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Home , Axon, Cardiac muscle, Elastic cartilage, Hyaline cartilage, Integumentary system, Merocrine

Martini’s Essentials of and 8e brings a legacy of superb illustration and text–art integration with a suite of new digital tools

The New Eighth edition takes the most popular features from the book and builds them out into effective interactives within the eText and Mastering A&P™

MARTINI / BARTHOLOMEW

ESSENTIALS OF Anatomy & Physiology EIGHTH EDITION

A01_MART3804_08_SE_WALK.indd 1 07/11/2018 09:28 Spotlight Figures Visually Summarize Difficult Physiological Processes, Making Them Easier to Understand

These highly visual one- and two-page presentations of tough topics provide a bridge between readings and related figures and photos to communicate information in a student-friendly, visually effective format.

Figure 8-9 SPOTLIGHT PROPAGATION OF AN

a a bb ContinuousContinuous Propagation Propagation AxonAxon hillock hillock SaltatorySaltatory Propagation Propagation 21 21 3 3 alongalong an an Unmyelinated Unmyelinated Axon InitialInitial segment segment alongalong a a Myelinated Myelinated Axon Axon InIn an an unmyelinated unmyelinated axon, axon, an an action action potential potential moves moves BecauseBecause myelin limits limits the the movement movement of of ions 11 22 33 alongalong by by continuous continuous propagation. propagation. The The action action acrossacross the the axon axon membrane, membrane, the the action action potentialpotential spreads spreads by by depolarizing depolarizing the the adjacent adjacent region region potentialpotential must must “jump” “jump” from from node node to to node node ofof the the axon axon membrane. membrane. This This process process continues continues to to duringduring propagation. propagation. This This results results in in much much spreadspread as as a achain chain reaction reaction down down the the axon. axon. fasterfaster propagation propagation along along the the axon. axon.

KEYKEY ExtracellularExtracellular Fluid Fluid 11 ExtracellularExtracellular Fluid Fluid 11 ++ ++ AsAs an an action action potential potential develops develops ActionAction RestingResting membrane membrane AnAn action action potential potential +30+30 mV mV ++ ++ ++ –70–70 mV mV ++ ++ –70–70 mV mV ++ potentialpotential ++ ++ ++ ++ ++ atat the the initial initial segment segment 1 1, the, the +30+30 mV mV ++ –70–70 mV mV ++ –70–70 mV mV potentialpotential developsdevelops at at the the ++ ++ ++ ++ ++ ++ ++ ++ membranemembrane potential potential at at this this site site + + ++ ++ GradedGraded ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ NaNa ++ initialinitial segment segment 1 1 . . + + ++ ++ depolarizationdepolarization ++ NaNa ++ depolarizesdepolarizes to to +30 +30 mV. mV. ++ ++ ++ ++ + + + + MyelinatedMyelinated ++ MyelinatedMyelinated ++ MyelinatedMyelinated RapidRapid 11 22 33 1 1 internodeinternode 2 2 internodeinternode 3 3 internodeinternode ––– ––– ––– ––– –––– – – depolarizationdepolarization ++ ++ ++ ++ ++ –– –––– – ––– –––– –––––– ––– ––– ––––– ––––– ++ ++ ++ CellCell membrane membrane CytosolCytosol RepolarizationRepolarization ++ ++ ++ ++++ ++ PlasmaPlasma membrane membrane CytosolCytosol

GradedGraded depolarization 22 22 ++ ++ ++ AsAs the the sodium ions ions entering entering at at AA local local current current ++ ++ –60–60 mV mV ++ –70–70 mV mV –60–60 mV mV –70–70 mV mV ++ ++ ++ ++ ++ ++ 1 1 spread spread away away from from the the open open ++ ++ ++ ++ ++ ++ producesproduces a a ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ voltage-gatedvoltage-gated channels, channels, a agraded graded gradedgraded ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ + + ++ ++ depolarizationdepolarization quickly quickly brings brings the the depolarizationdepolarization ++ ++ 11 22 33 ++ membranemembrane in in segment segment 2 2 to to –– –– –– ––– ––– –––– – – thatthat brings brings the the 1 1 2 2 3 3 ++ ++++ ++ ++ threshold.threshold. ++ axonaxon membrane membrane ++ ++ ++ ++LocalLocal––––––––––––––––––––––––––––––––++ –– –– ++ ++LoLo ++ ++ cacla cl ucrurerrnetnt atat the the next next node node ++ ++ ++ currentcurrent ++ toto threshold. threshold.

RepolarizationRepolarization 33 33 ++ ++ ++ AnAn action action potential potential now now occurs occurs in in AnAn action action potential potential (refractory)(refractory) ++ ++ ++ RepolarizationRepolarization +30+30 mV mV ++ ++ –70–70 mV mV ++ ++ segmentsegment 2 2 while while segment segment 1 1 ++ ++ ++ ++ ++ (refractory)(refractory) +30+30 mV mV ++ –70–70 mV mV developsdevelops at at ++ ++ ++ ++ ++ ++ ++ ++ ++ beginsbegins . repolarization. ++ + + ++ nodenode 2 2. . ++ ++ ++ ++ ++ ++ NaNa ++ NaNa+ + ++ ++ ++ ++ ++ ++ ++ ++ ++ 11 22 33 1 1 2 2 3 3 –– –– –– –––– – – –– –––– ++ ++++ ++++ –––––––––– ++ ++ –––––––––––––––––––––––– ++ ++ ++ ++ ++++++ ++ ++ ++ ++ ++++++++

44 44 ++ ++ ++ ++ ++ AsAs the the sodium sodium ions ions entering entering at at AA local local current current ++ ++ –60–60 mV mV –60–60 mV mV ++ ++ ++ ++ ++ segmentsegment 2 2 spread spread laterally, laterally, a a producesproduces a agraded graded ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ gradedgraded depolarization depolarization quickly quickly ++ ++ ++ depolarizationdepolarization that that ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ ++ bringsbrings the the membrane membrane in in segment segment ++ bringsbrings the the axon axon ++ ++ ++ ++ 11 22 33 3 3 to to threshold, threshold, and and the the cycle cycle is is –––– –– membranemembrane at at node node 1 1 2 2 3 3 –– ++ L L++ –– ++ –––– – – repeated.repeated. ++ ocoaclal enetnt –––––––––––––––– ++ LocalLocal ++ –––––––––––––––– ++ ++++ ++ c ucrurrr 3 3 to to threshold. threshold. ++ ++ ++++ ++ ++ ++ ++ ++ ++currentcurrent ++

256 257

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A01_MART3804_08_SE_WALK.indd 2 07/11/2018 09:28 NEW Spotlight Figure Videos Bring This Effective Text Feature to Life

NEW! 10 Spotlight Videos bring the popular in-text feature to life, with narrated, annotated guidance that walks students through some of toughest topics in A&P. Spotlight Video topics include: Inflammation and , Synovial , The Contraction Cycle, Refractive Problems, The Composition of Whole , The : Internal Anatomy and Blood Flow, Pulmonary Ventilation, Chemical Events in Digestion, A Summary of Function, and Regulation of .

