Anatomy and Physiology - The Unity of Form and Function

1242 Pages·2009·122.966 MB·English

by  Saladin

Anatomy and Physiology
Anatomy & Physiology: The Unity of Form
and Function
5th Edition
Saladin
(cid:1)(cid:2)(cid:3)
McGraw-Hill
McGraw−Hill Primis
ISBN−10: 0−39−099995−4
ISBN−13: 978−0−39−099995−5
Text:

Anatomy & Physiology: The Unity of Form
and Function, Fifth Edition
Saladin
This book was printed on recycled paper.
Anatomy and Physiology
http://www.primisonline.com
Copyright ©2009 by The McGraw−Hill Companies, Inc. All rights
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instructor is solely responsible for the editorial content of such
materials.
111 ANATGEN ISBN−10: 0−39−099995−4 ISBN−13: 978−0−39−099995−5
Anatomy
and
Physiology
Contents
Saladin (cid:127) Anatomy & Physiology: The Unity of Form and Function, Fifth Edition
Front Matter 1
Preface: The Evolution of a Storyteller 1
Letter to the Students 16
I. Organization of the Body 17
1. Major Themes of Anatomy and Physiology 17
Atlas A: General Orientation to Human Anatomy 44
2. The Chemistry of Life 67
3. Cellular Form and Function 103
4. Genetics and Cellular Function 139
5. Histology 167
II. Support and Movement 203
6. The Integumentary System 203
7. Bone Tissue 229
8. The Skeletal System 257
9. Joints 301
10. The Muscular System 335
Atlas B: Surface Anatomy 403
11. Muscular Tissue 419
III. Integration and Control 457
12. Nervous Tissue 457
13. The Spinal Cord, Spinal Nerves, and Somatic Reflexes 497
14. The Brain and Cranial Nerves 530
15. The Autonomic Nervous System and Visceral Reflexes 581
16. Sense Organs 602
17. The Endocrine System 653
IV. Regulation and Maintenance 699
18. The Circulatory System: Blood 699
19. The Circulatory System: The Heart 735
20. The Circulatory System: Blood Vessels and Circulation 771
iii
21. The Lymphatic and Immune Systems 831
22. The Respiratory System 879
23. The Urinary System 921
24. Water, Electrolyte, and Acid−Base Balance 958
25. The Digestive System 981
26. Nutrition and Metabolism 1029
V. Reproduction and Development 1063
27. The Male Reproductive System 1063
28. The Female Reproductive System 1093
29. Human Development 1133
Back Matter 1169
Appendix A: Changes in Terminology in the Fifth Edition 1169
Appendix B: Answer Keys 1170
Appendix C: Periodic Table of the Elements 1179
Appendix D: Symbols, Weights, and Measures 1180
Appendix E: Biomedical Abbreviations 1181
Glossary 1183
Credits 1199
Index 1201
iv
Saladin: Anatomy & Front Matter Preface: The Evolution of a © The McGraw−Hill 1
Physiology: The Unity of Storyteller Companies, 2010
Form and Function, Fifth
Edition
THE EVOLUTION OF A

Storyteller

Ken Saladin’s first step into authoring was a 318-page paper on the
ecology of hydras written for his 10th-grade biology class. With his
“first book,” featuring 53 original India ink drawings and
photomicrographs, a true storyteller was born.
“When I first became a textbook writer, I found myself bringing
the same enjoyment of writing and illustrating to this book that I
first discovered back when I was 15.”
–Ken Saladin
Ken’s 1st text in 1965
Ken's “first book,” One of Ken’s drawings
Hydra Ecology, 1965 from Hydra Ecology
Ken in 1964
Ken began working on his first
book for McGraw-Hill in 1993, and in
1997 the first edition of The Unity of
Form and Function was published.
In 2009 the story continues with the
fifth edition of Ken’s best-selling A&P
textbook.
The first edition (1997)
The story continues (2009)
v
2 Saladin: Anatomy & Front Matter Preface: The Evolution of a © The McGraw−Hill
Physiology: The Unity of Storyteller Companies, 2010
Form and Function, Fifth
Edition
A Good Story
SALADIN ANATOMY & PHYSIOLOGY
Anatomy & Physiology: The Unity of Form and Function tells a Storytelling Writing Style vii–ix
story made of many layers including the core science, clinical Appropriate Level
applications, the history of medicine, and the evolution of the human Interactive Material
body. Saladin combines this humanistic perspective on anatomy and Interesting Reading
physiology with vibrant photos and art to convey the beauty and
Artwork
excitement of the subject to
That Encourages Learning x–xi
beginning students.
