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Library of Congress Cataloging-in-Publication Data
Cohen, Barbara J.
Memmler’s The human body in health & disease / Barbara Janson
Cohen. 10th ed.
p. cm.
Includes index.
ISBN
1. Human physiology. 2. Physiology, Pathological. 3. Human anatomy.
[numbers, etc.]
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[numbers]
Reviewers
We gratefully acknowledge the generous contributions of the reviewers whose names appear
in the list that follows. These instructors were kind enough to read the text thoroughly and
make suggestions for improvement. Their comments determined many of the changes in content and direction for this revision, such as the increased number and types of learning aids,
addition of new art and revisions to existing art, a stronger focus on teaching and learning
anatomic and medical terminology, and an increased emphasis on physiology and the interrelatedness of structure and function. We hope they will be pleased with the results of their hard
work in this 10th edition of Memmler’s The Human Body in Health and Disease.
LaVon Barrett, RN, BSN
Amarillo College
Amarillo, TX
Michelle Cleary, PhD
Florida International University
Miami, FL
Nina Beaman, MS, CMA, RNC
Allied Health Program Area
Coordinator
Bryant and Stratton College
Richmond, VA
Stephen M. Colarusso, BS, NCTMB,
ACST
Director of Education
Charles of Italy School of Massage
Therapy
Lake Havasu City, AZ
Mark Andrew Bloom, BS, MS
Instructor of Biology
Texas Christian University
Fort Worth, TX
Zoe Hanson Cujak, BSN, MEd
Associate Dean, Service Occupations
Fox Valley Technical College
Appleton, WI
Kathleen Bode, RN, MS
Chair, Division of Health
Flint Hills Technical College
Emporia, KS
Katherine Fukuyama, BSN, MEd
Vancouver Community College
Vancouver, British Columbia, Canada
William J. Burke, BA
Madison Area Technical College
Madison, WI
Blackhawk Area Technical College
Monroe, WI
Glenn Grady, MEd, BSMT (ASCP),
CMA
Allied Health Department Chair
Miller-Motte Technical College
Wilmington, NC
Patti Calk, MEd, LOTR
University of Louisiana at Monroe
Monroe, LA
Kerry Hull, PhD
Associate Professor
Department of Biology
Bishop’s University
Lennoxville, Quebec, Canada
Kathy Carson, RPH
The Cleveland Institute of DentalMedical Assistants, Inc.
Mentor, OH
Tammee Neuhaus, MLT
Minnesota School of Health Sciences
Apple Valley, MN
Debra J. Paul, BAM, CMA
Medical Assisting Program Instructor
IVY Tech State College
South Bend, IN
Lisa S. Reed, RN, MS, CNOR
Department Chairperson for Surgical
Technology
New England Institute of Technology
Warwick, RI
Dyal N. P. Singh, BSc (Honors), MSc,
PhD
Professor of Anatomy
Director of Neuroscience
Ross University School of Medicine
Dominica, West Indies
Rox Ann Sparks, RN, BSN, MICN
Vocational Nursing Instructor
Merced College
Merced, CA
Alan H. Stephenson, BS, MS, PhD
Chair, Science Department
Edgecombe Community College
Tarboro, NC
Jean A. Zorko, MS, BSMT (ASCP)
Assistant Professor, Science
Stark State College of Technology
Canton, OH
Preface
Memmler’s The Human Body in Health and Disease is a textbook for introductory-level health professions and nursing
students who need a basic understanding of anatomy and
physiology, the interrelationships between structure and
function, and the effects of disease on body systems.
Like preceding editions, the tenth edition remains true
to Ruth Memmler’s original vision. Designed for health
professions and nursing students, the features and content specifically meet the needs of those who may be starting their health career preparation with little or no science
background. This book’s primary goals are:
To provide the essential knowledge of human anatomy, physiology, and the effects of disease, at an ideal
level of detail, and in language that is clear and
understandable.
◗ To illustrate the concepts discussed with anatomic
art that depicts the appropriate level of detail with
accuracy, simplicity, and elegance, and that is integrated seamlessly with the narrative.
◗ To incorporate the most recent scientific findings
into the fundamental material on which Ruth
Memmler’s classic text is based.
◗ To include pedagogy designed to enhance interest in
and understanding of the concepts presented.
◗ To teach the basic anatomic and medical terminology used in healthcare settings, preparing students to
function efficiently in their chosen health career.
◗ To present an integrated teaching-learning package
that includes all of the elements necessary for a successful learning experience.
◗
This revision is the direct result of in-depth market feedback solicited to tell us what instructors and students at this
level most need. We listened carefully to the feedback, and
the results we obtained are integrated into every feature of
this book. The text itself has been thoroughly revised and
updated to reflect the latest accepted scientific thought in
each area of the book. Because visual learning devices are so
important to students at this level, this edition also features
a completely revamped and expanded art program that
includes revised versions of many of the figures from previous editions as well as numerous all-new, full-color anatomic line drawings and photographs. Last but not least, these
features appear in an all-new design that makes the content
more user-friendly and accessible than ever.
◗ Organization and Structure
Like previous editions, the tenth edition uses a body
systems approach to the study of the normal human body
and how disease affects it. The book is divided into seven
units, grouping related information and body systems
together as follows:
◗ Unit I, The Body as a Whole (Chapters 1–4), focuses on the body’s organization; basic chemistry needed to understand body functions; cells and their
functions; and tissues, glands, and membranes.
◗ Unit II, Disease and the First Line of Defense
(Chapters 5 and 6), presents information on disease,
organisms that produce disease, and the integumentary system, which is the body’s first line of defense
against injury and disease.
◗ Unit III, Movement and Support (Chapters 7 and 8),
includes the skeletal and muscular systems.
◗ Unit IV, Coordination and Control (Chapters 9–12),
focuses on the nervous system, the sensory system,
and the endocrine system.
◗ Unit V, Circulation and Body Defense (Chapters
13–17), includes the blood, the heart and heart disease, blood vessels and circulation, the lymphatic
system, and the immune system.
