Hole's Human Anatomy and Physiology

1108 Pages·2006·178.7 MB·english

by  Shier D.N.

Shier−Butler−Lewis: Front Matter List of Clinical © The McGraw−Hill
Human Anatomy and Applications Companies, 2001
Physiology, Ninth Edition
Clinical Applications
Chapter 1 Chapter 14
1.1: Ultrasonography and Magnetic Resonance Imaging: 14.1: King George III and PorphyriaVariegata 555
A Tale of Two Patients 10 14.2: Leukemia 559
Chapter 2 14.3: The Return of the Medicinal Leech 569
14.4: Living with Hemophilia 570
2.1: Radioactive Isotopes Reveal Physiology 42 14.5: Replacing Blood 575
2.2: Ionizing Radiation: A Legacy of the Cold War 46
Chapter 15
2.3: CT Scanning and PET Imaging 58
Chapter 3 15.1: Heart Transplants 594
15.2: Arrhythmias 600
3.1: Faulty Ion Channels Cause Disease 70 15.3: Blood Vessel Disorders 608
3.2:The Blood-Brain Barrier 73 15.4: Measurement of Arterial Blood Pressure 612
3.3: Disease at the Organelle Level 80 15.5: Space Medicine 614
3.4: Cloning 102 15.6: Hypertension 617
Chapter 4 15.7: Exercise and the Cardiovascular System 619
15.8: Molecular Causes of Cardiovascular Disease 640
4.1: Overriding a Block in Glycolysis 117 15.9: Coronary Artery Disease 642
4.2: DNA Makes History 126
Chapter 16
4.3: Gene Amplification 132
4.4: Phenylketonuria 136 16.1: Immunotherapy 668
Chapter 5 16.2: Immunity Breakdown: AIDS 678
Chapter 17
5.1: Abnormalities ofCollagen 153
5.2: Tissue Engineering 162 17.1: Dental Caries 696
Chapter 6 17.2: Oh, My Aching Stomach! 705
17.3: Hepatitis 713
6.1: Skin Cancer 174 17.4: Gallbladder Disease 715
6.2: Hair Loss 178 17.5: Disorders of the Large Intestine 727
6.3: Acne 180
Chapter 18
6.4: Elevated Body Temperature 184
Chapter 7 18.1: Obesity 748
18.2: Do Vitamins Protect Against Heart Disease
7.1: Fractures 206 and Cancer? 751
7.2: Osteoporosis 210 18.3: Dietary Supplements—Proceed with Caution 765
7.3: Disorders of the Vertebral Column 231 18.4: Nutrition and the Athlete 768
Chapter 8 Chapter 19
8.1: Replacing Joints 287 19.1: The Effects of Cigarette Smoking on the Respiratory
8.2: Joint Disorders 290 System 782
Chapter 9 19.2: Lung Irritants 793
19.3: Respiratory Disorders that Decrease
9.1: Myasthenia Gravis 306 Ventilation 801
9.2: Use and Disuse of Skeletal Muscles 314 19.4: Exercise and Breathing 805
9.3: TMJ Syndrome 322 19.5: Disorders that Impair Gas Exchange 808
Chapter 10 Chapter 20
10.1: Migraine 365 20.1: Chronic Kidney Failure 824
10.2: Multiple Sclerosis 368 20.2: Glomerulonephritis 828
10.3: Factors Affecting Impulse Conduction 380 20.3: The Nephrotic Syndrome 837
10.4: Opiates in the Human Body 385 20.4: Renal Clearance 844
10.5: Drug Addiction 387 20.5: Urinalysis: Clues to Health 849
Chapter 11 Chapter 21
11.1: Cerebrospinal Fluid Pressure 400 21.1: Water Balance Disorders 862
11.2: Uses of Reflexes 407 21.2: Sodium and Potassium Imbalances 867
11.3: Spinal Cord Injuries 410 21.3: Acid-Base Imbalances 872
11.4: Cerebral Injuries and Abnormalities 419
11.5: Parkinson Disease 420 Chapter 22
11.6: Brain Waves 427 22.1: Prostate Enlargement 892
11.7: Spinal Nerve Injuries 440 22.2: Male Infertility 894
Chapter 12 22.3: Assisted Reproductive Technologies 914
22.4: Female Infertility 921
12.1: Cancer Pain and Chronic Pain 461 22.5: Treating Breast Cancer 924
12.2: Mixed-up Senses—Synesthesia 463 22.6: Human Milk—The Perfect Food for Human
12.3: Smell and Taste Disorders 468 Babies 927
12.4: Hearing Loss 477
12.5: Refraction Disorders 490 Chapter 23
Chapter 13 23.1: Preimplantation Genetic Diagnosis 944
23.2: Some Causes of Birth Defects 956
13.1: Using Hormones to Improve Athletic 23.3: Joined for Life 964
Performance 510 23.4: Old Before Their Time 971
13.2: Growth Hormone Ups and Downs 517
13.3: Disorders of the Adrenal Cortex 531 Chapter 24
13.4: Diabetes Mellitus 534 24.1: It’s All in the Genes 982
13.5: Misrepresenting Melatonin 535 24.2: Down Syndrome 992
24.3: Gene Therapy Successes and Setbacks 998
xiii
Shier−Butler−Lewis: Front Matter View from the Top © The McGraw−Hill
Human Anatomy and Companies, 2001
Physiology, Ninth Edition
Student Preface
W
elcome to the ninth edition of Hole’s Human Supplements, p. xxiv, are part of the support team
Anatomy and Physiology. Our goal in revis- giving you an easy climb to the top of the class.
ing this text is to provide you with the best
learning resource possible. Whether you are • Partner with the Student Study Guide to direct your
planning for a career in health care, athlet- study more efficiently.
ics, general science, or planning an expedi-
• Explore the laboratory manual exercises that
tion to Mt. Everest, this text is your partner into the fasci-
illustrate and review A&P facts and principles.
nating world of the human body.