“This book is a great marriage Sets the Standard
To help students manage the
of form and function. It pro- Conducive to Learning
tremendous amount of information
vides students with interesting,
in this introductory course, the
accurate information, introduc- Pedagogical Learning Tools xii–xiii
narrative is broken into short es them to clinical situations,
Engaging Chapter Layouts
segments, each framed by learning and cleverly distinguishes
Tiered Assessments Based on Key
objectives and self-testing review between the important and the
Learning Objectives
questions. This presentation unnecessary.”
strategy works as a whole to create –Amy Nunnally Innovative Chapter Sequencing xiv
a more efficient and effective way Front Range Community College
for students to learn A&P.
New in the Fifth Edition
New!
Revision of Chapter 20 This chapter on blood vessels
It’s not unusual to hear text-
now takes a regional approach. Instead of describing all the systemic
book cynics say that new edi-
arteries from head to toe and then starting over at the head to describe all
tions are just the same material
systemic veins, the author now addresses each body region and describes
bound in new covers, but that
its arterial inflow and venous outflow back-to-back. For example, Saladin
certainly isn’t true of this one.
treats the arteries and veins of the head and neck, then arteries and veins
Just listing my fifth-edition
of the thorax, then arteries and veins of the upper limb, and so on. This is
changes came to 113 pages
a more structurally and functionally integrated approach that is more
and 50,000 words.
conducive to memory. Students will also see more clearly that the arteries
–Ken Saladin and veins of a given region often have parallel names (subclavian artery
andsubclavian vein, for example).
New! Science Updates in the Fifth Edition!
“In comparing the 5th
• mechanism of osmosis • osteocalcin, a new bone hormone [edition] to the 4th, it is
clear that effort is put into
• gene regulation • athletic use of creatine
every paragraph to ensure
• cancer genes • Alzheimer disease
consistency, clarity, and
• epidermal keratinization
• appetite-regulating hormones accuracy. We love the 4th,
• tissue engineering
• advances in diabetes mellitus but Chapter 6 in the 5th is
• stem-cell controversy
even better.”
• platelet production
• evolution of skin color
–Judith Megaw
• sunscreens and skin cancer • ovarian folliculogenesis
Indian River State College
• genetics of malignant melanoma • advances in contraception
vvii
Saladin: Anatomy & Front Matter Preface: The Evolution of a © The McGraw−Hill 3
Physiology: The Unity of Storyteller Companies, 2010
Form and Function, Fifth
Edition
STORYTELLING
Writing Style
Appropriate Level
• Plain language for A&P students early in their curricula
“I like the way the author identifies situations in
• Careful word selection and paragraph structure
which completely explaining an idea or concept
• Appropriate for all audiences (international would be too overwhelming at this point in the
readers, English as a second language, and student’s academic career, as when he says, ‘To
nontraditional students) understand the units of measurement [for radia-
tion exposure] requires a grounding in physics
• Avoidance of "dumbed down" content
beyond the scope of this book.’ From the stu-
dent’s perspective, I think this builds a connec-
tion between the student and the author. As a
Interactive Material
result, I think the student is more likely to listen
• Review activities integrated in the chapter to the author’s written words on the important
matters than if the author tried to explain the
• Self-teaching prompts and simple experiments
concept perhaps in an effort to show how well
liberally seeded through the narrative
educated he is.”
• Learning aids such as pronunciation guides and –Tina Jones
insights into the origins and root meanings of Shelton State Community College
medical terms
Temporal Bones
If you palpate your skull just above and anterior to the
ear—that is, the temporal region—you can feel the
temporal bone, which forms the lower wall and part of
the floor of the cranial cavity (fig. 8.10). The temporal
bone derives its name from the fact that people often Homeostasis and Negative Feedback
develop their first gray hairs on the temples with the
passage of time.10 The relatively complex shape of the The human body has a remarkable capacity for self- restoration.
Hippocrates commented that it usually returns to a state of
equilibrium by itself, and people recover from most illnesses
even without the help of a physician. This tendency results
fromhomeostasis18 (HO-me-oh-STAY-sis), the body’s ability
to detect change, activate mechanisms that oppose it, and
thereby maintain relatively stable internal conditions.
