Seeley's Anatomy & Physiology, 10th edition

1272 Pages·2013·223.48 MB·english

by  Cinnamon VanPutte

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Seeley
THE

LEARNING Teaching students HOW to think
SYSTEM
anatomy & physiology
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An Interactive Cadaver my Course Content
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Dissection Experience g Maximize effi ciency by studying
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designed to help you master human g Your instructor selects the content
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g Content customized Dissection
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g Stunning cadaver specimens structures beneath the surface.
g Vivid animations Animation
g Lab practical quizzing g Over 150 animations make anatomy
and physiology easier to visualize
and understand.
Histology
g Study interactive slides that
simulate what you see in lab.
Imaging
g Correlate dissected anatomy
with X-ray, MRI, and CT scans.
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Brief
Contents
PART 1 PART 4
Organization of the Human Body Regulation and Maintenance
1 The Human Organism 1 19 Cardiovascular System: Blood 637
2 The Chemical Basis of Life 24 20 Cardiovascular System: The Heart 665
3 Cell Biology 56 21 Cardiovascular System: Blood Vessels and Circulation 709
4 Tissues 101 22 Lymphatic System and Immunity 769
23 Respiratory System 811
PART 2 24 Digestive System 858
Support and Movement 25 Nutrition, Metabolism, and Temperature Regulation 912
5 Integumentary System 139 26 Urinary System 946
6 Skeletal System: Bones and Bone Tissue 163 27 Water, Electrolyte, and Acid–Base Balance 988
7 Skeletal System: Gross Anatomy 191
8 Joints and Movement 239 PART 5
9 Muscular System: Histology and Physiology 265 Reproduction and Development
10 Muscular System: Gross Anatomy 309 28 Reproductive System 1016
29 Development, Growth, Aging, and Genetics 1063
PART 3
Appendices
Integration and Control Systems
A Periodic Table of the Elements A-1
11 Functional Organization of Nervous Tissue 361
B Scientific Notation A-2
12 Spinal Cord and Spinal Nerves 400
C Solution Concentrations A-3
13 Brain and Cranial Nerves 429 D pH A-4
14 Integration of Nervous System Functions 461 E Answers to Review and Comprehension Questions A-5
F Answers to Critical Thinking Questions A-6
15 The Special Senses 500
G Answers to Predict Questions A-23
16 Autonomic Nervous System 547
17 Functional Organization of the Endocrine System 569
18 Endocrine Glands 594
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Seeley’S
AnAtomy&
PhySiology
Cinnamon VanPutte
SoutHweStern IllInoIS College
Jennifer regan
unIVerSIty of SoutHern mISSISSIPPI
Andrew russo
unIVerSIty of IowA
rod Seeley
IdAHo StAte unIVerSIty
trent Stephens
IdAHo StAte unIVerSIty
Philip tate
SteVenS College
TM
van03636_ch00_FM.indd 1 12-10-12 11:03 AM
TM
SEELEY’S ANATOMY & PHYSIOLOGY, TENTH EDITION
Published by McGraw-Hill, a business unit of The McGraw-Hill Companies, Inc., 1221 Avenue of the Americas, New York,
NY 10020. Copyright © 2014 by The McGraw-Hill Companies, Inc. All rights reserved. Printed in the United States of America.
Previous editions © 2011, 2008, and 2006. 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 The McGraw-Hill Companies, Inc.,
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.
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ISBN 978–0–07–340363–2
MHID 0–07–340363–6
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Library of Congress Cataloging-in-Publication Data
Seeley, Rod R.
[Anatomy & physiology]
Seeley’s anatomy & physiology. — 10th ed. / Rod Seeley, Cinnamon VanPutte, Jennifer Regan, Andrew Russo.
p. cm.
Includes index.
ISBN 978–0–07–340363–2 — ISBN 0–07–340363–6 (hard copy : alk. paper) 1. Human physiology. 2. Human anatomy.
I. VanPutte, Cinnamon L. II. Regan, Jennifer. III. Russo, Andrew. IV. Title. V. Title: Seeley’s anatomy and physiology.
QP34.5.S4 2014
612–dc23
2012028548
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, and McGraw-Hill does not guarantee the accuracy of the
information presented at these sites.
www.mhhe.com
van03636_ch00_FM.indd 2 12-10-12 11:03 AM
About
tHe
Authors
Cinnamon L. VanPutte
Jennifer L. Regan Andrew F. Russo
Associate Professor of Biology
Instructor Professor of Molecular
Southwestern Illinois College
University of Southern Mississippi Physiology and Biophysics
Cinnamon has been teaching biology and human University of Iowa
For over ten years, Jennifer has taught introduc-
anatomy and physiology for almost two decades.
tory biology, human anatomy and physiology, Andrew has over 20 years of classroom experi-
At Southwestern Illinois College she is a full-time
and genetics at the university and community ence with human physiology, neurobiology,
faculty member and the coordinator for the
college level. She has received the Instructor of molecular biology, and cell biology courses at
anatomy and physiology courses. Cinnamon is
the Year Award at both the departmental and the University of Iowa. He is a recipient of the
an active member of several professional societies,
college level while teaching at USM. In addition, Collegiate Teaching Award and is currently the
including the Human Anatomy & Physiology
she has been recognized for her dedication to course director for Medical Cell Biology and
Society (HAPS). Her Ph.D. in zoology, with an
teaching by student organizations such as the Director of the Biosciences Graduate Program.
emphasis in endocrinology, is from Texas
Alliance for Graduate Education in Mississippi He is also a member of several professional
A&M University. She worked in Dr. Duncan
and Increasing Minority Access to Graduate societies, including the American Physiological
MacKenzie’s lab, where she was indoctrinated
Education. Jennifer has dedicated much of her Society and the Society for Neuroscience.
in the major principles of physiology and the
career to improving lecture and laboratory Andrew received his Ph.D. in biochemistry
importance of critical thinking. The critical
instruction at her institutions. Critical thinking from the University of California at Berkeley.
thinking component of Seeley’s Essentials of
and lifelong learning are two characteristics His research interests are focused on the molec-
Human Anatomy & Physiology epitomizes
Jennifer hopes to instill in her students. She ular neurobiology of migraine. His decision to
Cinnamon’s passion for the field of human
appreciates the Seeley approach to learning join the author team for Seeley’s Essentials of
anatomy and physiology; she is committed to
and is excited about contributing to further Human Anatomy & Physiology is the culmina-
maintaining this tradition of excellence.
