Get Complete eBook Download By email at student.support@hotmail.com Get Complete eBook Download By email at student.support@hotmail.com Get Complete eBook Download By email at student.support@hotmail.com ANATOMY & PHYSIOLOGY Elizabeth Mack Co Australia ● Brazil ● Canada ● Mexico ● Singapore ● United Kingdom ● United States Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com This is an electronic version of the print textbook. Due to electronic rights restrictions, some third party content may be suppressed. Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. The publisher reserves the right to remove content from this title at any time if subsequent rights restrictions require it. For valuable information on pricing, previous editions, changes to current editions, and alternate formats, please visit www.cengage.com/highered to search by ISBN#, author, title, or keyword for materials in your areas of interest. Important Notice: Media content referenced within the product description or the product text may not be available in the eBook version. Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com Anatomy & Physiology, 1st Edition Elizabeth Mack Co SVP, Product: Erin Joyner VP, Product: Thais Alencar © 2023 Cengage Learning, Inc. ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced or distributed in any form or by any means, except as permitted by U.S. copyright Product Director: Maureen McLaughlin law, without the prior written permission of the copyright owner. Product Manager: Diana Baniak Unless otherwise noted, all content is Copyright © Cengage Learning, Inc. 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Production Service: MPS Limited Designer: Chris Doughman Cover Image Source: Irina Shi/Shutterstock.com Library of Congress Control Number: 2022909327 ISBN: 978-0-357-80221-2 ISBN: 978-0-357-96964-9 Cengage 200 Pier 4 Boulevard Boston, MA 02210 USA Cengage is a leading provider of customized learning solutions with employees residing in nearly 40 diffe ent countries and sales in more than 125 countries around the world. Find your local representative at www.cengage.com. To learn more about Cengage platforms and services, register or access your online learning solution, or purchase materials for your course, visit www.cengage.com. Printed in the United States of America Print Number: 01 Print Year: 2022 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com Dedication In many ways, I have tried to package my classroom self into the pages of this book. I started teaching years ago, but answering questions, writing case studies, telling stories, and—most importantly—being inspired by the curiosity and wonder of thousands of students changed me. It was because of the students that I became the teacher that I am today. And so, I dedicate this, my first book, to them. For my students, thank you. iii Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com Brief Contents Unit 1 Levels of Organization Unit 3 Regulation, Integration, Control 1 The Art and Science of Learning in Anatomy and Physiology 2 2 Introduction to the Human Body 14 14 Anatomy of the Nervous System 524 3 The Chemical Level of Organization 48 15 The Somatic Nervous System 574 4 The Cellular Level of Organization 100 5 The Tissue Level of Organization 150 Unit 2 Support and Movement 13 The Nervous System and Nervous Tissue 478 16 The Autonomic Nervous System 624 17 The Endocrine System 650 Unit 4 Fluids and Transport 18 The Cardiovascular System: Blood 694 6 The Integumentary System 202 7 Bone Tissue and the Skeletal System 236 8 Axial Skeleton 278 20 The Cardiovascular System: Blood Vessels and Circulation 794 9 The Appendicular Skeleton 326 21 The Lymphatic and Immune System 860 10 Joints 354 19 The Cardiovascular System: The Heart 730 11 Muscle Tissue 386 Unit 5 Energy, Maintenance, and Environmental Exchange 12 The Muscular System 428 22 The Respiratory System 908 23 The Digestive System 962 iv Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com 24 Metabolism and Nutrition 1034 25 The Urinary System 1072 26 Fluid, Electrolyte, and Acid-Base Balance 1128 Brief Contents v Unit 6 Deviations from Homeostasis 27 The Reproductive Systems 1162 28 Anatomical and Physiological Response to Disease 1220 Appendix (Answers) A1 Glossary G1 Index I1 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. 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Get Complete eBook Download By email at student.support@hotmail.com Table of Contents Unit 1 Levels of Organization 1 1.1 The Art and Science of Learning in Anatomy and Physiology 2 3 The Chemical Level of Organization 48 3.1 lements and Atoms: The Building Blocks E of Matter 50 3.1a Elements and Compounds 50 3.1b Atoms and Subatomic Particles 51 The Science of Learning 3 1.1a F oreign, Familiar, and Mastery-Level Understanding 3 3.1c The Behavior of Electrons 55 3.2 Chemical Bonds 58 3.2a Ionic Bonds 59 1.1b Memory Formation and “Chunking” 5 3.2b Covalent Bonds 59 1.1c Retrieval Practice 6 3.2c Hydrogen Bonds 61 1.2 Bloom’s Taxonomy 6 1.3 What Is a Learning Objective? 9 3.3a The Role of Energy in Chemical Reactions 64 1.4 The Anatomy of Art 10 3.3b Characteristics of Chemical Reactions 66 1.4a Image Translation in Anatomy 10 3.3c Factors Influencing the Rate of Chemical Reactions 68 3.3 1.4b Comparing a Micro and Macro View 10 1.4c Learning from Physiology or Process Diagrams 11 2 2.1 Introduction to the Human Body 14 Overview of Anatomy and Physiology 15 3.4 Chemical Reactions 64 Inorganic Compounds Essential to Human Functioning 70 3.4a Water 71 3.4b Salts 74 3.4c Acids and Bases 75 3.5 2.1a The Themes of Anatomy and Physiology 17 rganic Compounds Essential to Human O Functioning 78 3.5a The Chemistry of Carbon 78 2.2 Structure and Function 18 3.5b Carbohydrates 80 2.3 Evolution and Human Variation 20 3.5c Lipids 83 2.4 Flow 21 3.5d Proteins 87 2.5 Homeostasis 23 3.5e Nucleic Acids 91 2.6 Structural Organization of the Human Body 27 2.6a The Levels of Organization 27 2.7 Anatomical Terminology 31 4 The Cellular Level of Organization 100 4.1 he Cell Membrane and Its Involvement in T Transport 102 2.7a Anatomical Position 32 2.7b Regional Terms 32 2.7c Directional Terms 32 2.7d Sections and Planes 35 2.7e Organization and Compartmentalization 38 4.1a S tructure and Composition of the Cell Membrane 102 4.1b Membrane Proteins 104 4.1c Transport across the Cell Membrane 105 vi Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. 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Get Complete eBook Download By email at student.support@hotmail.com 4.2 The Cytoplasm and Cellular Organelles 115 4.2a Organelles of the Endomembrane System 115 4.2b Organelles for Energy Production and Detoxification 117 4.2c The Cytoskeleton 120 4.3 4.4 4.5 4.6 Unit 2 Support and Movement 6 The Integumentary System 202 6.1 Layers of the Skin 203 The Nucleus and DNA 125 4.3a Organization of the Nucleus and Its DNA 126 Protein Synthesis 129 6.1a The Epidermis 204 4.4a From DNA to RNA: Transcription 131 6.1b The Dermis 212 4.4b From RNA to Protein: Translation 132 6.1c The Hypodermis 213 Cell Replication 134 6.2 Accessory Structures of the Skin 215 4.5a The Cell Cycle 135 6.2a Hair 215 4.5b DNA Replication 135 6.2b Nails 219 4.5c Cell Cycle Control 140 6.2c Sweat Glands 220 Cellular Differentiation 143 6.2d Sebaceous Glands 221 4.6a Stem Cells 144 Table of Contents vii 6.3 Functions of the Integumentary System 223 6.3a Protection 223 5 5.1 6.3b Sensory Function 223 The Tissue Level of Organization 150 Types and Components of Tissues 151 6.3c Thermoregulation 224 6.3d Vitamin D Synthesis 225 6.4 Healing the Integument 227 6.4a Injuries 227 5.1a The Four Types of Tissues 152 5.1b Extracellular Matrix 153 5.1c Cellular Connections 155 5.2 Epithelial Tissue 156 7 Bone Tissue and the Skeletal System 236 7.1 The Functions of the Skeletal System 237 5.2a Generalized Functions of Epithelial Tissue 157 5.2b The Epithelial Cell 159 5.3 5.2c Classification of Epithelial Tissues 160 7.1a Support, Movement, and Protection 238 5.2d Glands of Epithelia 166 7.1b Mineral Storage, Energy Storage, and Hematopoiesis 240 Connective Tissue 169 5.3a Functions of Connective Tissues 170 7.2 5.3b Classification of Connective Tissues 170 7.2a Long Bones 242 5.3c Connective Tissue Proper 170 7.2b Short Bones 243 5.3d Supportive Connective Tissues 178 7.2c Flat Bones 243 7.2d Irregular Bones 243 5.3e Fluid Connective Tissue 181 5.4 Muscle Tissue 183 5.5 Nervous Tissue 186 5.6 Membranes 188 5.7 Bone Classification 241 7.2e Sesamoid Bones 243 7.2f Bone Markings 248 7.3 he Microscopic Structure of Cartilage T and Bone 249 5.6a Tissue Membranes 188 7.3a Cartilage Cells and Tissue 250 Tissue Growth and Healing 190 7.3b Bone Cells and Tissue 250 5.7a Tissue Injury and Repair 190 7.3c Compact and Spongy Bone 252 5.7b Tissue and Aging 191 5.7c Tissues and Cancer 193 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. 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Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. viii Table of Contents 7.4 Get Complete eBook Download By email at student.support@hotmail.com F ormation and Growth of Bone and Cartilage 256 9 The Appendicular Skeleton 326 9.1 The Shoulder Girdle 329 7.4a Intramembranous Ossification 256 7.4b Endochondral Ossification 257 7.5 Growth, Repair, and Remodeling 259 9.1a Clavicle 330 7.5a Cartilage Growth 259 9.1b Scapula 330 7.5b How Bones Grow in Length 260 7.5c How Bones Grow in Diameter 261 9.2 9.2a Humerus 332 7.5d Bone Remodeling 263 9.2b Radius and Ulna 334 7.5e Hormones and Bone Tissue 263 7.5f Bone Repair 266 7.6 Bones and Homeostasis 268 9.2c Bones of the Wrist and the Hand 336 9.3 The Pelvic Girdle and Pelvis 338 9.3a Os Coxae 339 7.6a Nutrition and Bone Tissue 269 7.6b Exercise and Bone Tissue 270 Bones of the Arm 332 9.3b Features of the Whole Pelvis 341 9.4 Bones of the Leg 345 9.4a Femur 345 8 Axial Skeleton 278 8.1 Divisions of the Skeletal System 279 8.1a The Axial Skeleton 280 8.1b The Appendicular Skeleton 281 8.2 9.4d Bones of the Foot 349 10 Joints 354 8.2a Introduction to the Skull 281 10.1 Classification of Joints 355 8.2c The Skull as a Whole 294 8.2d Anterior View of the Skull 294 8.2e The Orbit 294 8.2f The Nasal Cavity, Septum, and Conchae 295 8.2g Paranasal Sinuses 297 8.2h Lateral View of the Skull 300 8.2i Posterior View of the Skull 301 8.2j The Interior of the Skull—the Brain Case 301 8.2k Development and Aging of the Skull 304 8.2l Bones Associated with the Skull: The Ossicles and the Hyoid Bone 308 The Vertebral Column 309 8.3a Regions of the Vertebral Column 309 8.3b Curvatures of the Vertebral Column 310 8.3c General Structure of a Vertebra 311 8.4 9.4c Tibia and Fibula 347 The Skull 281 8.2b Bones of the Skull 286 8.3 9.4b Patella 347 10.1a Structural Classification of Joints 356 10.1b Functional Classification of Joints 356 10.2 Fibrous Joints 359 10.2a Suture 359 10.2b Syndesmosis 360 10.2c Gomphosis 361 10.3 Cartilaginous Joints 361 10.3a Synchondrosis 361 10.3b Symphysis 362 10.4 Synovial Joints 363 10.4a Structural Features of Synovial Joints 364 10.4b Cushioning and Support Structures Associated with Synovial Joints 364 10.4c Types of Synovial Joints 366 10.5 Movements at Synovial Joints 370 8.3d Regional Vertebrae 314 10.5a Flexion and Extension 370 8.3e Intervertebral Discs 318 10.5b Abduction and Adduction 370 The Thoracic Cage 320 8.4a Sternum 321 8.4b Ribs 322 10.5c Circumduction 372 10.5d Rotation 372 10.5e Supination and Pronation 373 10.5f Dorsiflexion and Plantar Flexion 373 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. 