SmartArt Video: Endochondral Ossi cation

Watch the SmartArt Video for chapter 6, and then complete the question at right. Part A

A hard ossi ed in an adult actually begins within the as a miniature version composed of ______.

elastic

dense regular connective

dense irregular

brocartilage

Submit Request Answer

Coaching Activities in Mastering A&P™ allow instructors to assign the videos to ensure students view them.

A01_MART3804_08_SE_WALK.indd 3 07/12/18 2:31 PM Build Your Knowledge Integration Figures Emphasize That the Body Systems Together, Not in Isolation

Build Your Knowledge Integration features show students how body systems affect each other and work together to maintain .

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Build Your Knowledge How the URINARY SYSTEM integrates with the other body systems presented so far

Integumentary System

• The prevents • The Nervous System adjusts renal blood excessive fluid loss through surface; pressure; monitors distension of urinary produces D3, important for the bladder and controls renal production of ; sweat assist in elimination of and solutes • The urinary system eliminates nitrogenous wastes; maintains fluid, , and • The urinary system eliminates nitrogenous acid-base balance of blood, which is critical wastes; maintains fluid, electrolyte, and for neural function acid-base balance of blood that nourishes the skin

Respiratory System • The Endocrine System produces and ADH, which adjust rates of fluid and • The assists in the electrolyte reabsorption by kidneys regulation of pH by eliminating • The urinary system releases renin when local drops and erythropoietin • The urinary system assists in the elimination (EPO) when renal levels fall of carbon dioxide; provides bicarbonate buffers that assist in pH regulation

Cardiovascular System • The Lymphatic System provides adaptive (specific) defense against urinary tract • The Cardiovascular System delivers blood to glomerular , where filtration occurs; accepts fluids and solutes • The urinary system eliminates and reabsorbed during production wastes generated by cellular activities; acid pH of urine provides innate (nonspecific) • The urinary system releases renin defense against urinary tract infections to elevate blood pressure and erythropoietin (EPO) to accelerate red blood production Digestive System

Skeletal System • The Digestive System absorbs water needed to excrete wastes at kidneys; absorbs ions • The Skeletal System provides some needed to maintain normal body fluid protection for kidneys and with its concentrations; removes bilirubin axial divison; protects and proximal portion of • The urinary system excretes toxins absorbed by the digestive ; excretes • The urinary system conserves and bilirubin and nitrogenous wastes from the phosphate needed for bone growth liver; calcitriol production by kidneys aids calcium and phosphate absorption

Muscular System Urinary System • The controls urination by closing urethral . Muscle The urinary system excretes metabolic waste layers of trunk provide some protection and maintains normal body fluid pH and for urinary organs composition. It: • The urinary system excretes waste • regulates and blood pressure 18 products of muscle and • regulates plasma concentrations of sodium, ; assists in regulation of , chloride, and other ions calcium and phosphate concentrations • helps to stabilize blood pH • conserves valuable nutrients

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A01_MART3804_08_SE_WALK.indd 4 07/11/2018 09:28 NEW Interactive Versions of These Figures Allow Students to Explore at Their Own Pace

NEW! Build Your Knowledge Interactives give students the chance to navigate the inter- relationships among body systems within the eText.

Build Your Knowledge Coaching Activities are assignable in Mastering A&P and provide hints and wrong answer- specific feedback to ensure mastery of the concepts.

A01_MART3804_08_SE_WALK.indd 5 07/11/2018 09:28 The Most Affordable and Efficient Way to Learn—Pearson eText

Pearson eText is a simple-to-use, mobile-optimized, personalized reading experience. It allows students to easily highlight, take notes, and review key vocabulary all in one place—even when offline. Seamlessly integrated videos, rich media, and embedded interactives engage students and give them access to the help they need, when they need it.

Students can stop randomly searching online for study tools and flashcards that may not be credible or applicable to their course. Pearson eText contains study tools that align directly to the textbook adopted. Students can personalize a study notebook with the highlights and notes they take during reading, as well as the ones instructors share with the class, effectively creating a study guide.

A01_MART3804_08_SE_WALK.indd 6 07/11/2018 09:28 Mastering A&P™ Is So Much More than Online Homework

NEW! PAL 3.1 Mobile, Customizable Flashcards allow students to create a personalized, mobile-friendly deck of flashcards and quizzes using images from the virtual Practice Anatomy Lab 3.1. Students can use the checklist to filter down to the images referenced in the course. For optimal viewing, access the flashcards on a mobile device using Mastering login credentials.

Dynamic Study Modules (DSMs) continue to be the most favored study tool of surveyed students in the Mastering learning tools suite. Using a flashcard, ­gaming style, students figure out what they know and don‘t know, building confidence before a test. DSMs are available to students with a Mastering subscription and allow ­students to study the structures instructors want them to learn.

A01_MART3804_08_SE_WALK.indd 7 07/11/2018 09:28 Continue Learning the Toughest Topics in Mastering A&P and the eText

Interactive Physiology 2.0 are based on the award-winning tutorial program that helps students understand the most difficult physiological concepts. Updated and delivered in two formats for use with today‘s wide range of mobile devices and browsers.

A&P Flix are high-quality animations that remain trusted and among the most favored learning tools by instructors within the Mastering suite.

Pearson eText is available within Mastering when packaged with a new book, as an upgrade students can purchase online, or, with this title, can be adopted as a stand-alone item. Students can use the built-in Notebook to organize their notes, highlights and notes from their instructor.

