Fundamentals of Anatomy & Physiology. ISBN 0134396022, 978-0134396026

Fundamentals of Anatomy & Physiology
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Chapters + Clinical Cases Spotlight Figures
1 An Introduction to Anatomy SmartArt Homeostatic Regulation Using A&P to Save a Life 2 1–2 Levels of Organization
and Physiology 1
2 The Chemical Level of Organization 27 What Is Wrong with My Baby? 28 2–4 Chemical Notation
3 The Cellular Level SmartArt Protein Synthesis: Transcription The Beat Must Go On! 66 3–1 Anatomy of a Model Cell 3–7 Protein Synthesis, Processing, and Packaging 3–22 Overview of Membrane Transport
of Organization Protein Synthesis: Translation65 3–23 Stages of a Cell’s Life Cycle 3–24 DNA Replication
4 The Tissue Level of Organization 114 The Rubber Girl 115 4–21 Inflammation and Regeneration
5 The Integumentary System 152 He Has Fish Skin! 153 5–3 The Epidermis
6 Bones and Bone Structure SmartArt Endochondral Ossification 180 A Case of Child Abuse? 181 6–11 Endochondral Ossification 6–17 Types of Fractures and Steps in Repair
The Hormones Regulating
Calcium Ion Metabolism
7 The Axial Skeleton 208 Knocked Out 209 7–4 Sectional Anatomy of the Skull
8 The Appendicular Skeleton 243 Timber!! 244 8–14 Sex Differences in the Human Skeleton
9 Joints 265 What’s the Matter with the Birthday Girl? 266 9–2 Joint Movement
10 Muscle Tissue SmartArt Motor Units and Recruitment 291 Keep on Keepin’ on 292 10–10 Events at the Neuromuscular Junction 10–11 Excitation-Contraction Coupling
Anaerobic vs Aerobic Production of ATP 10–12 The Contraction Cycle and Cross-Bridge Formation
11 The Muscular System 336 Downward-Facing Dog 337 11–3 Muscle Action
12 Nervous Tissue 389 Did President Franklin D. Roosevelt Really 12–8 Processes that Produce the Resting Membrane Potential 12–13 Generation of an Action Potential
Have Polio? 390 12–14 Propagation of an Action Potential
13 The Spinal Cord, Spinal Nerves, SmartArt The Reflex Arc Prom Night 434 13–8 Structure, Function, and the Peripheral Distribution of Spinal Nerves (T1 – L2) 13–14 Spinal Reflexes
and Spinal Reflexes 433
14 The Brain and Cranial Nerves 465 The Neuroanatomist’s Stroke 466 14–4 Formation and Circulation of Cerebrospinal Fluid
15 Sensory Pathways and the Somatic Nervous System 512 Living with Cerebral Palsy 513 15–8 Somatic Sensory Pathways
16 The Autonomic Nervous System and Higher-Order Functions 535 Remember Me? 536 16–2 The Autonomic Nervous System
17 The Special Senses 565 A Chance to See 566 17–2 Olfaction and Gustation 17–13 Refractive Problems 17–16 Photoreception
18 SmartArt The Pancreas and Regulation 610

The Endocrine System Stones, Bones, and Groans 611 18–2 Structural Classification of Hormones 18–3 G Proteins and Second Messengers 18–18 Diabetes Mellitus
of Blood Glucose 18–20 The General Adaptation Syndrome
19 Blood 656 Crisis in the Blood 657 19–1 The Composition of Whole Blood 19–8 Hemolytic Disease of the Newborn
20 The Heart SmartArt The Cardiac Cycle 688 A Needle to the Chest 689 20–9 Heart Disease and Heart Attacks 20–13 Cardiac Arrhythmias
The Conducting System of the Heart
21 Blood Vessels and Circulation 727 Did Ancient Mummies Have Atherosclerosis? 728 21–33 Congenital Heart Problems
22 The Lymphatic System and Immunity SmartArt The Immune Response 785 Isn’t There a Vaccine for That? 786 22–21 Cytokines of the Immune System
23 The Respiratory System SmartArt Partial Pressures 834 No Rest for the Weary 835 23–13 Pulmonary Ventilation 23–25 Control of Respiration
24 SmartArt Structure and Function 884

The Digestive System An Unusual Transplant 885 24–15 The Regulation of Gastric Activity 24–27 The Chemical Events of Digestion
of the Liver Lobule
25 Metabolism, Nutrition, and Energetics 939 The Miracle Supplement 940 25–4 The Electron Transport Chain and ATP Formation 25–10 Absorptive and Postabsorptive States
26 The Urinary System SmartArt Structure of the Nephron 976 A Case of “Hidden” Bleeding 977 26–16 Summary of Renal Function
27 Fluid, Electrolyte, and Acid–Base Balance 1021 When Treatment Makes You Worse 1022 27–18 The Diagnosis of Acid–Base Disorders
28 The Reproductive System 1055 And Baby Makes Three? 1056 28–12 Hormonal Regulation of Male Reproduction 28–24 Hormonal Regulation of Female Reproduction
29 Development and Inheritance 1103 The Twins That Looked Nothing Alike 1104 29–5 Extra-embryonic Membranes and Placenta Formation
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The Digestive System The Urinary System The Male Reproductive System The Female Reproductive System Frederic H. Martini
STUDY CARD: BODY SYSTEMS OVERVIEW
The Integumentary System The Skeletal System
Salivary gland
Pharynx Oral cavity
Esophagus Hair
Mammary Axial Appendicular
Prostate Skeleton Skull Skeleton
gland
Liver Seminal gland
Gallbladder Supporting
Kidney bones
Stomach Ductus deferens Uterine
Epidermis and (scapula and
tube
Pancreas associated clavicle)
Ureter Sternum
Urinary glands
Small Large Ovary Upper
bladder Ribs
intestine intestine limb
Urethra
Uterus bones
Vertebrae
Vagina
Epididymis
Urethra External
genitalia Sacrum
Testis
Anus
Penis
Scrotum
Nails
Pelvis (supporting
bones plus sacrum)
Produces sex cells
and hormones;
supports embryonic
Produces sex cells and fetal development
and hormones from fertilization to birth
Lower
Processes food and Eliminates excess water, ORGANS PRIMARY FUNCTIONS ORGANS PRIMARY FUNCTIONS limb
absorbs nutrients salts, and waste products bones
Testes Produce sperm and hormones Ovaries Produce oocytes and hormones
ORGANS PRIMARY FUNCTIONS ORGANS PRIMARY FUNCTIONS Epididymis Stores, matures, and transports sperm Uterine Tubes Deliver oocyte or embryo to uterus;
Ductus Deferens Conducts sperm between epididymis and normal site of fertilization
Salivary Glands Secrete saliva; provide buffers and lubrication; Kidneys Form and concentrate urine; regulate blood pH
produce enzymes that begin digestion and ion concentrations; perform endocrine prostate Site of embryonic and fetal development and
Uterus Protects against Supports and
functions Seminal Glands Secrete fluid that makes up most of the exchange between maternal and embryonic/fetal environmental hazards; helps protects tissues; stores
Oral Cavity (Mouth) Cavity for food; works with associated structures bloodstreams; shed lining during menstruation
(Seminal Vesicles) volume of semen control body temperature minerals; forms blood cells
(teeth, tongue) to break up food and pass food Ureters Conduct urine from kidneys to urinary bladder
and liquids to pharynx Prostate Gland Secretes fluid and enzymes Site of sperm deposition; acts as birth canal
Vagina
Urinary Bladder Stores urine for eventual elimination during delivery; passageway for fluids during
Pharynx Conducts solid food and liquids to esophagus; Urethra Conducts semen to exterior ORGANS PRIMARY FUNCTIONS ORGANS PRIMARY FUNCTIONS
Urethra Conducts urine to exterior menstruation
chamber shared with respiratory tract Cutaneous Membrane Bones, Cartilages, Support, protect soft tissues; bones store minerals
Penis Contains erectile tissue; deposits sperm in
Clitoris Contains erectile tissue; produces pleasurable and Joints
Esophagus Delivers food to stomach vagina of female; produces pleasurable Epidermis Covers surface; protects deeper tissues
sensations during sexual activities
sensations during sexual activities Axial Skeleton (skull, Protects brain, spinal cord, sense organs, and soft
Stomach Secretes acids and enzymes; mechanically Labia Contain glands that lubricate entrance to vagina Dermis Nourishes epidermis; provides strength;
breaks down food Scrotum Surrounds the testes and controls their temperature contains glands vertebrae, ribs, sternum, tissues of thoracic cavity; supports the body
Mammary Glands Produce milk that nourishes newborn infant sacrum, cartilages, and weight over the lower limbs
Small Intestine Secretes digestive enzymes, buffers, and Hair Follicles Produce hair; innervation provides sensation ligaments)
hormones; absorbs nutrients
Hairs Protect the head Appendicular Skeleton Supports and positions the limbs; supports and
Liver Secretes bile; regulates nutrient composition Sebaceous Glands Secrete lipid coating that lubricates hair shaft (supporting bones, moves axial skeleton
of blood ISBN-13: 978-0-13-460995-9
ISBN-10: 0-13-460995-6 and epidermis cartilages, and ligaments
9 0 0 0 0 of the limbs)
Gallbladder Stores bile for release into small intestine Sweat Glands Produce perspiration for evaporative cooling
Bone Marrow Produces red blood cells and white blood cells;
Pancreas Secretes digestive enzymes and buffers; Nails Protect and stiffen distal tips of digits stores lipid reserves
contains endocrine cells
Sensory Receptors Provide sensations of touch, pressure,
Large Intestine Removes water from feces; stores wastes temperature, pain
9 780134 609959
Subcutaneous Layer Stores lipids; attaches skin to deeper structures
© 2018 Pearson Education, Inc., publishing as Benjamin Cummings. © 2018 Pearson Education, Inc., publishing as Benjamin Cummings. © 2018 Pearson Education, Inc., publishing as Benjamin Cummings.
A00_MART6026_11_SE_SC.indd 1 24/10/16 4:35 PM

Salivary gland
Pharynx Oral cavity
Esophagus Hair
gland
Liver Seminal gland
Kidney bones
tube
Ureter Sternum
Urinary glands
bladder Ribs
Urethra
Uterus bones
Vertebrae
Vagina
Epididymis
Urethra External
genitalia Sacrum
Testis
Anus
Penis
Scrotum
Nails
Pelvis (supporting
bones plus sacrum)
Produces sex cells
and hormones;
supports embryonic
Lower
Vagina
of blood ISBN-13: 978-0-13-460995-9
9 780134 609959

