Hole's Human Anatomy & Physiology 12e

Holes Human Anatomy and Physiology
Shier, Butler & Lewis

Twelfth Edition
Chapter 1 Outline
1.1 Introduction
A. Questions and observations that have led to knowledge.
B. Knowledge about structure and function of the human body.
1.2 Anatomy and Physiology
A. Anatomy: the study of the structure of the human body
B. Physiology: the study of the function of the human body
1.3 Levels of organization (12)
A. Subatomic Particles: electrons, protons, and neutrons
B. Atom: hydrogen atom, lithium atom, etc.
C. Subatomic Particles: electrons, protons, and neutrons
D. Atom: hydrogen atom, lithium atom, etc.
E. Molecule: water molecule, glucose molecule, etc.
F. Macromolecule: protein molecule, DNA molecule, etc.
G. Organelle: mitochondrion, Golgi apparatus, nucleus, etc.
H. Cell: muscle cell, nerve cell, etc.
I. Tissue: epithelia, connective, muscle and nerve
J. Organ: skin, femur, heart, kidney, etc.
K. Organ System: skeletal system, digestive system, etc.
L. Organism: the human
Organ systems (11)
A. Integumentary system
B. Skeletal system
C. Muscle system
D. Nervous system
E. Endocrine system
F. Cardiovascular system
G. Lymphatic system
H. Digestive system
I. Respiratory system
J. Urinary system
K. Male reproductive system
L. Female reproductive system
Clinical application (uses of)
A. Ultrasound (US)
B. Magnetic Resonance Imaging (MRI)
1.4 Characteristics of life (10)
A. Movement: change in position; motion
B. Responsiveness: reaction to a change
C. Growth: increase in body size; no change in shape
D. Reproduction: production of new organisms and new cells
E. Respiration: obtaining oxygen; removing carbon dioxide; releasing energy

from foods
F. Digestion: breakdown of food substances into simpler forms
G. Absorption: passage of substances through membranes and into body fluids
H. Circulation: movement of substances in body fluids
I. Assimilation: changing of absorbed substances into chemically different forms
J. Excretion: removal of wastes produced by metabolic reactions
1.5 Maintenance of life (5)
A. Water
1. Most abundant substance in body
2. Required for metabolic processes
3. Required for transport of substances
4. Regulates body temperature
B. Food
1. Provides necessary nutrients
2. Supplies energy
3. Supplies raw materials
C. Oxygen (gas)
1. One-fifth of air
2. Used to release energy from nutrients
D. Heat
1. Form of energy
2. Partly controls rate of metabolic reactions
E. Pressure
1. Application of force on an object
2. Atmospheric pressure: important for breathing
3. Hydrostatic pressure: keeps blood flowing
Homeostatic Control Mechanisms: monitors aspects of the internal environment and
corrects as needed. Variations are within limits. There are three (3) parts:
A. Receptor: provides information about the stimuli
B. Control Center: tells what a particular value should be (called the set point)
C. Effector: elicits responses that change conditions in the internal environment
There are two (2) types of homeostatic control mechanisms:
A. Negative feedback mechanisms
B. Positive feedback mechanisms
Negative feedback summary:
A. Prevents sudden, severe changes in the body
B. Reduces the actions of the effectors
C. Corrects the set point
D. Causes opposite of bodily disruption to occur, i.e. the negative
E. Limits chaos in the body by creating stability
F. Most common type of feedback loop
G. Examples: body temperature, blood pressure & glucose regulation
Positive feedback summary:
A. Increases (accelerates) the actions of the body
B. Produces more instability in the body
C. Produces more chaos in the body

D. There are only a few types necessary for our survival
E. Positive feedback mechanisms are short-lived
F. Controls only infrequent events that do not require continuous adjustments
G. Considered to be the uncommon loop
H. Examples: blood clotting and child birth
1.6 Organization of the human body
A. Body cavities
B. Membranes
Clinical application
A. Pleuritis
B. Peritonitis
1.7 Lifespan changes
A. Aging occurs from the microscopic level to the whole-body level.
1.8 Anatomical terminology
A. Anatomical Position: standing erect, facing forward, upper limbs at the sides,
palms facing forward and thumbs out
B. Terms of Relative Position (based on anatomical position):
1. Superior versus Inferior
2. Anterior versus Posterior
3. Medial versus Lateral
4. Ipsi-lateral versus Contra-lateral
5. Proximal versus Distal (only in the extremities)
6. Superficial versus Deep
7. Internal versus External
C. Body planes (3)
1. Sagittal or Median divides body into left and right portions
a. Mid-sagittal divides body into equal left and right portions
2. Transverse or Horizontal divides body into superior and inferior
portions
3. Coronal or Frontal divides body into anterior and posterior portions
D. Abdominal subdivisions (2)
1. Regional method (9 regions)
2. Quadrant method (4 quadrants)
E. Body regions
Outcomes to be Assessed
1.1: Introduction
Identify some of the early discoveries that lead to our current understanding of
the human body.
1.2: Anatomy and Physiology
Define anatomy and physiology and explain how they are related.
1.3: Levels of Organization
List the levels of organization in the human body and the characteristics of each.
1.4: Characteristics of Life
List and describe the major characteristics of life.
Define and give examples of metabolism.
1.5: Maintenance of Life

List and describe the major requirements of organisms.
Define homeostasis and explain its importance to survival.
Describe the parts of a homeostatic mechanism and explain how they function
together.
1.6: Organization of the Human Body
Identify the locations of the major body cavities.
List the organs located in each major body cavity.
Name and identify the locations of the membranes associated with the thoracic
and abdominopelvic cavities.
Name the major organ systems and list the organs associated with each.
Describe the general function of each organ system.
1.7: Lifespan Changes
Define aging.
Identify the levels of organization in the body at which aging occurs.
1.8: Anatomical Terminology
Properly use the terms that describe relative positions, body sections, and body
regions.

Twelfth Edition
Chapter 2 Outline
2.1 Introduction
A. Why study chemistry in an anatomy & physiology class?
1. Body functions depend on cellular functions
2. Cellular functions result from chemical changes
3. Biochemistry helps to explain physiological processes
2.2: Structure of Matter
A. Matter: anything that takes up space and has mass (weight). It is composed of
elements
B. Elements: composed of chemically identical atoms
1. Bulk elements required by the body in large amounts
2. Trace elements - required by the body in small amounts
3. Ultratrace elements required by the body in very minute amounts
C. Atoms: smallest particle of an element
Elements and Atoms
A. All matter is composed of elements
B. Elements are the parts of compounds
C. Elements are:
1. Bulk elements
2. Trace elements
3. Ultratrace elements
D. The smallest parts of atoms are elements
Atomic Structure
A. Atoms: composed of subatomic particles:
1. Proton carries a single positive charge
2. Neutron carries no electrical charge
3. Electron carries a single negative charge
B. Nucleus
1. Central part of atom
2. Composed of protons and neutrons
3. Electrons move around the nucleus
Atomic Number and Atomic Weight
A. Atomic number
1. Number of protons in the nucleus of one atom
2. Each element has a unique atomic number
3. Equals the number of electrons in the atom
B. Atomic weight
1. The number of protons plus the number of neutrons in one atom
2. Electrons do not contribute to the weight of the atom
Isotopes
A. Atoms with the same atomic numbers but with different atomic weights
B. Atoms with the same number of protons and electrons but a different number
of neutrons
C. Oxygen often forms isotopes (O16, O17, and O18)
D. Unstable isotopes are radioactive; they emit energy or atomic fragments
Molecules and Compounds
A. Molecule: particle formed when two or more atoms chemically combine
B. Compound: particle formed when two or more atoms of different elements
chemically combine
C. Molecular formula: depict the elements present and the number of each atom
present in the molecule
Bonding of Atoms
A. Bonds form when atoms combine with other atoms
B. Electrons of an atom occupy regions of space called electron shells which
circle the nucleus
C. For atoms with atomic numbers of 18 or less, the following rules apply:
1. The first shell can hold up to 2 electrons
2. The second shell can hold up to 8 electrons
3. The third shell can hold up to 8 electrons
2.1 From Science to Technology: Radioactive Isotopes Reveal Physiology
2.2 From Science to Technology: Ionizing Radiation
Bonding of Atoms
A. Lower shells are filled first
B. If the outermost shell is full, the atom is stable
Bonding of Atoms: Ions
A. Ions
1. An atom that gains or loses electrons to become stable
2. An electrically charged atom
B. Cations
1. A positively charged ion
2. Formed when an atom loses electrons
C. Anions
1. A negatively charged ion
2. Formed when an atom gains electrons
Ionic Bonds
A. An attraction between a cation and an anion
B. Formed when electrons are transferred from one atom to another atom
Covalent Bonds
A. Formed when atoms share electrons
1. Hydrogen atoms form single bonds
2. Oxygen atoms form two bonds
3. Nitrogen atoms form three bonds
4. Carbon atoms form four bonds
Bonding of Atoms: Structural Formula
A. Structural formulas show how atoms bond and are arranged in various
molecules
Bonding of Atoms: Polar Molecules

A. Molecule with a slightly negative end and a slightly positive end
B. Results when electrons are not shared equally in covalent bonds
C. Water is an important polar molecule
Hydrogen Bonds
A. A weak attraction between the positive end of one polar molecule and the
negative end of another polar molecule
B. Formed between water molecules
C. Important for protein and nucleic acid structure
Chemical Reactions
A. Chemical reactions occur when chemical bonds form or break among atoms,
ions, or molecules
B. Reactants are the starting materials of the reaction - the atoms, ions, or
molecules
C. Products are substances formed at the end of the chemical reaction
Types of Chemical Reactions
A. Synthesis Reaction more complex chemical structure is formed
B. Decomposition Reaction chemical bonds are broken to form a simpler
chemical structure
C. Exchange Reaction chemical bonds are broken and new bonds are formed
D. Reversible Reaction the products can change back to the reactants
Acids, Bases, and Salts
A. Electrolytes substances that release ions in water
B. Acids electrolytes that dissociate to release hydrogen ions in water
C. Bases substances that release ions that can combine with hydrogen ions
D. Salts electrolytes formed by the reaction between an acid and a base
Acid and Base Concentration
A. pH scale - indicates the concentration of hydrogen ions in solution
B. Neutral pH 7; indicates equal concentrations of H+ and OHC. Acidic pH less than 7; indicates a greater concentration of H+
D. Basic or alkaline pH greater than 7; indicates a greater concentration of
OH2.3: Chemical Constituents of Cells
A. Organic molecules
1. Contain C and H
2. Usually larger than inorganic molecules
3. Dissolve in water and organic liquids
4. Carbohydrates, proteins, lipids, and nucleic acids
B. Inorganic molecules
1. Generally do not contain C
2. Usually smaller than organic molecules
3. Usually dissociate in water, forming ions
4. Water, oxygen, carbon dioxide, and inorganic salts
Inorganic Substances
A. Water
1. Most abundant compound in living material
2. Two-thirds of the weight of an adult human

3. Major component of all body fluids
4. Medium for most metabolic reactions
5. Important role in transporting chemicals in the body
6. Absorbs and transports heat
B. Oxygen (O2)
1. Used by organelles to release energy from nutrients in order to drive
cells metabolic activities
2. Necessary for survival
C. Carbon dioxide (CO2)
1. Waste product released during metabolic reactions
2. Must be removed from the body
D. Inorganic salts
1. Abundant in body fluids
2. Sources of necessary ions (Na+, Cl-, K+, Ca2+, etc.)
3. Play important roles in metabolism
Organic Substances: Carbohydrates
A. Provide energy to cells
B. Supply materials to build cell structures
C. Water-soluble
D. Contain C, H, and O
E. Ratio of H to O close to 2:1 (C6H12O6)
F. Monosaccharides glucose, fructose
G. Disaccharides sucrose, lactose
H. Polysaccharides glycogen, cellulose
Organic Substances: Lipids
A. Soluble in organic solvents; insoluble in water
B. Fats (triglycerides)
1. Used primarily for energy; most common lipid in the body
2. Contain C, H, and O but less O than carbohydrates (C57H110O6)
3. Building blocks are 1 glycerol and 3 fatty acids per molecule
4. Saturated and unsaturated
C. Phospholipids
1. Building blocks are 1 glycerol, 2 fatty acids, and 1 phosphate per
molecule
2. Hydrophilic and hydrophobic
3. Major component of cell membranes
D. Steroids
1. Four connected rings of carbon
2. Widely distributed in the body, various functions
3. Component of cell membrane
4. Used to synthesize hormones
5. Cholesterol
Organic Substances: Proteins
A. Structural material
B. Energy source
C. Hormones
D. Receptors
E. Enzymes
F. Antibodies
G. Protein building blocks are amino acids
H. Amino acids held together with peptide bonds
Organic Substances: Nucleic Acids
A. Carry genes
B. Encode amino acid sequences of proteins
C. Building blocks are nucleotides
D. DNA (deoxyribonucleic acid) double polynucleotide
E. RNA (ribonucleic acid) single polynucleotide
2.3 From Science to Technology: CT Scanning and PET Imaging
2.1: Introduction
Give examples of how the study of living materials requires and understanding of
chemistry.
2.2: Structure of Matter
Describe how atomic structure determines how atoms interact.
Describe the relationships among matter, atoms, and molecules.
Explain how molecular and structural formulas symbolize the composition of
compounds.
Describe three types of chemical reactions.
Explain what acids, bases, and buffers are.
Define pH.
2.3: Chemical Constituents of Cells
List the major groups of inorganic chemicals common in cells.
Describe the general functions of the main classes of organic molecules in cells.

Twelfth Edition
Chapter 3 Outline
3.1: Introduction
A. The basic organizational structure of the human body is the cell.
B. There are 50-100 trillion cells in the human body.
C. Differentiation is when cells specialize.
D. As a result of differentiation, cells vary in size and shape due to their unique
function.
3.2: A Composite Cell
A. Also called a typical cell
B. Major parts include:
1. Nucleus
2. Cytoplasm
3. Cell membrane
Cell Membrane (aka Plasma Membrane)
A. Outer limit of the cell
B. Controls what moves in and out of the cell
C. Selectively permeable
D. Phospholipid bilayer
1. Water-soluble heads form surfaces (hydrophilic)
2. Water-insoluble tails form interior (hydrophobic)
3. Permeable to lipid-soluble substances
E. Cholesterol stabilizes the membrane
F. Proteins:
1. Receptors
2. Pores, channels and carriers
3. Enzymes
4. CAMS
5. Self-markers
3.1 Clinical Application: Faulty Ion Channels Cause Disease
Cell Adhesion Molecules (CAMs)
A. Guide cells on the move
B. Selectin allows white blood cells to anchor
C. Integrin guides white blood cells through capillary walls
D. Important for growth of embryonic tissue
E. Important for growth of nerve cells
Cytoplasm
A. Cytosol = water
B. Organelles = solids
Organelles
A. Endoplasmic Reticulum (ER)
1. Connected, membrane-bound sacs, canals, and vesicles
2. Transport system
3. Rough ER
a. Studded with ribosomes
4. Smooth ER
a. Lipid synthesis
1). Added to proteins arriving from rough ER
b. Break down of drugs
B. Ribosomes
1. Free floating or connected to ER
2. Provide structural support and enzyme activity to amino acids to form
protein
C. Golgi apparatus
1. Stack of flattened, membranous sacs
2. Modifies, packages and delivers proteins
D. Vesicles
1. Membranous sacs
2. Store substances
E. Mitochondria
1. Membranous sacs with inner partitions
2. Generate energy
F. Lysosomes
1. Enzyme-containing sacs
2. Digest worn out cell parts or unwanted substances
G. Peroxisomes
1. Enzyme-containing sacs
2. Break down organic molecules
H. Centrosome
1. Two rod-like centrioles
2. Used to produce cilia and flagella
3. Distributes chromosomes during cell division
I. Cilia
1. Short hair-like projections
2. Propel substances on cell surface
J. Flagellum
1. Long tail-like projection
2. Provides motility to sperm
K. Microfilaments and microtubules
1. Thin rods and tubules
2. Support cytoplasm
3. Allows for movement of organelles
L. Inclusions
1. Temporary nutrients and pigments
3.2 Clinical Application: Disease at the Organelle Level
Cell Nucleus
A. Is the control center of the cell
B. Nuclear envelope
1. Porous double membrane
2. Separates nucleoplasm from cytoplasm

C. Nucleolus
1. Dense collection of RNA and proteins
2. Site of ribosome production
D. Chromatin
1. Fibers of DNA and proteins
2. Stores information for synthesis of proteins
3.3: Movements Into and Out of the Cell
A. Passive (Physical) Processes
1. Require no cellular energy and include:
a. Simple diffusion
b. Facilitated diffusion
c. Osmosis
d. Filtration
B. Active (Physiological) Processes
1. Require cellular energy and include:
a. Active transport
b. Endocytosis
c. Exocytosis
d. Transcytosis
Simple Diffusion
A. Movement of substances from regions of higher concentration to regions of
lower concentration
B. Oxygen, carbon dioxide and lipid-soluble substances
Facilitated Diffusion
A. Diffusion across a membrane with the help of a channel or carrier molecule
B. Glucose and amino acids
Osmosis
A. Movement of water through a selectively permeable membrane from regions
of higher concentration to regions of lower concentration
B. Water moves toward a higher concentration of solutes
Osmosis and Osmotic Pressure
A. Osmotic Pressure ability of osmosis to generate enough pressure to move a
volume of water
B. Osmotic pressure increases as the concentration of nonpermeable solutes
increases
1. Isotonic same osmotic pressure
2. Hypertonic higher osmotic pressure (water loss)
3. Hypotonic lower osmotic pressure (water gain)
Filtration
A. Smaller molecules are forced through porous membranes
B. Hydrostatic pressure important in the body
C. Molecules leaving blood capillaries
Active Transport
A. Carrier molecules transport substances across a membrane from regions of
lower concentration to regions of higher concentration
B. Sugars, amino acids, sodium ions, potassium ions, etc.