Just as a climber selects gear for the climb and • Connect to atlases, study cards, coloring guides, and
learns the ropes, you plan a study route and select learn- CD-ROMS.
ing tools to master the concepts presented in anatomy
and physiology. We outfitted each chapter with learning Think of yourself as a climber. You are at the base
aids to assist you in the exploration and discovery of the of the mountain, gazing skyward across the rocky terrain.
human body systems. You are ready. Your body is a precision instrument of in-
View From the Top, p. xv, is your first stop in the terconnected systems that provides tools for the climb.
A&P exploration. Examine this guide to your text, which We have provided you with the tools for your explo-
maps the tools of the climb. Real-life stories, Clinical Ap- ration and discovery of human anatomy and physiology.
plications, key terms with pronunciations, questions at Learning is an adventure of the greatest magnitude,
the end of key sections, InnerConnections, reconnection and we are proud to be a part of your team.
for review, Life-Span Changes, end-of-chapter summaries,
review exercises, and links to technology are some of the Sincerely,
tools available to make your journey successful. David Shier, Jackie Butler, Ricki Lewis
Visual Guide to Online Learning Resources, p. xx,
provides a solid foothold to a wealth of activities and re-
sources supporting chapter content.
• Visit the Online Learning Center at
www.mhhe.com/shier. It offers quizzes, crossword
puzzles, labeling exercises, flashcards, and case
studies for all chapters.
• Link to the Essential Study Partner. This valuable
tool reinforces textbook content and gives you
additional activities for mastery of core concepts.
• Navigate through online dissections with adam
Online Anatomy.
• Search BioCourse.com for helpful animations, video
presentations, and laboratory exercises. Ricki Lewis, David Shier, Jackie Butler
xiv Student Preface
Shier−Butler−Lewis: Front Matter View from the Top © The McGraw−Hill
Human Anatomy and Companies, 2001
Physiology, Ninth Edition
V
IEW FROM THE TOP
Your Visual Guide to Hole’s Human Anatomy & Physiology
9
Begin Your Journey
Muscular System
C h a p t e r
with a climbing guide to chapter concepts. Build Your
Chapter Objectives provide a glimpse Chapter Objectives UWnodredrsstanding A&P
anhaerraadti tvoe .i mportant sections of the Afte1r. yDoues hcraivbee shtouwdi ecdo ntnheisc tcivhea ptitsesru,e y iosu p sahrto oufl dth bee s tarbulcet utroe of a calat-,imnseotemmrcbearthlaanitnoegud s idn bissaeknr—tde dth:at Vocabulary
skeletal muscle. connects cardiac muscle
2. Nfuanmctei otnh eo mf eaajcohr ppaarrtts. of a skeletal muscle fiber and describe the erg-,wcthoealrlkts :w. soyrnkesr gtoisgte—thmeru wscilteh a
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mechanism, how oxygen debt develops, and how a muscle may -gram,something written:
become fatigued. myogram—recording of a stems, prefixes, and
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body movements and help maintain posture. muscle cells. origins. Knowing the
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muscle cell.
reticul-,a net: sarcoplasmic understand newterms.
reticulum—network of
membranous channels
within a muscle fiber.
sarco-,flesh: sarcoplasm—
substance (cytoplasm)
within a muscle fiber.
syn-,together: synergist—muscle
that works with a prime
mover to produce a
movement.
tetan-,stiff: tetanic contraction—
-troph,well fed: muscular sustained muscular
hypertrophy—enlargement contraction.
of muscle fibers. -tonic,stretched: isotonic
voluntar-,of one’s free will: contraction—contraction
voluntary muscle—muscle during which the tension
that can be controlled by of a muscle remains
conscious effort. unchanged.
Connect to Real-Life
297
Stories L ike many things in life, individual muscles aren’t appreci- Children with Moebius syndrome are slow to reach developmen-
ated until we see what happens when they do not work. tal milestones but do finally walk. As they get older, if they are lucky, they
For children with Moebius syndrome, absence of the are left with only one symptom, but it is a rather obvious one—inability to
sixth and seventh cranial nerves, which carry impulses form facial expressions.
that introduce each topic. These vignettes, forodmd ctohlele cbtrioanin otfo s ythmep mtoumssc.les of the face, leads to an rare coAn dyiotiuonng w lahdeyn nsahme eudn dCehrwelesnety tTwhoo msuarsg ecraiellse dth aattt ewnotiuolnd teon tahbisle v heeryr
The first signs of Moebius syndrome are typically difficulty suck- to smile. In 1995 and 1996, when she was 7 years old, Chelsey had two
taken from headlines and scientific journal ing, excessive drooling, and sometimes crossed eyes. The child has dif- transplants of nerve and muscle tissue from her legs to either side of her
ficulty swallowing and chokes easily, cannot move the tongue well, and mouth, supplying the missing “smile apparatus.” Gradually, she ac-
reports, extend your view into chapter is very sensitive to bright light because he or she cannot squint or blink quired the subtle, and not-so-subtle, muscular movements of the mouth
or even avert the eyes. Special bottles and feeding tubes can help the that make the human face so expressive. Chelsey inspired several other
content. child eat, and surgery can correct eye defects. youngsters to undergo “smile surgery.”
The three types of muscle tissues are skeletal, smooth,
and cardiac, as described in chapter 5 (pages 160–161).
This chapter focuses on the skeletal muscles, which are
usually attached to bones and are under conscious control.
Anchor Your Structure of a Skeletal
Muscle
Understanding A skeletal muscle is an organ of the muscular system. It
is composed primarily of skeletal muscle tissue, nervous
tissue, blood, and connective tissues.