Salivary gland
Pharynx Oral cavity
Esophagus Hair
gland
Liver Seminal gland
Kidney bones
tube
Ureter Sternum
Urinary glands
bladder Ribs
Urethra
Uterus bones
Vertebrae
Vagina
Epididymis
Urethra External
genitalia Sacrum
Testis
Anus
Penis
Scrotum
Nails
Pelvis (supporting
bones plus sacrum)
Produces sex cells
and hormones;
supports embryonic
Lower
Vagina
of blood ISBN-13: 978-0-13-460995-9
9 780134 609959

The Muscular System The Nervous System The Endocrine System The Cardiovascular System The Lymphatic System The Respiratory System
CENTRAL NERVOUS
SYSTEM
Pineal gland Nasal cavity
Pituitary gland
Brain
Paranasal
sinuses
Spinal Pharynx
cord Parathyroid gland Thyroid gland Larynx
Trachea
Thymus
Thymus Lymph nodes Bronchi
Lung
Heart
Axial Appendicular
muscles Pancreas Diaphragm
muscles
Adrenal gland Capillaries Spleen
Kidney
Artery
Vein
Ovary in Testis in male

female
PERIPHERAL NERVOUS
Tendons SYSTEM Lymphatic
vessel
Peripheral
nerves
Directs immediate Delivers air to sites

responses to stimuli, Transports cells and Defends against where gas exchange
Moves and supports usually by coordinating dissolved materials, infection and disease; occurs between the
the body; produces the activities of other Directs long-term changes including nutrients, returns tissue ﬂuid to air and circulating blood;
heat organ systems in other organ systems wastes, and gases the bloodstream produces sound
ORGANS PRIMARY FUNCTIONS ORGANS PRIMARY FUNCTIONS ORGANS PRIMARY FUNCTIONS ORGANS PRIMARY FUNCTIONS ORGANS PRIMARY FUNCTIONS ORGANS PRIMARY FUNCTIONS
Skeletal Muscles Move skeleton; control entrances and exits Central Nervous System Acts as control center for nervous system; Pineal Gland May control timing of reproduction and Heart Propels blood; maintains blood pressure Lymphatic Vessels Carry lymph (water and proteins) and lymphocytes Nasal Cavities, Filter, warm, humidify air; detect smells; lessen
of digestive tract; contractions generate heat; (CNS) processes information; provides short-term set day-night rhythms from peripheral tissues to veins of the Paranasal Sinuses weight of skull
Blood Vessels Distribute blood around the body
support skeletal position; protect soft tissues control over activities of other systems cardiovascular system
Pituitary Gland Controls other endocrine glands; regulates growth Pharynx Conducts air to larynx; is a chamber shared with
Arteries Carry blood from heart to capillaries
Axial Muscles Support and position axial skeleton Brain Performs complex integrative functions; controls and fluid balance Lymph Nodes Monitor the composition of lymph; macrophages the digestive tract
both voluntary and involuntary activities Capillaries Permit diffusion between blood and engulf pathogens; stimulate immune response
Appendicular Muscles Support, move, and brace limbs Thyroid Gland Controls tissue metabolic rate; regulates blood Larynx Protects opening to trachea and contains
interstitial fluids
Spinal Cord Relays information to and from brain; performs calcium levels Spleen Monitors circulating blood; macrophages engulf vocal cords
Tendons, Aponeuroses Harness forces of contraction; attach muscles to Veins Return blood from capillaries to the heart
less-complex integrative functions; directs many pathogens; stimulates immune response
bones; assist other muscles Parathyroid Glands Regulate calcium levels (with thyroid gland) Trachea Filters air, traps particles in mucus; cartilages keep
simple involuntary activities Blood Transports oxygen, carbon dioxide, and blood Thymus Controls development and maturation of one airway open
Peripheral Nervous Links CNS with other systems and with sense Thymus Controls maturation of lymphocytes (T cells) cells; delivers nutrients and hormones; removes class of lymphocytes (T cells)
System (PNS) organs wastes; regulates temperature; defends against Bronchi Conducts air between trachea and lungs
Adrenal Glands Adjust water balance and tissue metabolism and
regulate cardiovascular and respiratory activity disease Lungs Move air as a result of thoracic cavity volume
changes that occur during breathing
Kidneys Control red blood cell production, elevate blood
pressure, and assist in calcium homeostasis Alveoli Sites of gas exchange between air and blood
Pancreas Regulates blood glucose levels
Gonads
Testes Support male sexual characteristics and
reproductive functions
Ovaries Support female sexual characteristics and

CENTRAL NERVOUS
SYSTEM
Pituitary gland
Brain
Paranasal
sinuses
Spinal Pharynx
Trachea
Thymus
Lung
Heart
Axial Appendicular
muscles
Kidney
Artery
Vein

female
PERIPHERAL NERVOUS
vessel
Peripheral
nerves

interstitial fluids
Gonads

CENTRAL NERVOUS
SYSTEM
Pituitary gland
Brain
Paranasal
sinuses
Spinal Pharynx
Trachea
Thymus
Lung
Heart
Axial Appendicular
muscles
Kidney
Artery
Vein

female
PERIPHERAL NERVOUS
vessel
Peripheral
nerves

interstitial fluids
Gonads

F U N D A M E N TA L S O F
Anatomy
Physiology
Eleventh Edition
Frederic H. Martini, Ph.D.

University of Hawaii at Manoa
Judi L. Nath, Ph.D.

Lourdes University, Sylvania, Ohio
Edwin F. Bartholomew, M.S.
William C. Ober, M.D. Claire E. Ober, R.N. Kathleen Welch, M.D. Ralph T. Hutchings
Art Coordinator and Illustrator Illustrator Clinical Consultant Biomedical Photographer
Kevin Petti Christine Boudrie, M.D. Ruth Anne O’Keefe, M.D.

San Diego Miramar College Lourdes University, Sylvania, Ohio
SmartArt Videos Clinical Cases
A01_MART6026_11_SE_FM_ppi-xxxii.indd 1 04/11/16 11:46 pm

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Notice: Our knowledge in clinical sciences is constantly changing. The authors and the publisher of this volume
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accurate for all circumstances. The authors and the publisher disclaim any liability, loss, or damage incurred as a
consequence, directly or indirectly, of the use and application of any of the contents of this volume.
Copyright © 2018, 2015, 2012 by Frederic H. Martini, Inc., Judi L. Nath, LLC, and Edwin F. Bartholomew,
Inc. Published by Pearson Education, Inc. All Rights Reserved. Printed in the United States of America. This
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Library of Congress Cataloging-in-Publication Data

Names: Martini, Frederic, author. | Nath, Judi Lindsley, author. | Bartholomew, Edwin F., author. | Ober,
William C., illustrator | Ober, Claire E., illustrator. | Welch, Kathleen (Kathleen Martini),
consultant. | Hutchings, R. T., illustrator.
Title: Fundamentals of anatomy & physiology / Frederic H. Martini, Judi L. Nath, Edwin F. Bartholomew;
William C. Ober, art coordinator and illustrator; Claire E. Ober, illustrator; Kathleen Welch, clinical
consultant; Ralph T. Hutchings, biomedical photographer; clinical cases by Christine Boudrie, Ruth Anne
O’Keefe.
Other titles: Fundamentals of anatomy and physiology
Description: Eleventh edition. | New York : Pearson Education, Inc., [2018] | Includes bibliographical
references and index.
Identifiers: LCCN 2016041391| ISBN 9780134396026 (student edition : alk. paper) | ISBN 0134396022
(student edition : alk. paper)
Subjects: | MESH: Anatomy | Physiology
Classification: LCC QP34.5 | NLM QS 4 | DDC 612—dc23 LC record available at
https://lccn.loc.gov/2016041391
1 16
ISBN 10: 0-13-439602-2; ISBN 13: 978-0-13-439602-6 (Student edition)

ISBN 10: 0-13-447727-8; ISBN 13: 978-0-13-447727-5 (Instructor’s Review Copy)
ISBN 10: 0-13-457600-4; ISBN 13: 978-0-13-457600-8 (NASTA)

Text and Illustration Team
Frederic (Ric) H. Martini, Ph.D. Judi L. Nath, Ph.D.

Author Author
Dr. Martini received his Ph.D. from Cornell Dr. Judi Nath is a biology professor and
University in comparative and functional the writer-in-residence at Lourdes Univer-
anatomy for work on the pathophysiol- sity, where she teaches at both the under-
ogy of stress. In addition to professional graduate and graduate levels. Primary
publications that include journal articles courses include anatomy, physiology,
and contributed chapters, technical reports, and magazine articles, pathophysiology, medical terminology, and science writing. She
he is the lead author of 10 undergraduate texts on anatomy and received her bachelor’s and master’s degrees from Bowling Green
physiology. Dr. Martini is currently affiliated with the University of State University, which included study abroad at the University
Hawaii at Manoa and has a long-standing bond with the Shoals of Salzburg in Austria. Her doctoral work focused on autoimmu-
Marine Laboratory, a joint venture between Cornell University nity, and she completed her Ph.D. from the University of Toledo.
and the University of New Hampshire. He has been active in the Dr. Nath is devoted to her students and strives to convey the intri-
Human Anatomy and Physiology Society (HAPS) for over 24 years cacies of science in captivating ways that are meaningful, interac-
and was a member of the committee that established the course tive, and exciting. She has won the Faculty Excellence Award—an
curriculum guidelines for A&P. He is now a President Emeritus of accolade recognizing effective teaching, scholarship, and com-
HAPS after serving as President-Elect, President, and Past-President munity service—multiple times and in 2013 was named as an
over 2005–2007. Dr. Martini is also a member of the American Ohio Memorable Educator. She is active in many professional
Physiological Society, the American Association of Anatomists, organizations, notably the Human Anatomy and Physiology
the Society for Integrative and Comparative Biology, the Australia/ Society (HAPS), where she has served several terms on the board
New Zealand Association of Clinical Anatomists, the Hawaii Acad- of directors. Dr. Nath is a coauthor of Visual Anatomy & Physiology,
emy of Science, the American Association for the Advancement of Visual Essentials of Anatomy & Physiology, Anatomy & Physiology,
Science, and the International Society of Vertebrate Morphologists. and Human Anatomy (published by Pearson), and she is the sole
author of Using Medical Terminology and Stedman’s Medical Termi-
Edwin F. Bartholomew, M.S. nology (published by Wolters Kluwer). Her favorite charities are
Author those that have significantly affected her life, including the local
Humane Society, the Cystic Fibrosis Foundation, and the ALS
Edwin F. Bartholomew received his
Association. In 2015, she and her husband established the Nath
undergraduate degree from Bowling
Science Scholarship at Lourdes University to assist students pur-
Green State University and his M.S.
suing science-based careers. When not working, days are filled
from the University of Hawaii. Mr. Bar-
with family life, bicycling, and hanging with the dogs.
tholomew has taught human anatomy
and physiology at both the secondary and undergraduate levels.
In addition, he has taught courses ranging from botany to zool- William C. Ober, M.D.
ogy at Maui Community College (now the University of Hawaii Art Coordinator and Illustrator
Maui College). For many years, he taught at historic Lahain- Dr. Ober received his undergraduate
aluna High School, the oldest high school west of the Rockies, degree from Washington and Lee Univer-
where he assisted in establishing a Health Occupations Students sity and his M.D. from the University of
of America (HOSA) chapter. He is a coauthor of Fundamentals Virginia. He also studied in the Depart-
of Anatomy & Physiology, Visual Anatomy & Physiology, Essentials ment of Art as Applied to Medicine at
of Anatomy & Physiology, Visual Essentials of Anatomy & Physiol- Johns Hopkins University. After graduation, Dr. Ober completed
ogy, Structure and Function of the Human Body, and The Human a residency in Family Practice and later was on the faculty at the
Body in Health and Disease (all published by Pearson). Mr. Bar- University of Virginia in the Department of Family Medicine and
tholomew is a member of the Human Anatomy and Physiology in the Department of Sports Medicine. He also served as Chief
Society (HAPS), the National Association of Biology Teachers, of Medicine of Martha Jefferson Hospital in Charlottesville, Vir-
the National Science Teachers Association, and the American ginia. He is currently a Visiting Professor of Biology at Washing-
Association for the Advancement of Science. ton and Lee University, where he has taught several courses and
iii