◗ Unit VI, Energy: Supply and Use (Chapters 18–22),
includes the respiratory system, the digestive system, metabolism, nutrition, temperature control,
body fluids, and the urinary system.
◗ Unit VII, Perpetuation of Life (Chapters 23–25), covers
the male and female reproductive systems, development and birth, and heredity and hereditary diseases.
The main Glossary defines the chapters’ boldfaced
terms, and a Glossary of Word Parts is a reference tool
that not only teaches basic medical and anatomic terminology but also helps students learn to recognize unfamiliar terms. Appendixes include a variety of supplementary information that students will find useful as they
work with the text, including answers to the Chapter
Checkpoint questions and Zooming In illustration questions (Appendix 6) that are found in every chapter.
◗ Pedagogic Features
Every chapter contains pedagogy that has been
designed with the health professions and nursing student
in mind (the User’s Guide that follows the Preface provides a “guided tour” of these features and their pedagogic benefits). Features marked with an asterisk (*) appear
in every chapter:
◗ *Learning Outcomes: Chapter objectives on the
first page of every chapter help the student organize
and prioritize learning.
ix
x
✦
CHAPTER SEVEN
*Selected Key Terms: List that accompanies the
Learning Outcomes presents the most important
terms covered in the chapter.
◗ *Chapter Checkpoints: Brief questions at the end
of main sections test and reinforce the student’s
recall of key information in that section.
◗ *“Zooming In” questions “(NEW to this edition):
Questions with the figure legends test and reinforce
the student’s understanding of concepts depicted in
the illustration. They are set in a second color to
increase their visibility.
◗ Phonetic pronunciations: Easy-to-learn phonetic
pronunciations are spelled out in the narrative,
appearing in parentheses directly following many
terms—no need for students to understand dictionary-style diacritical marks. (See the “Guide to
Pronunciation” below.)
◗ *Special interest boxes: Each chapter contains
three special interest boxes focusing on topics that
augment chapter content. The book includes five
kinds of boxes altogether:
◗ A Closer Look: Provide additional in-depth scientific detail on topics in or related to the chapter.
◗ Clinical Perspective: Focus on diseases and disorders relevant to the chapter, providing detailed
content for students training in different fields.
◗ Health Professions (NEW to this edition): Describe
various careers in the health professions, highlighting the reasons why students need a thorough
grounding in anatomy and physiology.
◗ Hot Topic (NEW to this edition): Focus on current
trends and research, reinforcing the link between
anatomy and physiology and related news coverage that students may have seen.
◗ Health Maintenances: Offer supplementary information on health and wellness issues.
◗ *Figures: The greatly expanded and revised art program includes full-color anatomic line art, both new
and revised, with a level of detail that matches that
of the narrative. Also NEW to this edition are photomicrographs, radiographs, and other scans,
included to give students a “preview” of what they
might see in real-world healthcare settings.
◗
Tables: The numerous new and revised tables in this
edition summarize key concepts and information in
an easy-to-review form.
◗ Color figure and table numbers (NEW to this edition): Figure and table numbers appear in color in
the narrative, helping students quickly find their
place after stopping to look at an illustration or
table. Figure callouts appear in blue type, and table
callouts, in red.
◗ *Word Anatomy: Organized by chapter headings, this
chart groups various word parts used in terms found in
the chapter. This learning tool helps students build
vocabulary and promotes recognition of even unfamiliar terms based on a knowledge of common word parts.
◗ *Summary: Outline-format summary provides a
concise overview of chapter content, aiding in study
and test preparation.
◗ *Questions for Study and Review: Study questions
have been thoroughly revised and organized hierarchically into three NEW levels in this edition
(answers appear in the Instructor’s Manual):
◗ Building Understanding: Includes fill-in-the-blank,
matching, and multiple choice questions that test
factual recall.
◗ Understanding Concepts: Includes short-answer
questions (define, describe, compare/contrast) that
test and reinforce understanding of concepts.
◗ Conceptual Thinking: Includes short-essay questions that promote critical thinking skills.
◗
◗ Summary
In short, the tenth edition of Memmler’s The Human
Body in Health and Disease builds on the successes of the
previous nine editions by offering clear, concise narrative
into which accurate, aesthetically pleasing anatomic art
has been woven. We have made every effort to respond
thoughtfully and thoroughly to reviewers’ and instructors’ comments, offering the ideal level of detail for students preparing for a career in the health professions and
nursing, and the pedagogic features that best support it.
We hope you will agree that the tenth edition of
Memmler’s is the best ever.
User’s Guide
In today’s health careers, a thorough understanding of
human anatomy and physiology is more important than
ever. Memmler’s The Human Body in Health and Disease not
only provides the conceptual knowledge you’ll need but
also teaches you how to apply it. This User’s Guide introduces you to the features and tools that will enhance your
learning experience.
A unifying theme of this text is the relationship
between structure and function, and how they differ in
health and disease. We’ve woven that theme into the
book’s design and approach. Take a few minutes to look
through the text and get acquainted with its organization.
The two tables of contents provide a framework for your
learning: the Brief Contents gives a wide-angle view of the
book’s “skeleton”—the units and chapters—while the
detailed Contents focuses in on the individual “bones,”
the topics themselves. As with the different body systems,
specific topics build on each other from chapter to chapter, with each supporting the ones that follow.
Next, take a look at the chapters themselves. We’ve
included some important tools to help you learn about
anatomy and physiology and apply your new knowledge:
Objectives and key terms highlight important concepts—helping you organize and prioritize learning.
◗ “Health Professions” boxes focus on a variety of
health careers—showing how the knowledge of
anatomy and physiology is applied in real-world
jobs.
◗ “Hot Topic” boxes provide cutting-edge content on
trends and research—giving a view to what is happening in the larger scientific community.
◗ “Clinical Perspective” boxes focus on physical disorders and related body processes as well as techniques
used in clinical settings—providing additional content on diseases and their treatments.
◗
“A Closer Look” boxes provide additional detail on
selected topics from the text—focusing in on the
details of structure and function.