A01_MART3804_08_SE_WALK.indd 8 07/11/2018 09:28 Preface

Welcome to the Eighth Edition of Essentials of Anatomy & Videos that walk students through these popular features Physiology! This textbook introduces the essential concepts to explain core concepts, and a Build Your Knowledge in- needed for an understanding of the body and helps teractive widget that allows them to see how body systems students place information in a meaningful context, develop work together to maintain homeostasis . In addition, many their problem-solving skills, and prepare for a career in a medi- Spotlight figures have Coaching Activities in Mastering, cal or allied health field. In this edition, we continue to build and the Body System figures correspond to Concept Map on this text’s hallmark quality: a clear, effective visual and nar- Coaching Activities that will bring home the concept of rative presentation of anatomy and physiology. During the body system integration. Instructors can assign homework revision process, the author and illustrator team drew upon from proven media programs such as Practice Anatomy their combined content knowledge, research skills, artistic Lab™ (PAL™) 3.1 and Interactive ­Physiology®—all organized talents, and 50-plus years of classroom experience to make by chapter—and have assignments automatically graded. this the best edition yet. Mobile friendly Dynamic Study Module questions help The broad changes to this edition are presented in the New to students study effectively and efficiently by allowing them the Eighth Edition section below. Also below are the sections to quiz themselves anytime, anywhere. In the Mastering Learning Outcomes and Chapter-by-Chapter Changes in A&P Study Area, students can access a full suite of self-study the Eighth Edition. tools, including Bone and videos and A&P Flix.

New to the Eighth Edition Learning Outcomes In addition to the technical changes in this edition, such as The chapters of the Eighth Edition are organized around spe- updated statistics and anatomy and physiology descriptions, cific Learning Outcomes that indicate what students should we have simplified the presentations to make the narrative be able to do after studying the chapter. easier to read. We have also focused on improving the inte- ⦁⦁ appear in chapter-opening num- gration of illustrations with the narrative. These are the key Learning Outcomes bered lists, as well as directly below each relevant chapter changes in this new edition: section heading. ⦁⦁ Improved readability uses simpler, shorter, more active ⦁⦁ do more than introduce sentences to make reading and studying easier for stu- Full-sentence chapter headings new topics; they state the core fact or concept that will dents. In all chapters, the Flesch/Kincaid reading levels be presented in the section. There is a one-to-one corre- have been decreased. spondence between the Learning Outcomes and the full- ⦁⦁ Improved text-art integration throughout the illustra- sentence section headings in every chapter. tion program enhances the readability of figures. Tabular ⦁⦁ Checkpoints are located at the close of each section information is now integrated into the figures so that the and ask students to pause and check their understand- relevant text is located immediately next to each part of a ing of facts and concepts. The Checkpoints reinforce the figure. Increased color saturation was also applied to the Learning Outcomes presented on the chapter-opening art throughout the text. page and below chapter section headings, resulting in a ⦁⦁ Terminology has been updated based on Terminologia systematic integration of the Learning Outcomes over Anatomica and , our references for the course of the chapter. Answers are located in the blue anatomical and tissue terms. We continue to use posses- Answers tab at the back of the book. All the Checkpoints sive forms of when the proposed alternative has have been reviewed, and questions were added or revised not been widely accepted, e.g., Parkinson’s and to reflect our improved readability. Huntington’s disease. All assessments in Mastering A&P are organized by the ⦁⦁ Mastering A&P®, Pearson’s online learning and assessment Learning Outcomes, making it easy for instructors to organize system, contains new assignable activities tied to features their courses and demonstrate results against goals for student in the book, including 10 narrated, annotated Spotlight achievement.

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Chapter-by-Chapter Changes in the Chapter 4 The Tissue Level of Organization ⦁⦁ Figure 4-1 An Orientation to the Body’s Tissues revised Eighth Edition ( replaces neural tissue) This annotated Table of Contents provides select examples ⦁⦁ Figure 4-2 Cell Junctions revised ( replaces of revision highlights in each chapter of the Eighth Edition. clear layer and reticular lamina replaces dense layer) ⦁⦁ Figure 4-3 The Surfaces of Epithelial Cells (added Lateral Chapter 1 An Introduction to Anatomy and Physiology surfaces and Basal surface labels) ⦁⦁ Section 1-1 revised ( replaces differen- ⦁⦁ Figure 4-4 Simple Epithelia revised (moved part letters to tiation; the same kind of replaces similar, but not highlight tissue types and enhance text-art integration) identical, organisms; Organisms exhibit movement. replaces ⦁⦁ Figure 4-5 Stratified Epithelia revised (moved part letters to Organisms can move.) highlight tissue types and enhance text-art integration) ⦁⦁ Figure 1-4 Negative Feedback: Control of Body Tempera- ⦁⦁ Figure 4-6 Methods of Glandular Secretion revised ture revised (new title) (Modes changed to Methods in figure title and letters ⦁⦁ Figure 1-10 Relationships among the Subdivisions of the added to different parts of the figure to enhance text-art Body Cavities of the Trunk revised (visceral layer of serous integration) replaces visceral pericardium, parietal layer of ⦁⦁ Table 4-2 revised (Method of Secretion replaces Mode of serous pericardium replaces parietal pericardium) Secretion) ⦁⦁ Review Questions: Level 1 revised (answer to question 21 ⦁⦁ Clinical Note Marfan’s Syndrome revised (Marfan replaces corrected) Marfan’s) ⦁⦁ Related Clinical Terms revised (acute and chronic terms ⦁⦁ Figure 4-9 revised (moved part added; injury added to definition of radiology) letters to highlight tissue types and enhance text-art integration) Chapter 2 The Chemical Level of Organization ⦁⦁ Figure 4-10 Dense Connective Tissue revised (moved ⦁⦁ Section 2-1 revised (clarified definition of radiation) part letters to highlight tissue types and enhance text-art ⦁⦁ Spotlight Figure 2-7 Chemical Notation revised (simpli- integration) fied introduction and replaced spelled out numbers with ⦁⦁ Figure 4-11 Types of Cartilage revised (moved part let- numerals to better integrate the Visual Representation ters to highlight tissue types and enhance text-art and Chemical Notation columns) integration) ⦁⦁ Section 2-8 revised (clarified that, in physiology, the term ⦁⦁ Figure 4-14 revised (moved part letters to electrolyte applies to both the ionizable substance and its highlight tissue types and enhance text-art integration) ions) ⦁⦁ Figure 4-15 Nervous Tissue revised (new title Nervous Tis- ⦁⦁ New Clinical Note (Too Sweet on Sugar replaces Fatty Acids sue replaces Neural Tissue) and Health) Chapter 5 The Integumentary System Chapter 3 Cell Structure and Function ⦁⦁ The text now uses subcutaneous layer as the primary term ⦁⦁ Section 3-7 Learning Outcome revised (sequence of and hypodermis as the secondary term. interphase and now correlates with section ⦁⦁ Figure 5-1 The General Structure of the Integumentary discussion) System revised (Subcutaneous layer replaces Hypodermis) ⦁⦁ Table 3-1 revised (propagation of impulses replaces ⦁⦁ Spotlight Figure 5-2 revised (part labels added to better conduction of nerve impulses) align text and art) ⦁⦁ Figure 3-5 Diffusion Across the Plasma Membrane revised ⦁⦁ Section 5-2 heading revised (shortened to Epidermal pig- (color of water molecules now matches those in Chapter mentation and dermal circulation influence skin color) 2 figures) ⦁⦁ Figure 5-5 Follicles and revised (Subcutaneous ⦁⦁ Figure 3-9 The Sodium-Potassium Exchange Pump revised layer replaces Hypodermis in part b) (corrected relative sizes of sodium and potassium ions) ⦁⦁ Figure 5-6 Sebaceous Glands and Their Relationship ⦁⦁ Spotlight Figure 3-7 Protein Synthesis, Processing, and to Hair Follicles revised (Subcutaneous layer replaces Packaging revised (added magnification of TEM illustrat- Hypodermis) ing ) ⦁⦁ Figure 5-7 Sweat Glands revised (Eccrine sweat ⦁⦁ Section 3-10 revised (cellular differentiation replaces replaces as primary term, differentiation) Subcutaneous layer replaces Hypodermis)