iv Text and Illustration Team
led student trips to the Galapagos Islands. He was on the Core published by Mosby-Yearbook Publishing). For his anatomical
Faculty at Shoals Marine Laboratory for 24 years, where he taught portrayal of the human body, the International Photographers
Biological Illustration every summer. Dr. Ober has collaborated Association has chosen Mr. Hutchings as the best photographer
with Dr. Martini on all of his textbooks in every edition. of humans in the 20th century. He lives in North London, where
he tries to balance the demands of his photographic assignments
Claire E. Ober, R.N. with his hobbies of early motor cars and airplanes.
Illustrator
Claire E. Ober, R.N., B.A., practiced Christine Boudrie, M.D.
family, pediatric, and obstetric nursing Clinical Contributor
before turning to medical illustration Dr. Boudrie studied at Brown Univer-
as a full-time career. She returned to sity in Providence, Rhode Island, for her
school at Mary Baldwin College, where B.S. in biology, and also obtained her
she received her degree with distinction in studio art. Follow- M.D. there. After graduation she served
ing a 5-year apprenticeship, she has worked as Dr. Ober’s part- in the National Health Service Corps, a
ner in Medical & Scientific Illustration since 1986. She was on program of the U.S. Public Health Service, which sponsored
the Core Faculty at Shoals Marine Laboratory and co-taught the her last 2 years of medical school. She was assigned to provide
Biological Illustration course with Dr. Ober for 24 years. The health education to the rural communities of southeast Michi-
textbooks illustrated by Medical & Scientific Illustration have gan with a special focus on seniors. She has had the great plea-
won numerous design and illustration awards. sure of working with a variety of undergraduate and graduate
students in the Northeast and Midwest, earning teaching excel-
Kathleen Welch, M.D. lence awards and a nomination for Carnegie Foundation’s U.S.
Clinical Consultant Professor of the Year in 2014. Currently, she chairs the Depart-
ment of Biology and Health Sciences at Lourdes University, a
Dr. Welch received her B.A. from the
small Franciscan liberal arts school in northwest Ohio.
University of Wisconsin–Madison, her
M.D. from the University of Washington
in Seattle, and did her residency in Fam- Ruth Anne O’Keefe, M.D.
ily Practice at the University of North Clinical Contributor
Carolina in Chapel Hill. Participating in the Seattle WWAMI rural Dr. O’Keefe did her undergraduate stud-
medical education program, she studied in Fairbanks, Anchor- ies at Marquette University, attended
age, and Juneau, Alaska, with time in Boise, Idaho, and Anacortes, graduate school at the University of
Washington, as well. For 2 years, she served as Director of Maternal Wisconsin, and received her M.D. from
and Child Health at the LBJ Tropical Medical Center in Ameri- George Washington University. She was
can Samoa and subsequently was a member of the Department of the first woman to study orthopedics at The Ohio State Univer-
Family Practice at the Kaiser Permanente Clinic in Lahaina, Hawaii, sity during her residency. She did fellowship training in trauma
and on the staff at Maui Memorial Hospital. She was in private surgery at Loma Linda University in California. She serves on
practice from 1987 until her retirement in 2012. Dr. Welch is a Fel- the board of Global Health Partnerships, a group that part-
low of the American Academy of Family Practice and a member of ners with a clinic serving 35,000 people in remote Kenya. She
the Hawaii Medical Association, the Maui County Medical Asso- lives in Albuquerque with her Sweet Ed. She is mother of four,
ciation, and the Human Anatomy and Physiology Society (HAPS). grandmother of nine, and foster mother to many.
With Dr. Martini, she has coauthored both a textbook on anatomy
and physiology and the A&P Applications Manual. She and Dr. Mar- Kevin Petti, PhD
tini were married in 1979, and they have one son. Smart Art Video Contributor
Dr. Petti is a professor at San Diego Mi-
Ralph T. Hutchings ramar College, and teaches courses in
Biomedical Photographer human anatomy and physiology, hu-
Mr. Hutchings was associated with the man dissection, and health education.
Royal College of Surgeons for 20 years. He is President Emeritus of the Human
An engineer by training, he has focused Anatomy and Physiology Society (HAPS) and holds a doctor-
for years on photographing the structure ate from the University of San Diego. As a dual U.S./Italian citi-
of the human body. The result has been a zen, he also teaches courses in Italy that focus on the genesis
series of color atlases, including the Color Atlas of Human Anatomy, of anatomy as a science and its influence on the Renaissance
the Color Atlas of Surface Anatomy, and The Human Skeleton (all masters.

Preface
The Eleventh Edition of Fundamentals of Anatomy & Physiology HAPS-based Learning Outcomes and the associated teaching
is a comprehensive textbook that fulfills the needs of today’s points. Author Judi Nath sat on the Human Anatomy and
students while addressing the concerns of their teachers. We Physiology Society (HAPS) committee that developed the
focused our attention on the question “How can we make this HAPS Learning Outcomes recommended to A&P teachers,
information meaningful, manageable, and comprehensible?” and the Learning Outcomes in this book are based on them.
During the revision process, we drew upon our content knowl-
edge, research skills, artistic talents, and years of classroom
experience to make this edition the best yet.
Chapter-by-Chapter Changes in the
The broad changes to this edition are presented in the New Eleventh Edition
to the Eleventh Edition section below, and the specific changes This annotated Table of Contents provides examples of revi-
are presented in the Chapter-by-Chapter Changes in the Elev- sion highlights in each chapter of the Eleventh Edition. For a
enth Edition section that follows. more complete list of changes, please contact the publisher.
Chapter 1: An Introduction to Anatomy and Physiology
New to the Eleventh Edition • Added a new Section 1–1 on using the text and art in tandem.
In addition to the many technical changes in this edition, such • New separate section (1-4) on medical terminology.
as updated statistics and anatomy and physiology descriptions, • Reorganized the chapter to start with simpler anatomical topics
we have made the following key changes: and build to more complex physiological ones. Homeostasis and
the roles of negative feedback now conclude the chapter as Sec-
■■ NEW SmartArt Videos help students better navigate key, tions 1–7 and 1–8, respectively.
complex pieces of art. Author Kevin Petti walks students • NEW Figure 1–1 A Conceptual Framework for Learning
through select pieces of art from the book, providing addi- • NEW Clinical Note: Habeas Corpus (“You Shall Have the Body”)
tional background and detail. • NEW Clinical Note: The Sounds of the Body
• Figure 1–8 The Control of Room Temperature (new homeostasis
■■ NEW design for homeostasis figures replaces former
design)
Tenth Edition figures in various chapters.
• Figure 1–9 Negative Feedback: Control of Body Temperature
■■ NEW Questions have been added to selected figures in (new homeostasis design)
all chapters to reinforce text–art integration. • Former Spotlight Figure 1–10 Diagnostic Imaging Techniques is
now a Clinical Note.
■■ Easier narrative leads to improved clarity of text.
• Questions added to Figures 1–3, 1–4, 1–5, 1–6, and 1–9.
Clearly organized text uses simpler, shorter, more active
sentences, with a reading level that makes reading and Chapter 2: The Chemical Level of Organization
studying easier for students. • Clinical Case: What Is Wrong with My Baby? revised
■■ Anatomical terms have been updated based on Termino- • Clinical Note: Radiation Sickness revised
logia Anatomica, Terminologia Histologica, and Terminologia • NEW Figure 2–1 Hydrogen Atom with Electron Cloud
• NEW Section 2–9 gathers together coverage of monomers,
Embryologica. Eponyms continue to be included within the
polymers, and functional groups to provide an overview to the
narrative. organic compounds.
• Table 2–8.Turnover Times moved to the Appendix as Turnover
Times of Organic Components of Four Cell Types.
Hallmark Features of This Text • NEW Clinical Note: Too Sweet on Sugar?
■■ 50 Spotlight Figures provide highly visual one- and two- • Questions added to Figures 2–3, 2–8, 2–9, 2–12, 2–15, 2–17,
2–24, and 2–26.
page presentations of tough topics in the book, with a
particular focus on physiology. Chapter 3: The Cellular Level of Organization
■■ 29 Clinical Cases get students motivated for their future careers. • Clinical Case: The Beat Must Go On! revised (new title)
Each chapter opens with a story-based Clinical Case related to • Figure 3–2 The Plasma Membrane revised (new added part b)
• Figure 3–8 Lysosome Functions revised
the chapter content and ends with a Clinical Case Wrap-Up.
• NEW Clinical Note: Lysosomal Storage Disease
■■ The repetition of the chapter-opening Learning Out-
• NEW Clinical Note: Free Radicals
comes below the coordinated section headings within
• Figure 3–13 The Process of Translation revised
the chapters underscores the connection between the

