonas vaginalis; the fungus
discharge of pus; inflammation and soreness at the Candida albicans; the genital warts virus (human
end of the penis; and pain on urinating, particularly papillomavirus, HPV); and the genital herpes viruses.
when the urine is concentrated first thing in the It is important for both partners to seek treatment to
morning. In about half of all cases, the agent avoid reinfecting each another. To prevent STIs,
responsible is Chlamydia trachomatis, a bacterium sexually active people should limit their sexual
that can also infect women, leading to partners, and use a condom for penetrative sex.
Urethra
SYMPTOMS OF NGU Inflammation
Inflammation of the of urethra
causes pain on
urethra causes pain urination
and soreness at the
external opening on Testis
the penis, and painful May become
swollen if
urination. If the
infection spreads
infection spreads,
the epididymides Epididymis
and the testes may Sometimes also
also become swollen. becomes inflamed
Egg
ENDOMETRIOSIS
Fragments of
endometrium start
growing in one tube,
causing blockage
Ovary
and distortion, and Uterus
rendering the tube Ovary
Uterus
useless as a
passageway for Antibody
eggs to the uterus.
Cervix
Mucus Cervix
OVULATION PROBLEMS
Any deviation from the normal ovulation pattern ANTIBODIES
TO SPERM
can cause problems with fertility. The precise Some women
problem can range from complete absence of make antibodies
Mucus
egg release to infrequent release. Factors that to their partner’s
can lead to ovulation problems include pituitary sperm, which Opening
and thyroid gland disorders, polycystic ovary are immobilized of cervix
as they travel Sperm
syndrome, long-term use of oral contraceptives, from the vagina
being very over- or underweight, stress, excessive to the cervix.
exercise, and premature menopause.
300
INFERTILITY DISORDERS
PROBLEMS WITH DIFFICULT PASSAGE
SPERM PRODUCTION OF SPERM
A man may produce sperm in low quantities, or Sperm has a long and tortuous journey from its
his sperm may be deformed or unable to swim source in the testis until it is ejaculated. Narrowing,
properly. All these problems reduce the likelihood blockage, or other distortion of any of the tubes,
that his sperm can contribute to conception. Huge including the epididymis and vas deferens, that
numbers of sperm must be produced in order for make up this network can slow or completely block
fertilization to occur; men in whom this does not the passage of sperm. Causes of this problem are
happen have a low sperm count. Microscopic various, but infection of the male reproductive
examination can reveal this problem and can also system is most likely. Some sexually transmitted
look at the size, shape, and movement (motility) infections (STIs, see p.298), most notably
of individual sperm. Problems in any of these gonorrhea, can cause inflammation of the tubes,
areas can cause reduced fertility. If only a small which leaves scar tissue that can distort their
volume of semen is produced per ejaculation, structure and affect their sperm-carrying ability.
fertility may also be reduced.
Narrowed lumen of
vas deferens
EJACULATION PROBLEMS
A number of ejaculation problems prevent sperm
from arriving in the vagina by the normal means,
making fertilization impossible. The most common
is erectile dysfunction (the difficulty in achieving
or maintaining an erection). This condition may
be a result of diabetes mellitus (see pp.142–143),
a spinal cord disease, impaired blood flow, certain
drugs, or psychological problems. Another
problem, retrograde ejaculation, causes semen
to flow back into the bladder because of faulty
valves; this can be a complication of surgery
for partial or complete removal of the prostate INFLAMED VAS DEFERENS
Damage to the vas deferens, one of the tubes that
gland. Various treatments are available that can transports the sperm, can prevent or slow down its
help reduce erectile dysfunction, depending passage. Infection, usually by a sexually transmitted
on the nature and cause of the problem. organism, can be responsible for such damage.
301
REPRODUCTION AND LIFE CYCLE
PREGNANCY AND LABOR DISORDERS
PROBLEMS CAN ARISE IN NORMALLY HEALTHY WOMEN DURING PREGNANCY AND LABOR, WHICH
MAY ENDANGER BOTH THE MOTHER’S AND THE BABY’S HEALTH. FEW DISORDERS OF PREGNANCY
AND LABOR HAVE ANY PERMANENT PHYSICAL EFFECT ON EITHER MOTHER OR BABY.
ECTOPIC PREGNANCY
About 1 percent of pregnancies
Fallopian
are ectopic; they are more tube
common in women under the
age of 30. The fertilized egg does
not implant in the uterine lining,
which is the normal place, but
develops in one of the fallopian
tubes or, more rarely, in another
Ovary
area altogether. The embryo Uterus
Fallopian
does not develop normally, so
tube
the pregnancy usually fails. IMPLANTED EMBRYO
The embryo must be surgically In an ectopic pregnancy, the egg
embeds in the wrong place—often
removed to avoid rupture of the in the fallopian tube. Normally, the
fallopian tube and to prevent embryo travels to the uterus, where Embryo embedded into
internal bleeding. growth and maturation occur. fallopian tube lining
PLACENTAL PROBLEMS
Two main problems can affect
the placenta: placenta previa,
in which the placenta covers Amniotic
fluid
the opening to the cervix; and
Placenta
placental abruption, in which Uterus
the placenta separates from the Blood
uterine wall. The degree of Umbilical between
cord uterus
severity in placenta previa
and
depends on how much of the placenta
cervix is covered. If completely
covered, the condition is Placenta Uterus
serious. Placental abruption Cervix
often comes on suddenly, and
can threaten the fetus because
essential blood supplies are PLACENTA PREVIA PLACENTAL ABRUPTION
compromised. Both conditions In complete placenta previa, as Premature separation of the
shown here, the placenta entirely placenta from the uterus may
can cause vaginal bleeding, but covers the cervix. In a less severe be concealed, as shown here,
in less severe cases, symptoms form, the placenta only partially in which case blood collects
may go unnoticed. obstructs the exit from the uterus. between the uterus and placenta.
302
PREGNANCY AND LABOR DISORDERS
MISCARRIAGE PRETERM LABOR
Miscarriage, or spontaneous Most pregnancies last for about
abortion, is the unintended end 40 weeks, but delivery during the
of a pregnancy before week 24. final three weeks is considered
It is very common, occurring in to be full term. Labor that
25 percent of all pregnancies. occurs before 37 weeks is
Most miscarriages occur in the known as preterm and results in
first 14 weeks of pregnancy; a premature baby. Premature
over half of them are due to a labor rarely causes maternal
genetic or fetal abnormality. problems, but the earlier the
Later miscarriages have various birth, the greater the problems
causes, ranging from physical encountered by the baby. The
problems with the cervix or cause is not always known, PREMATURE BABY
uterus to severe infection. but multiple births, urinary tract This premature baby is being fed
infection, and fetal abnormalities through a nasogastric tube because
Smoking, alcohol, or drug
his sucking reflex has yet to develop
abuse may also be factors. are known to be trigger factors. and his swallowing ability is poor.
If three or more occur Sometimes, premature labor can Other features are his tiny size,
consecutively, it is known as be halted or delayed, giving the wrinkled and yellow skin, and
recurrent miscarriage. baby more time in the womb. disproportionately large eyes.
Amniotic Placenta
fluid
ABNORMAL PRESENTATION
Eighty percent of babies adopt
the normal delivery position for
birth, with the head down and
facing toward the mother’s back.
The baby usually achieves this
position by about week 36.
Other babies are in a position
that may cause problems during
labor. Breech (see p.266) and
occipitoposterior positions (see
right) are the most common of
Fetus Umbilical
cord these abnormal presentations.
In a breech birth, the baby’s
Umbilical
buttocks present first. Some cord
Vaginal bleeding
presentations may allow the
Fetus facing Placenta
umbilical cord to drop through forward
THREATENED MISCARRIAGE the birth canal and cause fetal
The fetus remains alive and the
distress. The cervix and vagina
cervix is closed, although there OCCIPITOPOSTERIOR POSITION
is some blood loss. It may are more vulnerable to tears if Although the baby’s head is
proceed to full miscarriage, the presentation is abnormal. facing down, as is normal, the baby
when the fetus dies, or a is turned 180° toward the front,
successful birth. instead of facing the mother’s back.
303
REPRODUCTION AND LIFE CYCLE
INHERITED DISORDERS
INHERITED DISORDERS ARE CAUSED BY DEFECTIVE GENES OR ABNORMAL CHROMOSOMES.
IN CHROMOSOME DISORDERS, THERE IS A PROBLEM IN THE NUMBER OR STRUCTURE OF
CHROMOSOMES, WHEREAS IN GENE DISORDERS, THERE IS A FAULT IN ONE OR MORE GENES.