◗ “Health Maintenance” boxes cover common health
issues—offering useful information about how to
keep the body healthy.
◗ “Checkpoint” questions test your understanding of
the chapter’s key points—helping you review as you
proceed through the chapter.
◗ “Zooming In” questions ask you to focus in on the
illustration’s details and answer questions based on
what you see—reviewing important concepts and
honing your conceptual thinking.
◗ Phonetic pronunciations follow selected terms—helping you say the term correctly without having to stop
and look up complicated pronunciation symbols.
◗ The “Word Anatomy” chart helps you learn to recognize new terms based on your knowledge of word
parts—building vocabulary.
◗ Chapter summaries provide a quick review of key
points in outline form—helping you prepare for exams.
◗ Questions for Study and Review cover chapter content thoroughly—testing your recall of facts, reinforcing understanding of concepts, and teaching
critical thinking.
◗
The bonus CD contains a glossary of pronunciations
from Stedman’s Medical Dictionary and an electronic
image atlas. The pronunciation glossary allows you to
hear the correct pronunciation of key terms from the text
and practice them yourself, helping to prepare you to
communicate effectively in the healthcare setting. The
electronic image atlas, which contains the most important
illustrations from the text, is a convenient study tool that
lets you review and test your understanding of key body
structures.
xi
Box 1-3 • Health Professions
Health Information Technicians
E
very time a patient receives medical treatment, information is added to the patient’s medical record, which
includes data about symptoms, medical history, test results,
diagnoses, and treatment. Health information technicians
organize and manage these records, working closely with
physicians, nurses, and other health professionals to ensure
that medical records provide a complete, accurate basis for
quality patient care.
Accurate medical records are also essential for administrative purposes. Health information technicians assign a code to
each diagnosis and procedure a patient receives, and this
information is used for accurate patient billing. In addition,
health information technicians analyze medical records to discover trends in health and disease. This research can be used
to improve patient care, manage costs, and help establish new
medical treatments.
Health information technicians need a strong clinical
knowledge base. A thorough background in medical terminology is essential when reading and interpreting medical
records. Anatomy and physiology are definitely required!
Most health information technologists work in hospitals
and long-term care facilities. Others work in medical clinics,
government agencies, insurance companies, and consulting
firms. Job prospects are promising because of the growing
need for healthcare. In fact, health information technology is
projected to be one of the fastest growing careers in the United
States. For more information about this profession, contact
Box 8-2 Management
Hot Topics
the American Health Information
Association.
Anabolic Steroids: Winning at All Costs?
A
nabolic steroids mimic the effects of the male sex hormone testosterone by promoting metabolism and stimulating growth. These drugs are legally prescribed to promote
muscle regeneration and prevent atrophy from disuse after
surgery. However, athletes also purchase them illegally, using
them to increase muscle size and strength and improve
endurance.
When steroids are used illegally to enhance athletic performance, the doses needed are large enough to cause serious
side effects. They increase blood cholesterol levels, which may
lead to atherosclerosis, heart disease, kidney failure, and
Box 7-1
stroke. Steroids damage the liver, making it more susceptible
to disease and cancer, and suppress the immune system,
increasing the risk of infection and cancer. In men, steroids
cause impotence, testicular atrophy, low sperm count, infertility, and the development of female sex characteristics such as
breasts (gynecomastia). In women, steroids disrupt ovulation
and menstruation and produce male sex characteristics such
as breast atrophy, enlargement of the clitoris, increased body
hair, and deepening of the voice. In both sexes steroids
increase the risk for baldness and, especially in men, cause
mood swings, depression and violence.
Clinical Perspectives
Landmarking: Seeing With Your Fingers
M
ost body structures lie beneath the skin, hidden from
view except in dissection. A technique called landmarking allows health care providers to visualize hidden structures
without cutting into the patient. Bony prominences, or landmarks, can be palpated (felt) beneath the skin to serve as reference points for locating other structures. Landmarking is
used during physical examinations and surgeries, when giving
injections, and for many other clinical procedures. The lower
tip of the sternum, the xiphoid process, is a reference point in
the administration of cardiopulmonary resuscitation (CPR).
Practice landmarking by feeling for some of the other bony
prominences. You can feel the joint between the mandible and
the temporal bone of the skull (the temporomandibular joint,
or TMJ) anterior to the ear canal as you move your lower jaw
up and down. Feel for the notch in the sternum (breast bone)
between the clavicles (collar bones). Approximately 4 cm
below this notch you will feel a bump called the sternal angle.
This prominence is an important landmark because its location marks where the trachea splits to deliver air to both
lungs. Move your fingers lateral to the sternal angle to palpate
the second ribs, important landmarks for locating the heart
and lungs. Feel for the most lateral bony prominence of the
shoulder, the acromion process of the scapula (shoulder
blade). Two to three fingerbreadths down from this point is
the correct injection site into the deltoid muscle of the shoulder. Place your hands on your hips and palpate the iliac crest
of the hip bone. Move your hands forward until you reach the
anterior end of the crest, the anterior superior iliac spine
(ASIS). Feel for the part of the bony pelvis that you sit on.
This is the ischial tuberosity. It and the ASIS are important
landmarks for locating safe injection sites in the gluteal region.
Box 13-1
A Closer Look
Hemoglobin: Door to Door Oxygen Delivery
T
he hemoglobin molecule is a protein made of four chains
of amino acids (the globin part of the molecule), each of
which holds an iron-containing heme group. Each of the four
hemes can bind one molecule of oxygen.
Heme group
Globin chains
Hemoglobin. This protein in red blood cells consists of four
amino acid chains (globins), each with an oxygen-binding
heme group.
Box 5-2 • Health M aintenance
The
The Cold
Cold Facts
Facts about
about the
the Common
Common Cold
Cold
E
very year, an estimated one billion Americans suffer from
the symptoms of the common cold—runny nose, sneezing, coughing, and headache. Although most cases are mild
and usually last about a week, colds are the leading cause of
doctor visits and missed days at work and school.
