Essentials of Anatomy Physiology 3Rd Edition Christina A Gan Kenneth S Saladin Full Chapter

Essentials of Anatomy & Physiology
3rd Edition Christina A. Gan Kenneth S.

Saladin
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ISTUDY
Third Edition
Essentials of
Anatomy & Physiology
Kenneth S. Saladin
Georgia College
Robin K. McFarland
Cabrillo College
Digital Author
Christina A. Gan
Highline College
ISTUDY
ESSENTIALS OF ANATOMY & PHYSIOLOGY
Published by McGraw Hill LLC, 1325 Avenue of the Americas, New York, NY 10121. Copyright ©2022 by
McGraw Hill LLC. All rights reserved. Printed in the United States of America. No part of this publication may
be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without
the prior written consent of McGraw Hill LLC, including, but not limited to, in any network or other electronic
storage or transmission, or broadcast for distance learning.
Some ancillaries, including electronic and print components, may not be available to customers outside the
United States.
This book is printed on acid-free paper.
1 2 3 4 5 6 7 8 9 LWI 26 25 24 23 22 21
ISBN 978-1-260-59819-3
MHID 1-260-59819-5
Cover Image: Buena Vista Images/Getty Images
All credits appearing on page or at the end of the book are considered to be an extension of the copyright
page.
The Internet addresses listed in the text were accurate at the time of publication. The inclusion of a website
does not indicate an endorsement by the authors or McGraw Hill LLC, and McGraw Hill LLC does not
guarantee the accuracy of the information presented at these sites.
mheducation.com/highered
ISTUDY
Brief Contents
About the Authors iv PART FOUR
Table of Contents v
Taking Anatomy & Physiology to New Heights x Circulation and Defense
Making Anatomy & Physiology Intriguing and Inspiring xii 12 The Circulatory System I: Blood 385
Acknowledgments xxi
13 The Circulatory System II: The Heart and Blood
Vessels 410
14 The Lymphatic System and Immunity 462
PART ONE
Organization of the Body
PART FIVE
1 The Study of Anatomy and Physiology 1
Intake and Output
2 Life, Matter, and E
nergy 30
3 Cells 60 15 The Respiratory System 495
4 Histology—The Tissue Level of Organization 93 16 The Urinary System 522
17 The Digestive System 555
18 Nutrition and Metabolism 593
PART TWO
Support and Movement
5 The Integumentary System 125 PART SIX
6 The Skeletal S
ystem 143 Human Life Cycle
7 The Muscular System 197
19 The Reproductive System 625
20 Human Development and Aging 669
PART THREE
Internal Coordination Appendix A: Answer Keys A-1
8 The Nervous S ystem I: Nerve Cells, the Spinal Appendix B: Health Science Careers A-8
Cord, and Reflexes 248 Appendix C: Symbols, Weights, and Measures A-10
9 The Nervous System II: The Brain, Cranial Nerves, and Appendix D: Biomedical Word Roots, Prefixes, and Suffixes A-12
Autonomic Nervous System 280 Appendix E: Periodic Table of the Elements A-16
10 The Sense Organs 319 Glossary G-1
11 The Endocrine System 356 Index I-1
iii
ISTUDY
About the Authors
KENNETH S. SALADIN is Distinguished Professor of Biology, Emeritus, at Georgia College in
Milledgeville, Georgia, where he taught from 1977 to 2017. Ken’s courses included human anatomy and
physiology, introductory medical physiology, histology, animal behavior, parasitology, and natural his-
tory of the Galápagos Islands. Ken is a member of the Human Anatomy and Physiology Society,
American Physiological Society, American Association for Anatomy, Society for Integrative and
Comparative Biology, and Textbook and Academic Authors Association. He is the author of the best-
selling textbooks Anatomy & Physiology: The Unity of Form and Function and Human Anatomy. Ken’s
textbooks support several scholarships—as well as an endowed chair in biomedical science; an endowed
annual lecture in science, medicine, and society; and ecosystem conservation in the Galápagos Islands.
Tim Vacula
ROBIN MCFARLAND has taught anatomy and physiology at Cabrillo College in Aptos, California,
since 1998. She earned a Ph.D. in physical (biological) anthropology from the University of Washington,
where she studied the relationship between body fat and reproduction in primates. Robin subsequently
conducted research on comparative ape anatomy with colleagues at the University of California, Santa
Cruz. Robin is a member of the Human Anatomy and Physiology Society, and a member of the
American Association of Physical Anthropology. She is passionate about teaching anatomy and physiol-
ogy. She and her husband Jeff have two children: Reid and Madeleine. Robin enjoys hiking and climb-
ing mountains.
©Robin McFarland
CHRISTINA A. GAN, digital author for Connect, has been teaching anatomy and physiology, genet-
ics, microbiology, and general biology at Highline College near Seattle, Washington, since 2004. Before
that, she taught at Rogue Community College in Medford, Oregon for 6 years. She earned her M.A. in
biology from Humboldt State University where she studied population genetics, and is a member of the
Human Anatomy and Physiology Society. When she is not in the classroom or developing digital media,
she is climbing, mountaineering, skiing, kayaking, sailing, cycling, and mountain biking throughout the
Pacific Northwest.
Dedicated to the memory of my most important teacher and mentor, Donald R. Sly (1931–2019). K.S.S.
This book is dedicated to my students, who inspire and delight me. R.K.M.
The authors would enjoy hearing from colleagues and students alike who use this book and may wish to offer sug-
Yuen Lui Studios/Chris Gan
gestions for our next edition, or encouragement to continue doing certain things the way we have. Such feedback is
invaluable for improving a textbook, and the authors will endeavor to answer all correspondence.
Kenneth S. Saladin, Ph.D. Robin K. McFarland, Ph.D.
Milledgeville, Georgia Cabrillo College, Aptos, California
ksaladin2@windstream.net romcfarl@cabrillo.edu
iv
ISTUDY
Table of Contents
About the Authors iv

Table of Contents v
Chapter 2
Taking Anatomy & Physiology to New Heights x Life, Matter, and E
nergy 30
Making Anatomy & Physiology Intriguing and Inspiring xii 2.1 Atoms, Ions, and Molecules 31
Acknowledgments xxi
2.2 Water, Acids, and Bases 37
2.3 Organic Compounds 40
PART ONE Perspectives on Health 51
Organization of the Body 2.4 Energy and Chemical Reactions 53
Career Spotlight: Medical Technologist 56
Study Guide 57
Chapter 3
Cells 60
3.1 The General Structure of Cells 61
3.2 The Cell Surface 63
3.3 The Cell Interior 75
3.4 The Life Cycle of Cells 85
Perspectives on Health 89
Career Spotlight: Cytotechnologist 90
Study Guide 91
Eye of Science/Science Source
Chapter 4
Chapter 1 Histology—The Tissue Level of Organization 93
The Study of Anatomy and Physiology 1 4.1 The Study of Tissues 94
4.2 Epithelial Tissue 97
1.1 Anatomy—The Structural Basis of H uman Function 2
4.3 Connective Tissue 104
1.2 Physiology—Dynamic Processes in the Living Body 8
4.4 Nervous and Muscular Tissue—The Excitable Tissues 112
1.3 The Human Body Plan 13
4.5 Glands and Membranes 116
1.4 The Language of Medicine 21
4.6 Tissue Growth, Repair, and Death 119
Career Spotlight: Radiologic Technologist 26
Career Spotlight: Histotechnician 121
Study Guide 27
Study Guide 122
v
ISTUDY
PART TWO Chapter 7
Support and Movement The Muscular System 197
7.1 Muscular Tissue and Cells 198
7.2 Physiology of Skeletal Muscle 206
7.3 Cardiac and Smooth Muscle 215
7.4 Anatomy of the Muscular System 218
Aging of the Muscular System 243
Career Spotlight: Massage Therapist 243
Connective Issues 244
Study Guide 245
PART THREE
Internal Coordination
©Eye of Science/Science Source
Chapter 5
The Integumentary System 125
5.1 The Skin and Subcutaneous Tissue 126
5.2 Accessory Organs 134
Aging of the Integumentary System 139
Career Spotlight: Dermatology Nurse 139
Study Guide 141
Sciepro/Science Photo Library/Getty Images RF
Chapter 6
The Skeletal S
ystem 143
6.1 Skeletal Structure and Function 144 Chapter 8
6.2 Bone Development and Metabolism 150 The Nervous System I: Nerve Cells, The Spinal Cord,
Perspectives on Health 154 and Reflexes 248
6.3 The Axial Skeleton 155
8.1 Cells and Tissues of the Nervous System 249
6.4 The Appendicular Skeleton 171
8.2 The Physiology of Neurons 258
6.5 Joints 180
Aging of the Skeletal System 192
8.3 The Spinal Cord, Spinal Nerves, and Reflexes 265
Career Spotlight: Orthopedic Nurse 192
Career Spotlight: Occupational Therapist 276
Study Guide 277
Study Guide 194
vi
ISTUDY
Chapter 9 PART FOUR
The Nervous System II: The Brain, Cranial Nerves, Circulation and Defense
and Autonomic Nervous System 280
9.1 Overview of the Brain 281
9.2 Principal Divisions of the Brain 288
9.3 Multiregional Brain Functions 295
9.4 The Cranial Nerves 302
9.5 The Autonomic Nervous System 304
Aging of the Nervous System 313
Career Spotlight: Electroneurodiagnostic Technologist 314
Study Guide 316
Chapter 10 Dr. Yorgos Nikas/Science Source
The Sense Organs 319

10.1 Receptors and Sensations 320 Chapter 12
10.2 The General Senses 323 The Circulatory System I: Blood 385
10.3 The Chemical Senses—Taste and Smell 326
12.1 Introduction 386
10.4 The Ear—Equilibrium and Hearing 330
12.2 Erythrocytes 390
10.5 The Eye and Vision 339
12.3 Leukocytes 396
Aging of the Sense Organs 351
12.4 Platelets and Control of Bleeding 401
Career Spotlight: Optician 352
Career Spotlight: Phlebotomist 405
Study Guide 353
Study Guide 407
Chapter 11
The Endocrine System 356
Chapter 13
11.1 Overview of the Endocrine System 357 The Circulatory System II: The Heart and
11.2 Endocrine Physiology 360 Blood Vessels 410
11.3 The Hypothalamus and Pituitary Gland 363
13.1 Overview of the Cardiovascular System 411
11.4 Other Endocrine Glands and Tissues 369
13.2 Gross Anatomy of the Heart 414
11.5 Stress Physiology 379
13.3 Physiology of the Heart 421
Aging of the Endocrine System 380
13.4 General Anatomy of Blood Vessels 430
Career Spotlight: Diabetes Educator 380
13.5 Physiology of Circulation 435
13.6 Circulatory Routes and Blood Vessels 441
Study Guide 382
Aging of the Circulatory System 457
Career Spotlight: Electrocardiographic Technician 457
Study Guide 459
vii
ISTUDY
Chapter 14 Chapter 16
The Lymphatic System and Immunity 462 The Urinary System 522
14.1 The Lymphatic System 463 16.1 Functions of the Urinary System 523
14.2 Innate Immunity 472 16.2 Anatomy of the Kidney 525
14.3 Features of Adaptive Immunity 477 16.3 Glomerular Filtration 531
14.4 Cellular and Humoral Immunity 483 16.4 Tubular Reabsorption and Secretion 536
Perspectives on Health 489 16.5 Water Conservation 539
Aging of the Lymphatic and Immune Systems 490 Perspectives on Health 541
Career Spotlight: Public Health Nurse 490 16.6 Urine Storage and Elimination 541
Connective Issues 491 16.7 Fluid, Electrolyte, and Acid–Base Balance 546
Study Guide 492 Aging of the Urinary System 550
Career Spotlight: Dialysis Technician 550
PART FIVE Study Guide 552
Intake and Output
Chapter 17
The Digestive System 555
17.1 Overview of the Digestive System 556
17.2 The Mouth Through Esophagus 560
17.3 The Stomach 564
17.4 The Liver, Gallbladder, and Pancreas 571
17.5 The Small Intestine 576
17.6 Chemical Digestion and Absorption 580
17.7 The Large Intestine 584
Aging of the Digestive System 588
Career Spotlight: Dental Hygienist 588
Study Guide 590
©Susumu Nishinaga/Science Source
Chapter 18
Chapter 15 Nutrition and Metabolism 593
The Respiratory System 495
18.1 Nutrition 594
15.1 Functions and Anatomy of the Respiratory System 496 Perspectives on Health 602
15.2 Pulmonary Ventilation 506 18.2 Carbohydrate Metabolism 603
Perspectives on Health 511 18.3 Lipid and Protein Metabolism 607
15.3 Gas Exchange and Transport 512 18.4 Metabolic States and Metabolic Rate 611
Aging of the Respiratory System 517 18.5 Appetite Regulation 614
Career Spotlight: Respiratory Therapist 517 18.6 Body Heat and Thermoregulation 617
Connective Issues 518 Career Spotlight: Dietitian 621
Study Guide 519 Study Guide 622
viii
ISTUDY
PART SIX Chapter 20
Human Life Cycle Human Development and Aging 669
20.1 Fertilization and Preembryonic D
evelopment 670
20.2 The Embryonic and Fetal Stages 677
20.3 The Neonate 688
20.4 Aging, Senescence, and Death 693
Career Spotlight: Genetic Counselor 697
Study Guide 698
Appendix A: Answer Keys A-1

Appendix B: Health Science Careers A-8
Appendix C: Symbols, Weights, and Measures A-10
Appendix D: Biomedical Word Roots, Prefixes, and Suffixes A-12
Appendix E: Periodic Table of the Elements A-16
Glossary G-1
Index I-1
©David M. Phillips/Science Source
Chapter 19
The Reproductive System 625
19.1 Essentials of Sexual Reproduction 626
19.2 The Male Reproductive System 627
19.3 The Female Reproductive System 635
19.4 The Production and Union of Sex Cells 643
19.5 Pregnancy, Childbirth, and Lactation 658
Aging of the Reproductive System 663
Career Spotlight: Midwife 664
Study Guide 666
ix
ISTUDY
Taking Anatomy & Physiology
to New Heights
Chapter
Audience
13
are about 10 to 15 µm wide. The longest human cells are nerve cells (sometimes
Essentials of Anatomy & Physiology, third edition, is intended forslenderThe Circulatory

over a meter long) and muscle cells (up to 30 cm long), but these are usually too
to be seen with the naked eye. With a good light microscope, one can see
students in associate degree, certification, and career-
objects as small as 0.5 µm. Objects smaller than that generally require an electron
training programs; students in high-school advanced placement classes; microscope.students who are seeking a general education science class;
and those who may not have set foot in a college classroom for many years.
Physiology are appropriate to serve this broad spectrum of readers.
System II
ForThe
a variety
proseof reasons, cells cannot attain
and vocabulary in unlimited
Essentials size. of
If a Anatomy
cell grew ex-&
cessively large, it would rupture like an overfilled water balloon. Also, molecules
could not diffuse from place to place fast enough to support its metabolism. The
THEtime
Keeping in mind that many students are interested in exploring medical HEART
requiredAND
professions, aBLOOD
“Career
for diffusion VESSELS
Spotlight”
is proportional to thefeature
square ofhas beensoincluded
distance, if cell diam-in
eter doubled, the travel time for molecules within the cell would increase fourfold.
every chapter, and references to further career information are found in appendix B. if it took 10 seconds for a molecule to diffuse from the surface to the
For example,
center of a cell with a 10 µm radius, then we increased this cell to a radius of 1 mm,
Chapter Outline
it would take 278 hours to reach the center—far too slow to support the cell’s life
13.1 Overview of the Cardiovascular System
Theme activities.
13.1a
hasThe
13.1b
another
Having
Pulmonary
Position,
organs composed
and The
advantage: Systemic
of many small cells instead of fewer large ones
deathCircuits
of one or a few cells is of less consequence to the
structure andSize, and Shape
function of the organ.
of the whole Heart
The goal of this book is to help students succeed. Like climbing a 13.1c The Pericardium
13.2 Gross Anatomy of the Heart
mountain, learning essentials of anatomy and physiology takes B efo
13.2a There YoWall
Heart u G o On
place one step at a time, and, similar to the feeling of exhilaration 13.2b The Chambers
Answer
13.2c these questions from memory to test your
The Valves
when one has arrived at a mountain peak, there is a powerful sense understanding
13.2d of the previous
Blood Flow Through section. Reread the
the Chambers
of achievement upon mastering the knowledge of anatomy and material if you can’t answer the questions.
13.2e Coronary Circulation
1. Which term refers to all the cell contents between the
physiology. The mountain-climbing theme is echoed in visual and 13.3 Physiology of the Heart
plasma membrane and nucleus: cytosol, cytoplasm, tissue
13.3a Cardiac Muscle
pedagogical features of the book. A base camp on the first page of fluid, or extracellular fluid?
13.3b The Cardiac Conduction System
each chapter lists key information students need to understand in 13.3c 2. About how
Electrical bigand
Activity would a cell have to be for you to see it
Contraction
without
13.3d Nerve a microscope?
Supply to the Heart Are any cells actually this big? If so,
preparation for navigating the chapter. Throughout the chapter, 13.3e Thewhich ones?
Electrocardiogram
there are milestones that mark progress, such as the Before You Go 13.3f 3. Explain
The Cardiacwhy cells cannot grow to an indefinitely large size.
Cycle
13.3g Cardiac Output
On checkpoints with an image of a climber steadily
A colorized imagemoving
of
13.4 General Anatomy of Blood Vessels
upward. The study guide at the end of each chapter features a vic-
coronary blood vessels
13.4a The Vessel Wall
that have been injected
torious climber on the summit, a celebration that
with a mirrors the stu-
dye to enhance
13.4b Arteries, Capillaries, and Veins
dent’s mastery of the chapter information. their visibility in an X-ray. 3.2 The Cell Surface
13.4c Variations in Circulatory Routes
13.5 Physiology of Circulation
Such an image is called
a coronary angiogram. 13.5a Blood Pressure
SPL/Science Source ExpectedResistance
13.5b Peripheral Learning Outcomes
13.5c Regulation
When youofhave Bloodcompleted
Pressure and Flow
this section, you should be able to
13.5d Capillary Fluid Exchange
a. identify
13.5e Venous Return
the components of the plasma membrane and state their
BASE CAMP functions;
13.6 Circulatory Routes and Blood Vessels
Before ascending to the next level, be sure you’re 13.6a Theb.Pulmonary
describe Circuit
the composition, appearance, and functions of the
Study Guide
properly equipped with a knowledge of these glycocalyx
13.6b The Systemic that coats each cell;
Circuit
concepts from earlier chapters. c. describe the structure and functions of microvilli, cilia, flagella,
• Thoracic cavity anatomy (see section 1.3e) Clinical Applications/Perspectives
and pseudopods;on Health
• Desmosomes and gap junctions (see section 3.2d) • Clinical Application
d. name13.1:
theCardiac Arrythmia
different types of junctions that connect cells to each
• Muscle tissue (see section 4.4b) • Clinical Application
other,13.2:
andCongestive Heart
describe their functions; and
Assess Your Learning • Skeletal muscle excitation and contraction