Bleeding
Calcium Cancerous cells
deposits disrupt and
Hard deposits of breach tiny
calcium minerals blood vessels
may build up in
tumors Nerve
Pressure on the
nerves may cause
Blood vessel
the tumor to
Blood circulation
become painful to
is one major
surrounding
route for the
tissues
spread of
cancerous cells
A
Accommodation
cornea and front of the iris and lens.
Arteriole
functions, such as breathing and
the heartbeat.
The process by which the eyes A small terminal branch of an artery Bronchus (pl. bronchi)
adjust to focus on nearby or leading to even smaller capillaries, One of the larger air tubes in the
distant objects. which link to the veins. lungs. Each lung has a main
bronchus that branches into smaller
Adenoids Artery and smaller airways.
Clusters of lymphoid tissue on each An elastic, muscular-walled tube that
side of the back of the upper part
of the throat.
transports blood away from the heart
to other body parts. C
Capillary
Adipose tissue Atrium (pl. atria) One of the numerous tiny blood
Tissue made of specialized cells that One of two thin-walled, upper vessels that link the smallest arteries
store fatty (lipid) substances for chambers of the heart. and smallest veins.
energy, for protective “padding,”
and to provide heat insulation. Autonomic nervous system (ANS) Cardiac
The portion of the nervous system Relating to the heart.
Allele controlling unconscious functions
Form or version of a gene. For such as heartbeat and breathing. Cartilage
example, the gene for eye color Type of connective tissue that
has blue and brown alleles. Axon is tough and resilient, and often
The long, fiberlike process of a nerve flexible; forms some structural
.
Alveolus (pl alveoli) cell that conducts nerve impulses parts, such as the ear and nose,
One of many tiny air sacs at the ends away from the cell body. and lines bone ends inside joints.
of the airways in the lungs. Gases
diffuse in and out of blood through
the alveolar walls. B
Bacterium (pl. bacteria)
Central nervous system (CNS)
The brain and spinal cord; receives
and analyzes sensory data, and
Amino acid A type of microorganism with one initiates a response.
One of about 20 kinds of building- cell. Only a few of the many species
block subunits of protein. of bacteria cause disease. Cerebellum
A region of the brain located behind
Antibody Base the brainstem. It is concerned with
A soluble protein that attaches to In nucleic acids (DNA, RNA), a balance, posture, and the control of
body invaders, such as bacteria, and nitrogen-containing chemical unit or fine movement.
helps destroy them. nitrogenous base (adenine, thymine,
guanine, cytosine, uracil), the order Cerebrospinal fluid
Aorta of which carries genetic information. A watery fluid that bathes the brain
The central and largest artery of the and spinal cord.
body. It arises from the left ventricle Bile
of the heart and supplies oxygenated A greenish-brown fluid secreted by Cerebrum
blood to all other arteries except the the liver that is concentrated and The largest part of the brain; made
pulmonary artery. stored in the gallbladder; released up of two cerebral hemispheres. It
following food intake to help the contains the nerve centers for
Aortic valve digestion of fats. thought, personality, the senses, and
A triple-cusped valve at the origin of voluntary movement.
the aorta that allows blood to leave Biliary system
the left ventricle of the heart but The network of bile vessels formed by Chromosome
prevents backward flow. the ducts from the liver and the A threadlike structure, present
gallbladder, and the gallbladder itself. in all nucleated body cells,
Appendix that carries the genetic code
The wormlike, dead-ended structure Bone marrow for the formation of the body.
attached to the large intestine. Its Fatty tissue within bone cavities that Chromosomes coil into “X” shapes.
function, if it has one, is as may be red or yellow. Red bone A normal human body has 23 pairs
yet unknown. marrow produces red blood cells. of chromosomes.
306
GLOSSARY
Cochlea Diaphragm Epidermis
The coiled structure in the inner ear The dome-shaped muscular sheet The outer layer of the skin; its
that contains the organ of Corti, that separates the chest from the box-shaped cells become flatter and
which converts sound vibrations into abdomen. When the muscle scalier toward the surface.
nerve impulses for transmission to contracts, the dome flattens,
the brain. increasing chest volume and Epiglottis
drawing air into the lungs. A leaflike flap of cartilage located at
Collagen the entrance of the larynx, which
The body’s most important Diastole covers the opening of the airways
structural protein, present The period in the heartbeat cycle during swallowing and helps prevent
in bones, tendons, ligaments, when all four chambers are relaxed food or liquid from entering the
and other connective tissues. and the heart is filling with blood. windpipe (trachea).
See systole.
Colon Epithelium
The part of the large intestine that Digestive system Specialized covering or lining
extends from the cecum to the The mouth, pharynx, esophagus, tissue that forms sheets and
rectum. Its main function is to stomach, and intestines. Associated layers around and within many
conserve water by absorbing it organs are the pancreas, liver, organs and other tissues.
from the bowel contents. and gallbladder.
Esophagus
Cornea DNA (Deoxyribonucleic acid) The muscular tube, also known as the
The transparent dome at the front of A chemical with a double-helix food tube, that connects the pharynx
the eyeball that is the eye’s main structure that carries genetic with the stomach.
focusing lens. information in the sequence of its
paired subunits (bases); packaged Estrogen
Coronary into chromosomes. A sex hormone that prepares the
A term meaning “crown.” Refers uterine lining for an implanted,
to the arteries that encircle and Duodenum fertilized egg and stimulates the
supply the heart with blood. The C-shaped first part of the small development of a female’s secondary
intestine, into which the stomach sexual characteristics.
Corpus callosum empties. Ducts from the gallbladder,
The wide, fan-shaped band the liver, and the pancreas all Eustachian tube
consisting of about 20 million enter the duodenum. Tube connecting the back of the nose
nerve fibers that connects the to the middle ear cavity; allows air
two hemispheres of the cerebrum.
Cortex
E
Eardrum
pressure to equalize on either
side of the eardrum.
D
Dermis
pain and stress, and also activated
during exercise. G
Gallbladder
The thick inner layer of skin, made of Enzyme The fig-shaped bag lying under the
connective tissue; contains structures A protein that accelerates chemical liver, into which bile secreted by
such as sweat glands. reactions within cells. the liver passes to be stored.
307
GLOSSARY
Gastric juice Hormone including formation of adipose tissue,
Liquid produced by the stomach A chemical released by the cell membranes (phospholipid), and
lining that contains hydrochloric endocrine glands and some tissues. steroid hormones.
acid and digestive enzymes. Hormones act on specific receptor
sites in other parts of the body. Liver
Gastrointestinal tract The large organ in the upper right
The muscular tube that extends from Hypothalamus abdomen that performs vital chemical
the mouth, through the pharynx, A small structure located at functions, including detoxification of
esophagus, stomach, and intestines, the base of the brain, where the poisons and conversion of waste
to the rectum. Also known as the nervous and hormonal systems products to urea.
digestive tract. of the body interact. It is linked
to the thalamus above and the Lobe
Gene pituitary gland below. A rounded projection or subdivision
A distinct section of a chromosome forming part of a larger structure such
that is the basic unit of inheritance.
Each gene consists of a segment of
deoxyribonucleic acid (DNA)
I–K
Ileum
as the brain, lung, or liver.
Lymphatic system
containing the code that governs The final segment of the small An extensive network of transparent
the production of a specific protein. intestine, where most absorption lymph vessels and lymph nodes.
of nutrients takes place. It returns excess tissue fluid to the
Genome circulation and combats infections
The full set of genes, or hereditary Kidney and cancer cells.
information, for a living organism; One of two bean-shaped organs in
the human genome consists of the back of the abdominal cavity that Lymph node
20,000-25,000 genes. filter blood and remove wastes, A small, oval gland packed
particularly urea. with white blood cells that
Gray matter acts as a barrier to the spread of
The darker-colored regions of the Killer T cells infection. Nodes occur in series
brain and spinal cord that comprise White blood cells that can along lymph vessels.
mainly neuron cell bodies as opposed destroy damaged, infected, or
to their projecting fibers, which form malignant body cells by using Lymphocyte
white matter. proteins called lymphokines. White blood cell that is part of the
immune system; it protects against
Hair follicle
A pit on the surface of the skin
from which hair grows.
Larynx
The structure in the neck at the top
of the trachea, known as the voice
M
Medulla
box, that contains the vocal cords. The inner part of an organ, such as
Heart valve the kidneys or adrenal glands. Also
One of four structures in the heart Lens refers to the part of the brainstem
that allow the passage of blood in The internal lens of the eye, also called lying immediately above the start
one direction only. the crystalline lens; it fine-focuses of the spinal cord, just in front of
vision by adjusting its curvature. The the cerebellum.