Self-teaching prompts make
French physiologist Claude Bernard (1813–78)
reading more active. observed that the internal conditions of the body remain
quite constant even when external conditions vary great-
Word origins are footnoted. ly. For example, whether it is freezing cold or swelter-
ingly hot outdoors, the internal temperature of the body
Pro-NUN-see-AY-shun guides stays within a range of about 36° to 37°C (97°–99°F).
help beginning students mas- American physiologist Walter Cannon (1871–1945)
ter A&P. coined the term homeostasis for this tendency to main-
tain internal stability. Homeostasis has been one of the
Familiarity with word origins 18homeo the same stas to place, stand, stay
helps students retain mean-
ing and spelling.
vii
4 Saladin: Anatomy & Front Matter Preface: The Evolution of a © The McGraw−Hill
Physiology: The Unity of Storyteller Companies, 2010
Form and Function, Fifth
Edition
STORYTELLING
Writing Style
Interesting Reading
• Students say the enlightening 460 PART THREE Integration and Control Analogies explain tough
analogies, clinical applications, Dendrites and is decremental—itgets weaker with distance. A nerve scientific content in a way
Cell body Axon signal is much slower (not more than 2 m/sec in unmyelin-
historical notes, biographical aatxeodn sfi, btehrse) , lbasutt aitc tiiso nno npdoteecnretimale ngteanle. rEavteedn iant tah es ylonnagpetisct students can understand.
vimpnilgeseinragesehlutyttrse ei sn m,t foaoa nkrrmedea atedhtv.ie vo elbu,o tboiouknt naaor yt AiRmEmncxe eeptcfmmirrioatoabbncgbrr tpraaoleeonnrsyteese ntial –––++ + –– – ++ + –– – ++ + –– – ++ + ++– –– + ++– –– + ++– –– + ––– + + +––– + + +––+S + + –i––+g + + n –––+ a + + – ––l– + + + ––– + + +––– + + +––– ++ –+–– ++ –+–– +++ dmtdgtarktingihreosnieeainpese girrlointmi evgtafbtie ageueesnd bnt r shstcsiris e ehnada zepiri gsne og ;ito a anss yenitws tetah. rno e lcletdie.fuoT hso a ten rTisehmocsrncado h eueb imae eleams e scfocd, b-e gl srfpmfa.u it eer vprnrhAromleoiofnonemfdt-plye ti p apititenansn aahrtntgigggottnhhgeaoaet .epne if itll eauIsi ay aan nnf tlisg sla oca i degea esanontd.,nt,h h n iNx folWetfnnigeuihcroerkrg oesgehsonfae enpity o fde. rf,an ttt us niinIt h,steoto nhts hah ewnatfeo aee i a; t tbntoe gflb n h cuuak ner u ricoocs er astrgauenrmwex niaeonhp pniosi nnbns osst tnwscuejig iau lt,lonhr st e hioamhtttsttahthietf,,tteb k e e peeata apdlehhp na esarrpe frer l do aunhaoep ,wetcn shs dto ot eeettmhei twhhs i.tnolai hsyaeesf-t-tma scettiimmonbu rplaaontetees n jtuthisaetl p airthsoeedalufd cd otoifoe nsit n.o oTf tah t unrasev,w ew la eac ltocioannng
–+ – + – + – + – + – + – + – +– ++ –+ –+ – – + – +– +– +– +– + Myelinated Fiberdsistinguish an action potential from a nerve signal. The
• Elevaernn isnosmtreutchtionrgs nsaeyw t hanedy often –+ – + – + – + – + – + – + – +– +– +– +– +– ++ –+ –+ –– +– + ccMVoooavmlttetapergearesdr- e rdiean grteuwe lriansttohoem dde2 es,wi0—o0hnf0ans e twg etaeodet lreir f1sftf he2v-ra,a0eprnen0e 0t2r /s5icso/nam irpmc2mg e2 a yanitein nlg ita tnhhataehlet eset ne dii om rnsdefyiegb esigeol airnno ssf -.a tcrativoenl ipnog tewnatviael so. fI te xisc iltiakteio an l ipnreo douf cfeadll ibnyg
interesting from Saladin’s FIGURE 12.16 Conduction –o+ –f + a– + N– + e– r+ v– e+ – S+ –i g +–n +–a l+– i n+– a+–n ++ U –+n –m+ ––y e+–l i+n ated atRthhta eetnh cvieneiselteler . re pnTvooheidnneert eissf, — wmanmooduyr leeNdlg aidebanet ae foilrsnio ctswtmmulehel artpheti eo epsnid n ErtetCh oosiFeen ne mcfhtio.basuevlrii.d n fn grnNo oimoot nof l tgohpa weto e EuisnCn itnFso eh edso movienro t threa vneelxs tt oo nthee a enndd t hoef rteh eis l ian ter,a bnust-
Fiber. Note that the membrane polarity is reversed in the region of The only way a nerve signal can travel along an
innovative perspectives. tpsahiregeerna ioaascdl (tf gir(ooyrneeme lpl nogo)wo tae)inr ntegtr ia fabuilla sl(l cyrtek hpwdeo) aa.l arcAdrti zitrooeendgw ipaoaornndtd e ot nrfh etemiaa dsel oymam ntbdoar a.pr nTereshep veineo on nitttdhss.e rtreh mfer aencmetrobvrerya ne Tfidlniohtfwefiusr nsi(esoj uddase ot v wiesanr syf o tahfra esNw tf aiipbrere o trmnhc rueeaonsst siides, estnbsort usetarthn is et cho aeuaetx r n trnohealenee r mcotv)pe mrt faefiani vbe doi(eof riunnt gshr. e ee1ns 2ipossr.dit1gsgeo7 n aitayt)otsl. e fnrotimal tthraev feirlsst tdoo tmhei neon dto o tfh aen l aasxto. Sni;m a inlaerrlvye,
Note that an action potential itself does not travel along boef ccoomnedsu wcteioank eirs t hdee cfarsertmihgeenr ntiat lga. oTelhs .e iT sshieg rnaeaflo rccea, nhtnhoiast aitsrnpavece ltr eaction of action potentials.