development of the textbook. She received her tion of a passion for teaching that began in
Cinnamon and her husband, Robb, have two
Ph.D. in biology at the University of Houston, graduate school. He is excited about the oppor-
children: a daughter, Savannah, and a son, Ethan.
under the direction of Edwin H. Bryant and tunity to hook students’ interest in learning by
Savannah is very creative and artistic; she loves
Lisa M. Meffert. She is an active member of sev- presenting cutting-edge clinical and scientific
to sing, write novels and do art projects. Robb
eral professional organizations, including the advances. Andy is married to Maureen, a physical
and Ethan have their black belts in karate and
Human Anatomy and Physiology Society. During therapist, and has three daughters Erilynn,
Ethan is one of the youngest black belts at his
her free time, Jennifer enjoys spending time Becky, and Colleen, now in college and graduate
martial arts school. Cinnamon is also active in
with her husband, Hobbie, and two sons, Patrick school. He enjoys all types of outdoor sports,
martial arts and is a competitive Brazilian Jiu-Jitsu
and Nicholas. especially bicycling, skiing, ultimate Frisbee and,
practitioner. She has competed at both the Pan
before moving to Iowa, bodyboard surfing.
Jiu-Jitsu Championship and the World Jiu-Jitsu
Championship.
This text is dedicated to the students of human anatomy and physiology. Helping students develop a working knowledge
of anatomy and physiology is a satisfying challenge, and we have a great appreciation for the effort and enthusiasm of
so many who want to know more. It is difficult to imagine anything more exciting, or more important, than being
involved in the process of helping people learn about the subject we love so much.
iii
van03636_ch00_FM.indd 3 12-10-12 11:03 AM
wHAt
SetS
Seeley
APArt?
Seeley’s Anatomy & Physiology is written for the two-semester anatomy and physiology course. Th e writing is
comprehensive enough to provide the depth necessary for those courses not requiring prerCeHAqPuTEiRs 4i t  eTisss,u easnd yet1 1is7
presented with such clarity that it nicely balances the thorough coverage. Clear descriptions and exceptional
illustrationsm ceosemncbhyinmee. tToh eh e mlupc osutsu dcoennnetcst idvee vtiessluoep h eal pfis rsmup puornt dtheer stanads idnengd oritfi ct cheell sc, wohnicche lpootsk voefr ya mnuactho lmikey r eatincudla pr cheyllss iboutl oarge y
umbilical cord blood vessels between the mother and the child. cells of the immune system; macrophages; and blood cells (see
and to teach them how to use that information.
After birth, the mucous connective tissue can also be a rich source chapter 22).
of stem cells.
Dense Connective Tissue
AWdult cohnnectaive titssu e Mconsistsa of thkree teypes:s con netctihve tissiues Text
Dense connective tissue has a relatively large number of protein
proper (loose and dense), supporting connective tissue (cartilage
fibers, which form thick bundles and fill nearly all of the extracellular
and bone), and fluid connective tissue (blood).
a Markspeace. tMo stL of tehe cealls odf deveelopirng ?dense connective tissue are
Connective Tissue Proper spindle-shaped fibroblasts. Once the fibroblasts become completely
surrounded by matrix, they are fibrocytes. Dense connective tissue
Loose Connective Tissue
can be subdivided into two major groups: regular and irregular.
Loose connective tissue (table 4.8) consists of relatively few protein
Seeley Learning SysteDmens—e regEulmar cponhneactisvie sti sosune has protein fibers in the
fibers that form a lacy network, with numerous spaces filled with
extracellular matrix that are oriented predominantly in one direction.
ground substance and fluid. Three subdivisions of loose connec-
tive tissue are areolar, adiposeC, arnidt riecticaulla rT. Ahreionlark (ăi-nr ēg′ō-lăr) Dense regular collagenous connective tissue (table 4.9a) has abun-
dant collagen fibers, which give this tissue a white appearance. Dense
tissue is the “loose packing” material of most organs and other
regular collagenous connective tissue forms structures such as ten-
tissues; it attaches the skin to underlying tissues (table 4.8a). It con-
An emphasis on critical thinking is idnotnesg, rwatheicdh tchornonuegcth mouuts ctlhesi st ot ebxotnbeoso (kse. eT chhiasp taepr p9r)o, aancdh mcaonst be
tains collagen, reticular, and elastic fibers and a variety of cells. For
found in questions starting each chaplitgearm aenndts e, wmhbicehd cdoendn ewcitt bhoinne tsh toe bnoanrersa t(isveee ;c ihna pctleirn 8ic).a Tl hme actoel-rial
example, fibroblasts produce the fibrous matrix; macrophages
that is designed to bridge concepts exlpaglaenin feibde irns othf ed etnesxet cwointnhe rcetiavle- ltiifsesu aep rpelsiicsat tsitorentsc hainngd asncde ngaivreio s;
move through the tissue, engulfing bacteria and cell debris; mast
the tissue considerable strength in the direction of the fiber orien-
cells contain chemicals that hienlp e mnedd-ioafte- cihnfalpamtemr aqtiuoens; tainodn sly mth-at go beyond rote memorization; and in a visual program that
tation. Tendons and most ligaments consist almost entirely of thick
phocytes are involved in immpurensiteyn. tTsh me laotoesrei apla icnk iungn dofe rasrteaonladr able, relevant images.
bundles of densely packed parallel collagen fibers with the orientation
tissue is often associated with the other loose connective tissue
of the collagen fibers in one direction, which makes the tendons
types, adipose and reticular tis▶su eP. roblem-solving perspective from the book’s inception
and ligaments very strong, cablelike structures.