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Get Complete eBook Download By email at student.support@hotmail.com 10.5g Inversion and Eversion 373 12.2 Naming Skeletal Muscles 434 10.5h Protraction and Retraction 373 12.3 Axial Muscles 437 Table of Contents ix 10.5i Depression and Elevation 373 12.3a Muscles of Facial Expression 437 10.5j Excursion 374 12.3b Muscles That Move the Eyes 439 10.5k Opposition and Reposition 374 12.3c Muscles That Move the Lower Jaw 439 10.6 Anatomy of Selected Synovial Joints 375 12.3d Muscles That Move the Tongue 440 10.6a Temporomandibular Joint 375 12.3e Muscles That Move the Head 443 10.6b Shoulder Joint 376 10.6c Elbow Joint 376 12.3f Muscles of the Posterior Neck and the Back 444 10.6d Hip Joint 377 12.3g Muscles of the Abdomen 446 10.6e Knee Joint 379 12.3h Muscles of the Thorax 447 11 Muscle Tissue 386 11.1 Overview of Muscle Tissues 387 11.2 Skeletal Muscle 390 11.2a Skeletal Muscle Cells 392 11.2b The Sarcomere 393 11.2c The Neuromuscular Junction 394 11.3 S keletal Muscle Cell Contraction and Relaxation 395 11.3a The Sliding Filament Model of Contraction 396 11.3b Excitation-Contraction Coupling 397 11.3c Events at the Neuromuscular Junction 398 11.3d Events Along the Sarcolemma 399 11.3e Events at the Sarcomere 401 11.3f ATP and Muscle Contraction 402 11.3g Skeletal Muscle Cell Relaxation 404 11.4 Skeletal Muscle Metabolism 405 11.4a Sources of ATP 405 11.5 Whole Muscle Contraction 410 11.5a The Length-Tension Range of a Sarcomere 412 11.5b Sustained Muscle Contraction 412 11.5c Muscle Tone 414 11.5d Motor Units 414 11.6 Cardiac Muscle Tissue 417 12.3i Muscles of the Pelvic Floor and Perineum 450 12.4 Appendicular Muscles 452 12.4a Shoulder Muscles 453 12.4b Muscles That Move the Humerus 455 12.4c Muscles That Move the Forearm 456 12.4d Muscles That Move the Wrist, Hand, and Fingers 456 12.4e Muscles That Move the Feet and Toes 471 Unit 3 Regulation, Integration, Control 13 The Nervous System and Nervous Tissue 478 13.1 O rganization and Functions of the Nervous System 479 13.1a The Functions of the Nervous System 480 13.1b The Central and Peripheral Nervous Systems 481 13.2 Nervous Tissue and Cells 484 13.2a Neurons 484 13.2b Glial Cells 487 13.3 Neurophysiology 491 13.3a Membrane Potential 497 13.4 Communication between Neurons 510 13.4a Synapses 511 11.7 Smooth Muscle 419 12 The Muscular System 428 12.1 Interactions of Skeletal Muscles, Their Fascicle Arrangement, and Their Lever Systems 429 12.1a Interactions of Skeletal Muscles in the Body 429 12.1b Patterns of Fascicle Organization 431 14 Anatomy of the Nervous System 524 14.1 General Anatomy of the Nervous System 525 14.1a Anatomical Patterns of Nervous Tissue 526 14.1b Blood and Cerebrospinal Fluid 533 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. 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Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. x Table of Contents Get Complete eBook Download By email at student.support@hotmail.com 14.2 The Central Nervous System 536 14.2a E mbryonic Development of the Nervous System 537 14.2b The Brain 539 16.4 Broad Impacts of Autonomic Responses 642 16.4a Stress 643 14.2c The Diencephalon 549 17 The Endocrine System 650 14.2d Brainstem 551 17.1 An Overview of the Endocrine System 652 14.2e The Cerebellum 554 17.1a Chemical Signaling 652 14.2f Brain Systems and Functions that Bridge Brain Regions 554 17.1b Neural and Endocrine Long-Distance Signaling 653 14.2g The Limbic System 557 14.2h The Spinal Cord 557 14.3 The Peripheral Nervous System 560 17.2 Hormones 656 17.2a Types of Hormones 656 17.2b Pathways of Hormone Action 659 14.3a Ganglia 561 17.2c Factors Affecting Target Cell Response 662 14.3b Nerves 561 17.2d Regulation of Hormone Secretion 662 15 The Somatic Nervous System 574 15.1 S tructure and Function of Sensory and Motor Pathways 576 15.1a Reflexes 577 17.3 Endocrine Control by the Hypothalamus and Pituitary Gland 665 17.3a Posterior Pituitary 668 17.3b Anterior Pituitary 669 17.4 The Major Hormones of the Body 674 17.4a The Thyroid Gland 674 17.4b The Parathyroid Glands 679 15.2 Sensory Receptors 583 17.4c The Adrenal Glands 681 15.3 General Senses 587 17.4d The Adrenal Medulla 684 15.3a Touch 587 17.4e Disorders Involving the Adrenal Glands 684 15.4 Special Senses 593 17.4f The Pancreas 685 15.4a Vision 594 17.4g The Thymus 688 15.4b Taste (Gustation) 602 17.4h The Heart 688 15.4c Smell (Olfaction) 606 17.4i The Gastrointestinal Tract 688 15.4d Hearing (Audition) 607 17.4j The Kidneys 688 15.4e Equilibrium (Balance) 613 17.4k Adipose Tissue 688 17.4l The Skin 689 16 The Autonomic Nervous System 624 17.4m The Liver 689 Unit 4 Fluids and Transport 16.1 Overview of the Autonomic Nervous System 626 16.1a S ympathetic Division of the Autonomic Nervous System 626 16.1b Parasympathetic Division of the Autonomic Nervous System 632 16.2 C hemical Components of the Autonomic Responses 634 18 The Cardiovascular System: Blood 694 18.1 The Composition of Blood 695 18.1a The Functions of Blood 696 18.1b Whole Blood 696 16.3 Autonomic Reflexes and Homeostasis 638 16.3a The Structure of Reflexes 638 18.1c Plasma 697 18.1d Erythrocytes 700 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. 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Get Complete eBook Download By email at student.support@hotmail.com 18.1e The Life Cycle of Erythrocytes 703 Table of Contents xi 18.1f Leukocytes and Platelets 706 19.4c Other Factors Influencing Heart Rate and Contractility 781 18.1g Classification of Leukocytes 708 19.4d Stroke Volume 782 18.1h Platelets 712 18.2 P roduction of the Formed Elements 713 18.2a Sites of Hematopoiesis 713 18.2b Differentiation of Formed Elements from Stem Cells 714 18.2c Hemopoietic Growth Factors 715 18.3 Hemostasis 715 18.3a Vascular Spasm 717 18.3b Formation of the Platelet Plug 717 18.3c Coagulation 717 18.3d Fibrinolysis 719 18.3e Plasma Anticoagulants 719 18.4 Blood Typing 720 18.4a A ntigens, Antibodies, and Transfusion Reactions 720 19 The Cardiovascular System: The Heart 730 19.1 Heart Anatomy 731 19.1a Location of the Heart 732 19.1b Chambers and Circulation through the Heart 734 19.1c Membranes, Surface Features, and Layers 736 19.1d Layers 738 19.1e Internal Structure of the Heart 741 19.1f Coronary Circulation 748 19.2 Cardiac Muscle and Electrical Activity 751 20 The Cardiovascular System: Blood Vessels and Circulation 794 20.1 Anatomy of Blood Vessels 795 20.1a Structure-Function Relationships 798 20.1b Arteries 801 20.1c Arterioles 802 20.1d Capillaries 802 20.1e Metarterioles and Capillary Beds 804 20.1f Venules 805 20.1g Veins 805 20.1h Veins as Blood Reservoirs 805 20.1i Alternative Blood Flow Pathways 807 20.2 Blood Flow, Blood Pressure, and Resistance 809 20.2a Arterial Blood Pressure 810 20.2b Pulse 811 20.2c Variables Affecting Blood Flow and Blood Pressure 812 20.2d Factors That Contribute to the Pressure Gradient 812 20.2e Factors That Contribute to Resistance 813 20.2f Venous System 818 20.3 Capillary Exchange 821 20.3a The Role of Lymphatic Capillaries 823 20.4 Homeostatic Regulation of the Vascular System 824 19.2a Structure of Contractile Cardiac Muscle 752 20.4a Neural Regulation 824 19.2b Cardiac Muscle Metabolism 755 20.4b Endocrine Regulation 825 19.2c Conduction System of the Heart 755 20.4c Autoregulation of Blood Flow 826 19.2d Electrocardiogram 762 19.2e Nervous System Influence on Heart Activity 768 19.3 Cardiac Cycle 771 20.5 Circulatory Pathways 828 20.5a Pulmonary Circulation 829 20.5b Systemic Arteries 830 20.5c The Aorta 830 19.3a Pressures and Flow 771 20.5d Arteries Supplying the Upper Limbs 838 19.3b Phases of the Cardiac Cycle 773 20.5e Arteries Serving the Lower Limbs 838 19.3c Heart Sounds 776 20.5e Overview of Systemic Veins 840 19.4 Cardiac Physiology 779 19.4a Resting Cardiac Output 779 19.4b Exercise and Cardiac Function 781 20.5f The Hepatic Portal System 847 20.6 Development of Blood Vessels and Fetal Circulation 850 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. 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Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xii Table of Contents Get Complete eBook Download By email at student.support@hotmail.com 21 The Lymphatic and Immune System 860 21.1 Anatomy of the Lymphatic and Immune Systems 861 21.1a Functions of the Lymphatic System 862 21.1b Structure of the Lymphatic System 864 21.2 Overview of the Immune Response 872 21.3 B arrier Defenses and the Innate Immune Response 874 21.3a Cells of the Innate Immune Response 875 21.3b Recognition of Pathogens 878 21.3c Soluble Mediators of the Innate Immune Response 879 21.3d Inflammatory Response 879 21.3e Fever 882 21.4 The Adaptive Immune Response 884 21.4a T he Benefits of the Adaptive Immune Response 885 21.4b T Cell-Mediated Immune Responses 886 21.4c Antigens 886 21.4d T Cell Development and Differentiation 887 21.4e Mechanisms of T Cell-Mediated Immune Responses 887 22.4 Gas Exchange 935 22.4a Gas Exchange 936 22.5 Transport of Gasses 942 22.5a Oxygen Transport in the Blood 942 22.5b Carbon Dioxide Transport in the Blood 947 22.6 Respiratory Rate and Control of Ventilation 949 23 The Digestive System 962 23.1 Overview of the Digestive System 963 23.2 General Gross and Microscopic Anatomy of the Gastrointestinal (GI) Tract 967 23.2a Microscopic Structure of the GI Tract 967 23.2b Nerve Supply 970 23.2c Blood Supply 970 23.2d The Peritoneum 971 23.3 The Mouth, Pharynx, and Esophagus 973 23.3a The Mouth 974 23.3b The Tongue 976 23.3c The Salivary Glands 976 23.3d The Teeth 978 23.3e The Pharynx 980 23.3f The Esophagus 983 21.4f The Cellular Basis of Immunological Memory 888 23.3g The Stomach 985 21.4g T Cell Types and their Functions 889 23.3h Gastric Secretion 989 21.4h B Cells and their Functions 891 23.3i The Mucosal Barrier 991 21.4i B Cell Differentiation and Activation 892 23.3j The Small and Large Intestines 992 21.4j Antibody Structure 892 23.3k The Small Intestine 992 21.4k Active versus Passive Immunity 896 23.3l The Large Intestine 998 21.4l Responses to Different Pathogens 899 23.4 Accessory Organs in Digestion: The Liver, Pancreas, and Gallbladder 1004 23.4a The Liver 1005 Unit 5 Energy, Maintenance, and Environmental Exchange 22 The Respiratory System 908 22.1 Functions and Anatomy of the Respiratory System 909 22.1a Conducting Zone 911 22.1b The Respiratory Zone 921 22.1c The Gross Anatomy of the Lungs 922 22.2 The Process of Breathing 925 22.3 Respiratory Volumes and Capacities 933 23.4b The Gallbladder 1009 23.4c The Pancreas 1009 23.5 Chemical Digestion and Absorption: A Closer Look 1012 23.5a Chemical Digestion 1012 23.5b Absorption 1017 24 Metabolism and Nutrition 1034 24.1 Overview of Metabolic Reactions 1036 24.1a Catabolic Reactions 1037 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. 