Active Transport: Sodium-Potassium Pump
A. Active transport mechanism
B. Creates balance by pumping three (3) sodium (Na+) OUT and two (2)
potassium (K+) INTO the cell
C. 3:2 ratio
Endocytosis
A. Cell engulfs a substance by forming a vesicle around the substance
B. Three types:
1. Pinocytosis substance is mostly water
2. Phagocytosis substance is a solid
3. Receptor-mediated endocytosis requires the substance to bind to a
membrane-bound receptor
Exocytosis
A. Reverse of endocytosis
B. Substances in a vesicle fuse with cell membrane
C. Contents released outside the cell
D. Release of neurotransmitters from nerve cells
Transcytosis
A. Endocytosis followed by exocytosis
B. Transports a substance rapidly through a cell
C. HIV crossing a cell layer
3.4: The Cell Cycle
A. Series of changes a cell undergoes from the time it forms until the time it
divides
B. Stages:
1. Interphase
2. Mitosis
3. Cytokinesis
Interphase
A. Very active period
B. Cell grows
C. Cell maintains routine functions
D. Cell replicates genetic material to prepare for nuclear division
E. Cell synthesizes new organelles to prepare for cytoplasmic division
F. Phases:
1. G phases cell grows and synthesizes structures other than DNA
2. S phase cell replicates DNA
Mitosis
A. Produces two daughter cells from an original somatic cell
B. Nucleus divides karyokinesis
C. Cytoplasm divides cytokinesis
D. Phases of nuclear division:
1. Prophase chromosomes form; nuclear envelope disappears
2. Metaphase chromosomes align midway between centrioles
3. Anaphase chromosomes separate and move to centrioles
4. Telophase chromatin forms; nuclear envelope forms

Cytoplasmic Division
A. Also known as cytokinesis
B. Begins during anaphase
C. Continues through telophase
D. Contractile ring pinches cytoplasm in half
3.5: Control of Cell Division
A. Cell division capacities vary greatly among cell types
1. Skin and blood cells divide often and continually
2. Neuron cells divide a specific number of times then cease
B. Chromosome tips (telomeres) that shorten with each mitosis provide a mitotic
clock
C. Cells divide to provide a more favorable surface area to volume relationship
D. Growth factors and hormones stimulate cell division
1. Hormones stimulate mitosis of smooth muscle cells in uterus
2. Epidermal growth factor stimulates growth of new skin
E. Contact (density dependent) inhibition
F. Tumors are the consequence of a loss of cell cycle control
Tumors
A. Two types of tumors:
1. Benign usually remains localized
2. Malignant invasive and can metastasize; cancerous
B. Two major types of genes cause cancer:
1. Oncogenes activate other genes that increase cell division
2. Tumor suppressor genes normally regulate mitosis; if inactivated they
are unable to regulate mitosis
3. Cells are now known as immortal
3.6: Stem and Progenitor Cells
A. Stem cell:
1. Can divide to form two new stem cells
a. Self-renewal
2. Can divide to form a stem cell and a progenitor cell
3. Totipotent can give rise to every cell type
4. Pluripotent can give rise to a restricted number of cell types
B. Progenitor cell:
1. Committed cell
2. Can divide to become any of a restricted number of cells
3. Pluripotent
3.1 From Science to Technology: Therapeutic Stem Cells
3.7: Cell Death
A. Apoptosis:
1. Programmed cell death
2. Acts as a protective mechanism
3. Is a continuous process
3.1: Introduction
Define cell.
State the range of cell numbers and cells sizes in a human body.
State the term for cell specialization.
3.2: A Composite Cell
List the three major parts of a composite cell.
State the general function of organelles.
Explain how the structure of a cell membrane makes possible its function.
Describe each type of organelle, and explain its function.
Describe the parts of a cell nucleus and their functions.
3.3: Movement Into and Out of the Cell
Explain the various ways that substances move through the cell membrane.
Discuss how the mechanisms of crossing cell membranes differ.
3.4: The Cell Cycle
Describe the parts of the cell cycle and identify the major activities during each
part.
Explain why regulation of the cell cycle is important to health.
Distinguish between mitosis and cytokinesis.
List the stages of mitosis and describe the events of each stage.
3.5: Control of Cell Division
Explain how different types of cells differ in their rate of cells division.
State the range of cell divisions a cell typically undergoes.
Discuss factors that influence whether or not a cell divides.
Explain how cancer arises from too-frequent cell division.
Distinguish the two types of genetic control of cancer.
3.6: Stem and Progenitor Cells
Define differentiation.
Distinguish between a stem cell and a progenitor cell.
Explain how two differentiated cell types can have the same genetic information,
but different appearances and functions.
3.7: Cell Death
Define apoptosis.
Distinguish apoptosis from necrosis.
List the steps of apoptosis.
Describe the relationship between apoptosis and mitosis.

Twelfth Edition
Chapter 4 Outline
4.1: Introduction
A. Metabolic processes all chemical reactions that occur in the body
B. There are two (2) types of metabolic reactions:
1. Anabolism
a. Larger molecules are made from smaller ones
b. Requires energy
2. Catabolism
a. Larger molecules are broken down into smaller ones
b. Releases energy
4.2: Metabolic Processes
A. Consists of two processes:
1. Anabolism
2. Catabolism
Anabolism
A. Anabolism provides the materials needed for cellular growth and repair
B. Dehydration synthesis
1. Type of anabolic process
2. Used to make polysaccharides, triglycerides, and proteins
3. Produces water
Catabolism
A. Catabolism breaks down larger molecules into smaller ones
B. A catabolic process
1. Used to decompose carbohydrates, lipids, and proteins
2. Water is used to split the substances
3. Reverse of dehydration synthesis
4.3: Control of Metabolic Reactions
A. Enzymes
1. Control rates of metabolic reactions
2. Lower activation energy needed to start reactions
3. Most are globular proteins with specific shapes
4. Not consumed in chemical reactions
5. Substrate specific
6. Shape of active site determines substrate
Enzyme Action
A. Metabolic pathways
1. Series of enzyme-controlled reactions leading to formation of a
product
2. Each new substrate is the product of the previous reaction
B. Enzyme names commonly:
1. Reflect the substrate
2. Have the suffix ase
3. Examples: sucrase, lactase, protease, lipase

Cofactors and Coenzymes
A. Cofactors
1. Make some enzymes active
2. Non-protein component
3. Ions or coenzymes
B. Coenzymes
1. Organic molecules that act as cofactors
2. Vitamins
Factors That Alter Enzymes
A. Factors that alter enzymes:
1. Heat
2. Radiation
3. Electricity
4. Chemicals
5. Changes in pH
Regulation of Metabolic Pathways
A. Limited number of regulatory enzymes
B. Negative feedback
4.4: Energy for Metabolic Reactions
A. Energy is the capacity to change something; it is the ability to do work
B. Common forms of energy:
1. Heat
2. Light
3. Sound
4. Electrical energy
5. Mechanical energy
6. Chemical energy
ATP Molecules
A. Each ATP molecule has three parts:
1. An adenine molecule
2. A ribose molecule
3. Three phosphate molecules in a chain
B. Third phosphate attached by high-energy bond
C. When the bond is broken, energy is transferred
D. When the bond is broken, ATP becomes ADP
E. ADP becomes ATP through phosphorylation
F. Phosphorylation requires energy release from cellular respiration
Release of Chemical Energy
A. Chemical bonds are broken to release energy
B. We burn glucose in a process called oxidation
4.5: Cellular Respiration
A. Occurs in a series of reactions:
1. Glycolysis
2. Citric acid cycle (aka TCA or Krebs Cycle)
3. Electron transport system
Cellular Respiration
A. Produces:
1. Carbon dioxide
2. Water
3. ATP (chemical energy)
4. Heat
B. Includes:
1. Anaerobic reactions (without O2) - produce little ATP
2. Aerobic reactions (requires O2) - produce most ATP
Glycolysis
A. Series of ten reactions
B. Breaks down glucose into 2 pyruvic acid molecules
C. Occurs in cytosol
D. Anaerobic phase of cellular respiration
E. Yields two ATP molecules per glucose molecule
F. Summarized by three main phases or events:
1. Phosphorylation
2. Splitting
3. Production of NADH and ATP
Anaerobic Reactions
A. Event 1 - Phosphorylation
1. Two phosphates added to glucose
2. Requires ATP
B. Event 2 Splitting (cleavage)
1. 6-carbon glucose split into two 3-carbon molecules
C. Event 3 Production of NADH and ATP
1. Hydrogen atoms are released
2. Hydrogen atoms bind to NAD+ to produce NADH
3. NADH delivers hydrogen atoms to electron transport system if oxygen
is available
4. ADP is phosphorylated to become ATP
5. Two molecules of pyruvic acid are produced
6. Two molecules of ATP are generated
D. If oxygen is not available:
1. Electron transport system cannot accept new electrons from NADH
2. Pyruvic acid is converted to lactic acid
3. Glycolysis is inhibited
4. ATP production is less than in aerobic reactions
Aerobic Reactions
A. If oxygen is available:
1. Pyruvic acid is used to produce acetyl CoA
2. Citric acid cycle begins
3. Electron transport system functions
4. Carbon dioxide and water are formed
5. 34 molecules of ATP are produced per each glucose molecule
Citric Acid Cycle

A. Begins when acetyl CoA combines with oxaloacetic acid to produce citric
acid
B. Citric acid is changed into oxaloacetic acid through a series of reactions
C. Cycle repeats as long as pyruvic acid and oxygen are available
D. For each citric acid molecule:
1. One ATP is produced
2. Eight hydrogen atoms are transferred to NAD+ and FAD
3. Two CO2 produced
Electron Transport System
A. NADH and FADH2 carry electrons to the ETS
B. ETS is a series of electron carriers located in cristae of mitochondria
C. Energy from electrons transferred to ATP synthase
D. ATP synthase catalyzes the phosphorylation of ADP to ATP
E. Water is formed
Carbohydrate Storage
A. Carbohydrate molecules from foods can enter:
1. Catabolic pathways for energy production
2. Anabolic pathways for storage
B. Excess glucose stored as:
1. Glycogen (primarily by liver and muscle cells)
2. Fat
3. Converted to amino acids
4.6: Nucleic Acids and Protein Synthesis
A. Instruction of cells to synthesize proteins comes from a nucleic acid, DNA
Genetic Information
A. Genetic information instructs cells how to construct proteins; stored in
DNA
B. Gene segment of DNA that codes for one protein
C. Genome complete set of genes
D. Genetic Code method used to translate a sequence of nucleotides of DNA
into a sequence of amino acids
4.1 From Science to Technology: DNA Profiling Frees A Prisoner
Structure of DNA
A. Two polynucleotide chains
B. Hydrogen bonds hold nitrogenous bases together
C. Bases pair specifically (A-T and C-G)
D. Forms a helix
E. DNA wrapped about histones forms chromosomes
DNA Replication
A. Hydrogen bonds break between bases
B. Double strands unwind and pull apart
C. New nucleotides pair with exposed bases
D. Controlled by DNA polymerase
4.2 From Science to Technology: Nucleic Acid Amplification
Genetic Code
A. Specification of the correct sequence of amino acids in a polypeptide chain
B. Each amino acid is represented by a triplet code
RNA Molecules
A. Messenger RNA (mRNA):
1. Making of mRNA (copying of DNA) is transcription
B. Transfer RNA (tRNA):
1. Carries amino acids to mRNA
2. Carries anticodon to mRNA
3. Translates a codon of mRNA into an amino acid
C. Ribosomal RNA (rRNA):
1. Provides structure and enzyme activity for ribosomes
D. Messenger RNA (mRNA):
1. Delivers genetic information from nucleus to the cytoplasm
2. Single polynucleotide chain
3. Formed beside a strand of DNA
4. RNA nucleotides are complementary to DNA nucleotides (exception
no thymine in RNA; replaced with uracil)
Protein Synthesis
4.3 From Science to Technology: MicroRNAs and RNA Interference
4.7: Changes in Genetic Information
A. Only about 1/10th of one percent of the human genome differs from person to
person
Nature of Mutations
A. Mutations change in genetic information
B. Result when:
1. Extra bases are added or deleted
2. Bases are changed
C. May or may not change the protein
Protection Against Mutation
A. Repair enzymes correct the mutations
Inborn Errors of Metabolism
A. Occurs from inheriting a mutation that then alters an enzyme
B. This creates a block in an otherwise normal biochemical pathway
4.4 From Science to Technology: The Human Metabolome
4.1: Introduction
Define metabolism.
Explain why protein synthesis is important.
4.2: Metabolic Processes
Compare and contrast anabolism and catabolism.
Define dehydration synthesis and hydrolysis.
4.3: Control of Metabolic Reactions
Describe how enzymes control metabolic reactions.
List the basic steps of an enzyme-catalyzed reaction.
Define active site.
Define a rate-limiting enzyme and indicate why it is important in a metabolic

pathway.
4.4: Energy for Metabolic Reactions
Explain how ATP stores chemical energy and makes it available to a cell.
State the importance of the oxidation of glucose.
4.5: Cellular Respiration
Describe how the reactions and pathways of glycolysis, the citric acid cycle, and
the electron transport chain capture the energy in nutrient molecules.
Discuss how glucose is stored, rather than broken down.
4.6: Nucleic Acids and Protein Synthesis
Define gene and genome.
Describe the structure of DNA, including the role of complementary base pairing.
Describe how DNA molecules replicate.
Define genetic code.
Compare DNA and RNA.
Explain how nucleic acid molecules (DNA and RNA) carry genetic information.
Define transcription and translation.
Describe the steps of protein synthesis.
4.7: Changes in Genetic Information
Compare and contrast mutations and SNPs.
Explain how a mutation can cause a disease.
Explain two ways that mutations originate.
List three types of genetic changes.
Discuss two ways that DNA is protected against mutation.

Twelfth Edition
Chapter 5 Outline
5.1: Introduction
A. Similar cells with a common function are called tissues.
B. The study of tissues is called histology.
C. There are four (4) primary or major tissue types:
1. Epithelial Tissue
2. Connective Tissue
3. Muscle Tissue
4. Nervous Tissue
Intercellular Junctions
A. Tight junctions
1. Close space between cells
2. Located among cells that form linings
B. Desmosomes
1. Form spot welds between cells
2. Located among outer skin cells
C. Gap junctions
1. Tubular channels between cells
2. Located in cardiac muscle cells
5.2: Epithelial Tissue
A. General characteristics:
1. Cover organs and the body
2. Line body cavities
3. Line hollow organs
4. Have a free surface
5. Have a basement membrane
6. Are avascular
7. Cells readily divide
8. Cells tightly packed
9. Cells often have desmosomes
10. Function in protection, secretion, absorption, and excretion
11. Classified according to cell shape and number of cell layers
Epithelial Tissue
A. Simple squamous:
1. Single layer of flat cells
2. Substances pass easily through
3. Line air sacs
4. Line blood vessels
5. Line lymphatic vessels
B. Simple cuboidal:
1. Single layer of cube-shaped cells
2. Line kidney tubules
3. Cover ovaries
4. Line ducts of some glands
C. Simple columnar:
1. Single layer of elongated cells
2. Nuclei usually near the basement
3. Membrane at same level
4. Sometimes possess cilia
5. Sometimes possess microvilli
6. Often have goblet cells
7. Line uterus, stomach, intestines
D. Pseudostratified columnar:
1. Single layer of elongated cells
2. Nuclei at two or more levels
3. Appear striated
4. Often have cilia
5. Often have goblet cells
6. Line respiratory passageways
E. Stratified squamous:
1. Many cell layers
2. Top cells are flat
3. Can accumulate keratin
4. Outer layer of skin
5. Line oral cavity, vagina, and anal canal
F. Stratified cuboidal:
1. 2-3 layers
2. Cube-shaped cells
3. Line ducts of mammary glands, sweat glands, salivary glands, and
the pancreas
G. Stratified columnar:
1. Top layer of elongated cells
2. Cube-shaped cells in deeper layers
3. Line part of male urethra and part of pharynx
H. Transitional:
1. Many cell layers
2. Cube-shaped and elongated cells
3. Line urinary bladder, ureters, and part of urethra
Glandular Epithelium
A. Composed of cells that are specialized to produce and secrete substances
B. There are two (2) types:
1. Endocrine glands are ductless (key word: hormone)
2. Exocrine glands have ducts
a. Unicellular exocrine gland:
1.) Composed of one cell
2.) Goblet cell
b. Multicellular exocrine gland:
1.) Composed of many cells
2.) Sweat glands, salivary glands, etc.

3.) Simple and compound
Types of Glandular Secretions
A. Merocrine Glands
1. Fluid product
2. Salivary glands
3. Pancreas gland (?)
4. Sweat glands
B. Apocrine Glands
1. Cellular product
2. Portions of cells
3. Mammary glands
4. Ceruminous glands
C. Holocrine Glands
1. Secretory products
2. Whole cells
3. Sebaceous glands
5.1 From Science to Technology: Nanotechnology Meets the Blood-Brain Barrier
5.3: Connective Tissues
1. Most abundant tissue type
2. Many functions:
a. Bind structures
b. Provide support and protection
c. Serve as frameworks
d. Fill spaces
e. Store fat
f. Produce blood cells
g. Protect against infections
h. Help repair tissue damage
3. Have a matrix
4. Have varying degrees of vascularity
5. Have cells that usually divide
Connective Tissue: Major Cell Types Present
A. Fibroblasts
1. Fixed cell
2. Most common cell
3. Large, star-shaped
4. Produce fibers
B. Mast cells
1. Fixed cell
2. Release heparin
3. Release histamine
C. Macrophages
1. Wandering cell
2. Phagocytic
3. Important in injury or infection

Connective Tissue: Fiber Types Present
A. Collagenous fibers
1. Thick
2. Composed of collagen
3. Great tensile strength
4. Abundant in dense CT
5. Hold structures together
6. Tendons, ligaments
B. Reticular fibers
1. Very thin collagenous fibers
2. Highly branched
3. Form supportive networks
C. Elastic fibers
1. Bundles of microfibrils embedded in elastin
2. Fibers branch
3. Elastic
4. Vocal cords, air passages
Connective Tissues
A. Connective Tissue Proper:
1. Loose connective tissue
2. Adipose tissue
3. Reticular connective tissue
4. Dense connective tissue
5. Elastic connective tissue
B. Specialized Connective Tissue:
1. Cartilage
2. Bone
3. Blood
Connective Tissue Types
A. Loose Connective Tissue
1. Mainly fibroblasts
2. Fluid to gel-like matrix
3. Collagenous fibers
4. Elastic fibers
5. Bind skin to structures
6. Beneath most epithelia
7. Blood vessels nourish nearby epithelial cells
8. Between muscles
B. Adipose Tissue
1. Adipocytes
2. Cushions
3. Insulates
4. Store fats
5. Beneath skin
6. Behind eyeballs
7. Around kidneys and heart

C. Reticular Connective Tissue
1. Composed of reticular fibers
2. Supports internal organ walls
3. Walls of liver, spleen, lymphatic organs
D. Dense Connective Tissue
1. Packed collagenous fibers
2. Elastic fibers
3. Few fibroblasts
4. Bind body parts together
5. Tendons, ligaments, dermis
6. Poor blood supply
E. Elastic Connective Tissue
1. Abundant in elastic fibers
2. Some collagenous fibers
3. Fibroblasts
4. Attachments between bones
5. Walls of large arteries, airways, heart
F. Bone (Osseous Tissue)
1. Solid matrix
2. Supports
3. Protects
4. Forms blood cells
5. Attachment for muscles
6. Skeleton
7. Osteocytes in lacunae
G. Cartilage
1. Rigid matrix
2. Chondrocytes in lacunae
3. Poor blood supply
4. Three (3) types:
a. Hyaline Cartilage
1.) Most abundant
2.) Ends of bones
3.) Nose, respiratory passages
4.) Embryonic skeleton
b. Elastic Cartilage
1.) Flexible
2.) External ear, larynx
c. Fibrocartilage
1.) Very tough
2.) Shock absorber
3.) Intervertebral discs
4.) Pads of knee and pelvic girdle
H. Blood
1. Fluid matrix called plasma
2. Red blood cells

3. White blood cells
4. Platelets
5. Transports
6. Defends
7. Involved in clotting
8. Throughout body in blood vessels
9. Heart
5.1 Clinical Application: The Bodys Glue: The Extracellular Matrix
5.2 Clinical Application: Abnormalities of Collagen
5.4: Types of Membranes
A. There are four (4) types of epithelial membranes:
1. Serous Membranes
a. Line body cavities that do not open to the outside
b. Reduce friction
c. Inner lining of thorax and abdomen
d. Cover organs of thorax and abdomen
e. Secrete serous fluid
2. Mucous Membranes
a. Line tubes and organs that open to outside world
b. Lining of mouth, nose, throat, etc.
c. Secrete mucus
3. Cutaneous Membranes
a. Covers body
b. Skin
4. Synovial Membranes
a. Composed entirely of connective tissue
b. Lines joints
5.5: Muscle Tissues
1. Muscle cells also called muscle fibers
2. Contractile
3. Three (3) types:
a. Skeletal muscle
1.) Attached to bones
2.) Striated
3.)Voluntary
b. Smooth muscle
1.) Walls of organs
2.) Skin
3.) Walls of blood vessels
4.) Involuntary
5.) Non-striated
c. Cardiac muscle
1.) Heart wall
2.) Involuntary
3.) Striated
4.) Intercalated discs
5.6: Nervous Tissue
A. Found in brain, spinal cord, and peripheral nerves
B. Functional cells are neurons
C. Neuroglial cells support and bind nervous tissue components
D. Sensory reception
E. Conduction of nerve impulses
5.2 From Science to Technology: Tissue Engineering: Replacement Bladders and Hearts
5.1: Introduction
Describe a tissue, and explain the intercellular junctions found in tissues.
List the four major tissue types in the body.
5.2: Epithelial Tissues
Describe the general characteristics and functions of epithelial tissue.
Name the types of epithelium and identify and organ in which each is found.
Explain how glands are classified.
5.3: Connective Tissues
Describe the general characteristics of connective tissue.
Compare and contrast the cellular components, structures, fibers, and
extracellular matrix (where applicable) in each type of connective tissue.
Describe the major functions of each type of connective tissue.
5.4: Types of Membranes
Describe and locate each of the four types of membranes.
5.5: Muscle Tissues
Distinguish among the three types of muscle tissue.
5.6: Nervous Tissues
Describe the general characteristics and functions of nervous tissue.