Hemoglobin outer lens is called the cornea.
The protein in red blood cells that Meninges
combines with oxygen to carry the gas Ligament Three membrane layers around the
from the lungs and distribute it A band of tissue consisting of brain and spinal cord: the pia mater
around the body. collagen—a tough, fibrous, elastic on the inside, the arachnoid and the
protein. Ligaments support bones, dura mater next to the skull.
Hepatic mainly in and around joints.
Concerning the liver. Meniscus
Limbic system A crescent-shaped, shock-absorbing
Hepatocyte A collection of structures in the brain pad of cartilage found in the knee
A type of liver cell with that plays an important role in the and some other joints.
many functions, including automatic (involuntary) body
making bile. functions, instinctive behavior, Menopause
emotions, and the sense of smell. The end of the reproductive
Hippocampus period in women, when the
A structure in the limbic system in Lipid ovaries have ceased their
the brain concerned with learning Fatty or oily substance, insoluble in production of eggs and
and long-term memory. water, with varied roles in the body, menstruation has stopped.
308
GLOSSARY
Metabolism Nociceptor Ovary
The sum of all the physical and A nerve ending responding to One of two structures lying at the
chemical processes that take place painful stimuli. end of the fallopian tubes on each side
in the body. of the uterus. They store ovarian
Nucleic acid follicles, release the mature ova,
Middle ear Deoxyribonucleic acid (DNA) or and produce the female sex hormones
The air-filled cleft within the temporal ribonucleic acid (RNA): chains (estrogen and progesterone).
bone between the eardrum and the of nucleotides, with genetic
outer wall of the inner ear; contains information in the order of the Ovulation
ossicles. Also called the tympanic cavity. bases of the nucleotides. The release of an ovum from a
mature follicle in the ovary about
Mitochondrion (pl. mitochondria) Nucleotide midway through the menstrual
A cell organelle involved in the Building-block subunit of a cycle; if not fertilized, the egg
production of energy for cell functions. nucleic acid (DNA, RNA), is shed during menstruation.
It contains genetic material consisting of a sugar, phosphate,
(mitochondrial DNA) derived solely and a nitrogen-containing base. Ovum (pl. ova)
from the mother. The egg cell; if fertilization occurs,
Nucleus (pl. nuclei) the ovum may implant in the uterus
Mitral valve Control center of a cell, containing and develop into an embryo.
The valve that lies between the left the genetic material DNA.
atrium and left ventricle of the heart.
Motor neuron O P
Pancreas
A nerve cell that carries the impulses to Olfactory nerve A gland behind the stomach
muscles that cause movement. One of two nerves of smell that run that secretes digestive enzymes
from the olfactory bulb in the roof of and also hormones that regulate
Mucous membrane the nose directly into the underside of blood glucose levels.
The soft, mucus-secreting epithelial the brain.
layer lining the tubes and cavities Parasympathetic nervous
of the body. Optic nerve system
One of the two nerves of vision. Each One of the two divisions of the
Myocardium one has about one million nerve fibers autonomic nervous system. It
The special muscle of the heart. running from the retina to the brain, maintains and restores energy—for
The fibers form a network that carrying visual stimuli. example, by slowing the rate and
can contract spontaneously. strength of the heartbeat.
Organ
Myofibril Discrete body part or structure with a Parathyroid glands
Cylindrical element within muscle cells vital function: for example, the heart, Two pairs of yellowish endocrine
(fibers) consisting of thinner filaments liver, brain, or spleen. glands, located behind the thyroid
that move to produce muscle contraction. gland, that help control the level
Organelle of calcium in the blood.
N
Nephron
A tiny structure inside a cell that
has a specific role. The nucleus,
mitochondrion, and ribosomes
Parotid glands
The large pair of salivary glands
The kidney’s filtering unit, consisting are examples. situated, one on each side, above
of a filtration capsule (glomerulus) the angles of the jaw just below and
and a series of tubules, that reabsorbs Ossicle in front of the ears.
or excretes water and wastes to One of three tiny bones (the
control fluid balance. incus, malleus, and stapes) of Pelvis
the middle ear that convey The basinlike ring of bones to which the
Nerve vibrations from the eardrum lower end of the spine is attached and
Bundle of threadlike projections to the inner ear. with which the thigh bones articulate.
from individual neurons (nerve cells), The term also refers to the general lower
held together by a fibrous sheath. Ossification abdominal area.
Nerves carry electrical impulses to and The process of formation, renewal, and
from the brain and spinal cord and other repair of bone. Most bones in the body Pericardium
body parts. develop from cartilage. The layers of membrane surrounding
the heart. The outer fibrous sac
Neuron Osteon encloses the heart and the roots of
A single nerve cell with long The rod-shaped unit, also called the major blood vessels emerging
projections, the function of which a Haversian system, that is the building from it. The inner layer attaches to
is to transmit electrical impulses. block of cortical bone. the heart wall.
309
GLOSSARY
Periosteum Platelet Retina
The tough tissue that coats all Tiny fragment of a type of large cell A light-sensitive layer lining the
bone surfaces except joints and manufactured in bone marrow and inside of the back of the eye; it
from which new bone can be known as a megakaryocyte. Platelets converts optical images to nerve
formed; contains blood and are vital for blood clotting. impulses, which travel to the brain
lymphatic vessels and nerves. via the optic nerve.
Pleura
Peripheral nervous system A double-layered membrane, the inner RNA
All the nerves that fan out from the layer of which covers the lung while Ribonucleic acid, a substance
brain and spinal cord, linking these the outer layer lines the chest cavity. present in cells; different forms carry
parts with the rest of the body. The A layer of fluid lubricates and enables out various functions, including the
system consists of cranial nerves movement between the two. manufacture of proteins.
and spinal nerves.
Peristalsis
A coordinated succession of
Progesterone
A female sex hormone secreted
by the ovaries and placenta that
S
Saliva
contractions and relaxations allows the uterus to receive and A watery fluid secreted into the mouth
of the muscular wall of a tubular retain a fertilized egg. by the salivary glands to aid tasting,
structure, such as the intestines, chewing, and digestion.
that moves the contents along. Prostaglandins
A group of fatty acids, made in the Sex hormones
Peritoneum body, that have various functions and Steroid substances, including
The double-layered membrane that influence some hormones. testosterone in males and
lines the inner wall of the abdomen. estrogen and progesterone in
The peritoneum covers and partly Prostate gland females, that bring about
supports the abdominal organs. It A male accessory sex gland situated at the development of sexual
also secretes a fluid that lubricates the base of the bladder and opening characteristics. Sex hormones
the movement of the intestines. into the urethra. It secretes some of also regulate sperm and egg cell
the fluid in semen. production and the menstrual cycle.
Phagocyte
A white blood cell or similar cell that Protein Sphincter
surrounds and engulfs unwanted Huge molecule composed of chains A muscle ring, or local thickening of
matter, such as invading microbes of amino acids; the basis of many the muscle coat, surrounding an
and cellular debris. structural materials (keratin, opening in the body, such as the
collagen), enzymes, and antibodies. anus or the urethra.
Pharynx
The passage leading down from Pulmonary artery Spinal nerves
the back of the nose and the mouth The large artery that conveys The 31 pairs of combined motor
to the esophagus; it consists of the deoxygenated blood from the right and sensory nerves that emerge
nasopharynx, the oropharynx, and ventricle of the heart to the lungs from and enter the spinal cord.
the laryngopharynx. to be reoxygenated.
Spine
Pituitary gland
A pea-sized gland hanging from the
underside of the brain. The pituitary
R
Red blood cells
The column of 33 ringlike
bones, called vertebrae, that
divides into seven cervical vertebrae,
secretes hormones that control many Biconcave, disk-shaped cells, without 12 thoracic vertebrae, five lumbar
other glands in the body, and is nuclei, that contain hemoglobin. vertebrae, and the fused vertebrae
regulated by the hypothalamus. There are 4–5 million red cells in of the sacrum and coccyx.
1/
500 pint (1 milliliter) of blood.
Placenta Spleen
The disk-shaped organ that forms in Renal A lymphatic organ, situated
the uterus during pregnancy. It links Relating to the kidneys. on the upper left of the abdomen,
the blood supplies of the mother and that destroys worn-out red
fetus via the umbilical cord and Respiration blood cells, filters out impurities
nourishes the growing fetus. 1. Body movements of breathing. from the blood, and helps
2. Gas exchange of oxygen for fight infection.
Plasma carbon dioxide in the lungs.
The fluid part of the blood from 3. Similar gas exchange in the Stem cell
which all cells have been removed; tissues (cellular respiration). 4. Generalized type of cell, usually
it is mostly water, but contains some Breakdown of molecules such as fast-dividing, with the potential to
proteins, salts, and various nutrients, glucose to release their energy for become many different kinds of
including glucose. cellular functions. specialized cells.