Colds are caused by a viral infection of the mucous membranes
of the upper respiratory tract. More than 200 different viruses are
known to cause cold symptoms. While most colds occur in winter, scientists have found that cold weather does not increase the
risk of “catching” a cold; the incidence is probably higher in winter because people spend more time indoors, increasing the
chances that the virus will spread from person to person.
Colds spread primarily from contact with a contaminated
surface. When an infected person coughs or sneezes, small
droplets of water filled with viral particles are propelled
through the air. One unshielded sneeze may spread hundreds
of thousands of viral particles several feet. Depending upon
xii
temperature and humidity, these particles may live as long as
3 to 6 hours, and others who touch the contaminated surface
may pick up the particles on their hands.
To help prevent the transmission of cold viruses:
◗
◗
◗
◗
Avoid close contact with someone who is sneezing or
coughing.
Wash hands frequently to remove any viral particles you
may have picked up.
Avoid touching or rubbing your eyes, nose, or mouth with
contaminated hands.
Clean contaminated surfaces with disinfectant.
There are currently no medically proven cures for the common cold, and treatments only ease the symptoms. Because
viruses cause the common cold, antibiotics are of no benefit.
Getting plenty of rest and drinking lots of fluids are the best
ways to speed recovery.
Hemoglobin allows the blood to carry much more oxygen
than it could were the oxygen simply dissolved in the plasma.
A red blood cell contains about 250 million hemoglobins,
each capable of binding four molecules of oxygen. So, a single
red blood cell can carry about one billion oxygen molecules!
Hemoglobin reversibly binds oxygen, picking it up in the
lungs and releasing it in the body tissues. Active cells need
more oxygen and also generate heat and acidity. These changing conditions promote the release of oxygen from hemoglobin into metabolically active tissues.
Immature red blood cells (erythroblasts) produce hemoglobin as they mature into erythrocytes in the red bone marrow.
When the liver and spleen destroy old erythrocytes they break
down the released hemoglobin. Some of its components are
recycled, and the remainder leaves the body as a brown fecal
pigment called stercobilin. In spite of some conservation,
dietary protein and iron are still essential to maintain supplies.
with their
sels, and
wn as osne, which
s up the
of other
d in rings
ER-shan)
one cells
xtend out
can be in
h its cenwn as an
channel
The second type of bone tissue, called spongy, or cancellous, bone has more spaces than compact bone. It is
made of a meshwork of small, bony plates filled with red
marrow. Spongy bone is found at the epiphyses (ends) of
the long bones and at the center of other bones. Figure 74 shows a photograph of both compact and spongy tissue
in a bone section.
Checkpoint 7-1 A long bone has a long narrow shaft and two irregular ends. What are the scientific names for the shaft and the
ends of a long bone?
7
Checkpoint 7-2 What are the two types of osseus (bone) tissue
Figure 8-1 Structure of a skeletal muscle. Connective tissue coverings are shown. (B, Reprinted with permission from Gartner
LP, Hiatt JL. Color Atlas of Histology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2000.) ZOOMING IN ✦ What is the innermost layer of connective tissue in a muscle? What layer of connective tissue surrounds a fascicle of muscle fibers?
Figure 7-21 The pelvic bones. (A) Anterior view. (B) Lateral view; shows jo
lum. ZOOMING IN ✦ What bone is nicknamed the “sit bone”?
head of the femur is the greater trochanter (troKAN-ter), used as a surface landmark. The lesser
trochanter, a smaller elevation, is located on the
medial side. On the posterior surface there is a
long central ridge, the linea aspera, which is a
point for attachment of hip muscles.
◗
can be f
der fibu
thus, it
olus (m
lower en
inner as
lower en
outer as
projecti
th
The patella (pah-TEL-lah), or kneecap (see Fig. 7-1), is
embedded in the tendon of the large anterior thigh
muscle, the quadriceps femoris, where it crosses the
k
j i t It i
l f
id (SES h
Medical terms are built from standardized word parts (prefixes, roots and suffixes). Learning the meanings of these parts can help you
remember words and interpret unfamiliar terms.
WORD PART
MEANING
EXAMPLE
Bones
diaoss, osse/o
oste/o
-clast
through, between
bone, bone tissue
bone, bone tissue
break
The diaphysis, or shaft, of a long bone is between the two ends, or epiphyses.
Osseous tissue is another name for bone tissue.
The periosteum is the fibrous membrane around a bone.
An osteoclast breaks down bone in the process of resorption.
Divisions of the Skeleton
paranear
pariet/o
wall
cost/o
rib
supraabove, superior
infrabelow, inferior
metanear, beyond
I. Types of muscle
A. Smooth muscle
1. In walls of hollow organs, vessels, and respiratory passageways
2. Cells tapered, single nucleus, nonstriated
3. Involuntary; produces peristalsis; contracts and relaxes
slowly
B. Cardiac muscle
1. Muscle of heart wall
2. Cells branch; single nucleus; lightly striated
3. Involuntary; self-excitatory
C. Skeletal muscle
1. Most attached to bones and move skeleton
2. Cells long, cylindrical; multiple nuclei; heavily striated
3. Voluntary; contracts and relaxes rapidly
II. Muscular system
1. Functions
a. Movement of skeleton
b. Maintenance of posture
c. Generation of heat
The paranasal sinuses are near the nose.
The parietal bones form the side walls of the skull.
Intercostal spaces are located between the ribs.
The supraspinous fossa is a depression superior to the spine of the scapula
The infraspinous fossa is a depression inferior to the spine of the scapula.
The metacarpal
3. Isometric contractions—tension increases, but muscle
does not shorten
III. Mechanics of muscle movement
1. Attachments of skeletal muscles
a. Tendon—cord of connective tissue that attaches
muscle to bone
(1) Origin—attached to more fixed part
(2) Insertion—attached to moving part
b. Aponeurosis—broad band of connective tissue that
attaches muscle to bone or other muscle
A. Muscles work together
1. Prime mover—performs movement
2. Antagonist—produces opposite movement
3. Synergists—steady body parts and assist prime mover
B. Levers and body mechanics—muscles function with skeleton as lever systems
1. Components
a. Lever—bone
b. Fulcrum—joint
c Force—muscle contraction
Questions for Study and Review
Building Understanding
Fill in the blanks.