Twelfth Edition
Chapter 6 Outline
6.1: Introduction
A. Two or more kinds of tissues grouped together and performing specialized
functions constitutes an organ.
B. The skin and its various structures make up the integumentary system.
6.2: Skin and Its Tissues
A. Composed of several tissue types
B. Maintains homeostasis
C. Protective covering
D. Retards water loss
E. Regulates body temperature
F. Houses sensory receptors
G. Contains immune system cells
H. Synthesizes chemicals
I. Excretes small amounts of wastes
Skin Cells
A. Help produce Vitamin D needed for normal bone and tooth development
B. Some cells (keratinocytes) produce substances that simulate development
of some white blood cells
Layers of Skin (3)
A. Epidermis
B. Dermis
C. Subcutaneous layer
1. Aka hypodermis
2. Beneath dermis
3. Some also call it the superficial fascia
4. Some consider it not part of the skin
Epidermis
A. Lacks blood vessels
B. Keratinized
C. Thickest on palms and soles (0.8-1.4mm)
D. Melanocytes provide melanin
E. Rests on basement membrane
F. Stratified squamous epithelia
G. There are five (5) layers of the epidermis:
1. Stratum corneum
2. Stratum lucidum
3. Stratum granulosum
4. Stratum spinosum
5. Stratum basale
H. Heredity and environment determine skin color
1. Genetic Factors
a. Varying amounts of melanin

b. Varying size of melanin granules
c. Albinos lack melanin
2. Environmental Factors
a. Sunlight
b. UV light from sunlamps
c. X-rays
d. Darkens melanin
3. Physiological Factors
a. Dilation of dermal blood vessels
b. Constriction of dermal blood vessels
c. Accumulation of carotene
d. Jaundice
6.1 Clinical Application: Tanning and Skin Cancer
Dermis
A. On average 1.0-2.0mm thick
B. Contains dermal papillae
C. Binds epidermis to underlying tissues
D. Irregular dense connective tissue
E. Muscle cells
F. Nerve cell processes
G. Specialized sensory receptors
H. Blood vessels
I. Hair follicles
J. Glands
K. There are actually two (2) layers to the dermis:
1. Papillary layer
a. Thin
b. Superficial
c. Dermal papillae here
2. Reticular layer
a. 80% of dermis
b. Cleavage, tension or Langers lines are here
Subcutaneous Layer
A. Aka hypodermis
B. Loose connective tissue and
C. Adipose tissue is present
D. Insulates
E. Major blood vessels present
6.3: Accessory Structures of the Skin
A. Accessory structures of the skin originate from the epidermis and include:
1. Hair follicles
2. Nails
3. Skin glands
Hair Follicles
A. Epidermal cells
B. Tube-like depression
C. Extends into dermis
D. Three (3) parts:
1. Hair root
2. Hair shaft
3. Hair papilla
E. Dead epidermal cells
F. Melanin
G. Arrector pili muscle
Nails
A. Protective coverings
B. Three (3) parts:
1. Nail plate
2. Nail bed
3. Lunula
6.2 Clinical Application: Hair Loss
Sebaceous Glands
A. Usually associated with hair follicles
B. Holocrine glands
C. Secrete sebum (oil)
D. Absent on palms and soles
Sweat Glands
A. Aka sudoriferous glands
B. Widespread in skin
C. Originates in deeper dermis or hypodermis
D. Eccrine glands
E. Apocrine glands
F. Ceruminous glands
G. Mammary glands
6.3 Clinical Application: Acne
6.4: Regulation of Body Temperature
A. Regulation of body temperature is vitally important because even slight shifts
can disrupt metabolic reactions.
Heat Production and Loss
A. Heat is a product of cellular metabolism
1. The most active body cells are the heat producers and include:
a. Skeletal muscle
b. Cardiac muscle
c. Cells of certain glands such as the liver
B. The primary means of heat loss is radiation
1. Also there is conduction, convection and evaporation
Problems in Temperature Regulation
A. Hyperthermia abnormally high body temperature
B. Hypothermia abnormally low body temperature
6.4 Clinical Application: Elevated Body Temperature
6.5: Healing of Wounds and Burns
A. Inflammation is a normal response to injury or stress.

B. Blood vessels in affected tissues dilate and become more permeable, allowing
fluids to leak into the damaged tissues.
C. Inflamed skin may become:
1. Reddened
2. Swollen
3. Warm
4. Painful
Healing of Cuts
Types of Burns
A. First degree burn superficial, partial-thickness
B. Second degree burn deep, partial-thickness
C. Third degree burn full-thickness
1. Autograft
2. Homograft
3. Various skin substitutes
Rule of Nines for Adults
A. Skin becomes scaly
B. Age spots appear
C. Epidermis thins
D. Dermis becomes reduced
E. Loss of fat
F. Wrinkling
G. Sagging
H. Sebaceous glands secrete less oil
I. Melanin production slows
J. Hair thins
K. Number of hair follicles decreases
L. Nail growth becomes impaired
M. Sensory receptors decline
N. Body temperature unable to be controlled
O. Diminished ability to activate Vitamin D
6.1: Introduction
Define organ, and name the large organ of the integumentary system.
6.2: Skin and Its Tissues
List the general functions of the skin.
Describe the structure of the layers of skin.
Summarize the factors that determine skin color.
6.3: Accessory Structures of the Skin
Describe the accessory structures associated with the skin.
Explain the functions of each accessory structure of the skin.
6.4: Regulation of Body Temperature
Explain how the skin helps regulate body temperature.
6.5: Healing of Wounds and Burns
Describe the events that are part of wound healing.

Distinguish among the types of burns, including a description of healing with
each type.
Summarize lifespan changes in the integumentary system.

Twelfth Edition
Chapter 7 Outline
7.1: Introduction
A. Human skeleton initially cartilages and fibrous membranes
B. Hyaline cartilage is the most abundant cartilage
C. By age 25 the skeleton is completely hardened
D. 206 bones make up the adult skeleton (20% of body mass)
1. 80 bones of the axial skeleton
2. 126 bones of the appendicular skeleton
7.2: Bone Structure
A. Bones of the skeletal system vary greatly in size and shape
B. There is similarity in structure, development, and function
Bone Classification
A. Bone Classification:
1. Long Bones
2. Short Bones
a. Sesamoid Bones
3. Flat Bones
4. Irregular Bones
5. Wormian Bones
Parts of a Long Bone
A. Epiphysis
1. Distal
2. Proximal
B. Diaphysis
C. Metaphysis
D. Compact bone
E. Spongy bone
F. Articular cartilage
G. Periosteum
H. Endosteum
I. Medullary cavity
J. Trabeculae
K. Bone marrow
L. Red marrow and yellow marrow
Microscopic Structure
A. Bone cells are called osteocytes
B. Osteocytes transport nutrients and wastes
C. The extracellular matrix of bone is largely collagen and inorganic salts
1. Collagen gives bone resilience
2. Inorganic salts make bone hard
Compact Bone
A. Osteon aka Haversian System
B. Central canal
C. Perforating canal aka Volkmanns canal
D. Osteocytes
E. Lamellae
F. Lacunae
G. Bone matrix
H. Canaliculi
Spongy Bone
A. Spongy bone is aka cancellous bone
7.3: Bone Development and Growth
A. Parts of the skeletal system begin to develop during the first few weeks of
prenatal development
B. Bones replace existing connective tissue in one of two ways:
1. As intramembranous bones
2. As endchondral bones
Intramembranous Bones
A. Intramembranous Bones
B. These bones originate within sheetlike layers of connective tissues
C. They are the broad, flat bones
1. Skull bones (except mandible)
D. Are known as intramembranous bones
Endochondral Bones
A. Endochondral Bones
B. Bones begin as hyaline cartilage
1. Form models for future bones
C. These are most bones of the skeleton
D. Are known as endochondral bones
Endochondral Ossification
A. Hyaline cartilage model
B. Primary ossification center
C. Secondary ossification centers
D. Epiphyseal plate
E. Osteoblasts vs. osteoclasts
Growth at the Epiphyseal Plate
A. First layer of cells
1. Closest to the end of epiphysis
2. Resting cells
3. Anchors epiphyseal plate to epiphysis
B. Second layer of cells
1. Many rows of young cells
2. Undergoing mitosis
C. Third layer of cells
1. Older cells
2. Left behind when new cells appear
3. Cells enlarging and becoming calcified
D. Fourth layer of cells
1. Thin
2. Dead cells
3. Calcified extracellular matrix
Homeostasis of Bone Tissue
A. Bone Resorption action of osteoclasts and parathyroid hormone aka
parathormone aka PTH
B. Bone Deposition action of osteoblasts and calcitonin
C. Occurs by direction of the thyroid and parathyroid glands
Factors Affecting Bone Development, Growth and Repair
A. Deficiency of Vitamin A retards bone development
B. Deficiency of Vitamin C results in fragile bones
C. Deficiency of Vitamin D rickets, osteomalacia
D. Insufficient Growth Hormone dwarfism
E. Excessive Growth Hormone gigantism, acromegaly
F. Insufficient Thyroid Hormone delays bone growth
G. Sex Hormones promote bone formation; stimulate ossification of epiphyseal
plates
H. Physical Stress stimulates bone growth
7.1 Clinical Application: Fractures
7.4: Bone Function
A. Bones shape, support, and protect body structures
Support, Protection, and Movement
A. Gives shape to head, etc.
B. Supports bodys weight
C. Protects lungs, etc.
D. Bones and muscles interact
E. When limbs or body parts move
Blood Cell Formation
A. Also known as hematopoiesis
B. Occurs in the red bone marrow
Inorganic Salt Storage
A. Calcium
B. Phosphate
C. Magnesium
D. Sodium
E. Potassium
7.2 Clinical Application: Osteopenia and Osteoporosis: Preventing Fragility Fractures
7.5: Skeletal Organization
A. The actual number of bones in the human skeleton varies from person to
person
B. Typically there are about 206 bones
C. For convenience the skeleton is divided into the:
1. Axial skeleton
2. Appendicular skeleton
Divisions of the Skeleton
A. Axial Skeleton
1. Skull
2. Spine
3. Rib cage
B. Appendicular Skeleton
1. Upper limbs
2. Lower limbs
3. Shoulder girdle
4. Pelvic girdle
7.6: Skull
A. Is composed of the cranium (brain case) and the facial bones
1. Frontal Bone (1)
a. Forehead
b. Roof of nasal cavity
c. Roofs of orbits
d. Frontal sinuses
e. Supraorbital foramen
f. Coronal suture
2. Parietal Bones (2)
a. Side walls of cranium
b. Roof of cranium
c. Sagittal suture
3. Occipital Bone (1)
a. Back of skull
b. Base of cranium
c. Foramen magnum
d. Occipital condyles
e. Lambdoidal suture
4. Temporal Bones (2)
a. Side walls of cranium
b. Floor of cranium
c. Floors and sides of orbits
d. Squamous suture
e. External acoustic meatus
f. Mandibular fossa
g. Mastoid process
h. Styloid process
i. Zygomatic process
5. Sphenoid Bone (1)
a. Base of cranium
b. Sides of skull
c. Floors and sides of orbits
d. Sella turcica
e. Sphenoid sinuses
6. Ethmoid Bone (1)
a. Roof and walls of nasal cavity
b. Floor of cranium
c. Wall of orbits
d. Cribiform plates
e. Perpendicular plate
f. Superior and middle nasal conchae
g. Ethmoid sinuses
h. Crista galli
7. Maxillary Bones (2)
a. Upper jaw
b. Anterior roof of mouth
c. Floors of orbits
d. Sides of nasal cavity
e. Floors of nasal cavity
f. Alveolar processes
g. Maxillary sinuses
h. Palatine process
8. Palatine Bones (2)
a. L shaped bones located behind the maxillae
b. Posterior section of hard palate
c. Floor of nasal cavity
d. Lateral walls of nasal cavity
9. Zygomatic Bones (2)
a. Prominences of cheeks
b. Lateral walls of orbits
c. Floors of orbits
d. Temporal process
10. Lacrimal Bones (2)
a. Medial walls of orbits
b. Groove from orbit to nasal cavity
11. Nasal Bones (2)
a. Bridge of nose
12. Vomer Bone (1)
a. Inferior portion of nasal septum
13. Inferior Nasal Conchae (2)
a. Extend from lateral walls of nasal cavity
14. Mandible Bone (1)
a. Lower jaw
b. Body
c. Ramus
d. Mandibular condyle
e. Coronoid process
f. Alveolar process
g. Mandibular foramen
h. Mental foramen
Infantile Skull
A. Fontanels fibrous membranes
7.7: Vertebral Column
A. The vertebral column, or spinal column, consists of many vertebrae separated

by cartilaginous intervertebral discs
1. Cervical vertebrae (7)
2. Thoracic vertebrae (12)
3. Lumbar vertebrae (5)
4. Sacral (4-5 fused segments)
a. Sacrum is fused bone
5. Coccygeal (3-4 fused segments)
a. Coccyx is fused bone
6. Cervical curvature
7. Thoracic curvature
8. Lumbar curvature
9. Sacral curvature
10. Rib facets
11. Vertebral prominens
12. Intervertebral discs (IVD)
13. Intervertebral foramina (IVF)
Typical Vertebrae
A. Includes the following parts:
1. Vertebral body
2. Pedicles
3. Lamina
4. Spinous process
5. Transverse processes
6. Vertebral foramen
7. Facets
Cervical Vertebrae
A. Atlas 1st; supports head
B. Axis 2nd; dens pivots to turn head
C. Transverse foramina
D. Bifid spinous processes
E. Vertebral prominens useful landmark
Thoracic Vertebrae
A. Long spinous processes
B. Rib facets
Lumbar Vertebrae
A. Large bodies
B. Thick, short spinous processes
Sacrum
A. 4-5 fused segments
B. Median sacral crest
C. Posterior sacral foramina
D. Posterior wall of pelvic cavity
E. Sacral promontory aka base
F. Area toward coccyx is the apex
Coccyx
A. Aka tailbone
B. 3-4 fused segments
7.3 Clinical Application: Disorders of the Vertebral Column
7.8: Thoracic Cage
A. The thoracic cage includes the ribs, the thoracic vertebrae, the sternum, and the
costal cartilages that attach the ribs to the sternum.
1. Ribs (12)
2. Sternum
3. Thoracic vertebrae (12)
4. Costal cartilages
5. Supports shoulder girdle and upper limbs
6. Protects viscera
7. Role in breathing
Ribs
A. Humans have 12 pairs of ribs:
1. True ribs (7)
2. False ribs (5), of which:
a. Floating (2)
B. There are some anomalies:
1. Cervical ribs
2. Lumbar ribs
Rib Structure
A. Shaft
B. Head posterior end; articulates with vertebrae
C. Tubercle articulates with vertebrae
D. Costal cartilage hyaline cartilage
Sternum
A. Three (3) parts of the sternum:
1. Manubrium
2. Body
3. Xiphoid process
7.9: Pectoral Girdle
A. Also known as the shoulder girdle
B. Clavicles
C. Scapulae
D. Supports upper limbs
E. True shoulder joint is simply the articulation of the humerus and scapula
Clavicles
A. Articulate with manubrium
B. Articulate with scapulae (acromion process)
C. A-C joint
Scapulae
A. Spine
B. Supraspinous fossa
C. Infraspinous fossa
D. Acromion process
E. Coracoid process
F. Glenoid fossa or cavity
7.10: Upper Limb
A. Humerus
B. Radius
C. Ulna
D. (Interosseous membrane)
E. Carpals
F. Metacarpals
G. Phalanges
Humerus
A. Head
B. Greater tubercle
C. Lesser tubercle
D. Anatomical neck
E. Surgical neck
F. Deltoid tuberosity
G. Capitulum
H. Trochlea
I. Coronoid fossa
J. Olecranon fossa
Radius
A. Lateral forearm bone
B. Head
C. Radial tuberosity
D. Styloid process
Ulna
A. Medial forearm bone
B. Trochlear notch
C. Olecranon process
D. Coronoid process
E. Styloid process
Wrist and Hand
A. Carpal Bones (16 total bones)
1. Scaphoid
2. Lunate
3. Triquetral
4. Pisiform
5. Hamate
6. Capitate
7. Trapezoid
8. Trapezium
B. Metacarpal Bones (10)
C. Phalangeal Bones (28)
1. Proximal phalanx
2. Middle phalanx
3. Distal phalanx
7.11: Pelvic Girdle
A. Coxal Bones (2)
1. Supports trunk of body
2. Protects viscera
3. Forms pelvic cavity
Hip Bones
A. Also known as the coxae:
1. Acetabulum
2. There are three (3) bones:
a. Ilium
1.) Iliac crest
2.) Iliac spines
3.) Greater sciatic notch
b. Ischium
1.) Ischial spines
2.) Lesser sciatic notch
3.) Ischial tuberosity
c. Pubis
1.) Obturator foramen
2.) Symphysis pubis
3.) Pubic arch
Greater and Lesser Pelves
A. Greater Pelvis
1. Lumbar vertebrae posteriorly
2. Iliac bones laterally
3. Abdominal wall anteriorly
B. Lesser Pelvis
1. Sacrum and coccyx posteriorly
2. Lower ilium, ischium, and pubic bones laterally and anteriorly
Differences Between Male Female Pelves
A. Female pelvis
1. Iliac bones more flared
2. Broader hips
3. Pubic arch angle greater
4. More distance between ischial spines and ischial tuberosities
5. Sacral curvature shorter and flatter
6. Lighter bones
7. Why?
7.12: Lower Limb
A. Femur
B. Patella
C. Tibia
D. Fibula
E. Tarsals
F. Metatarsals
G. Phalanges
Femur
A. Longest bone of body
B. Head
C. Fovea capitis
D. Neck
E. Greater trochanter
F. Lesser trochanter
G. Linea aspera
H. Condyles
I. Epicondyles
Patella
A. Aka kneecap
B. Anterior surface of the knee joint
C. Flat sesamoid bone located in the quadriceps tendon
Tibia
A. Aka shin bone
B. Medial to fibula
C. Condyles
D. Tibial tuberosity
E. Anterior crest
F. Makes the medial malleolus
Fibula
A. Lateral to tibia
B. Long, slender
C. Head
D. Makes the lateral malleolus
E. Non-weight bearing
Foot
A. Tarsal Bones (14)
1. Calcaneus
2. Talus
3. Navicular
4. Cuboid
5. Lateral (3rd) cuneiform
6. Intermediate (2nd) cuneiform
7. Medial (1st) cuneiform
B. Metatarsal Bones (10)
C. Phalanges (28)
1. Proximal
2. Middle
3. Distal
A. Decrease in height at about age 30
B. Calcium levels fall
C. Bones become brittle
D. Osteoclasts outnumber osteoblasts

E. Spongy bone weakens before compact bone
F. Bone loss rapid in menopausal women
G. Hip fractures common
H. Vertebral compression fractures common
7.1: Introduction
Discuss the living tissues found in bone even though bone appears to be inert.
7.2: Bone Structure
Classify bones according to their shapes and name an example from each group.
Describe the macroscopic and microscopic structure of a long bone and list the
functions of these parts.
7.3: Bone Development and Growth
Distinguish between intramembranous and endchondral bones and explain how
such bones develop and grow. Describe the effects of sunlight, nutrition,
hormonal secretions, and exercise on bone development and growth.
7.4: Bone Function
Discuss the major functions of bone.
7.5: Skeletal Organization
Distinguish between the axial and appendicular skeletons, and name the major
parts of each.
7.6: Skull 7.12: Lower Limb
Locate and identify the bones and the major features of the bones that comprise
the skull, vertebral column, thoracic cage, pectoral girdle, upper limb, pelvic
girdle, and lower limb.
Describe the differences between male and female skeletons.
Describe lifespan changes in the skeletal system.