310
GLOSSARY
Sympathetic nervous system Thorax Vagus nerves
One of the two divisions of the The part of the trunk between the The tenth pair of cranial nerves;
autonomic nervous system. It neck and the abdomen that contains helps control automatic functions
prepares the body for action— the heart and the lungs. such as heartbeat and digestion.
for example, by constricting
blood vessels in the intestines Tissue Vas deferens
and skin. Body structure made of similar One of a pair of tubes that lead
cells that perform one main from the testes; each tube carries
Synapse function; types include muscle sperm, which mix with fluid
The junction between two nerve and connective tissues. before entering the urethra.
cells, or between a nerve cell and
a muscle fiber or a gland. Chemical Tonsils Vein
messengers are passed across a Oval masses of lymphoid tissue A thin-walled blood vessel that
synapse to produce a response on the back of the throat. They returns blood at low pressure
in a target cell. help protect against childhood from body organs and tissues
infections by attacking to the heart.
Synovial fluid microorganisms that enter
Thin, slippery, lubricating fluid within through the nose and mouth. Vena cava
a joint. One of the two large veins, the
Trachea superior and inferior vena cavae,
Synovial joint A muscular tube lined with mucous that empty into the right atrium
A mobile joint with a membrane that membrane and reinforced by about of the heart.
produces a lubricating fluid. 20 rings of cartilage.
Ventricle
Systole
The period in the heartbeat cycle
during which first the atria and
U
Umbilical cord
A chamber or compartment, usually
fluid-filled. Examples include two
cardiac ventricles in the heart.
then the ventricles contract to The structure that connects
force blood out of the heart. the placenta to the fetus. It provides Vertebra (pl. vertebrae)
See diastole. the immunological, nutritional, and One of the 33 bones of the vertebral
hormonal link with the mother. column (spine).
T
Taste bud
Urea
A waste product of the breakdown of
Virus
The tiniest form of infectious
A spherical nest of receptor cells proteins; the nitrogen-containing microorganism (germ). It takes over
found mainly on the tongue; each bud component of urine. a cell to produce copies of itself.
responds most strongly to a sweet,
salty, sour, or bitter flavor. Ureter Vocal cords
Tube through which urine passes One of two sheets of mucous
Tendon from each kidney to the bladder. membrane stretched across the
A strong band of collagen fibers inside of the larynx that vibrate
that joins muscle to bone and Urethra to produce voice sounds when
transmits the pull caused by The tube that carries urine from the air passes between them.
muscle contraction. bladder to the exterior; much longer in
Urinary tract
W-Z
White blood cell
hormone-producing sex glands in The system that forms and excretes Any of the colorless blood
the scrotum. urine; made up of the kidneys, cells that play a role in the
ureters, bladder, and urethra. immune system.
Testosterone
The principal male sex hormone; Uterus White matter
produced in the testis and in A hollow muscular structure in Nerve tissue in the brain and
small amounts in the adrenal which the fetus grows until birth. spinal cord formed mainly of
gland on top of the kidney, and the projecting fibers, or axons,
in the ovary.
Thalamus
V
Vagina
of neurons (nerve cells).
Zygote
A mass of gray matter found The muscular passage from the The single cell produced when
deep in the brain, on top of the uterus to the outside of the body; it an ovum is fertilized by a sperm;
brainstem. The thalamus receives stretches during sexual intercourse it contains the genetic material
and processes sensory information. and childbirth. (DNA) for a new person.
311
INDEX
INDEX
Page numbers in bold type cerebrovascular disorders 124 heartbeat 154–155
indicate main references. coronary arteries 150, 153 hormones in 20, 132
coronary artery disease 156 plasma 21
A
abortion, spontaneous 303
imaging 12, 13
in newborn baby 275
pulmonary artery 151
respiratory system 163, 167
urine production 247
blood cells 27, 37
abscesses 126, 195 respiratory system 163 liver functions 220
Achilles tendon 67, 75 thrombosis 158 production in bone marrow 42
acids, digestion 228 arterioles 179 see also red blood cells; white blood
acne 189, 280 arthritis 60–61 cells
acromegaly 140 articular cartilage 46 blood clots: embolism 124, 158
“Adam’s apple” 171 asthma 173 heart attack 156
adenine 30, 31, 287 astrocytes 83 inflammatory response 201
adenoids 192 atherosclerosis 156, 157 skin repair 180
adipose cells 27, 37 athlete’s foot 207 thrombosis 124, 158
adrenal glands 133, 134, 136, 138 atria, heart 151, 152, 154 blood groups, genetics 293
adrenocorticotropic hormone (ACTH) atrial fibrillation 159 blood pressure, hypertension 159
134, 138 atriopeptin 132 blood sugar see glucose
afterbirth see placenta atrioventricular valves, heart 152 blood vessels 149
aging 128, 129, 284–285 autoimmune disorders 61, 141, 142 aging 284
AIDS 209 autonomic nervous system (ANS) 78, in brain 86
air, breathing 162, 168–170, 217 106–109 cardiovascular system 146
airway see bronchi; trachea axons, neurons 80, 82, 85 cerebrovascular disorders 124
alcohol, liver disease 236 embolism 158
alleles, genes 290–291, 292–293
allergies 173, 188, 208
alveoli 164, 167
B
B lymphocytes 172, 194, 196–197
in fetus 265, 274
heart 150, 151
imaging 12, 13
emphysema 175 babies: birth 268–271 kidneys 244, 246
gas exchange 162, 164, 166 blood circulation 275 liver 220, 222
Alzheimer’s disease 125 gender 291 lungs 153
amine hormones 139 growth and development 276–279 menstrual cycle 283
amino acids 233 newborn 272, 274–275 in newborn baby 275
digestion 229, 230, 231 premature 303 in skin 178, 179, 183
manufacture of 32 bacilli 204 temperature regulation 181
amniotic fluid 264 back: muscles 66, 68 vasodilation 201
ampulla, balance 119 see also spine see also arteries; capillaries; veins
amygdala 94, 111 bacteria 204–205 body fat: cells 27, 35, 37
amylase 215, 229 antibiotics 205 obesity 143
anabolism 233 digestive disorders 234, 235 subcutaneous fat 179
anatomy 10–11 gut flora 193, 204, 224 body hair, puberty 280, 282
see also individual organs and inflammatory response 198–201 body temperature, regulation 23, 181
systems prostatitis 294 bone marrow 42, 43
androgens 133, 137 sexually transmitted infections 298–299 bones 19, 38–61
angina 156 urinary tract infections 248 ankle and foot 55
angiography 12 balance 119 cells 42
ankle 44, 55, 59 ball-and-socket joints 45 disorders 56–58
antibiotics, resistance to 205 basal ganglia 92, 109 in ear 49, 116, 118
antibodies 148, 172, 196, 197 bases, DNA 30, 32, 287, 288 fractures 56–57
allergic response 208 basophils 194 growth 42, 134, 276
in colostrum 273 bicarbonate, digestive system 232 imaging 12
fertility problems 300 biceps muscles 73 joints 44–47
immunization 208 bile 213, 219, 220, 223, 229 as levers 72
antidiuretic hormone (ADH) 135 bile duct 220 ligaments 55
antigens 196, 197, 208 binocular vision 122 in newborn baby 272
anus 212, 213, 227 bipolar neurons 82 osteoporosis 56, 58
aorta 150, 151, 153 birth 268–271 pelvis 53
appendix 213, 225 disorders 303 repair 57
arachnoid 88, 98, 100 preparing for 266–267 rib cage 52
areola, nipples 259 bladder: anatomy 242, 243 shapes 41
arms: blood vessels 146 cystitis 248 skeleton 14, 40–41