Adipose tissue and reticula▶r tiPsseude aagreo gcoyn bnuecitlidvse stitsusudeesn wt ictho mprehension from knowledge to application (Predict questions,
The general structures of tendons and ligaments are similar,
special properties. Adipose tissue (tCabrliet i4c.8abl )T cohninsikstisn ogf aqduipeosctyiotens,s , and Learn To Predict Answer)
but they differ in the following respects: (1) The collagen fibers of
which contain large amounts of lipid. Unlike other connective tis-
ligaments are often less compact, (2) some fibers of many ligaments
sue types, adipose tissue is composed of large cells and a small
are not parallel, and (3) ligaments are usually more flattened than
amount of extracellular matrix, which consists of loPorseelyd aircrta nQgeude stiotennsd ocnhs aalnledn fgoerm st suhdeeetnst os rt oba unsdes tohf etiirs suunesd.erstanding of
collagen and reticular fibers with some scattered elastic fibers.
new concepts to solve aD pernosbe lreemgu. lAarn eslwasetrics ctoon tnheec tqivuee tsitsisounes ( taarbel ep 4ro.9vbi)d ceodn sists of
Blood vessels form a network in the extracellular matrix. The adi-
at the end of the bopoakra, lalelllo bwunindgle ss toufd ceonlltasg eton efivbaerlus aatned tahbeuinr dreasnpt oelnassteics afinbedr st.o T he
pocytes are usually arranged in clusters, or lobules, separated from
elastin in elastic ligaments gives them a slightly yellow color. Dense
one another by loose connective tissue. Adipose tissuune dfuenrscttaionnds aths e logic used to arrive at the correct answer. All Predict question
regular elastic connective tissue forms some elastic ligaments, such
an insulator, a protective tissue, and a site of energya sntosrwaegers. Lhiapvides been rewritten in teaching style format to model the answer
as those in the vocal folds and the nuchal (noo′kăl; back of the neck)
take up less space per calorie than either carbohydrafoters t ohre p srtoutedienns t. Helps students learn how to think critically.
ligament, which lies along the posterior of the neck, helping hold
and therefore are well adapted for energy storage.
the head upright. When elastic ligaments are stretched, they tend to
Adipose tissue exists in both yellow and brown forms. Yellow
636 PART 3  Integration and Control Systems shorten to their original length, much as an elastic band does.
adipose tissue is by far the most abundant. Yellow adipose tissue
CRiTiCAL THiNkiNGappears white at birth, but it turns yellow with age because of Predict 4
the accumulation of pigments, such as carotene, a plant pigment
1. Tmhues hwyiptho tthhael aamntoerhiyopr oppithuyistiaartly hp. Worathatyl sisyh sstuuecmhm ac osnpanecenicatlss c t ihrcceu ahlayntpoor tyhm saylas--etab o6. lAai nzp aaetnie anatot’mss yre aaspn odsn poshe uytsoiro clcohgreoy n iinocs tvfriu tacvmtoirint a asDkm sd tewfiiocn isetnu cAdye. nO.ts n Iteon sptu rehddeinuctt mans, explain the advantages of having elastic ligaments that extend from vertebra 
tem advantageous? claims the person would suffer from hypocalcemia. The other student to vertebra in the vertebral column and why it would be a disadvantage if 
2. AaIgfnl uypdcoa uatuigr eiwonnnate ,n e wAxtehiDtdihb H tiaot ,s l ro opewrov a lesylrpddseeoipc stisthfieiaecr o(gstynrbahameivr?srspi tEt ty)ooxt, (mppchwolosaln,yie nwtuna. roiinaua s l( xadfee xywdicole uislois ana pudsr emaionn iend(s pi nsaretooe rrd g ulitmuncicstoiusoslpnisen))u.,,i tes )i,s t hfcatyohlloeateuhi um opanuogsn girnteehhedt e a,c t tah c kntaaihdtlnc e, awi uldoa hmvwysan ? nlpeecndvedeedl, s cnao wnsitdeoef uotiahmlcdar at r l beaatmcoihnraae iemen r aei wgakhbsitsthi oiodorncp cnttfuiho reen.ti r Whwy noisoteuhr.lm d wb Taohlc oorchmaundr eg dteyoo ,b , rsouwcnh tendons, which connect skeletal muscles to bone, were elastic.
color results from the cy 7t.o Ac phatirenot marrivees pat ithge memeergnentcys r oionm itnh ane u ntciosnssciuoues ’cson dni-umer-
3. A patient complains of headaches and visual disturbances. A casual tion. A medical emergency bracelet reveals that he has diabetes. The Dense irregular connective tissue contains protein fibers
glance reveals enlarged fingero bouness, am heaivtyo decpohsitoionn odf broniea o vaern d itsp aatiebntu isn ind eitahenr dti abbetlico coomda o rs iunsuplinp slhyoc.k . IHto wi csa nd yoiuf tfeillc ult to
the eyes, and a prominent jaw. The doctor determines that the head- which, and what treatment do you recommend for each condition? arranged as a meshwork of randomly oriented fibers. Alternatively,
atmhcoeh nessek uasenllc dra envtdiios utnha. alN td atimhsteue prtbhraeesn hecnoecrdtsme hr eioosfsneu aetl tcp icfainrtuouosmiigtnla giruon ytch ritreues mpahdsroeodrb i libfpesm rfaeref,s fosaeruncrtdweie n enwgxn pihtclhoa iierann- disip n o8o.s Pltoern e gdgfeicdrrt soestoreammsste. . o yf Bteherl lcooonwsweqnu ea nacdedsi opifp oexopsosesue rie nftoa ibtn teainsbse iasenpds ep rbco-eiaclaizuesde the fibers within a given layer of dense irregular connective tissue
why increased pressure exists within the skull. 9. Katie was getting nervous. At 16, she was the only one in her group of can be oriented in one direction, whereas the fibers of adjacent
4. MttThh4yeo. rGspotri ivlodaedibnsuom tcrhta iiatonotn raa ib oepisfla iaatt yirnee, no danteb psrlieeigts untuoi latt tebad smr oefcyotre eott urhhmdmgyol rdiayeoen oipen dsf i b ttds uleteeoiiittmoenramdrruamy ll aeimatptvnboeeinrnlesyo gi or shrtwmufo ahbTeaeslStcttiaHtahuynhet, rc orT ehro.3 aey,f rpnas oenmir dd-na r irnaee.s wIutfomWarlbnf i otehdhctnoe ahhdnavoeesri rtnr n wh ftngmoeh ot orohsopket r hhs hexualeeaeldra rtbi snttned yhocaoa adust atme t saeKit fte auDa mirbltstr ivacee. chidJ kewoai gml,sdo eDynurepmenrlh dn.si i aJ tnfsnoreoeueislm,eva cstwpeteiarohhand ibogabnn e .yo e Kp o aragtdbanel telldnierarei tes tlshdohoyy a e msehd l ewxa veapavaelle sr wa aoiiwcarlnh nyboeofislrdl od r d ioltrrlreoedeedi nea K.tp meHaagsinteitenisdduedr. l aamdtiounllg-t sCtruidlltaaeiyrcn ecatrossl na tTonreeh a coiptrniipvekelny tit enicsdhsg uaa tep tntfheeoarer rmsclyeos rnisincghneheopte tavtssna gottilofve secs o toeonlx vnteheera ccatti ilspvaeeyrs oet rbei.s nlsDeucmeeon u.ts htera ahigtre rehsee gavu e-
5. Over the past year, Julie has gradually gained weight. The increase in would never menstruate. Dr. Josephine then asked Katie to wait in the quessttrieonngsth h ienl pm banuyil ddi rsetcutdioennst b'su kt nleossw slterednggeth o ifn a annayt osimngyle & d irection
adipose tissue is distributed omver ehetra trbunok, lfiascem, and ( nsecek,e a ncd hhera pter 2ou5ter) r.oom while she spoke privately to her mother. She explained to
meausislcyl.e H mear sps haypspiceiaarns tsou sbpee dctesc rCeuassehdin. gJRu sliyene adltrsooim cfeeeu lasn lwdae oarkrd aenrtsd iab srsuesrisiueess e forKKmaattiisee’ s is m tgoehmnee tthic aatlf lKyr amtaieam lhea asn eadnw dhreoorg gernonk inad sesn opsriftoi vdiutlycy es ymmndorreop mohfe .t ahTeht omiucaglhe tissue phytshioanlo dgoye ws rheigleu ldare cvoenlonpecintigv er etiasssuoen.ing and critical thinking skills.