Twelfth Edition
Chapter 8 Outline
8.1: Introduction
A. Are known as articulations
B. Functional junctions between bones
C. Bind parts of skeletal system together
D. Make bone growth possible
E. Permit parts of the skeleton to change shape during childbirth
F. Enable body to move in response to skeletal muscle contraction
G. Three (3) classifications of joints will be considered
8.2: Classification of Joints
A. Fibrous joints
1. Dense connective tissues connect bones
2. Between bones in close contact
B. Cartilaginous joints
1. Hyaline cartilage or fibrocartilage connect bones
C. Synovial joints
1. Most complex
2. Allow free movement
D. These joints are also known as:
1. Synarthrotic joints
a. Considered immovable
2. Amphiarthrotic joints
a. Slightly movable
3. Diarthrotic joints
a. Freely movable
Fibrous Joints
A. There are three (3) types of fibrous joints (synarthroses):
1. Syndesmosis
2. Suture
3. Gomphosis
B. Syndesmosis:
1. A sheet or bundle of fibrous tissue connecting bones
2. Lies between tibia and fibula (interosseous membrane)
C. Suture:
1. Between flat bones
2. See teeth-like projections
3. Thin layer of connective tissue connects bones
4. Skull
D. Gomphosis:
1. Cone-shaped bony process in a socket
2. Tooth in jawbone
Cartilaginous Joints
A. There are two (2) types of cartilaginous joints (amphiarthroses):

1. Synchondrosis
2. Symphysis
B. Synchondrosis:
1. Bands of hyaline cartilage unite bones
2. Epiphyseal plate (temporary)
3. Between manubrium and the first rib (costal cartilages)
C. Symphysis:
1. Pad of fibrocartilage between bones
2. Pubic symphysis
3. Joint between bodies of adjacent vertebrae
8.3: General Structure of a Synovial Joint
A. Synovial joints are freely moveable (diarthroses)
B. There are three (3) types of diarthroses
C. There are specific parts of a diarthroses:
1. Articular cartilage
2. Joint cavity
3. Joint capsule
4. Synovial membrane
5. Synovial fluid
6. Meniscus
7. Bursae
8.4: Types of Synovial Joints
A. Uni-axial
1. Hinge joint
2. Pivot or trochoid joint
B. Bi-axial
1. Saddle or sellar joint
2. Condylar or ellipsoidal joint
C. Multi-axial
1. Ball and socket joint
2. Gliding or plane joint
Types of Synovial Joints
A. Pivot Joint
1. Between atlas (C1) and the dens of axis (C2)
B. Hinge Joint
1. Elbow joint
2. Between phalanges
C. Saddle Joint
1. Between carpal and 1st metacarpal (of thumb)
D. Condylar Joint
1. Between metacarpals and phalanges
2. Between radius and carpals
E. Ball-and-Socket Joint
1. Hip joint
2. Shoulder joint
F. Gliding Joint
1. Between carpals
2. Between tarsals
3. Between facets of adjacent vertebrae
8.5: Types of Joint Movements
A. Movement at a joint occurs when a muscle contracts and its fibers pull its
moveable end (insertion) towards its fixed end (origin).
Types of Joint Movements
A. Abduction/adduction
B. Dorsiflexion/plantar flexion
C. Flexion/extension/hyperextension
D. Lateral flexion
E. Rotation
F. Circumduction
G. Supination/pronation
H. Eversion/inversion
I. Protraction/retraction
J. Elevation/depression
8.6: Examples of Synovial Joints
A. The shoulder, elbow, hip, and knee are large, freely moveable joints.
Shoulder Joint
A. Ball-and-socket
B. Head of humerus and glenoid cavity of scapula
C. Loose joint capsule
D. Bursae
E. Ligaments prevent displacement
F. Very wide range of movement (circumduction)
Elbow Joint
A. Hinge joint
1. Trochlea of humerus
2. Trochlear notch of ulna
B. Gliding joint
1. Capitulum of humerus
2. Head of radius
C. Flexion and extension
D. Many reinforcing ligaments
E. Stable joint
Hip Joint
A. Ball-and-socket joint
B. Head of femur and acetabulum of coxa
C. Heavy joint capsule
D. Many reinforcing ligaments
E. Less freedom of movement than shoulder joint
F. Circumduction
Knee Joint
A. Largest joint
B. Most complex
C. Medial and lateral condyles of distal end of femur and
D. Medial and lateral condyles of proximal end of tibia and
E. Femur articulates anteriorly with patella
F. Strengthened by many ligaments and tendons
G. Menisci separate femur and tibia
H. Bursae
8.1 Clinical Application: Replacing Joints
8.2 Clinical Application: Joint Disorders
A. Joint stiffness is an early sign of aging
B. Fibrous joints first to change; can strengthen however over a lifetime
C. Changes in symphysis joints of vertebral column diminish flexibility and
decrease height (remember water loss from the IVDs)
D. Synovial joints lose elasticity
E. Disuse hampers the blood supply
F. Activity and exercise can keep joints functional longer
8.1: Introduction
List the functions of joints.
8.2: Classification of Joints
Explain how joints can be classified according the type of tissue that binds the
bones together.
Describe how bones of fibrous joints are held together.
Describe how bones of cartilaginous joints are held together.
8.3: General Structure of a Synovial Joint
Describe the general structure of a synovial joint.
8.4: Types of Synovial Joints
Distinguish among the six types of synovial joints and give an example of each
type.
8.5: Types of Joint Movements
Explain how skeletal muscles produce movements at joints, and identify several
types of joint movements.
8.6: Examples of Synovial Joints
Describe the shoulder joint and explain how its articulating parts are held
together.
Describe the elbow, hip, and knee joints and explain how their articulating parts
are held together.
Describe lifespan changes in joints.

Twelfth Edition
Chapter 9 Outline
9.1: Introduction
A. Three (3) Types of Muscle Tissues
1. Skeletal Muscle
a. Usually attached to bones
b. Under conscious control
c. Somatic
d. Striated
2. Smooth Muscle
a. Walls of most viscera, blood vessels and skin
b. Not under conscious control
c. Autonomic
d. Not striated
3. Cardiac Muscle
a. Wall of heart
b. Not under conscious control
c. Autonomic
d. Striated
9.2: Structure of Skeletal Muscle
A. Skeletal Muscle
1. Organ of the muscular system
a. Skeletal muscle tissue
b. Nervous tissue
c. Blood
d. Connective tissues
2. Fascia
3. Tendons
4. Apo neuroses
Connective Tissue Coverings
A. Muscle coverings:
1. Epimysium
2. Perimysium
3. Endomysium
B. Muscle organ
C. Fascicles
D. Muscle cells or fibers
E. Myofibrils
F. Thick and thin myofilaments
1. Actin and myosin proteins
2. Titin is an elastic myofilament
Skeletal Muscle Fibers
A. Sarcolemma
B. Sacroplasm
C. Sarcoplasmic reticulum (SR)
D. Transverse (T) tubule
E. Triad
1. Cisternae of SR
2. T tubule
F. Myofibril
G. Actin myofilaments
H. Myosin myofilaments
I. Sarcomere
9.3: Skeletal Muscle Contraction
A. Movement within the myofilaments
B. I band (thin)
C. A band (thick and thin)
D. H zone (thick)
E. Z line (or disc)
F. M line
Myofilaments
A. Thick myofilaments
1. Composed of myosin protein
2. Form the cross-bridges
B. Thin myofilaments
1. Composed of actin protein
2. Associated with troponin and tropomyosin proteins
Neuromuscular Junction
A. Also known as NMJ or myoneural junction
B. Site where an axon and muscle fiber meet
C. Parts to know:
1. Motor neuron
2. Motor end plate
3. Synapse
4. Synaptic cleft
5. Synaptic vesicles
6. Neurotransmitters
Motor Unit
A. Single motor neuron
B. All muscle fibers controlled by motor neuron
C. As few as four fibers
D. As many as 1000s of muscle fibers
Stimulus for Contraction
A. Acetylcholine (ACh)
B. Nerve impulse causes release of ACh from synaptic vesicles
C. ACh binds to ACh receptors on motor end plate
D. Generates a muscle impulse
E. Muscle impulse eventually reaches the SR and the cisternae
9.1 Clinical Application: Myasthenia Gravis
Excitation-Contraction Coupling
A. Muscle impulses cause SR to release calcium ions into cytosol
B. Calcium binds to troponin to change its shape
C. The position of tropomyosin is altered
D. Binding sites on actin are now exposed
E. Actin and myosin molecules bind via myosin cross-bridges
The Sliding Filament Model of Muscle Contraction
A. When sarcromeres shorten, thick and thin filaments slide past one another
B. H zones and I bands narrow
C. Z lines move closer together
Cross Bridge Cycling
A. Myosin cross-bridge attaches to actin binding site
B. Myosin cross-bridge pulls thin filament
C. ADP and phosphate released from myosin
D. New ATP binds to myosin
E. Linkage between actin and myosin cross-bridge break
F. ATP splits
G. Myosin cross-bridge goes back to original position
Relaxation
A. Acetylcholinesterase rapidly decomposes Ach remaining in the synapse
B. Muscle impulse stops
C. Stimulus to sarcolemma and muscle fiber membrane ceases
D. Calcium moves back into sarcoplasmic reticulum (SR)
E. Myosin and actin binding prevented
F. Muscle fiber relaxes
Energy Sources for Contraction
A. 1) Creatine phosphate and 2) Cellular respiration
B. Creatine phosphate stores energy that quickly converts ADP to ATP
Oxygen Supply and Cellular Respiration
A. Cellular respiration:
1. Anaerobic Phase
a. Glycolysis
b. Occurs in cytoplasm
c. Produces little ATP
2. Aerobic Phase
a. Citric acid cycle
b. Electron transport system
c. Occurs in the mitochondria
d. Produces most ATP
e. Myoglobin stores extra oxygen
Oxygen Debt
A. Oxygen debt amount of oxygen needed by liver cells to use the accumulated
lactic acid to produce glucose
1. Oxygen not available
2. Glycolysis continues
3. Pyruvic acid converted to lactic acid
4. Liver converts lactic acid to glucose

Muscle Fatigue
A. Inability to contract muscle
B. Commonly caused from:
1. Decreased blood flow
2. Ion imbalances across the sarcolemma
3. Accumulation of lactic acid
C. Cramp sustained, involuntary muscle contraction
D. Physiological vs. psychological fatigue
Heat Production
A. By-product of cellular respiration
B. Muscle cells are major source of body heat
C. Blood transports heat throughout body core
9.4: Muscular Responses
A. Muscle contraction can be observed by removing a single skeletal muscle fiber
and connecting it to a device that senses and records changes in the overall length
of the muscle fiber.
Threshold Stimulus
A. Minimal strength required to cause contraction
Recording of a Muscle Contraction
A. Recording a Muscle Contraction
1. Twitch
a. Latent period
b. Period of contraction
c. Period of relaxation
2. Refractory period
3. All-or-none response
Length-Tension Relationship
Summation
A. Process by which individual twitches combine
B. Produces sustained contractions
C. Can lead to tetanic contractions
Recruitment of Motor Units
A. Recruitment - increase in the number of motor units activated
B. Whole muscle composed of many motor units
C. More precise movements are produced with fewer muscle fibers within a
motor unit
D. As intensity of stimulation increases, recruitment of motor units continues until
all motor units are activated
Sustained Contractions
A. Smaller motor units (smaller diameter axons) - recruited first
B. Larger motor units (larger diameter axons) - recruited later
C. Produce smooth movements
D. Muscle tone continuous state of partial contraction
Types of Contractions
A. Isotonic muscle contracts and changes length
B. Eccentric lengthening contraction

C. Concentric shortening contraction
D. Isometric muscle contracts but does not change length
Fast Twitch and Slow Twitch Muscle Fibers
A. Slow-twitch fibers (Type I)
1. Always oxidative
2. Resistant to fatigue
3. Red fibers
4. Most myoglobin
5. Good blood supply
B. Fast-twitch glycolytic fibers (Type IIa)
1. White fibers (less myoglobin)
2. Poorer blood supply
3. Susceptible to fatigue
C. Fast-twitch fatigue-resistant fibers (Type IIb)
1. Intermediate fibers
2. Oxidative
3. Intermediate amount of myoglobin
4. Pink to red in color
5. Resistant to fatigue
9.2 Clinical Application: Use and Disuse of Skeletal Muscles
9.5: Smooth Muscles
A. Compared to skeletal muscle fibers, smooth muscle fibers are:
1. Shorter
2. Single, centrally located nucleus
3. Elongated with tapering ends
4. Myofilaments randomly organized
5. Lack striations
6. Lack transverse tubules
7. Sarcoplasmic reticula (SR) not well developed
Smooth Muscle Fibers
A. Visceral Smooth Muscle
1. Single-unit smooth muscle
2. Sheets of muscle fibers
3. Fibers held together by gap junctions
4. Exhibit rhythmicity
5. Exhibit peristalsis
6. Walls of most hollow organs
B. Multi-unit Smooth Muscle
1. Less organized
2. Function as separate units
3. Fibers function separately
4. Iris of eye
5. Walls of blood vessels
Smooth Muscle Contraction
A. Resembles skeletal muscle contraction in that:
1. Interaction between actin and myosin

2. Both use calcium and ATP
3. Both are triggered by membrane impulses
B. Different from skeletal muscle contraction in that:
1. Smooth muscle lacks troponin
2. Smooth muscle uses calmodulin
3. Two neurotransmitters affect smooth muscle
a. Acetlycholine (Ach) and norepinephrine (NE)
4. Hormones affect smooth muscle
5. Stretching can trigger smooth muscle contraction
6. Smooth muscle slower to contract and relax
7. Smooth muscle more resistant to fatigue
8. Smooth muscle can change length without changing tautness
9.6: Cardiac Muscle
A. Located only in the heart
B. Muscle fibers joined together by intercalated discs
C. Fibers branch
D. Network of fibers contracts as a unit
E. Self-exciting and rhythmic
F. Longer refractory period than skeletal muscle
9.7: Skeletal Muscle Actions
A. Skeletal muscles generate a great variety of body movements.
B. The action of each muscle mostly depends upon the kind of joint it is
associated with and the way the muscle is attached on either side of that joint.
Body Movement
A. Four Basic Components of Levers:
1. Rigid bar bones
2. Fulcrum point on which bar moves; joint
3. Object - moved against resistance; weight
4. Force supplies energy for movement; muscles
Origin and Insertion
A. Origin immovable end
B. Insertion movable end
Interaction of Skeletal Muscles
A. Prime mover (agonist) primarily responsible for movement
B. Synergists assist prime mover
C. Antagonist resist prime movers action and cause movement in the opposite
direction of the prime mover
D. Fixators
9.8: Major Skeletal Muscles
9.3 Clinical Application: TMJ Syndrome
A. Myoglobin, ATP, and creatine phosphate decline
B. By age 80, half of muscle mass has atrophied
C. Adipose cells and connective tissues replace muscle tissue
D. Exercise helps to maintain muscle mass and function
9.1: Introduction
List various outcomes of muscle action.
9.2: Structure of a Skeletal Muscle
Describe how connective tissue is a part of the structure of a skeletal muscle.
Name the major parts of a skeletal muscle fiber and describe the functions of
each.
9.3: Skeletal Muscle Contraction
Describe the neural control of skeletal muscle contraction.
Identify the major events that occur during skeletal muscle fiber contraction.
List the energy sources for skeletal muscle fiber contraction.
Describe how a muscle may become fatigued.
Describe oxygen debt.
9.4: Muscular Responses
Distinguish between fast and slow twitch muscle fibers.
Distinguish between a twitch and a sustained contraction.
Describe how exercise affects skeletal muscles.
Explain how various types of muscular contractions produce body movements
and help maintain posture.
9.5: Smooth Muscle
Distinguish between the structures and functions of multiunit smooth muscle and
visceral smooth muscle.
Compare the contraction mechanisms of skeletal and smooth muscle fibers.
9.6: Cardiac Muscle
Compare the contraction mechanisms of skeletal and cardiac muscle fibers.
9.7: Skeletal Muscle Actions
Explain how the attachments, locations, and interactions of skeletal muscles
make possible certain movements.
9.8: Major Skeletal Muscles
Identify and locate the skeletal muscles of each body region and describe the
action (s) of each muscle.