(see section 7.2a)
Failure e. explain the processes for moving material through cellular
• Perspectives on Health
membranes.
• Resting membrane potentials and action
Outcomes potentials (see section 8.2a and b) A great deal of physiology takes place at the cell surface—for example, the bind-
End of Chapter
• Aginging
of of
thesignal molecules
Circulatory such as hormones, the stimulation of cellular activity, the
System
attachment ofElectrocardiographic
cells to each other, and the transport of materials into and out of cells.
To test your knowledge, discuss the following topics with a study 11. The processes
• Career of genetic transcription and translation,
Spotlight:
This, then, is where we begin our study of cellular structure and function. Like an
Technician
partner or in writing, ideally Module
from memory.
9 including the roles
• Connective Issues
of mRNA, rRNA, and tRNA
Circulatory
System 12. How the amino
• Study Guide acid sequence of a protein is represented by the
codons of mRNA
3.1 The General Structure of Cells
13. How proteins are processed and secreted after their assembly
1. Fundamental components of a cell on a ribosome
2. Intracellular
x and extracellular fluids
3. The typical size range of human cells and what factors limit 3.4 The Life Cycle of Cells
ISTUDY
cell size
∙ Chapter 7—new information on causes of muscle fatigue;
What’s New in the Third streamlined chapter by omitting minor muscles; expanded
Edition? discussion of health benefits of exercise
The new edition of Essentials of Anatomy & Physiology by ∙ Chapter 8—expanded discussion of organization of the
Saladin and McFarland has been significantly updated. A hall- nervous system and added a figure; expanded discussion of
mark of previous editions, according to both students and review- functions of the nervous system; added table of functions of
ers, is the exceptionally clear writing. In this new edition, we neuroglial cells; expanded explanation of myelin
continue our commitment to students, with approachable lan- ∙ Chapter 9—new information on meningitis and traumatic
guage and relatable examples and analogies. We present current, brain injury; updates on the basal nuclei
solid scientific information. We have included numerous updates ∙ Chapter 10—added evolutionary perspectives on taste prefer-
based on recent, peer-reviewed journal articles, as well as updated ence and present-day obesity and comparative, evolutionary
clinical examples and disease statistics. We have expanded dis- perspectives on the sense of smell; new research on smell and
cussions of health and disease to help students apply concepts of Alzheimer disease and depression
anatomy and physiology to their daily lives. ∙ Chapter 11—new summary tables for pituitary gland
hormones and hormones from other sources; updated discus-
Updated Science and Enhanced sion of oxytocin; added new information about leptin
Content ∙ Chapter 12—new summary table of ABO blood group; updated
discussion of research on gene therapy and sickle-cell disease
Some examples of updated or new scientific information, as well
∙ Chapter 13—updates on the interaction between heart and
as enhanced anatomical and physiological concepts, follow:
brain; streamlined discussion of coronary circulation; updat-
∙ Chapter 1—new information about use of PET scans to diag- ed blood pressure guidelines
nose Alzheimer disease ∙ Chapter 14—expanded discussion of microbiome; new re-
∙ Chapter 3—updated discussion of genomic medicine; new search about neutrophil extracellular traps
summary table of features and functions of organelles ∙ Chapter 15—expanded discussion of surfactant and prema-
∙ Chapter 4—expanded discussion of epithelial functions; new ture infants; new information about effects of e-cigarettes
research on brown and white fat and endocrine functions of (vaping) and smoking marijuana on respiratory health;
adipose tissue; new Clinical Application and photo of dia- updated statistics regarding tobacco cigarette smoking
betic foot ulcers; new information on regenerative medicine ∙ Chapter 17—updates on enteric nervous system; updates on
and stem cells rotavirus vaccine and childhood mortality
∙ Chapter 5—updates on pathology and immunotherapy of ∙ Chapter 18—updates on sugar consumption in the United
melanoma States and obesity
∙ Chapter 6—updates on the endocrine function of bones and ∙ Chapter 19—new information about prostate cancer; new in-
their widespread effects on the body; updates on functions of formation on the role the fetus plays in initiating labor
osteocytes; new Clinical Application on rickets
∙ Chapter 20—added new information about the zica virus
xi
ISTUDY
Making Anatomy & Physiology
Intriguing and Inspiring
Essentials of Anatomy & Physiology crafts the facts of A&P into Muscle
art and prose in a way that makes the book exciting and reward-
fiber
Nucleus
ing to read.
A band
Captivating Art and

I band
Z disc
Photography Mitochondria Openings into

transverse tubules
Sarcoplasmic
reticulum
A&P is a highly visual subject; beautiful illustrations pique
the curiosity and desire to learn. Essentials of Anatomy & Terminal cisterns
Transverse tubule
Physiology’s illustrations set a new standard in the A&P Sarcolemma

Myofibrils
Essentials market, where many students regard themselves Sarcoplasm
as visual learners.
Myofilaments
Cognitive Skill Building

Essentials of Anatomy & 196 PART 2 Support and Movement
Epineurium Perineurium Endoneurium
Physiology asks questions that Posterior root

Rootlets
8. One long bone meets another at its 2. The growth zone of a child’s long bones is the articular cartilage.
not only test memory, but also a. diaphysis.
Posterior root
d. metaphysis. ganglion Nerve
fiber
b. epiphyseal plate. e. epiphysis. Anterior 3. Bones that articulate with the parietal bone include the frontal,
exercise and expand the c. periosteum.
root temporal, occipital, and zygomatic bones.
Spinal
student’s thinking skills at 9. The spinal cord passes through the
nerve
of the vertebrae. 4. On a living person, it would be possible to palpate the muscles Fascicle
a. vertebral foramina d. obturator foramina in the subscapular fossa but not those of the supraspinous fossa.
multiple levels of Bloom’s b. intervertebral foramina e. bodies
Blood
vessels
5. Reaching behind you to take something out of your hip pocket
Taxonomy of Learning c. transverse foramina (a) involves hyperextension of the elbow.
10. The principal facial bone between the orbit and upper teeth is the
Outcomes. Within Connect™ a. frontal bone. d. mandible. 6. Blood
The bones that enclose the brain develop from fetal cartilage.
there is also the opportunity

vessels
b. zygomatic bone. e. parietal bone. PASIEKA/Science Photo
(b)
c. maxilla. 7. Synovial fluid is secreted by the bursae.

Library/Getty Images
to assess student 11. The mastoid process and external acoustic meatus are parts of 8. Fascicle
In strict anatomical terminology, the words arm and leg both
Epineurium
refer to regions with only one bone. Perineurium

understanding of the Learning the bone.
Unmyelinated nerve fibers
9. Parathyroid hormone is an important stimulus for bone
Outcomes by leveraging 12. Osteocytes contact each other through channels called
in the bone matrix. deposition.
Myelinated nerve fibers
Endoneurium
question filters that allow

Myelin
13. A tendon joins a muscle to a bone whereas a joins 10. Climbing a flight of stairs requires strong, alternating adduc-
tion and abduction of the hip joint.
the curation of custom one bone to another.
Answers in Appendix A
assignments and efficient 14. The lubricant in the shoulder and hip joints is called .
reporting for administrative 15. As people age they experience

bone mass.
, a gradual loss of
Testing Your Comprehension
assessment purposes. 16. are bone cells that secrete collagen and stimulate 1. Most osteocytes of an osteon are far removed from blood vessels,
calcium phosphate deposition. but are still able to respond to hormones in the blood. Explain
how it is possible for hormones to reach and stimulate these cells.
17. is the science of body movement.
2. How does the regulation of blood calcium concentration exem-
18. The femur is prevented from slipping sideways off the tibia in plify negative feedback and homeostasis?
part by a pair of crescent-shaped cartilages called the lateral 3. Name the action that would occur at each of the following
and medial . joints in the indicated situation. (For example, the shoulder
in picking up a suitcase. Answer: elevation.) (a) The arm
19. Bones of the skull are joined along lines called .
when you raise it to rest your hand on the back of a sofa on
20. A herniated disc occurs when a ring called the cracks. which you’re sitting. (b) Your neck when you look up at a
plane in the sky. (c) Your tibia when you turn the toes of one
Answers in Appendix A foot to touch the heel of the other foot. (d) Your humerus
when you reach up to scratch the back of your head. (e) A
bowler’s backswing. (f) A basketball player’s foot as she
What’s Wrong with makes a jump shot. (g) Your shoulder when you pull back on
These Statements? the oars of a rowboat. (h) Your elbow when lifting a barbell.
(i) A soccer player’s knee when kicking the ball. (j) Your
Briefly explain why each of the following statements is false, or index finger when dialing an old rotary telephone. (k) Your
reword it to make it true. thumb when you pick up a tiny bead between your thumb
1. There are equal numbers of carpal and tarsal bones. and index finger.
xii
ISTUDY
Expected Learning
Outcomes 3.4 The Life Cycle of Cells
This book provides a ready-made course are about 10 to 15 µm wide. The longest human cells are nerve cells (sometimes
outline of course objectives and means of Expected Learning
over a meter long) and Outcomes
muscle cells (up to 30 cm long), but these are usually too
assessment with its “Expected Learning slender
When to be
you seencompleted
have with the naked
thiseye. With ayou
section, goodshould
light microscope,
be able toone can see
Outcomes” presented at the start of each objects as small as 0.5 µm. Objects smaller than that generally require an electron
a. describe the stages of a cell’s life cycle and list the events that
microscope.
chapter section.
define
For each of
a variety stage; andcells cannot attain unlimited size. If a cell grew ex-
reasons,
cessively
b. name large,
the itstages
would of rupture
mitosis like an overfilled
and
CHAPTER describe
13 The
water
what balloon.
occurs Also,
Circulatory
molecules
in each.
System II 429
could not diffuse from place to place fast enough to support its metabolism. The
Assess Your Learning time required for diffusion is proportional to the square of distance, so if cell diam-
3.4a eterThedoubled, Cell the travel
Cycle time for molecules within the cell would increase fourfold.
Outcomes For example, if it took 10 seconds for a molecule to diffuse from the surface to the
The purpose of the cardiac cycle is to eject blood A basic
into principle
the
center great
of a cell of cellaThe
arteries.
with biology
10 is that
vol-radius,
µm allwe
then cells arise from
increased existing
this cell cells,ofboth
to a radius 1 mm,in
The parallel “Assess Your Learning an
ume of blood ejected by each ventricle per minute (mL/min.) evolutionary
it would take sense,
is called
278 the reaching
hours across billions of years to the earliest
to reach the center—far too slow to support the cell’s life
cardiac cell, and in
Outcomes” at the end of each chapter our
output. Mathematically, it is the product of stroke volume, lifetimes, when
SV (mL/beat),
activities. we
Having organs grow from
and heart a single-celled fertilized egg to
composed of many small cells instead of fewer large onesa fetus, infant,
provides
rate, HR a(beats/min.)—that
comprehensive overview
is, SV × HRof key
= CO. and
Typicaladult.
hasadult Most
another restingcells haveare
values
advantage: Thea finite
death life
of one span,
or aduring
few cellswhich theyconsequence
is of less must accurately to the
points in the chapter. Study guide questions duplicate structuretheirand DNA and separate
function of the whole the copies
organ. into two daughter cells. The life cycle
70 mL/beat (SV) × 75 beats/min. (HR) = 5,250 mL/min. (CO)
probe understanding of concepts and of a cell extends from one division to the next. This cell cycle is divided into four
The body’s
highlight forentire volume
students whatoftheyblood
need(usually
to 4–6main
L) passes
phases: through
G1, S,the G2heart
, andevery
M (fig. 3.16).
minute. Vigorous exercise can raise CO to as much The
review. Bef
as or
21first e gap
L/min., You and(GGo On is an interval between cell division (the “birth” of
world-class
) phase
1
athletes can pump up to 35 L/min. two new cellsthese
fromquestions
a parent cell)
Given that SV × HR = CO, there are obviously Answer
only two ways to increasefromand memoryDNA to replication.
test your During this time, a new
cell synthesizes
understanding proteins,
of the grows,
previousand section.
carries out its preordained
Reread the tasks for the body,
cardiac output: Increase the heart rate or the stroke suchvolume (or both).enzymes
as secreting The heartifrate
it’s athedigestive gland cell. Cells in G1 also begin to
Before You Go On/ material
1. are
Which
if
increases when the sympathetic nervous system is activated and its neurotransmit-
replicate their
you can’t
centrioles
termOther
refers
answer
in preparation
to all the cell
questions.
forcontents
the nextbetween
division, the
and they accumulate
ter, norepinephrine, and the similar hormone epinephrine released. agents
Apply What You Know the materials plasma needed in the next
membrane
that increase heart rate include thyroid hormone, nicotine, and caffeine. In contrast,
The synthesis (S) phaseslows
and phase
nucleus:
is fluid?
to replicate
cytosol, their DNA. tissue
cytoplasm,
a period in which a cell replicates its DNA, doubling
the parasympathetic nervous system and its neurotransmitter fluid,acetylcholine
or extracellular
Intermediate aids such as “Before You Go it in preparation for the upcoming cellhave
division.
to beRemember
for you totheseelaw
it of complemen-
down the heart rate, as do excessive levels of calcium or2.potassium. About how big would a cell
On” and “Apply What You Know” provide tary base pairing
without inmicroscope?
a DNA (see by “Nucleic
Are anyAcids cells [DNA
actuallyand RNA]”
this big? Ifinso,
section 2.3). If Figu
Increasing the stroke volume (and thereby cardiac output) is accomplished
an easy means for meeting the requirements you knew that
which one strand
ones?
increasing the contraction strength of the cardiomyocytes. Stronger contractions are of the double helix had a base sequence ATCGCA, you
of an outcome-driven
caused by sympatheticcurriculum and also
system chemicals couldand
epinephrine predict fromwhy
3.norepinephrine,
Explain this cells
law that
as well the one
as
cannot grow across
to anfrom it must read
indefinitely largeTAGCGT.
size. Mito
work to encourage active learning over This predictability
calcium, the hormone glucagon, and the drug digitalis. Conversely, several factors can also enables a cell to produce duplicate copies of its
passive
weaken reading.
myocardial contractions and reduce cardiac DNA. In theincluding
output, S phase,potassium
each DNA or molecule in the nucleus “unzips”
ng calcium excesses, oxygen deficiency, and abnormally at several placespH
low blood along its length,
(acidosis). Noteseparating the double helix into
med.
two strandsstrength;
that some agents affect both the heart rate and contraction (fig. 3.17, panel 1 in-
epinephrine ). At each of these sites, an en-
Met
ory vesicles creases both, and potassium excess (hyperkalemia) reduces
zyme calledboth.DNA polymerase (green in panel 2 ) reads the
3.2 onThe CellandSurface
aph
e protein by base sequence one strand assembles nucleotides
Pr
op
osis.
ase
in the right order to make a complementary strand. At
ha
Apply What You Know
se
each Expected
replication Learning
site, two of Outcomes
these enzymes work simul-
Physical exercise obviously increases cardiac output. Do you think it achieves
this through heart rate, contraction strength, ortaneously, moving
When
both? Explain. youalong
have their DNA strands
completed in opposite
this section, you should be able to
directions. The end result of this process going on in
a. identify
numerous places the components
at once of the plasma
on the 46 chromosomes is membrane and state their
functions; G2
that, by the end of the S phase, the cell has two com- Second gap phase
plete sets of b. identical
describe DNAthe composition,
molecules. appearance,
Each DNA and functions of the
Growth and preparation
glycocalyx that coats each cell; for mitosis
molecule is composed of one strand from the old
Bef or e You G o O n DNA and one c. describe the structure
that has been andby
newly made functions
the poly-of microvilli, cilia, flagella,
and pseudopods;
merase (panel 3 ). Each chromosome, at that point,
Answer these questions from memory to test your d. name the different types of junctions that connect cells to each
has two identical DNA molecules, which are available
understanding of the previous section. Reread the
material if you can't answer the questions.
to be divided other, and describe
up between daughtertheir
cellsfunctions;
at the nextand
cell
division. e. explain the processes for moving material through cellular Syn
7. Describe the structure of intercalated discs and membranes. DN
The second
explain the functional importance of each feature. gap (G2) phase is a relatively brief in-
tervalA between
great
8. Why must the signal for each heartbeat slow down at the dealDNA replication
of physiology andplace
takes cell at
division.
the cell In G2,
surface—for example, the bind-
xiii
AV node? a cell finishes
ing of replicating
signal molecules its centrioles
such as and
hormones, synthesizes
the en-
stimulation of cellular activity, the
ISTUDY zymes attachment of cells
that control cell to each other, and the transport of materials into and out of cells.
division.
9. Why is it so important that the action potential of a cardio-
This, then, is where we begin our study of cellular structure and function. Like an
CHAPTER 5 The Integumentary System 135
Making Anatomy & Physiology Epithelial root
Intriguing and Inspiring