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Get Complete eBook Download By email at student.support@hotmail.com 24.1b Anabolic Reactions 1039 24.1c Metabolic Reactions 1040 24.2 Macronutrients and Metabolism 1041 25.5 Additional Endocrine Activities of the Kidney 1109 25.5a Vitamin D Synthesis 1110 24.2a Glycolysis 1042 25.5b Erythropoiesis 1110 24.2b Citric Acid Cycle 1045 25.5c Calcium Reabsorption 1110 24.2c Oxidative Phosphorylation and the Electron Transport Chain 1047 24.3 Metabolic States of the Body 1055 24.3a The Absorptive State 1055 24.3b The Postabsorptive State 1055 24.3c Starvation 1057 24.4 Energy and Heat Balance 1058 Table of Contents xiii 25.6 Gross and Microscopic Anatomy of the Urinary Tract (Ureters, Urinary Bladder, and Urethra) 1111 25.6a The Ureters 1111 25.6b The Bladder 1112 25.6c The Urethra 1114 25.7 Urine Characteristics and Elimination 1117 24.4a Metabolic Rate 1060 24.5 Nutrition and Diet 1060 24.5a Food and Metabolism 1061 24.5b Vitamins and Nutrients 1061 24.5c Minerals 1062 26 Fluid, Electrolyte, and Acid- Base Balance 1128 26.1 Body Fluids and Fluid Compartments 1130 26.1a Body Water Content 1130 25 The Urinary System 1072 25.1 Functions of the Urinary System 1073 25.2 G ross and Microscopic Anatomy of the Kidney 1075 25.2a External Anatomy 1075 26.1b Fluid Compartments 1131 26.1c Composition of Bodily Fluids 1133 26.1d Fluid Movement between Compartments 1133 26.1e Solute Movement between Compartments 1136 26.2 Water Balance 1138 25.2b Internal Anatomy 1075 26.2a Regulation of Water Intake 1139 25.2c The Structure and Function of the Nephrons 1079 26.2b Regulation of Water Output 1141 25.3 Physiology of Urine Formation 1087 25.3a Glomerular Filtration Process and Rate 1088 26.2c Role of ADH 1141 26.3 Electrolyte Balance 1143 25.3b Net Filtration Pressure (NFP) 1090 26.3a Roles of Electrolytes 1144 25.3c Mechanisms of Reabsorption and Secretion 1093 26.3b Regulation of Sodium and Potassium 1146 25.3d Reabsorption and Secretion in the Nephron Loop 1099 25.3e Reabsorption and Secretion in the Distal Convoluted Tubule 1103 25.3f The DCT and the Juxtaglomerular Apparatus 1103 25.3g Collecting Ducts and Recovery of Water 1104 25.4 H omeostasis and Control over the Formation of Urine 1106 25.4a Renin–Angiotensin–Aldosterone 1106 25.4b Antidiuretic Hormone (ADH) 1108 25.4c Natriuretic Hormones 1108 26.3c Regulation of Calcium and Phosphate 1147 26.4 Acid-Base Balance 1148 26.4a R espiratory Regulation of Acid-Base Balance 1150 26.4b Renal Regulation of Acid-Base Balance 1151 26.5 Acid-Base Homeostasis 1153 26.5a Metabolic Acidosis 1153 26.5b Metabolic Alkalosis: Primary Bicarbonate Excess 1154 26.5c Respiratory Acidosis: Primary Carbonic Acid/CO2 Excess 1154 26.5d Respiratory Alkalosis: Primary Carbonic Acid/CO2 Deficiency 1154 26.5e Compensation Mechanisms 1155 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. 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Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xiv Table of Contents Get Complete eBook Download By email at student.support@hotmail.com Unit 6 Deviations from Homeostasis 27.6d Spermiogenesis 1197 27.6e Testosterone 1198 27.7 Sex (Coitus) 1200 27.8 Pregnancy, Birth, and Lactation 1204 27 The Reproductive Systems 1162 27.8a Fertilization 1204 27.8b The Preembryonic Stage 1204 27.8c Development of the Placenta 1206 27.1 Overview of Human Reproductive Systems 1163 27.8d Hormones of Pregnancy 1208 27.2 Development of Reproductive Structures 1166 27.8e Labor and Childbirth 1209 27.2a D evelopment of the Sexual Organs in the Embryo and Fetus 1166 27.2b Further Sexual Development Occurs at Puberty 1170 27.2c Breasts 1171 27.3 Anatomy of Biological Females 1173 27.3a External Genitalia 1173 27.8f Postpartum 1209 27.8g Lactation 1209 28 Anatomical and Physiological Response to Disease 1220 27.3b Vagina 1174 28.1 Hypertension Case Study 1221 27.3c Ovaries 1175 28.2 Cystic Fibrosis Case Study 1225 27.3d The Uterine Tubes 1176 27.3e The Uterus and Cervix 1177 27.4 The Ovarian and Uterine Cycles 1179 28.2a Lungs 1226 28.3 Pulmonary Embolism Case Study 1230 28.4 Femoroacetabular Impingement Case Study 1233 27.4a The Ovarian Cycle 1180 28.5 Arthritis Case Study 1235 27.4b The Uterine Cycle 1186 28.6 Cardiac Failure Case Study 1238 27.5 Anatomy of Biological Males 1189 27.5a External Genitalia 1190 27.5b The Penis 1190 27.5c The Scrotum 1192 27.5d The Testes 1193 27.6 Spermatogenesis and Spermiogenesis 1195 27.6a Nurse Cells 1196 27.6b Gametes 1196 27.6c Spermatogenesis 1197 28.7 Stroke Case Study 1241 28.8 Type 2 Diabetes Mellitus Case Study 1243 28.9 Chronic Obstructive Pulmonary Disease Case Study 1247 28.10 Pregnancy Case Study 1251 Appendix (Answers) A1 Glossary G1 Index I1 Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com About the Author Dr. Elizabeth Mack Co is Assistant Clinical Professor in the Departments of Biology and Health Sciences at Boston University (BU). She teaches Gross (cadaveric) Anatomy, Human Physiology, and Physiology of Reproduction. Her teaching career spans a variety of courses, including Human Infectious Diseases, Introductory Biology, Cellular and Molecular Biology, Human Biology, Human Pathophysiology, and Histology. Dr. Co received her Ph.D. in Biomedical Sciences (with a focus on Immunology) from the University of California, San Francisco; she earned her BA with High Honors in Biology and Education at Mount Holyoke College in Massachusetts. Outside of teaching, Dr. Co holds positions in a number of science organizations, including: • The HAPS (Human Anatomy and Physiology Society) Learning Objectives Panel • Principal Investigator of Assessing Student Engagement and Efficacy of Remote Learning, BU • Independent Contractor and Presenter for Howard Hughes Medical Institute (HHMI) BioInteractive • Society for College Science Teachers • National Science Teachers Association • American Association of Anatomists • American Physiological Society As a professor, Dr. Co is renowned for her passion—both in regard to the human body and about learning itself. In 2018 she was nominated by students and members of the faculty at BU and received the Metcalf Award for Excellence in Teaching, Boston University’s highest teaching award. Dr. Co’s current research focuses on learning, particularly critical thinking skills development. She puts this research into practice by integrating an active learning and study skills curriculum in her courses. One of the focal points she investigates is how “student awareness about their learning impacts their assessment performance.” xv Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com Preface As I move around in the world from doctors’ offices to dinner parties, I occasionally am asked what I do for work. When I reply “I teach Anatomy and Physiology,” people tend to have very strong reactions. From “Oh! I absolutely LOVED that course in college” to “A&P almost ended my interest in medicine” to “Oh, wow, you must have a very hard job.” Everyone has intense feelings about A&P. I typically reply “Actually, I have the BEST job in the world because everyone has a body and so there is a common baseline of shared curiosity.” But the fact of the matter is that A&P can be intimidating for students (and for us teachers, too!) because there is a lot of information that can be taught. One of the keys as an instructor to having students leave with positive intense feelings is finding a balance in how much information to present and how to present it. One of the goals I had for this book was to lighten and streamline the content. Instructors are in a perennial push-pull with the desire to reduce the burden on our students and the desire to prepare them for their future exams and courses. If we sacrifice anatomical structures by not teaching enough of them, we might leave our students underprepared; if we sacrifice the interesting connections, our students may lack the passion and excitement for the subject; and if we keep everything in, they might be overwhelmed. In the writing of this book, I wanted to give instructors and learners the choice whether to explore deeper into the interesting connections and content. I separated these topics into “Cultural Connections” and “Digging Deeper” features. Cultural Connections are usually ways that the topics being covered connect to everyday health, or the way that history impacts health or science today. Digging Deeper features often discuss relevant diseases or the science behind healthcare technology. Increasing student persistence is a core need shared across community colleges and universities in the United States, with 30–50 percent1,2of students never completing the two-semester Anatomy & Physiology course. Recognizing that the course can be extraordinarily challenging due to its expansive depth and breadth of coverage, I address this lack of student persistence by improving student preparedness and helping students see themselves and the world around them reflected in what they Gultice, Amy, Ann Witham, and Robert Kallmeyer. “Are your students ready for anatomy and physiology? Developing tools to identify students at risk for failure.” Advances in Physiology Education (June 2015): 108-115. Doi:10.1152 /advan.00112.2014, https://pubmed.ncbi.nlm.nih.gov/26031727/ 2 Vedartham, Padmaja B. Investigating Strategies to Increase Persistence and Success Rates among Anatomy & Physiology Students: A Case Study at Austin Community College District. 