Connective Tissue Coverings
of anatomy and physiology with key terms Amnu sicnldesiv ainddu ahle sldk eilne tpaol smitiuosnc lbey i sla yseeprsa roaft edde nfsreo mco nadnjeaccteivnet
tissue called fascia(fash′e-ah). This connective tissue sur-
and their phonetic pronunciations. The rounds each muscle and may project beyond the end of its
muscle fibers to form a cordlike tendon.Fibers in a tendon
bold face terms found throughout the intertwine with those in the periosteum of a bone, attach-
ing the muscle to the bone. In other cases, the connective
narrative are key to building your science tciaslslueeds aapssoonceiuatreods ewsi(tahp a″ om-nuus-crloe′ sfeo¯zr)m, wbrhoiacdh, mfibaryo uatst aschhe ettos
vocabulary. the coverings of adjacent muscles (figs. 9.1 and 9.2).
A tendon, or the connective tissue sheath of a tendon
(tenosynovium), may become painfully inflamed and
swollen following an injury or the repeated stress of ath-
letic activity. These conditions are called tendinitisand
tenosynovitis,respectively. The tendons most com-
monly affected are those associated with the joint cap-
sules of the shoulder, elbow, hip, and knee, and those
involved with moving the wrist, hand, thigh, and foot.
Keep Your Eyes Peeled The layer of connective tissue that closely sur-
rounds a skeletal muscle is called the epimysium.An-
other layer of connective tissue, called the perimysium,
extends inward from the epimysium and separates the
muscle tissue into small sections. These sections contain
for boxed informationthat connects buulin).d Eleasc ho fm skueslceltea lf imbeur swcliet hfiinbe ars f acsaclliecdle f(afsacsiccilceuslu(fsa)s cliiecs- Figure 9.1
chapter ideas to clinical situations, wcoivtheirnin ag claaylleerd o efn cdoonmnyecsituivme (tfiisgssu.e 9 i.2n athned f9o.r3m). Loaf yae rtsh ionf Tmeunsdcolenss taot toatchhe rm muuscscleles st.o bones, whereas aponeuroses attach
discusses changes in organ structure and 298 Unit Two
function, and introduces new medical
technology or experiments.
Shier−Butler−Lewis: Front Matter View from the Top © The McGraw−Hill
Human Anatomy and Companies, 2001
Physiology, Ninth Edition
V
IEW FROM THE TOP
Your Visual Guide to Hole’s Human Anatomy & Physiology
Cross-bridges Actin filament
Myosin filament
Troponin Tropomyosin Myosin molecule Actin molecule
Figure 9.6
Thick filaments are composed of the protein myosin, and thin filaments are composed of actin. Myosin molecules have cross-bridges that
extend toward nearby actin filaments.
with the sarcolemma and thus contain extracellular fluid.
Each transverse tubule lies between two enlarged portions Actin, myosin, troponin, and tropomyosin are abundant
of the sarcoplasmic reticulum called cisternae,and these in muscle cells. Scarcer proteins are also vital to mus-
three structures form a triadnear the region where the cle function. This is the case for a rod-shaped muscle
actin and myosin filaments overlap (fig. 9.7). protein called dystrophin.It accounts for only 0.002%
of total muscle protein in skeletal muscle, but its ab-
sence causes the devastating inherited disorder
Duchenne muscular dystrophy, a disease that usually
Although muscle fibers and the connective tissues as- affects boys. Dystrophin binds to the inside face of
sociated with them are flexible, they can tear if over- muscle cell membranes, supporting them against the
Reinforce Your sist rceatcllheedd a. Tmhuiss ctylep es toraf iinn.juTryh eis s ceorimoumsonne sins aotfh tlehtee sin ajunrdy pmoinwueterf ualm foournctes ooff cdoysnttrroapchtiino,n m. Wusictlheo cuet lles vbeunr stth aensde
depends on the degree of damage the tissues sustain. die. Other forms of muscular dystrophy result from ab-
Mastery Ifna sac ima irlde mstarianins , inotnalyc ta, afenwd mlittules cfluen fcibtieorns iasr elo isntj.u Irne da, sthee- natotarmchaelsit.ies of other proteins to which dystrophin
vere strain, many muscle fibers as well as fascia tear,
and muscle function may be lost completely. A severe
strain is very painful and is accompanied by discol-
oration and swelling of tissues due to ruptured blood The Sliding Filament Theory
of chapter content by answering vaerastseedls t.i sSsuuregse.ry may be required to reconnect the sep- Ttahl em suasrccloems.e Treh iiss icso bnesciaduesreed c othnetr afuctnicotnio onfa aln u ennitt ioref sskkeellee--
the review questionsfound at tal muscle can be described in terms of the shortening of Watch for Signs
sarcomeres within it. According to the sliding filament
the end of major sections of the 1 Describe how connective tissue is associated with a tmheenortsy ,dwo hneont tshaercmosmelevreess cshhoanrtgeen ,l etnhget hth. iRcka thanerd, tthhieny fjiulast-
narrative. 32 sDEkxeepsllceartiianbl ewm thhuyes c sglkeee.nleetraall msturuscctluer feib oefr as askpepleeatar l smtruiastcelde. fiber. swoglicioacdrnuedsr psto,ha fets ht o ceove neHnretl eazarpon n oowfet hsti hdeareen, n dsw,a itrathcnhoed mt Ih tebher aeetn h Zfdirn sol mifgniel eatb smon tmaehrn oretovsnwe md ecsor.l, ov Atsihnese rgt htrtooeis--- directing you to exciting
4 Explain the physical relationship between the gether, shortening the sarcomere (fig. 9.8). animations found in the Online
sarcoplasmic reticulum and the transverse tubules. Neuromuscular Junction Essential Study Partner.