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⦁⦁ Build Your Knowledge revised (added in , special- ⦁⦁ Spotlight Figure 6-35 Synovial Joints revised (Plane ized integumentary glands secrete to Integumentary replaces Gliding joint; gliding inserted into System functions) Movement text) ⦁⦁ Level 1: Reviewing Facts and Terms revised (answers to ⦁⦁ Figure 6-40 The Joint revised (added PCL abbrevia- questions 5 and 9 corrected) tion after Posterior cruciate and ACL abbreviation after Anterior cruciate ligament labels) Chapter 6 The Skeletal System ⦁⦁ Figure 6-1 A Classification of by Shape revised Chapter 7 The Muscular System (bone art enlarged, added Sectional view label to part c) ⦁⦁ Figure 7-1 The Organization of Skeletal Muscles revised ⦁⦁ Clinical Note: Types of Fractures and Steps in Repair (added part letters to enhance text–art integration) revised (replaced x-rays of Displaced fracture and Spiral ⦁⦁ Figure 7-2 The Organization of a re- fracture) vised (enhanced art) ⦁⦁ Figure 6-8 The revised (enlarged figure and in- ⦁⦁ Figure 7-3 Changes in the Appearance of a creased color and contrast; added label) during Contraction of a Skeletal Muscle Fiber (added Re- ⦁⦁ Figure 6-9 The Axial and Appendicular Divisions of the laxed label in part a and Relaxed myofibril label Skeleton revised ( cage replaced Thoracic cage to corre- in part b) late with the Axial Skeleton bone count; coxal bone deleted ⦁⦁ Spotlight Figure 7-4 Events at the Neuromuscular Junc- from box) tion revised (updated ACh receptor membrane channel ⦁⦁ Figure 6-10 The Adult , Part I revised (added leader art and added text to step 5) dots to leader lines of Coronal suture, Squamous suture, and ⦁⦁ Figure 7-6 Steps Involved in Skeletal Lambdoid suture) and Relaxation revised (updated ACh receptor membrane ⦁⦁ Figure 6-12 Sectional Anatomy of the Skull revised (added channel and T / art) forked leader to Frontal sinuses label) ⦁⦁ Figure 7-10 Muscle Metabolism revised (in part c, the hy- ⦁⦁ Figure 6-13 The Paranasal Sinuses revised (Ethmoidal cells drolysis of ATP replaces pyruvate as the source of hydrogen replaces Ethmoidal sinuses) ions at peak activity) ⦁⦁ Figure 6-16 The revised (color coded ⦁⦁ Table 7-12 Muscle Terminology revised (Terms Indicating Vertebral regions to match art in later chapters) Specific Regions of the Body moved to left column to bet- ⦁⦁ Figure 6-17 Typical Vertebrae of the Cervical, Thoracic, ter correlate with introduced in and Regions revised (changed color in icon art to Chapter 1) match Figure 6-18 icon art) ⦁⦁ Figure 7-17 Muscles of the revised (in part b, ⦁⦁ Figure 6-19 The Sacrum and Coccyx revised (adjusted po- transverse perineal replaces transverse perineus) sition of Lateral sacral crest leader line in part b) ⦁⦁ Figure 6-20 The Thoracic Cage revised (added thoracic Chapter 8 The Nervous System cage definition) ⦁⦁ Section 8-1 revised (recognized the ⦁⦁ Figure 6-24 The Right and revised (RADIUS (ENS) as a third division of the peripheral nervous system) and ULNA labels changed to Radius and Ulna to match use ⦁⦁ Figure 8-5 Schwann Cells and Peripheral revised in other figures in chapter) (added neurolemmocytes as a secondary term for Schwann ⦁⦁ Figure 6-25 The Bones of the Wrist and revised cells; neurolemma replaces ) (rearranged terms in Proximal Carpals box to match se- ⦁⦁ Figure 8-14 Gross Anatomy of the revised quence as discussed in the text) (lumbosacral enlargement replaces lumbar enlargement; ven- ⦁⦁ Section 6-10 revised (Plane movement replaces Gliding tral roots replaces anterior roots; dorsal roots replaces poste- movement) rior roots; spinal replaces ) ⦁⦁ Figure 6-26 The Hip Bones and the Pelvis revised (Sacro- ⦁⦁ Figure 8-15 Sectional Anatomy of the Spinal Cord revised iliac joint replaces Sacroiliac joint) (spinal ganglion replaces dorsal root ganglion) ⦁⦁ Figure 6-33 Rotational Movements revised (added a red ⦁⦁ Figure 8-16c The revised (Medial view replaces Sagit- dot to mark the location of the joint involved in rota- tal section, replaces Brain stem) tional movements of the head) ⦁⦁ Section 8-8 The PNS connects the CNS with the body’s ⦁⦁ Section 6-11 heading and Learning Outcome revised external and internal environments, Cranial revi- (joints replaces articulations) sion (added sentence: If the full name of the cranial nerve is