bones 40 epithelial cells 184 skull 48–49
elbow joint 44 incontinence 249 spine 50–51
lymphatic system 192 blastocyst 260, 261, 263 structure 42–43
muscles 64, 66 bleeding: in brain 124 tendons 72
nervous system 78 menstrual cycle 283 tissue 37
arrhythmia, heart 159 blood 21, 148 wrist and hand 54
arteries 146, 149 cardiovascular system 146 Bowman’s capsule 244, 246, 247
in brain 86 clotting 148 boys: gender 291
312
INDEX
puberty 280–1 homeostasis 23 chromosomes: cell division 289
brain 78, 86–97 in newborn baby 275 disorders 304
aging 285 carpal bones 40, 44, 54 DNA 30–31, 33
anatomy 86–87 carpal tunnel syndrome 75 fertilization of egg 289
autonomic nervous system 108 cartilage 43 and gender 291
blood supply 86 bone development 42, 276 genome 34–35, 286–287
cranial nerves 102–103 cells 36 patterns of inheritance 290–291
disorders 124–126 ears 116 sex cells 289
growth and development 277 intervertebral disks 50 chronic obstructive pulmonary disease
infections 126 joints 44, 46, 47 (COPD) 175
information processing 20 larynx 171 chyme 219, 224, 228, 229
memories, thoughts, and emotions in newborn baby 272 cilia 28, 184, 198, 260
110–111 osteoarthritis 60 circle of Willis 86
nerve damage 83 rib cage 52 circulatory system see cardiovascular
primitive brain 94–95 torn cartilage 59 system
protection 88 catabolism 233 cirrhosis, liver 236, 237
scanning 13 cataracts, eyes 285 clavicle 40, 45
sense of taste and smell 113 cecum 224, 225, 232 clitoris 257, 258
sense of touch 115 cells 10, 24–37 clots see blood clots
sleep cycles 97, 138 aging 284 cocci 204
stroke 157 anatomy 27 coccyx 41, 50, 51, 53
structures 86–87, 90–91 blood 148, 194 cochlea 116–118, 128, 285
tissues 36 bone 42 cold, common 172
vision 120, 122 cancer 305 cold sores 188
brainstem 87, 90, 93, 96 cell membrane 26, 27, 28 collagen 44, 55, 284
breastbone 40, 52 cellular respiration 166 collarbone 40
breastfeeding 273 development of embryo 260–263 colon 213, 224–227, 232, 239
breasts 259 division 289 color: color blindness 293
disorders 296 DNA 30–31, 286 eyes 33, 292
milk production 135 egg cells 256 skin pigmentation 187
in pregnancy 265 epithelial tissues 184 colostrum 273
in puberty 282 genetic control 35 columnar cells 184
breathing 166–170, 217, 272 growth, renewal, and repair 233 communication: facial expressions 68
see also respiratory system inflammatory response 198–201 see also speech
bronchi 162–165 muscle 70 compact bone 42, 43
bronchioles 162–165, 167, 173 neurons 80–81 complement system, immune system
bronchitis 173, 175 sex cells 289 196–197
skin renewal 178 computerized tomography (CT) 13
sperm 252 conception 260, 289
C
calcium 42, 58, 137
tissues 36–37
types 27
central nervous system (CNS) 78
cone cells, retina 120
conjunctiva, eye 121
connective tissue 36, 37
cancer 305 centriole, cells 26 aging 284
breast 296 cerebellum 86, 87, 90–91, 109 cartilage 43
colorectal 239 cerebral cortex 90, 92, 109, 113 joints 46
lung 174 cerebrospinal fluid (CSF) 83 tendons 72
prostate 294 brain 88, 89, 91 contractions, labor 267–270
skin 12, 187 spinal cord 98, 100 cornea 120, 121, 129, 185
testicular 295 cerebrum 86, 87, 90–91, 92 coronary arteries 150, 153
Candida albicans 207, 209, 299 cervical vertebrae 41, 44, 51 coronary artery disease 156
canine teeth 216, 278 cervix 257, 264 coronary veins 150
capillaries 146, 149 birth 270 corpus callosum 87, 92
lymphatic system 192, 193 fertility problems 300 corpus luteum 258, 283
in skin 179 menopause 285 cortex, brain 110, 111
vasodilation 201 placenta previa 302 coughing 171, 217
carbohydrates 229, 232, 233 preparation for birth 267, 268–269 cranial nerves 102–103, 113
carbon dioxide: aging 284 chemotaxis 201 cranium 48, 277
in blood 21 chest: breathing 168–170 cuboidal cells 185
cardiovascular system 146 muscles 64, 66 cystic fibrosis 304
gas exchange 164, 166–167 nervous system 78 cystitis 248
cardiac muscle 67 children: growth and development cysts 189, 296
angina 157 276–279 cytoplasm 21, 26, 29
heart attack 156 puberty 280–283 cytosine 30, 31, 287
heartbeat 155 chlamydia 298, 299 cytoskeleton, cells 26
cardiac skeleton 150 chloride, digestive system 232
cardiovascular system 15, 144–159
anatomy 146–147
blood and blood vessels 148–149
choking 217
cholesterol: atherosclerosis 157
in blood 148
D
deafness 128, 285
disorders 156–159 in colon 232 defecation 227
heart 150–151 gallstones 238 defenses: immune system 194–209
heartbeat 154–155 chondrocytes 36, 43 skin and hair 186–187
313
INDEX delivery, birth 270–271 ejaculation 252, 254, 255 disorders 129
dementia 125 fertility problems 301 epithelium 184-185
dendrites 80, 85 puberty 280 eyelids 69, 123
dentine 216 elastic cartilage 36, 43 muscles 121, 123
dermatomes 105 elbow 44, 73 optic nerve 103
dermis 36, 37 electrical signals: heartbeat 13, 155, 159 tears 123, 193
aging 284 nerve impulses 20, 84–85
skin structure 178, 179
touch sensors 182, 183
diabetes mellitus 142–143
electrocardiography (ECG) 13
electron microscopy 12
ellipsoidal joints 45
F
face: bones 48
diabetic nephropathy 248 embolism 124, 158 expressions 68, 102
diaphragm 163 embryo 256, 260–263 hair 280
breathing 168–169, 170 cells 35 muscles 68–69
hiatus hernia 235 ectopic pregnancy 302 facet joints, spine 50
diet, nutrients 232–233 see also fetus fallopian tubes 28, 256
digestive system 17, 24, 210–239 embryonic disk 262 conception in 260
anatomy 212–213 emotions 110–111 ectopic pregnancy 302
digestion 228–231 emphysema 175 fertility problems 300
disorders 234–239 enamel, teeth 216 lining 257
homeostasis 23 endocrine system 15, 130–143 pelvic inflammatory disease 298, 300
hormones 133 glands 132–133 false ribs 52
immune system 193 hormonal action 138–139 fascicles: muscles 70
large intestine 224–227 hormonal disorders 140–143 nerves 82
liver 220–223 endometrium 256, 261, 265 fat see body fat
mouth and throat 214–217 endometriosis 296, 300 fats, digestion 223, 229, 232, 233
nutrients and metabolism 232–233 menstrual cycle 296 fatty acids 233
stomach and small intestine 218–219 endoplasmic reticulum, cells 26, 29 feces 212, 224, 226, 227
diphtheria 205 endoscopy 13 diverticular disease 239
diseases: bacteria 204–205 energy 233 fiber in 233
cancer 305 enzymes 32 in newborn baby 272
imaging the body 12–13 digestive system 24, 193, 213, 228–230 feedback systems: homeostasis 23
immunization 208 gut flora 224 hormones 138, 139, 281, 282
lymphatic system 192 heart attack 156 feet: athlete’s foot 207
sexually transmitted infections 298–299 pancreatic 223 bones 41, 55
see also individual diseases in saliva 215 muscles 65, 67
disk prolapse 57 in stomach 218 in newborn baby 272
diverticular disease 239 eosinophils 194 skin 186
DMARDs 61 epidermis 183 tendons 72
DNA 30–35 aging 284 toenails 180, 186
in bacteria 204 defensive function 186–187 walking 55
genome 34, 286–287 skin structure 178, 179 X-rays 12
mitochondrial DNA 35 epididymis 252, 253, 301 female reproductive system 256–259
mutations 288 epiglottis 212, 214 disorders 296–297
noncoding and “junk” DNA 34 in coughing 171 infertility 300
replication 288 in swallowing 162, 217 puberty 282
in viruses 202, 209 epithelium 27, 35, 36, 184–185 femur 41, 47, 272
dominant genes 292–293 digestion 219, 231 fertility disorders 300–301
Down syndrome 304 inflammatory response 198 fertilization 260, 289
dreams 97 lining of mouth 214 fetus 256
duodenum 218-219, 223 equilibrium 23 blood circulation 274
digestion 229 erythropoietin 133 development of 264–265