Each skeletal muscle fiber is connected to an extension (a
Skeletal Muscle nerve axon) of a motor neuron(mo′tor nu′ron) that Processes come alive and help
Contraction passes outward from the brain or spinal cord. Normally a
A muscle fiber contraction is a complex interaction of sak meloettoarl nmeuusrcolne. fiber contracts only upon stimulation by you navigate through complex
several cellular and chemical constituents. The final re- The site where the axon and muscle fiber meet is
sult is a movement within the myofibrils in which the called a neuromuscular junction(myoneural junction). concepts.
filaments of actin and myosin slide past one another, There, the muscle fiber membrane is specialized to form a
shortening the sarcomeres. When this happens, the mus- motor end plate,where nuclei and mitochondria are abun-
cle fiber shortens and pulls on its attachments. dant and the sarcolemma is extensively folded (fig.9.9).
302 Unit Two
Sarcomere Sarcomere
Z line HA zboanned Z line A band
Z line H-zone Z line
Actin filaments 1) Relaxed Myosin filaments There Are No Boundaries
when it comes to illustrations, photographs,
and tables. The art is designed and placed to
2) Slightly contracted
help you visualize structures and processes,
to clarify complex ideas, to represent how
structures relate to each other, to summarize
sections of the narrative, and to present
(a) 3) Further contracted (b) pertinent data.
Figure 9.8
When a skeletal muscle contracts, individual sarcomeres shorten as thick and thin filaments slide past one another (23,000×).
In September 1985, two teenage tourists from Hong Kong ing and, eventually, breathing. Fortunately, physicians can
went to the emergency room at Montreal Children’s Hos- administer an antitoxin substance that binds to and inac-
pital complaining of extreme nausea and weakness. Al- tivates botulinum toxin in the bloodstream, stemming fur-
though doctors released them when they could not ther symptoms, although not correcting damage already
identify a cause of the symptoms, the girls returned that done.
night—far sicker. Now they were becoming paralyzed and Prompt treatment saved the touring teens, and astute
had difficulty breathing. This time, physicians recognized medical detective work led to a restaurant in Vancouver
symptoms of botulism. where they and thirty-four others had eaten roast beef
Botulism occurs when the bacterium Clostridium botu- sandwiches. The bread had been coated with a garlic-but-
linumgrows in an anaerobic (oxygen-poor) environment, ter spread. The garlic was bottled with soybean oil and
such as in a can of food. The bacteria produce a toxin should have been refrigerated. It was not. With bacteria
that prevents the release of acetylcholine from nerve ter- that the garlic had picked up in the soil where it grew, and
minals. Symptoms include nausea, vomiting, and diar- eight months sitting outside of the refrigerator, conditions
rhea; headache, dizziness, and blurred or double vision; were just right for C. botulinumto produce its deadly
and finally, weakness, hoarseness, and difficulty swallow- toxin.
304 Unit Two
Shier−Butler−Lewis: Front Matter View from the Top © The McGraw−Hill
Human Anatomy and Companies, 2001
Physiology, Ninth Edition
9.1
Clinical Application
Extend Your View
Myasthenia Gravis
Ionf athne a buotodiym. mInu nmey adsistoherdneiar, gthraev iism m(MuGn)e, tshyastt epmar ta titsa cthkes npearr-t tcMhoiGnrdd icmtiaoannin . tlTaivoinedi nangy,e oamrr o-imnstop rprmoevoaipnl lgel i vtwheeitsihr, into fascinating Clinical Applicationsfound
vous system, particularly receptors for acetylcholine on muscle cells at neuro- thanks to a combination of the fol- throughout the chapters. Explore information on
monues-cthuilradr tjhuen cntoiormnsa,l nwuhmebree rn oefu arocne tymlceheotlsin me uresccelep tcoersll .a tP tehoepslee jwunitcht ioMnGs. Ohanv ea low•ingDa ctrrueegtaystlc mthheoanltit nisne:hsitbeirtase, which related pathology, historical insights, and
whole-body level, this causes weak and easily fatigued muscles. boosts availability of technological applications of knowledge in anatomy
acetylcholine.
MG affect hundreds of thou- affected facial and neck muscles. Many •Removing the thymus gland, and physiology.
sands of people worldwide, usually have limb weakness. About 15% of pa- which oversees much of the
women, beginning in their twenties or tients experience the illness only in the immune response.
thirties and men in their sixties and muscles surrounding their eyes. The •Immunosuppressant drugs.
seventies. The specific symptoms disease reaches crisis level when respi- •Intravenous antibodies to bind
depend upon the site of attack. For ratory muscles are affected, requiring a and inactivate the ones causing
85% of patients, the disease causes ventilator to support breathing. MG the damage.
generalized muscle weakness. Many does not affect sensation or reflexes. •Plasma exchange, which
people develop a characteristic flat Until 1958, MG was a serious rapidly removes the damaging
smile and nasal voice and have diffi- threat to health, with a third of patients antibodies from the circulation.
culty chewing and swallowing due to dying, a third worsening, and only a This helps people in crisis.
There’s No
on the actin filaments, allowing linkages to form between and over, as long as ATP is present and nerve impulses
myosin cross-bridges and actin (fig. 9.11b). cause ACh release at that neuromuscular junction.