Twelfth Edition
Chapter 10 Outline
10.1: Introduction
A. Cell types in neural tissue:
1. Neurons
2. Neuroglial cells (also known as neuroglia, glia, and glial)
Divisions of the Nervous System
A. Central Nervous System (CNS)
1. Brain
2. Spinal cord
B. Peripheral Nervous System (PNS)
1. Cranial nerves
2. Spinal nerves
Divisions of Peripheral Nervous System
A. Sensory Division
1. Picks up sensory information and delivers it to the CNS
B. Motor Division
1. Carries information to muscles and glands
C. Divisions of the Motor Division:
1. Somatic carries information to skeletal muscle
2. Autonomic carries information to smooth muscle, cardiac muscle, and
glands
10.1 Clinical Application: Migraine
10.2: General Functions of the Nervous System
A. The three general functions of the nervous system:
1. Receiving stimuli = sensory function
2. Deciding about stimuli = integrative function
3. Reacting to stimuli = motor function
Functions of Nervous System
A. Sensory Function
1. Sensory receptors gather information
2. Information is carried to the CNS
B. Motor Function
1. Decisions are acted upon
2. Impulses are carried to effectors
C. Integrative Function
1. Sensory information used to create:
a. Sensations
b. Memory
c. Thoughts
d. Decisions
10.3: Description of Cells of the Nervous System
A. Neurons vary in size and shape
B. They may differ in length and size of their axons and dendrites
C. Neurons share certain features:
1. Dendrites
2. A cell body
3. An axon
Myelination of Axons
A. White Matter
1. Contains myelinated axons
2. Considered fiber tracts
B. Gray Matter
1. Contains unmyelinated structures
2. Cell bodies, dendrites
10.2 Clinical Application: Multiple Sclerosis
10.4: Classification of Neurons and Neuroglia
A. Neurons vary in function
1. They can be sensory, motor, or integrative neurons
B. Neurons vary in size and shape, and in the number of axons and dendrites that
they may have
C. Due to structural differences, neurons can be classified into three (3) major
groups:
1. Bipolar neurons
2. Unipolar neurons
3. Multipolar neurons
Classification of Neurons: Structural Differences
A. Bipolar neurons
1. Two processes
2. Eyes, ears, nose
B. Unipolar neurons
1. One process
2. Ganglia of PNS
3. Sensory
C. Multipolar neurons
1. 99% of neurons
2. Many processes
3. Most neurons of CNS
Classification of Neurons: Functional Differences
A. Sensory Neurons
1. Afferent
2. Carry impulse to CNS
3. Most are unipolar
4. Some are bipolar
B. Interneurons
1. Link neurons
2. Aka association neurons or internuncial neurons
3. Multipolar
4. Located in CNS
C. Motor Neurons
1. Multipolar
2. Carry impulses away from CNS
3. Carry impulses to effectors
Types of Neuroglial Cells in the PNS
A. Schwann Cells
1. Produce myelin found on peripheral myelinated neurons
2. Speed up neurotransmission
B. Satellite Cells
1. Support clusters of neuron cell bodies (ganglia)
Types of Neuroglial Cells in the CNS
A. Microglia
1. CNS
2. Phagocytic cell
B. Astrocytes
1. CNS
2. Scar tissue
3. Mop up excess ions, etc.
4. Induce synapse formation
5. Connect neurons to blood vessels
C. Oligodendrocytes
1. CNS
2. Myelinating cell
D. Ependyma or ependymal
1. CNS
2. Ciliated
3. Line central canal of spinal cord
4. Line ventricles of brain
Regeneration of A Nerve Axon
10.5: The Synapse
A. Nerve impulses pass from neuron to neuron at synapses, moving from a presynaptic neuron to a post-synaptic neuron.
Synaptic Transmission
A. Neurotransmitters are released when impulse reaches synaptic knob
10.6: Cell Membrane Potential
A. A cell membrane is usually electrically charged, or polarized, so that the inside
of the membrane is negatively charged with respect to the outside of the
membrane (which is then positively charged).
B. This is as a result of unequal distribution of ions on the inside and the outside
of the membrane.
Distribution of Ions
A. Potassium (K+) ions are the major intracellular positive ions (cations).
B. Sodium (Na+) ions are the major extracellular positive ions (cations).
C. This distribution is largely created by the Sodium/Potassium Pump (Na+/K+
pump).
D. This pump actively transports sodium ions out of the cell and potassium ions
into the cell.
Resting Potential
A. Resting Membrane Potential (RMP):
1. 70 mV difference from inside to outside of cell
2. It is a polarized membrane
3. Inside of cell is negative relative to the outside of the cell
4. RMP = -70 mV
5. Due to distribution of ions inside vs. outside
6. Na+/K+ pump restores
Local Potential Changes
A. Caused by various stimuli:
1. Temperature changes
2. Light
3. Pressure
B. Environmental changes affect the membrane potential by opening a gated ion
channel
C. Channels are 1) chemically gated, 2) voltage gated, or 3) mechanically gated
D. If membrane potential becomes more negative, it has hyperpolarized
E. If membrane potential becomes less negative, it has depolarized
F. Graded (or proportional) to intensity of stimulation reaching threshold potential
G. Reaching threshold potential results in a nerve impulse, starting an action
potential
Action Potentials
A. At rest, the membrane is polarized (RMP = -70)
B. Threshold stimulus reached (-55)
C. Sodium channels open and membrane depolarizes (toward 0)
D. Potassium leaves cytoplasm and membrane repolarizes (+30)
E. Brief period of hyperpolarization (-90)
All-or-None Response
A. If a neuron responds at all, it responds completely
B. A nerve impulse is conducted whenever a stimulus of threshold intensity or
above is applied to an axon
C. All impulses carried on an axon are the same strength
Refractory Period
A. Absolute Refractory Period
1. Time when threshold stimulus does not start another action potential
B. Relative Refractory Period
1. Time when stronger threshold stimulus can start another action potential
10.3 Clinical Application: Factors Affecting Impulse Conduction
10.7: Synaptic Transmission
A. This is where released neurotransmitters cross the synaptic cleft and react with
specific molecules called receptors in the postsynaptic neuron membrane.
B. Effects of neurotransmitters vary.
C. Some neurotransmitters may open ion channels and others may close ion
channels.
Synaptic Potentials
A. EPSP
1. Excitatory postsynaptic potential
2. Graded
3. Depolarizes membrane of postsynaptic neuron
4. Action potential of postsynaptic neuron becomes more likely
B. IPSP
1. Inhibitory postsynaptic potential
2. Graded
3. Hyperpolarizes membrane of postsynaptic neuron
4. Action potential of postsynaptic neuron becomes less likely
Summation of EPSPs and IPSPs
A. EPSPs and IPSPs are added together in a process called summation
B. More EPSPs lead to greater probability of an action potential
Neurotransmitters
Neuropeptides
A. Neurons in the brain or spinal cord synthesize neuropeptides.
B. These neuropeptides act as neurotransmitters.
C. Examples include:
1. Enkephalins
2. Beta endorphin
3. Substance P
10.4 Clinical Application: Opiates in the Human Body
10.8: Impulse Processing
A. Way the nervous system processes nerve impulses and acts upon them
1. Neuronal Pools
a. Interneurons
b. Work together to perform a common function
c. May excite or inhibit
2. Convergence
a. Various sensory receptors
b. Can allow for summation of impulses
3. Divergence
a. Branching axon
b. Stimulation of many neurons ultimately
Neuronal Pools
A. Groups of interneurons that make synaptic connections with each other
B. Interneurons work together to perform a common function
C. Each pool receives input from other neurons
D. Each pool generates output to other neurons
Convergence
A. Neuron receives input from several neurons
B. Incoming impulses represent information from different types of sensory
receptors
C. Allows nervous system to collect, process, and respond to information
D. Makes it possible for a neuron to sum impulses from different sources
Divergence
A. One neuron sends impulses to several neurons
B. Can amplify an impulse
C. Impulse from a single neuron in CNS may be amplified to activate enough
motor units needed for muscle contraction
10.1: Introduction
Describe the general functions of the nervous system.
Identify the two types of cells that comprise nervous tissue.
Identify the two major groups of nervous system organs.
10.2: General Functions of the Nervous System
List the functions of sensory receptors.
Describe how the nervous system responds to stimuli.
10.3: Description of Cells of the Nervous System
Describe the three major parts of a neuron.
Define neurofibrils and chromatophilic substance.
Describe the relationship among myelin, the neurilemma, and the nodes of
Ranvier.
Distinguish between the sources of white matter and gray matter.
10.4: Classification of Neurons and Neuroglia
Identify structural and functional differences among neurons.
Identify the types of neuroglia in the central nervous system and their functions.
Describe the Schwann cells of the peripheral nervous system.
10.5: The Synapse
Define presynaptic and postsynaptic.
Explain how information passes from a presynaptic to a postsynaptic neuron.
10.6: Cell Membrane Potential
Explain how a cell membrane becomes polarized.
Define resting potential, local potential, and action potential.
Describe the events leading to the conduction of a nerve impulse.
Compare nerve impulse conduction in myelinated and unmyelinated neurons.
10.7: Synaptic Transmission
Identify the changes in membrane potential associated with excitatory and
inhibitory neurotransmitters.
10.8: Impulse Processing
Describe the basic ways in which the nervous system processes information.

Twelfth Edition
Chapter 11 Outline
11.1: Introduction
A. The central nervous system (CNS) consists of the brain and spinal cord.
B. The brainstem connects the brain to the spinal cord.
C. Communication to the peripheral nervous system (PNS) is by way of the spinal
cord.
11.2: Meninges
A. The meninges
1. Membranes of CNS
2. Protect the CNS
3. Three (3) layers:
a. Dura mater
1.) Tough mother
2.) Venous sinuses
3.) Falx
b. Arachnoid mater
1.) Spiderweb-like
2.) Space contains cerebrospinal fluid (CSF)
c. Pia mater
1.) Faithful mother
2.) Encapsulates blood vessels
11.3: Ventricles and Cerebrospinal Fluid
A. There are four (4) ventricles
B. The ventricles are interconnected cavities within cerebral hemispheres and
brain stem
C. The ventricles are continuous with the central canal of the spinal cord
D. They are filled with cerebrospinal fluid (CSF)
E. The four (4) ventricles are:
1. Lateral ventricles (2)
a. Known as the first and second ventricles
2. Third ventricle
3. Fourth ventricle
F. Interventricular foramen
G. Cerebral aqueduct
Cerebrospinal Fluid
A. Secreted by the choroid plexus (Can you recall the specific cells?)
B. Circulates in ventricles, central canal of spinal cord, and the subarachnoid
space
C. Completely surrounds the brain and spinal cord
D. Excess or wasted CSF is absorbed by the arachnoid villi (And where are these
located?)
E. Clear fluid similar to blood plasma
F. Volume is only about 120 ml.

G. Nutritive and protective
H. Helps maintain stable ion concentrations in the CNS
11.1 Clinical Application: Cerebrospinal Fluid Pressure
11.4: Spinal Cord
A. Slender column of nervous tissue continuous with brain and brainstem
B. Extends downward through vertebral canal
C. Begins at the foramen magnum and terminates at the first and second lumbar
vertebrae (L1/L2) interspace
Functions of Spinal Cord
A. Conduit for nerve impulses to and from the brain and brainstem
B. Center for spinal reflexes
Reflex Arcs
A. Reflexes are automatic, subconscious responses to stimuli within or outside the
body
1. Simple reflex arc (sensory motor)
2. Most common reflex arc (sensory association motor)
Reflex Behavior
A. Example is the knee-jerk reflex
1. Simple monosynaptic reflex
2. Helps maintain an upright posture
B. Example is a withdrawal reflex
1. Prevents or limits tissue damage
C. Example crossed extensor reflex
1. Crossing of sensory impulses within the reflex center to produce an
opposite effect
11.2 Clinical Application: Uses of Reflexes
Tracts of the Spinal Cord
A. Ascending tracts conduct sensory impulses to the brain
B. Descending tracts conduct motor impulses from the brain to motor neurons
reaching muscles and glands
Ascending Tracts
A. Major ascending (sensory) spinal cord tracts:
1. Fasciculus gracilis and fasciculus cuneatus
2. Spinothalamic tracts
a. Lateral and anterior
3. Spinocerebellar tracts
a. Posterior and anterior
Descending Tracts
A. Major descending (motor) spinal cord tracts:
1. Corticospinal tracts
a. Lateral and anterior
2. Reticulospinal tracts
a. Lateral, anterior and medial
3. Rubrospinal tract
11.3 Clinical Application: Spinal Cord Injuries
11.5: Brain
A. Functions of the brain:
1. Interprets sensations
2. Determines perception
3. Stores memory
4. Reasoning
5. Makes decisions
6. Coordinates muscular movements
7. Regulates visceral activities
8. Determines personality
B. Major parts of the brain:
1. Cerebrum
a. Frontal lobes
b. Parietal lobes
c. Occipital lobes
d. Temporal lobes
e. Insula
2. Diencephalon
3. Cerebellum
4. Brainstem
a. Midbrain
b. Pons
c. Medulla oblongata
Brain Development
A. Neural tube
B. Three primary vesicles:
1. Forebrain (Prosencephalon)
2. Midbrain (Mesencephalon)
3. Hindbrain (Rhombencephalon)
C. Five secondary vesicles:
1. Telencephalon
2. Diencephalon
3. Mesencephalon
4. Metencephalon
5. Myelencephalon
Structure of the Cerebrum
A. Corpus callosum
1. Connects cerebral hemispheres (a commissure)
B. Gyri
1. Bumps or convolutions
C. Sulci
1. Grooves in gray matter
a. Central sulcus of Rolando
D. Fissures
1. Longitudinal: separates the cerebral hemispheres
2. Transverse: separates cerebrum from cerebellum
3. Lateral fissure of Sylvius

Lobes of the Cerebrum
A. Five (5) lobes bilaterally:
1. Frontal lobe
2. Parietal lobe
3. Temporal lobe
4. Occipital lobe
5. Insula aka Island of Reil
Functions of the Cerebrum
A. Interpreting impulses
B. Initiating voluntary movements
C. Storing information as memory
D. Retrieving stored information
E. Reasoning
F. Seat of intelligence and personality
Functional Regions of the Cerebral Cortex
A. Cerebral cortex
1. Thin layer of gray matter that constitutes the outermost portion of
cerebrum
2. Contains 75% of all neurons in the nervous system
Functions of the Cerebral Lobes
Sensory Areas (post-central sulcus)
A. Cutaneous sensory area
1. Parietal lobe
2. Interprets sensations on skin
B. Visual area
1. Occipital lobe
2. Interprets vision
C. Auditory area
1. Temporal lobe
2. Interprets hearing
D. Sensory area for taste
1. Near base of the central sulcus
E. Sensory area for smell
1. Arises from centers deep within the cerebrum
Association Areas
A. Regions that are not primary motor or primary sensory areas
B. Widespread throughout the cerebral cortex
C. Analyze and interpret sensory experiences
D. Provide memory, reasoning, verbalization, judgment, emotions
E. Association areas:
1. Frontal lobe association areas
a. Concentrating
b. Planning
c. Complex problem solving
2. Parietal lobe association areas
a. Understanding speech
b. Choosing words to express thought
3. Temporal lobe association areas
a. Interpret complex sensory experiences
b. Store memories of visual scenes, music, and complex patterns
4. Occipital lobe association areas
a. Analyze and combine visual images with other sensory
experiences
Motor Areas (pre-central sulcus)
A. Primary motor areas
1. Frontal lobes
2. Control voluntary muscles
B. Brocas area
1. Anterior to primary motor cortex
2. Usually in left hemisphere
3. Controls muscles needed for speech
C. Frontal eye field
1. Above Brocas area
2. Controls voluntary movements of eyes and eyelids
Hemisphere Dominance
A. The left hemisphere is dominant in most individuals
1. Dominant hemisphere controls:
a. Speech
b. Writing
c. Reading
d. Verbal skills
e. Analytical skills
f. Computational skills
2. Nondominant hemisphere controls:
a. Nonverbal tasks
b. Motor tasks
c. Understanding and interpreting musical and visual patterns
d. Provides emotional and intuitive thought processes
Memory
A. Short term memory
1. Working memory
2. Closed neuronal circuit
3. Circuit is stimulated over and over
4. When impulse flow ceases, memory does also unless it enters long-term
memory via memory consolidation
B. Long term memory
1. Changes structure or function of neurons
2. Enhances synaptic transmission
11.4 Clinical Application: Traumatic Brain Injury
Basal Nuclei
A. Masses of gray matter
B. Deep within cerebral hemispheres

C. Caudate nucleus, putamen, and globus pallidus
D. Produce dopamine
E. Control certain muscular activities
1. Primarily by inhibiting motor functions
Diencephalon
A. Between cerebral hemispheres and above the brainstem
B. Surrounds the third ventricle
C. Includes:
1. Thalamus
a. Gateway for sensory impulses heading to cerebral cortex
b. Receives all sensory impulses (except smell)
c. Channels impulses to appropriate part of cerebral cortex for
interpretation
2. Epithalamus
3. Hypothalamus
a. Maintains homeostasis by regulating visceral activities
b. Links nervous and endocrine systems (hence some say the
neuroendocrine system
4. Optic tracts
5. Optic chiasm
6. Infundibulum
7. Posterior pituitary
8. Mammillary bodies
9. Pineal gland
10. The Limbic System consists of:
a. Portions of frontal lobe
b. Portions of temporal lobe
c. Hypothalamus
d. Thalamus
e. Basal nuclei
f. Other deep nuclei
g. Functions:
1.) Controls emotions
2.) Produces feelings
3.) Interprets sensory impulses
11.5 Clinical Application: Parkinson Disease
Brainstem
A. Three parts:
1. Midbrain
2. Pons
3. Medulla Oblongata
Midbrain
A. Between diencephalon and pons
B. Contains bundles of fibers that join lower parts of brainstem and spinal cord
with higher part of brain
C. Cerebral aqueduct
D. Cerebral peduncles (bundles of nerve fibers)
E. Corpora quadrigemina (centers for visual and auditory reflexes)
Pons
A. Rounded bulge on underside of brainstem
B. Between medulla oblongata and midbrain
C. Helps regulate rate and depth of breathing
D. Relays nerve impulses to and from medulla oblongata and cerebellum
Medulla Oblongata
A. Enlarged continuation of spinal cord
B. Conducts ascending and descending impulses between brain and spinal cord
C. Contains cardiac, vasomotor, and respiratory control centers
D. Contains various nonvital reflex control centers (coughing, sneezing,
swallowing, and vomiting)
Reticular Formation
A. Complex network of nerve fibers scattered throughout the brain stem
B. Extends into the diencephalon
C. Connects to centers of hypothalamus, basal nuclei, cerebellum, and cerebrum
D. Filters incoming sensory information
E. Arouses cerebral cortex into state of wakefulness
Types of Sleep
A. Slow wave
1. Non-REM sleep
2. Person is tired
3. Decreasing activity of reticular system
4. Restful
5. Dreamless
6. Reduced blood pressure and respiratory rate
7. Ranges from light to heavy
8. Alternates with REM sleep
B. Rapid Eye Movement (REM)
1. Paradoxical sleep
2. Some areas of brain active
3. Heart and respiratory rates irregular
4. Dreaming occurs
Cerebellum
A. Inferior to occipital lobes
B. Posterior to pons and medulla oblongata
C. Two hemispheres
D. Vermis connects hemispheres
E. Cerebellar cortex (gray matter)
F. Arbor vitae (white matter)
G. Cerebellar peduncles (nerve fiber tracts)
H. Dentate nucleus (largest nucleus in cerebellum)
I. Integrates sensory information concerning position of body parts
J. Coordinates skeletal muscle activity
K. Maintains posture
11.6 Clinical Application: Brain Waves
11.6: Peripheral Nervous System
A. Cranial nerves arising from the brain
1. Somatic fibers connecting to the skin and skeletal muscles
2. Autonomic fibers connecting to viscera
B. Spinal nerves arising from the spinal cord
1. Somatic fibers connecting to the skin and skeletal muscles
2. Autonomic fibers connecting to viscera
Nerve and Nerve Fiber Classification
A. Sensory nerves
1. Conduct impulses into brain or spinal cord
B. Motor nerves
1. Conduct impulses to muscles or glands
C. Mixed (both sensory and motor) nerves
1. Contain both sensory nerve fibers and motor nerve fibers
2. Most nerves are mixed nerves
3. ALL spinal nerves are mixed nerves (except the first pair)
Nerve Fiber Classification
A. General somatic efferent (GSE) fibers
1. Carry motor impulses from CNS to skeletal muscles
B. General visceral efferent (GVE) fibers
1. Carry motor impulses away from CNS to smooth muscles and glands
C. General somatic afferent (GSA) fibers
1. Carry sensory impulses to CNS from skin and skeletal muscles
D. General visceral afferent (GVA) fibers
1. Carry sensory impulses to CNS from blood vessels and internal organs
E. Special somatic efferent (SSE) fibers
1. Carry motor impulses from brain to muscles used in chewing,
swallowing, speaking and forming facial expressions
F. Special visceral afferent (SVA) fibers
1. Carry sensory impulses to brain from olfactory and taste receptors
G. Special somatic afferent (SSA) fibers
1. Carry sensory impulses to brain from receptors of sight, hearing and
equilibrium
Cranial Nerves
A. Remember:
1. Cranial nerves are designated C N
2. Cranial nerves are designated with Roman numerals (I XII)
Cranial Nerves I and II
A. Olfactory nerve (CN I)
1. Sensory nerve
2. Fibers transmit impulses associated with smell
B. Optic nerve (CN II)
1. Sensory nerve
2. Fibers transmit impulses associated with vision
Cranial Nerves III and IV