of blood tests. The results reveal elevated blood levels of cortisol and reproductive hormone, testosterone, than the female reproductive
ACTH. There is no evidence( otfa anb elxetr ap4itu.8itacry) s,o usrcue ocf hAC TaHs. in thheor msopnel, eesetronge na, Knatdie d ildy nmot repflehct thne toissduee chsa,n gaes sex pwecteedl. l as in
Predict the cause of Julie’s condition and the treatments that are likely What malfunction in Katie’s body would cause this? Why does Katie’s Predict 5
iv to be recommended. bone marrow and the livboedyr l.o okI fte miinsin ec ifh shae irs agecnettiecarllyi zmealed? by a network of
reticular fibers and reticular cells. Reticular cells prAondswuersc ine A tphpened i rx eFticular Scars consist of dense irregular connective tissue made of collagen fibers. 
fibers and remain closely attached to them. The spaces between Vitamin C is required for collagen synthesis. Predict the effect of scurvy, which 
is a nutritional disease caused by vitamin C deficiency, on wound healing.
Visit this book’s website at wtwhwe.m rhehtei.ccoum/lsaeerl efyi1b0 feorr csh acpatenr q ucizozens, itnateirnact iave  lwearindineg  evxearcrisiees, taynd  ootfh eor sttuhdye tro ocls.ells, such
anatomy & physiology
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800 PART 4  Regulation and Maintenance
Clinical 
IMPACT Acquired immunodefi ciency Syndrome
Acquired immunodeficiency syndrome numbers of helper T cells. Nonetheless, over a RNA from producing viral DNA. AZT can delay
(AIDS) is a life-threatening disease caused period of years the HIV numbers gradually the onset of AIDS but does not appear to
by the human immunodeficiency virus increase, and helper T cell numbers decrease. increase the survival time of AIDS patients.
(HIV). HIV is transmitted from an infected Normally, approximately 1200 helper T cells are However, the number of babies who contract
person to a noninfected person in body fluids, present per cubic millimeter of blood. An HIV- AIDS from their HIV-infected mothers can be
such as blood, semen, or vaginal secretions. infected person is diagnosed with AIDS when one dramatically reduced by giving AZT to the
The major methods of transmission are through or more of the following conditions appear: mothers during pregnancy and to the babies
unprotected sexual contact, through contami- The helper T cell count falls below 200 cells/mm3, following birth.
nated needles used by intravenous drug users, an opportunistic infection occurs, or Kaposi Protease inhibitors are drugs that inter-
through tainted blood products, and from a sarcoma develops. fere with viral proteases. The current treatment
pregnant woman to her fetus. Evidence indicates Opportunistic infections involve organisms for suppressing HIV replication is highly active
that household, school, and work contacts do that normally do not cause disease but do so antiretroviral therapy (HAART). This therapy
not result in transmission. Reduced exposure to when the immune system is depressed. Without uses drugs from at least two classes of antivirals.
HIV is the best prevention for its transmission. helper T cells, cytotoxic T and B cell activation Treatment may involve combining three drugs,
Practices such as abstinence, the use of latex is impaired, and adaptive resistance is sup- such as two reverse transcriptase inhibitors and
condoms, monogamy, and avoiding sharing pressed. Examples of opportunistic infections one protease inhibitor, because HIV is unlikely
needles are effective ways to reduce exposure include pneumocystis (noo-mō-sis′tis) pneu- to develop resistance to all three drugs. This
to HIV. Medical professionals should also use monia (caused by an intracellular fungus, strategy has proven very effective in reducing
care when handling body fluids, such as wear- Pneumocystis carinii), tuberculosis (caused by the death rate from AIDS and partially restoring
ing latex gloves. an intracellular bacterium, Mycobacterium health in some individuals.