1. The shaft of a long bone is called the ______.
2. The structural unit of compact bone is the ______.
3. Red bone marrow manufactures ______.
4. Bones are covered by a connective tissue membrane
called ______.
5. Bone matrix is produced by ______.
Matching
Match each numbered item with the most closely related lettered item.
a. condyle
___ 6. A rounded bony projection
b. foramen
___ 7. A sharp bony prominence
c. fossa
___ 8. A hole through bone
d. sinus
___ 9. A bony depression
e. spine
___ 10. An air-filled bony cavity
teoarthritis, rheumatoid arthritis, and gout?
Multiple-choice
b. hinge
___ 11. On which of the following bones would the
c. pivot
mastoid process be found?
d. ball-and-socket
a. occipital bone
b femur
U d t di C
t
Ancillaries
A complete teaching and learning package is available for
both faculty and students. For more information, please visit
the text’s companion website at http://connection.LWW.com/
memmler, or contact your local LWW representative.
Free Instructor’s Manual packaged with Instructor’s
Resource CD, which includes a test generator, image
bank, PowerPoint™ slides, and the Instructor’s
Manual files (0-7817-5392-9).
◗ Free transparency set (0-7817-6167-0).
◗ Free course preparation assistance for instructors and
◗
tutoring for students, powered by Smarthinking™ , an
online support service featuring access to live e-structors. To demo this service, please visit the website listed
above.
◗ Online course materials and management powered
by WebCT and Blackboard. To demo the online
course, please visit the website listed above.
◗ Student Study Guide available for purchase either
alone (0-7817-5172-1) or packaged with the text
(0-7817-6207-3).
xv
Acknowledgments
To prepare a textbook, an author needs the assistance of many skilled people. This is my
opportunity to thank those who have helped with revisions for the 10th edition of Memmler’s
The Human Body in Health and Disease. My editor, John Goucher, has guided this project
through from start to finish and showed great skills in putting out fires. Senior Development
Editor Dana Knighten kept her eye on the big picture as well as the tiniest details—and everything in between. Jason Taylor gave advice on the entire manuscript and also wrote the special interest boxes and chapter summary questions. Kerry Hull’s contribution as a reviewer
landed her the job of writing all of the ancillary materials, assisted by Ancillary Editor Molly
Ward. Elizabeth Connolly and Jennifer Clements kept the art program on track, managing all
of the electronic art files.
My thanks to all the many reviewers, listed separately, who made such valuable and
detailed comments on the text. Their insights and advice truly guided every aspect of this new
edition.
Enormous thanks to Craig Durant and Dragonfly Media Group for their brilliant work on
the art program. They understood our needs, often better than we did, and rendered art astonishing in its clarity, instructional value, and beauty of design.
And as always, thanks to my husband Matthew, currently an instructor in anatomy and
physiology, for his advice on and contributions to the text.
Brief Contents
Unit 1
◗
The Body as a Whole 1
1. Organization of the Human Body 000
2. Chemistry, Matter, and Life 000
3. Cells and Their Functions 000
4. Tissues, Glands, and Membranes 000
Unit II
◗
Disease and the First Line of Defense 000
5. Disease and Disease-Producing Organisms 000
6. The Skin in Health and Disease 000
Unit III
◗
Movement and Support 000
7. The Skeleton: Bones and Joints 000
8. The Muscular System 000
Unit IV
◗
Coordination and Control 000
9. The Nervous System: The Spinal Cord and Spinal Nerves
000
10. The Nervous System: The Brain and Cranial Nerves 000
11. The Sensory System 000
12. The Endocrine System: Glands and Hormones 000
Unit V
◗
Circulation and Body Defense 000
13. The Blood 000
14. The Heart and Heart Disease 000
15. Blood Vessels and Blood Circulation 000
16. The Lymphatic System and Lymphoid Tissue 000
17. Body Defenses, Immunity, and Vaccines 000
Unit VI
◗
Energy: Supply and Use 000
18. Respiration 000
19. Digestion 000
20. Metabolism, Nutrition, and Body Temperature 000
21. Body Fluids 000
22. The Urinary System 000
Unit VII
◗
Perpetuation of Life 000
23. The Male and Female Reproductive Systems 000
24. Development and Birth 000
25. Heredity and Hereditary Diseases 000
Glossary 000
Glossary of Word Parts 000
Appendices 000
Index 000
xix
Contents
Unit I
◗
Movement That Requires Cellular Energy
How Osmosis Affects Cells
THE BODY AS A WHOLE 000
1
Cell Aging 000
Cells and Cancer 000
Organization of the Human Body 000
Studies of the Human Body 000
Cancer Risk Factors 000
Levels of Organization 000
Body Systems 000
Metabolism and Its Regulation 000
4
Homeostasis 000
The Effects of Aging 000
Structure of Epithelial Tissue 000
Special Functions of Epithelial Tissue 000
Glands 000
Directions in the Body 000
Directional Terms 000
Planes of Division 000
Connective Tissue 000
Body Cavities 000
Soft Connective Tissue 000
Fibrous Connective Tissue 000
Hard Connective Tissue 000
Dorsal Cavity 000
Ventral Cavity 000
The Metric System 000
Muscle Tissue 000
Nervous Tissue 000