A. Oculomotor nerve (CN III)
1. Primarily motor nerve
2. Motor impulses to muscles that:
a. Raise eyelids
b. Move the eyes
c. Focus lens
d. Adjust light entering eye
3. Some sensory
a. Proprioceptors
B. Trochlear nerve (CN IV)
2. Motor impulses to muscles that move the eyes
3. Some sensory
a. Proprioceptors
Cranial Nerve V
A. Trigeminal nerve (CN V)
1. Mixed nerve
2. Three (3) sisters
a. Ophthalmic division
1.) Sensory from surface of eyes, tear glands, scalp,
forehead, and upper eyelids
b. Maxillary division
1.) Sensory from upper teeth, upper gum, upper lip, palate,
and skin of face
c. Mandibular division
1.) Sensory from scalp, skin of jaw, lower teeth, lower
gum, and lower lip
2.) Motor to muscles of mastication and muscles in floor of
mouth
Cranial Nerves VI and VII
A. Abducens nerve (CN VI)
2. Motor impulses to muscles that move the eyes
3. Some sensory
a. Proprioceptors
B. Facial nerve (CN VII)
1. Mixed nerve
2. Sensory from taste receptors
3. Motor to muscles of facial expression, tear glands, and salivary glands
Cranial Nerves VIII and IX
A. Vestibulocochlear nerve (CN VIII)
1. Aka acoustic or auditory nerve
2. Sensory nerve
3. Two (2) branches:
a. Vestibular branch
1.) Sensory from equilibrium receptors of ear

b. Cochlear branch
1.) Sensory from hearing receptors
B. Glossopharyngeal nerve (CN IX)
1. Mixed nerve
2. Sensory from pharynx, tonsils, tongue and carotid arteries
3. Motor to salivary glands and muscles of pharynx
Cranial Nerve X
A. Vagus nerve (CN X)
1. Mixed nerve
2. Somatic motor to muscles of speech and swallowing
3. Autonomic motor to viscera of thorax and abdomen
4. Sensory from pharynx, larynx, esophagus, and viscera of thorax and
abdomen
Cranial Nerves XI and XII
A. Accessory nerve (CN XI)
2. We called this Spinal Accessory because:
a. Cranial branch
1.) Motor to muscles of soft palate, pharynx and larynx
b. Spinal branch
1.) Motor to muscles of neck and back
2.) Some sensory
a.) Proprioceptor
B. Hypoglossal nerve (CN XII)
1. Primarily motor
2. Motor to muscles of the tongue
3. Some sensory
a. Proprioceptor
Spinal Nerves
A. ALL are mixed nerves (except the first pair)
B. 31 pairs of spinal nerves:
1. 8 cervical nerves
a. (C1 to C8)
2. 12 thoracic nerves
a. (T1 to T12)
3. 5 lumbar nerves
a. (L1 to L5)
4. 5 sacral nerves
a. (S1 to S5)
5. 1 coccygeal nerve
a. (Co or Cc)
Dermatome
A. An area of skin that the sensory nerve fibers of a particular spinal nerve
innervate
Spinal Nerves
A. Dorsal root (aka posterior root)

1. Sensory root
2. Axons of sensory neurons are in the dorsal root ganglion
B. Dorsal root ganglion
1. Aka DRG
2. Cell bodies of sensory neurons whose axons conduct impulses inward
from peripheral body parts
C. Ventral root (aka anterior root)
1. Motor root
2. Axons of motor neurons whose cell bodies are in the spinal cord
D. Spinal nerve
1. Union of ventral root and dorsal roots
2. Hence we now have a mixed nerve
Nerve Plexuses
A. Nerve plexus
1. Complex networks formed by anterior branches of spinal nerves
2. The fibers of various spinal nerves are sorted and recombined
3. There are three (3) nerve plexuses:
a. Cervical plexus
1.) Formed by anterior branches of C1-C4 spinal nerves
2.) Lies deep in the neck
3.) Supply to muscles and skin of the neck
4.) C3-C4-C5 nerve roots contribute to phrenic nerves
bilaterally
b. Brachial plexus
1.) Formed by anterior branches C5-T1
2.) Lies deep within shoulders
3.) There are five (5) branches:
a.) Musculocutaneous nerve
i. Supply muscles of anterior arms and skin
of forearms
b.) Ulnar and c). Median nerves
i. Supply muscles of forearms and hands
ii. Supply skin of hands
d.) Radial nerve
i. Supply posterior muscles of arms and skin
of forearms and hands
e.) Axillary nerve
i. Supply muscles and skin of anterior,
lateral, and posterior arms
c. Lumbosacral plexus
1.) Formed by the anterior branches of L1-S5 roots
2.) Can be a lumbar (L1-L5) plexus and a sacral (S1-S5)
plexus
3.) Extends from lumbar region into pelvic cavity
4.) Obturator nerve
a.) Supply motor impulses to adductors of thighs

5.) Femoral nerve
a.) Supply motor impulses to muscles of anterior
thigh and sensory impulses from skin of thighs and
legs
6.) Sciatic nerve
a.) Supply muscles and skin of thighs, legs and feet
11.7 Clinical Application: Spinal Nerve Injuries
11.7: Autonomic Nervous System
A. Functions without conscious effort
B. Controls visceral activities
C. Regulates smooth muscle, cardiac muscle, and glands
D. Efferent fibers typically lead to ganglia outside of the CNS
E. Two autonomic divisions regulate:
1. Sympathetic division (speeds up)
a. Prepares body for fight or flight situations
2. Parasympathetic division (slows down)
a. Prepares body for resting and digesting activities
Autonomic Nerve Fibers
A. All of the neurons are motor (efferent)
1. Preganglionic fibers
a. Axons of preganglionic neurons
b. Neuron cell bodies in CNS
2. Postganglionic fibers
a. Axons of postganglionic neurons
b. Neuron cell bodies in ganglia
Sympathetic Division
A. Thoracolumbar division location of preganglionic neurons
B. Preganglionic fibers leave spinal nerves through white rami and enter
paravertebral ganglia
C. Paravertebral ganglia and fibers that connect them make up the sympathetic
trunk
D. Postganglionic fibers extend from sympathetic ganglia to visceral organs
E. Postganglionic fibers usually pass through gray rami and return to a spinal
nerve before proceeding to an effector
F. Exception: preganglionic fibers to adrenal medulla do not synapse with
postganglionic neurons
Parasympathetic Division
A. Craniosacral division location of preganglionic neurons
B. Ganglia are near or within various organs
1. Terminal ganglia
C. Short postganglionic fibers
1. Continue to specific muscles or glands
D. Preganglionic fibers of the head are included in nerves III, VII, and IX
E. Preganglionic fibers of thorax and abdomen are parts of nerve X
Autonomic Neurotransmitters
A. Cholinergic fibers
1. Release acetylcholine
2. Preganglionic sympathetic and parasympathetic fibers
3. Postganglionic parasympathetic fibers
B. Adrenergic fibers
1. Release norepinephrine
2. Most postganglionic sympathetic fibers
Actions of Autonomic Neurotransmitters
A. Result from binding to protein receptors in the membrane of effector cells:
1. Cholinergic receptors
a. Bind to acetylcholine (Ach)
b. Muscarinic
1.) Excitatory
2.) Slow
c. Nicotinic
1.) Excitatory
2.) Rapid
2. Adrenergic receptors
a. Bind to epinephrine and norepinephrine
b. Alpha and beta
1.) Both elicit different responses on various effectors
Terminating Autonomic Neurotransmitter Actions
A. The enzyme acetylcholinesterase rapidly decomposes the acetylcholine that
cholinergic fibers release.
B. Norepinephrine from adrenergic fibers is removed by active transport.
Control of Autonomic Activity
A. Controlled largely by CNS
B. Medulla oblongata regulates cardiac, vasomotor and respiratory activities
C. Hypothalamus regulates visceral functions, such as body temperature, hunger,
thirst, and water and electrolyte balance
D. Limbic system and cerebral cortex control emotional responses
A. Brain cells begin to die before birth
B. Over average lifetime, brain shrinks 10%
C. Most cell death occurs in temporal lobes
D. By age 90, frontal cortex has lost half its neurons
E. Number of dendritic branches decreases
F. Decreased levels of neurotransmitters
G. Fading memory
H. Slowed responses and reflexes
I. Increased risk of falling
J. Changes in sleep patterns that result in fewer sleeping hours
11.1: Introduction
Describe the general structure of the brain.
Describe the relationship among the brain, brainstem, and spinal cord.
11.2: Meninges
Describe the coverings of the brain and spinal cord.
11.3: Ventricles and Cerebrospinal Fluid
Describe the formation and function of cerebrospinal fluid.
11.4: Spinal Cord
Describe the structure of the spinal cord and its major functions.
Describe a reflex arc.
Describe reflex behavior.
11.5: Brain
Name the major parts of the brain and describe the functions of each.
Distinguish among motor, sensory, association areas of the cerebral cortex.
Explain hemisphere dominance.
Explain stages in memory storage.
Explain the functions of the limbic system and reticular formation.
11.6: Peripheral Nervous System
List the major parts of the peripheral nervous system.
Describe the structure of a peripheral nerve and how its fibers are classified.
Name the cranial nerves and list their major functions.
Explain how spinal nerves are named and their functions
11.7: Autonomic Nervous System
Describe the general characteristics of the autonomic nervous system.
Distinguish between the sympathetic and the parasympathetic divisions of the
autonomic nervous system.
Describe a sympathetic and a parasympathetic nerve pathway.
Explain how the autonomic neurotransmitters differently affect visceral effectors

Twelfth Edition
Chapter 12 Outline
12.1: Introduction
A. General senses
1. Receptors that are widely distributed throughout the body
2. Skin, various organs and joints
B. Special senses
1. Specialized receptors confined to structures in the head
2. Eyes, ears, nose and mouth
12.2: Receptors, Sensation, and Perception
A. Sensory receptors
1. Specialized cells or multicellular structures that collect information
from the environment
2. Stimulate neurons to send impulses along sensory fibers to the brain
B. Sensation
1. A feeling that occurs when brain becomes aware of sensory impulse
C. Perception
1. A persons view of the stimulus; the way the brain interprets the
information
Receptor Types
A. Chemoreceptors
1. Respond to changes in chemical concentrations
B. Pain receptors (nociceptors)
1. Respond to tissue damage
C. Thermoreceptors
1. Respond to changes in temperature
D. Mechanoreceptors
1. Respond to mechanical forces
E. Photoreceptors
1. Respond to light
Sensory Impulses
A. Stimulation of receptor causes local change in its receptor potential
B. A graded electrical current is generated that reflects intensity of stimulation
C. If receptor is part of a neuron, the membrane potential may generate an action
potential
D. If receptor is not part of a neuron, the receptor potential must be transferred to
a neuron to trigger an action potential
E. Peripheral nerves transmit impulses to CNS where they are analyzed and
interpreted in the brain
Sensations and Perception
A. Projection
1. Process in which the brain projects the sensation back to the apparent
source
2. It allows a person to pinpoint the region of stimulation

Sensory Adaptation
A. Ability to ignore unimportant stimuli
B. Involves a decreased response to a particular stimulus from the receptors
(peripheral adaptation) or along the CNS pathways leading to the cerebral cortex
(central adaptation)
C. Sensory impulses become less frequent and may cease
D. Stronger stimulus is required to trigger impulses
12.3: General Senses
A. Senses associated with skin, muscles, joints and viscera
B. Three (3) groups:
1. Exteroceptive senses (exteroceptors)
a. Senses associated with body surface such as touch, pressure,
temperature, and pain
2. Visceroceptive senses (interoceptors)
a. Senses associated with changes in the viscera such as blood
pressure stretching blood vessels and ingestion of a meal
3. Proprioceptive senses
a. Senses associated with changes in muscles and tendons such as
at joints
Touch and Pressure Senses
A. Free nerve endings
1. Common in epithelial tissues
2. Simplest receptors
3. Sense itching
B. Tactile (Meissners) corpuscles
1. Abundant in hairless portions of skin and lips
2. Detect fine touch; distinguish between two points on the skin
C. Lamellated (Pacinian) corpuscles
1. Common in deeper subcutaneous tissues, tendons and ligaments
2. Detect heavy pressure and vibrations
Temperature Senses
A. Warm receptors
1. Sensitive to temperatures above 25oC (77o F)
2. Unresponsive to temperature above 45oC (113oF)
B. Cold receptors
1. Sensitive to temperatures between 10oC (50oF) and 20oC (68oF)
C. Pain receptors
1. Respond to temperatures below 10oC
2. Respond to temperatures above 45oC
Sense of Pain
A. Free nerve endings
B. Widely distributed
C. Nervous tissue of brain lacks pain receptors
D. Stimulated by tissue damage, chemical, mechanical forces, or extremes in
temperature
E. Adapt very little, if at all

Visceral Pain
A. Pain receptors are the only receptors in viscera whose stimulation produces
sensations
B. Pain receptors respond differently to stimulation
C. Pain receptors are not well localized
D. Pain receptors may feel as if coming from some other part of the body
E. Known as referred pain
Referred Pain
A. May occur due to sensory impulses from two regions following a common
nerve pathway to brain
Pain Nerve Pathways
A. Acute pain fibers
1. A-delta fibers
2. Thin, myelinated
3. Conduct impulses rapidly
4. Associated with sharp pain
5. Well localized
B. Chronic pain fibers
1. C fibers
2. Thin, unmyelinated
3. Conduct impulses more slowly
4. Associated with dull, aching pain
5. Difficult to pinpoint
Regulation of Pain Impulses
A. Thalamus
1. Allows person to be aware of pain
B. Cerebral cortex
1. Judges intensity of pain
2. Locates source of pain
3. Produces emotional and motor responses to pain
C. Pain inhibiting substances:
1. Enkephalins
2. Serotonin
3. Endorphins
12.1 Clinical Application: Treating Pain
Proprioception
A. Mechanoreceptors
B. Send information to spinal cord and CNS about body position and length, and
tension of muscles
C. Main kinds of proprioceptors:
1. Pacinian corpuscles in joints
2. Muscle spindles in skeletal muscles*
3. Golgi tendon organs in tendons*
*considered to be stretch receptors
Stretch Receptors
Visceral Senses
A. Receptors in internal organs
B. Convey information that includes the sense of fullness after eating a meal as
well as the discomfort of intestinal gas and the pain that signals a heart attack
12.4: Special Senses
A. Sensory receptors are within large, complex sensory organs in the head
B. Smell in olfactory organs
C. Taste in taste buds
D. Hearing and equilibrium in ears
E. Sight in eyes
Sense of Smell
A. Olfactory receptors
1. Chemoreceptors
2. Respond to chemicals dissolved in liquids
B. Olfactory organs
1. Contain olfactory receptors and supporting epithelial cells
2. Cover parts of nasal cavity, superior nasal conchae, and a portion of the
nasal septum
Olfactory Nerve Pathways
A. Once olfactory receptors are stimulated, nerve impulses travel through
B. Olfactory nerves to - olfactory bulbs to - olfactory tracts to limbic
system (for emotions) and olfactory cortex (for interpretation)
Olfactory Stimulation
A. Olfactory organs located high in the nasal cavity above the usual pathway of
inhaled air
B. Olfactory receptors undergo sensory adaptation rapidly
C. Sense of smell drops by 50% within a second after stimulation
D. Olfactory code
1. Hypothesis
2. Odor that is stimulated by a distinct set of receptor cells and its
associated receptor proteins
12.2 Clinical Application: Mixed-Up Senses: Synesthesia
Sense of Taste
A. Taste buds
1. Organs of taste
2. Located on papillae of tongue, roof of mouth, linings of cheeks and
walls of pharynx
B. Taste receptors
1. Chemoreceptors
2. Taste cells modified epithelial cells that function as receptors
3. Taste hairs microvilli that protrude from taste cells; sensitive parts of
taste cells
Taste Sensations
A. Four primary taste sensations
1. Sweet stimulated by carbohydrates
2. Sour stimulated by acids
3. Salty stimulated by salts

4. Bitter stimulated by many organic compounds
B. Spicy foods activate pain receptors
Taste Nerve Pathways
A. Sensory impulses from taste receptors travel along:
1. Cranial nerves to
2. Medulla oblongata to
3. Thalamus to
4. Gustatory cortex (for interpretation)
12.3 Clinical Application: Smell and Taste Disorders
Sense of Hearing
A. Ear
1. Organ of hearing
B. Three (3) sections:
1. External ear
2. Middle ear
3. Inner ear
External Ear
A. Auricle
1. Collects sound waves
B. External auditory meatus
1. Lined with ceruminous glands
2. Carries sound to tympanic membrane
3. Terminates with tympanic membrane
C. Tympanic membrane
1. Vibrates in response to sound waves
Middle Ear
A. Tympanic cavity
1. Air-filled space in temporal bone
B. Auditory ossicles
1. Vibrate in response to tympanic membrane
2. Malleus, incus and stapes
3. Hammer, anvil and stirrup
C. Oval window
1. Opening in wall of tympanic cavity
2. Stapes vibrates against it to move fluids in inner ear
Auditory Tube
A. Also known as the Eustachian tube
B. Connects middle ear to throat
C. Helps maintain equal pressure on both sides of tympanic membrane
D. Usually closed by valve-like flaps in throat
Inner Ear
A. Complex system of labyrinths
1. Osseous labyrinth
a. Bony canal in temporal bone
b. Filled with perilymph
2. Membranous labyrinth
a. Tube within osseous labyrinth
b. Filled with endolymph
B. Three (3) parts of labyrinths:
1. Cochlea
a. Functions in hearing
2. Semicircular canals
a. Functions in equilibrium
3. Vestibule
a. Functions in equilibrium
Cochlea
A. Scala vestibuli
1. Upper compartment
2. Leads from oval window to apex of spiral
3. Part of bony labyrinth
B. Scala tympani
1. Lower compartment
2. Extends from apex of the cochlea to round window
3. Part of bony labyrinth
C. Cochlear duct
1. Portion of membranous labyrinth in cochlea
D. Vestibular membrane
1. Separates cochlear duct from scala vestibuli
E. Basilar membrane
1. Separates cochlear duct from scala tympani
12.4 Clinical Application: Getting a Cochlear Implant
Organ of Corti
A. Group of hearing receptor cells (hair cells)
B. On upper surface of basilar membrane
C. Different frequencies of vibration move different parts of basilar membrane
D. Particular sound frequencies cause hairs of receptor cells to bend
E. Nerve impulse generated
12.5 Clinical Application: Hearing Loss
Sense of Equilibrium
A. Static equilibrium
1. Vestibule
2. Senses position of head when body is not moving
B. Dynamic Equilibrium
1. Semicircular canals
2. Senses rotation and movement of head and body
Vestibule
A. Utricle
1. Communicates with saccule and membranous portion of semicircular
canals
B. Saccule
1. Communicates with cochlear duct
C. Macula
1. Hair cells of utricle and saccule
Macula
A. Responds to changes in head position
B. Bending of hairs results in generation of nerve impulse
Semicircular Canals
A. Three (3) canals at right angles
1. Ampulla
a. Swelling of membranous labyrinth that communicates with the
vestibule
2. Crista ampullaris
a. Sensory organ of ampulla
b. Hair cells and supporting cells
c. Rapid turns of head or body stimulate hair cells
Sense of Sight
A. Visual accessory organs
1. Eyelids
2. Lacrimal apparatus
3. Extrinsic eye muscles
Eyelid
A. Palpebra
B. Composed of four (4) layers:
1. Skin
2. Muscle
3. Connective tissue
4. Conjunctiva
C. Orbicularis oculi closes eyelid
D. Levator palpebrae superioris opens eyelid
E. Tarsal glands secrete oil onto eyelashes
F. Conjunctiva mucous membrane; lines eyelid and covers portion of eyeball
Lacrimal Apparatus
A. Lacrimal gland
1. Lateral to eye
2. Secretes tears
B. Canaliculi
1. Collect tears
C. Lacrimal sac
1. Collects from canaliculi
D. Nasolacrimal duct
1. Collects from lacrimal sac
2. Empties tears into nasal cavity
Extrinsic Eye Muscles
A. Superior rectus
1. Rotates eye up and medially
B. Inferior rectus
1. Rotates eye down and medially
C. Medial rectus
1. Rotates eye medially
D. Lateral rectus
1. Rotates eye laterally
E. Superior oblique
1. Rotates eye down and laterally
F. Inferior oblique
1. Rotates eye up and laterally
Structure of the Eye
A. Hollow
B. Spherical
C. Wall has three (3) layers:
1. Outer fibrous tunic
2. Middle vascular tunic
3. Inner nervous tunic
Outer Tunic
A. Cornea
1. Anterior portion
2. Transparent
3. Light transmission
4. Light refraction
B. Sclera
1. Posterior portion
2. Opaque
3. Protection
Middle Tunic
A. Iris
1. Anterior portion
2. Pigmented
3. Controls light intensity
B. Ciliary body
1. Anterior portion
2. Pigmented
3. Holds lens
4. Moves lens for focusing
C. Choroid coat
1. Provides blood supply
2. Pigments absorb extra light
Anterior Portion of Eye
A. Filled with aqueous humor
Lens
A. Transparent
B. Biconvex
C. Lies behind iris
D. Largely composed of lens fibers
E. Elastic
F. Held in place by suspensory ligaments of ciliary body