vi Preface
• NEW Clinical Note: Drugs and the Plasma Membrane • Figure 7–3 The Adult Skull revised (hyphenates the terms supra-
• Figure 3–21 Receptor–Mediated Endocytosis revised orbital and infra-orbital)
• Spotlight Figure 3–23 Stages of a Cell’s Life Cycle revised • Figure 7–9 The Ethmoid revised (ethmoidal labyrinth replaces
lateral mass)
• Questions added to Figures 3–3, 3–9, 3–11, 3–15, 3–17, 3–18,
and 3–19. • Spotlight Figure 7–4 Sectional Anatomy of the Skull revised
(updated trigeminal nerve [V] terminology)
Chapter 4: The Tissue Level of Organization • Figure 7–14 The Orbital Complex revised (art and photograph
• NEW Figure 4–1 An Orientation to the Body’s Tissues now share labels)
• Figure 4–2 Cell Junctions revised (basal lamina replaces clear layer • Figure 7–15 The Nasal Complex revised (part b new art)
and reticular lamina replaces dense layer) • Figure 7–17 The Vertebral Column revised (new color-coded
• Table 4–1.Classifying Epithelia revised vertebral regions)
• Connective tissue proper has been separated out into its own sec- • Figure 7–22 Sacrum and Coccyx revised (new coccyx label
tion, Section 4–5. This section now also includes the discussion configuration)
of fasciae. • Questions added to Figures 7–16, 7–17, and 7–23.
• Figure 4–9 The Cells and Fibers of Connective Tissue Proper
revised (added fibrocyte) Chapter 8: The Appendicular Skeleton
• Figure 4–10 Embryonic Connective Tissues revised (now share • NEW Clinical Case: Timber!!
labels) • Figure 8–6 Bones of the Right Wrist and Hand revised (carpal
• The fluid connective tissues blood and lymph now have their bones separated out into proximal and distal carpals)
own section, Section 4–6. • NEW Clinical Note: Shin Splints
• Questions added to Figures 4–3, 4–14, 4–16, 4–18, and 4–19. • Clinical Note: Carpal Tunnel Syndrome includes new illustration
Chapter 5: The Integumentary System • Questions added to Figures 8–1, 8–6, 8–8, and 8–12.
• NEW Clinical Case: He Has Fish Skin! Chapter 9: Joints
• Figure 5–1 The Components of the Integumentary System revised • NEW Clinical Note: Bursitis and Bunions
• The dermis and hypodermis sections have been moved up to • NEW Clinical Note: Dislocation
become Sections 5–2 and 5–3, respectively, to give students more
• Spotlight Figure 9–2 Joint Movement revised (headings labeled
anatomical background to understand the later physiological
sections. as parts a, b, and c; plane joint replaces gliding joint)
• Figure 9–5 Special Movements (part labels added; arrows moved
• Spotlight Figure 5–3 The Epidermis revised (matched SEM
and art) onto photographs in new parts d and e)
• Section 9–5 now covers the hinge joints of the elbow and knee, while
• NEW Clinical Note: Nips, Tucks, and Shots
Section 9–6 covers the ball-and-socket shoulder and hip joints.
• Figure 5–12 Hair Follicles and Hairs revised (new part b)
• NEW Build Your Knowledge Figure 9–11 Integration of the
• Figure 5–14 Sweat Glands revised (uses eccrine sweat glands as SKELETAL system with the other body systems presented so far
primary term) (replaces System Integrator)
• NEW Clinical Note: Your Skin, A Mirror of Your Health • Questions added to Figures 9–1, 9–3, 9–6, and 9–9.
• NEW Clinical Note: Burns and Grafts
• NEW Build Your Knowledge Figure 5–15 Integration of the Chapter 10: Muscle Tissue
INTEGUMENTARY system with the other body systems presented • NEW Clinical Case: Keep on Keepin’ On
so far (replaces System Integrator) • Figure 10–1 The Organization of Skeletal Muscles revised (added
• Questions added to Figures 5–1, 5–6, 5–8, 5–10, and 5–13. tendon attachment to bone)
• Figure 10–5 Sarcomere Structure, Superficial and Cross-Sectional
Chapter 6: Bones and Bone Structure (formerly called Osseous Tissue
Views revised (new figure icon)
and Bone Structure)
• Figure 10–6 Levels of Functional Organization in a Skeletal Mus-
• NEW Figure 6–4 Bone Lacking a Calcified Matrix
cle revised (new grouping of art)
• Figure 6–5 Types of Bone Cells revised (art and layout to parallel
• Figure 10–7 Thin and Thick Filaments revised (new art for parts
text)
b, c, and d)
• NEW Figure 6–6 Osteons of Compact Bone (former part a
• Spotlight Figure 10–9 Events at the Neuromuscular Junction
removed)
revised (art now shows Na+ flow through membrane channels)
• We now clarify in the section titles that Section 6–5 covers both
• Spotlight Figure 10–11 The Contraction Cycle and Cross-Bridge
interstitial and appositional growth, while remodeling is covered
Formation revised (improved step boxes visibility)
in Section 6–6.
• Figure 10–16 Effects of Repeated Stimulations revised (new art
• Spotlight Figure 6–17 Types of Fractures and Steps in Repair
organization and explanatory text)
revised (tibia replaces humerus to better match photograph)
• Information about tension production at the level of skeletal
• Questions added to Figures 6–3, 6–5, 6–7, and 6–10.
muscles has been separated out into a new section, Section 10–6.
Chapter 7: The Axial Skeleton • Figure 10–20 Muscle Metabolism revised (text and art in bottom
• Figure 7–2 Cranial and Facial Subdivisions of the Skull revised box)

Preface vii
• Figure 10–21 Fast versus Slow Fibers revised (micrograph is a TEM • Figure 12–14 Propagation of an Action Potential revised (added
not LM) part labels)
• Coverage of muscle fatigue has been moved from the muscle • NEW Figure 12–16 Events in the Functioning of a Cholinergic
metabolism section to the muscle performance section, Synapse revised (now runs across two pages; text in steps revised)
Section 10–8. • Table 12–4 Representative Neurotransmitters and Neuromodula-
• NEW Clinical Note: Electromyography tors revised (endorphins separated from opioids)
• Discussion on the effects of skeletal muscle aging has been • Figure 12–17 Mechanisms of Neurotransmitter and Receptor
moved from Chapter 11 and included with muscle hypertrophy Function revised (chemically gated ion channel art now matches
and atrophy in Section 10–8. that in previous figures)
• Questions added to Figures 10–3, 10–6, 10–14, and 10–21. • Questions added to Figures 12–2, 12–4, and 12–16.
Chapter 11: The Muscular System Chapter 13: The Spinal Cord, Spinal Nerves, and Spinal Reflexes
• NEW Clinical Case: Downward-Facing Dog • Figure 13–1 An Overview of Chapters 13 and 14 revised
• Figure 11–1 Muscle Types Based on Pattern of Fascicle Organiza- • Figure 13–2 Gross Anatomy of the Adult Spinal Cord revised
tion revised (added new part b)
• Figure 11–2 The Three Classes of Levers revised (new icons for • Uses the term posterior and anterior in reference to spinal roots,
each lever) ganglion, and rami instead of dorsal and ventral (e.g., Figure 13–3,
• Spotlight Figure 11–3 Muscle Action revised (new art in part c) 13–4, 13–5, and Spotlight Figure 13–8)
• The introduction to axial and appendicular muscles has been • Figure 13–6 A Peripheral Nerve revised (corrected magnified sec-
made into a separate section, Section 11–5, to provide an over- tion in part a)
view before we cover the muscles in detail. • NEW Figure 13–9 Nerve Plexuses and Peripheral Nerves revised
• NEW Clinical Note: Signs of Stroke (labels grouped and boxed)
• Figure 11–12 Oblique and Rectus Muscles and the Diaphragm • Figure 13–10 The Cervical Plexus revised (corrected cranial nerve
revised (added transversus thoracis label to part c) designation, e.g., accessory nerve [XI] replaces accessory nerve
[N XI])
• Figure 11–17 Muscles That Move the Forearm and Hand revised
(corrected leader for triceps brachii, medial head) • Figure 13–12 The Lumbar and Sacral Plexuses revised (removed
Clinical Note)
• Figure 11–18 Muscles That Move the Hand and Fingers revised
• Spotlight Figure 13–14 Spinal Reflexes revised (added part labels
• Figure 11–21 Muscles That Move the Leg revised (quadriceps femo-
to better coordinate with text)
ris replaces quadriceps muscles)
• Figure 13–15 The Classification of Reflexes revised (reorganized
categories within inclusive boxes)
MUSCULAR system with the other body systems presented so far
(replaces System Integrator) • Figure 13–17 The Plantar Reflex and Babinski Reflex revised
(Babinski reflex replaces Babinski sign/positive Babinski reflex and
• Questions added to Figures 11–5, 11–6, 11–10, 11–17, 11–19, and
plantar reflex replaces negative Babinski reflex)
11–21.
• Questions added to Figures 13–3, 13–5, 13–9, and 13–15.
Chapter 12: Nervous Tissue
• Chapter title changed from Neural Tissue to Nervous Tissue
Chapter 14: The Brain and Cranial Nerves
• Figure 14–1 An Introduction to Brain Structures and Functions
• Section 12–1 includes discussion of the Enteric Nervous System
revised (added part labels a–f to better coordinate with text)
(ENS) as a third division of the nervous system
• Figure 14–2 Ventricular System revised (ventricular system of the
• Figure 12–1 A Functional Overview of the Nervous System
brain replaces ventricles of the brain)
revised (added a body figure to support text-art integration)
• Figure 14–3 The Relationships among the Brain, Cranium, and
• Moved coverage of synapse structures from Section 12–2 into Sec-
Cranial Meninges revised periosteal cranial dura replaces dura mater
tion 12–7 so it is now right before students need it to understand
[periosteal layer] and meningeal cranial dura replaces dura mater
synaptic function.
[meningeal layer])
• Figure 12–3 Structural Classification of Neurons revised (moved
• Figure 14–5 The Diencephalon and Brainstem revised (corrected
part labels and text above art)
cranial nerve designation, e.g., in Cranial Nerves box, CN replaces
• Figure 12–5 Neuroglia in the CNS revised (deleted micrograph; N for nerve designations.)
label grouping for neuroglia)
• The sections on the midbrain (now Section 14–5) and cerebel-
• Schwann cell text updated (neurolemmocytes replaces neurilemma lum (now Section 14–6) have been switched, so that we now
cells and neurolemma replaces neurilemma). cover all of the brainstem together.
• Figure 12–7 Peripheral Nerve Regeneration after Injury revised • Figure 14–10 The Thalamus revised (thalamic nuclei labels now
• Spotlight Figure 12–8 Resting Membrane Potential revised (text color coded to clarify brain regions that receive thalamic input;
revised in first two columns) medial geniculate body and lateral geniculate body replace medial
• Figure 12–9 Electrochemical Gradients for Potassium and geniculate nucleus and lateral geniculate nucleus)
Sodium Ions revised (text revised in part c) • Figure 14–18 Origins of the Cranial Nerves revised (new brain
• Figure 12–11 Graded Potentials revised (text in step 2) cadaver photograph; cranial nerve labels boxed together)
• NEW Spotlight Figure 12–13 Generation of an Action Potential • Questions added to Figures 14–1, 14–3, 14–9, 14–13, 14–15,
revised (text in step boxes) 14–22, and 14–26.