Escaping the Fact
Reconnect to chapter 2, Proteins, page54
Relaxation
Cross-bridge Cycling When nerve impulses cease, two events relax the mus-
The force that shortens the sarcomeres comes from cross- cle fiber. First, the acetylcholine that remains in the
c(pwppB“l(tebbsrt99hhaelncrror.hrith..loeeioigie11eseda1d rinschiad2a2c sts1tggkgdktsie dhba-Me4l oeeetbodr.)y) tso)dn, cc ,rwhyo , aT cioa s”t tpeocdwpnhn(tahtm h 9oursagudpe namnaiitl.nleenl on1htsyi l lr tp gua i s2zi oereibpnhnruicstasea ,ftreart gct rgc lsi)eaoesclfoaAlo. tas iehntcot,vocsnrT hkiT hno,sinstnta (sehdh-itPrc 9( b ottfifedtceotb. hreisirho1nso pmgleor ineaa 2 eedcc. lwu it camebcr akrangh9tttaenoni)kecesigheen..slsnd d 1t s n teeieisaWt t2oh nfn-dta hhfccocbwa,wei s hoeertrlfrfa) feoiaiicAn n.ieirnltn ldsmmsseno ahtWaTdaso ag mm me-yreb fPfieaabphco nnnoie n nAerouternctt nseioono hmntyTldidtrtmt hlttne.c orhPgg hsei eaea l wTenu.ye reea gt ct erruhs ge moAcaara m(cn bretir otaAs iAnnlusdtnizsnnmeaeaniT s y sDy( tedt cttcdf-oyPmecbhh h P ilbi roo gc ieteente reenahb.hnsa h sigp nihiiducn9de taA snneretes.dsi dg p1ocaadn Tni ase tcotc1 tssgdpttebP earhtice,) o hi mieoa.crkrfsconotvou n tssihearui noe4tsesrtddnneear-f----,., sasTnftfqrtttpCmahhhiiheyynucreobbhatieeienndreinieesser cvvcata rri scs rkayeeuzp. speaayeSlln celtlsqrscslyteiecuestaecooemut cip hamx ois mn teoasor)opoalihgn,en,enesnotl l ue qits. mdiaddv a o llr.nun,ysoT me ennam ioeeT,dwscfhpyr. asn reah t eifhacjteh ts cdore elptofef(tPTchalfarctaea oeofoeereecor hl aoAxrflreensihnol ngmmpr cyg o′cogoanepiteratteo meTsd a indto esuhxyAt slfeouv usn sjdl . Pm,nowoggaeiumcelau-csm eartCmTmt9ecbr, anns. oh-e.lsinnse eamat h b .chohrusaydtn cvehT3armTdttlnirt dor lriefomsleoo sldte9rei itbho u keha mi im nb sFhdlnsoar g dvnneepe llt elia iisrtcdcoggeeet flbnpnihp iesunsxtanaaipiandde′ea .gouar mdguobrieon to cdal dloiecebnixeTngteurcesa hnmsutlest mhsbkiahnonoiod9othitornsetsn s n(aucreeea l ptf)zs.rfi d eAotrilaigl4o c rknskl nrumoaouytyst sst f tein ha0h c a r(tfehre hsm s mbtttildi o wehs)gmseob o ht nsaneefty.i(pseo htsde i l ehaxoe gd hftin eleitl tswamcteioocm eanlethwao inipxi gofreauio kbu ssc bnno bnetuosittsrluftmi″.afs chiri t fur,o h t e gr staaib l to .c(oehtTt pre cc rnavoeutopesl hearororanIh niolidtraae toetttaselnlunkfieksioceeso ,annbecz s rnkqnda m -aet rstita a yldtneac(aushttrges nmorenfiielnrhsminton e innc te roei necsnitgte salaarenuno′ 9tm rundehmolm)ae d.uestfel apdsut, .seggo e n msm 1orrsutc9et eili de csrw o aii.obg wtalonmpl.-to sooiAuuxa ceet1suueuhysTvhnhpl onrlntu st s1bmssTta sesteilhj.iaegdavcc ht. mo a oeh)ect r wPfiotesnllli eeIo(alrTi h)tnndooeeeecst ea)fn-t .,,.stro g ehhno tksisda aaesee ofi hsrt sier tf -nhidoeahttlasstshreavelu sceceeo xoe d eetnr ssbciis ifrnfsni′o naoaft sd fdir ntctcfenorbpoherhseksmor uo nu e e omotmoool gisd oafffufffh t r i . cos ottjttttttia″hh hhIhhhhnentiı˘leeeeeeeegsss-t- ltbf(beiaaeaf(uhffooonsxrnyeiiranse rggttkd mt elm w..m,hlla nea999m neaesAPe sts... tned e444oahoahcssrnd01n 2rlsea iahtl ))t c)sialhelr..e.tecnh k teohersPohaaee ti lienefittsonlducn hh pr era aesmofalteusslo. yoncco ssreI, aswfueft ftdo ouonaoat ltreeairnnuhrpleian v mud etsrpltcte de t s eh otoar,tfomr,en etinra nennfsnpt sdtkana i saidcrntlltosne oichelhoccscaneavu enieri(t cosdilof a o duaif lteas tfgouhpilh is,rc.nao ntseica aaoh.9ng t h st n,a.eAt gvf s4 isl nnpa baioenh0stsnedairxfoh)tesacs i.eg oleaio tstter sr th aheiu.bt htfon herssreseTsero d e nlibtfhncr f ynioleoeenfeat,a oih ragslapbtfo tceeitiocutl fnhoa rearu( lran dnfn ntaeleilhtue s d ttgxhmteiaa umsoahne osr.smnaa ea f flrn9wsc f allpuo ltu.ekenaoeh4lnoxolletlnd0eaes---tl, tBsrtSethhheynepleaesdcaa tt aftcs enuae uhmo gdnsCafi secn nch s tahggoeiaroe avuniesnnser g i irgsaonenape rstlgpsege , cacaorifhrnrionffte a uis olocop antan fthttd neeeoler idd arfis se,nt,o ..aftc rlLhghguiieaanefnrengt--ce
306 tflheex ebso tdhye floegrw aat rtdh ew khneene (af igpUse.r n9so.i4tn0 Twanwadlko 9s. 4o1r) .runs. It also Life-Span Changes particular organ systems.