24 PART 1 Organization of the Body sheath
Hair shaft Hair medulla
One of the greatest challenges faced by students of anatomy and physiology is

the vocabulary. In this book, you will encounter such Latin terms as corpus callo-
We have seen how a nerve signal is initiated; now we examine sum (a brain how structure)
it travels and Stimulating Prose
to itsextensor carpi radialis longus (a forearm muscle). You 10 The Sense Organs 3
CHAPTER
might wonder
final destination. The action potential is a voltage spike over a limited area of plasma why structures aren’t called by more common names that everyone
Far more than “just the facts,” Essentials
This sec-of
membrane. However, it triggers another action potential can understand,
in the membrane andimmedi-
how you will ever remember
Ossicles: such formidable terms.
Hair cortex
Semicircular ducts
Sebaceous tion will
centriole give you some
Arrector
(SEN-tree-ole) answers com-
An organelle to these questions
Anatomy
Stapes & and some
Physiology’s
long-term useful
obstruction narrative
tipsairflow
Connective
of style
on master-
and congenital
Oval window Pre
ately ahead of it, and that
glandaction potential triggers another, and so forth. Thus, we get
muscle Incus tissue
ing anatomical
posed terminology.
of a short cylinder of nine triplets ofweaves substantially reduced pulmonary
Malleus relevant details intoroot an engaging
sheath ventilation; anatomical
Vestibular nerve d
a chain reaction of oneHairaction potential after another along
receptor the Itlength
microtubules, of a nerve
is of usually
greatestpaired
fiber.
with another
importance to use medical one
termsof the leadingItcauses
precisely. may seem of death in old age.
trivial hereditary dis
This chain reaction constitutes the nerve signal. An illuminating analogy to this is trapezium,story of human form and function. Vivid
Hair root centriole perpendicular
if you misspell to
Hair trapezius
matrix it; origin
as of the butcilium (SIL-ee-um)
in doing so, you would A hairlike process, with an
be changing connective
Cochlear nervetissu
standing up a long row of dominoes and pushing the first mitotic one analogies that captivate thefromimagination makeof Vestibule
the over.
name When
spindle;
of Hair that
bulb domino
aidentical
back to the basal
muscle body
to the of of a wrist
name axoneme,
bone. projecting
A “little” the apical
error such surface
as more extrace
Apocrine
falls, it pushes over thesweat
second, and so forth—and the chain reaction
a misspelling
cilium produces
Auricleor flagellum.
malleus
Dermal a
(fig.
as wave
3.13)
malleolus complex
changes theconcepts
an epithelial
name of easier
a cell; to
often
middle-ear understand.
motile
bone and
toserving
the to usually with
Cochlea
gland
of energy traveling to the end of the line. No one domino cephalic
moves (seh-FAL-ic)
to the papilla Pertaining
other end of the to the head. propel matter across the surface of an epitheli- lular fiber; fo
name of
Tympanic a protuberance of the ankle. A difference of only one letter distinguishes Round window
cerebellum (SER-eh-BEL-um) A large portion um, but sometimes nonmotile and serving a capsules for o
line; a falling domino is a local event. Similarly, an action potential
Blood gustation
membrane is(the
a local
senseevent, but from gestation (pregnancy). The health professions
of taste)
capillaries of the brain posterior to the brainstem and
Auditory sensory role. (fig. 3.5) holdscavity
Tympanic them in
it triggers the next oneinand, like the row of falling dominoes,demand
wetoget precision
wave and accuracy. People’s well-being may depend on it, and indeed
dermal
papilla
inferior
canal theacerebrum, of responsible
energy for circulatory shock A state of cardiac output adipose tissu
traveling from one end of the axon to the other. That traveling many wavepatients
is the die simply
nerve signal
equilibrium, motor coordination, certain
because of written and oral miscommunication among
inadequate to meet the metabolic needs of
Tensor tympani
blood).
muscle
(fig. 8.11). Action potentials do not travel; nerve signals do. hospital staff.
perceptual abilities, and memory of learned the body. cooperative
Auditory tube effe
(a) (b) 0.5 mm
motor skills. (fig. 9.6) circulatory system An organ system consisting hormones, or
Lobule fluid (CSF) (SERR-eh-bro-SPY-
cerebrospinal Figure 5.5ofStructurethe heart,ofblood a Hair vessels,
and Itsand blood; the
Follicle. nervous syste
Each hair has an arrector muscle, also known as an arrector pili.16 It contracts
nul, seh-REE-bro-SPY-nul) A liquid in that(a) Anatomy cardiovascular
of the follicle andsystem plusstructures.
associated the blood. single overall
response to cold, fear, and touch, making the hair
fills thestand
Apply on endof
What
ventricles and
Youthecausing
brain, “goose
Know the central (b) Light cisterna
micrograph of the base ofAa fluid-filled
(sis-TUR-nuh) hair follicle. space or coronal plane
Outer ear Middle ear Inner ear
Figure Legend Questionsbumps.” In other mammals, raising the hairs traps an insulating layer of warm air
canal A of
misspells
the spinal
student means
next to the skin or makes the animal appear larger and less vulnerable to a potential
between the CNS it
cord,toand
and dura
ilium. In
writethe about
mater.
complaining
space part of the small
about the
sac, intestine
system
points
such as thecalled
b: Ed Reschke/Getty Images
andthe
lost,
cisterna
a cisterna
student
thechyli
ileum,
ofsays,
of the
butlymphatic
the endoplasmic
Figure “I 10.6
was General
coronary circul
Anatomyvessels
of thethat
Ear.s
enemy. In relatively hairless humans, the effect is not obvious.
Thought questions in manyHair figure
color legends
derives fromencourage cerebrum
students
different types andonly
(me-AY-tus), (seh-REE-brum,
toone
proportionsisthink of analytically
a letter
passage off!”
melanin. SER-eh-brum)
throughThe instructor
Black
the and says,
temporal The?• leading
bone
In light reticulum
“But you of your knowledge
changed
to the eardrum.or Golgi
the of hair, discuss
complex.
entire
It fol- meaningAlsothe called
of a (fig. 13.5)
largest and most superior part validity cistern.
of an advertising claim that a? shampoo
Cranial nerves are numbered I through
brown
about the art, not merely view hairit.
areThese
coloredquestions
by a form of are
melanin
lows
also called
agreat
slightly
the word.”
for S-shaped
eumelanin. With
in-classAnother,
course
the helpforof the
sulfur-rich
about
of 3brain,
cm. It is lined
a dictionary, withthe
explain (figs.
skininstructor’s
and 3.13,
possesses 7.2)
reasoning. corpus Body o
will “nourish your hair.” Where and howGive does thea name and roman numeral of the th
melanin called pheomelanin causes various divided
ceruminous
shades ofandinto two
blond convoluted
sebaceous
in moderate glands. cerebral clone
The secretions of these glands form cerumen
amounts, A population of cells that are mitotically
yellow organ,
cranial nerve emerging at theasright
opps
discussion. and orange to red hair if more abundant. Gray (earwax),
hemispheres whichhair
and white waterproofs
separated
result from bythe canal,
aadeep
combina-longitudinal
hair get its sole nourishment?
inhibits bacterial growth, and keeps
descended the ear-
from the same parent cell
of this and are
figure. tail, or cervix
tion of air in the medulla and scanty pigment drum inpliable.
fissure.the cortex. It also coats the guard hairs at the entrance to the canal, making
identical to each them
other genetically or in other cortex (plural, c
sticky and
cervical more effective atPertaining
(SUR-vih-cul) blocking parasites
to the neck and debris fromrespects.
entering the canal. some organs
Building Vocabulary Hair Growth or any cervix. 1.4a Analyzing Medical Terms coagulation (co-AG-you-LAY-shun) The brum, lymph
The Middle
cervix (SUR-vix) Ear 1. The neck. 2. A narrow or clotting of blood, lymph, tissue fluid, or or encloses ti
The plethora of medicalHairtermsgrowsinbyA&Pmitosisisofone ThereHair
cellsofin the hair necklike
matrix. is a simple trick
cells to becoming more comfortable with the technical lan-
What we colloquiallypart andof an follicle
organ
call thesuch
together
eardrum as the is uterus
more properly known semen. as the tympanic costal (COSS-tu
are pushed toward the skin surface as the cells
a student’s most daunting challenges. Chapter 1 guage
belowofthem
and gallbladder.
medicine.
multiply. Those The hairwho, cells at first, find scientific terms confusing and dif-
membrane. It marks(fig. the 19.6)
beginning of the middle ear. Medial collagento the(COLL-uh-jen)
membrane is The most abundant cranial (CRAY-n
become progressively keratinized and die as they ficult areto pushed upward, away
pronounce, spell, from and the remember often feel more confident once they
teaches core principles blood
of how to inbreak words a tiny air-filled
channel proteinchamber, A protein the tympanic
in the plasma cavity, only 2 to 3 mmproteinwide. Itincontains
the body, the forming the fibers of of the skull.
supply the dermal papilla. A typicalrealize
scalp hair the in a young adult grows for
body’s
membrane that logic
three smallest hasbones ofand
aItpore how its two
through suchsmallest
it for terms are muscles.
theskeletal composed.
manyThe A term
three
connective bones, suchinas
tissues hypona-
places such as the cranial nerve
down into familiar roots, prefixes, and suffixes,
6 to 8 years at a rate of about 1 mm per 3 days
called
(10–18
auditory
tremia
cm/year).
ismaterials
less
ossicles,
then
forbidding
5 stops
transfer the
grow-
once
vibrations wefrom recognize
the tympanic it is composed
membrane to the ofbones.
three common
ing and the follicle atrophies over a period passage
of 2ear. 3ofweeks.
or From Finally, between
the hair cytoplasm dermis, tendons, and nected to the
making medical terminology less intimidating inner word elements:lateral tohypo-
medial, theyenters
(below are the malleus6natr-
normal), (attached to the inside
(sodium), and of -emia
the (blood
a resting phase 1 to 3 months long, during and
which extracellular
it may fall fluid.
out on (fig.
7its own3.3) or be columnar A cellular shape that iscondi-
significantly through foram
tympanic membrane), incus, and stapes (STAY-peez). 8
while teaching the importance
pushed outof byprecision in
a new hair growing ittion).
chemoreceptor
beneath in
The
Thus,
thetympanic
same hyponatremia
An
follicle. organ
membrane We or cell not
typically
would
islosea deficiency
specialized
vibrate freely to if theofairtaller
sodium thanon
pressure
inwide.
the (fig.
one side
blood.4.2)Those three cranium The c
50 to 100 scalp hairs per day.
spelling (ilium/ileum, malleus/malleolus). were word
detectmuch elements
chemicals,
greater than asappear
in the carotid
pressure over
on theand bodies
other over and
side. in many other
commissure
Therefore, the middlemedical terms: hypothermia,
(COM-ih-shur)
ear is con- A bundle of nerve the brain; tog
taste
nected buds.
natriuretic,
to the pharynx anemia, and so (pharyngotympanic
by the auditory on. Once you learn fibers
or thethatmeanings
eustachian crosses
9
) tube.from of hypo-,
one sidenatri-,
of the brain form the skul
∙ An end-of-bookFunctions “Glossary” of Hair provides
Thisand tube-emia,
cholecystokinin is normally youflattened
(CCK) andhaveclosed,
(CO-leh-SIS-toe-KY-nin)
already thebuttoolswhen towe atyawn ororspinal
least swallow, cord
partially it opens
tounderstand
the other. hundreds crista An anat
andAof allows
polypeptideair to enter
employed or leave asthe tympanic and
a hormone cavity. This complement
equalizes air pressure 1. Toon complete or enhance the crista galli of
clear definitions In
ofcomparison
the mostto important or
other mammals, the relative
other
hairlessness
theneurotransmitter,
two
biomedical
sides of theoftympanichumans
terms.
isbysosome
membrane,unusual but unfortunately it also frequently allows of something else, as in
Scientific secreted
terms are brain
typically neu-
composed structure
of one or
or function
more of the following a mitochondr
frequently used terms, andthe“Appendix
that it raises question, WhyD: do we havethroatanyinfections
hair at all? to spread
Excepttoon thethemiddle
scalp,ear it (see Clinical Application 10.2).
rons and
elements: cells of the small intestine. In the the coordinated action of two hormones. 2. A cross section A
Biomedical Word Roots, Prefixes, and Suf- The two muscles of the middle ear are called the stapedius (sta-PEE-dee-us)
anddigestive
tensor system, stimulates
tympani (TEN-sur contraction ofThey
TIM-pan-eye). the insert onsystem
the of plasma
stapes and mal-proteins involved in defense axis of the bo
fixes” defines nearly
16
pilo =400
hair Greek and Latin ∙ At least
gallbladder,
leus, respectively. In one
release roottoand
of bile,
response (stem) butthat
loudsecretion slowly bears
of thenoises
building core
against meaning
such pathogens.
as thunder, of the word. In car- cuboidal (cue-B
roots, which make up about 90% of today’s pancreatic
they contract diology,
enzymes.
and inhibitforthe example,
movementthe rootbones,
of these is cardi- (heart).
concentration
protecting sensory Many
gradient
cells of wordsA have
differencetwo inor that is roughl
the inner ear
cholesterol more fromroots.
destructive
(co-LESS-tur-ol) In adipocyte,
overstimulation.
A steroid that theTheyroots areare
not chemical
adequately
adip- (fat) and -cytefrom
effective,
concentration (cell).one Word
point to the height an
medical terms.
functions roots
as part areofoftenthe plasma linkedmembranethroughand an o or other another,vowel as on totwomake sidesthe
of word
a plasma more typically look
∙ Footnoted word origins show how new terms oss = bone;pronounceable.
5 as a precursor for all other steroids in the
icle = little membrane. (fig. 4.2)
are composed of familiar word roots. 6 body.
malleus ∙ A prefix may be present at the beginning of a word to modify its core meaning.
= hammer, mallet conception The fertilization of an egg, current A mo
incus = anvil (CON-dro-site) A cartilage cell.
chondrocyte
7
For example, gastric (pertaining to the stomach or to the belly of a muscle) producing a zygote. such as ions
∙ Pronunciation guides that appear through- 8
stapes
(fig. =4.19)
stirrup conceptus All products of conception, ranging cutaneous (cue-T
takes on a variety of new meanings when prefixes are added to it: epigas-
out chapters make it easier to pronounce key 9
Bartholomeo
chronic Eustachio (1520–74),
1. Long-lasting. Italian anatomist
2. Pertaining to a dis- from a fertilized egg to the full-term fetus skin.
tric (above the stomach), hypogastric (below the stomach), and endogastric
terms, and make these words more likely to ease that progresses
(within the stomach).
slowly and has a long with its embryonic membranes, placenta, and cyanosis (SY-u
duration. Compare acute. umbilical cord. Compare embryo, fetus, skin and muc
be remembered and understood. ∙ A suffix may be added to the end of a word to modify its core meaning. For
chronic bronchitis A chronic obstructive preembryo. or hypoxemia
xiv pulmonary example,
diseasemicroscope,
characterizedmicroscopy, by damaged microscopic, and microscopist
condyle (CON-dile) havesurface
An articular differ- on a cyclic adenosine
ent meanings
and immobilized respiratorybecause cilia,ofexcessive
their suffixes alone. bone, usually in the form of a knob (as on the A cyclic mol
ISTUDY mucus secretion, infection of the lower mandible), serving to smooth the motion of a removal of tw
respiratory tract, and bronchial inflammation; joint. (fig. 6.9) second messe
Study Guide CHAPTER 3 Cells 91
The “Study Guide” at the end of each chapter
provides an overview of key points, as well as Study Guide
a variety of self-testing question formats to
Assess Your Learning
effectively reinforce the material. A student Outcomes
who masters these study guides should do well To test your knowledge, discuss the following topics with a study 11. The processes of genetic transcription and translation,
including the roles of mRNA, rRNA, and tRNA
on an exam. partner or in writing, ideally from memory.
12. How the amino acid sequence of a protein is represented by the
codons of mRNA
3.1 The General Structure of Cells
13. How proteins are processed and secreted after their assembly
1. Fundamental components of a cell on a ribosome
2. Intracellular and extracellular fluids
3. The typical size range of human cells and what factors limit 3.4 The Life Cycle of Cells
cell size
1. Four phases of the cell cycle and the main events in each phase
2. How DNA is replicated in preparation for mitosis
3.2 The Cell Surface
3. Functions of mitosis
1. Molecular components and organization of the plasma 4. Four stages of mitosis; changes in chromosome structure and
membrane distribution that occur in each stage; and the role of centrioles
2. Varieties and functions of the plasma membrane proteins and the mitotic spindle
3. The composition, location, and functions of a cell’s glycocalyx 5. The mechanism and result of cytokinesis
4. Structural and functional distinctions between microvilli, cilia,
flagella, and pseudopods
5. Structural distinctions and respective advantages of three types of Testing Your Recall
cell junctions—tight junctions, desmosomes, and gap junctions
1. The clear, structureless gel in a cell is its
6. The eight modes of transport through a plasma membrane a. nucleoplasm.
and how they differ with respect to the use of carrier proteins, b. endoplasm.
direction of movement of the transported substances, and c. cytoplasm.
demand for ATP d. neoplasm.
e. cytosol.
3.3 The Cell Interior
2. New nuclei form and a cell begins to pinch in two during
1. Components and functions of the cytoskeleton a. prophase.
2. Types of cell inclusions and how inclusions differ from b. metaphase.
organelles c. interphase.
3. What organelles have in common and how they differ, as a d. telophase.
92 PART 1 Organization of the Body class, from other cellular components e. anaphase.
4. Structure of the nucleus, particularly of its nuclear envelope, 3. The amount of in a plasma membrane affects its
chromatin, and nucleoli fluidity.
5. A serves as a mechanical linkage between adjacent 18. Liver cells can detoxify alcohol with two organelles, the
5. Two forms of endoplasmic reticulum, their spatial relationship, a. phospholipid
cells but does not obstruct the movement of materials through and .
their structural similarities and differences, and their functional b. cholesterol
the space between cells. 19. A macrophage would use the process of differences to engulf a
a. glycocalyx c. glycolipid
dying tissue cell. d. glycoprotein
b. phospholipid bilayer 6. The composition, appearance, locations, and function of
c. tight junction 20. To crawl about in the body’s tissues or engulf foreign matter, a
ribosomes e. integral protein
macrophage would use structures called 7. its
Structure of. the Golgi complex and its role in the synthesis,
d. gap junction 4. Cells specialized for absorption of matter from the extracellular
e. desmosome packaging, and secretion of cell products
Answers in Appendix A fluid are likely to show an abundance of
6. The word root phago- means 8. Similarities and differences between lysosomes and peroxi- a. lysosomes.
a. eating. What’s Wrong with These somes in structure, contents, and functions b. microvilli.
b. drinking. 9. Structure, function, and evolutionary origin of mitochondria, c. mitochondria.
c. emitting fluid. Statements? and the significance of mitochondrial DNA d. secretory vesicles.
d. intracellular. Briefly explain why each of the following 10. Structure,
statements locations,
is false, or and functions of centrioles e. ribosomes.
e. extracellular. reword it to make it true.
7. The amount of DNA in a cell doubles during
1. A cell specialized for absorption would be expected to have a
a. prophase.
high density of cilia on its surface.
b. metaphase.
2. DNA replication occurs during mitosis.
c. anaphase.
3. A cell can release its secretory products by exocytosis, phago-
d. the S phase.
cytosis, or pinocytosis.
e. the G2 phase.
4. In the plasma membrane, the phosphate heads of the phospho-
8. Fusion of a secretory vesicle with the plasma membrane and lipid molecules cluster together in the middle of the membrane
release of the vesicle’s contents is and the fatty acid tails are pointed toward the ICF and ECF.
a. exocytosis. 5. Cells of the digestive glands store enzymes in their lysosomes
b. receptor-mediated endocytosis. and release them into the digestive tract when needed to digest
c. active transport. food.
d. pinocytosis. 6. As a carrier-mediated transport process, facilitated diffusion
e. phagocytosis.
9. Most cellular membranes are made by
a. the nucleus.
requires ATP.
7. Osmosis is a type of active transport involving water.
8. White blood cells can move about in the tissues by means of
Multiple Question Types
b. the cytoskeleton. either cilia or pseudopods.
c. enzymes in the peroxisomes. 9. Desmosomes enable solutes to pass from cell to cell. ∙ “Testing Your Recall” questions check for
d. the endoplasmic reticulum. 10. Ribosomes and the Golgi complex play similar roles in the
e. replication of existing membranes. synthesis of proteins. simple memory of terms and facts.
10. Which of the following is/are not involved in protein synthesis?
∙ The false assertions in “What’s Wrong
Answers in Appendix A
a. ribosomes
b. centrioles
c. mRNA
Testing Your Comprehension with These Statements?” require students
d. rough endoplasmic reticulum 1. Breast milk contains both sugar (lactose) and proteins (albumin
e. codons and casein). Identify which organelles of the mammary gland to analyze the validity of ideas and to ex-
11. Most human cells are 10 to 15 wide. cells are involved in synthesizing and secreting these compo-
12. When a hormone cannot enter a cell, it binds to a at nents, and describe the structural pathway from synthesis to plain or rephrase each false statement.
the cell surface. release from the cell.
13. are channels in the plasma membrane that open or