viii Preface
Chapter 15: Sensory Pathways and the Somatic Nervous System • Figure 17–10 Factors Affecting Focal Distance revised (clarified
• Figure 15–1 An Overview of Events Occurring Along the Sensory text within figure; added Focal point label to all the art)
and Motor Pathways revised • Figure 17–11 Accommodation revised (fovea centralis replaces
• Figure 15–2 Receptors and Receptive Fields revised (different col- fovea)
ors for each receptive field and added Epidermis and Free nerve • Figure 17–14 Structure of Rods, Cones, and the Rhodopsin Mol-
endings labels) ecule revised (pigmented epithelium replaces pigment epithelium)
• Figure 15–3 Tonic and Phasic Sensory Receptors revised (new • Figure 17–23 The Internal Ear revised (ampullary crest replaces
background colors for graphs) crista ampullaris; clarified position of membranous labyrinth in
• Figure 15–4 Tactile Receptors in the Skin revised (added myelin part a art)
sheath to afferent nerve fiber in part c; part d, bulbous corpuscle • Figure 17–24 The Semicircular Ducts revised (ampullary cupula
replaces Ruffini corpuscle; part e, lamellar [pacinian] corpuscle replaces cupula; vestibular nerve replaces vestibular branch in part a)
replaces lamellated [pacinian] corpuscle) • Figure 17–26 Pathways for Equilibrium Sensations revised
• NEW Figure 15–6 Locations and Functions of Chemoreceptors (cochlear nerve replaces cochlear branch)
• Figure 15–7 Sensory Pathways and Ascending Tracts in the Spinal • Figure 17–30 Sound and Hearing revised (added new art to illus-
Cord revised (gracile fasciculus replaces fasciculus gracilis, cuneate trate step 4)
fasciculus replaces fasciculus cuneate) • Figure 17–32 Pathways for Auditory Sensations revised (auditory
• Spotlight Figure 15–8 Somatic Sensory Pathways revised replaces sound and acoustic in steps 2 and 5)
(introduced “somatotopy” in Sensory Homunculus boxed text) • Questions added to Figures 17–4, 17–7, 17–21, and 17–28.
Chapter 18: The Endocrine System
Chapter 16: The Autonomic Nervous System and Higher-Order • Figure 18–1 Organs and Tissues of the Endocrine System revised
Functions (clarified hormones in Gonads box)
• NEW Clinical Case: Remember Me? • Table 18–1 Mechanisms of Intercellular Communication revised
• NEW Spotlight Figure 16–2 The Autonomic Nervous System (added autocrine communication)
(incorporates old Figures 16–4 and 16–6. added Pons and • Spotlight Figure 18–3 G Proteins and Second Messengers revised
Medulla oblongata labels on the art) (added positive feedback involving protein kinase C; clarified
• A new summary Section 16–6 called “The differences in the calcium ion sources for binding with calmodulin)
organization of sympathetic and parasympathetic structures lead • Figure 18–6 Three Mechanisms of Hypothalamic Control over
to widespread sympathetic effects and specific parasympathetic Endocrine Function revised (removed numbers and added color
effects” has been created. coding to enhance links between hypothalamic structures and
• The sections on memory, states of consciousness, and behavior functions)
have been combined into Section 16–9. • Figure 18–7 The Hypophyseal Portal System and the Blood Sup-
• Figure 16–11 The Reticular Activating System (RAS) revised (CN ply to the Pituitary Gland revised (regulatory hormones replaces
II and CN VIII replace N II and N VIII, respectively) regulatory factors)
• NEW Build Your Knowledge Figure 16–12 Integration of the • Figure 18–8 Feedback Control of Endocrine Secretion revised
NERVOUS system with the other body systems presented so far (added two banners to separate part a from parts b and c; incor-
(replaces System Integrator) porated old part d with a new color-coded table within part a)
• Questions added to Figures 16–1, 16–3, 16–4, 16–7, and 16–11. • Figure 18–9 Pituitary Hormones and Their Targets revised (added
color codes to correlate with Figure 18–6)
Chapter 17: The Special Senses • Figure 18–11 Synthesis and Regulation of Thyroid Hormones
• Figure 17–1 The Olfactory Organs revised (I replaces N I) (added step art to part a that describes synthesis, storage, and
• Spotlight Figure 17–2 Olfaction and Gustation revised (added secretion of thyroid hormones; added new homeostasis design to
part a and b labels) part b that illustrates the regulation of thyroid secretion)
• Figure 17–3 Papillae, Taste Buds, and Gustatory Receptor Cells • Figure 18–12 Anatomy of the Parathyroid Glands revised (princi-
revised (new figure title; added Midline groove label to part a) pal cells replaces chief cells)
• Figure 17–4 External Features and Accessory Structures of the Eye • Figure 18–13 Homeostatic Regulation of the Blood Calcium Ion
revised (lateral angle replaces lateral canthus, medial angle replaces Concentration revised (new homeostasis design)
medial canthus, bulbar conjunctiva replaces ocular conjunctiva, eyelid • Figure 18–14 The Adrenal Gland and Adrenal Hormones revised
replaces palpebrae) (added new micrograph and new design for part c)
• Figure 17–5 The Sectional Anatomy of the Eye revised (corneo- • Figure 18–17 Homeostatic Regulation of the Blood Glucose
scleral junction replaces corneal limbus) Concentration revised (new homeostasis design)
• Figure 17–6 The Pupillary Muscles revised (dilator pupillae replaces • Figure 18–19 Endocrine Functions of the Kidneys revised (new
pupillary dilator muscles; sphincter pupillae replaces pupillary constrictor) homeostasis design in part b)
• Figure 17–7 The Organization of the Retina revised (pigmented • NEW Build Your Knowledge Figure 18–21 Integration of the
layer of retina replaces pigmented part of retina; switched parts b ENDOCRINE system with the other body systems presented so
and c to parallel new sequence in the text) far (replaces System Integrator)
• A new overview section, Section 17–4, called “The focusing of • Questions added to Figures 18–6, 18–8, 18–9, 18–14, and
light on the retina leads to the formation of a visual image” has 18–17.
been created in the text.

Preface ix
Chapter 19: Blood Chapter 21: Blood Vessels and Circulation

• NEW Clinical Case: Crisis in the Blood • Figure 21–2 Histological Structures of Blood Vessels revised
• Section 19–1 now covers the main functions and characteristics (added luminal diameters for all vessels)
of blood, as well as an introduction to both plasma and formed • Figure 21–4 The Organization of a Capillary Bed revised (deleted
elements (combined with the old Section 19–2). metarterioles)
• Figure 19–4 Stages of RBC Maturation: Erythropoiesis and • Figure 21–8 Relationships among Vessel Luminal Diameter,
Figure 19–5 Recycling of Red Blood Cell Components sequence Cross-Sectional Area, Blood Pressure, and Blood Velocity within
changed because of chapter reorganization. the Systemic Circuit revised (vessel luminal diameter replaces vessel
• Figure 19–6 Blood Types and Cross-Reactions revised (corrected diameter in part a; vessel lumens replaces vessels in part b)
shapes of anti-A and anti-B antibodies) • Figure 21–11 Forces Acting across Capillary Walls revised (added
• Figure 19–7 Blood Type Testing revised (anti-Rh replaces anti-D; tissue cells background)
added “clumping” or “no clumping” under test results for • The discussion of vasomotion has been moved from Section
clarification) 21–1 to Section 21–3, to cover this process with other vessel
• Figure 19–11 The Phases of Hemostasis (Vascular, Platelet, and physiology.
Coagulation) and Clot Retraction revised (clotting factors replaces • Figure 21–12 Short-Term and Long-Term Cardiovascular
platelet factors in step 2; new blood clot SEM) Responses revised (new homeostasis design)
• Table 19–2.Differences in Blood Group Distribution revised • Figure 21–13 Baroreceptor Reflexes of the Carotid and Aortic
• Questions added to Figures 19–3, 19–5, 19–6, and 19–10. Sinuses revised (new homeostasis design)
• Figure 21–14 The Chemoreceptor Reflexes revised (new homeo-
Chapter 20: The Heart stasis design)
• Figure 20–1 An Overview of the Cardiovascular System revised • Figure 21–15 The Hormonal Regulation of Blood Pressure and
(new art and boxed labels) Blood Volume revised (new homeostasis design)
• Figure 20–2 The Location of the Heart in the Thoracic Cavity revised • Figure 21–16 Cardiovascular Responses to Blood Loss revised
(parietal layer of serous pericardium replaces parietal pericardium) (new homeostasis design)
• Figure 20–4 The Heart Wall revised (visceral layer of serous pericar- • Figure 21–24 Arteries Supplying the Abdominopelvic Organs revised
dium replaces epicardium [visceral pericardium])
• Figure 21–27 Major Veins of the Head, Neck, and Brain revised
• Figure 20–5 The Sectional Anatomy of the Heart revised (tricuspid (added confluence of sinuses to parts a, b and c)
valve replaces right AV [tricuspid] valve; mitral valve replaces left AV
• Figure 21–28 The Venous Drainage of the Abdomen and Chest
[mitral] valve)
revised (median sacral replaces medial sacral; hemi-azygos replaces
• Figure 20–7 Valves of the Heart and Blood Flow revised (red arrows hemiazygos)
replace black arrows in part a; black arrows deleted in part b)
• Figure 21–29 Flowchart of Circulation to the Superior and Infe-
• Figure 20–10 The Conducting System of the Heart and the Pace- rior Venae Cavae revised
maker Potential revised (pacemaker potential replaces prepotential)
• Figure 21–31 The Hepatic Portal System revised
• Figure 20–11 Impulse Conduction through the Heart and Accompa-
nying ECG Tracings revised (added ECG tracings next to the step art)
CARDIOVASCULAR system with the other body systems pre-
• Figure 20–12 An Electrocardiogram (ECG) revised (QRS complex sented so far (replaces System Integrator)
replaces QRS interval in part b)
• Questions added to Figures 21–2, 21–7, 21–12, 21–15, 21–21,
• Figure 20–14 Cardiac Contractile Cells revised (cardiac contrac- and 21–29.
tile cells replaces cardiac muscle cells; former Figure 20–5 moved
because of chapter reorganization to provide structural informa- Chapter 22: The Lymphatic System and Immunity
tion right before functional information) • The coverage of the lymphatic system is now Section 22–1.
• Figure 20–15 Action Potentials in Cardiac Contractile Cells and • Figure 22–1 The Components of the Lymphatic System revised
Skeletal Muscle Fibers revised (ventricular contractile cell replaces (Other Lymphoid Tissues and Organs heading replaces Lymphoid
ventricular muscle cell) Tissues and Organs heading because lymph nodes are organs)
• Figure 20–16 Phases of the Cardiac Cycle revised (moved labels • Figure 22–5 Lymphoid Nodules moved (formerly Figure 22–7,
for Atrial systole, Atrial diastole, Ventricular systole, and Ventricu- moved due to chapter reorganization)
lar diastole to perimeter of art for increased correlation)
• Figure 22–6 The Structure of a Lymph Node revised and moved
• Figure 20–17 Pressure and Volume Relationships in the Cardiac Cycle (cortex replaces outer cortex; paracortex replaces deep cortex;
revised (modified colors of banners to match the perimeter art of Fig- formerly Figure 22–8, moved due to chapter reorganization)
ure 20–16 Phases of the Cardiac Cycle for increased correlation)
• Figure 22–7 The Thymus moved (formerly Figure 22–9, moved
• Figure 20–19 Factors Affecting Cardiac Output revised (added due to chapter reorganization)
EDV and ESV)
• Figure 22–8 The Spleen moved (formerly Figure 22–10, moved
• Figure 20–23 Factors Affecting Stroke Volume revised (added key) due to chapter reorganization)
• Figure 20–24 A Summary of the Factors Affecting Cardiac Output • The original Section 22–1 has been moved to become Section
revised (deleted arrow from Preload to End-systolic volume box) 22–2 and adapted so that it is now titled “Lymphocytes are
• Table 20–1 Structural and Functional Differences between Car- important to the innate (nonspecific) and adaptive (specific)
diac Contractile Cells and Skeletal Muscle Fibers revised (cardiac defenses that protect the body.”
contractile cells replaces cardiac muscle cells) • We have broadened the definition of the term “immune
• Questions added to Figures 20–1, 20–5, 20–11, 20–15, 20–21, response” from a “defense against specific antigens” to “the
and 20–24. body’s reaction to infectious agents and abnormal substances.”