Signs of aging in the muscular system begin to appear in
one’s forties, although a person usually still feels quite
Strenuous athletic activity may partially or completely energetic and can undertake a great variety of physical
tear the calcaneal (Achilles) tendon. This injury occurs activities. At a microscopic level, though, supplies of the
Learn the Ropes mplaoys ts fproeqrtus etnhtalyt iinnv omlvided qleu-iacgke md oavtehmleetensts w ahnod rduinre co-r mAToPle,c aunleds ctrheaatt inene apbhleo smphuastcel—es dteoc lfiunnec. tTiohne— dmiaymoegtleorbs inof,
tional changes. A torn calcaneal tendon usually re- some muscle fibers may subtly shrink, as the muscle lay-
quires surgical treatment. ers in the walls of veins actually thicken, making the ves-
sels more rigid and less elastic. Very gradually, the
muscles become smaller, drier, and capable of less force-
and reconnect to key The soleus(so′le-us) is a thick, flat muscle located ful contraction. Connective tissue and adipose cells
beneath the gastrocnemius, and together these two mus- begin to replace some muscle tissue.
concepts found in previous ctilbeisa faonrmd ftihbue lcaa, lafn odf itth eex lteegn.d Ts htoe tshoele huese al rbisye ws afryo mof tthhee are mBuyc ha gme o8r0e, neoffteicctesa bolfe .a gNineagr loyn htahlef mthue smcuulsacr lesy mstaesms
calcaneal tendon. It acts with the gastrocnemius to cause present in young adulthood has atrophied, particularly if
chapters that promote your plantar flexion of the foot (figs. 9.40 and 9.41). the person is relatively inactive. Aging affects the inter-
The flexor digitorum longus(flek′sor dij″ı˘-to′rum play between the muscular and nervous systems. Decline
understanding of new long′gus) extends from the posterior surface of the tibia in motor neuron activity leads to muscle atrophy, and di-
to the foot. Its tendon passes along the plantar surface of minishing muscular strength slows reflexes.
information. the foot. There the muscle divides into four parts that at- Exercise can help maintaining a healthy muscular
tach to the terminal bones of the four lateral toes. This system, even among the oldest of the old. It counters the
muscle assists in plantar flexion of the foot, flexion of the less effective oxygen delivery that results from the de-
four lateral toes, and inversion of the foot (fig. 9.41). creased muscle mass that accompanies age. Exercise also
maintains the flexibility of blood vessels, which can de-
Invertor crease the likelihood of hypertension developing. How-
The tibialis posterior(tib″e-a′lis pos-te¯r′e-or) is the deep- ever, a physician should be consulted before starting any
est of the muscles on the back of the leg. It connects the exercise program.
fibula and tibia to the ankle bones by means of a tendon According to the National Institute on Aging, exer-
that curves under the medial malleolus. This muscle as- cise should be of two types—strength training and
sists in inversion and plantar flexion of the foot aerobics—bracketed by a stretching “warm up” and “cool
(ETitfshihv egaee . llr9epot.g4one.r1gr oI),. tns cetrouansp nl(iefkicbetu sm ltauhrseisc )tliebl olioan cgaauntsedd ( ptohener ″tfohi-benu ella′aut estr oal olt hnsegid′ gfeou oost)f dmcatiaml oenumpwscs.oaec ncrS.l .teht”Ta ri nhesnSttnie rtsgta r otteiihhn ntvc ac,ta htrrwr eaiywanih nsgotieihl rnseiek ng msi rssicoPc mcnoyouusxreousmepmryspsnthtactegiripoestslacoenuei mtepinvseoo tfstsmi eiemfs ns cu df toa rtgsltoh hesm ie fteltscobx eoih uwozfl ib aa obspmasneeotcotti rsidsirmlltedgtoetihe shet snte“seysfoctt ns lur haaisboedladrrgaiiywnsetnfnemah t g d giimsotrennet hh iofn agustdfo,m int e sseau aotcdc.ucalhnlr tll d rs A”ee dsurec m ste eaolbsj riesroistfueaeo in eignnssiiebngsssi--dgxinttce s hp r,a ec rfwtxiotrseevahirrnii icndcagiei h sntpse h g,em ee,r wn saimodmyhnuu ipcl rseirhacsosn u svtacleheacenesr-. mfmibyurasoclsguimdwditlayiiaiussstr(ehstm( arcdf oimsliy″ee-pbsa a hwitrlnsr′oij eoyne-aap s -lfpkiasih′bhorntyioe )esctr(s)eamssil,P n luaeIea.nnssdi′pndfk lme auracme-utilrsasamoulcrpll uaytdhitl niiayisonrg ′nc t rtrfa hhroouoee-fsfm u ceemmo)d aun anbsntPyyciersl cdmoemt geifu.rfvaiesseccsc isutieiialnsva.s terTuehsis
348 stiyvset ermep aosr to fneew gerro bwosu tosUl dwenirti hits d oTenpw rmeososoido—n.those who are ac- myastdchhiesaneriaaasc etg erorariv zdeisids( ombrydi ″emars.u-sthclee′ns et-haaht garraev w′ies)ak Canhdro enaisci ldyisease
fatigued. It results from the immune system’s attack on
EUxnpdaenrds tYaonudring Ctccefioolbennorclitvtlrrula oarortilcieemsttfstnis cisuvooiyousahnrnorteeridagi(s(noif(rck.enikaucu″ogpebsna n hrt-tvhi-voMy-toelru llta(a ulhee′k′s-lnseu ′hleht teTscuua¯ukttrrnsrrn″)yeiet))c rtmccoaChl-rSuS moicpusennhciormgd-alino eeilnogttssafgis′. oroneaaansfe h m oiti-nRrhnufueva ssw)ot c c elolhoSuecTinn.ccletthuyrcaa rhrat cyhinstn eiico tqromtenun sueeits e rsof acgofdclrrmeteiaotns mmmmmmmppshaayyyyyyyirrnoooooooae stklmptslsoooiyiyantptsngamrsimtelaysiih(i(uysanpnmiy((ramsa(mt((opsmim(mh(-mmiiamo(-″-iiishroot′-i″uemhito--ol-″eos′r′sits-oocaadn′pitio-u′-hlos ′′tkj′-fa)ilı′e)˘smrinsah-)op′s)mre-emil PtT-sji)haeunSa) uIh-emnrnttam)stu)Ccfhio)Lldatuo)atiolyoArtPom st So rncrinosP mrnooon sfy eolrg smea mosrefl muts ooinnpaiguir fougesbotoh shmntessisnctelsdcae linsuo puted to m ftysatsls n ocao r.sqtut ali rkfuotmem slhedm iy cmtlveuuisuieu sessiloftlesrisscraav i aoucllaronees ln ermfegs e e .atfp t. ituo honbabifssfesoeo csa mrttdmulh semy..eeu .t upsilsecsasgclruet ld.ese..u.e
individual muscle fibers, producing rapid and to straining the anterior leg muscles, often as a result of
of medical terminology.Brush up on phonetic fibrosiusn(cfio-obrrdoi′sniast)edD aecgtievnietyra wtiivteh idni sae amsue sicnl ew.hich connective torticowllailsk(itnogr ″utı˘p-k aonld′i sd) oCwonn dhiitlilosn. in which the neck muscles,
tissue with many fibers replaces skeletal muscle tissue. such as the sternocleidomastoids, contract involuntarily.