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given, then only the Roman numeral is needed, such as optic ⦁⦁ Figure 9-10 The Sectional Anatomy of the revised (in nerve (II)).This addition affects figure labels parts a and c, replaces fovea; in part b, neural and text narrative. layer replaces neural part and pigmented layer replaces pig- ⦁⦁ Figure 8-22 The Basal Nuclei revised (removed amygdaloid mented part; part c caption revised [Superior view of dissection body from Basal Nuclei box since it is considered a compo- of the right eye replaces Horizontal dissection of the right eye]) nent of the limbic system) ⦁⦁ Figure 9-11 Retinal Organization revised (pigmented layer ⦁⦁ Figure 8-25 The Cranial Nerves, parts a and b revised of replaces pigmented part of retina and neural layer of (N preceding Roman numeral of named optic nerves is retina replaces neural part of retina; fovea centralis replaces deleted) fovea) ⦁⦁ Figure 8-26 Peripheral Nerves and Nerve Plexuses revised ⦁⦁ Figure 9-14 Focal Point, Focal Distance, and Visual Ac- (leader line from Femoral nerve corrected) commodation revised (in part a, text in art changed to ⦁⦁ Figure 8-27 Dermatomes revised (CN V replaces N V) ”Light rays from a distant source (object) are parallel”, and ⦁⦁ Figure 8-29 A Stretch revised (quadriceps muscles re- caption revised by adding “the greater the angle of arriving places muscles in second line of caption) light rays and”; art in parts d and e exchanged to better ⦁⦁ Figure 8-31 The Posterior Column Pathway revised (Pri- match art in parts a, b, and c) mary Sensory changed to Primary Somatosensory ⦁⦁ Spotlight Figure 9-16 Refractive Problems revised (added Cortex; Dorsal root ganglion changed to Spinal ganglion) “a process called ” to the end of introduc- ⦁⦁ Figure 8-32 The Corticospinal Pathway revised (brainstem tory paragraph) replaces brain stem) ⦁⦁ Figure 9-18 The Structure of Rods and Cones revised (pig- ⦁⦁ Figure 8-35 The Parasympathetic Division revised mented epithelium replaces pigment epithelium) (N changed to CN; added postganglionic on rec- ⦁⦁ Figure 9-20 The Visual Pathways revised (Optic nerves [II] tum art) replaces Optic nerves [N II]) ⦁⦁ Table 8-2 The Effects of the Sympathetic and Parasympa- ⦁⦁ Figure 9-21 The Anatomy of the revised (Facial nerve thetic Divisions of the ANS on Various Body Structures re- [VII] replaces Facial nerve [N VII] and Vestibulocochlear vised (EYE: Sympathetic Effects - Focusing for distance vision nerve [N VIII] replaces Vestibulocochlear nerve [N VIII]) replaces Focusing for near vision; Parasympathetic Effects - ⦁⦁ Figure 9-23 The Internal Ear revised (ampullary crests re- Focusing for close vision replaces Focusing for distance vision) places cristae) ⦁⦁ Figure 9-24 The Semicircular Ducts revised (ampullary crest Chapter 9 The General and Special replaces ; ampullary cupula replaces cupula; ⦁⦁ Figure 9-3 Tactile Receptors in the Skin revised (added Vestibular nerve replaces Vestibular branch) myelin sheath to in Tactile Discs box; ⦁⦁ Figure 9-25 The Utricla and revised (macula of bulbous corpuscle replaces Ruffini corpuscle; lamellar [pacin- replaces macula) ian] corpuscle replaces lamellated [pacinian] corpuscle) ⦁⦁ Figure 9-27 Sound and Hearing revised ( re- ⦁⦁ Figure 9-4 and the Regulation of Auto- places Cochlear branch of cranial nerve VIII) nomic Functions revised (changed carotid sinus to carotid ⦁⦁ Figure 9-28 Pathways for Auditory Sensations revised sinuses and added a second leader; aortic arch replaces aor- (Vestibular nerve replaces Vestibular branch; Vestibuloco- tic sinus and corrected position of leader line) chlear nerve [VIII] replaces Vestibulocochlear nerve [N VIII]; ⦁⦁ Figure 9-6 The Olfactory Organs revised (in part a, in step 5, auditory replaces acoustic) changed Olfactory nerve (N I) to Olfactory nerve fibers (I); in part b, dendritic bulb replaces knob) Chapter 10 The Endocrine System ⦁⦁ Figure 9-7 Taste Buds and Gustatory Epithelial Cells ⦁⦁ Figure 10-1 Organs and Tissues of the Endocrine System revised (new title; in part a, eliminated line spacing be- revised (deleted Secretes from the examples of Organs with tween the four primary taste sensations to indicate that Secondary Endocrine Functions) all portions of the provide sweet, salty, sour, and ⦁⦁ Figure 10-2 The Role of Target Cell Receptors in bitter sensations; in part b, gustatory epithelial cell replaces Action revised ( replaces neural tissue; skeletal mus- gustatory cell) cle fiber replaces skeletal muscle tissue) ⦁⦁ Figure 9-8 The Accessory Structures of the Eye revised (lat- ⦁⦁ Figure 10-4 Hypothalamic Control over Endocrine Func- eral angle replaces lateral and medial angle replaces tion revised (added color coding to boxed text to enhance medial canthus) links between hypothalamic structures and functions)