2. A person with lactose intolerance cannot digest lactose, so
instead of being absorbed by the small intestine, this sugar
∙ “Testing Your Comprehension” questions
close in response to various stimuli.
14. Cells are somewhat protected from mechanical trauma by a
passes undigested into the large intestine. Here, it causes
diarrhea among other signs. Which of the membrane transport
necessitate insight and application to clini-
carbohydrate surface coat called the .
15. The separation of chromatids from each other marks the
processes do you think is most directly involved in the
diarrhea? On that basis, explain why the diarrhea occurs. cal and other scenarios.
stage of mitosis. 3. Consider a cardiac muscle cell, an enzyme-producing pancreat-
ic cell, a phagocytic white blood cell, and a hormone-secreting
16. The majority of molecules that compose the plasma membrane
cell of the ovary. Which of these would you expect to show the
are .
greatest number of lysosomes? Mitochondria? Rough endo-
17. Two human organelles that are surrounded by a double plasmic reticulum? Smooth endoplasmic reticulum? Explain
membrane are the and . each answer.
Design Element Credits: (Camping): monkographic/Shutterstock; (Abseiling): Image Source; (Stethoscope): MedicalRF.com;
(Clouds): Pakhnyushchy/Shutterstock.com; (Doctors): Purestock/SuperStock; (Mountain climber): McGraw-Hill Education.
xv
ISTUDY
13.3 Physiology of the Heart
13.3a Cardiac Muscle
13.3b The Cardiac Conduction System
13.3c Electrical Activity and Contraction
13.3d Nerve Supply to the Heart
13.3e The Electrocardiogram
13.3f The Cardiac Cycle
Making Anatomy & Physiology

A colorized image of
13.4 General Anatomy of Blood Vessels
coronary blood vessels
13.4a The Vessel Wall
that have been injected
13.4b Arteries, Capillaries, and Veins
with a dye to enhance
Intriguing and Inspiring their visibility in an X-ray. 13.4c Variations in Circulatory Routes
Such an image is called 13.5 Physiology of Circulation
a coronary angiogram. 13.5a Blood Pressure
SPL/Science Source 13.5b Peripheral Resistance
13.5c Regulation of Blood Pressure and Flow
13.5d Capillary Fluid Exchange
BASE CAMP Tying It All Together
13.5e Venous Return
13.6 Circulatory Routes and Blood Vessels
Before ascending to the next level, be sure you’re
properly equipped with a knowledge of these Base Camp
13.6a The Pulmonary Circuit
13.6b The Systemic Circuit
concepts from earlier chapters.
∙ “Base Camp” lists key concepts from e arlier
• Thoracic cavity anatomy (see section 1.3e) Clinical Applications/Perspectives on Health
chapters that a student should know before
• Clinical Application 13.1: Cardiac Arrythmia
• Desmosomes and gap junctions (see section 3.2d)
• Muscle tissue (see section 4.4b) embarking
• Clinical Application 13.2:on the new Heart
Congestive one, and effectively
• Skeletal muscle excitation and contraction Failure ties all chapters together into an integrated
(see section 7.2a) whole.
• Resting membrane potentials and action
potentials (see section 8.2a and b) End of Chapter
• Aging of the Circulatory System
• Career Spotlight: Electrocardiographic
Technician
Module 9 458
Circulatory
PART 4 Circulation and Defense • Connective Issues
System CONNECTIVE ISSUES • Study Guide
Ways in Which the CARDIOVASCULAR SYSTEM Affects Other Organ Systems

All Systems
The heart and blood vessels circulate the blood and distribute it throughout the body, deliver-
ing hormones and essentials such as nutrients and oxygen, and removing wastes. Capillary
filtration and osmosis maintain fluid balance in all organs.
Lymphatic and Immune Systems

Capillary filtration produces tissue fluid, which
becomes lymph; all lymph ultimately returns to
Integumentary System
the bloodstream at the subclavian veins; the
The routing of blood to and away
bloodstream carries the leukocytes and plasma
from the skin is vital to maintaining
proteins involved in immunity.
body temperature.
Skeletal System Respiratory System
Connective Issues The bloodstream picks up RBCs, WBCs,

and platelets from the red bone marrow
and delivers the hormones that regulate
Capillary osmosis and low pulmonary blood
pressure prevent the lungs from filling with
fluid.
∙ No organ system functions in isolation. The the production of these formed elements. It
also provides minerals for bone deposition
“Connective Issues” tool shows how every and delivers hormones that regulate the
metabolism of osseous tissue. Urinary System
organ system affects all other body systems, Capillary filtration is the first step in urine
production, and capillary reabsorption carries
and generates a more holistic understanding away the water and solutes reabsorbed by
the kidneys; kidney function is regulated by
of human function. Muscular System