apno taexnotina;l rianth tehr,e itm setimmburlaantees jtuhset parhoedaudc toifo nit .o Tf ah unse,w w aec tcioann ompuecnh a fnayr tvhoelrt atghea-nre 1gu m lamte dbgefaotIeresf . iBt oubte nfcoormetuen saa tteocloy ,tw tiheeaorke n tios potential stimulates the production of a
ndeisrtvine gsuigisnha la ins aa cttriaovne lipnogt ewntaivael ofrfo emx cait antieornve p sroigdnuacle. dT hbye aaxnoonth, ewr hneordee t hofe Raaxnovleinemr meevae wirsy e mx piololisnmede etteor EonCr Flee assnx dal toth negtr etoh ies it, you might think that the signal could
Clinical applications dseolmf-pinroopesa.g Natoin ogn aec dtioomn ipnoot etrnatviaellss. tIot tihs el iekned a o lfi nthee o lfi nfael,l binugt ianng a ibounnsd raenacceh othf viso lptoaginet-l,r ethguel asitgendtagla itse sju.t Wst thsterno nthge e dnioflufuigsh- b k d d t t th Thi
each domino pushes over the next one and there is a trans- to open these gates and create a new action potential. This
mission of energy from the first domino to the last. Similarly, action potential has the same strength as the one at the
make the abstract science no one action potentialtravels to the end of an axon; a nerve previous node, so each node of Ranvier boosts the signal
signal is a chain reaction of action potentials. back to its original strength (35mV). This mode of
more relevant. newI fo onne en aecxtti oton ipt,o yteonut imali gshtitm tuhliantke st hthate tphreo sdiugcntailo nco oufl da psirgonpaalg actoinodnu ocft ioan n iesr vcea lsliegdn asla ltthaatot rsye2e8mcso ntod ujcutmiopn —frtohme
also start traveling backward and return to the soma. This node to node (fig. 12.17b).
does not occur, however, because the membrane behind In the internodes, saltatory conduction is therefore based
the nerve signal is still in its refractory period and cannot on a process that is very fast (diffusion of ions along the fiber)
be restimulated. Only the membrane ahead is sensitive to but decremental. In the nodes, conduction is slower but non-
stimulation. The refractory period thus ensures that nerve decremental. Since most of the axon is covered with myelin,
signals are conducted in the proper direction, from the conduction occurs mainly by the fast diffusion process. This
soma to the synaptic knobs. is why myelinated fibers transmit signalsmuch faster (up to
A traveling nerve signal is an electrical current, but it 120m/sec) than unmyelinated ones (up to 2 m/sec).
312 PART TWO Support and Movement is not the same as a current traveling through a wire.
A current in a wire travels millions of meters per second 28 fromsaltare to leap, to dance
INSIGHT 9.4 Clinical Application
Knee Injuries and Arthroscopic Surgery
Although the knee can bear a lot of weight, it is highly vulner-
able to rotational and horizontal stress, especially when the
knee is flexed (as in skiing or running) and receives a blow from Twisting motion
behind or from the side. The most common injuries are to a
meniscus or the anterior cruciate ligament (ACL) (fig. 9.30).
Knee injuries heal slowly because ligaments and tendons have
a very scanty blood supply and cartilage usually has no blood
vessels at all.
The diagnosis and surgical treatment of knee injuries has
been greatly improved by arthroscopy, a procedure in which Foot fixed
the interior of a joint is viewed with a pencil-thin instrument,
the arthroscope, inserted through a small incision. The
arthroscope has a light source, a lens, and fiber optics that
allow a viewer to see into the cavity, take photographs or
videotapes of the joint, and withdraw samples of synovial
fluid. Saline is often introduced through one incision to
expand the joint and provide a clearer view of its structures.