2018. National American University, Ed.D. dissertation. ERIC, https://eric.ed.gov/?id=ED583935 1 are learning to engage them in the learning process. Increasing student confidence in both these areas will allow them to tackle the rigors of this course and lead to greater persistence in their education—and hopefully their career path. Learner Support As an instructor, how often are you asked “So, what will be on the test?” When we stop to think about the job of a student, they are not only trying to learn the material, but trying to learn how the instructor teaches and assesses their students. One effective mechanism for conveying the expectations of the course is through the use of learning objectives. Learning Objectives (LOs) can be used by an instructor to frame their pedagogy, as a list of goals for your students to make sure that you prepare them for. Sharing these same LOs with your students communicates to them what you are going to be assessing them on. In other words, it effectively answers the question “What will be on the test?” before it is even asked. The Human Anatomy and Physiology Society (HAPS) has set out to define a set of learning outcomes (LOs) for Anatomy, Physiology, and A&P courses. As a member of the Physiology LO panel, I have participated firsthand in the careful process through which these LOs are created. The LOs are honed over months through the collaboration of some of the colleagues I respect most in our field. It is no exaggeration that some of these LOs have individually taken hours to write or improve. They are the most thorough, well-considered and well-crafted set available. I have written this text almost completely tailored to the LOs provided by HAPS. On occasion I provide additional LOs specific to the content I have created; often these are higher-order LOs. Chapter 1 is dedicated entirely to helping each student build a learning framework so they are more prepared to engage with all the content that follows. This chapter explains the science behind learning and introduces the concept of metacognition to set the foundation for learning A&P in a systemic way. From there, each chapter orients students around the metacognitive aspects of the content to help them tie the concepts to the wider world around them. Features in each chapter that support student learning and success in A&P include: • Learning Checks: This feature provides periodic section assessments throughout the chapter to check your learning. • Student Study Tips: These tips are written by actual students who have been successful in A&P. xvi Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com • Learning Connections: Chapter 1 details different ways to • • • • • learn the material in A&P. Throughout the book, Learning Connections suggest learning approaches. Chapter Review: At the end of every chapter are assessment questions for each section, including a Mini Case with questions. LOs, questions, and a brief summary are provided for each section. Cultural Connections: Sometimes the things that we fall in love with in A&P are the ways that the material connects to our everyday lives. Cultural Connections are small features in each chapter that attempt to do just that. Consider these topics the ones you are most likely to share with others at the dinner table. Digging Deeper: The content in this text is streamlined, but sometimes you may want to know more about a given topic. This feature provides that deeper exploration. Apply to Pathophysiology: In most of scientific history we have learned about how the body works by studying the times when it doesn’t! We did not understand blood sugar regulation until we studied diabetes; we did not understand much about how viruses affect our cells until the HIV pandemic. The Apply to Pathophysiology feature helps students strengthen their understanding of physiology by examining a disease state. Anatomy of: This feature describes different concepts graphically. Critical Thinking A 2017 study of Google employees3 found that among the qualities of the most successful workers, STEM expertise comes in last. The top skills were listening well, teamwork, and critical thinking. Fostering critical thinking in the classroom is often cited as a goal of instructors, including myself. When I first began measuring my students’ critical thinking skills using Bloom’s taxonomy and my own exam data (Co, 2019),4 I was shocked that, despite this being a top priority of mine, my students performed poorly on higher-order cognitive skill questions. I realized that my pedagogical approach had been to show critical thinking, to tell them how important it is, but that, as with any skill, I needed to give them supported opportunities to practice. Based on these findings, I developed a new pedagogical approach in my classroom. I teach critical thinking practice through multiple choice questions that build upon each other, concept by concept, to arrive at an understanding of a complex 3 https://www.washingtonpost.com/news/answer-sheet/wp/2017/12/20 /the-surprising-thing-google-learned-about-its-employees-and-what-it-means -for-todays-students 4 Co, E. (2019). “The power of practice: adjusting curriculum to include emphasis on skills.” Journal of College Science Teaching 48 (5): 22–27. Preface xvii system or pathology. Blood pressure, for example, is a factor in the body with many layers (osmosis, Starling’s forces, capillary dynamics, vasoconstriction, neural control). To create a critical thinking activity on blood pressure, I start with simple concepts such as osmosis, which helps the students to remind themselves of the fundamental ideas and build confidence. From there we move on, like steppingstones in a path, to more and more complex ideas. In this text I provide stepwise practice for students to build their critical thinking skills in each chapter. These Apply to Pathophysiology features first ask students to recall fundamental information and then apply it in a new situation. To give students additional practice in critical thinking, Chapter 28 is composed entirely of case studies. The 10 cases within can be assigned at the end of the semester or at intervals as the instructor chooses. Inclusivity and Diversity—and Accuracy The need to include more diverse content in the Anatomy and Physiology course was one of my biggest inspirations for writing this text. An example of how this issue came into my awareness occurred about 10 years into my teaching career. I attended a science museum with an exhibit on the human body that, naturally, I gravitated toward. One feature used a size measurement to estimate the volume of blood in each museum visitor. My body, the exhibit computer told me, contained 4.6 liters of blood. I walked away shaking my head. I’d been teaching physiology for a decade and everyone knows the human body contains 5 to 5.5 liters of blood. How many times had I said that in class? All the calculations we use in class on the cardiovascular system are based on this range. It dawned on me that I, a slightly smaller-than-average woman, may not necessarily be represented in physiological estimates. I dug into the background on this and discovered that most of the average numbers we teach came from studies of men—young men, probably mostly white men, with an average weight of 150 pounds. Since then, when I teach, I introduce the idea of “average man,” a mythological 150-pound white man on whom we base our calculations. The students and I look around our classroom (which is a large auditorium) and reflect that average man is not usually among us. We are beautifully diverse and require a wider range of numbers. In this book I have tried, when possible, to research and provide more accurate and representative numbers for us. In other cases I provide the anatomical and physiological factors that influence the value range. This text will not only prompt students to think deeper about their learning; it will also challenge them to take a broader look Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xviii Preface Get Complete eBook Download By email at student.support@hotmail.com at the cultural assumptions that have an impact on anatomy and medicine. For example, Hoffman et al. (2016)5 explored biases held by medical students and revealed deeply racist beliefs that could affect their patient care—ideas such as the one that Black Americans have higher pain tolerances and therefore require less treatment for their pain. I believe that no one holds onto racist or bias-laden beliefs because they want to; rather, racist ideas persist because they haven’t been sufficiently challenged. There hasn’t been, in the education of these medical students, enough accurate information about the diversity and unity in function that exists among human bodies. Anatomy and Physiology is often the threshold into health education that our future clinicians pass through, and so this subject represents especially fertile ground to facilitate critical thinking when it comes to biases within scientific information. In developing this text, I benefited from the reviews of a number of instructors, including Inclusion and Diversity (I&D) advocate Dr. Edgar Meyer, author of “Diversity and Inclusion in Anatomy & Physiology Education, Degree Programs, and Professional Societies.”6 My goal was to create an inclusive and diverse textbook in Anatomy & Physiology. Taking into consideration Dr. Meyer’s feedback, I created a seven-point I&D plan, including: 1. More diverse models and imagery throughout the text 2. “Cultural Connections” features that link science with culture 3. In-class active learning opportunities to maximize inclusive and diverse academic experiences 4. Curriculum and anatomy pertaining to transgender and gender nonconforming individuals 5. Inclusive language that is sensitive to diversity in students 6. Clinical examples detailing the predispositions of certain racial and socioeconomic groups to display health care disparities, such as sickle cell anemia 7. Defining “average” values and providing comparative data, where applicable Organization of the Text Chapter 1, “The Art and Science of Learning in Anatomy and Physiology,” is devoted to explaining methods students can use to approach learning. Dr. Co’s commitment to her students comes through as she explains the proper mindset needed to 5 Hoffman, K.M., Trawalter, S., Axt, J.R., and Oliver, N.M. (2016). “Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites” Proceedings of the National Academy of Sciences 113 (16): 4296–4301. Doi: 10.1073/pnas.1516047113, https://www.pnas .org/content/113/16/4296 6 Meyer, E. R., and Cui, D. (2019). “Diversity and inclusion in anatomy & physiology education, degree programs, and professional societies.” HAPS Educator 23 (2): 396–419. Doi: 10.21692/haps.2019.012, https://files.eric.ed.gov/fulltext /EJ1233545.pdf study Anatomy & Physiology. She shares study tips from her previous students to offer a peer perspective to learners. Chapters are organized as follows: • Unit 1 (Level of Organization) contains chapters that exam- ine the levels of organization of the structures of the human body. • Unit 2 (Support and Movement) includes the chapters of the musculoskeletal system. • Unit 3 (Regulation, Integration, and Control) contains chapters about systems that contribute to homeostasis through