several blood-borne hormones.
Vasodilation in the muscles provides the added

oxygen and energy substrates required for exercise
and removes the metabolites and heat generated
by the muscles.
Digestive System
Capillaries of the intestinal wall pick up and transport
digested nutrients; special capillaries (sinusoids) of the
liver cleanse the blood of bacteria and other impurities;
the circulatory system reabsorbs and recycles bile acids
and minerals from the intestines; and blood-borne hor-
Nervous System mones regulate gastrointestinal activity and appetite.
Endothelial cells of the cerebral blood vessels produce the
blood–brain barrier; capillary filtration in the choroid plexuses
of the brain produces cerebrospinal fluid; and strokes from
cerebral hemorrhage are a leading cause of death.
Reproductive System
The bloodstream transports all sex hormones;
vasodilation produces penile erection, enabling
intercourse and fertilization; and blood vessels in
the scrotum act as a countercurrent heat exchange
Endocrine System system that prevents overheating of the testes,
The bloodstream transports all hormones, and includes the portal which would otherwise halt sperm production.
system of blood vessels for hypothalamo–pituitary communication.
xvi
ISTUDY
and increases the risk of myocardial infarction (see Perspectives aging. However, numerous studies show that exercise, while it
on Health). doesn’t stop the clock from ticking, slows it considerably. Exercise
Systemic arteries stiffened by arteriosclerosis cannot expand increases flexibility of arteries, lowers resting heart rate, and boosts
effectively to accommodate the pressure surges of cardiac systole. the ability of the heart to pump blood efficiently. It has the added
Consequently, blood pressure may rise steadily with age. Athero- benefit of lowering blood pressure. In addition, exercise is associ-
sclerosis also narrows the arteries and reduces blood flow to such ated with increased cerebral blood flow and enhanced cognitive
vital organs as the brain, kidneys, and the heart itself, weakening function. Staying active, not smoking, and maintaining a normal
these organs. Reduced flow to skeletal muscles reduces physi- body-mass index all increase the chance of having good cardio-
cal endurance. Atherosclerotic plaques can become focal points vascular health into old age.
Career Spotlight
C A R E E R SPOTLIGHT ∙ “Career Spotlight” features provide a relevant career
E l e c t r o c a r d i o g r a p h i c Te c h n i c i a n example in every chapter with basic information on
An electrocardiographic (ECG or EKG) technician prepares electrocardiograms
educational requirements, and expand student awareness
(ECGs) for diagnostic, exercise testing, and other purposes. The ECG techni-
cian prepares the patient for the test by attaching electrodes to specific sites of opportunities in a llied health professions. “Appendix
on the chest and limbs and monitors the equipment while results are recorded.
One can become a certified ECG technician through programs at community B” refers students to o nline sources of further informa-
colleges or vocational colleges. A typical course of training entails 4 months
beyond high school and includes anatomy and physiology, medical terminol-
ogy, interpretation of cardiac rhythms, patient-care techniques, cardiovascular
tion about 20 career fields and a list of 83 more health-
medication, and medical ethics. Many people, however, become ECG techni- 72 PART 1 Organization of the Body
care career ideas.
cians through on-the-job training rather than formal programs. Most employers © MCT/Getty Images
prefer to train people who are already in a health-care profession, such as nurses’
aides. With more advanced training, one may become a cardiovascular technologist and assist physicians in diagnosis, cardiac
catheterization, echocardiography, and other more specialized skills and for correspondingly better salaries. For further informa-
tion on a career as an ECG technician or cardiovascular technologist, see appendix B.
Clinical Application 3.2
CALCIUM CHANNEL BLOCKERS
Membrane channels may seem only an abstract concept until we see how they
relate to disease and drug design. For example, drugs called calcium channel
blockers are often used to treat high blood pressure (hypertension). How do they
Clinical Application work? The walls of the arteries contain smooth muscle that constricts to narrow
the vessels and raise blood pressure, or relaxes to let them widen and reduce
blood pressure. Excessive, widespread vasoconstriction (vessel narrowing) can
∙ “Clinical Application” essays apply cause hypertension, so one approach to the treatment of hypertension is to in-
basic science to interesting issues of hibit vasoconstriction. In order to constrict, smooth muscle cells open calcium
channels in the plasma membrane. The inflow of calcium activates the proteins
health and disease.
CHAPTER 20 Human Development and Aging 687 of muscle contraction. Calcium channel blockers act, as their name says, by pre-
venting calcium channels from opening and thereby preventing constriction.
Facilitated Diffusion
PERSPECTIVES ON H E A L T H The next two processes, facilitated diffusion and active transport, are called carrier-
Perspectives onis theHealth
mediated transport because they employ carrier proteins in the plasma membrane.
Facilitated diffusion (see fig. 3.8b)
14
movement of a solute through a cel-
lular membrane, down its concentration gradient, with the aid of a carrier. It does
not ∙involve
“Perspectives
any ATP (energy)on Health” essays
cell. Themake basic science
Methods of Contraception
expenditure by the carrier binds a particle
C ontraception means any procedure or device intended to pre-
vent pregnancy (the presence of an implanted conceptus in
the uterus). This essay summarizes the most popular methods and
or fitting. The sponge provides protection for up to 12 hours, and
must be left in place for 6 hours after intercourse.
relevant
on the side to thewhere
of a membrane student’s interest
the solute in health and
is more concentrated, disease.
then releases
on the side where it is less concentrated. The carrier transports solutes that other-
it
some issues involved in choosing among them. Hormonal Methods wise couldn’t pass through the membrane or would pass less efficiently. One use
Behavioral Methods
Most hormonal methods of contraception are aimed at preventing of facilitated diffusion is to remove sugar (glucose) from the blood and transport it
ovulation. They mimic the negative feedback effect of ovarian hor-
Abstinence (refraining from intercourse) is, obviously, a completely mones on the pituitary gland, inhibiting FSH and LH secretion so
into cells. The process is very rapid, with one protein carrier transporting as many
reliable method if used consistently. The fertility awareness-based follicles do not mature. For most women, they are highly effective as 1,000 glucose molecules per second across the plasma membrane.
method (sometimes called the rhythm method) relies on avoiding and present minimal complications.
intercourse near the time of expected ovulation. Among typical The oldest and still the most widely used hormonal method in
users, it has a 25% failure rate, partly due to lack of restraint and the United States is the combined oral contraceptive (birth-control Active Transport
partly because it is difficult to predict the exact date of ovulation. pill). It is composed of estrogen and progestin, a synthetic progester-
Intercourse must be avoided for at least 7 days before ovulation so one. It must be taken daily, at the same time of day, for 21 days each Active transport (see fig. 3.8c) is a process that employs a carrier protein and uses
there will be no surviving sperm in the reproductive tract when the cycle. The 7-day withdrawal allows for menstruation. Side effects energy from ATP to move a solute through the membrane up its concentration
egg is ovulated, and for at least 2 days after ovulation so there will include an elevated risk of heart attack or stroke in smokers and in
be no fertile egg present when sperm are introduced.
Withdrawal (coitus interruptus) requires the male to withdraw
the penis before ejaculation. This often fails because of lack of
women with a history of diabetes, hypertension, or clotting disorders.
Other hormonal methods avoid the need to remember a daily
pill. One option is a skin patch that releases estrogen and proges-
Aging of Body Systems
gradient—that is, from the side where it is less concentrated to the side where it is al-
ready more concentrated. Active transport requires ATP because moving particles up
a gradient requires an energy input, like pedaling a bicycle uphill. If a cell stops pro-
willpower, because some sperm are present in the preejaculatory
fluid, and because sperm ejaculated anywhere in the vulva can po-
tin transdermally. It is changed at 7-day intervals (three patches per
month and 1 week without). The NuvaRing is a soft flexible vaginal ∙ ATP,
ducing “Agingowingof [Body
to cell death orSystems]”
poisoning, active is transport
a section ceaseswithin systems
immediately.
tentially get into the reproductive tract. ring that releases estrogen and progestin for absorption through the Anchapters
especially important
that active-transport
describes how process
each isorgan
the sodium–potassium
system changes
vaginal mucosa. It must be worn continually for 3 weeks and removed
Barrier and Spermicidal Methods for the fourth week of each cycle. Medroxyprogesterone (trade name (Na+–K+) pump. Sodium is normally much more concentrated in the ECF than in
Barrier methods are designed to prevent sperm from getting Depo-Provera) is a progestin administered by injection every 3 the ICF,over time, especially
and potassium inICF.
is more so in the oldYet age.
cellsThis discussion
continually pump more expands
Na+
months. It provides highly reliable, long-term contraception, although
into or beyond the vagina. They are most effective when used out and more K+ into the cell. The Na+–K+ pump binds three sodium ions from the
with chemical spermicides, available as nonprescription foams, in some women it causes headaches, nausea, or weight gain.
Some drugs can be taken orally after intercourse to prevent
anatomical and physiological understanding
ICF and ejects them from the cell, then binds two potassium ions from the ECF
beyond the
creams, and jellies. Second only to birth-control pills in popularity
is the male condom, a sheath usually made of latex, worn over the
penis. Female condoms that cover the vulva and line the vagina
implantation of a conceptus. These are called emergency contra-
ceptive pills (ECPs), or “morning-after pills." An ECP is a high dose
prime
and releases theseof life,
into andIt repeats
the cell. is highly relevant
the process over and toover,
patient treatment,
using one ATP
molecule for each cycle. The Na+–K+ pump plays roles in controlling cell volume
are also available. Condoms are the only contraceptive methods
that also protect against disease transmission. Condoms have the
of estrogen and progestin or a progestin alone. It can be taken
within 72 hours after intercourse and induces menstruation within since older patients constitute most of
(water follows Na by osmosis); generating body heat (ATP consumption releases
+ the health-care
2 weeks. ECPs inhibit ovulation, inhibit sperm or egg transport in
advantages of being inexpensive and requiring no medical ex-
amination or prescription. the uterine tube, and prevent implantation. They do not work if a market. the electrical excitability of your
heat); maintaining nerves,
CHAPTER 7 The muscles,
Muscular and heart; 243
System
The diaphragm is a latex dome worn over the cervix to block blastocyst is already implanted. and providing energy for other transport pumps to draw upon in moving such sol-
sperm migration. It requires a physical examination and prescription
Intrauterine Devices utes as glucose through the plasma membrane. About half of the calories that you
to ensure proper fit, but is otherwise comparable to the condom in
convenience and reliability, provided it is used with a spermicide. Agingdevices
Intrauterine devices (IUDs) are springy, often T-shaped “burn” every day are used just to operate
of the Muscular System There areyour Nareasons
multiple +
–K+ pumps.
for the loss of strength. Aged muscle
Without a spermicide, it is not very effective. Unlike the male and inserted through the cervical canal into the uterus. Some IUDs has fewer myofibrils; more disorganized sarcomeres; smaller mito-
female condoms, the diaphragm and other methods that follow of- act by releasing a synthetic progesterone, but most have a
fer no protection from sexually transmitted diseases. copper wire wrapping or copper sleeve. IUDs irritate the uter-
A common
Vesicular Transport chondria; and reduced amounts of ATP, myoglobin, glycogen, and
effect of aging is loss of muscle mass, and while the creatine phosphate. Increased adipose and fibrous tissue in the mus-
The sponge is a concave foam disc inserted before inter- ine lining and interfere with blastocyst implantation, and cop-
course to cover the cervix. It is coated with spermicide and acts by
degree varies among individuals,
per IUDs also inhibit sperm motility. An IUD can be left in place
All everyone
of the processes discussed
experiences some up
clestolimits
thistheir
point move molecules
movement or ions individually
and blood circulation. In addition, there
absorbing semen and killing the sperm. It requires no prescription for 5 to 12 years.
muscle atrophy and loss of strength withthe
through age.plasma
Muscular strength are
membrane. In fewer
vesicular neurons in thehowever,
motor transport, spinal cord,cells move
so some larger
muscle atrophy
and mass peak in the 20s, and by the age of 80, most people may result from reduced nerve supply. The neurons that do remain
have only half as much strength and endurance. Many people produce less acetylcholine and stimulate the muscles less effectively.
(10 lb)= weight,
75 cannot lift a 4.5 kg facil easy making such sim-
14
(continued on over
next page)
age Even though people typically lose muscle mass and function as
ple tasks as carrying a bag of groceries very difficult. Loss of they age, these effects are noticeably less in people who continue
muscle mass not only reduces mobility and ability to carry out to exercise throughout life. Statistics indicate that less than a quarter
normal daily tasks, but also increases the risk of obesity, cardio- of adults in the U.S. get the recommended amount of aerobic and
vascular disease, and type 2 diabetes. Fast-twitch muscle fibers strength-training exercise. The rising proportion of inactive adults
show the earliest and greatest atrophy, resulting in increased and the associated high rates of obesity contribute to increased risk
reaction time, slower reflexes, and reduced coordination, mean- for several chronic, deadly diseases, including Alzheimer disease.
ing that tasks such as buttoning the clothes take more time and Regular exercise, even if one starts late in life, counteracts these
effort. age-related diseases and improves overall quality of life.
xvii
ISTUDY
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ISTUDY
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ISTUDY
McGraw-Hill empowers students to learn and
succeed in the Anatomy and Physiology course.
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unable to pass the A&P course*
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personalized learning to individual LearnSmart Prep helps
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Concept Overview
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*Statistic courtesy of The New England
Journal of Higher Education
ISTUDY
Acknowledgments
I gratefully acknowledge the team at McGraw-Hill who have pro- My heartfelt appreciation goes to our team at McGraw-Hill who
vided excellent ideas and unfailing encouragement throughout this have provided such friendship, collegiality, and support over my
project. I am immensely grateful to my coauthor Ken Saladin for a 27-year history in textbooks; to Robin for adding this new dimen-
rewarding collaboration and firm friendship. I appreciate my col- sion and stimulating collaboration to my writing career; to my
leagues at Cabrillo College who inspire me every day with their colleagues at Georgia College for an atmosphere that supports
dedication to student success. Finally, I wish to thank my husband and rewards such work; and to Diane for her steadfast love and
Jeff and my children Reid and Madeleine. encouragement.
Robin McFarland Ken Saladin
Our grateful thanks are extended to these reviewers, who read early drafts of these chapters and provided instructive comments to help
shape the content within these pages.
Darlene R. Dulin Barbara Reitz
Ivy Tech Community College, Valparaiso Campus Pensacola State College
Amy Goode Susan Rohde

Illinois Central College Triton College
Kristin A. Jacobson Flex Rachael L. Smith

Illinois Central College Greenville Technical College
Elizabeth A. Mays Sherry S. Stewart

Illinois Central College Navarro College
Tanya Z. Quiroz Heather Stottman

Central Carolina Technical College Navarro College
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Design Element Credits: (Camping): monkographic/Shutterstock; (Abseiling): Image Source; (Stethoscope): MedicalRF.com;
(Clouds): Pakhnyushchy/Shutterstock.com; (Doctors): Purestock/SuperStock; (Mountain climber): McGraw-Hill Education.
xxi
ISTUDY
ISTUDY
PART 1 Organization of the Body Chapter
The Study of Anatomy

and Physiology
1
Chapter Outline
1.1 A natomy—The Structural Basis of Human
Function
1.1a The Study of Anatomy
1.1b Examination of the Body
1.1c Techniques of Medical Imaging
1.1d Anatomical Variation
1.2 P hysiology—Dynamic Processes in the
Living Body
1.2a The Physiological Sciences
1.2b Essential Life Functions
1.2c Homeostasis and Feedback
1.2d Physiological Variation
1.3 The Human Body Plan
1.3a Levels of Human Structure
1.3b Anatomical Position
1.3c Anatomical Planes
1.3d Major Body Regions
1.3e Body Cavities and Membranes
1.3f Organ Systems
1.4 The Language of Medicine
1.4a Analyzing Medical Terms
1.4b Singular and Plural Forms
1.4c Directional Terminology
Clinical Applications/Perspectives on Health

• Clinical Application 1.1: Men in the Oven
• Clinical Application 1.2: Peritonitis
End of Chapter
• Career Spotlight: Radiologic Technologist
• Study Guide
A full-body image made by
magnetic resonance imaging
(MRI). MRI is one of several
ways of viewing the interior of
the body without surgery.
Simon Fraser/Science Source
Module 1
Body Orientation
ISTUDY
2 PART 1 Organization of the Body
N o branch of science hits as close to home as the science of our

own bodies. We’re grateful for the dependability of our hearts,
we’re awed by the capabilities of joints and muscles displayed by ath-
letes, and we are curious about the mysteries of mind and emotion. We
want to know how our body works, and when it malfunctions, we want to
know what’s happening and what we can do about it. In recent decades,
scientists have revealed a wealth of information about our bodies, but
fascination with the science of the body is nothing new. Ancient texts
and art are testaments to humanity’s timeless quest to know and heal the
body and mind.
This book introduces the essentials of human structure and function.
It will give you a deeper understanding of the healthy body, as well as
accurate, up-to-date insights into disease processes. The disciplines of
anatomy and physiology are fundamental to health-care professionals,
as well as to those who study human performance, fitness, and nutrition.
Beyond that, however, the study of anatomy and physiology provides a
deeply satisfying sense of self-understanding.
In this chapter, we introduce the disciplines of anatomy and physiology.
We discuss criteria that define life and consider a core concept called
homeostasis, a vital process necessary for maintaining life. We look at the
body’s general structural plan and levels of organization. Finally, because
one of the greatest challenges to beginning students is to master vocabu-
lary associated with anatomy and physiology, we end the chapter with
tools to help you effectively learn and use the language of the body.
1.1
Anatomy—The Structural Basis of
Human Function
Expected Learning Outcomes
When you have completed this section, you should be able to
a. define anatomy and physiology;
b. describe some of the subfields of human anatomy;
c. explain the importance of dissection;
d. describe some methods of examining a living patient;
e. discuss the principles and applications of some medical imaging
methods; and
f. discuss the significance of variations in human anatomy.
ISTUDY
CHAPTER 1 The Study of Anatomy and Physiology 3
Anatomy is the study of the structure of the body, with an emphasis on how it relates
to function. Physiology is the study of dynamic processes in the living body. The
two disciplines are very much intertwined, and both are necessary to understand the
totality of the body.
1.1a The Study of Anatomy

There are many approaches to the study of human anatomy, both in research for
the purposes of discovery and understanding, and in clinical settings for diagno-
sis and treatment. Gross anatomy is structure visible to the naked eye, either by
surface observation or dissection. Ultimately, though, body functions result from
individual cells. To see those, we usually take tissue samples, thinly slice and stain
them, and observe them under the microscope. This approach is called histology.1
Histopathology is the microscopic examination of tissues for signs of disease.
Surface anatomy is the external structure of the body, and is especially im-
portant in conducting a physical examination of a patient. Systemic anatomy is the
study of one organ system at a time; this is the approach taken by introductory text-
books such as this one. Regional anatomy is the study of multiple organ systems
at the same time in a given region of the body, such as the head or chest. Medical
schools and anatomical atlases typically teach anatomy from this perspective, be-
cause it is more logical to dissect all structures of the head and neck, the chest, or a
limb, than to try to dissect the entire digestive system, then the cardiovascular system,
and so forth. Dissecting one system almost inevitably destroys organs of other sys-
tems that stand in the way.
Apply What You Know

Do you think that a surgeon thinks more in terms of systemic anatomy or regional
anatomy? Explain your answer.
You can study human anatomy from an atlas; yet, as fascinating and valuable
as anatomy atlases are, they teach almost nothing but the locations, appearances,
and names of structures. This book is much different; it deals with what biologists
call functional morphology2—not simply describing structures but also analyzing
how they function.
Functional morphology draws heavily on comparative anatomy, the study of
more than one species. Such comparisons reveal similarities and differences, high-
light evolutionary trends, and clarify structure–function relationships. Often, human
structure makes sense only when we compare it to the structure of other animals.
The human pelvis, for example, has a unique bowl-shaped configuration that can be
best understood by comparison with animals such as a chimpanzee, whose pelvis is
adapted to walking on four legs rather than two.
1.1b Examination of the Body

There are many ways to examine the body, the simplest of which is inspection—
simply looking at the surface as physicians do during a physical examination. A
deeper understanding depends on dissection3—carefully cutting and separating tis-
sues to reveal relationships between structures. The word anatomy4 literally means
“cutting apart.” Historically, the study of anatomy relied on dissections of dead hu-
man bodies, or cadavers,5 to accurately map the human body. Cadaver dissection
remains an essential part of the training of many health-science students.
1
histo = tissue; logy = study of
2
morpho = form; logy = study of
3
dis = apart; sect = cut
4
ana = apart; tom = cut
5
cadere = to fall or die
ISTUDY
Dissection, of course, is not the method of choice when examining a living

patient! Some additional methods of clinical examination include the following:
∙ Palpation6 is feeling structures with the fingertips, such as palpating a swollen
lymph node or taking a pulse.
∙ Auscultation7 (AWS-cul-TAY-shun) is listening to the natural sounds made
by the body, such as heart and lung sounds.
∙ Percussion is tapping on the body and listening to the sound for signs of ab-
normalities such as pockets of fluid or air.
∙ Medical imaging includes methods of viewing the inside of the body without
surgery. Anatomy learned in this way is called radiologic anatomy, and those
who use radiologic methods for clinical purposes include radiologists and
radiologic technologists (see Career Spotlight at the end of the chapter).
1.1c Techniques of Medical Imaging

It was once common to diagnose disorders through exploratory surgery—opening
the body and taking a look inside to see what was wrong. Most exploratory surgery
has been replaced by imaging techniques that allow physicians to see inside the
body without cutting, posing much less risk to the patient. Medical imaging meth-
ods are called noninvasive if they involve no penetration of the skin or body orifices.
Invasive techniques may entail inserting ultrasound probes into the esophagus, va-
gina, or rectum to get closer to the organ to be imaged, or injecting substances into
the bloodstream or body passages to enhance image clarity.
Anatomy students today must be acquainted with the basic methods of imaging
and their advantages and limitations. Many images in this book have been produced
by the following techniques. Most of these methods produce black and white images;
those in the book are colorized to enhance detail or for esthetic appeal.
Radiography (fig. 1.1a, b) is the process of photographing internal structures
with X-rays, a form of high-energy radiation. The term X-ray also applies to a pho-
tograph (radiograph) made by this method. X-rays are absorbed by dense structures
6
palp = touch, feel
7
auscult = listen
Figure 1.1 Radiologic Images of the Head.