the sHurIfVac ien ofef ctthioen v ibruegs,i ncsa lwlehde gnp 1a2 p0r, obtienidns otno ttruabnesrmcuiltotesids) b, ascytperhiiulims , (Tcaruepseodn embya ap aslleixduuamll)y, inhibSittilol rsin, wthhiec hr epsreeavrecnht tshtaeg ien saerreti oinn toefg vriarsael Clinical Emphasis—Case Studies
a CD4 molecule on the surface of a cell. The candidiasis (kan-di-dī′ă-sis; a yeast infection of DNA into the host cell’s DNA. Another advance
CD4 molecule is found primarily on helper T the mouth or vagina caused by Candida albicans), in AIDS treatment is a test for measuring viral
cells, and it normally enables helper T cells to and protozoans that cause severe, persistent load, which measures the number of viral
adhere to other lymphocytes—for example, diarrhea. Kaposi sarcoma is a type of cancer RNA molecules in a milliliter of blood. The Bring Relevance to the Reader
during antigen presentation. Certain mono- that produces lesions in the skin, lymph nodes, actual level of HIV is one-half the RNA count
cytes, macrophages, neurons, and neuroglia and visceral organs. AIDS symptoms resulting because each HIV has two RNA strands. Viral
also have CD4 molecules. Once attached to the from the effects of HIV on the nervous system load is a good predictor of how soon a person
CD4 molecules, the virus injects its genetic include motor retardation, behavioral changes, will develop AIDS. If viral load is high, the
mbeagtienrsi alt o( RrNepAli)c aanted. eCnozpymiese s oifn ttoh eth ev icreulsl aanrde progAre scsuivree fdoerm AeInDtiSa ,h aansd y peto tsosi bbley dpissyccohvoerseisd.. othnes evti roafl AloIaDd Sis i slo lwik.e Ilty itso a loscoc puor sssoibolnee tro t dheatne citf ▶ NEW! Chapter opening photos and scenarios have been
manufactured using the organelles and materi- Management of AIDS can be divided into two developing viral resistance by an increase in
als within the cell. Replicated viruses escape categories: (1) management of secondary infec- viral load. In response, a change in drug dose correlated to provide a more complete story and begin
from the cell and infect other cells. tions or malignancies associated with AIDS or type may slow viral replication. Current
Following infection by HIV, within 3 weeks and (2) control of HIV replication. In order for treatment goals are to keep viral load below critical thinking from the start of the chapter
to 3 months, many patients develop mono- HIV to replicate, the viral RNA is used to make 500 RNA molecules per milliliter of blood.
nucleosis-like symptoms, such as fever, sweats, viral DNA, which is inserted into the host cell’s Effective treatment for AIDS is not the
ftahtriogaute, ,d miaurrshcelea ,a rnadsh j,o ainndt aswchoelsle, nh elyamdapchh en,o sdoerse. DduNcAtio. nT hoef nineswe rvteirda lv RirNalA D aNnAd pdriroetcetisn sth, we hpricoh- sthame ep oaisn at cthuarte . tEhve evni riuf sv iirsa lu lnodaedt edcetcerde aisne st htoe ▶ UPDATED! Learn to Predict and chapter Predict questions
Within 1–3 weeks, these symptoms disappear as are assembled to form new HIV. Key steps in blood, the virus still remains in cells through-
the immune system responds to the virus by the replication of HIV require viral enzymes. out the body. The virus may eventually mutate with unique Learn to Predict Answers
producing antibodies and activating cytotoxic The enzyme reverse transcriptase promotes and escape drug suppression. The long-term
T cells that kill HIV-infected cells. However, the the formation of viral DNA from viral RNA, and goal for deterring AIDS is to develop a vaccine
immune system is not able to eliminate HIV integrase (in′te-grās) inserts the viral DNA into that prevents HIV infection. ▶ Clinical Impact boxes (placed at key points in the text)
completely, and by about 6 months a kind of the host cell’s DNA. A viral protease (prō′tē-ās) Because of improved treatment, people with
“set point” is achieved in which the virus con- breaks large viral proteins into smaller proteins, HIV/AIDS can now live for many years. Thus,
tinues to replicate at a low but steady rate. This which are incorporated into the new HIV. HIV/AIDS is being viewed increasingly as a ▶ Case Studies
chronic stage of infection lasts, on average, Blocking the activity of HIV enzymes can chronic disease, not a death sentence. Working
8–10 years, and the infected person feels good inhibit the replication of HIV. The first effec- together, a multidisciplinary team of occupa-
and eAxlhthiboiutsg fhe wh,e ilfp aenr yT, scyemllps toarme si.nfected and tmivied itnreea (tAmZenTt; oafz ′Ai-IdDōS-t whīa′sm tih-ed ēdnr)u,g a alszoid coatlhleyd- tisiotsn/adli ethtiecriaanpsis, tps,s ypchhyosliocagli stthse, rianpfeiscttsi,o nusu tdriistieoanse- ▶ UPDATED! Clinical Genetics essays have been updated
destroyed during the chronic stage of HIV zidovudine (zī-dō′voo-dēn). AZT is a reverse physicians, and others can help patients with
infection, the body responds by producing large transcriptase inhibitor, which prevents HIV HIV/AIDS have a better quality of life. and streamlined for accuracy and impact
▶ UPDATED! Diseases and Disorders tables
Clinical Impact boxes these in-depth boxed essays explore relevant ▶ UPDATED! Systems Pathologies with System Interactions
vatn0o3636p_chi22c.insdd 8o00f clinical interest. Subjects covered include pathologies, curren12-t09 -10 12:36 PM
research, sports medicine, exercise physiology, and pharmacology.
804 PART 4  Regulation and Maintenance CHAPTeR 22   Lymphatic System and Immunity 805
Systems Systemic Lupus erythematosus
PATHOLOGY  SKELETAL MUSCULAR
INTEGUMENTARY Aofr tbhorniteis ,t tisesnudei ncaitnis ,d aenvde ldoepa.th  Danedst mruucsticounla or fw meuaskcnlees tsi soscuceu r.