pronunciations and definitions of related terms It is more commonly called wryneck.
often used in clinical situations.
Shier−Butler−Lewis: Front Matter View from the Top © The McGraw−Hill
Human Anatomy and Companies, 2001
Physiology, Ninth Edition
V
IEW FROM THE TOP
Your Visual Guide to Hole’s Human Anatomy & Physiology
Marvel at the Dynamic
Interactions
of body system organs. The InnerConnections’illustrations,
found at the ends of selected chapters, conceptually link the
highlighted body system to every other system. These graphic
I n n e r C o n n e c t i o n s representations review chapter concepts, make connections,
Muscular System and stress the “big picture” in learning and applying the
concepts and facts of anatomy and physiology.
Integumentary System Lymphatic System
The skin increases Muscle action
heat loss during pumps lymph
skeletal muscle through lymphatic
activity. Sensory vessels.
receptors function
in the reflex contol
of skeletal muscles.
Skeletal System Digestive System
Bones provide Skeletal muscles
attachments that are important in
allow skeletal swallowing. The
muscles to cause digestive system
movement. absorbs needed
nutrients.
Nervous System Respiratory System
Neurons control Breathing depends
muscle on skeletal muscles.
contractions. The lungs provide
oxygen for body
cells and eliminate
carbon dioxide.
Endocrine System Urinary System
Hormones help Skeletal muscles
increase blood flow help control
to exercising urine elimination.
skeletal muscles.
Cardiovascular System Reproductive System
Blood flow delivers Skeletal muscles
oxygen and nutrients are important in
Muscular System and removes wastes. sexual activity.
Muscles provide the force for moving
body parts.
The Online Learning Center is your link to electronic learning resources that will help you review and understand the chapter content.
Chapter 9: Muscular System
Visit the Student OLC on your text website at: http://www.mhhe.com/shier
350 Unit Two
Meet the Challenge
Go to:
•Chapter Quiz Visit selected websites and link
•Flashcards to activities that reinforce
Climb Online •Concentration anatomy and physiology topics.
•Labeling Exercises Webquest sites were previewed
•Crossword Puzzles and selected by laboratory man-
(cid:1)•Webquest ual author and teacher, Terry R.
Martin.
and connect to the electronic learning Connect for Success
resources that give greater depth to chapter Go• toC: hapter Overview Use the study outline and get a
(cid:1)•Study Outline firm hold on chapter content.
content. Found at the end of every chapter, •Student Tutorial Service Master the art of “learning how to
•Study Skills learn” by using these great online
this link to the Online Learning Centeris •Additional Readings tools.
•Career Information
a “site to see.”
Link to Online Resources
Go to:
•Internet Activities Action is the name of the game.
•Weblinks Watch muscle contraction action
•BioCourse potential and the crossbridge
(cid:1)•Animation Activities cycle.
•Lab Exercises Answer the quiz questions and
•adam Online Anatomy check your results.
•Essential Study Partner
Anchor Your Knowledge
Go to:
•Human Body Case Studies View tissue samples from the on-
•Chapter Clinical Applications line histology site.
•Chapter Case Studies Compare the intricate structures
•News Updates of smooth, skeletal, and cardiac
(cid:1)•Histology muscle tissue.
•Cross-Sectional Miniatlas
Chapter Nine Muscular System 351
Shier−Butler−Lewis: Front Matter View from the Top © The McGraw−Hill
Human Anatomy and Companies, 2001
Physiology, Ninth Edition
Complete Your Journey
Chapter Summary
with a focus on the Chapter Summary. Introduction (page 298) b. Linkages form between myosin and actin, and the
Use this outline for review and as a tool for Tcahred itahcr.ee types of muscle tissue are skeletal, smooth, and asacrticno mfilearme.ents move inward, shortening the
organizing your thoughts. S(ptarugec t2u9re8 )of a Skeletal Muscle S(pkaeglee t3a0l 6M)uscle Contraction
Svak1re.iloeutbCacas...lo cnmonctFOFnuieeaasntslcsshscleucctselciii eevrwaat sie ctv ciih aostteohari n psvettins i enaecsuerr xsosctetuht m t oeecieevnfapos cemd,avo h asestcu i serostss idhkwsnmc urelgoeoeplesfle’usl lstne g aasxsehlust r or nmrvsuurekoouctteu uwtstluschneo,rlt edeerva k ..lbac someocdlfluu yscls .oaacnrnl,en da et nigcsdrtsoiuvueep.s of Mac1uti.snc labCaen.. rfdoib smscaaATseiacn-hrt ybntmed eicor v atioypsbhedninour negdbestlne raili fa np n ikcarcl uddeyagctlliimacorlenooilw anionegsnsn nn.s serg-t ie b.osttths erhftui e heAdfl u atagaTstrcec tPtfs hticr hinroenaoe rmn flr aid etl naeaaaotdns mtwsae slccs enito dhnh emti tnehtn.o beegmT ir aanhgmuncyeest o aciwtmvnhcleei tyafti mtiohfn lisp ae babimnrenniortn oe v.hodntiehfditan,eedrgs