(a) An X-ray (radiograph) of the head. (b) A col-
orized cerebral angiogram, made by injecting a
substance opaque to X-rays into the circulation
and then taking an X-ray of the head to visual-
ize the blood vessels. (c) A CT scan of the head
at the level of the eyes. (d) An MRI scan of the
head at the level of the eyes. The optic nerves
appear in red and the muscles that move the
eyes in green. (e) A PET scan of the brain of an
unmedicated schizophrenic patient. Red areas
indicate regions of high metabolic rate. In this
patient, the visual center of the brain (at bottom
of photo) was especially active.
a: ©U.H.B. Trust/Tony Stone Images/Getty Images; b: Zephyr/
Science Source; c: Miriam Maslo/Science Source; d: UHB
Trust/Getty Images e: ISM/Sovereign/Medical Images
?• Why is a PET scan considered invasive,

whereas MRI is noninvasive? (a) X-ray (radiograph) (b) Cerebral angiogram (c) Computed to
ISTUDY
CHAPTER 1 The Study of Anatomy and Physiology 5
such as bone, teeth, and tumors, which produce a lighter image than soft tissues.
Radiography is commonly used in dentistry; mammography; diagnosis of fractures;
and examination of the digestive, respiratory, and urinary tracts. Some disadvan-
tages of radiography are that images of overlapping organs can be confusing; slight
differences in tissue density are not detected well; and, although the risk of harm is
very low, X-rays can potentially cause mutations and cancer.
Computed tomography8 (the CT scan) (fig. 1.1c) is a more sophisticated
application of X-rays. The patient is moved through a ring-shaped machine that
emits low-intensity X-rays on one side and receives them with a detector on the
opposite side. A computer analyzes signals from the detector and produces an
image of a “slice” of the body about as thin as a coin. CT scanning has the ad-
vantage of imaging thin sections of the body, so there is little organ overlap and
the image is much sharper than a conventional X-ray. CT scanning is useful for
identifying tumors, aneurysms, cerebral hemorrhages, kidney stones, and other
abnormalities.
Magnetic resonance imaging (MRI) (fig. 1.1d) is better than CT for visualizing
soft tissues. The patient lies in either a tube or an open-sided scanner with a powerful
electromagnet. Hydrogen atoms in the patient’s tissues alternately align themselves
with this magnetic field and with a radio-frequency field turned on and off by the
technologist. These changes in hydrogen alignment generate signals that are analyzed
by computer to produce an anatomical image. MRI can “see” clearly through the
skull and spine to produce images of the nervous tissue within, and it is better than
CT for distinguishing between soft tissues such as the white and gray matter of the
brain. It has some disadvantages, however, such as the claustrophobic feeling some
patients experience in the scanner, and long exposure times that prevent sharp images
being made of the constantly moving stomach and intestines. Functional MRI (fMRI)
is a form of MRI that visualizes moment-to-moment changes in tissue function. fMRI
scans of the brain, for example, show shifting patterns of activity as the brain applies
itself to a specific task. This method has been very useful in clarifying which parts
of the brain are involved in emotions, thought, language, sensation, and movement.
tomo = section, cut, slice; graphy = recording process

8
(a) X-ray (radiograph) (b) Cerebral angiogram (c) Co
(c) Computed tomographic (CT) scan (d) Magnetic resonance image (MRI) (e) Positron emission tomographic
(PET) scan
ISTUDY
Positron emission tomography (the PET scan) (fig. 1.1e) is used to assess
the metabolic state of a tissue and to distinguish which areas are most active. It uses
an injection of radioactively labeled glucose to highlight which tissues are most
actively consuming energy at the moment of the scan. In cardiology, for example,
PET scans can show the extent of tissue death from a heart attack. Because damaged
tissue consumes little or no glucose, it appears dark. PET scans are widely used to
diagnose cancer and evaluate tumor status. It is now possible to diagnose Alzheimer
disease using PET scans. Until recently, a definitive diagnosis required analysis of
brain tissue after death. Diagnosing living people with PET scans makes earlier
diagnosis possible, potentially leading to more effective management of the disease.
The PET scan is an example of nuclear medicine—the use of radioisotopes to treat
disease or to form diagnostic images of the body.
Sonography9 (fig. 1.2) uses a handheld device placed firmly against the skin;
it emits high-frequency ultrasound and receives signals reflected back from inter-
nal organs. Sonography avoids the harmful effects of X-rays, and the equipment is
relatively inexpensive and portable. It also is very useful for imaging motion, such
as operation of the heart valves, ejection of blood from the heart, and fetal move-
ments. It is the method of choice in obstetrics, where the image (sonogram) can
be used to locate the placenta and evaluate fetal age, position, and development.
Echocardiography is the sonographic examination of the beating heart. The primary
disadvantages of sonography are that it does not produce a very sharp image and it
cannot penetrate bone.
1.1d Anatomical Variation

A quick look around any classroom is enough to show that no two humans look
exactly alike; on close inspection, even identical twins exhibit differences. Anat-
omy atlases and textbooks can easily give you the impression that everyone’s
internal anatomy is the same, but this simply is not true. Someone who thinks
that all human bodies are the same internally would be a very confused medical
student or an incompetent surgeon. Books such as this one teach
only the most common structural patterns—the anatomy seen in
approximately 70% or more of people.
Some people completely lack certain organs. For example,
most of us have a palmaris longus muscle in the forearm, but not
everyone does. Most of us have one spleen, but some people have
two. Most have two kidneys, but some have only one. Figure 1.3
shows some common variations in human anatomy, and Perspec-
tives on Health (in section 1.2) describes a particularly dramatic
variation.
sono = sound; graphy = recording process

9
(a)
Figure 1.2 Sonography. (a) Producing a sonogram. (b) Three-

dimensional sonogram of a fetus at 32 weeks of gestation.
a: Kevin Brofsky/Getty Images; b: ©Ken Saladin
?• Why is this procedure safer than radiography for fetal