BBaacckkggrroouunndd iinnffoorrmmaattiioonn Skin lesions occur frequently and 
SSiittnnyyeessggmmtt eett..hhmm TTaaiitthhcc eett llii uussnnssppaauuuummeessssee ee aaddrrnnyyeeddttss hhccccrreeeeiimmllbbllsseeaa ssaatt oottrrhheess eeuudd ssssaa kk((mmSSiinnLLaa ggEErreeaa))ddss ihh sbb attyyhhn ttaa hhatt ueeii sstbb occooihhmddaayymrr’’aassucc oottneewwerr nniidss ttiiiiismmcce ammoosffeuu tt, nnhhmeeee essddayyiinssss----- taord eti hffm eua ssduee nt h.w Hionarnisrien l ogbs yos  efr exthspueol shtsua riiner.   NERVOUS
dsceShpoeugbeeslnalrr eserewaee etiftlmtgnh eaorwaeuge.r ares niageLmny t sc2ote ue ctsiola5uonee courun rgvny eammh lce sdh,dnw iehplmhg ,d  l  caaelbeeoh eeansk rsynsdtu r NNnidd  i.GGe oeamAA nsae aai CneneveeaaLssggwommiefom stnn ndgudyheeoufrti lmdddn c egttueeoo::enllot eholya oeew::nc pr- fitm cr,ah wtr trris mcmeonoaiosot::eemeo sd   ,minbrteddr L s.nnFhh  h  e3ahnsauuNa ipetdwaveeu l0  trctst emrltosir ssm hgeiaytahh  at traibtw esgadhaoecar.eth e  letedK  sntatpe cle eehh sudones  dao ttnne eap dnooseeeum drl tuw  wdr ectr sh wnarefossin taoediesne rurontwdthwnerrehwcrirgk  csesadfehseo io asi e tnL  reanfr aecr  onuegsntkgnedh cf.c   h   d l eayeae ni’ tsvred  er    eettooaarrssrreessssee eetteeeeffeelliihhbbddeeffnnrr ccll--((NNffeeoorr aaooooffbbaaffkk--ss nnwllwddiiddIIaammonnobbbbaa lliiggaannttttooddyynneeiimmrorottiinnssuuiioottmmnT n T iiooddbbmnmniittuuddSShhssggtt rrppssiimmdddodoss rrii eeyyggeLeLggeyey t o occbbaa((aaooeeSSohydydpp hssgg nnee aaeeEEttccnnolol2at2atddmmaatLtLssfiiiTiiererllnnalloosssseeetteeeg ,,e22eddyy l l nnnnoossEE ,,taaiissalalss thnmmnsseeaa hAA,,iiiiotot llaaededb,b,hssnn nn ffeenssss e ttddffettnuunnnss rrGllffppaa )), ,se sssssttoo ddhhoggaatt rooaaessecee.. ii cc,,tt b b aaaahhhhrbrb e rrbb nn sseerrriiavvrrTTaadhhoonnaaoomlmlttigggguunaameaeiai mmoouyyaaeefnniinn issffhhllttddeetteevv ee llaaesllw w ddiis hh dd ttddddananoo etetveveniinmmsse ttassateiivvppiimmhheehihee nl n ee iiaepep ss eettrrcnnttlaavvnnoftrtrllppiiddoeeos s eeryrsggeeeess a aaiimmmmrro o iiuurrfgg f e oo ssddrr rr t trrmttii hhssaaaeerrttiisnnbb S iicc.sseememeaaeessnnuuuuetetkkmm eessccctnnaauullL yyttooii llllTiirrsseeccmm tiitntn cctteeccyyvvaalm llee iinn Eommuu uueeeiielyooeerrtotohnnaaaaee eell uc cooddrddssoo eee e nnllss gg u mdmdied fd frr sccll..pmddsswwdadasfsfs vv ees sseeaaeen n leeooii iiTT.. uccypcc a ee,,eeaaplpusos o nn ssiioossbbuu emmiAAiinnsttsssteehhccuunnrccccttffkllndd millliltmme iio rraarrvvssaaooooffoomeellttppetteppccttsks uu))tteettssiiboaoauu h hroommmnn,,lbaabbiipp bbllncceaea icceerDrDnneaellllsspdpdeett heeeoorree..oosseeoiittddagixxppiiebe gg roor hh rooeeicrirInNINnmmossddccwnDDuddeeiioollsls aann ddiiuuxoxossyeeeeoggffss iiiasool,,AnAnnnoonrrbbrrNNmee ii lxslx sa ss dlssttuculmlmnnnnohoh“ffttccpp..ss s.iiteess h hoo to thhnnAAwrr ppoeoeprrssummTu o ohhssiiTTaaoaacmcmaaeeene eessaar t tlmmwwtt,,ooorrhaattoottlflgigsshhss h yoottttt eeeee eeeeucuciilllbb ettuuffriiuhhuee uuttniniabbfd aa lleesoo eeiT sssspphuhuppv vcceyeyllaamtt”sb.sssnsneeefflleeeeaann hhaasseiie ee trtr-ltlt llee,,rruFvll ttdddda44ssa a , , i coorssrhoh ffeeddooss ootssffe SStno--00mm ss cce,e,eww ddtstuue.etteoor r aalff,,LL oossiissrof–of–ldootbbo mmyy uunnrrnlnImmhhrrkkccmm, , tttffEE 5 5 p eecpcneoohhobbccTooTo c cllatttteeiioo00ycycuut toxhhiinneeiaae ettmm ceeeeaarrrgh gh nccltlaaiis%s%accattpllddtteeee ti ..yygghooeeaaaaidideaea eeuugiieeidgm usmsm uuEoonddvnnna a ett.nn.nn ttlltteeis siidoo elelhlhhhnhh llinnnnssraassFFp p Sepess attdaaeetoo ffi .y.eeii..eemmaaaaa tt..yLraaootoo ltts s ebbttffTnTnIiIitlliieyyi itlitffnn.h h ssEpbrpbrhnnvhonnlooooff rr,aaDD oohhiiyrr deedrressooeeeyee nddtt nndedeggteeaatt ooeeccetteli grgrmNNphrddxx iiee, oaacciiiidds tdtd u uffvveaauueemmppoeaddai inno o TTpaafddAAa feelilissggmll mmimimaiti ccllggdedeemaaii mc ctssnnuucch hh mwwttttccmmronntt uuttSSeeaauiiaoao ppllcceoooroueueeoottsoaaiiLLliilnnaannsaiacerhrhlilillullnzztuturrrrnnttlseaeaillllssssEEnnhdhhddyyyyyeeeeeeeesssssstttt..,.,,,,., acorapRcernphcee ec ransaraxoUoeusrabctmiysllloeecntIu nnliesinmeonlnxsfltras rg.  ssoa piiml,A no l dmniyrwn bnaoe p,a m hldsbtvlrinoe toioeauaci iwegelnmnthto sinredsn op eic irln oannaga s itar sr nn lhceolgolii   vaa vftppeml euhonetdar hseors ekiDn U entle frdiio odu uv i cuapnIrRrpnnelaaGnocm aCrecltnlIeedn n hthayNcaE  ui ebcee naoevlfr rpSde aAvbosdnaueh tieimlTl fa rlt mo oRoumrpiymsniIociur  tatiYaaVeeaciendinisnnnn.,.umo    dEddg rrm..b     raayn bees;  cfeauveser,d s hboyrS(T RitHEnrynE•••••••fleiem        gaSsarmshSFFAAAAptP oyaemklmrnnntyIftvti oRtteab niShetvegiitmrmA-- irnaerloimuhienyaTrtntLisetisaifla Ohaso iesaol,buf aaR mtnlrnthemYisdepam)e,   lp adumaatrorutrstigyciso u dclraus rlgyus ons face 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fever is present in most cases of active SLE. The progress of the disease is potent therapies as conditions warrant. Aspirin and nonsteroidal anti- Predict 8
unpredictable, with flare-ups followed by periods of remission. The sur- inflammatory drugs are used to suppress inflammation. Antimalarial drugs
vival after diagnosis is greater than 90% after 10 years. The most frequent are prescribed to treat skin rash and arthritis in SLE, but the mechanism of The red lesion Lucy developed on her arm is called purpura (pu˘r′poo-ra˘),
causes of death are kidney failure, central nervous system dysfunction, action is unknown. Patients who do not respond to these drugs and those and it is caused by bleeding into the skin. The lesions gradually change
Figure 22A Systemic infections, and cardiovascular disease. who have severe SLE are helped by glucocorticoids. Although glucocorti- color and disappear in 2–3 weeks. Explain how SLE produces purpura.