If surgery is required, additional small incisions can be made
for the surgical instruments and the procedures can be
observed through the arthroscope or on a monitor.
Arthroscopic surgery produces much less tissue damage “Saladin clearly describes anatomical
tm whioathrnOe ar ctq hoguonriacpvfkeetln dyfti.rcioo mnsua trl hgseeu oprngaset ernylloa wra n lidog fatemennea nbrtel eposlra cpae ah taaiem ndstatsrm intaogg erteedcn odAvoCenLr. AlTliigginbaatiemmarle eiocnnortt l cl((arttuootecrrrnniaa))lte structures and physiological processes in
Tlwighitaehm isnue rntght ee(o ojnor i n“thte acnradvveoisntty)s,, ” t dharr ieslltasrd ipsa ftrhhooeml el i gthianemt ome nitdth detlh erf eoomuf guthhr eta hpnead th ieotinlbetis’as, Mmeedniiasclus (torn) a way that engages students. His great
and fastens it with screws. The grafted ligament is more taut use of historical references and clinical
and “competent” than the damaged ACL. It becomes ingrown Patellar ligament
wofi tmh obrleo ocodl lvaegsesne,l sw ahnicdh s feurrvtehse ra sst rae nsugbthsternast eit fionr t timhee .d Feoploloswitiinogn applications gives the students something
arthroscopic ACL reconstruction, a patient typically must use
cthruetrcahpeys fofor r6 7t ot o1 01 0w edeakyss, afonldlo wuendd ebrgy os esluf-pdeirrevcisteedd pexheyrscicisael tangible to relate to their newly acquired
therapy. Healing is completed in about 9 months. FIGURE 9.30 Knee Injuries.
information.”
An important aspect of human bipedalism is the elements(infra-, supra-, pre-), and the terms superficial
ability to “lock” the knees and stand erect without anddeep, you should be able to work out the reasoning –Patricia Bernard
tiring the extensor muscles of the leg. When the knee behind most of these names and develop a system for
itsh ee xfteemnudre dr otota ttehse mfueldleisatl ldye gorne et haell otwibeiad. bTyh tihs ea cAtCioLn, remembering the locations of these bursae. Erie Community College
locks the knee, and in this state, all the major knee The Ankle Joint
lpiogapmliteenutss amreu tswcilset edro atantde st autht.e T of eumnulorc kl athteer aklnlyee ,a tnhde Thetalocrural29(ankle)joint includes two articulations—
u ntwThiset sk ntheee jloiginatm heanst ast. least 13 bursae. Four of these are ajo imnte dbieatlw jeoeinnt thbeet wfibeuenla tahned t itbailau sa, nbdo ttha luens calonsde da ilna teornael
anterior: the superficial infrapatellar, suprapatellar, pre- joint capsule (fig. 9.31). The malleoli of the tibia and fibu-
preagtieolnla ra, raen dth dee eppo pinliftreaapl atbeullrasar. Laoncda tesedm inim tehme bproapnloitseuasl lma oosvt esrihdaen-tgo -tshied eta mluost ioonn .e aTchhe saindke llei kthe ear ecfaopre a hnads par emveonret
bursa (not illustrated). At least seven more bursae are restricted range of motion than the wrist.
found on the lateral and medial sides of the knee joint.
From figure 9.29c, your knowledge of the relevant word 29talo ankle crural pertaining to the leg
viii
Saladin: Anatomy & Front Matter Preface: The Evolution of a © The McGraw−Hill 5
Physiology: The Unity of Storyteller Companies, 2010
Form and Function, Fifth
Edition
Medical History Saladin “puts the human
CHAPTER 25 The Digestive System 1007
in human A&P” with his occasional vignettes on
INSIGHT 25.5 Medical History mwwohaornkm w in iht hteh area hrweoilllyed eginron hte itsso ss .s tHoemee, haacanhdd, ” ah a ewn rdifae hn ae an lwodan dyga eruedgp theota ertree tdinul yrCn ta otno aj ohdiinas the people behind the science. Students say these
The Man with a Hole in His Stomach them. He was once gone for 4 years before poverty made him
yield to Beaumont’s financial enticement to come back. stories make learning A&P more fun and stimulating.