Units of Length 000
Units of Weight 000
Units of Volume 000
Temperature 000
2
Tissues, Glands, and Membranes 000
Tissue Classification 000
Epithelial Tissue 000
The Neuron 000
Neuroglia 000
Membranes 000
Epithelial Membranes 000
Connective Tissue Membranes 000
Membranes and Disease 000
Chemistry, Matter, and Life 000
Elements 000
Benign and Malignant Tumors 000
Atoms 000
Benign Tumors 000
Malignant Tumors 000
Symptoms of Cancer 000
Diagnosis of Cancer 000
Molecules and Compounds 000
The Importance of Water 000
Mixtures: Solutions and Suspensions
Chemical Bonds 000
Tissues and Aging 000
Ionic Bonds 000
Covalent Bonds 000
Compounds: Acids, Bases and Salts 000
The pH Scale 000
Unit II
Buffers 000
Isotopes and Radioactivity 000
Use of Radioactive Isotopes 000
Chemistry of Living Matter 000
Organic Compounds 000
◗
DISEASE AND THE FIRST LINE OF
DEFENSE 000
5
Disease and Disease-Producing Organisms 000
Categories of Disease 000
3
Cells and Their Functions 000
The Role of Cells 000
Microscopes 000
Cell Structure 000
Plasma Membrane 000
The Nucleus 000
The Cytoplasm 000
Surface Organelles 000
Cellular Diversity 000
Protein Synthesis 000
Nucleic acids- DNA and RNA
Cell Division 000
Stages of Mitosis 000
Movement of Substances Across the Plasma
Membrane 000
Movement That Does Not Require Cellular Energy 000
Predisposing Causes of Disease 000
The Study of Disease 000
Disease Terminology 000
Treatment and Prevention of Disease 000
Complementary and Alternative Medicine 000
Prevention of Disease 000
Infectious Disease 000
Modes of Transmission 000
Microbiology- The Study of Microorganisms 000
Normal Flora 000
Bacteria 000
Viruses 000
Fungi 000
Protozoa 000
Parasitic Worms 000
Roundworms 000
Flatworms 000
xxi
xxii
✦
CONTENTS
Tumors 000
Infection 000
Structural Disorders 000
Fractures 000
Skeletal Changes in the Aging 000
Microbial Control 000
Microbes and Public Health 000
Aseptic Methods 000
Infection Control Techniques 000
Antimicrobial Agents 000
The Joints 000
Laboratory Identification of Pathogens 000
More About Synovial Joints 000
Disorders of Joints 000
Bacterial Isolations and Tests 000
Staining Techniques 000
Other Methods of Identification 000
8
6
The Skin in Health and Disease 000
Smooth Muscle 000
Cardiac Muscle 000
Skeletal Muscle 000
Structure of the Skin 000
Epidermis 000
Dermis 000
Subcutaneous Layer 000
The Muscular System 000
Structure of a Muscle 000
Muscle Cells in Action 000
Energy Sources 000
Effects of Exercise 000
Types of Muscle Contractions 000
Accessory Structures of the Skin 000
Sebaceous (Oil) Glands 000
Sudoriferous (Sweat) Glands 000
Hair 000
Nails 000
The Mechanics of Muscle Movement 000
Functions of the Skin 000
Muscles Work Together 000
Levers and Body Mechanics 000
Protection Against Infection 000
Protection Against Dehydration 000
Regulation of Body Temperature 000
Collection of Sensory Information 000
Other Activities of the Skin 000
Skeletal Muscle Groups 000
Muscles of the Head 000
Muscles of the Neck 000
Muscles of the Upper Extremities 000
Muscles of the Trunk 000
Muscles of the Lower Extremities 000
Observation of the Skin 000
Color 000
Lesions 000
Burns 000
Effects of Aging on Muscles 000
Muscular Disorders 000
Tissue Repair 000
Effects of Aging on the Integumentary System 000
Care of the Skin 000
Skin Disorders 000
Dermatitis 000
Psoriasis 000
Cancer 000
Acne and Other Skin Infections 000
Alopecia (Baldness) 000
Allergy and Other Immune Disorders 000
Pressure Ulcers 000
The Muscular System 000
Types of Muscle 000
Diseases of Muscles 000
Disorders of Associated Structures 000
Unit IV
◗
COORDINATION AND CONTROL 000
9
The Nervous System: The Spinal Cord and
Spinal Nerves 000
Role of the Nervous System 000
Unit III
◗
MOVEMENT AND SUPPORT 000
7
The Skeleton: Bones and Joints 000
Bones 000
Bone Structure 000
Bone Growth and Repair 000
Bone Markings 000
Bones of the Axial Skeleton 000
Framework of the Skull 000
Framework of the Trunk 000
Bones of the Appendicular Skeleton 000
The Upper Division of the Appendicular Skeleton 000
The Lower Division of the Appendicular Skeleton 000
Disorders of Bone 000
Metabolic Disorders 000
Structural Divisions 000
Functional Divisions 000
Neurons and Their Functions 000
Structure of a Neuron 000
Types of Neurons 000
Nerves and Tracts 000
Neuroglia 000
The Nervous System at Work 000
The Nerve Impulse 000
The Synapse 000
The Spinal Cord 000
Structure of the Spinal Cord 000
The Reflex Arc 000
Medical Procedures Involving the Spinal Cord 000
Diseases and Other Disorders of the Spinal Cord 000
The Spinal Nerves 000
Branches of the Spinal Nerves 000
Disorders of the Spinal Nerves 000
CONTENTS ✦ xxiii
The Autonomic Nervous System (ANS) 000
Divisions of the Autonomic Nervous System 000
Functions of the Autonomic Nervous System 000
10 The Nervous System: The Brain and Cranial
Nerves 000
The Brain 000
Protective Structures of the Brain and Spinal Cord 000
Cerebrospinal Fluid 000
The Cerebral Hemispheres 000
Functions of the Cerebral Cortex 000
Communication Areas 000
Memory and the Learning Process 000
The Diencephalon 000
The Limbic System 000
The Brain Stem 000
The Midbrain 000
The Pons 000
The Medulla Oblongata 000