x Preface
• Figure 22–9 The Origin and Distribution of Lymphocytes revised • Figure 23–8 Alveolar Organization revised and moved (pneumo-
and moved (hemocytoblasts replaces multipotent hemopoietic stem cyte type I and type II replaces type I and type II pneumocyte; blood
cell; formerly Figure 22–10, moved due to chapter reorganization) air barrier replaces respiratory membrane; formerly Figure 23–10,
• Figure 22–10 Innate Defenses revised moved due to chapter reorganization
• Figure 22–11 How Natural Killer Cells Kill Cellular Targets moved • Figure 23–9 The Gross Anatomy of the Lungs revised and moved
(formerly Figure 22–12, moved due to chapter reorganization) (formerly Figure 23–7, moved due to chapter reorganization)
• Figure 22–12 Interferons revised • Figure 23–10 The Relationship between the Lungs and Heart
revised (labeled Anterior border in part b; formerly Figure 23–8,
• NEW Figure 22–13 Pathways of Complement Activation revised
moved due to chapter reorganization)
(added the Lectin Pathway)
• Figure 23–11 An Overview of the Key Steps in Respiration revised
• Figure 22–14 Inflammation and the Steps in Tissue Repair moved
(formerly Figure 22–15, moved due to chapter reorganization) • NEW Figure 23–13 Primary and Accessory Respiratory Muscles
• Figure 22–15 Classes of Lymphocytes revised and moved (regula- • NEW Spotlight Figure 23–14 Pulmonary Ventilation
tory T cells replaces suppressor T cells; formerly Figure 22–5, moved • Figure 23–15 Pressure and Volume Changes during Inhalation
due to chapter reorganization) and Exhalation revised and moved (outlined boxes with same
• Figure 22–16 An Overview of Adaptive Immunity revised and color as respective line graphs for better correlation; formerly
moved (former title: An Overview of the Immune Response; for- Figure 23–14, moved due to chapter reorganization)
merly Figure 22–17, moved due to chapter reorganization) • Figure 23–16 Pulmonary Volumes and Capacities revised
• Figure 22–17 Forms of Immunity revised and moved (acquired • Figure 23–18 An Overview of Respiratory Processes and Partial
replaces induced; formerly Figure 22–16, moved due to chapter Pressures in Respiration revised (added new icon art)
reorganization) • Figure 23–23 A Summary of the Primary Gas Transport Mechanisms
• Figure 22–18 Antigens and MHC Proteins revised revised (added oxygen and carbon dioxide partial pressure values)
• Spotlight Figure 22–21 Cytokines of the Immune System revised • Spotlight Figure 23–25 Control of Respiration revised
and moved (formerly Figure 22–28, moved due to chapter • Figure 23–26 The Chemoreceptor Response to Changes in PCO2
reorganization) revised (new homeostasis design)
• Figure 22–22 A Summary of the Pathways of T Cell Activation • NEW Build Your Knowledge Figure 23–28 Integration of the
revised and moved (regulatory T cells replaces suppressor T cells; for- RESPIRATORY system with the other body systems presented so
merly Figure 22–21, moved due to text reorganization) far (replaces System Integrator)
• Figure 22–23 The Sensitization and Activation of B Cells moved • Questions added to Figures 23–2, 23–7, 23–8, 23–13, 23–16,
(formerly Figure 22–22, moved due to chapter reorganization) 23–20, and 23–26.
• Figure 22–24 Antibody Structure and Function moved (formerly
Figure 22–23, moved due to chapter reorganization) Chapter 24: The Digestive System
• Figure 22–27 An Integrated Summary of the Immune Response • Figure 24–1 Components of the Digestive System revised
revised and moved (regulatory T cells replaces suppressor T cells; for- (mechanical digestion replaces mechanical processing)
merly Figure 22–26, moved due to chapter reorganization • Figure 24–2 The Mesenteries revised (added Visceral peritoneum
• NEW Build Your Knowledge Figure 22–30 Integration of the label to part d)
LYMPHATIC system with the other body systems presented so far • Figure 24–3 Histological Organization of the Digestive Tract
(replaces System Integrator) revised (muscular layer replaces muscularis externa; intestinal glands
• Questions added to Figures 22–3, 22–8, 22–12, 22–17, 22–25, replaces mucosal glands; submucosal neural plexus replaces submuco-
and 22–26. sal plexus)
• Figure 24–4 Peristalsis revised (Initial State now step 1)
Chapter 23: The Respiratory System • Figure 24–6 Anatomy of the Oral Cavity revised (oral vestibule
• NEW Clinical Case: No Rest for the Weary replaces vestibule; frenulum of tongue replaces lingual frenulum)
• Figure 23–3 The Structures of the Upper Respiratory System revised • Figure 24–7 The Teeth moved (formerly Figure 24–8, moved due
(epithelial surface replaces superficial view in micrograph of part a) to chapter reorganization)
• Figure 23–3 The Structures of the Upper Respiratory System revised • Figure 24–8 Deciduous and Permanent Dentitions revised (new
(pharyngeal opening of auditory tube replaces nasopharyngeal meatus) title; deciduous replaces primary; permanent replaces secondary;
• Original Sections 23–3 and 23–4 have been combined into a new canine replaces cuspid; formerly Figure 24–9, moved due to chap-
Section 23–3 on the conducting portion of the lower respiratory ter reorganization)
system. This section now includes coverage of the bronchial tree. • Figure 24–9 Anatomy of the Salivary Glands moved (formerly
• Figure 23–6 The Anatomy of the Trachea revised (cross-sectional Figure 24–7, moved due to chapter reorganization)
diagram of trachea and esophagus replaces micrograph to better • Section 24–3, titled “The pharynx and esophagus are passageways
highlight trachealis) that transport the food bolus from the oral cavity to the stom-
• NEW Section 23–4 has been added titled “The respiratory portion ach,” now combines coverage of the pharynx, esophagus, and
of the lower respiratory system is where gas exchange occurs.” deglutition.
This covers the respiratory bronchioles, alveolar ducts and alveoli, • Figure 24–12 Gross Anatomy of the Stomach revised (new title;
and the blood air barrier. pyloric part replaces pylorus)
• Figure 23–7 The Bronchi, Lobules, and Alveoli of the Lung • Figure 24–14 The Secretion of Hydrochloric Acid Ions revised
revised and moved (new art in part c; formerly Figure 23–9, (new title; anion countertransport mechanism replaces countertrans-
moved due to chapter reorganization) port mechanism; added Dissociation label for clarification)