Perhaps the most famous episode in the history of digestive Beaumont despised St. Martin's drunkenness and profanity
physiology began in 1822 on Mackinac Island between Lake and was quite insensitive to his embarrassment and discom-
Michigan and Lake Huron. Alexis St. Martin, a 28-year-old fort over the experiments. Yet St. Martin’s temper enabled
Canadian voyageur (fig. 25.33), was standing outside a trading Beaumont to make the first direct observations of the relation-
post when he was accidentally hit by a shotgun blast from ship between emotion and digestion. When St. Martin was ,y p
3W fielleiatm a wBeaayu. mAonn tA, rwmays sduomcmtoor nsetda ttioon eexda maitn eF oSrtt. MMaarctiknin. aAcs, prianrgt—icausla wrlye dniosbwtre eksn saoewdn,, Btaheeas ustymumotpneat t nheoetxteicdp nleiettrrlveio mduisg eseysnsttitoeenm ro i.nc chUuibrn--der crude frontier conditions and
Bkeeya’us megognt” lpartoetrr wudroetde ,t h“aro puogrht ioSnt. oMf atrhtein ’lsu nlagc earsa ltaerdg ea nads ab uturnr-t i ts dBiegaeusmtivoen ta cwptuivbiitltiyhs.h eda alm boooks int 18n33o t heatq lauid itphem foeunndatt,i onh e discovered many of the basic
flesh. Below that was a portion of the stomach with a puncture for modern gafsatricc tpshy soioflo ggya asndt rdiicet eptichs. yIts wiaos leontghuys iadstii-scussed in this chapter.
ibne istt “tloar gpeic ke noouutg bho tnoe rfercaegimvee nmtsy afonrde fdinregsesr .”t hBee wauomunodn,t tdhiodu hgihs cRaulslys iraenc epivheyds iob ylo tghise“t mII vecadniac aPnl ac volloomvmo (uk1n8 i4tdy9 –ai1rn9ed3 6hc)a tdpl yneor f oeinrqmutaeold u nhttihisl e cavity of the stomach, observe
h e dSiudr pnroits ienxgplye, cht eS tli.v Meda.r tOinv teor sau prveirvieo.d of months the wound cmeelethboradtse dp eioxnpieetersrime dme nbtoys otBnie odauingme,so taniotn,n Pdina vaalnoilvmm arelosc. eBsivutei ldds inethgee o n1t9 th0h4ee process of digestion,” Beaumont
extruded pieces of bone, cartilage, gunshot, and gun wadding. Nobel Prize fowr Phryositoelo.g y“ Io rc Maendic ipneo.ur in water with a funnel and put in food with a
Asos ltahreg ew tohuant dB ehaeuamledo,n at hfiasdtu tlao (choovleer) irte wmiathin ae dc oinm tphree ssst otom pacreh-, the Ibna 1s8e5 o3f, Bhiessa supkmuolol,n oatn nsdli, pd paieednd ado fn e dwso rwmaeeew kics e l,ta shtueerf.f eSmrte. dM oaar ubtilnto wcao tngo- ain with a siphon.” He put pieces
vffieesetnubtl laefo,. obTdouw tf rinto wmaua ctsho eomarisitniilegys oo dupete.c nAied defo.d lA dt h yoeefy at rics losauuteeldr ,l anStote. rlM ognargretweinr owsvuaepsrp stohtrieltl totihtnahunee rd Bp theoya sutiomouloorof ngmotisf’setr .sd m ,i Scweoaehlxm oasaesce,th m ocfooooirlnnns c ea lauxanstadi mio sosnputsnlb erwm,i. neiartHeg ttt oroe i bfiet nuextsnpte eeodler nis mcstt hehc enoemtvrsr i eicbsacayttll os moaf cgha asntrdic r ejumicoev etdo tthheem l ehaoduinrlgy
hhoimm oe.n B peuabulmico fnutn, dhso wanedve wr, awnatse dim tbou sehdip w hitihm a 1 p,5a0s0si omnialetes stoe nhsies dlivigeeds itnio wn rteot clahccetdhic pe aocmviedr itisyn stitnse aa do t inofy f A hshymdacrokec whrliiotchri cah ias acwidnif. edS at .n EMd uasrertvion- pe, who could do little but report
otinhf ead tae chsctisiidn pye.en Vrts eaorsny aa llui tentxlieqp uewena sosep kpannoodrwt upnne iartfybo otromu tle eddai rg2ne3. sH8t eieo xtnop, oeakrni mSdt e.h nMet assr atoiwnn esoerfatneli lnce h pailrndodrme bnise, ealidtren vehdteo qdad ti eatuhdk eie i2rh th8ea i dmydc eb.a oerHesn naC tfttoale rPia nBanreeiasd,ud wm chohenortye.u BdBlyedr atohu eemcnvo hhneelto nwhara dsoic c caucrid o. uHtsei dper othvee ds tothmaat cdhi,g beustti ohne
hscimho oovl earn sde hvaedra lli tytelea rids.e Ba ehaouwm socnite nhtaisdt sn ewvoerrk ,a ytteetn hdee dp rmoveeddic taol found that HCl alone did not digest meat; gastric juice must
bweit ha na almstoustet enxop eeqriumipemnteenr.t U, nhde edr icsrcuodvee rferdon mtiearn cyo onfd itthioen sb aasnidc contain some other digestive ingredient. Theodor Schwann,
facts of gastric physiology discussed in this chapter. one of the founders of the cell theory, identified that ingredient
its m“Io ctaionn l,o aonkd dailrmecotslyt sineeto t hthee p croacveitsys ooff tdhieg essttoiomna,”c hB,e oabusmeorvnet as pepsin. Beaumont also demonstrated that gastric juice is
wsproooten., “aI ncda nd rpaowu rt hine mwa oteurt wagitahi na wfuitnhn eal sainpdh opnu.”t Hine f opoudt pwieitche as secreted only in response to food; it did not accumulate
ofcohf rem meexiasattm so ionnf a aAt isomtnrei. nrHigce ain astneond tt hE evu irsaotlosp meo, afw cghhao as ntcrodicu r ledjum idcooev elittdot lteth hbeeum tl ehraeodpuionrlrgyt btheattw heuenng mere iasl sc aauss epdre bviyo uthsely wthaollsu gohf tt. hHe ee mdipsptyro svteodm athceh irdueba- William Beaumont (1785–1853) Alexis St. Martin (1794–1880)
that it contained hydrochloric acid. He proved that digestion bing against each other.