12 The Endocrine System: Glands and
Hormones 000
Hormones 000
Hormone Chemistry 000
Hormone Regulation 000
The Endocrine Glands and Their Hormones 000
The Pituitary 000
The Thyroid Gland 000
The Parathyroid Glands 000
The Adrenal Glands 000
The Pancreas and Its Hormones 000
The Sex Glands 000
The Thymus Gland 000
The Pineal Gland 000
Other Hormone-Producing Tissues 000
Prostaglandins 000
Hormones and Treatment 000
Hormones and Stress 000
Aging and the Endocrine System 000
The Cerebellum 000
Brain Studies 000
The Electroencephalograph 000
Disorders of the Brain and Associated Structures 000
Hydrocephalus 000
Stroke and Other Brain Disorders 000
Injury 000
Degenerative Diseases 000
Cranial Nerves 000
Names and Functions of the Cranial Nerves 000
Disorders Involving the Cranial Nerves 000
Aging of the Nervous System 000
11 The Sensory System 000
The Senses 000
Sensory Receptors 000
Special and General Senses 000
The Eye and Vision 000
Coats of the Eyeball 000
Pathway of Light Rays and Refraction 000
Function of the Retina 000
Muscles of the Eye 000
Nerve Supply to the Eye 000
Errors of Refraction and other Eye Disorders 000
The Ear 000
The Outer Ear 000
The Middle Ear and Ossicles 000
The Inner Ear 000
Otitis and Other Disorders of the Ear 000
Other Special Sense Organs 000
Sense of Taste 000
Sense of Smell 000
Unit V
◗
CIRCULATION AND BODY DEFENSE 000
13 The Blood 000
Functions of the Blood 000
Transportation 000
Regulation 000
Protection 000
Blood Constituents 000
Blood Plasma 000
The Formed Elements 000
Hemostasis 000
Blood Clotting 000
Blood Types 000
The ABO Blood Type Group 000
The Rh Factor 000
Uses of Blood and Blood Components 000
Whole Blood Transfusions 000
Use of Blood Components 000
Blood Disorders 000
Anemia 000
Leukemia 000
Clotting Disorders 000
Blood Studies 000
The Hematocrit 000
Hemoglobin Tests 000
Blood Cell Counts 000
The Blood Slide (Smear) 000
Blood Chemistry Tests 000
Coagulation Studies 000
Bone Marrow Biopsy 000
The General Senses 000
Sense of Touch 000
Sense of Pressure 000
Sense of Temperature 000
Sense of Position 000
Sense of Pain 000
Sensory Adaptation 000
14 The Heart and Heart Disease 000
Circulation and the Heart 000
Location of the heart 000
Structure of the Heart 000
The Pericardium 000
Special Features of the Myocardium 000
xxiv
✦
CONTENTS
Divisions of the Heart 000
Blood Supply to the Myocardium 000
Function of the Heart 000
Cardiac Output 000
The Heart’s Conduction System 000
Control of the Heart Rate 000
Heart Sounds 000
The Reticuloendothelial System 000
Disorders of the Lymphatic System and Lymphoid
Tissue 000
Lymphedema 000
Lymphadenopathy 000
Splenomegaly 000
Lymphoma 000
Heart Disease 000
Classifications of Heart Disease 000
Congenital Heart Disease 000
Rheumatic Heart Disease 000
Coronary Artery Disease 000
Heart Failure 000
The Heart in the Elderly 000
Prevention of Heart Disease 000
Heart Studies 000
Treatment of Heart Disease 000
Medications 000
Correction of Arrhythmias 000
Heart Surgery 000
15 Blood Vessels and Blood Circulation 000
Blood Vessels 000
Blood Circuits 000
Vessel Structure 000
Systemic Arteries 000
The Aorta and Its Parts 000
The Iliac Arteries and Their Subdivisions 000
Arteries That Branch to the Arm and Head 000
Anastomoses 000
17 Body Defenses, Immunity, and Vaccines 000
Why Do Infections Occur? 000
Nonspecific Defenses 000
Chemical and Mechanical Barriers 000
Phagocytosis 000
Natural Killer Cells 000
Inflammation 000
Fever 000
Interferon 000
Immunity 000
Inborn Immunity 000
Acquired Immunity 000
The Antigen—Antibody Reaction 000
Naturally Acquired Immunity 000
Artificially Acquired Immunity 000
Disorders of the Immune System 000
Allergy 000
Autoimmunity 000
Immune Deficiency Diseases 000
Multiple Myeloma 000
The Immune System and Cancer 000
Transplantation and the Rejection Syndrome 000
Systemic Veins 000
The Venae Cavae and Their Tributaries 000
Venous Sinuses 000
The Hepatic Portal System 000
The Physiology of Circulation 000
Capillary Exchange 000
The Dynamics of Blood Flow 000
The Pulse 000
Blood Pressure 000
Arterial Degeneration and Other Blood Vessels
Disorders 000
Hemorrhage 000
Shock 000
Thrombosis 000
Varicose Veins 000
16 The Lymphatic System and Lymphoid Tissue
000
The Lymphatic System 000
Functions of the Lymphatic System 000
Lymphatic Circulation 000
Lymphatic Capillaries 000
Lymphatic Vessels 000
Movement of Lymph 000
Lymphoid Tissue 000
Lymph Nodes 000
The Spleen 000
The Thymus 000
The Tonsils 000
Other Lymphoid Tissue 000
Unit VI
◗
ENERGY: SUPPLY AND USE 000
18 Respiration 000
Phases of Respiration 000
The Nasal Cavities 000
The Pharynx 000
The Larynx 000
The Trachea 000
The Bronchi 000
The Lungs 000
The Process of Respiration 000
Pulmonary Ventilation 000
Gas Exchange 000
Transport of Oxygen 000
Transport of Carbon Dioxide 000
Regulation of Respiration 000
Abnormal Ventilation 000
Breathing Patterns 000
Disorders of the Respiratory System 000
Disorders of the Nasal Cavities and Related Structures 000
Infection 000
Hay Fever and Asthma 000
Chronic Obstructive Pulmonary Disease (COPD) 000
Sudden Infant Death Syndrome (SIDS) 000
Respiratory Distress Syndrome (RDS) 000
Cancer 000
Disorders Involving the Pleura 000