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⦁⦁ Figure 10-8 Pituitary and Their Targets revised ⦁⦁ Figure 11-9 The Vascular, , and Coagulation (changed color of secretion oval to en- Phases of Hemostasis revised (added label for hance link with revised boxed text color in Figure 10-4) clarification) ⦁⦁ Section 10-4 Title revised (The gland synthesizes that affect the rate of metabolism replaces Chapter 12 The Cardiovascular System: The Heart The thyroid gland lies inferior to the and requires io- ⦁⦁ Section 12-1 revised (clarified that pericardium includes an dine for hormone synthesis) outer fibrous pericardium and an inner serous pericardium) ⦁⦁ Table 10-1 The Pituitary Hormones revised (under Target ⦁⦁ Figure 12-1 The Location of the Heart in column, Interstitial endocrine cells of testes replaces Intersti- revised (parietal layer of serous pericardium replaces parietal tial cells of testes) pericardium, visceral layer of serous pericardium replaces vis- ⦁⦁ Figure 10-10 The Homeostatic Regulation of the Blood ceral pericardium) Calcium Ion Concentration revised (clarified that figure ⦁⦁ Figure 12-3 The Position and Anatomy of the Heart re- discusses calcium ion concentration in blood and calcito- vised (parts are rearranged; part a art now shows the posi- nin’s limited role in bone deposition) tion of the heart) ⦁⦁ Table 10-2 Hormones of the Thyroid Gland and Parathy- ⦁⦁ Figure 12-4 The Heart Wall and Tissue roid Glands revised (principal cells replaces chief cells) revised (parietal layer of serous pericardium replaces parietal ⦁⦁ Figure 10-13 The Endocrine revised (bile re- pericardium, visceral layer of serous pericardium replaces vis- places common ) ceral pericardium) ⦁⦁ Figure 10-14 The Homeostatic Regulation of the Blood Glu- ⦁⦁ Spotlight Figure 12-5 The Heart: Internal Anatomy and cose Concentration revised (added Homeostatic to figure Blood Flow revised ( replaces right atrioven- title and clarified normal blood levels is a range) tricular valve, replaces left atrioventricular valve) ⦁⦁ Clinical Note Mellitus revised (updated estimated ⦁⦁ Figure 12-6 The Valves of the Heart revised (tricuspid re- number of people in the U.S. with some form of diabetes) places right AV [tricuspid] valve, mitral valve replaces left AV ⦁⦁ Clinical Note Endocrine Disorders revised (congenital hypo- [bicuspid] valve) thyroidism replaces cretinism and infantile hypothyroidism) ⦁⦁ Figure 12-8 Action Potentials in Cardiac Contractile Cells and Skeletal Muscle Fibers revised (new figure title; ⦁⦁ Build Your Knowledge revised (clarified that vitamin 3D is a precursor to calcitriol production in the Integumentary cardiac contractile cell replaces cardiac , skeletal System box) muscle fiber replaces skeletal muscle) ⦁⦁ Figure 12-11 The revised (Changed color of Chapter 11 The Cardiovascular System: Blood central Cardiac cycle to enhance text and art) ⦁⦁ Spotlight Figure 11-1 The Composition of Whole Blood ⦁⦁ Figure 12-12 revised (new part a art avoids revised (clarified definition of hematocrit; updated nor- crossing of leader lines) mal hematocrit range for adult males and adult females) ⦁⦁ Figure 12-13 Autonomic Innervation of the Heart revised ⦁⦁ Section 11-3 Abundance of Red Blood Cells section re- ( [X] replaces Vagus [N X]) vised (described the composition of the three layers ob- served after centrifugation of whole blood) Chapter 13 The Cardiovascular System: Blood Vessels ⦁⦁ Section 11-3 Structure of RBCs section revised (clarified and Circulation that a flexible accounts for ability of RBCs ⦁⦁ Figure 13-2 The Structure of the Various Types of Blood bend and squeeze through capillaries) Vessels revised (clarified internal, or , diameters of ⦁⦁ Section 11-3 and Reserves revised (Sex and Iron blood vessels) Reserves replaces Gender and Iron Reserves) ⦁⦁ Figure 13-8 The of the Carotid Si- ⦁⦁ Figure 11-3 Recycling of revised (clarified nuses and Aortic Arch revised (new Figure title; Barorecep- that Fe 2+ is an iron ion; added label to ) tors in carotid sinuses and aortic arch replaces Baroreceptors ⦁⦁ Clinical Note Abnormal Hemoglobin revised (sickle cell in aortic and carotid sinuses) disease [SCD] replaces sickle cell anemia [SCA]) ⦁⦁ Figure 13-18 The Venous Drainage of the and ⦁⦁ Figure 11-6 Blood Types and Cross-Reactions revised (cor- Chest revised (hemi-azygos replaces hemiazygos) rected shapes of anti-A and anti-B ) ⦁⦁ Figure 13-19 A Flowchart of the Tributaries of the Superior ⦁⦁ Figure 11-7 Blood Typing Testing revised (added “clump- and Inferior revised (Hemi-azygos replaces ing” or “no clumping” under test results for clarification) Hemiazygos)