Lupus erythematosus No cure for SLE exists, nor is there one standard of treatment, because coids effectively treat inflammation, they can produce undesirable side
The butterfly rash results from  the course of the disease is highly variable and patient histories differ widely. effects, including suppression of normal adrenal gland functions. In patients
inflammation in the skin. Treatment usually begins with mild medications and proceeds to increasingly with life-threatening SLE, very high doses of glucocorticoids are used.
The ability to produce monoclonal antibodies may result in effective antigens of a particular type than normal cells, resulting in greater are modified to resemble human antibodies. This approach has then lysed by natural killer cells. Herceptin slows disease progression
Sytrseattmeenmts fosr tuPmaorst. Ihf ano anltoigegn uineiquse tbo tuomoxr ecelsls c atn hbe esetr esatmpenrte dealivderys. T uemxor pcelllso marye als oa be smporee sucsceipfit ibcle tco doamn-dition oalrlo wdedi smoonorcdloneal ran rtibeodliaest toe sdnea kt poas t athe pimamurnte iscystueml.ar banod idncryea sses ysusrvtiveal mtime., bPutr ite iss neot na cutree fdor birneas t aca nsceirm. plifi ed
found, monoclonal antibodies can deliver radioactive isotopes, drugs, age, or normal cells may be better able to recover from the treatment. Some uses of monoclonal antibodies to treat tumors are yield- Many other immunotherapy approaches are being studied, and
cattsohxeei inm s,sm entuznuyem sdeyss,t yoerm cf yttooo k kriilnlm etsh teh acaet lktl.i l,Ul tnehfeo atrutmucnoahrt ecel ylSl, dsoyir efsactrl tyr eeosre amacrctihvesartes Patthhat oOthnele oi mprmgobuylneem sv ywsitiegthm nm reocenoogtcnltiozeneas l t bhane temiboogndoyic ndloenlsiavl e awryn tsiibytsotdehym a ss a ias patientir nahdg iopiasrocttmivoies iinrogdy irne esf uo(l1t3s1l.I l)F ohora vweex aceamupsdeled, tmbheoy nroe gcbrloesnasailo cnan kotfi bgBo-drcieeolsl lwuymitnh- d imnorfe otreratmmenats tthaito usne th ea imbmuoneu sytst emth aree su rfe eto abe tdeuvelroepedd. topic.
hmaavle c efollus.n Ndo nnoe tahnetliegses,n t hoins atuppmroora cche lmls atyh abte i us sneofut la ilfs doa pmreasgeen tto o nno rnmora-l fdoersetirgony sa nthtieg emno. Anoftcelro tnhael fainrstti beoxpdoiessu, rree,n ad mereimngo trhy er etrsepaotnmsee nqtu iinckelfy- pbihnodms atso wa igthro fwewth s fidacet oefrf ethctast. iHs eorvceerpetxinp,r eas smedo nionc 2lo5n–a3l0 a%n toibf opdryi-, ASSeSS YOuR PROgReSS
cells is minimal. For example, tumor cells may have more surface fective. In a process called humanization, the monoclonal antibodies mary breast cancers. The antibodies “tag” cancer cells, which are 63. What is immunotherapy? Give some examples.
v
van03636_ch22.indd 804 12-v0a9n-1003 6 3162_:3c6h 2P2M.indd 805 12-09-10 12:36 PM
van03636_ch00_FM.indd 5 12-10-12 11:03 AM
Exceptional Art—Always created from the student perspective
A picture is worth a thousand words—especially when you’re learning anatomy
and physiology. Because words alone cannot convey the nuances of anatomy or
the intricacies of physiology, Seeley’s Anatomy & Physiology employs a dynamic
program of full-color illustrations and photographs that support and further clarify
430 PART 3  Integration and Control Systems
the textual explanations:
▶1 3U.1P DDAevTeElDop! mFuenndt aomf tehnet aClN FSigures teamefdro mw thite hne usrpal eccreistas la nodn gilvien riese stou spenpsooryr, ta uatonnodm nic,o anwd linked to APR
enteric neurons of the peripheral nervous system. They also give
▶ LEUARPNIDNGA OTUTECODM!E SHomeostasis fi gures were rervisei stoe adll thteo p idgmreanwted ace llcs oofr three bloadtyi, othen a dfrrenoaml me dtuhllea, the CHAPTER 26   Urinary System 949
facial bones, and the dentin of the teeth.