functions 219 esophagus 212, 213 miscarriage 303
ulcers 234 hiatus hernia 235 multiple pregnancy 266
dura mater 88, 98, 100 esophageal varices 237 position in uterus 266, 303
swallowing 217 fiber 232
E
eardrum 117, 118, 128
estrogen 133, 137, 256, 258
fertility problems 300
menopause 285
fibrinogen 148, 180, 201
fibrocartilage 43
fibroids, uterus 297
ears 116–119 menstrual cycle 282, 283 fibula 41
aging 285 puberty 282 fingers 54, 180, 182
balance 119 Eustachian tube 116, 128 flatworms 207
bones 49, 116, 118 exhalation, breathing 169, 170 flu 173
disorders 128 expressions, facial 68, 102 fluids 21
ectopic pregnancy 302 extracellular fluid 21, 200 flukes 207
eczema 188 eyebrows 69, 186 fluoroscopy 12
egg cells (ova) 27, 256 eyelashes 186 focusing problems, eyes 129
ectopic pregnancy 302 eyes 120–123 folic acid 127
fertilization 260, 289 aging 285 follicle-stimulating hormone (FSH) 134,
and inheritance of gender 291 color 33, 292 258, 281, 282–283
meiosis 289 color blindness 293 follicles: hair 178, 179, 181, 182
ovulation 258, 283, 300 development of 278–279 ovaries 258, 282, 283
314
INDEX
fontanelles, skull 272, 277 Graves’ disease 141 fertility problems 300
food: digestive system 210–239 gray matter: brain 36, 92–93 glands 134–137
nutrients 232–233 spinal cord 98, 99 homeostasis 23
foot see feet greenstick fracture 56 information processing 20
fractures 56–57, 58 growth, babies 276–279 menopause 285
fungi 207 growth hormone (GH) 20, 134, 140 menstrual cycle 258, 283
growth plates, bones 42, 276 and osteoporosis 58
G
galactose 230
guanine 30, 31, 287
gullet 212
gums 216
in puberty 280–283
sex hormones 134, 137, 252, 256
Human Genome Project 34, 287
gallbladder 213, 221, 223 gut flora 193, 204, 224 humerus 40, 44, 45
gallstones 238 hyaline cartilage 36, 43, 46
gametes 256
gamma rays, scanning the body 13
gammaglobulins 196
H
hair 16
hydrocele 295
hydrochloric acid 193, 218, 228
hyoid bone 48, 50, 171, 214
ganglia, nerves 104, 106 defensive functions 186 hypertension 159
gas exchange 164, 166–167 growth 181 hyperthyroidism 141
gastric juices 193, 218 in puberty 280, 282 hypothalamus 86, 87, 95
gastric pits, stomach 228 temperature regulation 181 autonomic nervous system 106, 108
gastritis 235 hair cells, ears 118, 119 feedback system 138
gender, inheritance of 291 hair follicles 178, 179, 181, 182, 189 hormones 132, 134, 135, 138, 139,
genes 33–35 hamstring muscles 67, 74 282
bacteria 204 hands: bones 41, 54, 276 in puberty 281
control of cells 35 carpal tunnel syndrome 75 hypothyroidism 141
disorders 304 dexterity 278–279
dominant genes 292–293
genome 34–35
inheritance 286–293
fingernails 180
joints 44, 45
muscles 65
I
ileum 213, 219
mitochondrial genes 35 rheumatoid arthritis 61 ilium (hip bone) 40, 53
mutations 288 tendons 72 imaging the body 12–13
patterns of inheritance 290–291 touch sensors 182 immune system 16, 190–209
recessive genes 292–293 head: growth 277 allergies 208
sex cells 289 hair 186 autoimmune disorders 61, 141, 142
viruses 202 muscles 68–69 auxiliary immune system 193
genitals: female 258 nervous system 78 HIV and AIDS 209
male 252–253 skull 48–49 hormones 132
in newborn baby 272 headaches, migraine 125 infections 202–207
in puberty 280, 282 healing, fractures 57 inflammatory response 195, 198–201
sexually transmitted infections 298–299 health 11 local infections 195
genome 34–35, 286–287 hearing 116–118, 128, 285 lymphatic system 192–193
germs see bacteria; microorganisms; heart 163 specific responses 196
viruses anatomy 150–151 immunization 208
girls: gender 291 cardiovascular system 146 impetigo 188
puberty 282–283 disorders 156–159 incisors 216
glands 130–143 electrocardiography 13 incontinence, urinary 249
hormones 134–137 heart attack 156 infections 202–207
lymph nodes 192, 194 heartbeat 154–155 bacteria 204–205
male reproductive system 254 hormones 132 brain 126
see also individual glands muscle 67, 153 local 195
glandular cells 185 in newborn baby 272, 275 sexually transmitted (STIs) 298–299
glaucoma 129 valves 150–152 superbugs 205
glial cells 36, 80, 83 height, children’s growth 277 urinary tract 248
gliding joints 44–45 Helicobacter pylori 234, 235 infertility 300–301
globulins 148 hemoglobin 148, 167 inflammatory response 195, 198–201
glomerulonephritis 248 hemorrhage, brain 124 influenza 173, 202
glomerulus, kidneys 244, 246, 247 hepatic portal system 220, 222 information processing 20
glottis, vocal cords 171 hepatocytes 25, 220 inhalation, breathing 168, 170
glucagon 133, 136, 142 hernia, hiatus 235 inheritance 286–293
glucose: in blood 148 Herpes simplex 188 inherited disorders 304
cellular respiration 166 hiatus hernia 235 injuries, inflammatory response 198
diabetes mellitus 142–143 hinge joints 44–45 insulin 133, 136, 142–143
digestive system 231, 233 hippocampus 94, 111 interstitial fluid 21, 192, 193
hormone control 136 hips 40, 45, 53, 60 intervertebral disks 46, 50
liver functions 220 histamine 199, 201, 208 intestines: digestion 230–231
glycerol 233 histoplasmosis 207 hormones 133
glycogen 220, 233 HIV 209 immune system 193
goblet cells 184, 260 homeostasis 23, 106 large intestine 212, 213, 224–227
goiter 141 hookworms 207 in newborn baby 272
Golgi complex, cells 26, 29 hormones 132 parasitic worms 207
gonorrhea 298 action of 138–139 small intestine 212, 213, 219
goose pimples 181 disorders 140–143 see also colon; rectum
315
INDEX intracellular fluid 21 injuries 59 lining of mouth 214
involuntary muscles 67 joints 44, 46, 47 peritoneum 213
involuntary responses 108 spine 50 memory 110–111, 125
iris, eye 121 light: pineal gland and 138 memory cells, immune system 196, 197,
iron, hemoglobin 148 vision 120–121 208
islets of Langerhans 136, 142 light microscopy (LM) 12 meninges 87, 88, 98
limbic system 86, 94–95, 108 meningitis 126
J
jaw: bones 48
lipids 229
lips, muscles 69
liver 212, 213, 220–223
meniscus, knee joint 47, 59
menopause 58, 285, 297
menstrual cycle 282, 283
fibrocartilage 46 disorders 236–237 endometriosis 296
in newborn baby 272 in newborn baby 272 ovulation 256, 258
teeth 216 nutrient processing 232 menstruation 282, 283, 285
jejunum 213, 219 tissues 24–25 Merkel’s disk 115, 183
joints 19, 44–47 liver spots, skin 284 metabolism 132, 141, 233
arthritis 60–61 lobes, brain 90 metacarpal bones 41, 54
cartilage 59 loop of Henle 244, 246, 247 metatarsal bones 41, 44, 55
disorders 59–61 lumbar vertebrae 51 meticillin 205
jaws 42 lungs: blood vessels 153 microfilaments, cells 26
ligaments 55 breathing 168–170 microorganisms 194–195, 202–207
movement 72 cancer 174 see also bacteria; viruses
muscles 64, 66 chronic obstructive pulmonary microreceptors 20
in newborn baby 272 disease 175 microscopy 12
pelvis 53 coughing 171 microtubules, cells 26
spine 50 cystic fibrosis 304 microvilli, cells 26, 28
wrist 54 disorders 173–175 migraine 125
gas exchange 164, 166–167 milk, breastfeeding 135, 259, 273
K
Kaposi’s sarcoma 209
inflammatory response 198–201
in newborn baby 272
pulmonary embolism 158
milk teeth 272, 278
minerals 220, 232
miscarriage 303, 304
karyotypes, chromosomes 34 respiratory system 162 mitochondria 26, 29, 35
keratin: in hair 181 structure 164–165 mitral valve, heart 151, 152
in nails 180 luteinizing hormone (LH) 134, 258, 281, molars 216, 278
in skin 178, 186 282–283 molecules, crossing cell membrane 29
keratinocytes 187 lymphatic system 16 moles 189
ketones 142 anatomy 192–193 monocytes 194, 199
kidneys 242, 244–247 lymph fluid 21, 192–193, 194 morula 260