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⦁⦁ Figure 13-20 The Hepatic Portal System revised (clarified ⦁⦁ Figure 15-7 Alveolar Organization revised (pneumocyte drainage of left and right gastroepiploic ) type I replaces type I pneumocyte, and pneumocyte type II ⦁⦁ BYK Integrator (lactate replaces ) replaces type II pneumocyte; blood air barrier replaces respi- ⦁⦁ Review Questions Level 1 Column B revised (aortic arch ratory membrane) and carotid sinuses replaces aortic and carotid sinuses) ⦁⦁ Figure 15-8 The Gross Anatomy of the revised (added caption “The lobes are shown as though transparent Chapter 14 The Lymphatic System and Immunity to make the main branching of the bronchial tree visible”) ⦁⦁ Definition of the term “immune response” revised from ⦁⦁ Spotlight Figure 15-10 Pulmonary Ventilation revised “a defense against specific antigens” to “the body’s reac- (clarified structures and that accessory respiratory tion to infectious agents and abnormal substances” ) muscles are only active in forced ) ⦁⦁ Figure 14-1 The Components of the Lymphatic System ⦁⦁ Figure 15-11 Pulmonary Volumes and Capacities revised revised (added CNS lymphatic vessels to the art; Other Lym- (TV replaces VT as abbreviation for tidal volume; clarified phoid Tissues and Organs heading replaces Lymphoid Tis- table describing sex differences) sues and Organs heading because nodes are organs) ⦁⦁ Spotlight Figure 15-16 The Control of revised ⦁⦁ Spotlight Figure 14-4 Origin and Distribution of Lympho- (CN replaces N) cytes revised (hemocytoblasts replaces hematopoietic stem cells) ⦁⦁ BYK Integrator revised (deleted nourish from Integumen- ⦁⦁ Figure 14-6 The Structure of a revised (cortex tary System description) replaces outer cortex; paracortex replaces deep cortex) ⦁⦁ Figure 14-9 The Body’s Innate Defenses revised (clarifies Chapter 16 The Digestive System the roles of complement) ⦁⦁ Section 16-1 revised under Secretion, added salts to the ⦁⦁ Figure 14-11 Forms of Immunity revised (artificially ac- substances released into the digestive tract quired replaces artificially induced) ⦁⦁ Section 16-1 revised (clarified that the enteric nervous system ⦁⦁ Figure 14-12 An Overview of Adaptive Immunity revised [ENS} consists of the and ) (former title “An Overview of the Immune Response”; ⦁⦁ Figure 16-1 The Components of the Digestive System re- new title emphasizes that adaptive immunity is part of vised (mechanical digestion replaces mechanical processing, the “immune response”) chemical digestion replaces chemical breakdown) ⦁⦁ Figure 14-17 An Integrated Summary of the Immune Re- ⦁⦁ Figure 16-2 The Structure of the Digestive Tract revised sponse (new title corresponds with broadened definition (included within the Mucosa box, of the term “immune response”; regulatory T cells replaces replaces muscularis externa) suppressor T cells) ⦁⦁ Figure 16-4 The Oral Cavity revised ( re- places lingual frenulum) Chapter 15 The Respiratory System ⦁⦁ Figure 16-6 Teeth: Structural Components and Dental ⦁⦁ Figure 15-1 The Structures of the Respiratory System re- Succession revised (cement replaces , alveolar vised (Respiratory replaces Smallest bronchioles) process replaces bone of alveolus, replaces ⦁⦁ Figure 15-2 The Respiratory Mucosa revised (mucus re- primary teeth, permanent teeth replaces adult teeth) places mucus layer) ⦁⦁ Figure 16-8 The Anatomy of the revised (muscu- ⦁⦁ Figure 15-3 The Nose, , and revised lar layer replaces muscularis externa; added gastrin-produc- (posterior internal apertures replaces internal nares, and nos- ing G cells to part d caption) trils replaces external nares) ⦁⦁ Spotlight Figure 16-9 Regulation of Gastric Activity revised ⦁⦁ Clinical Note Cystic revised (added text to clarify (muscular layer replaces muscularis externa; neural inhibition that affects not only the respiratory system, and hormonal inhibition added to Intestinal Phase KEY) but also the digestive and reproductive systems) ⦁⦁ Figure 16-11 The Intestinal Wall revised (muscular layer ⦁⦁ Figure 15-4 The Anatomy of the Larynx and replaces muscularis externa; Goblet cells [intestinal mucous revised (glottis in the open position art and photomicro- cells] replaces Mucous cells) graph now positioned next to each other) ⦁⦁ Figure 16-13 The Pancreas revised (bile duct replaces com- ⦁⦁ Figure 15-5 The Anatomy of the revised (main mon bile duct) bronchi replaces primary bronchi and lobar bronchi replaces ⦁⦁ Figure 16-14 The Surface Anatomy of the Liver revised secondary bronchi) (bile duct replaces ) ⦁⦁ Figure 15-6 Bronchial Branching and a Lobule of the ⦁⦁ Figure 16-15 Liver revised (portal replaces revised (new figure title; segmental bronchi replaces portal area; interlobular bile duct replaces bile duct, inter- tertiary bronchi) lobular replaces branch of the hepatic artery proper,

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interlobular replaces branch of hepatic portal vein; stel- ⦁⦁ Figure 18-11 Organs for Conducting and Storing Urine revised late replaces Kupffer cells) (new figure title; ureteral orifices replaces ureteral openings) ⦁⦁ Figure 16-16 The revised (bile duct replaces ⦁⦁ NEW Figure 18-12 The Control of Urination common bile duct) ⦁⦁ Figure 18-14 Ions in Body Fluids revised (caption revised ⦁⦁ Figure 16-17 The Large Intestine revised (teniae coli re- to emphasize electrical neutrality within each fluid places tenia coli because there is no singular form to refer compartment) to one of the longitudinal bands) ⦁⦁ BYK Integrator Urinary System revised (excretes replaces ⦁⦁ Spotlight Figure 16-18 Chemical Events in Digestion (clar- removes) ified large organic molecules are chemically broken down before absorption) Chapter 19 The ⦁⦁ BYK Integrator revised (clarified mechanical and chemi- ⦁⦁ Section 19-1 revised ( replaces cal digestion functions in Digestive System box) spermatozoa/ as the primary term) ⦁⦁ Figure 19-2 The , Testes, and Seminiferous Tu- bules revised (sperm replaces spermatozoa) Chapter 17 Metabolism and Energetics ⦁⦁ Section 19-2 revised ( muscle replaces dartos; sustenocytes ⦁⦁ Figure 17-2 Nutrient Use in Cellular Metabolism revised replaces sustentacular cells; replaces prostate gland) (electron transport chain replaces electron transport system) ⦁⦁ Figure 19-3 revised (sperm replaces ⦁⦁ Figure 17-4 The Cycle revised (electron transport spermatozoa/spermatozoon) chain replaces electron transport system) ⦁⦁ Figure 19-6 The revised ( replaces prepuce) ⦁⦁ Spotlight Figure 17-5 Electron Transport Chain and ATP ⦁⦁ Spotlight Figure 19-7 Regulation of Male Reproduction Formation revised (new figure title and clarified the role revised (interstitial endocrine cells replaces interstitial cells; of chemiosmosis in ATP formation) sperm replaces spermatozoa) ⦁⦁ Figure 17-6 A Summary of the Yield of Aerobic Me- ⦁⦁ Figure 19-10 Development and the tabolism revised (electron transport chain replaces electron Ovarian Cycle revised (ovarian follicle replaces follicle; in transport system) caption, clarified that ovarian follicles enter the 28-day ⦁⦁ Figure 17-7 Metabolism revised (clarified ovarian cycle as tertiary ovarian follicles) that gluconeogenesis only involves noncarbohydrates; ⦁⦁ Section 19-3 revised (functional layer of re- deleted Other box from art) places functional zone of endometrium, and basal layer of endometrium replaces basilar layer of endometrium) Chapter 18 The Urinary System ⦁⦁ Figure 19-12 The Female External Genitalia revised (bulb ⦁⦁ Section 18-1 revised (metabolic wastes replaces organic wastes) of vestibule replaces vestibular bulb) ⦁⦁ Figure 18-2 The Position of the Kidneys revised (clarified ⦁⦁ Spotlight Figure 19-14 Regulation of Female Reproduction locations of last thoracic and third lumbar vertebrae to bet- revised (ovarian follicle replaces follicle; ranges ter correlate with text) added for both Celsius and Fahrenheit scales; and Menses ⦁⦁ Figure 18-4 The Blood Supply to the Kidneys revised (part label changed to Menstrual Phase) a, added segmental artery label; part b, renal pyramid re- ⦁⦁ BYK Integrator Reproductive System revised (kidneys places , and added interlobar artery and interlobar excrete replaces kidneys remove in Urinary System box) vein labels to better correlate with part a) ⦁⦁ Figure 18-5 A Representative and the Collect- Chapter 20 Development and Inheritance ing System revised (highlighted general functions of ⦁⦁ Figure 20-1 Fertilization revised (in part b, changed step 2 descending limb and ascending limb in the Nephron Loop title and text in steps 3 and 4; clarified when DNA synthe- box with bullet points; descending thin limb replaces thin sis occurs, sperm replaces spermatozoon) descending limb) ⦁⦁ Figure 20-3 Events in Implantation revised (cytotropho- ⦁⦁ Figure 18-6 The revised (in part a, capsular blast replaces cellular trophoblast, syncytiotrophoblast re- outer layer replaces parietal epithelium, visceral layer replaces places syncytial trophoblast) visceral epithelium; in part b, fenestrated endothelium ⦁⦁ Figure 20-4 The Inner Cell revised (extra-embryonic replaces capillary epithelium, processes of re- replaces extraembryonic, changed from day 12 places filtration slits; in part c, foot processes replaces pedicels) to day 15) ⦁⦁ Figure 18-10 The Renin-Angiotensin-Aldosterone System ⦁⦁ Spotlight Figure 20-5 Extra-Embryonic Membranes and and Regulation of GFR revised (new figure title; systemic Formation revised (added mucus plug to week 10/ veins replaces venous reservoirs) step 5 art)