Aftteer xreta ddineg sthcisr siepcttioino, ynou o shfo fuelde bde abbalec tok system compoAn seerniets so f tpoou cthhese d efiv egloupsr ien .t hMe anateirniotr apairnt osf the neural Renal capsule
A. Describe the development of the neural tube and name tube, forming three brain regions in the early embryo (figure 13.3a):
ctohen emsibsrtyoennicc pyou tchhers oanud gthhe aoduultt beraainc shtr uoctrugreas nth ast ysteam for ebrain, or prosencephalon (pros-en-sef′ă-lon); a midbrain, or Cortex
they become. mesencephalon (mez-en-sef′ă-lon); and a hindbrain, or rhomben- Artery and vein Medulla
▶ B.N ExEplWain t!h Ae olrlig fiin gofu three vse nwtrieclerse o fv thise ubraailnl.y linked toc ecprhaeloant (ero mco-benn-ssiefs′ăt-elonn)c. Tyh et phorucohu wgallhs boecuomt et thhee v arious in the renal sinus Segmental artery
portions of the adult brain (table 13.2). The forebrain divides into the R(sepnaacle s)inus Hilum (indentation)
Thet berxaint. i sTh th e epa srta omf thee ccenotrlaol nresrv aourse s yastlewm (aCyNsS ) uthsaet ids forte ltehnceep shaalomn (ete l-teyn-pseef′ă o-lofn )a, wrhriochw be,c ocmyets othpe clearesbmrum, and
conitanin ead wciethliln, thsey cmranbialo clasvi tfyo (frig uiroe n13s.1,) . aItn codns imsts oofl tehec uletsh,e editecnc.ephalon (dī-en-sef′ă-lon). The midbrain remains a single Renal pyramid Renal artery
brainstem, the cerebellum, the diencephalon, and the cerebrum structure as in the embryo, the mesencephalon, but the hindbrain Renal vein
(table 13.1). The brainstem includes the medulla oblongata, the divides into the metencephalon (met′en-sef′ă-lon), which becomes the Renal papilla
▶p onSs, taendp t-hbe myi-dsbtraeinp. WPer boegcine osusr sfit ugdyu orf ethse brain and the pons and cerebellum, and the myelencephalon (mī′el-en-sef′ă-lon), Minor calyx Renal pelvis
cranial nerves by describing how the CNS develops in the fetus. which becomes the medulla oblongata (figure 13.3b,c). Major calyx
▶ AThtel aCsN-Sq fourmasl iftryom c aa fdlata pvlaeter oifm ectaodgeermsal tissue (see The pouch cavities become fluid-filled ventricles (ven′tri-klz). Renal column Ureter
chapter 4), the neural plate, on the dorsal surface of the embryo, The ventricles are continuous with each other and with the central Medullary rays
▶w hiIchl lisu insftlureancteed din ptaartb byl ethse underlying rod-shaped notochord canal of the spinal cord. The neural tube develops flexures that cause (a)
(figure 13.2). The lateral sides of the neural plate become elevated the brain to be oriented almost 90 degrees to the spinal cord.
▶an se uwPraavhle csor, eftsotor, masni ndsg ti hndee ceuer-natble fryo ol-fd stsh.i eTd nheeeu crwrael spittl aohtfe ebiaelcchlou mfoseldts rtihsa ec tnailelouedrna als ASSESS YOUR PROGRESS CReonrtaelx capsule
groove. The neural folds move toward each other in the midline,
▶a ndN theE crWests! f uCse otol corerat es aa nteuurraal ttuiboe (nfig uoref 1a3.r2)t. Tmhe acekphealsic the a1r. tN ammeo three fi vee npogucahegs ionf thge neural tube and the part of the Medulla
portion of the neural tube becomes the brain, and the caudal portion adult brain that each division becomes. R(sepnaacle s)inus
▶b ecoMmeas cthre osp-intaol -comrd.i Nceruora la crretst cells are cells that separate 2. What do the cavities of the neural tube become in the adult brain?
RReennaall ppyarpailmlaid H(inilduemn tation)
Renal column Renal artery
Renal vein
FUNDaMeNTal Figure
Major calyx
Minor calyx Renal pelvis
Ureter
(b)
Anterior
FiguRE 26.3 Frontal Section of the Kidney and ureter
(a) A frontal kidney section shows that the cortex forms the outer part of the kidney, and the medulla forms the inner part. A central cavity called the renal sinus 
contains the renal pelvis. The renal columns of the kidney project from the cortex into the medulla and separate the pyramids. (b) Photograph of a longitudinal 
section of a human kidney and ureter.
Corpus callosum Cerebrum
Diencephalon Thalamus Posterior
Hypothalamus van03636_ch26.indd 949 12-09-18 11:34 AM
Midbrain
454 PART 3  Integration and Control Systems
Brainstem Pons
Table 13.5 CCeeCrreerbbaeenlllliuuamml Nerves and Their Functions—Continued
Medulla Consequences of
oblongata
Cranial Nerve Foramen or Fissure* Function Lesions to Nerve
Medial view
X. Vagus Jugular foramen Sensory, motor,† and  Difficulty swallowing  
FIGURE 13.1 Regions of the Brain Left vagus nerve paSreansysomrpy afrtohmet iicnferior   aunvudl/ao rd hevoiaartseesn aewssa;y   from 
Medial view of a mid-saggital section of the right half of the brain. Pharyngeal pharynx, larynx, thoracic   side of the dysfunction
branch Superior vagal and abdominal organs; sense 
Right vagus ganglion of taste from posterior tongue
nerve Larynx Inferior vagal
ganglion Motor to soft palate, pharynx, 
Superior laryngeal intrinsic laryngeal muscles 
branch (voice production), and an 
extrinsic tongue muscle 
(palatoglossus)
van03636_ch13.indd 430 Right recurrent 12-0Ll9ae-r1fy0tn r ge1e2c:au2lr2 r bePrMnatnch Proprioceptive from  
laryngeal branch those muscles
Cardiac branch
Cbraarndciahc Lung Panarda saybmdopmatihneatli cv itsoc etrhaoracic 
Pulmonary plexus
Clearly labeled photos of dissected human Heart
Esophageal plexus
cadavers provide detailed views of anatomical Liver Celiac plexus Stomach
Spleen
structures, capturing the intangible characteristics
of actual human anatomy that can be appreciated
only when viewed in human specimens.
Kidney
Colon Pancreas
Small
intestine
XI. Accessory Foramen magnum Motor† Difficulty elevating the 
Jugular foramen Motor to sternocleidomastoid  scapula or rotating the neck
and trapezius
Accessory nerve
vi
Spinal roots of accessory nerve
Accessory nerve
Cervical
spinal
nerves
van03636_ch00_FM.indd 6 12-10-12 11:03 AM
Trapezius
muscle
Sternocleidomastoid
muscle
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