(b) assessment?
ISTUDY
Another random document with
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explained herself, and it “passes me,” as Luigi would say, how she came to
be keeping a Roman pension by the Ponte Margherita. Russian she was,
Russian was at the bottom of all her tongues; but evidently it had for so long
been overlaid by the rest of Europe that she had almost forgotten it was
there. Each of her languages, however, was a language of her own, full of
odd pretty tones and inflexions that coiled and scooped and curled with a
singular music. When the struggle over the fritto misto died down Teresa
seized the word with decision, the word that seemed furthest from Madame
de Shuvaloffs indelicacy, and with Berta’s ready help she kept the
conversation on a purer level. We talked of the terrible rise in the price of
provisions: did Olga know (Olga was Madame de Shuvaloff) that Luigi had
found it was entirely due to the weakness of the government?—the criminal
weakness of the ministry before the threats of the bassa plebe; and if you ask
how it is that the common people insist on an increase in the cost of living,
which seems improbable, Teresa assures you that in fact they don’t know
what they want, such is their ignorance and their folly. We only perceive that
the country is in a sad condition, and Luigi declares—but Madame Olga
suddenly shrieks out with a shrill exclamation, followed by a little fountain
of airy laughter, for she has just remembered that she forgot to give any
directions to her servant, before leaving Rome this morning, and she
believes the creature capable of anything—of anything—and heaven knows
what will have happened to the midday meal of her pensioners! “How many
is your table?” asked Teresa with sympathetic concern. “Eighty!” cried
Madame Olga lightly, and she fumbled in her bag and showed us a couple of
five-franc notes that she had expressly borrowed from one of her guests,
only last night, for Colomba the cook to go marketing with to-day. Well,
isn’t it unlucky? “I shall lose them all—all my eighty!” the little lady
humorously wailed. “I lose them always; Mimi and I, we shall starve!”
I expected a howl from Mimi, but she took it unmoved; she knew her
mother. Teresa, it was evident, knew her less, for Teresa gloomed anxiously
upon the prospect, trying to hold little Olga to her words and beginning to
offer advice and warning. You couldn’t trust a Roman cook—surely Olga
had discovered that; and lodgers, in these bad times, are precious articles and
you must handle them cautiously. “But how many did you say—?” It broke
upon Teresa that Olga had played with her over the number, and her face
was a pleasant mixture of dignity a little ruffled and mannerliness striving to
meet a joke. Madame de Shuvaloff became instantly serious; and though it
didn’t appear that the disaster of the dinnerless pensioners weighed on her,
she was desperate, unutterably hopeless, over the tragedy of a woman’s life
in the great horrible world. “Men,” she said bitterly, “do what they will with
us”—and the eyes of Berta and Teresa met in a swift glance as they hastily
struck up their give-and-take on the question of the likeliest methods of
attracting the right kind of lodger to share one’s home. One should possibly
advertise in the newspapers—but the topic was unfortunately chosen, for
Madame Olga immediately flung off into a rippling titter of mirth, thin and
savage, at the notion of “attracting,” were it only as boarders at one’s table,
the men who make the world so black a place for a woman. “All beasts!” she
declared flatly; and this was her opportunity for a story that she addressed
particularly at me, glaring with her great eyes in the horror of what she told.
Truly the Russian wild sends out strange little emissaries to the cities of
civilization. This tiny frail slip of a woman, who looked as though a puff of
air from the frozen plain would shrivel her dead, had somehow scrambled
across Europe and held her own and lodged herself in a cranny of Rome; and
there she had stuck, she had survived, you couldn’t tell how, with a tenacity
of slender claws that could grasp and cling where a heavier weight would
have found no chance of foothold. She was evidently indestructible. The
world, by her account, massed its ponderous strength to crush her; but there
was nothing in her that might be crushed, no superfluous sensitive stuff to be
caught by a blow; there was nothing but one small central nut or bead of
vitality, too hard for the world itself to crack. She thrived upon the conflict; I
don’t for a moment suppose that the world was as unkind to her as it was, for
example, to poor foolish old Teresa; but she believed herself to be singled
out for its crudest attack, and the thought was exquisite and stimulating. She
had, moreover, a real artistic passion; her fire and thrill were genuine when
she talked of the strange things that were doing among the artists; but I note
that it had to be the art of the present, the art of a chattering studio rather
than of a hushed museum—she couldn’t have thrilled and fired before the
beauty of the past and dead, where there aren’t the same intoxicating
revolutions to be planned and exploded upon an unsuspicious age. Drama
she needed, and of drama you can always have your fill if you know as well
as she did how to make it. Why yes, she created a notion of mysterious
conspiracy, somewhere lurking in the background, by her very refusal to
explain and apologize when she was late for lunch.
As for her story of the baseness of men, told with extreme earnestness in
three languages, she made a very good thing of it and we were all impressed.
But much more striking than her story was the picture that rose before me of
her establishment, her boarding-house by the Tiber, where a dozen lodgers
(she reduced them to a dozen), mostly like herself from the Russian inane,
gathered and mingled, quarrelled and stormed at each other, conspired,
bribed the cook, made love to the landlady (of course I have only her word
for it), eloped without settling their bills, lent her five-franc notes to pay at
least for the next meal—but chiefly talked, talked day and night, sat
interminably talking, while Olga rated the servants or hunted for the lost key
of the larder, while Colomba had hysterics and dropped the soup-tureen,
while Mimi killed flies at the window and had her own little crisis of nerves
over a disappointment about a box of chocolates. All these visions appeared
in the story—which was a story of the monstrous behaviour of one of the
lodgers, a young man of whom Olga had tried to make a friend. A friend!—
yes, Olga believed in friendship, in spite of a hundred disillusions; she
believed in a species of friendship that transcends the material, the physical;
but we needn’t go into that, for though she had believed in it, the young
man’s behaviour had pretty well killed her faith, once for all, and she now
saw that there could be no true friendship in a world where half the world
(the brutes of men) have no sense of honour, none of loyalty, none of
idealism, transcendentalism, immaterialism; and Teresa still held her lips
placidly bunched while Olga circled among these safe abstractions, but the
little wretch came presently down with a bump again upon plainer terms,
and it behoved Teresa to intervene with all her decision. Olga said that the
young man had proved to be not only destitute of these safe vague qualities,
but terribly in possession of other qualities, quite of the opposite kind, which
she proceeded to name; and their names lacked that soft classical buzz and
blur (idealism, materialism, prunes-and-prism—the termination is
reassuring), and on the contrary were so crude and clear-cut that Teresa
pushed back her chair and suggested another delightful long ramble in the
forest, a “country afternoon,” such as we all adored.
There really was no malice in Olga, the little wretch; for to be malicious
you must at least have some consciousness of the feelings of other people,
you must know what will hurt them; and Olga was aware of no feelings, no
subject of sensation, save her own and herself. Imagine all the relations of
the world to be arranged like the spokes of a wheel, with no crossing or
tangling before they reach the middle; and Olga herself in the middle, with
every thread of feeling that exists all radiating away from her into space: that
was the order of nature as Olga saw it, that indeed was her fashion of
introducing order of any kind into the universe. One must simplify
somehow; and if, unlike Olga, you suspect people of thinking and feeling on
their own account, all anyhow, turning the cart-wheel into a tangle—well
then you must order your private affairs, your habits, your household at
least, into some kind of reposeful pattern. Olga had no need of a stupid
mechanical pattern, the mere work of her own hands, to be imposed upon the
facts around her. Let Colomba rave, let the lodgers hurl their boots among
the crockery (she happened to mention it as one of their ways), let the
boarding-house seethe and heave like a page of Dostoevsky: no matter, the
universe kept its grand simplicity, all lines met at the centre, Olga was there.
The story of the base young man had no bearing upon anybody but herself;
Teresa was shocked, but Olga didn’t care, didn’t notice, and she went on
absorbed in her narrative—or she would have done so if Mimi hadn’t made
another diversion (to be frank, she was sick before she could get to the door)
in which the young man was finally dropped and forgotten.
Emilio now joined us, very hot and shiny from the train, and as soon as
he had refreshed himself we issued forth—an orderly procession, for Mimi
clung pensively awhile to her mother’s arm; and it was agreed that we
should enjoy ourselves unconventionally, fearlessly, in a walk through the
greenwood to Castel Gandolfo. We mustn’t forget, however, that Fräulein
Dahl, Berta’s German friend, would be descending from Castel Gandolfo
(where she lived) to meet us; and we immediately saw that whichever of the
forest-paths we chose we should certainly miss her. “We had better go
perhaps no further than this,” said Berta, pausing under the blue posters of
the wall we had already studied that morning; and Emilio proposed the
amendment that it would be safer still to wait in the middle of the town, by
the tram-station, where the lady would be sure to look for us. But Berta
yearned for the country; so she and Teresa spread a couple of newspapers
upon a dust-heap under the posters, gathered their skirts, deposited
themselves with care, and pointed out that one had a charming glimpse of
the country from this very spot. A little way up the lane indeed there was
leafy shadow and the beginning of a woodland ride; and Olga, restlessly
ranging, called to us to come further and take to the forest. But Teresa and
Berta were established, and they declared themselves at ease where they
were—though I can’t say they looked very easy, with their veils pulled down
and their knees drawn neatly together, both clutching the ornate handles of
their umbrellas. “People will think we are strange gurls,” said Berta,
“sprawling by the road like this!” Emilio had to make the best he could of
their wild English ways; he leant with resignation against the picture of a
highly developed young woman in evening dress, who held out a box of pills
with a confident smile; he sucked at a long cigar in silence. Mimi really did
sprawl; she lay where she fell, she slept the sleep in which one repairs the
disasters of a recent meal.
I followed her mother up the shadowy path into the woodland, where we
were to watch carefully for Berta’s expected friend. When at last you are
clear of the pigs and chickens of Albano you plunge immediately into the
Virgilian forest that spreads and spreads over the hills, between the two deep
bowls of the lakes. The ancient darkness of ilex leads you on, and the
darkness changes to hoary sun-sprinkled oak-shadow, to open spaces where
the big white rock-rose flowers against the outcrop of the grey stone, and the
path stumbles on into damp green tunnels among the chestnut saplings; and a
laden mule, driven by a bare-footed boy, appears with a jangle of bells that
carry me off and away, deeper and deeper into the time-softened goodness of
the wondrous land, the Saturnian land, the great mother of kindly beast and
songful man—for the boy sings as he plods up the pathway, with long sweet
notes that are caught by a hungry ear, caught and lost, caught again in the far
distance with an echo of the years of gold, of the warm young earth in its
innocence. How can we praise the land that Virgil praised? Leave the word
to Virgil, listen while he repeats it again—again. I can hear nothing else till
the last sound of it has died; and my companion, the strange little wild thing
from the east, lifts up her finger and is silent and motionless till it ceases.
What does Olga know of the golden years and the Saturnian land? Nothing,
nothing whatever; but she listens with uplifted finger, entranced by the
freedom of the forest, for a few fine moments forgetful of her own existence.
Then she is herself again, flitting and scrambling down the path to meet a
figure that approaches through the green shadows.
IX. CASTEL GANDOLFO
F RAULEIN DAHL came striding up the woodland path with a free swing
of her arms and flourish of her staff—not a Virgilian figure, yet classical
too in her way, carrying her head in the manner of a primeval mother-
goddess of the tribes. Didn’t the old Mediterranean settler, pushing inland
from the coast where he had beached his boat—didn’t he, somewhere in the
ilex-solitude of the Italic hills, encounter certain ruder and ruggeder
stragglers from the north?—and hadn’t these tall and free-stepping strangers
brought with them their matriarch, the genius of their stock, a woman
ancient as time and still as young as the morning, with her grey eyes and
her broad square brow and her swinging tread? No doubt my ethnology is
very wild, but thus it sprang into my mind and took form at the sight of the
woman who approached—for whom the name of Fräulein Dahl, so flat and
so featureless, seemed absurdly inadequate.
She flopped when she saw us, she stood serene and large while the little
Russian dashed about her with cries and pecks. Olga hung upon her with
excited endearments, with lithe gesticulations that made the new-comer
look entirely like a massive and rough-hewn piece of nature, unmoved by
the futile humanity that scrambles upon her breast. I really can’t speak of
her by the name of a middle-aged spinster from Dresden (which indeed she
was); for I can only think of her as Erda, as the earth-mother of the ancient
forest; and when she addressed me in her deep voice and her Saxon speech,
brief and full, it was as though she uttered the aboriginal tongue of the
northern twilight, the Ursprache of the heroes. I ought to have answered
only with some saga-snatch of strong rough syllables, like the clash of
shield and spear beneath the spread of the Branstock; and as I couldn’t do
this, and my poor little phrases of modern politeness were intolerably thin
and mean for such an encounter, I must own that my conversation with Erda
didn’t flourish, and I had mainly to look on while Olga, not troubled by my
scruples, clawed and dragged her into the fever of our degenerate age.
Think of Erda clutched by the skirt, pecked with familiar kisses, haled out
of the forest into the presence of Teresa and Berta, where they sit on their
dust-heap and wave their black gloves in a voluble argument, the heat and
the flies having by this time fretted their tempers and considerably flawed,
it would seem, their joy in the freedom of the country. But nothing can
disturb the large repose of Erda’s dignity, and the groundlings of the dust
recover themselves as she appears, suddenly sweeten their smiles and their
voices, advance to meet and greet a middle-aged spinster from Dresden,
hard-featured and shabbily clad.
It took a long while to settle how best, how with the greatest propriety
and safety, to make the journey of a mile or two from the dust-heap to the
height of Castel Gandolfo, where our new friend had her abode. How are
we to be perfectly certain that if we drive by the highroad we shan’t wish
we had walked through the wood?—but before deciding to walk through
the wood, let us remember that since Teresa sprained her ankle at Porto
d’Anzio last summer it has never been the ankle that it was before. Emilio
eagerly advised caution, caution! “Aha!” said Berta, “he knows he will be
forced to carry her all day on his back, as at Porto d’Anzio.” (What a
picture!) Emilio felt the heat distressingly, liberally; his gloss was already
much bedimmed, he was in no case to shoulder the lovely burden this
afternoon. But Erda brandished her staff and struck out for the forest, Olga
fluttered after her, Mimi awoke refreshed with a sudden convulsion of black
legs and flung herself in pursuit; and Teresa laughed surprisingly on a high
reckless note, lunging quite vulgarly at Emilio with her umbrella, and
declared herself equal to carrying him, if need be, “pig-a-back jolly well all
the time!”—such was her phrase. This was the right vein of rollick for the
adventure of a country holiday, and in this spirit we accomplished the
journey, not a little elated by the sense of our ease and dash. Emilio did his
best to reach our level; he stepped out vigorously, mopping his brow, and
after some careful cogitation in silence he edged to my side and nudged me,
pointing to Teresa and Berta where they breasted the stony path in front of
us. “They are verri sporting gurls,” said Emilio.
Erda guided us by winding ways to her abode—which was a great black
gaunt old villa, masked by a high wall, muffled by thickets of mystery; she
opened a door in the wall, and immediately the place was so grand and sad,
so brave and dark, that its influence arose and hushed us as we crowded into
the dank courtyard. Me at least it silenced, and I should wish to forget
Teresa’s remark when the door closed behind us and she felt the mounting
chill of the scarred and stained old pavement beneath her tread. Erda had
found the right retreat for the austerity of the poetry of her style; here she
lived alone, screened from the world, musing in her big cool mind upon the
processes of time. I wanted to tell her that she had no business to admit this
party of haphazard starers into her privacy; for Teresa would be certain to
make other remarks, like her last, when she tramped under the vaulted entry
and climbed the bare stone stairway and beheld the heroic emptiness of the
great saloon. She made many indeed; but Erda’s far-away smile passed over
our heads, and you could see that it wasn’t a few bits of trash like ourselves,
idly invading her sanctuary, that would profane the height of her solitude.
For my part I strayed about the great saloon, looked from the windows at
the shining view of the broad Campagna, tried not to listen to Olga’s
polyglot chatter—and wondered how this singular being occupied herself in
her lonely days. For after all she was a German spinster, a stranger and a
pilgrim like the rest of us; and one ought to be able to picture the detail of
her life as she lived it, between the azure bowl of the Alban lake behind her
and the silvery plain in front, instead of surrendering the impression to the
romance of the ancient poetry she had brought with her from the north.
She appeared to have brought nothing else. The great room contained no
personal trace of her whatever, nothing but a few old chunks of furniture
that were evident relics of the noble owners of the house. On the walls there
were pale vestiges of festal painting, on the chairs and tables there was a
glimmer of exhausted gold; and there was nothing else, not a stick, not a
crock, to suggest that a stranger had arrived to take possession of the past.
The woman from Germany stood in the middle of the wide floor, distantly
smiling; and she filled the space like a monument, with a grand pervasion
of her presence, a distribution of her authority—so that she seemed to
inhabit the amplitude of her retreat, to populate it, even though she had
never sat down in one of the gilded chairs, never written a line or opened a
book there, never put the room to any of the common uses of life. If I tried
to imagine how she employed herself when she was alone, I could only see
her still standing there in the midst, smiling out of her big tolerant serenity,
while the evening darkened and the night shut her in with her secret
thoughts. I wonder what they were. There seemed to be all the simplicity of
the world in her air and poise—and deeps of old wisdom too, full of such
long and wild experience as would trouble the repose of most of us; but she
didn’t care, the memories of the dark forest and the fighting men and the
clashing assemblies had never disturbed her secular dream; and now at last,
driven from the haunts of her tribe, she had found a place empty and large
enough to contain her for a few centuries more, perhaps, till the vulgar
invasion becomes too much for her even here—and I should like to know
where she will then betake herself. And what would she think, meanwhile,
if she guessed how my fancy had transformed a plain and elderly Saxon,
living for her convenience in a fine old villa near Rome?—for she had no
romantic view of herself, she saw her own image as unceremoniously, I am
sure, as any of the trivial starers might see it, who for the moment were
making free with her domain.
She really was, however, more splendid than she knew; and it can’t be
denied that a truly intelligent inspiration had brought her to the fine old
Roman villa. The empty shell of the grand style, so long abandoned, was
the one place in the world for her; for she needed greatness and grandeur,
and she couldn’t have found either among the tattle and the comfort and the
sentiment from which she had escaped; and she needed desolation, a faded
grandeur, a dilapidated greatness, secure from the smart uneasy assertion of
our own age’s ridiculous attempt to be magnificent. Erda was surely the
most peculiar of all the Roman pilgrims I encountered; she had come to
Rome because it is big and bare—and yet not inane, not dumb to
reverberating echoes, like the mere virginal monstrosity of untrodden lands.
The echoes of the great saloon were innumerable; old festivities, old
revelries creaked and croaked in it above a droning and moaning undertone
in which I could distinguish, with a very little encouragement, the most
awful voices of lust and hate and pride. Erda had only to stand still and
silent in the evening gloom to discover that she had the company of all the
passions that had clashed about her in the time of the heroes; she felt at
home there, no doubt—she couldn’t have endured an atmosphere soaked in
the childish spites and jealousies of the present. Yes, she was rightly
installed and lodged—and let that be enough for us; I check the trivial
curiosity that sets me wondering how she really existed, how she came by
the possession of the strange old house, how long she had lived there.
Oddest and unlikeliest of all, if it comes to that, is the fact that Olga and
Teresa should have had the entry of her solitude, should be cackling in
unconcerned familiarity beneath her smile, should be putting her foolish
questions which I try to disregard. I hadn’t the least intention of asking
them how they had made the acquaintance of the earth-mother; I didn’t
want to know, for example, that when she first came to Rome she had dwelt
for a time in Olga’s dishevelled boarding-house; and you never can tell, if I
should press too closely I might be met with nonsense of that kind. I much
prefer to stand apart, in the embrasure of one of the high windows, and to
notice how flat the thin shriek of these women was falling in the vacancy of
the saloon. No wonder Erda could afford to smile. With one turn of her
hand she could have bundled the whole party out of her sight and her mind;
I never so clearly saw the contract between the real person, standing square
upon her feet, and the sham, drifting and pitching helplessly because it
hasn’t the human weight to hold it to the ground. Even Emilio, who had
seemed weighty enough as he trudged and mopped himself in the forest-
path, had now shrunk to a ducking deprecating apologizing trifle to whom
nobody attended. The women indeed maintained their flutter and gibber
unabashed; but their noise didn’t even reach to the great ceiling of the room,
it broke up and dropped in mid-air; it utterly failed to mingle with the real
echoes of the place, deeply and hoarsely speaking above our heads.
There now, however, when we had quite given up expecting her, arrived
Miss Gilpin. She appeared in the doorway and she stopped on the threshold
for a moment, collecting the eyes of the company before she made her
advance. She was a trim little woman, not very young, but with an
extremely pretty head of fox-brown hair; and with a graceful gesture of
both hands she sang out a greeting to us all, at a distance, in a small tuneful
voice, standing where the light fell upon the bright coils of her hair; and
with her arms still wide she tripped along the floor to join our party, giving
a hand here and a smile there in a sort of dance-figure of sweetness and
amiability—pausing finally, before me the stranger, with a kind little
questioning smile, while she waited and looked to Erda for an introduction.
You haven’t forgotten, perhaps, that Miss Gilpin had a certain reputation of
pride; and indeed she was a public celebrity, for she was the authoress of
books, of several books, though she didn’t rely upon these for her effect on
entering a room. Her mazy motion and her hair and her gracious ways were
enough for a beginning, let alone the flattering charm of her inclination
when I was duly presented. She pressed my hand as though to say that
already she marked me off from the rest of the company—whose second-
rate mixture we could both appreciate, she and I; but for her part she didn’t
mean to be wanting in civility to the good souls, and so—“Cara mia!—che
piacere!—dopo tanto!”—she warbled her cries and beamed and inclined her
head in a manner to make everybody feel exceedingly plain and coarse.
The finest instrument of her superiority, could the rest of the company
perceive it, was her Italian accent. It was probably lost on them, but it did
all its execution on me. She continued to talk Italian, though Teresa
plumped out her rich-vowelled English in return, and though Erda disdained
the use of any speech but her elemental Gothic. Miss Gilpin’s Italian, you
see, was remarkably perfect; her intonation had the real right ringing edge
to it, which you don’t often hear upon English lips. She pounced upon the
stresses and bit off the consonants and lingered slidingly upon the long
vowels—but I needn’t describe it, you easily recall the effect; and the point
of it was that she had acquired it all by her taste, by her tact, by her talent—
not merely because she couldn’t help it, rubbing against the language all the
time (like Olga or Teresa) in the middle-class tagrag of the town. To me at
least the distinction was very clear. Poor old Teresa, with her English airs,
betrayed herself by the genuine slipshod of her swift Roman interjections,
now and then, aside to her niece or to Emilio; she would mumble or hiss out
a word or two in which there was no mistaking the carelessness of the
native. Miss Gilpin, exquisitely intoning her lovely syllables, had none of
the smirch of professionalism; she seemed to bring the language of Dante
into the drawing-room of a princess—and yet she was just a clever little
English lady, smart and pretty and well-bred, and you couldn’t for a
moment suppose she was anything else.
She was the authoress of several cultivated and charming works, so I
have always understood, in which Italian history and Italian landscape were
artfully blended—her art showing peculiarly in this, that her gush of
romance (over the landscape) was redeemed from weak femininity by her
scholarship, while her severity and soundness (over the history) was
humanized by her descriptions of peasant life, village humours, parochial
ceremonies; and so you learned about the popes and the great ladies of the
Renaissance, and at the same time you slipped unawares into the very heart
of the old unspoilt enchanting country, the real Italy—or perhaps I should
put it the other way round, the vintage and the white oxen and the kindly
old village-priest coming first, leading you easily onward and upward to the
very heart of the Renaissance. Anyhow Miss Gilpin had her note, and I
believe she struck it to considerable applause. But she didn’t assume the
style of a woman of letters—in this matter too there was nothing
professional about her. She was still the Englishwoman of good connexions,
who happened to be related by marriage or even friendship to two or three
of the most splendid houses of Rome—but who wore this accidental
embellishment very simply, just as a matter of course, needing no words—
and who lived by herself, lived daintily on small means, lived in Italy
because she loved the dear villagers and the white oxen; and when you had
taken in all this, she had still in reserve the telling fact that she wrote these
remarkable books, the kind of books you wouldn’t expect from an elegant
little Englishwoman of the Alban hills—or indeed from a woman at all,
considering their scholarly and manly style; so that she beats the
professional literary hack upon his own ground without making a parade of
it—showing up his assumptions and pretensions rather cleverly, don’t you
agree? There were plenty of people who did agree, and who told her so; and
altogether Miss Gilpin, living amusingly and unconventionally in the Alban
hills, might be thought to enjoy a happy and original position in her world.
Erda was one of the quaint impossible friends that dear little Nora Gilpin
always managed to unearth, with her talent for discovering interest where
other people would fail to notice it.
Behold Miss Gilpin, then, seating herself at ease in one of the great
gilded arm-chairs and making a circle around her of Minna Dahl’s yet more
impossible, frankly impossible, rout of acquaintance; though it happens that
among them to-day is an awkward young Englishman, looking very much
out of his place and apparently with nothing to say for himself, who isn’t
quite the kind of thing that Minna generally produces on these occasions.
(Yes, in Miss Gilpin’s company I am reduced to giving Erda her own poor
name.) An eye may be kept upon the young Englishman—Miss Gilpin will
have a word with him before she goes. For the present she rustles and
warbles, settling herself in the cardinal’s chair; and she sends Emilio on an
errand for something she has left below, she remembers a question she
particularly wished to ask Madame de Shuvaloff (how lucky a chance!), she
places Berta at her side, not noticing the slight defiance in Berta’s attitude,
with a little friendly tap; and here is a pretty group, gathered and constituted
all in a minute, to brighten the blankness of Minna’s gaunt unhomely
drawing-room. For indeed the dark saloon of the historic passions had
become a drawing-room at once; Miss Gilpin, as she sat there, had
somehow given it the clever touch that makes a room personal, individual, a
part of yourself—the touch that is so slight, though it achieves such a
difference. How is it done? She simply pushes a chair or two, breaking their
rigid rank, she lays her handkerchief on the bare table and casually throws
her moss-green scarf over the back of an angular couch; she draws Berta on
to a low stool beside her (Berta’s face was a study indeed), she raises her
eyes with a clear gaze of thanks to the cavalier who returns with her tiny
embroidered bag; and the proud old room seems to have surrendered to her
charm, adapting itself to her, attentively serving to accommodate her friends
and her scattered possessions. Poor Minna Dahl, she is strangely without
the knack of making a place comely and habitable.
But Minna Dahl, for a woman like Miss Gilpin, is refreshing in her
singularity; that is the secret of dear Nora’s odd friendship for this uncouth
and unlovely German whom she has picked up somewhere in her
neighbourhood. The lone German, with her offhand manners and her
dreadful clothes, makes a pleasing change for a creature so compact of
civilization as Miss Gilpin. Ah, there are times when we are sick of culture,
bored by style, exasperated by the finer feelings; and then the relief, the
repose in the company of somebody who never reads, never feels, never
questions—who exists in placid contentment like a natural fact, like a tree
in the solid earth! Miss Gilpin could tell you that after visiting Minna she
returns with the sense of having spent a fortnight alone by the sea-side; she
goes home to the world, to her book and her style, invigorated by great
draughts of quiet weather, her imagination laved by the soothing surging
monotony of the ocean tides; these are her very words. She could also tell
you that Minna’s abysmal ignorance of the Italian Renaissance, and
Minna’s atrocious Italian accent, and Minna’s failure to obtain the least
little footing in the splendid houses of Rome—Miss Gilpin could tell you
(but these are not her words) that by all this too she is very considerably
fortified as she trips home to tea. For the fact is that Miss Gilpin is not as
young as she was, and the reviewers are less respectful to her scholarship
than they used to be, and perhaps she begins to be aware that she mustn’t
visit the Marchesa and the Principessa too often in these days; and so, and
so, as Miss Gilpin flutters away to her solitary chair by the evening lamp,
she quite congratulates herself on the rare chance of a quiet time with her
work, snatched from the claims of the world—which wasn’t the way she
had put it when she set out, rather wearily, to call on old Minna this
afternoon. Who then shall grudge her the strength she is imbibing at this
moment, while she dismisses Emilio with a smile and repeats (in her pure
intonation) a phrase that Minna has just mangled in her strange Teutonic
Italian?
Mimi, the horrid child, had been misbehaving again in some way, and
she and her mother had been fighting it out, and Minna had serenely
interposed and excused the child—“In somma, non è un gran che,” said
Minna with her bocca tedesca; and then, chiming upon the air, the same
words tinkled like silver bells from the mouth of Miss Gilpin—with a
difference that can’t be written in print, though it yawns to the ear as the
distance between the Altmarkt and the Piazza del Popolo. Miss Gilpin
perhaps hadn’t done it on purpose, but the effect was to bring the eyes of
Erda (Erda once more!) largely sweeping round upon her, with a gleam of
amusement under which Miss Gilpin for an instant faltered. Erda towered
above her, good-humoured, ironic, solid; and Miss Gilpin had the sudden
misgiving (how well I know it) that she was being watched by a
dispassionate onlooker. She sat enthroned in her chair of state, with her
satellites and her litter of possessions about her; and Erda stood
dispossessed in the background, claiming no rights in the place or the scene;
and yet that passing glimpse of Erda’s amusement disarranged the plan, and
a wan chill for a moment blenched the satisfaction of Miss Gilpin. Oh, it
was nothing, it vanished—at least it vanished for Miss Gilpin; she was
herself again, she held and graced the situation. For me, however, it was
enough to restore my Erda to her predominance—or rather to reveal that
she had never lost it. To suppose that little Miss Gilpin could really install
herself in the empty seat of grandeur, fill it with her fine shades and her
diminutive arts! Erda is still there, massive in her simplicity, knowing no
arts, needing none.
To me it was a relief, I must say, when at last Miss Gilpin broke up the
party and we streamed forth again into the brilliant evening. Erda dismissed
us all with a deep farewell at the gateway, leaving us to face the renewed
problem of the path, the fatigues of the journey, the tram that we should
probably miss, the train of which Emilio had forgotten the hour. Miss Gilpin
hastily made off to her own abode, near by, waving a light loose invitation
to us all to visit her there “next time,” and annoying Berta extremely by
disappearing before she could have observed the very guarded manner of
Berta’s reply. “She won’t see me there in a horry,” said this young woman
with proper pride. Mimi refused to walk another step, Olga stormed, Emilio
spread his hands and shook his fingers in a wrangle with Teresa over his
forgetfulness; and so we proceeded to the tram and the train and the
scramble of our fretful times. But for my part I carried back to Rome a
vision that I kept securely and that is still before me: Erda closing the gate
behind us, Erda remounting the black stairway and re-entering the solitude
of her great room, Erda standing there in the middle of it, all by herself,
never moving, while again the old night rolls in upon her from the dead
plain.
X. VIA SISTINA
M ISS GILPIN, before she fled, had duly taken the measure of the
awkward young Englishman; a probing question or two had given her
all the insight she required. And the consequence was that a very little
later, when she happened to be spending a day or two with some friends in
Rome, I was summoned to present myself at their apartment in the Via
Sistina. I had an idea that this was decidedly an upward step for me. Miss
Gilpin’s level, as I understood it, was a higher than I had touched as yet,
and I set off in response to this call from the Via Sistina with some
complacency. It was only a few days ago, after all, that I had drifted to the
Fountain of the Tortoises in the condition of a mere romantic waif, knowing
nobody, knowing nothing of the true life of the real Rome; and now the shut
doors were opening, I had passed within, I had my own Roman circle like
Deering himself. I watched a British family-party issuing from their hotel in
the Piazza di Spagna for the sight-seeing of the afternoon—I watched them
with amused supremacy. They whispered to each other, noticing me, that I
was evidently an old hand, a familiar resident; or if they didn’t I whispered
for them—and so sympathetically that I was quite flattered by the respectful
envy of their tone. The next moment I was face to face with Deering
himself; he was being besieged, as it chanced, at the foot of the Spanish
Steps, by those dreadful little boys in velvet breeches and matted curls of
whom we had spoken the other day.
He was vexed that I should see him at this disadvantage. The little
beasts, they were treating him as they treat the common tourist; they hadn’t
noticed the extreme Romanism of his hat. Deering vilified them most
idiomatically, but they had no sense of style. The right way with violent
children is more universal, I think; it applies to them all and everywhere, if
you have the command of it; but Deering was singularly helpless, and the
children bothered and clung to him, recognizing their prey. When at last he
had beaten them off he was greatly ruffled, and he snapped at me rather
pettishly, demanding to know where I came from and was going. That was
easily explained; but how could I account for the presence of Deering on
the Spanish Steps, in the thick of the rabble of the English ghetto? We
mounted the splendid flight, evading a courteous gentleman who merely
wanted us to look, for he said so, at a remarkable collection of mosaic
jewelry which he happened to be carrying in a cabinet under his arm;
Deering winced at his approach and answered me with raised voice in
Italian. His pretty hands danced before him in the urgency of his surprise,
his amusement, at finding himself in these haunts of the simple Briton; it
took him back, he said, to the days of his innocence; and it flashed upon me
that Deering had now turned yet another corner of his emancipation—the
newest and latest perversity, perhaps, was to throw over the marble halls of
the Via Nazionale and to come round again to the tea-room of the English
old maids at this end of the town. The rate at which Deering refines upon
refinement is bewildering to a plain man. But no, Deering hadn’t pursued
his culture to this point as yet, though no doubt he would arrive there in
time; it was just an accident that had led him into the neighbourhood of the
tea-room this afternoon.
And a lucky accident too—for I was pleased to tell Deering how I had
followed the thread which he had placed in my hand the other day. “My
poor friend,” he said, “how you have bungled it! Is it to this that I have
brought you?” He warned me that I had missed my opportunity, he wasn’t
responsible for my floundering plunges. Yet he bade me proceed, and he
should look on from a distance and mark the progress of my madness.
“Return to me,” he said, “when you recover your senses.” Madness, he
plainly indicated, lay in the direction of Miss Gilpin and the Via Sistina; the
coils of the friends of Miss Gilpin, once they have caught an imprudent
explorer, effectually destroy his chances of attaining to—well, to what? If
Deering is going to start his old refrain about the “real Rome” I have now
my answer; I have discovered this much at least, that there are many more
“real Romes” than are dreamed of in his preciosity. Already a dozen people,
I assured him, had opened my eyes to the reality of Rome; some said it no
longer existed, some said it was a very poor affair, some said it was a secret
only known to themselves; but they all had their views, and I didn’t yet feel
able to discriminate finally, to determine which of them was in possession
of the truth. I must go forward and hear more; and I promised to let him
know when I came to a conclusion. “Go your way by all means,” said
Deering, “and come and tell me when you escape.” So we left it at that, and
we parted at the head of the magnificent stairway; Deering carried his
swaying grace (but he was developing plumply, I observed as he went)
towards the gardens of the Pincio, and I turned in the other direction down
the narrow switchback of the Via Sistina.
These friends of Miss Gilpin occupied a dim and constricted apartment,
and they too were rather dim. They were English, they consisted of husband
and wife and daughter, and they disappointed, I must own, my idea that I
had ascended the scale of initiation when I reached their door. Mr. and Mrs.
Clarkson, Miss Agnes Clarkson—you can’t make much of a romance out of
names like these; you must take them as you find them, wan respectable
gentle-mannered Britons, who had been spending the winter in the south
because Mr. Clarkson has a delicate chest. They had found the winter colder
than they had expected, and perhaps they had found it long. Rome is
delightful, is wonderful, is full of beauty and instruction—Mrs. Clarkson,
hooking comfortably at her crochet, entirely recognized this; but then so
much of its beauty, and practically all its instruction, is too bitterly cold in
the winter season for Mr. Clarkson’s chest; and no, they hadn’t been able to
go about very much, or indeed at all, though they had enjoyed their walks
upon the Pincio; and their rooms were excellent, all they could desire, but
Mrs. Clarkson, as she leaned uncomplainingly against the rococo spikes and
jags of her chairback, was bound to say that a hired apartment was never the
same as one’s home—great indeed as is the privilege and pleasure of
foreign travel. Mrs. Clarkson had on the whole no more to say, but her
husband took the view that the winter was over now, and he mentioned that
he was thinking out an excursion or two for them to make before they
returned to England; and as for Miss Agnes Clarkson, a hollow-cheeked
maiden with a suffocated voice, she really had nothing to say at all, beyond
reminding us that it would soon be too hot for sight-seeing in comfort.
Dimness seemed indeed to settle upon us all, and we scarcely knew what to
talk of next.
But this was in the absence of Miss Gilpin, who happened to be out
when I arrived. The door presently opened, and the flimsy draperies were
caught aside by Miss Gilpin’s hand as she peeped into the room with a little
air of coyness and archness—I don’t know why, unless because it was one
of her methods of entering a room, and she thought this one as good as
another. She floated in on a waft of sweetness and light, followed by a
gentleman. “More company for you,” she exclaimed—“I’ve brought Mr.
Bashford!” She stood aside, directing Mr. Bashford, installing him in the
circle with proprietary gestures and cries; and she reached out back-handed
to me as she did so, pacifying my impatience till she could give me her
attention. The Clarkson family were roused, a faint warmth kindled their
chill. “Why, father,” said Mrs. Clarkson, “you remember Mr. Bashford—he
came here when Miss Gilpin was with us the last time.” “To be sure, to be
sure—we are quite in society when Miss Gilpin is with us!”—and Mr.
Clarkson amiably bestirred himself to meet the incursion of the world.
Agnes swept her mother’s work-basket out of a chair, her father’s patience-
cards off the table; she ministered as she could, but society seemed to
disregard her. She fidgeted round the room, disturbing the thin litter of
home-life which they had sprinkled over the alien bedrock of the Via
Sistina—very thin and sparse it was, easily swept into a corner with a few
English volumes from the circulating library. Within five minutes of the
departure of the Clarksons every trace of their settlement in the south could
have been obliterated; you wouldn’t have supposed that the Clarksons
belonged to a conquering race. But they were grateful, it seemed, for the
brightening of their dimness; if they couldn’t do much for themselves, they
were glad to be taken in hand by their brilliant friend.
Their brilliant friend was aware of it. Miss Gilpin was now free to
encourage the shy young man she had run across at Castel Gandolfo; she
beckoned him into a corner and soon put him at his ease. Miss Gilpin is
known for her cleverness in drawing out shy young men and winning their
confidence; it is an art that perhaps you don’t usually associate with little
literary ladies of a certain age, and that is just what makes it so pretty and so
clever in Miss Gilpin. She does it with all the naturalness in the world—you
mustn’t imagine that she makes a foolish affectation of youth, of
playfulness, or that she vulgarly uses her charm. No, her manner is brisk,
sensible, downright—but I needn’t dwell upon it at this juncture, for she
had no difficulty with the present young man. She made short work of me;
having tamed and civilized and made me presentable within five minutes,
she returned to the Clarksons and sought to create a circle of general talk.
The poor Clarksons, they couldn’t be left longer in their helplessness; their
charming friend must give them the support of her social ease. But Miss
Gilpin really used more tact than they needed, for the Clarksons were
talking away quite gaily with Mr. Bashford. They were talking about a
family whom they had met last winter at Torquay, nice kind quiet people, to
whom it most oddly appeared that Mr. Bashford was related. “Do you hear
that, Agnes?” cried Mrs. Clarkson, “Mr. Bashford is a cousin of the
Marshams.” Why, how small the world is! Agnes had seen a great deal of
the Marshams at Torquay, and it was worth while having come to Rome,
she seemed to imply, for the unexpected chance of talking about them to a
friend and a cousin. “Have you heard from them lately?” she asked—it
might have been the first question she had asked in Rome with a sincere
interest in the answer. Miss Gilpin even spoilt things a little by her
intervention; Mrs. Clarkson had dropped her crochet to tell Mr. Bashford
about a drive she had taken with Mrs. Marsham last winter, but the story
faltered and the hooking was resumed before the competent sweep of Miss
Gilpin’s tact. She was so brilliant that it became rather dull and dowdy to
talk about the Marshams.
Mr. Bashford, however, was not to be discouraged; he chanced to have
received a letter quite recently from his cousins, and he was anxious to tell
Miss Agnes that they had this year selected Bournemouth for their winter
retreat, and had there been enjoying the best of weather. “Do you hear that,
mother?” exclaimed Miss Agnes; “the Marshams have been at
Bournemouth.” The Clarksons, very remarkably, had themselves been at
Bournemouth the year before last, and Mr. Bashford really envied them the
experience. Mr. Bashford was not noticeable in appearance, at least upon
the golf-course at Torquay; though for the streets of Rome he was perhaps
too weather-bronzed, too tawny-haired, too baggy in his homespun
clothing. One may well wonder how it happens that Mr. Bashford, who
certainly hasn’t a delicate chest, can have strayed so far from the first green
at Bournemouth in this fine spring weather. He and Mr. Clarkson are there
again, it seems, as they fall into an absorbing discussion of the merits of the
course—Mr. Bashford knows it well, having played many a round there a
few years ago. “Now they’re off!” says Mrs. Clarkson, smiling over her
hook; and she too, good soul, might be seated in her corner of the ladies’
drawing-room at the Sea View Hotel, while she tranquilly enquires of Miss
Gilpin whether she isn’t badly “wanting her tea.” Mr. Bashford, in short,
had made the Clarksons feel thoroughly at home; the long chill of the
Roman winter was a thing of the past, they breathed the kindly and
temperate air of the Marine Parade. Mr. Bashford, you may judge, was just
such another poor wandering exile, driven by mischance into a region
where the servants simply can’t, with the best will in the world, learn how
to serve an English tea—Mrs. Clarkson protested feelingly that she had
done what she could to teach them, and in vain.
But no, the story of Mr. Bashford was not such as you might suppose.
Later on I learned it, and I found to my surprise that this golfing gossiping