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⦁⦁ Figure 20-6 The Placenta and Placental Circulation John Senter, Austin Community College revised (Mucus plug replaces Cervical (mucous) plug) George Spiegel, College of Southern Maryland ⦁⦁ Figure 20-7 Development during the First Trimester Ashley Spring, Eastern Florida State College revised (new part a Week 3 art and new Week 4, 8, and fiberoptic photographs) Our gratitude is also extended to the many faculty and stu- ⦁⦁ Figure 20-8 Fetal Development in the Second and Third dents at campuses across the United States (and out of the Trimesters revised (new photograph of 6-month-old country) who made suggestions and comments that helped ) us improve this edition of Essentials of Anatomy & Physiology. ⦁⦁ Figure 20-16 The Milk Ejection Reflex (new title replaces A textbook has two components: narrative and visual. The Milk Let-Down Reflex) Virtually without exception, reviewers stressed the impor- ⦁⦁ Figure 20-16 A Map of Human revised tance of accurate, integrated, and visually attractive illustrations (Down Syndrome replaces Down’s Syndrome; Marfan’s in helping students understand essential material. The creative talents brought to this project by our artist team, ­William Ober, Syndrome replaces Marfan Syndrome; Sickle Cell Disease re- M.D. and Claire Ober, R.N., are inspiring and very much appre- places Sickle Cell Anemia) ciated. Bill and Claire worked closely and tirelessly with us, im- ⦁⦁ Section 20-8 The Human Genome revised (new title; parting a unity of vision to the book as a whole while making it added description of -editing technique CRISPR/ both clear and beautiful. The superb art program is also greatly Cas9) enhanced by the incomparable bone and cadaver photographs of Ralph T. Hutchings, formerly of The Royal College of Surgeons in England. Acknowledgments We are deeply indebted to the Pearson staff and SPi Global, whose efforts were so vital to the creation of this edition. Special Every textbook represents a group effort. Foremost on the list are thanks are due to Norine Strang for her skillful management of the faculty and reviewers whose advice, comments, and collec- the project through the entire production process. We appreciate tive wisdom helped shape this edition. Their interest in the sub- the excellent design contributions of Jerilyn Bockorick, Design ject, their concern for the accuracy and method of presentation, Manager, Mark Ong, cover designer, and Alisha Webber, interior and their experience with students of widely varying abilities and text designer. backgrounds made the review process an educational experience. We must also express our appreciation to Lauren Chen and To these individuals, who carefully recorded their comments, Kimberly Twardochleb for their work on the media supplements opinions, and sources, we express our sincere appreciation and that accompany this title, and to our colleague Kevin Petti, for best wishes. his outstanding efforts to script and record the new Spotlight We thank them for their participation and list their names Videos. and affiliations below. Thanks also to Wendy Mears, Product Marketing Manager, Derek Perrigo, Field Marketing Manager, and the entire Pearson Science sales team for keeping their on the of the Reviewers for the Eighth Edition market and helping us meet the needs of our users. Above all, thanks to Jessica Picone for her patience in nur- Meghan Andrikanich, Lorain County Community College turing this project, and to Cheryl Cechvala, Senior Acquisitions Jaysen Arno, Pitt Community College Editor, for her dedication to the success of this book. Nick Butkevich, Schoolcraft College Finally, we would like to thank our families for their love and Kristin Jacobson Flex, Illinois Central College support during the revision process. No two people could expect to produce a flawless textbook of Deborah Furbish, Wake Technical Community College this scope and complexity. Any errors or oversights are strictly Layla Khatib, Moraine Valley Community College our own rather than those of the reviewers, artists, or editors. Brian Kipp, Grand Valley State University In an effort to improve future editions, we ask that readers with Tara Leszczewicz, College of DuPage pertinent information, suggestions, or comments concerning Geralyne Lopez-de-Victoria, Midlands Technical College the organization or content of this textbook e-mail us directly Sudeep Majumdar, Temple College at the e-mail address below. Any and all comments and sugges- Gary McIlvain, Marshall University tions will be deeply appreciated and carefully considered in the Angela Porta, Kean University preparation of the next edition. April Rottman, Rock Valley College [email protected]

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