homeostasis 23 lymph nodes 192–193, 194 mosquitoes, malaria 206
hormones 133, 135 lymph vessels 194 motor nerves 82
stones 249 lymphocytes 194, 196 autonomic nervous system 106
killer T cells 196 lymphokines 196 positional sense 73
kinins 201 lysosome 26, 200 spinal reflexes 105
knee: joint 46–47 motor skills 19, 278–279
patella 41
patellar spinal reflex 105
torn cartilage 59
M
macrophages 194, 196–197, 199
mouth 214–217
anatomy 214
digestive system 212
Kupffer cells 25 macula, balance 119 muscles 69
macular degeneration, eyes 285 sense of taste 113
L
labia 258
magnetic resonance imaging (MRI) 13,
111
malaria 206
teeth 216
movement 19, 70, 72–73
mucus, coughing and sneezing 171
labor 266, 268–269 male reproductive organs 252–253 multiple-gene inheritance 293
birth 270–271 disorders 294–295 multiple pregnancy 266
disorders 303 infertility 301 multiple sclerosis (MS) 127
lacrimal glands 102, 123 malignant tumors 305 multipolar neurons 82
language see speech mammary glands 135, 259 muscles 14, 19, 64–74
large intestine see intestines see also breasts autonomic nervous system 106, 108–109
laryngopharynx 162 mammogram 12 breathing 168, 170
larynx 162, 171, 217 manual dexterity, development of 278– cells 27, 35, 36
legs: blood vessels 147 279 contraction 70, 71
bones 41 marrow, bone, 42, 43 development of 278–279
growth 276 mast cells 208 digestive system 212, 226, 227
joint disorders 59 Meissner’s corpuscles 115, 182, 183 disorders 74
knee joint 46–47 melanin: moles 189 eye 121, 123
lymphatic system 193 skin pigmentation 134, 187, 188 face, head, and neck 68–69
muscles 65, 67 melanocytes 134, 187, 188, 189 hands 54
nervous system 79 melanoma 12 heart 150, 153
lens, eye 120, 121, 285 melanosomes 187 joints 46
leukocytes see white blood cells melatonin 132, 138 movement 70, 72–73
levers, body parts as 72 membranes: cells 26, 27, 28 proprioceptive sense 73, 102
ligaments 55 epithelial tissues 184 puberty 280
316
INDEX
stomach 218 organelles 26, 27, 28, 29 peritoneum 213
structure 70–71 organs 24 peroxisome, cells 26
tendons 72 see also individual organs Peyer’s patches 192, 193
tissues 37, 67 oropharynx 162, 214 phagocytes 172
tongue 214 ossicles, ear 49, 117, 118 phagocytosis 197, 200
mutations 288 ossification, bones 42, 276 phalanges 41, 54, 55
myelin, nerves 81, 85, 127 osteoarthritis 60 phalanxes 41
myofibers 70–71 osteoblasts 42, 57 pharynx 214
myofilaments 70–71 osteoclasts 42 anatomy 162
osteocytes 42 coughing 171
N
nails 16, 180, 186
osteons 43
osteoporosis 56, 58
otitis media with effusion 128
swallowing food 212, 217
phospholipids 28
photoreceptor cells 27
nasal bones 49 ova see egg cells physiology 11
nasopharynx 162, 171, 214 ovaries 256, 257, 258 pia mater 88, 98, 100
neck muscles 68–69 hormones 133, 136, 137 pigmentation: aging 284
nematodes 207 menstrual cycle 282, 283 hormones and 134
nephrons, kidneys 244, 246–247 pelvic inflammatory disease 298 melanin 187, 188
nerve cells see neurons puberty 282 pineal gland 132, 138
nerves 82 ovulation 256, 258, 282, 300 pituitary gland 87, 132, 134–135
carpal tunnel syndrome 75 ovum see egg cells hormones 138, 139
dermatomes 105 oxygen: and aging 284 menstrual cycle 283
hormones and 132 in blood 148 puberty 281, 282
multiple sclerosis (MS) 127 in brain 86 tumors 140
regeneration 83 breathing 168, 170 pivot joints 44–45
touch sensors 179 cardiovascular system 146 placenta 260
nervous system 15, 76–128 cellular respiration 166 delivery 270, 271
aging 285 fetal development 265 development of 263
autonomic nervous system 106–109 gas exchange 164, 166–167 functions 265
brain 86–97 newborn baby 275 problems 302
ears, hearing, and balance 116–119 pulmonary circulation 153 plasma 21, 148, 197, 201
eyes and vision 120–123 oxytocin 135 plasmids, bacteria 205
homeostasis 23 platelets 37, 148–149, 180
information processing 20
nerves and neurons 80–81
peripheral nerves 102–105
P
pacemaker, heart 155, 159
pleural cavity 163
pleural membranes 163, 165
plexus, spinal nerves 104
positional sense 73 Pacinian corpuscles 115, 182, 183 portal hypertension 237
senses 112–123 pain 19 positron emission tomography (PET)
sensory feedback 19 inflammatory response 198, 201 scans 13
spinal cord 98–99 palate 214, 217 posture 19
tissues 36 pancreas 133, 212, 213, 223 potassium 232
touch sensors 115, 182–183 diabetes mellitus 142–143 pregnancy: conception to embryo
neuromuscular spindles 73 hormones 136 260–263
neurons 27, 35, 80–81 pancreatitis 142, 238 delivery 270–271
aging 285 papillae, tongue 114 disorders 302–303
brain 92 parasites 206, 207 fetal development 264–265
nerve impulses 84–85 parasympathetic autonomic nervous labor 268–269
neurotransmitters 84 system 106, 107 preparing for birth 266–267
neutrophils 180, 194, 199, 200, 201 parathyroid glands 137 ultrasound scans 13
newborn baby 272, 274–275 parotid glands 212, 215 premolars 216
nipples 259 patella 41, 47 preterm labor 303
nongonococcal urethritis (NGU) 299 patellar spinal reflex 105 primitive brain 94–95
nose: auxiliary immune system 193 pelvic inflammatory disease (PID) 298, progesterone 133, 137, 282, 283
respiratory system 162 300 prolactin 135
sense of smell 112, 113 pelvis 40, 53 prolactinomas 140
sneezing 171 childbirth 268, 271 prolapsed uterus 297
nostrils 69, 162 in newborn baby 272 proprioceptive sense 19, 73, 102
nuclear medicine imaging 13 penis 252, 253 prostate gland 243, 253
nuclear membrane, cells 26 erection 255 disorders 294
nucleolus, cells 26 sexual intercourse 260 semen 254, 255
nucleoplasm, cells 26 urinary system 243 proteins: complement system 196–197
nucleus 26, 30 pepsin 228, 230 digestion 229
cell division 289 peptic ulcers 234 in food 232
neurons 80 peptidase enzymes 231 protein-based hormones 139
nutrients 232–233 peptides 233 synthesis 32, 220, 233
pericardial cavity 163 protists (protozoa) 206
O
olfactory epithelium 102, 112, 162
periods 282, 283, 285
periosteum 42, 276
peripheral nervous system (PNS) 78,
psoriasis 188
puberty 256, 258, 280–283
pubic hair 280, 282
oligodendrocytes 83 102–105 public health, immunization 208
omentum 213 peristalsis 212, 218 pulmonary artery 151, 163, 165
317
S
INDEX pulmonary circulation 153 repair 180
pulmonary embolism 158 sweat 22
pulmonary valve, heart 151, 152 sacrum 40, 50, 51, 53 temperature regulation 181
pulmonary vein 151, 153, 163, saddle joints 45 touch sensors 182–183
165 saliva 21, 114 see also rashes
pupil, eye 103, 121, 123 salivary glands 193, 212, 214, 215 skull: bones 40, 41, 48–49
pus 195 scabs, skin repair 180 fontanelles 272, 277
pyelonephritis 248 scalp, hair 186 growth 277
scanning electron microscopy (SEM) 12 joints 44, 48, 277
R
radius 40, 44, 45
scans, imaging the body 12–13
scapula 40, 41, 45, 68
scars 180
sleep cycles 97, 138
“slipped disk” 57
small intestine see intestines
rashes 126, 188 Schwann cells 80, 81, 85 smell, sense of 102, 112–113, 162
recessive genes 292–293 scrotum 252, 253, 295 smoking, lung diseases 174, 175
rectum 213, 226 sebaceous glands 179, 186, 189 smooth muscle 27, 37, 67
colorectal cancer 239 sebum 179, 186, 189 sneezing 171, 172
defecation 227 secretory vesicles, cells 26 social skills, development of 278–279
red blood cells 27, 37, 148–149 semen (seminal fluid) 255 sodium 232
reflexes 108 semicircular canals, ear 117, 119 sounds: hearing 116, 118, 285
aging 285 semilunar valves, heart 152 vocalization 171
in babies 278 semimovable joints 44 speech and language 110