Essentials of Anatomy Physiology 3Rd Edition Christina A Gan Kenneth S Saladin Full Chapter

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Essentials of Anatomy & Physiology

3rd Edition Christina A. Gan Kenneth S.

This book is printed on acid-free paper.

Cover Image: Buena Vista Images/Getty Images

About the Authors iv

©Eye of Science/Science Source

Sciepro/Science Photo Library/Getty Images RF

Chapter 10 Dr. Yorgos Nikas/Science Source

The Sense Organs 319

Appendix A: Answer Keys A-1

Essentials of Anatomy & Physiology, third edition, is intended forslenderThe Circulatory

Assess Your Learning • Skeletal muscle excitation and contraction

Captivating Art and

Photography Mitochondria Openings into

Physiology’s illustrations set a new standard in the A&P Sarcolemma

Cognitive Skill Building

Physiology asks questions that Posterior root

there is also the opportunity

c. maxilla. 7. Synovial fluid is secreted by the bursae.

refer to regions with only one bone. Perineurium

question filters that allow

reporting for administrative 15. As people age they experience

Making Anatomy & Physiology Epithelial root

Intriguing and Inspiring

One of the greatest challenges faced by students of anatomy and physiology is

13. are channels in the plasma membrane that open or

Making Anatomy & Physiology

Ways in Which the CARDIOVASCULAR SYSTEM Affects Other Organ Systems

Lymphatic and Immune Systems

Skeletal System Respiratory System

Connective Issues The bloodstream picks up RBCs, WBCs,

of human function. Muscular System

Vasodilation in the muscles provides the added

Study made personal

Laptop: McGraw Hill; Woman/dog: George Doyle/Getty Images

Affordable solutions, Solutions for

Padlock: Jobalou/Getty Images Checkmark: Jobalou/Getty Images

Study anytime, anywhere “I really liked this

Everything you need in one place

Calendar: owattaphotos/Getty Images

Learning for everyone

50% of the country’s students are

Practice Atlas for A&P is an

Amy Goode Susan Rohde

Kristin A. Jacobson Flex Rachael L. Smith

Elizabeth A. Mays Sherry S. Stewart

Tanya Z. Quiroz Heather Stottman

Remote Proctoring & Browser-Locking Capabilities

The Study of Anatomy

Clinical Applications/Perspectives on Health

N o branch of science hits as close to home as the science of our

1.1a The Study of Anatomy

Apply What You Know

1.1b Examination of the Body

Dissection, of course, is not the method of choice when examining a living

1.1c Techniques of Medical Imaging

Figure 1.1 Radiologic Images of the Head.

?• Why is a PET scan considered invasive,

tomo = section, cut, slice; graphy = recording process

(a) X-ray (radiograph) (b) Cerebral angiogram (c) Co

1.1d Anatomical Variation

sono = sound; graphy = recording process

Figure 1.2 Sonography. (a) Producing a sonogram. (b) Three-