control over other systems. • Unit 4 (Fluids and Transport) examines the systems that regulate fluids and fluid flow throughout the body. • Unit 5 (Energy, Maintenance, and Environmental Exchange) is all about exchange with the external environment. • Our last unit, Unit 6 (Deviations from Homeostasis), contains two chapters that are beyond the homeostatic function of the body: reproduction and the changes that occur in our bodies in disease. Art Throughout my teaching career I have spent a lot of time and energy observing how students interact with instructional art. Often illustrations, symbols, or representations that seem easy to understand using our expert eyes are not intuitive for an introductory learner. In designing each figure, I drew the structures and concepts as I would do and have done while talking to students in office hours. Our amazing illustrators then took what I produced and turned it into art. This instructional art approach is infused throughout the book but especially prominent in our “Anatomy of…” features. Years ago, I learned in an undergraduate educational psychology class that science students often had trouble developing a scientist identity because they didn’t see images of scientists that looked like them. The idea of representation has wide ranging ripple effects. Clinicians see a variety of patients; students see a variety of possible selves. When we choose a limited palate of representative humans in instructional art, we limit the scope of what students are exposed to in several ways. Therefore, I asked our art team to work with me on creating and sourcing images that represented a spectrum of bodies from young to old, across different sizes, gender expressions and ethnicities. Whether you are a student or an instructor, please know that I have written this book for you. I hope that it helps you learn or teach and that you find it helpful in your A&P journey. I would love to hear back from you about it, whether it is typos, constructive suggestions, ideas for enrichment or, perhaps you’d Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com like to suggest your own study tips. Please know my virtual door is always open and I would love to chat with you. I hope you develop the most positive feelings about A&P! Liz Co, July 2022 eco@bu.edu MindTap MindTap is the online learning platform that gives you complete control of your course. Craft personalized, engaging learning experiences that boost performance and deliver access to eTextbooks, study tools, assessments, and student performance analytics— whether you are teaching an in-person, online, or hybrid course. To provide a personalized, engaging digital learning experience, you can deliver your course in MindTap integrated with your institution’s Learning Management System (LMS). MindTap supports your instruction by teaching students core concepts using a prebuilt, customizable learning path that progresses from understanding to application with readings from the eTextbook, study tools, interactive media, auto-graded assessments and more, including: • Learn Its: 15-minute activities that pair concise narrative and multimedia with assessments to improve students’ conceptual understanding of difficult concepts. • Case Studies: Engage students with clinical scenarios and challenge them to higher-level understanding with autograded assessments. • Mastery Training (powered by Cerego): Use cognitive science principles to help students learn key terms faster and more effectively by utilizing retention, distributed learning, and retrieval practice. • Virtual Labs: Includes 3D models and Institute of Human Anatomy cadaver dissection videos, with assessment content for pre- and post-lab. • Practice Tests: Mimics exam questions so students can confidently prepare on their own. Students choose the chapters they want to study and generate a test with the desired number of questions. • Chapter Quizzes: Measures how well students have mastered material after completing chapter readings and activities. Students see feedback explaining the correct answer after they submit the quiz. • Flashcards: Students can use ready-made, mobile-friendly flashcards, or create their own, to learn key terms and concepts. Preface xix • Lecture PowerPoints: Key points from the text are outlined, along with images and active-learning activities to keep students engaged. • Image PowerPoints: These slides give instructors easy access to all images from the text. • Instructor Manual: Each chapter’s Instructor Manual includes a chapter outline, key terms list, suggested activities, discussion questions, video links to share with students, and answers to Apply to Pathophysiology questions from the text. • Labeling Worksheets: Students can practice labeling anatomical structures during class, while studying, or for a grade. Cengage Unlimited Boost Access and Affordability Cengage Unlimited is the cost-saving student plan that includes access to our entire library of eTextbooks, online platforms and more—in one place, for one price. For just $124.99 for four months, a student gets online and offline access to Cengage course materials across disciplines, plus hundreds of student success and career readiness skill-building activities. See www.cengage.com/unlimited/instructor for more information. HAPS We created both print and digital content in this product with direct ties to HAPS learning outcomes. Each piece of information was intentionally chosen to support A&P student learning. Throughout the text and MindTap, students and instructors can see which content is tied to each learning outcome. The Human Anatomy and Physiology Society includes more than 1,700 educators who work together to promote excellence in the teaching of this subject area. The HAPS A&P Learning Outcomes measure student mastery of the content typically covered in a two-semester Human A&P curriculum at the undergraduate level. The full Learning Outcomes are available at https://www.hapsweb.org. OpenStax Certain content in this product was developed using open-source content from OpenStax’s Anatomy & Physiology product. OpenStax (www.openstax.org) is part of Rice University and is a 501(c)(3) nonprofit charitable corporation. We would like to thank the contributing authors and editorial team for their work on Openstax’s Anatomy & Physiology, which can be accessed here: https://openstax.org/details/ books/anatomy-and-physiology. Instructor Resources • Test Bank: Build your exam from a list of multiple-choice and short-answer questions. Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com Acknowledgments Writing a book is an enormous and consuming task. As I sit here writing the acknowledgments, I feel as though I could write for days because there are so many people who have helped either directly or indirectly. Nanette Tomicek, thank you for your insights on the hardest of the chapters. Janet Brodsky, your precision is unparalleled, I am thankful for your partnership throughout the book. I’ll start with my family. In many ways, this book is my third child, I feel as though I dreamed about it, hoped for it, and poured my heart and soul into it. It also, at times, interrupted my life in the ways that a newborn can. Therefore, my first acknowledgment is to my two human children, Talia and Eliot, who had to be patient and understanding and occasionally got less of their mom’s time for the duration of the writing cycle. For all the times you sat next to me writing your books as I wrote mine, drew bones on the floor of my office while I finished a paragraph, and generally cheered me on, thank you. You are the loves of my life. Hilary Engebretson, your comments as a reviewer were always spot on. You corrected content, adjusted my voice, and lent a perspective that always helped me bring things back in check. I very much appreciate your contributions. Sam, thank you for describing my early morning typing as a “steady pitter patter” instead of disruptive, for all the things you took on or waited for when I needed to write, for all of your listening, but most of all, for your steadfast and contagious belief in LFC, I do not think this book could or would exist without you. I need to thank my work wife, who patiently answered my exasperated phone calls, took walks with me when I needed to get out of my head, edited many sentences, brought clarity and insight to biological concepts, and who has always been in my corner, thank you. I wouldn’t have wanted to share this work journey or all those nachos with anyone else. Now for the book team, first, thank you, Julie Scardiglia, for being the maven of details and always patiently redirecting me to my priorities. Brendan Killion patiently kept us all on task and driving forward, and we all owe him thanks that this book is being published in 2022, instead of 2032. Akshat Mehta, Angelina McNulty, and Emily Ackerman, you each brought your own strengths to the book and I am so very grateful. Akshat, I’ve always said that there is a teacher in you! Thank you for sharing that teacher with the world in the pages of this book. Angelina and Emily, many, many students will be helped by the student study tips you’ve shared with them. You are learning assistants through and through. Thank you for providing your unique insights the process of learning A&P. I am not only grateful for your contributions to the book, but for the privilege of getting to a part of your journey as you transitioned from my students to my colleagues. I cannot wait to see what you do next in the world. This text would not make half as much sense as it does and would have commas in all the wrong places, if not for the careful editing of Christopher Chien. Thank you. One of the most important things to me in conceiving this book was that the images within it represent a diverse set of bodies. I dreamed that we could fill the pages of the book with beautiful images of people of different shapes, sizes, ages, and appearances. Dragonfly brought that dream into vivid color and created a book that is more magnificent than I could have dreamed. I owe the amazing artists a huge thank you. To Kelsey Kerr, Katherine Caudill-Rios, Maureen McLaughlin, and Diana Baniak. You saw an author in me. When I believed that a book would be a dream, you picked me out, coached me along, and willed it into reality. I am a person of many, many words, but I am not sure if I will ever find all of the right ones to be able to thank you for helping me make this transition. You are the birth coaches of this book baby. I am forever thankful. This text, MindTap content, and instructor supplements were improved thanks to the insights of many Anatomy & Physiology instructors who shared their ideas, concerns, and feedback with the product team at Cengage. Thank you to the following participants who dedicated their time to improving the product through focus groups, surveys, interviews, and product testing. Special thanks to the following reviewers: Janet Brodsky, Ivy Tech Community College Stephen Burnett, Clayton State University Mary Colon, Seminole State College of Florida Hilary Engebretson, Whatcom Community College Stephen Henry, Houston Community College Austin Hicks, The University of Alabama Nathaniel King, Palm Beach State College Ann LeMaster, Ivy Tech Community College Edgar Meyer, University of Mississippi Medical Center Andrew Nguyen, CUNY Queensborough Community College Julie Posey, Columbus State Community College Rosemary Stelzer, University of Wisconsin-Milwaukee Nanette Tomicek, Thomas Jefferson University Padmaja Vedartham, Lone Star College System Kelsha Washington, Florida A&M University Theo Worrell, Delgado Community College Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 1 Get Complete eBook Download By email at student.support@hotmail.com Rawpixel.com/Shutterstock.com The Art and Science of Learning in Anatomy and Physiology Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com The Art and Science of Learning in Anatomy and Physiology Chapter 1 3 Chapter Introduction In some ways learning can be discipline specific. However, in many ways learning is learning, regardless of the content. In this chapter we will explore some of the science behind how we learn in order to help you foster success in Anatomy and Physiology (A&P). 