Preface xi
• Spotlight Figure 24–15 The Regulation of Gastric Activity revised • Figure 25–6 Glycolysis and Gluconeogenesis revised (added
(clarified Key in steps 1 and 2) NADH S NAD to show pyruvate is reduced to form lactate when
• The new Section 24–5 called “Accessory digestive organs, such as oxygen is lacking)
the pancreas and liver, produce secretions that aid in chemical • Figure 25–7 Lipolysis and Beta-Oxidation revised (new title; low-
digestion” now covers these accessory organs all in one place. ered total ATP yield)
• Figure 24–16 Anatomy of the Pancreas moved (formerly Figure • Figure 25–8 Lipid Transport and Use revised (formerly Figure 25–9)
24–18, moved due to chapter reorganization) • Spotlight Figure 25–10 Absorptive and Postabsorptive States
• Figure 24–17 Gross Anatomy of the Liver revised and moved revised (membrane receptor replaces carrier protein; formerly
(new title; added Peritoneal cavity label to part a; formerly Figure Spotlight Figure 25–11)
24–19, moved due to chapter reorganization) • Figure 25–11 MyPlate, MyWins revised (new title)
• Figure 24–18 Histology of the Liver revised and moved (portal • Questions added to Figures 25–2, 25–5, 25–7, 25–8, and 25–14.
triad replaces portal area; reoriented micrograph to better correlate
with art in part b; renamed portal triad structures to interlobular Chapter 26: The Urinary System
bile duct, interlobular vein, and interlobular artery; stellate macro- • Figure 26–6 The Anatomy of a Representative Nephron and the
phage replaces Kupffer cells; formerly Figure 24–20, moved due to Collecting System revised (new figure title; removed functional
chapter reorganization) anatomy descriptions; descending thin limb replaces thin descending
• Figure 24–19 The Anatomy and Physiology of the Gallbladder limb in all relevant figures)
and Bile Ducts revised (bile duct replaces common bile duct; for- • Figure 26–7 The Functional Anatomy of a Representative
merly Figure 24–21, moved due to chapter reorganization) Nephron and the Collecting System revised (added Extraglo-
• Figure 24–20 Gross Anatomy and Segments of the Intestine merular mesangial cells label in part a to clarify their distinction
moved (new title; formerly Figure 24–16, moved due to chapter from juxtaglomerular cells; intraglomerular mesangial cell replaces
reorganization) mesangial cell)
• Figure 24–21 Histology of the Intestinal Wall revised (new title; • Figure 26–8 The Locations and Structures of Cortical and Juxta-
added new part c showing Paneth cells; intestinal gland replaces medullary Nephrons moved (formerly Figure 26–7, renumbered
intestinal crypt; formerly Figure 24–17, moved due to chapter because of chapter reorganization)
reorganization) • Figure 26–9 An Overview of Urine Formation revised (added
• Figure 24–22 The Secretion and Effects of Major Duodenal Hor- functional anatomy descriptions from former Figure 26–6)
mones revised (new title; clarified secretin’s primary effect) • Figure 26–11 The Response to a Reduction in the GFR revised
• Figure 24–23 The Secretion and Effects of Major Digestive Tract (new homeostasis design)
Hormones revised (new title; added new pancreas art) • There is a new section called Principles of Reabsorption and
• Figure 24–25 Histology of the Colon revised (new title; added Secretion at the beginning of Section 26–5 to provide an over-
two more teniae coli to the icon art to show general positions of view of this process before we get into its details.
all three teniae coli) • Figure 26–12 Transport Activities at the PCT revised (corrected
• Added coverage of the microbiome under Section 24–7 on the color of cotransport mechanism symbol in the art)
large intestine. • A new Section 26–6 called “Countercurrent multiplication allows
• NEW Figure 24–26 The Defecation Reflex the kidneys to regulate the volume and concentration of urine”
• Spotlight Figure 24–27 The Chemical Events of Digestion revised has been added to emphasize this content, especially the role of
the medullary osmotic gradient. This also includes a more com-
• Figure 24–27 Digestive Secretion and Water Reabsorption in the
plete kidney function testing section.
Digestive Tract revised (added new art next to Dietary Input box)
• Spotlight Figure 26–16 Summary of Renal Function revised
(added new step 8 discussing papillary duct permeability to urea
DIGESTIVE system with the other body systems presented so far
and art showing urea transporter)
(replaces System Integrator)
• Figure 26–18 Organs for Conducting and Storing Urine revised
(deleted “[in urogenital diaphragm]” in part b)
Chapter 25: Metabolism, Nutrition, and Energetics (title changed to • NEW Figure 26–20 The Control of Urination
include nutrition) • NEW Build Your Knowledge Figure 26–21 Integration of the
• NEW Figure 25–1 Metabolism of Organic Nutrients and Nutrient URINARY system with the other body systems presented so far
Pools (replaces System Integrator)
• We now cover oxidation–reduction reactions in Section 25–1. • Questions added to Figures 26–5, 26–6, 26–11, 26–14, and
• Figure 25–2 Glycolysis moved (formerly Figure 25–3) 26–18.
• Figure 25–3 The Citric Acid Cycle revised and moved (electron Chapter 27: Fluid, Electrolyte, and Acid–Base Balance
transport chain replaces electron transport system; formerly Figure • Figure 27–5 Homeostatic Regulation of Sodium Ion Concentra-
25–4) tion in Body Fluids revised (new homeostasis design)
• NEW Spotlight Figure 25–4 The Electron Transport Chain and • Figure 27–6 Integration of Fluid Volume Regulation and Sodium
ATP Formation Ion Concentration in Body Fluids revised (new homeostasis design)
• Figure 25–5 A Summary of the Energy Yield of Glycolysis and • Figure 27–7 Major Factors Involved in Disturbances of Potassium
Aerobic Metabolism revised (total ATP yield from a glucose mol- Ion Balance revised (new homeostasis design)
ecule based on new values of ATP yield per NADH [2.5 ATP vs.
• Figure 27–8 Three Classes of Acids Found in the Body revised
previous 3 ATP] and FADH2 [1.5 ATP vs. previous 2 ATP]).
(metabolic acids replaces organic acids)

xii Preface
• Figure 27–13 pH Regulation of Tubular Fluid by Kidney Tubule • Figure 28–21 The Process of Oogenesis revised (new title; former
Cells revised (incorporated buffer system type next to relevant Figure 28–15 moved due to chapter reorganization)
chemical reactions for better art–text integration) • Figure 28–22 Follicle Development and the Ovarian Cycle revised
• Figure 27–15 Homeostatic Regulation of Acid–Base Balance (former Figure 28–16 moved due to chapter reorganization; new
revised (new homeostasis design) ovary art)
• Figure 27–16 Responses to Metabolic Acidosis revised (new • Figure 28–23 A Comparison of the Structure of the Endometrium
homeostasis design) during the Phases of the Uterine Cycle revised (new title; former
• Figure 27–17 Responses to Metabolic Alkalosis revised (new Figure 28–20 moved due to chapter reorganization)
homeostasis design) • Spotlight Figure 28–24 Hormonal Regulation of Female Repro-
• Questions added to Figures 27–2, 27–7, 27–10, 27–14, and duction revised (text in Follicle Phase of the Ovarian Cycle box
27–16. changed to reflect that one tertiary follicle from a group becomes
dominant; Tertiary ovarian follicle development label replaces Follicle
Chapter 28: The Reproductive System development label; temperature ranges changed for both Celsius
• NEW Clinical Case: And Baby Makes Three? and Fahrenheit scales; and Menses label changed to Menstrual
• Section 28–2, retitled “The structures of the male reproductive
Phase)
system consist of the testes and scrotum, duct system, acces- • Under Section 28–6, there are new discussions of contraception
sory glands, and penis,” is now focused on male reproductive and infertility, and sexually transmitted diseases.
anatomy. • Under Section 28–7, there is a new discussion of development of
• FAP10 Figure 28–2 The Descent of the Testes deleted internal reproductive organs, with a new Figure 28–26 The Devel-
• Figure 28–4 Anatomy of the Seminiferous Tubules revised opment of Male and Female Internal Reproductive Organs.
(includes only parts a and b of former Figure 28–5) • NEW Build Your Knowledge Figure 28–27 Integration of the
• Figure 28–5 Anatomy of the Epididymis revised (former Figure REPRODUCTIVE system with the other body systems presented
28–9 moved due to chapter reorganization) so far (replaces System Integrator)
• Figure 28–6 Anatomy of the Ductus Deferens and Accessory • Questions added to Figures 28–7, 28–9, 28–11, 28–22, 28–23,
Glands revised and reorganized (former Figure 28–10 moved due and 28–25.
to chapter reorganization) Chapter 29: Development and Inheritance
• Figure 28–7 Anatomy of the Penis revised and reorganized (for- • Figure 29–1 Fertilization revised (changed some titles and text in
mer Figure 28–11 moved due to chapter reorganization; new step art; clarified when DNA synthesis occurs)
erectile tissue box)
• Figure 29–3 Stages in Implantation revised (cytotrophoblast
• There is now a Section 28–3 called “Spermatogenesis occurs in replaces cellular trophoblast; syncytiotrophoblast replaces syncytial
the testes, and hormones from the hypothalamus, pituitary gland, trophoblast)
and testes control male reproductive functions” that covers male
• Figure 29–4 The Inner Cell Mass and Gastrulation revised
reproductive physiology.
(changed Gastrulation from Day 12 to Day 15)
• Section 28–3 now starts with an Overview of Mitosis and Meiosis.
• Spotlight Figure 29–5 Extra-Embryonic Membranes and Placenta
• NEW Figure 28–8 A Comparison of Chromosomes in Mitosis Formation revised (added cervical plug to Week 10/step 5 art)
and Meiosis
• Figure 29–6 Anatomy of the Placenta after the First Trimester
• Figure 28–9 The Process of Spermatogenesis revised (former revised (replaced first sentence of part a text)
Figure 28–7 moved due to chapter reorganization; sperm replaces
• Figure 29–7 The First 12 Weeks of Development revised (new art
spermatozoa)
at 3 weeks of development replaces Week 2 SEM)
• Figure 28–10 Spermatogenesis in a Seminiferous Tubule revised
• Section 29–5, now called “During the second and third trimes-
(includes only parts c and d of former Figure 28–5; moved due to
ters, fetal development primarily involves growth and organ func-
chapter reorganization)
tion,” focuses on the fetal development during this period.
• Figure 28–11 The Process of Spermiogenesis and Anatomy of a
• Section 29–6, called “During gestation, maternal organ
Sperm revised (former Figure 28–8 moved due to chapter reorga-
systems support the developing fetus; the reproductive system
nization; sperm replaces spermatozoa)
in particular undergoes structural and functional changes”
• The reworked Section 28–4 is now titled “The structures of the now presents the maternal changes, including hormonal
female reproductive system consist of the ovaries, uterine tubes, effects.
uterus, vagina, and external genitalia” and focuses on presenting
• Figure 29–12 The Milk Ejection Reflex revised (new title)
the female reproductive anatomy.
• Figure 29–17 Inheritance of an X-Linked Trait revised (former
• Figure 28–15 Anatomy of the Uterine Tubes revised (former
Figure 29–18 moved due to chapter reorganization)
Figure 28–17 moved due to chapter reorganization; new epithe-
lial surface SEM) • Figure 29–18 Crossing Over and Recombination revised (clari-
fied text in part b; former Figure 29–17 moved due to chapter
• Figure 28–19 Anatomy of the Female External Genitalia revised
reorganization)
(former Figure 28–22 moved due to chapter reorganization)
• The reworked Section 28–5 titled “Oogenesis occurs in the ova-
ries, and hormones from the hypothalamus, pituitary gland, and Appendix
ovaries control female reproductive functions” presents female
• NEW Table 3 Four Common Methods of Reporting Gas Pressure
reproductive physiology. This section now gathers information
on oogenesis, the ovarian cycle, and the uterine cycle, as well as • NEW Table 4 Turnover Times of Organic Components of Four
their coordination. Cell Types