respiratory 171 seminal vesicles 253, 254 development of 278–279
spinal 105 seminiferous tubules 252, 254 vocal cords 162
swallowing 217 senses 112–123 vocalization 171
reflux, urine 248 hearing 116–118 sperm 252, 254–255
renal artery 245 and memory 110 cells 27, 35
renal vein 245 proprioceptive sense 19, 102 fertility problems 300, 301
replication, DNA 288 smell 112–113 fertilization of egg 260, 289
reproductive system 17, 250–275 taste 113, 114 and inheritance of gender 291
baby 272–275 touch 115, 182–183 movement 28
conception to embryo 260–263 vision 120–123 puberty 280, 281
female 256–259 sensors, skin 182–183 sexual intercourse 260
female disorders 296–297 sensory nerves 82 sphincters 227, 249
autonomic nervous system 106 spina bifida 127
fetal development 264–265
positional sense 73 spinal cord 51, 78, 98–99
infertility disorders 300–301
spinal reflexes 105 nerve damage 83
male 252–255
touch 115 spina bifida 127
male disorders 294–295
sex cells: cell division 289 spinal nerves 104
menopause 285
chromosome disorders 304 spinal reflexes 105
pregnancy and labor disorders egg 258 spine 18
302–303 meiosis 289 disk prolapse 57
sexually transmitted infections mitosis 289 intervertebral disks 46, 50
298–299 sperm 252 spinal canal 100
respiratory system 16, 160–175 sex chromosomes 291, 293 vertebrae 50–51
anatomy 162–163 sex glands 137 spirilla 204
breathing 168–170 sex hormones 134 spleen 192, 193
disorders 172–175 and osteoporosis 58 sprains 59
gas exchange 166–167 ovaries 133, 136, 137, 256 squamous cells 185
homeostasis 23 testes 136, 137, 252 stem cells 27
immune system 193 sex-linked inheritance 293 sternum 40, 52, 169, 170
inflammatory response 198–201 sexual intercourse 260 steroid hormones 133, 134, 136, 139
lungs 164–165 sexually transmitted infections (STIs) stomach 213
pulmonary circulation 153 298–299 anatomy 218
reflexes 171 shoulder 41, 45 disorders 234–235
vocalization 170 sigmoid colon 213, 227, 239 hormones 133
reticular activating system (RAS) 96 sinoatrial node, heart 155 immune system 193
reticular formation 96 sinus tachycardia 159 stones 238, 249
retina: epithelium 185 sinuses 48 strain, muscles 74
macular degeneration 285 skeletal muscle 37, 67, 70 striated muscle 67, 70
optic nerve 103 skeleton see bones stroke 124, 157
vision 120, 122 skin 16, 178–189 subconscious behavior 94
rheumatoid arthritis 61 aging 284 subcutaneous fat 179
ribosomes, cells 26, 32 cancer 12, 187 superbugs 205
ribs 40, 52 connective tissue 36, 37 suture joints, skull 44, 48, 277
breathing 163, 168–170 defensive functions 186–187 swallowing 103, 217
ringworm 207 dermatomes 105 sweat 22, 179, 181
RNA 35, 209 disorders 188–189 sweat glands 178, 179
viruses 202, 203, 209 immune system 193 sympathetic autonomic nervous system
rod cells, retina 120 pigmentation 134, 187, 188, 284 106
roundworms 207 puberty 280 synapses 80, 84
Ruffini corpuscles 115, 183 renewal 178 synovial fluid 44, 46
318
INDEX
synovial joints 44, 46 transcellular fluid 21 ventricular tachycardia 159
synovial membrane 44, 46, 47, 61 transcription, DNA 32 vertebrae 18, 41, 50–51
syphilis 299 translation, DNA 32 disk prolapse 57
systems 14–17, 24–25 tricuspid valve, heart 151, 152 intervertebral disks 46
homeostasis 23 triplets 266 joints 44
see also individual systems trypanosomes 206 spinal cord 99, 100
tumors 12, 140, 305 vertebral column 40
T
T lymphocytes 192, 196
see also cancer
twins 266
vibrations, hearing 118
villi: chorionic 263, 265
U
digestion 219, 230, 231
tanning, skin pigmentation 187 viruses 202–203
tapeworms 207
HIV 209
tarsal bones 41, 44, 55 ulcers, peptic 234
taste 103, 113, 114 ulna 40, 44 respiratory infections 172–173
tear glands 193 ultrasound scans 13 vision 120–123
tears 123 ultraviolet (UV) light 187 aging 285
teeth 212, 216 umbilical cord 264, 270, 271, 275 color blindness 293
abscesses 195 unipolar neurons 82 development of 278–279
chewing food 214, 216 upper airway infections 172–173 disorders 129
development 278 ureter 242, 243, 253 optic nerve 103
milk teeth 272, 278 urethra 242, 243, 255, 257 visual cortex 110, 122
in newborn baby 272 urethritis, nongonococcal 299 vitamins: digestive system 232
temperature regulation 23, 181 urinary system 17, 240–249 storage in liver 220
tendinitis 74 anatomy 242–243 vitamin B group 224, 232
tendons 72, 74–75 disorders 248–249 vitamin K 224, 232
tenosynovitis 74 epithelium 184 vitiligo 188
testes 133, 252, 253 homeostasis 23 vitreous humor, eye 120
cancer 295 kidneys 244–247 vocal cords 162, 217
hormones 136, 137, 281 urinary tract infections 248 puberty 280
hydrocele 295 urine 242, 247 vocalization 171
puberty 280, 281 uterus 256, 257 voluntary muscles 67
testosterone 133, 137, 252, 280, 281 after birth 273 voluntary responses 109
thalamus 86, 87, 90, 93, 113 birth 270–271 vulva 258
thermoregulation 23 blood circulation 274
W
thinking 111 contractions 267–270
thoracic vertebrae 51 endometriosis 296, 300
thoughts 111 fetal development 264–265
throat 172, 214–215, 217 fetal position 266 walking 55
thrombocytes 148 fibroids 297 waste products 21
thrombosis 124, 156, 158 hormones 135 aging 284, 285
thumb 45, 54 implantation of blastocyst 261 in blood 148
thymine 30, 31, 287 menstrual cycle 283 digestive system 213
thymus gland 132, 192, 272 pregnancy disorders 302–303 urinary system 242, 247
thyroid cartilage 171 problems in labor 303 water: body fluids 21
thyroid gland 132, 137 prolapse 297 in colon 232
disorders 141 uvula 214 drinking 23
hormones 134, 139 wax, in ears 116, 128
thyroid-stimulating hormone (TSH) 134,
135
thyrotropin-releasing hormone 134, 139
V
vaccines 208
white blood cells 148–149
functions 172, 195
inflammatory response 198–201
thyroxine 141 vacuoles, cells 26 lymphatic system 192
tibia 41, 47 vagina 257, 264 skin repair 180
tinea infections 207 birth 270–271 types 194
tissues, types of 36–37 menopause 285 white matter 36, 92–93, 98
toes 55, 180, 186 prolapsed uterus 297 windpipe see trachea
tongue 214 sexual intercourse 260 wisdom teeth 216, 278
hyoid bone 50 vulva 258 womb see uterus
sense of taste 114 valves: heart 150–152, 157 worms, parasitic 207
sneezing 171 veins 149
wounds 83, 180, 198
tonsils 192 vas deferens 252, 253, 255, 301
tooth see teeth vasodilation 201 wrinkles, skin 284
toothache 195 vasopressin 135 wrist: bones 40, 54
touch, sense of 115, 179, 182–183 veins 146, 149 carpal tunnel syndrome 75
toxins 205, 222 coronary veins 150 fibrocartilage 46
trachea 165 esophageal varices 237 joints 44, 45
anatomy 162, 163 in newborn baby 275
breathing 164, 169
bronchoscopy 13
coughing 171, 217
respiratory system 163
thrombosis 158
vena cava 151, 153, 221
XYZ
X-rays 12–13
epithelial cells 184 ventricles: brain 89, 91 yeasts 207, 209
inflammatory response 198–201 heart 150, 151, 152, 154 zygote 260
319
ACKNOWLEDGMENTS
ACKNOWLEDGMENTS
DK Publishing would like to thank several people for their help in the preparation of this book. Anna Barlow contributed
valuable comments on the cardiovascular system. Peter Laws assisted with visualization, and additional design work was done
by Mark Lloyd and Louise Waller. Three-dimensional illustrations were created from a model supplied by Zygote Media
Group, Inc. Ben Hoare, Peter Frances, and Ed Wilson all provided editorial assistance, Katie John did the proofreading, and
Hilary Bird provided the index. Marianne Markham and Andrea Bagg contributed to the initial development work.
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