1.1 The Science of Learning 1.1a Foreign, Familiar, and Mastery-Level Understanding Let’s take an example of a person who is learning a new language. We could also use an example of a spectator trying to learn about the game of baseball, or a student studying physics, or an architect learning about building construction, but let’s take a new language. Let’s say our learner’s name is Talia. Talia goes to Spanish class for the first time. The teacher speaks in Spanish and Talia understands none of it. She guesses as to the instructions based on the instructors’ gestures and tone of voice. After a few classes, Talia begins to pick up on some of the vocabulary of the class. She is learning Spanish words in her own time, using flashcards, online quizzing apps, recognizing phrases. She eventually becomes very familiar with Spanish words. After a few years, Talia travels to Mexico. She finds she is able to recognize enough Spanish words to be able to understand signs and ads that are printed in Spanish. However, Talia now sits in a café in Mexico City. A friendly stranger approaches her and begins to make conversation in Spanish. Will Talia be able to converse with the stranger? Probably not, because there is a difference between being familiar with a language and being able to converse in it. Conversation is a skill, a dynamic skill that involves listening, decoding, recall, comprehension, and creativity. Talia has not yet practiced these skills. She has the content she needs but will need to practice the skill of conversation before she can employ it with ease. Learning A&P (or really most anything) can be thought of the same way: there is the content of what you are learning, and the skills involved in its mastery and application. In terms of A&P, we have vocabulary, concepts, functions, structures, and locations, and then we need to learn how to connect ideas and apply knowledge in a new context, analyze new data. For example, if you were to become a clinician and a patient had a pain in their abdomen, it would not be sufficient to list off a memorized set of organs in the abdomen. You, the clinician, must apply your knowledge of the area and an understanding of the symptoms that the patient is experiencing and analyze the data from clinical tests to diagnose and treat the patient. You must think critically about the information you know and apply it in a new circumstance, one that may be nuanced or unique. Therefore, it is insufficient to simply memorize in A&P; we must learn the lifesaving skills of application, analysis, and critical thinking. Let’s go back to Talia, the Spanish language learner, for a moment. Talia needs to engage in separate processes of memorizing vocabulary and practicing the skill of conversation. She cannot dive first into practicing the skill, nor is it sufficient to stop at memorization. If we were to diagram Talia’s learning it would look something like Figure 1.1. Talia’s stage 1 of learning happened in the classroom when she was a beginning learner. She is currently at an advanced level of stage 2; she has a lot of vocabulary Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com 4 Unit 1 Levels of Organization Figure 1.1 Stages of Learning Stage 1: Foreign Stage 2: Familiar Stage 3: Mastery and is able to understand written text and recall meaning. If she practices the skills involved in conversation, she will reach stage 3—mastery of Spanish—and able to converse with ease. The science of learning tells us that the transition between foreign and familiar is one that is best achieved through repetition and exposure. The methods of repeat exposure may look different from one type of learning to another, but in A&P learning, this may look like: reading/rereading your notes, copying your notes over, watching and rewatching lectures, reading and rereading your textbook, and using flashcards to memorize terminology. The transition from familiarity to mastery, however, is a bit different. Here, the difference in our language-learning example is between being able to translate printed words or being fluid in a conversation. In A&P, mastery means not only being able to identify the deltoid muscle but being able to predict functional deficits with deltoid injury, or being able to identify, based on a set of symptoms, the location of an injury. In further mastery, you may find, as a clinician, that you need to communicate about A&P on a variety of levels. For example, you may use one set of terms to discuss a case with a colleague who is also a clinician, but you may need to translate information when conveying it to others in ways that are respectful of their level of knowledge and understanding. In A&P, examples of practice might include: teaching or explaining the material to someone else, drawing a structure or structures, writing out an explanation of a concept, recreating a graph with explanations, completing practice problems, or answering the question what happens if these components don’t work? (Figure 1.2 and Table 1.1). Figure 1.2 T ransitioning Between the Stages of Learning Using a Variety of Learning Techniques Stage 1: Foreign Transition from foreign to familiar through repetitive exposure to the material: • Reading/rereading your notes • Copying your notes over • Watching and rewatching lectures • Reading and rereading your textbook • Using flashcards to memorize terminology Stage 2: Familiar Stage 3: Mastery Transition from familiarity to mastery through practice: • Teaching or explaining the material to someone else • Drawing a structure or structures • Writing out an explanation of a concept • Recreating a graph with explanations • Completing practice problems • Answering the question what happens if these components don’t work? Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com The Art and Science of Learning in Anatomy and Physiology Chapter 1 5 Table 1.1 Learning Strategies That Build Familiarity and Those That Build Mastery Familiarity-Building Learning Strategies Mastery-Building Learning Strategies Reading Drawing a representation of an anatomical structure Looking over notes Teaching someone else the material Copying notes over Quizzing yourself Flashcards Having a friend quiz you Listening to/watching lectures Explaining a process Labeling an unlabeled drawing Ordering the parts of a process after mixing them up Looking at a process you’ve learned, ask yourself about each component “what would happen if this was broken, how would that impact the entire process?” 1.1b Memory Formation and “Chunking” Everyone has limits to their learning and memory. People who enter memorization competitions (yes! There are such things!) have a variety of different strategies for learning vast quantities of information quickly. The first technique is quite easy to employ. It is storytelling. Let’s say that you have been asked to remember four words and recall them back four hours later. The four items are cookie, staircase, yellow, and music. Imagine you go about the rest of your day for the next four hours and then are asked to recall these four random words. Few people would be able to do so easily. But what if you paused for a moment, after getting your list of words, and created a quick story or visual for learning (Cookie monster is sitting on the bright yellow staircase listening to his favorite music)? If you paint this image in your mind, it is much more likely that you will be able to remember the four words a long time from now. Similarly, in A&P we can create short stories known as mnemonic devices. For example, there are 12 nerves that exit the brain and innervate structures mostly found in the head and neck. These 12 nerves are known as cranial nerves. Their names are: olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, and hypoglossal. You got that? What was the fifth one? It’s a challenge. However, what if, in order to remember them, we take just their first initials: OOOTTAFVGVAH and make a story such as On, on, on they traveled and found Voldemort guarding very ancient horcruxes? If you have read the Harry Potter books (or seen the movies) you will remember this mnemonic pretty easily. You still have to learn the names of the cranial nerves and that the second V, for example, stands for vagus, but it makes the process easier. Chunking is the term for grouping items together as you learn them. It’s a way to cheat your working memory into holding onto more information. Let’s take an example. Please remember the following numbers—4195082637—in order, and repeat them back in five minutes. It seems like a challenging task. What if, instead, we chunk them like this: (419) 508-2637? That form of chunking is widely employed for memorizing telephone numbers. Birth dates are another example; instead of 10152004 you may remember a birthday as 10/15/2004. So how do we chunk information in A&P? One great example is learning structure and function together. Forms of chunking you might use could be: ● ● ● ● similarities and differences. structure and function. structures in order, for example, from top to bottom or superficial to deep. structures that are together in one location—for example, the three layers of protective tissue, called meninges, over the brain—can be learned together in one chunk. Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com 6 Unit 1 Levels of Organization Table 1.2 Examples of Chunking Example 1: Chunking structures by shared functions Example 2: Chunking structures by similarities Cellular Structures and Their Functions ● Lysosomes break down material through enzymes ● Peroxisomes break down material through hydrogen peroxide ● Smooth endoplasmic reticulum breaks down some toxins ● Nucleus holds the instructions for building proteins ● Ribosomes build proteins ● Golgi apparatus modifies proteins Structures within the Abdominal Cavity ● Stomach ● Greater omentum ● Small intestine ● Large intestine ● Lesser omentum ● Liver ● Mesocolon chunked chunked Recycling Functions ● Lysosomes ● Peroxisomes ● Smooth endoplasmic reticulum Protein-Building Functions ● Nucleus ● Ribosomes ● Golgi apparatus Organs ● Stomach ● Small intestine ● Large intestine ● Liver Membranes ● Greater omentum ● Lesser omentum ● Mesocolon Two examples of chunking in A&P are provided in Table 1.2. Chunking is a great tool to incorporate as you move from foreign to familiar in your learning. 1.1c Retrieval Practice Retrieval practice refers to memory strengthening. The more often you are asked to recall information, the easier it becomes to remember. Let’s say that you change the passcode to your new mobile phone, email account, or favorite website. The first few times you enter this passcode it may be difficult to remember, but after the thirtieth time you’ve logged in, the passcode becomes rote, or habitual. The learning concept of retrieval practice is part of the philosophy behind assigning homework or quizzes or in-class questions during a course. The more times you are asked about a concept, a structure, or an idea, the more habitual it becomes to recall that piece of information. Your instructor may provide opportunities for you to practice retrieval, such as quizzes, but you can do this for yourself as a learner as well. Examples of retrieval practice in studying can be: ● ● ● ● ● using flashcards, redrawing, or rewriting from memory. labeling an unlabeled diagram. paraphrasing a process or idea (especially effective if you are trying to tell someone else about this process or idea). predicting what questions could be asked of you about a structure/concept/idea. summarizing information at the end of a section or chapter. Retrieval practice is a great tool to use as you move from foreign to familiar in your learning. 1.2 Bloom’s Taxonomy In our example of learning a new language, we differentiated between content (words, concepts, ideas) and skills (application, analysis, and so on). In education there is a well-accepted framework for considering the skills involved in a question or task. The framework is called Bloom’s Taxonomy (Figure 1.3). Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com The Art and Science of Learning in Anatomy and Physiology Chapter 1 7 Figure 1.3 Bloom’s Taxonomy CREATE ANALYZE EVALUATE USE INFORMATION TO CREATE SOMETHING NEW CRITICALLY EXAMINE INFO & MAKE JUDGMENTS Design, Build, Construct, Plan, Produce, Devise, Invent Judge, Test, Critique, Defend, Criticize TAKE INFO APART & EXPLORE RELATIONSHIPS Categorize, Examine, Compare/Contrast, Organize APPLY USE INFORMATION IN A NEW (BUT SIMILAR) SITUATION Use, Diagram, Make a Chart, Draw, Apply, Solve, Calculate UNDERSTAND UNDERSTANDING & MAKING SENSE OUT OF INFORMATION Interpret, Summarize, Explain, Infer, Paraphrase, Discuss REMEMBER FIND OR REMEMBER INFORMATION List, Find, Name, Identify, Locate, Describe, Memorize, Define The framework conveys a few central points: ● ● ● ● Different assessment questions or tasks target different skills. If you are asked, “which of the following words best defines the term tissue?” You are being asked to recall the definition of tissue. If, instead, you were asked “You are looking through the microscope at a tissue that has a high degree of cellularity, with every cell contacting another cell except for a free edge at the top of your view. What type of tissue are you most likely looking at?” You are being asked to apply what you know about tissue types to a new situation you have never encountered before. These tasks and the skills involved are different from each other. These skills are iterative. You cannot apply information in a new context if you cannot remember it. Therefore, application depends on knowledge. The skills build on each other, but one is not necessarily harder than another. It could be more challenging to apply knowledge than to remember something, but if you were asked a remembering question about a tiny obscure tidbit of knowledge, or asked to apply a general concept, the application question in this case would be easier than the remembering question. Everyone is working with a different brain. Some students are natural memorizers; these students need to work on their skills of application and analysis. Some students struggle with memorization, but problem solving comes easily to them. To be the most successful, you need to learn about yourself as a learner first, then work on the skills that need the most building. You can talk with your instructor about what to expect on your assessments in your A&P course. Within this book we label the assessment questions with the Bloom’s level the question is targeting to get you familiar with your skills and growth areas. It is common for 70–80 percent of the questions on an exam to be either remembering or understanding questions, and 20–30 percent of the questions to be applying or analyzing questions. Your instructor may also include questions or tasks that target the creating Bloom’s level in your course. Study strategies that target each Bloom’s level are summarized in Table 1.3. Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com 8 Unit 1 Levels of Organization Table 1.3 Learning Strategies and Question Examples That Target Each Bloom’s Level Bloom’s Level Skills Example Question Remember ● Memorize Define ● Recall details Which of these is the correct definition of osmolarity? Recognize a concept in a new situation ● Thoroughly understand a concept Which of the solutions in this diagram is hyperosmotic? Apply information in a new situation ● Use a previous example to or model to understand a new example What will happen to interstitial fluid volume if the concentration of glucose increased there? Assess a new piece of data or graph to make a conclusion The blood pressure readings of four patients can be found in this table. Which one might have the highest blood osmolarity? Justify a conclusion Choose a best among a group of plausible explanations Which of these diseases is likely to cause an increase in osmolarity of the blood? Produce a new work, idea, or writing Design a solution that is hyperosmotic to blood plasma. Describe the effects on the tissues (and red blood cells) if this solution was injected into the bloodstream ● Understand ● Apply ● Analyze ● Evaluate ● ● Create ● Individual Strategies Practice labeling diagrams List characteristics ● Flashcard practice/quiz ● Draw, classify, select, or match items ● Write out the textbook definitions ● ● Describe a biological process in your own words ● Provide examples of a process ● Write a sentence using new vocabulary words ● Review each process you have learned and then ask yourself: what would happen if you increase or decrease a component? ● If possible, graph a biological process and create scenarios that change the shape or slope of the graph ● Analyze and interpret data in primary literature or a textbook without reading the author’s interpretation and then compare your analysis to the author’s ● Compare and contrast two ideas or concepts ● Create a map of the main concepts by defining the relationships of the concepts using one- or two-way arrows ● ● Practice justification of each of the wrong answers for complex questions Write a paragraph summarizing a major idea or process ● Draw your own physiological diagram to illustrate a concept or process ● Group Strategies Check a drawing that another student labeled ● Create lists of concepts and processes that your peers can match ● Place flash cards in a bag and take turns ● ● ● Discuss content with peers Take turns quizzing each other about definitions and have your peers check your answers Practice writing out answers to practice questions (or write your own) and have your peers check your answers ● Take turns teaching your peers a biological process while the group critiques the content ● Work together to analyze and interpret data and defend your analyses to your peers ● Work together to identify all of the concepts in a paper or textbook chapter, create individual maps linking the concepts together with arrows and words that relate the concepts, and then review your peer’s maps and defend your own ● ● Justify your stance to your group on each answer of case study questions Design your own fictional case study and ask your peers to do the same. ● Exchange case studies for each other to solve ● Adapted from Crowe et al., 2008. Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com The Art and Science of Learning in Anatomy and Physiology Chapter 1 9 The activities that you use to study and learn can incorporate all these ideas. As you study you want to make sure you move from familiarity-building techniques to mastery-building techniques (Table 1.1). You also want to be sure to incorporate activities that target different Bloom’s levels (Table 1.3). Remember that no two learners have the same brain; therefore, the ways that you learn best may very well be different from those of a friend or even your instructor! As you progress through your education, you will discover that some learning strategies work for you and some do not! You may also find that some strategies work better for some material, while other strategies are more adapted for other courses. For example, you may find differences in how you approach even A&P material within the same course. Ultimately, as you become more in tune with your learning processes, you will have a better sense of which strategies to apply when and in what order. 