Acknowledgments
This textbook represents a group effort, and we would like to helped create the photo/art combinations that have resulted in
acknowledge the people who worked together with us to create clearer presentations and a greater sense of realism in important
this Eleventh Edition. anatomical figures. We are also grateful to the talented team at
Foremost on our thank-you list are the instructors who Imagineering (imagineeringart.com) for their dedicated and
offered invaluable suggestions throughout the revision process. detailed illustrative work on key figures. The color micrographs
We thank them for their participation and list their names and in this edition were provided by Dr. Robert Tallitsch, and his
affiliations below. assistance is much appreciated. Many of the striking anatomy
photos in the text and in Martini’s Atlas of the Human Body are
Lois Borek, Georgia State University
the work of biomedical photographer Ralph Hutchings; his
Angela Bruni, Mississippi Gulf Coast Community College
images played a key role in the illustration program.
Marien Cendon, Miami Dade College, Kendall Campus
We also express our appreciation to the editors and sup-
Jose Chestnut, Essex County College
port staff at Pearson Science.
James E. Clark, Manchester Community College
We owe special thanks to Senior Acquisitions Editor Cheryl
Ferdinand Esser, Mercy College
Cechvala for shepherding this project from start to finish. Her
Robert S . Kellar, Northern Arizona University
ability to manage every detail with such fervor and interest is
Beth A . Kersten, State College of Florida
commendable. She also has an incredible command of the
Mary Katherine Lockwood, University of New Hampshire
English language coupled with exceptional oratory ability—it’s
Naomi Machell, Delaware County Community College
always fun having candid conversations. Although this was her
Russell Nolan
first year as our editor, she possesses the skills of a seasoned
Amanda R . Pendleton, Amarillo College
veteran. She is our biggest advocate and is always willing to
Louise Petroka, Gateway Community College
champion our cause—despite the challenges of working with
Courtney B. Ross, Gwinnett Technical College
authors. We are appreciative of all her efforts on our behalf.
Natalia Schmidt, Leeward Community College
Content Producer Jessica Picone was extremely skilled at
Scott L . Simerlein, Purdue University North Central
keeping this project moving forward. Throughout every itera-
Patricia Steinke, San Jacinto College Central
tion, she kept track of the files, ensured we were on task, and
Diane G . Tice, Morrisville State College
maintained her high standards. Working with authors can be
Pauline Ward, Houston Community College
challenging, and Jessica was up for the task! Editorial Coordina-
Sarah Ward, Colorado Northwestern Community College
tor Kimberly Twardochleb was always available and answered
Mary Weis, Collin College
every question we had with speed and accuracy. Having two
Colleen Winters, Towson University
highly skilled professionals working with us eased our burden.
The accuracy and currency of the clinical material in this Thanks for not only preparing our material for publication, but
edition reflects the work of our Clinical Case contributors, making sure it was the best it could possibly be. This past year
Christine Boudrie, M.D. and Ruth Anne O’Keefe, M.D., who could not have happened without them.
provided constant, useful feedback on each chapter. Suzanne Olivier, our Development Editor, is the absolute
Virtually without exception, reviewers stressed the impor- best in the business. Suzanne’s ability to look at science mate-
tance of accurate, integrated, and visually attractive illustra- rial in new ways was astonishing. Moreover, she skillfully en-
tions in helping readers understand essential material. The couraged us to think about presenting science information a
revision of the art program was directed by Bill Ober, M.D., bit differently, too. She played an essential part in revising this
and Claire E. Ober, R.N. Their suggestions about presentation Eleventh Edition. Her unfailing attention to readability, consis-
sequence, topics of clinical importance, and revisions to the tency, and quality was indispensable to the authors in meeting
proposed art were of incalculable value to us and to the project. our goal of delivering complex A&P content in a more student-
The illustration program for this edition was further enhanced friendly, learner-centered way.
by the efforts of several other talented individuals. Jim Gibson We are grateful to Lorretta Palagi for her very careful atten-
designed many of the Spotlight Figures in the art program and tion to detail and consistency in her copyedit of the text and art.
consulted on the design and layout of the individual figures. This book would not exist without the extraordinary dedi-
His talents have helped produce an illustration program that is cation of the Production team who solved many problems un-
dynamic, cohesive, and easy to understand. Anita Impagliazzo der pressure with unfailing good cheer. Norine Strang skillfully
xiii

xiv Acknowledgments
led her excellent team at Cenveo to move the book smoothly Editor-in-Chief Serina Beauparlant, who took over the reins
through composition. and worked closely with our new editor, Cheryl Cechvala, to
The striking cover and clear, navigable interior design were ensure we had the resources necessary to publish what students
created by tani hasegawa. Thanks also to Mark Ong, Design need to succeed and what professors want in a textbook. And,
Manager, who devised innovative solutions for several complex a round of applause and a backflip go out to Derek Perrigo,
design challenges. Senior A&P Specialist, our biggest cheerleader.
Thanks to our Photo Researcher, Kristin Piljay, and the per- To help improve future editions, we encourage you to send
missions team at Cenveo for finding, obtaining, and coordinat- any pertinent information, suggestions, or comments about
ing all the photos in the photo program. the organization or content of this textbook to us directly, us-
Thanks are also due to Kate Abderholden, Editorial Assis- ing the e-mail addresses below. We warmly welcome comments
tant, who served as project editor for the print supplements for and suggestions and will carefully consider them in the prepa-
instructors. Thanks also to Stacey Weinberger for handling the ration of the Twelfth Edition.
physical manufacturing of the book.
Frederic (Ric) H. Martini
We are also grateful to Lauren Chen, Rich Media Content
Haiku, Hawaii
Producer, and Kristin Sanchez, Associate Mastering Producer,
for their creative efforts on the media package, most especially [email protected]
MasteringA&P. Judi L. Nath
We would also like to express our gratitude to the fol- Sandusky, Ohio
lowing people at Pearson Science: Paul Corey, President, who [email protected]
continues to support all our texts; Barbara Yien, Director of
Development, who kindly kept all phases moving forward un- Edwin F. Bartholomew
der all circumstances; Allison Rona, Executive Marketing Man- Lahaina, Hawaii
ager; and the dedicated Pearson Science sales representatives [email protected]
for their continuing support of this project. Special thanks to

Contents
Preface v
Clinical Notes
Habeas Corpus (“You Shall Have the Body”) 5
The Sounds of the Body 13
UNIT 1 LEVELS OF ORGANIZATIONS Diagnostic Imaging Techniques 16
1 An Introduction to Anatomy 2 The Chemical Level of

and Physiology 1 Organization 27
An Introduction to Studying the Human Body 2 An Introduction to the Chemical Level of Organization 28
1-1 To make the most of your learning, read the text and 2-1 Atoms are the basic particles of matter 28
view the art together 2
Atomic Structure 28
Getting to Know Your Textbook 2
Elements and Isotopes 29
Anatomy of a Chapter 3
Atomic Weights 30
1-2 Anatomy (structure) and physiology (function) are Electrons and Energy Levels 31
closely integrated 3
2-2 Chemical bonds are forces formed by interactions
Anatomy 4
between atoms 32
Physiology 5
Ionic Bonds 34
1-3 Levels of organization progress from chemicals to a Covalent Bonds 35
complete organism 6 Hydrogen Bonds 36
1-4 Medical terminology is important to understanding States of Matter 37
anatomy and physiology 7
2-3 Decomposition, synthesis, and exchange reactions
1-5 Anatomical terms describe body regions, anatomical are important types of chemical reactions in
positions and directions, and body sections 7 physiology 37
Surface Anatomy 7 Basic Energy Concepts 37
Sectional Anatomy 13 Types of Chemical Reactions 38
1-6 Body cavities of the trunk protect internal organs and 2-4 Enzymes speed up reactions by lowering the energy
allow them to change shape 14 needed to start them 39
The Thoracic Cavity 15 2-5 Inorganic compounds lack carbon, and organic
The Abdominopelvic Cavity 18 compounds contain carbon 40
1-7 Homeostasis, the state of internal balance, is 2-6 Physiological systems depend on water 40
continuously regulated 18 The Properties of Aqueous Solutions 41
Mechanisms of Homeostatic Regulation 19 Colloids and Suspensions 42
An Overview of the Process of Homeostatic Regulation 19
2-7 Body fluid pH is vital for homeostasis 43
1-8 Negative feedback opposes variations from normal,
whereas positive feedback enhances them 19 2-8 Acids, bases, and salts have important physiological
roles 44
The Role of Negative Feedback in Homeostasis 20
Acids and Bases 44
The Role of Positive Feedback in Homeostasis 22
Salts 44
Systems Integration, Equilibrium, and Homeostasis 23
Buffers and pH Control 44
Chapter Review 24
2-9 Living things contain organic compounds made up of
SmartArt Videos
monomers, polymers, and functional groups 45
Figure 1–10 Positive Feedback: Blood Clotting. 22
Spotlights 2-10 Carbohydrates contain carbon, hydrogen, and oxygen
Levels of Organization 8 in a 1:2:1 ratio 45
Clinical Case Monosaccharides 45
Using A&P to Save a Life 2 Disaccharides and Polysaccharides 46
xv

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Fundamentals of Anatomy & Physiology

18 SmartArt The Pancreas and Regulation 610

24 SmartArt Structure and Function 884

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Ovary in Testis in male

Directs immediate Delivers air to sites

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Ovary in Testis in male

Directs immediate Delivers air to sites

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Ovary in Testis in male

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Frederic H. Martini, Ph.D.

Judi L. Nath, Ph.D.

Edwin F. Bartholomew, M.S.

Kevin Petti Christine Boudrie, M.D. Ruth Anne O’Keefe, M.D.

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Library of Congress Cataloging-in-Publication Data

ISBN 10: 0-13-439602-2; ISBN 13: 978-0-13-439602-6 (Student edition)

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Frederic (Ric) H. Martini, Ph.D. Judi L. Nath, Ph.D.

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Chapter 19: Blood Chapter 21: Blood Vessels and Circulation

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1 An Introduction to Anatomy 2 The Chemical Level of

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