Ciliary Body
A. Forms internal ring around the front of the eye
B. Ciliary processes radiating folds
C. Ciliary muscles contract and relax to move lens
Accommodation
A. Changing of lens shape to view objects
Iris
A. Composed of connective tissue and smooth muscle
B. Pupil is hole in iris
C. Dim light stimulates radial muscles and pupil dilates
D. Bright light stimulates circular muscles and pupil constricts
Aqueous Humor
A. Fluid in anterior cavity of eye
B. Secreted by epithelium on inner surface of the ciliary body
C. Provides nutrients
D. Maintains shape of anterior portion of eye
E. Leaves cavity through Canal of Schlemm
Inner Tunic
A. Retina
B. Contains visual receptors
C. Continuous with optic nerve
D. Ends just behind margin of the ciliary body
E. Composed of several layers
F. Macula lutea yellowish spot in retina
G. Fovea centralis center of macula lutea; produces sharpest vision
H. Optic disc blind spot; contains no visual receptors
I. Vitreous humor thick gel that holds retina flat against choroid coat
Posterior Cavity
A. Contains vitreous humor thick gel that holds retina flat against choroid coat
Major Groups of Retinal Neurons
A. Receptor cells, bipolar cells, and ganglion cells - provide pathway for impulses
triggered by photoreceptors to reach the optic nerve
B. Horizontal cells and amacrine cells modify impulses
Light Refraction
A. Refraction
1. Bending of light
2. Occurs when light waves pass at an oblique angle into mediums of
different densities
Types of Lenses
A. Convex lenses cause light waves to converge
B. Concave lenses cause light waves to diverge
Focusing On Retina
A. As light enters eye, it is refracted by:
1. Convex surface of cornea
2. Convex surface of lens
B. Image focused on retina is upside down and reversed from left to right
Visual Receptors
A. Rods
1. Long, thin projections
2. Contain light sensitive pigment called rhodopsin
3. Hundred times more sensitive to light than cones
4. Provide vision in dim light
5. Produce colorless vision
6. Produce outlines of objects
B. Cones
1. Short, blunt projections
2. Contain light sensitive pigments called erythrolabe, chlorolabe, and
cyanolabe
3. Provide vision in bright light
4. Produce sharp images
5. Produce color vision
12.6 Clinical Application: Refraction Disorders
Visual Pigments
A. Rhodopsin
1. Light-sensitive pigment in rods
2. Decomposes in presence of light
3. Triggers a complex series of reactions that initiate nerve impulses
4. Impulses travel along optic nerve
B. Pigments on cones
1. Each set contains different light-sensitive pigment
2. Each set is sensitive to different wavelengths
3. Color perceived depends on which sets of cones are stimulated
4. Erythrolabe responds to red
5. Chlorolabe responds to green
6. Cyanolabe responds to blue
Stereoscopic Vision
A. Provides perception of distance and depth
B. Results from formation of two slightly different retinal images
A. Age related hearing loss due to:
1. Damage of hair cells in organ of Corti
2. Degeneration of nerve pathways to the brain
3. Tinnitus
B. Age-related visual problems include:
1. Dry eyes
2. Floaters (crystals in vitreous humor)
3. Loss of elasticity of lens
4. Glaucoma
5. Cataracts
6. Macular degeneration
12.1: Introduction
Explain the difference between general senses and special senses.
12.2: Receptors, Sensation, and Perception
Name the five types of receptors and state the function of each.
Explain how receptors stimulate sensory impulses.
Explain how a sensation is produced.
12.3: General Senses
Distinguish between general and special senses.
Describe the differences among receptors associated with the senses of touch,
pressure, temperature, and pain.
Describe how the sensation of pain is produced.
Explain the importance of stretch receptors in muscles and tendons.
12.4: Special Senses
Explain the relationship between the senses of smell and taste.
Name the parts of the ear and the function of each part.
Distinguish between static and dynamic equilibrium.
Name the parts of the eye and the function of each part.
Explain how the eye refracts light.
Explain how the brain perceives depth and distance.
Draw a diagram of the visual nerve pathways.

Twelfth Edition
Chapter 13 Outline
13.1 Introduction
A. The endocrine system assists the nervous system with communication and
control of the body
B. The cells, tissues, and organs are called endocrine glands
1. They are ductless
2. They use the bloodstream
3. They secrete hormones
4. There are also similar glands called paracrine and autocrine glands that are
quasi-endocrine
C. Other glands that secrete substances are the exocrine glands
1. They have ducts
2. They deliver their products directly to a specific site
Review Figure 13.1
13.2: General Characteristics of the Endocrine System
A. The endocrine and nervous systems communicate using chemical signals
1. Neurons release neurotransmitters into a synapse affecting postsynaptic
cells
2. Endocrine glands release hormones into the bloodstream to specific target
cell receptors
Animation: Hormonal Communication
Review Figure 13.2
Review Table 13.1
13.3: Hormone Action
A. Hormones are released into the extracellular spaces surrounding endocrine
cells
B. Review Figure 13.3
Chemistry of Hormones
A. Chemically, hormones are either:
1. Steroid or steroid-like hormones such as:
a. Sex hormones
b. Adrenal cortex hormones
2. Non-steroid hormones such as:
a. Amines
b. Proteins
c. Peptides
d. Glycoproteins
Review Figure 13.4
Review Table 13.2
Review Table 13.3
Action of Hormones
A. Steroids
Review Table 13.4
Review Figure 13.5
Animation: Mechanism of Steroid Hormone Action
Action of Hormones
Non-steroid hormones
Review Table 13.5
Review Figure 13.7
Animation: Peptide Hormone Action
13.1 Clinical Application
Prostaglandins
A. Prostaglandins:
1. Are paracrine substances
2. Act locally
3. Are very potent in small amounts
4. Are not stored in cells but synthesized just before release
5. Rapidly inactivate
6. Regulate cellular responses to hormones
7. Can activate or inhibit adenylate cyclase
a. Controls cAMP production
b. Alters a cells response to hormones
8. Has a wide variety of effects
13.4: Control of Hormonal Secretions
A. Primarily controlled by negative feedback mechanism
B. Hormones can be short-lived or may last for days
C. Hormone secretions are precisely regulated
Control Sources
Review Figure 13.10
Control Sources
Review Figure 13.8
13.5: Pituitary Gland
A. Lies at the base of the brain in the sella turcica
B. Consists of two distinct portions:
1. Anterior pituitary (adenohypophysis)
2. Posterior pituitary (neurohypophysis)
Review Figure 13.9
Anterior Pituitary Hormones
A. Hypothalamic releasing hormones stimulate cells of anterior pituitary to
release hormones
B. Nerve impulses from hypothalamus stimulate nerve endings in the posterior
pituitary gland to release hormones
Review Figure 13.12
Review Figures 13.13 and 13.14
Review Figure 13.15
Posterior Pituitary Hormones
A. Structurally consists of nerve fibers and neuroglia v. glandular epithelial cells

of the anterior pituitary gland
B. The nerve fibers originate in the hypothalamus
C. Two hormones are produced:
1. Antidiuretic hormone (vasopressin)
2. Oxytocin
Review Table 13.6
13.6: Thyroid Gland
A. The thyroid gland has two lateral lobes and lies just below the larynx
B. It produces three hormones:
1. T3 (thyroxine)
2. T4 (triiodothyronine)
3. Calcitonin
Structure of the Gland
Thyroid Hormones
Review Figure 13.20 and Table 13.7
Review Table 13.8 and Figures 13.21, 13.22, and 13.23
13.7: Parathyroid Glands
A. The parathyroid glands are on the posterior surface of the thyroid gland
B. There are typically four parathyroid glands
C. It secretes one hormone:
1. PTH (parathyroid hormone or parathormone)
Structure of the Glands
Parathyroid Hormone
Review Figure 13.26
Review Figure 13.27
Review Table 13.9
13.8: Adrenal Glands
A. The adrenal glands are closely associated with the kidneys
B. The gland sits like a cap on each kidney
C. Hormones are secreted from two different areas of the gland, the adrenal cortex
and the adrenal medulla
D. Numerous hormones are secreted by the adrenal glands
Hormones of the Adrenal Medulla
Review Table 13.10
Hormones of the Adrenal Cortex
Review Table 13.11
Animation: Action of Glucocorticoid Hormone
13.1 From Science to Technology
13.9: Pancreas
A. The pancreas has two major types of secretory tissue
B. This is why it is a dual functioning organ as both an exocrine gland and

endocrine gland
C. Three hormones are secreted from the islet cells:
1. Alpha cells secrete glucagon
2. Beta cells insulin
3. Delta cells secrete somatostatin
Structure of the Glan
Hormones of the Pancreatic Islets
Review Table 13.12
Review Figure 13.36
13.10: Other Endocrine Glands
A. Pineal Gland
1. Secretes melatonin
2. Regulates circadian rhythms
B. Thymus Gland
1. Secretes thymosins
2. Promotes development of certain lymphocytes
3. Important in role of immunity
C. Reproductive Organs
1. Ovaries produce estrogens and progesterone
2. Testes produce testosterone
3. Placenta produces estrogens, progesterone, and gonadotropin
D. Other organs: digestive glands, heart, and kidney
13.11: Stress and Its Effects
A. Survival depends on maintaining homeostasis
B. Factors that change the internal environment are potentially life-threatening
C. Sensing such dangers directs nerve impulses to the hypothalamus
D. This can trigger a loss of homeostasis
Types of Stress
A. Two types of stress:
1. Physical stress
2. Psychological stress
Responses to Stress
Review Figure 13.37
Review Table 13.13
A. Endocrine glands decrease in size
B. Muscular strength decreases as GH levels decrease
C. ADH levels increase due to slower break down in liver and kidneys
D. Calcitonin levels decrease; increase risk of osteoporosis
E. PTH level changes contribute to risk of osteoporosis
F. Insulin resistance may develop
G. Changes in melatonin secretion affect the body clock
H. Thymosin production declines increasing risk of infections
13.1: Introduction
Define hormone.
Distinguish between endocrine and exocrine glands.
13.2: General Characteristics of the Endocrine System
Explain what makes a cell a target cell for a hormone.
List some important functions of hormones.
13.3: Hormone Action
Describe how hormones can be classified according to their chemical
composition.
Explain how steroid and non-steroid hormones affect their target cells.
13.4: Control of Hormone Secretion
Discuss how negative feedback mechanisms regulate hormone secretion.
Explain how the nervous system controls hormone secretion.
13.5-13.10: Pituitary Gland Other Endocrine Glands
Name and describe the locations of the major endocrine glands and list the
hormones that they secrete.
Describe the actions of the various hormones and their contributions to
homeostasis.
Explain how the secretion of each hormone is regulated.
13.11: Stress and Its Effects
Distinguish between physical and psychological stress.
Describe the general stress response.
Describe some of the changes associated with aging of the endocrine system.

Twelfth Edition
Chapter 14 Outline
14.1 Introduction
A. Blood
1. Is connective tissue
2. Transports vital substances
3. Maintains stability of interstitial fluid
4. Distributes heat
B. Blood cells
1. Form mostly in red bone marrow and are:
2. Red blood cells (RBCs)
3. White blood cells (WBCs)
4. Platelets (cell fragments)
C. The amount of blood varies with body size, changes in fluid concentration,
changes in electrolyte concentration, and amount of adipose tissue
D. Blood is about 8% of body weight
E. Adult blood volume is about 5 liters
Review Figure 14.1
Review Figure 14.2
Review Figure 14.3
14.2: Blood Cells
A. Blood cells originate in red marrow from hemocytoblasts or hematopoietic
stem cells
B. Stem cells can then:
1. Give rise to more stem cells
2. Specialize or differentiate
The Origin of Blood Cells
Review Figure 14.4
Characteristics of Red Blood Cells
A. Red blood cells are:
1. Erythrocytes
2. Biconcave discs
3. One-third hemoglobin or:
a. Oxyhemoglobin
b. Deoxyhemoglobin
4. Able to readily squeeze through capillaries
5. Lack nuclei and mitochondria
Review Figure 14.5
Red Blood Cell Counts
A. RBC counts is the number of RBCs in a cubic millimeter or microliter of blood
B. It may vary depending on age and health
C. Typical ranges include:
1. 4,600,000 6,200,000 in males

2. 4,200,000 5,400,000 in adult females
3. 4,500,000 5,100,000 in children
D. RBC counts reflects bloods oxygen carrying capacity
Red Blood Cell Production and Its Control
A. Low blood oxygen causes the kidneys and the liver to release erythropoietin
(EPO) which stimulates RBC production
B. This is a negative feedback mechanism
C. Within a few days many new blood cells appear in the circulating blood
Review Figure 14.6
Dietary Factors Affecting Red Blood Cell Production
A. Vitamin B12 and folic acid are necessary
1. They are required for DNA synthesis making them necessary for the
growth and division of all cells
B. Iron is also necessary
1. It is required for hemoglobin synthesis
Review Table 14.1
Review Figure 14.7
Review Table 14.2 and Figure 14.8
Destruction of Red Blood Cells
Review Table 14.3
Types of White Blood Cells
A. White blood cells:
1. Are leukocytes
2. Protect against disease
3. WBC hormones are interleukins and colony-stimulating factors which
stimulate development
4. There are five types of WBCs in two categories:
a. Granulocytes
1). Neutrophils
2). Eosinophils
3). Basophils
b. Agranulocytes
1). Lymphocytes
2). Monocytes
Neutrophils
A. Light purple granules in acid-base stain
B. Lobed nucleus
C. Other names
1. Segs
2. Polymorphonuclear leukocyte
3. Bands (young neutrophils)
D. First to arrive at infections
E. Phagocytic
F. 54% - 62% of leukocytes
G. Elevated in bacterial infections

Review Figure 14.10
Eosinophils
A. Deep red granules in acid stain
B. Bi-lobed nucleus
C. Moderate allergic reactions
D. Defend against parasitic worm infestations
E. 1% - 3% of leukocytes
F. Elevated in parasitic worm infestations and allergic reactions
Review Figure 14.11
Basophils
A. Deep blue granules in basic stain
B. Release histamine
C. Release heparin
D. Less than 1% of leukocytes
E. Similar to eosinophils in size and shape of nuclei
Review Figure 14.12
Monocytes
A. Largest of all blood cells
B. Spherical, kidney-shaped, oval or lobed nuclei
C. Leave bloodstream to become macrophages
D. 3% - 9% of leukocytes
E. Phagocytize bacteria, dead cells, and other debris
Review Figure 14.13
Lymphocytes
A. Slightly larger than RBC
B. Large spherical nucleus surrounded by thin rim of cytoplasm
C. T cells and B cells
1. Both important in immunity
D. B cells produce antibodies
E. 25% - 33% of leukocytes
Review Figure 14.14
Functions of White Blood Cells
A. WBCs protect against infection
B. These leukocytes can squeeze between the cells of a capillary wall and enter
the tissue space outside the blood vessel (called diapedesis)
Review Figure 14.15
Review Figure 14.16
White Blood Cell Counts
A. A procedure used to count number of WBCs per cubic millimeter of blood
1. Typically 5,000 10,000 per cubic millimeter of blood
B. Leukopenia:
1. Low WBC count (below 5,000)
2. Typhoid fever, flu, measles, mumps, chicken pox, AIDS
C. Leukocytosis:
1. High WBC count (above 10,000)
2. Acute infections, vigorous exercise, great loss of body fluids

D. Differential WBC count
1. Lists percentages of types of leukocytes
2. May change in particular diseases
Review Table 14.4
Blood Platelets
A. Platelets are also known as thrombocytes
B. They are cell fragments of megakaryocytes
C. They lack a nucleus and are roughly half the size of a RBC
D. There are approximately 130,000 360,000 per cubic millimeter of blood
E. They help repair damaged blood vessels by sticking to broken surfaces
Review Table 14.5
14.3: Blood Plasma
A. Blood plasma is:
1. Straw colored
2. The liquid portion of blood
3. 55% of blood volume
4. 92% water
5. Includes transporting nutrients, gases, and vitamins
6. Helps regulate fluid and electrolyte balance and maintain pH
Plasma Proteins
A. These are the most abundant dissolved substances (solutes) in plasma
Review Table 14.6
Gases and Nutrients
A. The most important blood gases:
1. Oxygen
2. Carbon dioxide
B. Plasma nutrients include:
1. Amino acids
2. Simple sugars
3. Nucleotides
4. Lipids
a. Fats (triglycerides)
b. Phospholipids
c. Cholesterol
Nonprotein Nitrogenous Substances
A. These are molecules containing nitrogen but are not proteins
B. In plasma they include:
1. Urea product of protein catabolism; about 50% of nonprotein nitrogenous
substances
2. Uric acid product of nucleic acid catabolism
3. Amino acids product of protein catabolism
4. Creatine stores phosphates
5. Creatinine product of creatine metabolism
6. BUN blood urea nitrogen; indicates health of kidney
Plasma Electrolytes
A. Plasma contains a variety of these ions called electrolytes
B. They are absorbed from the intestine or released as by-products of cellular
metabolism
C. They include:
1. Sodium (most abundant with chloride)
2. Potassium
3. Calcium
4. Magnesium
5. Chloride (most abundant with sodium)
6. Bicarbonate
7. Phosphate
8. Sulfate
14.4: Hemostasis
A. Hemostasis refers to the stoppage of bleeding
B. Actions that limit or prevent blood loss include:
1. Blood vessel spasm
2. Platelet plug formation
3. Blood coagulation
Blood Vessel Spasm
A. Blood vessel spasm
1. Triggered by pain receptors, platelet release, or serotonin
2. Smooth muscle in blood vessel contracts
Platelet Plug Formation
A. Platelet plug formation
1. Triggered by exposure of platelets to collagen
2. Platelets adhere to rough surface to form a plug
Review Figure 14.17
Blood Coagulation
A. Blood coagulation
1. Triggered by cellular damage and blood contact with foreign surfaces
2. A blood clot forms
3. This is a:
a. Hemostatic mechanism
b. Causes the formation of a blot clot via a series of reactions which
activates the next in a cascade
c. Occurs extrinsically or intrinsically
Review Table 14.7
Extrinsic Clotting Mechanism
A. Extrinsic clotting mechanism
1. Chemical outside of blood vessel triggers blood coagulation
2. Triggered by tissue thromboplastin (factor III) (not found in blood)
3. A number of events occur that includes factor VII, factor X, factor V,
factor IV, and factor II (prothrombin)
4. Triggered when blood contacts damaged blood vessel walls or tissues
5. This is an example of a positive feedback mechanism
Review Figure 14.18

Intrinsic Clotting Mechanism
A. Intrinsic clotting mechanism
1. Chemical inside blood triggers blood coagulation
2. Triggered by Hageman factor XII (found inside blood)
3. Factor XII activates factor XI which activates IX which joins with factor
VIII to activate factor X
4. Triggered when blood contacts a foreign surface
Review Tables 14.18 and 14.19
Review Figure 14.19
Fate of Blood Clots
A. After a blood clot forms it retracts and pulls the edges of a broken blood vessel
together while squeezing the fluid serum from the clot
B. Platelet-derived growth factor stimulates smooth muscle cells and fibroblasts
to repair damaged blood vessel walls
C. Plasmin digests the blood clots
D. A thrombus is an abnormal blood clot
E. An embolus is a blood clot moving through the blood vessels
Review Figure 14.20
Prevention of Coagulation
A. The smooth lining of blood vessels discourages the accumulation of platelets
and clotting factors
B. As a clot forms fibrin absorbs thrombin and prevents the clotting reaction from
spreading
C. Anti-thrombin inactivates additional thrombin by binding to it and blocking its
action on fibrinogen
D. Some cells such as basophils and mast cells secrete heparin (an anticoagulant)
Review Table 14.10
14.5: Blood Groups and Transfusions
A. In 1910, identification of the ABO blood antigen gene explained the observed
blood type incompatibilities
B. Today there are 31 different genes known to contribute to the surface features
of RBCs determining compatibility between blood types
Antigens and Antibodies
A. Terms to become familiar with:
1. Agglutination clumping of red blood cells in response to a reaction
between an antibody and an antigen
2. Antigens a chemical that stimulates cells to produce antibodies
3. Antibodies a protein that reacts against a specific antigen
Review Figure 14.21
Review Figure 14.22
ABO Blood Group
A. Based on the presence or absence of two major antigens on red blood cell
membranes
1. Antigen A
2. Antigen B
Review Table 14.12
Review Table 14.13
Rh Blood Group
A. The Rh blood group was named for the rhesus monkey
B. The group includes several Rh antigens or factors
C. Rh positive presence of antigen D or other Rh antigens on the red blood cell
membranes
D. Rh negative lack of these antigens
E. The seriousness of the Rh blood group is evident in a fetus that develops the
condition erythroblastosis fetalis or hemolytic disease of the newborn
Review Figure 14.23
14.1: Introduction
Describe the general characteristics of blood and discuss its major functions.
Distinguish among the formed elements of blood and the liquid portion of blood.
14.2: Blood Cells
Describe the origin of blood cells.
Explain the significance of red blood cells counts and how they are used to
diagnose disease.
Discuss the life cycle of a red blood cell.
Summarize the control of red blood cell production.
Distinguish among the five types of white blood cells and give the function(s) of
each type.
Describe a blood platelet and explain its functions.
14.3: Blood Plasma
Describe the functions of each of the major components of plasma.
14.4: Hemostasis
Define hemostasis and explain the mechanisms that help to achieve it.
Review the major steps in coagulation.
Explain how to prevent coagulation.
14.5: Blood Groups and Transfusions
Explain blood typing and how it is used to avoid adverse reactions following
blood transfusions.
Describe how blood reactions may occur between fetal and maternal tissues.