1.3 What Is a Learning Objective? Learning objectives (LOs) are used as a means of transparency between the instructor and the learner. They are, essentially, a means of answering the age-old student question: What are we supposed to learn? In this book we have included LOs at the top of every section of text. The LOs appear again at the end of each chapter along with questions that target those objectives. The goal of this design is to help you to become familiar with anticipating the types of assessment questions you want to prepare for. The text indicates higher-order and lower-order Bloom’s level LOs using different icons. Remember that you may want to use different learning strategies for different levels. Your instructor may have additional LOs that they include in their lectures or syllabus. Again, LOs are tools of transparency; your instructor is communicating with you about what they feel is important for you to learn. You can also ask your instructor questions when you are unsure of your objectives. An example of an LO and how to use it in your learning can be found in Figure 1.4. Figure 1.4 Anatomy of a Learning Objective (LO) Example LO from Chapter 4 and one approach to learning the material it targets. Anatomy of an LO Compare and contrast The content chromatin, chromosomes, and chromatids. The verb Description Timing Function Chromatin Loosely wound DNA Interphase DNA (genes) accessible for transcription Chromosome Compacted DNA Mitosis Meiosis Condense DNA for movement and sorting during mitosis and meiosis One of two replicates Mitosis Meiosis One of two replicated sisters separates to daughter cells Drawing Chromatid or Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com 10 Unit 1 Levels of Organization 1.4 The Anatomy of Art 1.4a Image Translation in Anatomy Learning anatomy will require a skill you have likely not had a lot of time to practice in your education: learning visually. Unlike most of your classes where the majority of your interaction with the material was through words or numbers, anatomy—and to some extent physiology—really asks that you learn images. In particular, you will be asked to transfer your visual understanding from images you have seen before to novel images. You will often find that you have studied an image from one perspective, only to need to translate to another. For example, if you have studied an image from the front, you will use what you understand about the three-dimensional relationships among the organs or structures to be able to break down and understand an image of the same area taken from above. Similarly, studying tissues through microscopes is challenging for the first few times you do it. After practice, your ability to translate what you see to the structures you have learned will grow. Beginning A&P students often find these skills challenging, until they practice them over time. Looking at a new image can be overwhelming at first. Like many anatomists, you may find it helpful to first find a landmark, a structure you know well. From that landmark, you can begin to identify the other structures around it that you recognize. In Figure 1.5 you can walk through this process. Figure 1.5A illustrates a simple and straightforward diagram of the heart from an anterior (front) perspective. For simplicity, only three structures are labeled in this exercise. Now examine Figure 1.5B, which is an image of the same organ in the same perspective (anterior/front) but drawn by a different artist. Can you find the three structures? Now examine Figure 1.5C. Here you are looking at the same organ (the heart) from a different perspective (superior/from above). Find your three structures again. Repeating this strategy with new images is a great way to work toward mastery. In your study process, you can repeat this with unlabeled images as many times as is helpful to you. A last step in this process can be to draw the image for yourself. Keep in mind that the point of this is not about artistry, but that working through the task of representing the relationship among anatomical structures is a fantastic way to assess your mastery of the material. Another example of image translation is applying what you are learning in one type of image to another type. In A&P texts we use drawings more than any other type of instructional image because medical illustrators can make the structures stand out from each other using color and lines and it is the easiest type of image for the beginning anatomist to be able to discern. However, as a clinician, the anatomical imagery you will use every day is much less straightforward. As we learn, we can begin to practice the translation of our knowledge from drawing to more relevant types of images by using photography and clinical images such as CT scans and X-rays. As with the examples in Figure 1.5, the first step in this process is to find a landmark. From there, build your understanding of the image out by finding and labeling the structures adjacent to your landmark. Compare the artist drawing (see Figure 1.5A), a photograph (Figure 1.5D), and a magnetic resonance image (MRI) of the heart (Figure 1.5E). In Figure 1.5A we have labeled the largest artery in the body, the aorta. Can you find the aorta in Figures 1.5D and 1.5E? 1.4b Comparing a Micro and Macro View A frequently used illustration technique in A&P is presenting a zoomed-in view of a structure simultaneously with the zoomed-out view. In science, we typically use the terms micro and macro for these views, respectively. You can see an example in Figure 1.6. Can you find where on the macro view (Figure 1.6A) the structure presented Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com The Art and Science of Learning in Anatomy and Physiology Chapter 1 11 Figure 1.5 Image Translation Anatomy requires visual literacy and image translation. Here we compare two drawings of the anterior perspective of the heart (A and B) with a superior perspective of the heart (C). Translating these diagrams to a photo (D) and finally an MRI (E) requires a strong working knowledge of the heart structures. Aorta Superior vena cava Aorta Superior vena cava Superior vena cava Left ventricle Left ventricle B Left ventricle C Morris Huberland/Science Source Wanuttapong suwannasilp/Alamy Stock Photo A Aorta D E in the micro view (Figure 1.6B) is? Always make sure to reorient yourself when you are presented with figures such as these. 1.4c Learning from Physiology or Process Diagrams Illustrating a dynamic process in a static image is a challenging task for our illustrators. These images, as straightforward as we try to make them, can be complicated to digest as a learner. Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com 12 Unit 1 Levels of Organization Figure 1.6 Micro and Macro Views Comparing a (A) micro and (B) macro view of a muscle cell sarcomere. Z disk Z disk Thin ÿlament (actin) Thick ÿlament (myosin) A Sarcomere Z disk Z disk Thin ÿlament (actin) Thick ÿlament (myosin) Elastic ÿlaments (titin) B Before you set about trying to memorize or learn from a figure, make sure that you understand what the figure is trying to convey. Together, let’s go through Figure 1.7. This is a fairly standard drawing of a foundational physiological concept (osmosis). As we break down this image, some questions you might ask yourself are: ● ● ● ● There are four different arrows used in the image—one orange, one green, a single-headed arrow in black, and a double-headed arrow in black. What are the arrows trying to illustrate? There are red dots. What do these represent? Is it significant that the red dots are on one side of the U-shaped tube and not the other? There is a dashed line at the bottom of this tube. What does it represent? Is this image trying to show two U-shaped tubes side-by-side, or is it trying to show what happens in one tube over time? Arrows are of particular trickiness in physiological diagrams. They can be used to show the direction of movement in a dynamic process, used to convey time, or used to illustrate differences. In this image they are doing all three things! Which arrow do you think is trying to convey the passage of time? If you answered the green arrow, you are correct! The orange arrow is trying to convey the direction of movement, in this case of water. In the U-shaped tube on the right, time has passed, water has moved, and the black arrow is pointing out to you that an increase in water volume can be observed. Asking yourself questions about a figure you are learning from not only ensures that you are beginning your learning with the correct understanding but also works Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Get Complete eBook Download By email at student.support@hotmail.com The Art and Science of Learning in Anatomy and Physiology Chapter 1 13 Figure 1.7 n Example Figure Illustrating the Movement of Water in Response to an A Osmotic Gradient Solute Volume increase Osmosis Semipermeable membrane to fortify your knowledge of the key components of the process. You should also take into consideration the figure legend and related text to assist in your interpretation of a diagram. Cultural Connection It’s All Greek to Me! The average A&P student will learn more new vocabulary words in each chapter than an introductory language student! Similar to learning any language, A&P students must memorize the words but also master how to use these words in communication with others. Conveniently, there is some redundancy within A&P terminology and so you can often use clues to understand the words. The majority of terms used in A&P are derived from ancient Greek and Latin words. More specifically, a predominant number of anatomical terms come from Latin, and a predominant number of medical terms (e.g., conditions, diseases, professions, and so on) come from ancient Greek. The emphasis on using these two languages likely originated with the very first anatomical study, which occurred in ancient Rome and early medicine and which was a focus in ancient Greece. Anatomists described structures in the body using plain descriptors, but as language changed over the centuries we were left with very complex terminology. For example, in Chapter 3 you will learn the term ligand. The first half of this word, liga, is from the Latin ligare, which means “to bind.” Later, in Chapter 10, you will learn the term ligament; a ligament is a structure that connects, or binds, two bones together. Doing the work in Chapter 3 to understand the origin of liga makes learning in Chapter 10 easier! Throughout the text we will assist you with the interpretation of these Greek and Latin-derived words. As a student your primary goal is to master the content of this course. However, this herculean task is much easier if you know about yourself as a learner and have an array of tools to employ in your process. As you go through the course, consider which tools are working for you and which content or skill areas you have the most room to grow in. It is important to make sure you incorporate a variety of diverse learning techniques into your journey to mastery of the material. You will find tips and strategies throughout the book, but your instructors and this chapter are resources that are always available as you consider, observe, and refine your learning techniques. Get Complete eBook Download By email at student.support@hotmail.com Copyright 2023 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.