2. Skeletal muscle fibers the repetition of the cross-bridge cycle.
a. Each skeletal muscle fiber is a single muscle cell, 2. Relaxation
dbcegf...... wrcaammiMTTCTWoenachhrrhtnyouuthoadieeiiolscsnsesn ce Mcsuecasnsr hcil-fsyrevl nuebi ru amtiells a lros aimffrteifnn iiopmrsditsblibge,ehvla ga eeiae.e aeemet)ntrnsmrniu sstm toute d iebhesaonsnnr u .enr fmcs fitae Tletts.omite r ynh o(ocnpserIoyhyffe et re bfoaw liostcirxibhiastbovenni,tiinet rnaietndsthdi dicnrt al ro mreofstsidclniai,c siplto o inc .aaiZfottnfntrklmoh ino a loaccbeaiimecghnen nennbtelo.t ei dlatt wannssfsh sno, m deie wafdrAseo rnmy c iinrf tdtaoebomrh a, lsaoar tml i sc ipmn lncomatiyodoi nrnafnomecsnink.s, lmo t aayCayirHpnngm aboanle .dcrslazeuscatisoi nnincmwountlensemeiitci.h. 3. bbEacac......nerdctmseATCACAgryonehrraycTcunnoecen eetPssaotrist tshcvigomst ympnsily-eeulneubouuc s.pr merprihofcsoizt icpeudpoeubselsldelsghes ei iA dec refon sbof ls tTsrielebari beip tmPs cynrlhech kea kdroueaaamx aen sicrlteenga epeeatisnert tlttei.sioaay esnnoitxc rlsoibtndcgtne hrirdh y segooeue e os n waffpics l onkeaiaoohrn n rnm atmecmeehn noscpruedu tgpeo ces ysslladcsrlyca aeulltolnscehsdel mi aeana .fufp,ritoii mb cpbsrtcee eera rrr iesreeni.op vstfc nio eiborcrsnreauan m tpatlutiirurin—osedamgencltdy th.fi oeotorn.
into the cytoplasm and are associated with the 4. Oxygen supply and cellular respiration
cisternae of the sarcoplasmic reticulum. a. Anaerobic respiration yields few ATP molecules,
3. The Sliding Filament Theory whereas aerobic respiration provides many ATP
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Your Route to Success 6. Excimtaetiaonns coof nthtrea ctrtiaonns vceoruspe ltiunbgules. 7. Ha.eatM puroscdluecs trieopnresent an important source of body heat.
a. tAo mreulesacslee cimalpciuulmse isoignns.als the sarcoplasmic reticulum b. lMosots at so fh tehaet. energy released by cellular respiration is
in the Health Critical Thinking Questions
352 Unit Two
Professions 1. Why do you think athletes generally perform better if or substances that dilate blood vessels help relieve such
they warm up by exercising lightly before a competitive soreness?
event? 5. Several important nerves and blood vessels course
2. Following childbirth, a woman may lose urinary control through the muscles of the gluteal region. In order to
(incontinence) when sneezing or coughing. Which avoid the possibility of damaging such parts,
muscles of the pelvic floor should be strengthened by intramuscular injections are usually made into the lateral,
requires more than the memorization of 3. eWxheract isstee ptos hmeilgph ct obnet rtoakl ethni sto p mroibnliemmi?ze atrophy of swuopuelrdio hr eplpo rytiooun loofc tahtee tghluist emuus smcleed iinu sa. pWahtiaetn lta?ndmarks
skeletal muscles in patients who are confined to bed for 6. Following an injury to a nerve, the muscles it supplies
facts. The Critical Thinking Questionsat prolonged times? with motor nerve fibers may become paralyzed. How
the end of each chapter apply main 4. amAcsut islvacecl etmi cmu aasccyil defe ,a etnlh dseo yor tseht.i eHmr ouswulab tmset iapgnahcitne ts hr eaecc aecppuptmolirucsla,a tatieno dnin to hafn eheat wtehleoecu dtlridisc ayaboll uset deim xmpuullasaictniloe tnso ? paa pssaitvieenlyt tohre c iomntproarcttainngc et hoef mm owviitnhg
concepts to clinical or research situations
and take you beyond memorization to 354 Unit Two
utilization of knowledge.
Review Exercises
Part A 27. Compare the structures of cardiac and skeletal muscle
12.. LDiisstt itnhgeu tihshre be ettywpeeesn o fa mteunsdcolen taisnsdu ea.n aponeurosis. 28. fmCibouemsrcspl.aer ceo tnhter acchtaiorancst.eristics of cardiac and skeletal
Check Your 34.. mDDeiusstscicnrligebu.ei sthhe a cmoonnnge cdteiveep tfiassscuiea ,c souvbecruintagns eoof uas s fkaeslceitaa,l and 2390.. DDiesftiinneg upirsimh eb emtwoveeern, asy mneursgcilset’,sa onrdig ainn taangdon iitsst .insertion.
subserous fascia. Part B
Understanding 56.. dLDeiessstcc trrhiibbee em taha nejo efruu prnoacmrttisou nosc fo uafl asekra ecjulhen tpcaatli rmot.nu.scle fiber, and Mfunatccthio tnhse i mn ucosclulems nin I Ic.olumn I with the descriptions and
7. Define motor unit,and explain how the number of fibers I II
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25. Define peristalsisand explain its function. U.Largest muscle in the body
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Physiology, Ninth Edition
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Link to the Online Learning Center (www.mhhe.com/shier) and Connect to
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Physiology, Ninth Edition
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Navigate through online dissection with adam Online Anatomy
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Physiology, Ninth Edition
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