rfoequnudire tdh aHtC Hl aCnl da lcoonueld d eidv enno ot cdciugre osut tmsideeat t; hgea ssttorimc ajuchic,e b umtu hset For his part, St. Martin felt helpless and humiliated by FIGURE 25.33 Doctor and Patient in a Pioneering Study of
coonnet oafin t hseo fmoeu nodtehres ro fd tighee scteivlle t hinegorreyd, iideennt.t ifTiehdeo tdhoatr inSgcrhewdaiennnt, Beaumont’s experiments. The fur trappers taunted him as “the Digestion.
as pepsin. Beaumont also demonstrated that gastric juice is
secreted only in response to food; it did not accumulate
btheattw heuenng mere iasl sc aauss epdre bviyo uthsely wthaollsu gohf tt. hHe ee mdipsptyro svteodm athceh irdueba- William Beaumont (1785–1853) Alexis St. Martin(1794–1880)
bing against each other.
For his part, St. Martin felt helpless and humiliated by FIGURE 25.33 Doctor and Patient in a Pioneering Study of
Beaumont’s experiments. The fur trappers taunted him as “the Digestion.
More than a few distinguished scientists and clini-
cians say they found their inspiration in reading of
the lives of their predecessors. Maybe these stories
will inspire some of our own students to go on to
do great things.
–Ken Saladin
256 PART TWO Support and Movement
Evolutionary Medicine Rapidly growing, INSIGHT 8.2 Evolutionary Medicine othf et heeth tmhroeied— biosn ae .s eTphaer aintef ebroionre n(saesea lf icgo. n8c.1h3a)—.the largest
increasingly fascinating Evolutionary Significance of the Palate Vomer
In most vertebrates, the nasal passages open into the oral cav- Thevomer forms the inferior half of the nasal septum
icbwpbtaorayeev.rl iatMicctitchy ahrle maeifnwrtsomeg b,im tadew l tufstheo,rh oirbenmery go ou s curswtoaghta nlhi dsltcll iyroapga wvretsooitsitn,l yt obhg . onra Ieniugvta r.ee o kT dfar oh di tcpoee huda rpepl atwra oatilenia pnm ttitgoedha. lasayintml;l tosiaanewil nplo,s a roeurdauasesrt r ietlh oystio gtdc hhodige nom ent siteanthtseuiaasde-l, ttp(sphisholoeeoarnewrt e epf.dia, eg”T rs epwhw.a eea8rhn ll.siild3cue ihrpoca. fuenr Trledsiahfo eree8pr r .psth4va lbaotlao l)mtf. ec ioe aIttrsfors tft iar hlnenatesahdg emene m paeetbse htallrhiaaplt mntees crenofaepodil dtrlitumyco mu bsmtlo hainemres ae ofpnb,o sllsraata mstd“eo pee mf ld sooute fwhbnp yea---
Evolutionary medicine provides novel anterior part of the nasal septum.