CONTENTS ✦ xxv
Age and the Respiratory Tract 000
Special Equipment for Respiratory Treatment 000
19 Digestion 000
Function and Design of the Digestive System 000
The Wall of the Digestive Tract 000
The Peritoneum 000
Body Temperature 000
Heat Production 000
Heat Loss 000
Temperature Regulation 000
Fever 000
Responses to Excessive Heat 000
Responses to Excessive Cold 000
Organs of the Digestive Tract 000
The Mouth 000
The Teeth 000
The Pharynx 000
The Esophagus 000
The Stomach 000
The Small Intestine 000
The Large Intestine 000
The Accessory Organs 000
The Salivary Glands 000
The Liver 000
The Gallbladder 000
The Pancreas 000
Enzymes and the Digestive Process 000
The Role of Water 000
Digestion, Step-by-Step 000
Absorption 000
Absorption of Fats 000
Absorption of Vitamins and Minerals 000
Control of Digestion 000
Hunger and Appetite 000
Eating Disorders 000
Disorders of the Digestive System 000
Peritonitis 000
Diseases of the Mouth and Teeth 000
Disorders of the Esophagus and Stomach 000
Intestinal Disorders 000
Infection of the Salivary Glands 000
Cirrhosis and Other Liver Diseases 000
Gallstones 000
Pancreatitis 000
Aging and the Digestive System 000
20 Metabolism, Nutrition, and Body
Temperature 000
Metabolism 000
Cellular Respiration 000
The Use of Nutrients for Energy 000
Anabolism 000
Minerals and Vitamins 000
Nutritional Guidelines 000
Carbohydrates 000
Fats 000
Proteins 000
Vitamin and Mineral Supplements 000
The Food Guide Pyramid 000
Alcohol 000
Nutritional Disorders 000
Food Allergies 000
Malnutrition 000
Overweight and Obesity 000
Underweight 000
Nutrition and Aging 000
21 Body Fluids 000
The Importance of Water 000
Fluid Compartments 000
Water Balance 000
Sense of Thirst 000
Electrolytes and Their Functions 000
Electrolyte Balance 000
Acid—Base Balance 000
Regulation of pH 000
Abnormal pH 000
Disorders of Body Fluids 000
Fluid Therapy 000
Excretion 000
Organs of the Urinary System 000
The Kidneys 000
Blood Supply to the Kidney 000
Structure of the Kidney 000
Functions of the Kidney 000
Formation of Urine 000
The Ureters 000
The Urinary Bladder 000
The Urethra 000
Urination 000
The Urine 000
Normal Constituents 000
Abnormal Constituents 000
Disorders of the Urinary System 000
Kidney Disorders 000
Disorders of the Ureters 000
Disorders of the Urethra 000
The Effects of Aging 000
22 The Urinary System
Excretion 000
Organs of the Urinary System 000
The Kidneys 000
Blood Supply to the Kidney 000
Structure of the Kidney 000
Functions of the Kidney 000
Formation of Urine 000
The Ureters 000
The Urinary Bladder 000
The Urethra 000
Urination 000
The Urine 000
Normal Constituents 000
Abnormal Constituents 000
Disorders of the Urinary System 000
Kidney Disorders 000
Disorders of the Ureters 000
Disorders Of the Bladder 000
Disorders of the Urethra 000
The Effects of Aging 000
xxvi
✦
CONTENTS
The Mammary Glands and Lactation 000
Disorders of Pregnancy, Childbirth, and Lactation 000
Unit VII
◗
PERPETUATING LIFE 000
23 The Male and Female Reproductive
Systems 000
Reproduction 000
Meiosis 000
The Male Reproductive System 000
The Testes 000
Accessory Organs 000
Semen 000
The Urethra and Penis 000
Hormonal Control of Male Reproduction 000
The Effects of Aging on Male Reproduction 000
Disorders of the Male Reproductive System 000
Structural Disorders 000
Infections 000
Tumors 000
The Female Reproductive System 000
The Ovaries 000
The Ova and Ovulation 000
Accessory Organs 000
The Menstrual Cycle 000
Beginning of the Cycle 000
Ovulation 000
The Menstrual Phase 000
Menopause 000
Hormone Replacement Therapy 000
Birth Control 000
Disorders of the Female Reproductive System 000
Menstrual Disorders 000
Benign and Malignant Tumors 000
Infections 000
Infertility 000
24 Development and Birth 000
Pregnancy 000
Fertilization and the Start of Pregnancy 000
The Placenta 000
Development of the Embryo 000
The Fetus 000
The Mother 000
Childbirth 000
The Four Stages of Labor 000
Cesarean Section 000
Multiple Births 000
Termination of Pregnancy 000
Pregnancy-Induced Hypertension 000
Postpartum Disorders 000
Lactation Disturbances 000
25 Heredity and Hereditary Diseases 000
Genes and Chromosomes 000
Dominant and Recessive Genes 000
Distribution of Chromosomes to Offspring 000
Sex Determination 000
Sex-Linked Traits 000
Hereditary Traits 000
Gene Expression 000
Genetic Mutation 000
Genetic Diseases 000
Congenital Versus Hereditary Diseases 000
Examples of Genetic Diseases 000
Treatment and Prevention of Genetic Diseases 000
Genetic Counseling 000
Progress in Medical Treatment 000
Glossary 000
Glossary of Word Parts 000
Appendixes 000
Appendix 1 Metric measurements 000
Appendix 2 Celsius-Fahrenheit temperature conversion
scale 000
Appendix 3 Periodic table of the elements 000
Appendix 4 Laboratory tests 000
Table 1, Routine urinalysis 000
Table 2, Complete blood count 000
Table 3, Blood chemistry tests 000
Appendix 5 Infectious diseases and their causative
conditions 000
Table 1, Bacterial diseases 000
Table 2, Viral diseases 000
Table 3, Prion diseases 000
Table 4, Fungal diseases 000
Table 5, Protozoal diseases 000
Appendix 6 Answers to Chapter Checkpoint and
Zooming In questions 000
Index 000