Palatine Bones Mandible
and intriguing ways of looking at: Thepalatine bones form the rest of the hard palate, part of Themandible (fig. 8.15) is the strongest bone of the skull
the wall of the nasal cavity, and part of the floor of the orbit and the only one that can move noticeably. It supports the
• menopause (hsaered f ipgasl.a 8te.5 aar aen tdw 8o. 1la3r)g. eAgt rtehaet epro pstaelraotliantee rfaolr caomrninears. of the ltoicwateiro nte eatnhd a nfdac piarlo veixdperse assttiaocnh. mIte ndt efvoerl ompuss calse ss oepf amraatse-
right and left bones in the fetus, joined by a median carti-
••••• tbtsbhhkiopeeidn eyso dwc rhaioeglalieioisntrrm too fo mthi tochondria EIInNv moSolIsuGtt viHeornTtea b8rray.t2 eSs ,i gthnei Enfiavcsoaallnu ptcteeti(fztZTmahinohZirayohyaraeveeorYgsnmel t ego- i(it grcswsmneezooto ne mdyeffbaa-eaem dgoMlotp rmtolifaonh gociaATmolgaee ra ftTfisaa ar tens(i.-lrseest chi clti8yreahbyechas a.ecto-B m24pl c hb6n tfa eomoh hy ie ob go-aMa a naFao.rtnant nhbrAn8p eenddgfdei.eYd lsti 4 e sa;n8c-eu a usr trst.)nfehh5hos .ondPsoiuaeusero f)s aymlf .nt b)rl te ilo Eah aeimyoftcmrxnaeoh f ctp raeo eolthaotie hnfra ms raanboedzamtcni yhe lhtzga gatsn eepy lb ol estalgroemTinsonohdu z.ecmda oetyaetT f egriahsp och osttaaf ith e m lbcrho tfeot ohewfap p on cettrarirfiheh ooc nys emtaeoc hkth eteefuzaioeaklrsnysl scss ll tege i aahcnoaocaitnesflt---t av-lah oohapa lfaaotr bfooocg t trlteoirtioiaihnhcinrdqTTrmzuaeteno,uoehhl leueu pdecnaeetnrs honto t e amb icpiiattjsnlnthooahloi av twbladniesni lnetotoy gtei mdsoetpd tdf etirhl oechye btailt fhofran ertlh tmhel reit thelt sh a peewih ac lpe tadrc cthasso on oa r smyis tctlargnh uhhmltetnlae.iawpeees onidplT s. upvpnod mehhmote a,sihy mirsbes .sste tsn lbsi iaTh eanjs tmejo,egtha,ot th i eolewliern ite nr ok satbpe hat ytfe eoaoasmae m nndrislsetnt eus h ytppsahigrtse fhrvahlop ,i oe yneemenra( tsssRod bun iaemtoa Aisbdrexannn aeY eiic( adnemlrSte-hl ha.m eaaI vb uTnM.ns,re lu slichotreSyd-semtomefx )lie.ic ,dichhp—e egha ie-nvohtblishtt eilttiih ondalaasstyesrltt)-t-
• lactose intolerance ity. Mammals, by contrast, have aLT hapecrlaaimclraaimlt aBel2o7 nt(LehAsCaKt-r ish-emupl)abornaest feorsm tpahrte o f nthae sasbmle yul sss cohlfea sltlh oaewn cd h dsineapl. irTveahsrseyi o ignnlnsa enrad nssud. r Ifnrai cdtehg eeo sfr etthghieao tnb o aodcfyc t ohimse mmmaoerdnkatetadel
cavity from the oral cavity. In ormdedeiarl w talol o f meacha oirnbitt (afigi. n8.1 4o). uThrey harei gtheh sm malleest ta-protuberance, the inner surface has a pair of small points,
• the kidney and life on dry land bolic rate, we must digest our fobdoepnoreesds osif o trnh aec sapkllueildld, athlbyeo ul;ta ctihrniem s aizole f orofsd stahe eh loritu tlstee sof ina gmedrenomaibl .r taA-h is,
• the palate we chew it thoroughly to break nsiaotcu asnuladcp drirm aiiannl isntatcoo i nt h slei fnme.a sTaeala crlsal vf,ri otyem. athse eiyley c odllecitg ine thsist ed Condylar process Mandibular condyles
Coronoid process
• theories of aging and death particles before swallowing it. TNThwaeos as mlp aBlalo rnleacetastnegu laarnllaosalw bosne su fosrm tthoe b rcidoge nof tthine ue Mandibular notch
breathing during this prolongedn ocseh (seeew figi. n8.g3) .and support cartilages that shape its Mandibular foramen
lower portion. If you palpate the bridge, you can easily
feel where the nasal bones end and the cartilages begin.
The nasal bones are often fractured by blows to the nose. Alveolar process Ramus
Inferior Nasal Conchae Mental foramen
There are three conchae in the nasal cavity. The superior Mental protuberance
andmiddle conchae, as discussed earlier, are parts of Angle
Body
2267zlaycgroi m to t ejoairn, ,t ou ncritye FIGURE 8.15 The Mandible.
ix