Twelfth Edition
Chapter 15 Outline
15.1 Introduction
A. The heart pumps 7,000 liters of blood through the body each day
B. The heart contracts some 2.5 billion times in an average lifetime
C. The heart and all blood vessels make up the cardiovascular system
D. The blood vessels make up two circuits:
1. Pulmonary circuit
2. Systemic circuit
Review Figure 15.1
15.2: Structure of the Heart
A. The heart is a hollow, cone-shaped, muscular pump
B. There are four chambers:
1. Two atria (for blood storage)
2. Two ventricles (one low pressure pump and one high pressure pump)
Size and Location of the Heart
A. The heart size varies with body size
B. The heart lies in the thoracic cavity
C. The average size of the heart is:
1. 14 centimeters long
2. 9 centimeters wide
D. The heart is:
1. Posterior to the sternum
2. Medial to the lungs
3. Anterior to the vertebral column
4. The base lies beneath the 2nd rib
5. The apex at the 5th intercostal space
6. It lays just above the diaphragm
Review Figure 15.2
Review Figure 15.3
Coverings of the Heart
A. The coverings of the heart include the pericardium:
1. Fibrous pericardium
2. Visceral pericardium
3. Parietal pericardium
Review Figure 15.4
Wall of the Heart
A. The heart wall has three distinct layers:
1. Epicardium (outer layer)
2. Myocardium (middle layer)
3. Endocardium (inner layer)
Review Figure 15.5
Review Table 15.1

Heart Chambers and Valves
A. The heart is divided into four chambers:
1. Right atrium:
a. Receives blood from the:
1). Inferior vena cava
2). Superior vena cava
3). Coronary sinus
2. Right ventricle
a. Receives blood from the right atrium
3. Left atrium
a. Receives blood from the pulmonary veins
4. Left ventricle
a. Receives blood from the left atrium
Review Table 15.2
Review Figure 15.6
Skeleton of the Heart
A. The fibrous rings, together with other masses of dense connective tissue in the
portion of the septum between the ventricles (interventricular septum), constitute
the skeleton of the heart
Review Figure 15.9
Path of Blood Through the Heart
Review Figure 15.10
Review Figure 15.11
Blood Supply to the Heart
A. The left and right coronary arteries supply blood to the tissues of the heart
Review Figure 15.15
Review Figures 15.12, 15.13, and 15.14
15.3: Heart Actions
A. The heart chambers function in coordinated fashion
B. Heart actions are regulated so that atria contract (atrial systole) while ventricles
relax (ventricular diastole); followed by ventricles contract (ventricular systole)
while atria relax (atrial diastole)
Review Figure 15.16
Cardiac Cycle
A. During a cardiac cycle, the pressure in the heart chambers rise and falls
B. In atrial systole and ventricular diastole:
1. Blood flows passively into the ventricles
2. The remaining 30% of blood is pushed into the ventricles
3. The A-V valves open and the semilunar valves close
4. The ventricles relax
5. This causes an increase in ventricular pressure
C. In ventricular systole and atrial diastole:
1. The A-V valves close
2. The chordae tendinae prevent the cusps of the valves from bulging too far
into the atria
3. The atria relax
4. The blood flows into atria
5. The ventricular pressure increases and opens the semilunar valves
6. The blood flows into pulmonary trunk and aorta
Animation: The Cardiac Cycle
Animation: Mechanical Events of the Cardiac Cycle
Heart Sounds
A. A heart beat through a stethoscope sounds like lubb-dupp
B. The lubb
1. The first heart sound
2. It occurs during ventricular systole
3. The A-V valves are closing
C. The dupp
1. The second heart sound
2. It occurs during ventricular diastole
3. The pulmonary and aortic semilunar valves are closing
D. A murmur abnormal heart sound from the cusps not completely closing
Review Figure 15.17
Cardiac Muscle Fibers
A. Cardiac muscle fibers form a functional syncytium
B. This is a mass of cells that function as a unit
C. Two such areas exist in the heart:
1. In the atrial walls called the atrial syncytium
2. In the ventricular walls called the ventricular syncytium
Animation: Action Potentials in the Sinoatrial (SA) Node
Cardiac Conduction System
A. Clumps or strands of specialized cardiac muscle tissue which initiate and
distribute impulses throughout the myocardium
B. The cardiac conduction system coordinates the events of the cardiac cycle
Review Figure 15.19
Animation: Conducting System of the Heart
Electrocardiogram
A. An electrocardiogram or ECG is a recording of electrical changes that occur in
the myocardium during the cardiac cycle
B. It is used to assess the hearts ability to conduct impulses
C. The deflections in the normal ECG, or waves, include:
1. P wave atrial depolarization
2. QRS complex (three waves) ventricular depolarization
3. T wave ventricular repolarization
Animation: Baroreceptor Reflex Control of Blood Pressure
Review Figure 15.22
Regulation of the Cardiac Cycle

A. The SA node controls the heart rate
B. There are also sympathetic and parasympathetic fibers that control the heart
rate as well
C. There are also regulatory reflex centers that influence heart rate
D. Additional factors that may influence heart rate include:
1. Physical exercise
2. Body temperature
3. Concentration of various ions including:
a. Potassium
b. Calcium
4. Parasympathetic impulses decrease heart action
5. Sympathetic impulses increase heart action
6. Cardiac center regulates autonomic impulses to the heart
Review Figure 15.24
Animation: Action Potentials in Cardiac Muscle Cells
15.4: Blood Vessels
A. The blood vessels are organs of the cardiovascular system
B. The blood vessels form a closed circuit to and from the heart
C. The blood vessels include:
1. Arteries - carry blood away from the ventricles of the heart
2. Arterioles - receive blood from the arteries and carry blood to the
capillaries
3. Capillaries - sites of exchange of substances between the blood and the
body cells
4. Venules - receive blood from the capillaries
5. Veins - carry blood toward the atria of the heart
Review Figure 15.25
Arteries and Arterioles
A. Arteries:
1. Thick strong wall (three layers or tunics)
2. Endothelial lining
3. Middle layer of smooth muscle and elastic tissue
4. Outer layer of connective tissue
5. Carries blood under relatively high pressure
B. Arterioles:
1. Thinner wall than an artery (three layers or tunics)
2. Endothelial lining
3. Middle and outer layers are thinned
4. Some smooth muscle tissue
5. Small amount of connective tissue
6. Helps control blood flow into a capillary
Review Figure 15.26
Capillaries
A. Capillaries are the smallest diameter blood vessels

B. They connect the smallest arteriole and the smallest venule
C. They are extensions of the inner lining of arterioles
D. The walls are endothelium only
E. They are semi-permeable
Review Figure 15.27
Review Figure 15.28
Review Figure 15.29
Review Figure 15.30
Venules and Veins
A. Venule:
1. Microscopic vessels that continue from the capillaries and merge to form
veins
2. Thinner walls than arterioles
3. Less smooth muscle and elastic tissue than arteriole
B. Veins:
1. Thinner walls than arteries (three layers or tunics)
2. Middle wall poorly developed
3. Many have flap-like valves
4. Carry blood under relatively low pressure
5. Function as blood reservoirs
Review Table 15.3
15.5: Blood Pressure
A. Blood pressure is the force the blood exerts against the inner walls of the blood
vessels
Arterial Blood Pressure
A. Arterial blood pressure:
1. Rises when the ventricles contract
2. Falls when the ventricles relax
3. Systolic pressure is the maximum pressure during ventricular contraction
4. Diastolic pressure is the minimum pressure when the ventricles relax
Review Figure 15.33
Factors That Influence Arterial Blood Pressure
Review Figure 15.34
Control of Blood Pressure
A. Blood pressure (BP) is determined by cardiac output (CO) and peripheral
resistance (PR) according to this relationship: BP = CO x PR
B. Maintenance of blood pressure requires regulation of these two factors
Review Figure 15.36
Animation: Arteriolar Resistance and Blood Pressure
Venous Blood Flow
A. Blood pressure decreases as the blood moves through the arterial system and
into the capillary network, so little pressure remains at the venular ends of the
capillaries
B. Only partly a direct result of heart action
C. Dependent on:
1. Skeletal muscle contraction
2. Breathing
3. Venoconstriction
Review Figure 15.39
Central Venous Pressure
A. All veins, except those returning to the heart from the lungs, drain into the
right atrium
B. This is therefore pressure in the right atrium
C. Factors that influence it alter flow of blood into the right atrium
D. It effects pressure within the peripheral veins
E. A weakly beating heart increases central venous pressure
F. An increase in central venous pressure causes blood to back up into the
peripheral veins
G. This can lead to peripheral edema
15.6: Paths of Circulation
A. Blood vessels can be divided into two major pathways:
1. The pulmonary circuit
2. The systemic circuit (includes coronary circulation)
Pulmonary Circuit
Review Figure 15.40
Review Figure 15.41
Systemic Circuit
A. Composed of vessels that lead from the heart to all body parts (except the
lungs) and back to the heart
B. Includes the aorta and its branches
C. Includes the system of veins that return blood to the right atrium
15.7: Arterial System
Review Figure 15.51
Principal Branches of the Aorta
Review Table 15.4
Arteries to the Brain, Head, and Neck
Arteries to the Shoulder and Upper Limb
Review Figure 15.47
Arteries to the Thoracic and Abdominal Walls
Review Figure 15.48
Arteries to the Pelvis and Lower Limb
15.8: Venous System

Review Figure 15.58
Characteristics of Venous Pathways
A. Vessels of the venous system originate with the merging of capillaries into
venules, venules into small veins, and small veins into larger ones
B. Unlike arterial pathways, those of the venous system are difficult to follow due
to irregular networks and unnamed tributaries
Veins from the Brain, Head, and Neck
Review Figure 15.52
Veins from the Upper Limb and Shoulder
Review Figure 15.53
Veins from the Abdominal and Thoracic Walls
Review Figure 15.54
Veins from the Abdominal Viscera
Review Figure 15.55
Review Figure 15.56
Veins from the Lower Limb and Pelvis
Review Figure 15.57
A. Cholesterol deposition in the blood vessels
B. Heart enlargement
C. Death of cardiac muscle cells
D. Increase in fibrous connective tissue of the heart
E. Increase in adipose tissue of the heart
F. Increase in blood pressure
G. Decrease in resting heart rate
15.1: Introduction
Discuss the functions of the organs of the cardiovascular system.
15.2: Structure of the Heart
Distinguish between the various coverings of the heart and the layers that
compose the wall of the heart.
Identify and locate the major parts of the heart and discuss the function of each
part.
Trace the pathway of the blood through the heart and the vessels of coronary
circulation.
15.3: Heart Actions
Describe the cardiac cycle and explain how heart sounds are produced.
Identify the parts of a normal ECG pattern and discuss the significance of this
pattern.
Explain control of the cardiac cycle.
15.4: Blood Vessels
Compare the structures and functions of the major types of blood vessels.
Describe how substances are exchanged between blood in capillaries and the
tissue fluid surrounding body cells.
15.5: Blood Pressure
Explain how blood pressure is produced and controlled.
Describe the mechanisms that aid in returning venous blood to the heart.
15.6: Paths of Circulation
Compare the pulmonary and systemic circuits of the cardiovascular system.
15.7-15.8: Arterial System Venous System
Identify and locate the major arteries and veins.
Describe the lifespan changes in the cardiovascular system.

Twelfth Edition
Chapter 16 Outline
16.1 Introduction
A. The lymphatic system is a vast collection of cells and biochemicals that travel
in lymphatic vessels
B. It is a network of vessels that assist in circulating fluids
C. It is closely associated with the cardiovascular system
D. It transports excess fluid away from the interstitial spaces
E. It transports fluid to the bloodstream
F. It transports fats to the bloodstream
G. It helps defend the body against diseases
16.2: Lymphatic Pathways
Review Figure 16.1
Lymphatic Capillaries
Review Figure 16.2
Lymphatic Vessels
A. The walls are similar but thinner than those of veins
B. Lymphatic vessels are composed of three layers:
1. An endothelial lining (inner)
2. Smooth muscle (middle)
3. Connective tissue (outer)
C. Larger vessels lead to lymph nodes and then to larger lymphatic trunks
Review Figure 16.3
Lymphatic Trunks and Collecting Ducts
A. The trunks drain lymph from the lymphatic vessels
B. They are named for the regions they serve such as lumbar, intestinal,
intercostal, bronchomediastinal, subclavian, and jugular
Review Figure 16.6
Review Figure 16.7
Animation: Lymphatic System
16.3: Tissue and Fluid Lymph
A. Lymph is essentially tissue fluid that has entered a lymphatic capillary
B. Lymph formation depends on tissue fluid formation
Tissue Fluid Formation
A. Capillary blood pressure filters water and small molecules from the plasma
B. The resulting fluid has:
1. Much the same consistency as plasma
2. Contains water and dissolved substances
3. Contains smaller proteins which create plasma colloid osmotic pressure
Lymph Formation
A. Filtration from the plasma normally exceeds reabsorption, leading to the net
formation of tissue fluid
B. This increases the tissue fluid hydrostatic pressure within interstitial spaces
forcing fluid into lymphatic capillaries forming lymph
C. This process prevents accumulation of excess tissue fluid or edema
Lymph Function
A. Lymphatic vessels play a role in:
1. Absorption of dietary fats
2. Delivering fats to the bloodstream
3. Collecting of excess interstitial fluids
4. Delivering excess fluids to the bloodstream
5. Delivering foreign particles to the lymph nodes
Review Figure 16.8
16.4: Lymph Movement
A. Hydrostatic pressure of tissue fluid drives the lymph into the lymphatic
capillaries
B. Muscle activity largely influences the movement of lymph through the
lymphatic vessels via:
1. Action of skeletal muscles
2. Respiratory movements
3. Smooth muscle in the larger lymphatic vessels
4. Valves in the lymphatic vessels
Lymph Flow
Review Figure 16.10
Obstruction of Lymph Movement
Review Figure 16.9
16.5: Lymph Nodes
A. Lymph nodes or lymph glands are located along the lymphatic pathways
B. They contain lymphocytes and macrophages to fight invading pathogens
Structure of a Lymph Node
Review Figure 16.10
Locations of Lymph Nodes
A. Lymph nodes are found in groups or chains along the paths of the larger
lymphatic vessels throughout the body, including the:
1. Cervical region
2. Axillary region
3. Supratrochlear region
4. Inguinal region
5. Pelvic cavity
6. Abdominal cavity
7. Thoracic cavity
Review Figure 16.11
Functions of Lymph Nodes
A. Lymph nodes have two primary functions:
1. Filter potentially harmful particles from the lymph
2. Act with immune surveillance provided by macrophages and lymphocytes
B. Along with the red bone marrow, the lymph nodes are centers for lymphocyte
production
16.6: Thymus and Spleen
A. These are two other lymphatic organs with functions similar to those of the
lymph nodes
Thymus
A. The thymus is:
1. Larger in infancy and during puberty
2. Small in an adult
3. Replaced by fat and connective tissue in the elderly
4. Site of T lymphocyte (or T cell) production
5. Secretes protein hormones called thymosins
Review Figure 16.13
Review Figure 16.12
Spleen
A. The spleen is:
1. The largest lymphatic organ
2. Located in the upper left abdominal quadrant
3. Has sinuses filled with blood
4. Contains two tissue types:
a. White pulp (lymphocytes)
b. Red pulp (red blood cells, lymphocytes and macrophages)
Review Figure 16.14
Review Table 16.1
16.7: Body Defenses Against Infection
A. The presence and multiplication of a pathogen in the body may cause an
infection
B. Pathogens are:
1. Disease causing agents
2. Bacteria, viruses, complex microorganisms, and spores of multicellular
organisms
C. The body can prevent entry of pathogens or destroy them with defense
mechanisms such as:
1. Innate defenses:
a. These are general defenses
b. They protect against many pathogens
2. Adaptive defenses:
a. Known as immunity
b. More specific and precise targeting specific antigens
c. Are carried out by lymphocytes
16.8: Innate (Nonspecific) Defenses
Review Table 16.3
Species Resistance
A. Refers to a given type of organism, or species, that develops diseases unique to
it
Animation: Nonspecific Immunity
Mechanical Barriers
A. The skin and mucous membranes create mechanical barriers
B. Mechanical barriers are considered the first line of defense (all other nonspecific defenses are part of the second line of defense)
Chemical Barriers
A. Enzymes in body fluids provide a chemical barrier to pathogens, and they may
include:
1. Interferons are hormone-like peptides and stimulate phagocytosis
2. Defensins are peptides produced by neutrophils and other granulocytes.
They cripple microbes.
3. Collectins are proteins with broad protection against bacteria, yeast and
some viruses
4. Complement is a group of proteins in plasma and other body fluids that
stimulate inflammation, attract phagocytes and enhance phagocytosis
Animation: Antiviral Activity of Interferon
Animation: Activation of Complement
Animation: Complement Function
Natural Killer (NK) Cells
A. NK cells are a small population of lymphocytes defending against viruses and
cancer by secreting cytolytic substances called perforins that destroy the infected
cell
B. NK may also enhance inflammation
Inflammation
A. Inflammation produces local redness, swelling, heat and pain
B. Table 16.2 summarizes the process
Animation: The Inflammatory Responses
Phagocytosis
A. Phagocytosis removes foreign particles from the lymph
B. Phagocytes are also in the blood vessels and in the tissues of the spleen, liver
or bone marrow
C. The most active phagocytic cells are neutrophils and monocytes
D. Chemicals attract these phagocytic cells to the injury and this is called
chemotaxis
Animation: Phagocytosis
Fever
A. A fever begins when a viral or bacterial infection stimulates lymphocytes to
proliferate, producing cells that secrete a substance called interleukin-1 (IL-1)
16.9: Adaptive (Specific) Defenses or Immunity
A. This is the third line of defense and known as immunity
B. It is resistance to particular pathogens or to their toxins or metabolic byproducts
C. It is based on the ability to distinguish molecules that are part of the body
(self from non-self)
D. Antigens are molecules that can elicit an immune response
Antigens
A. Antigens may be:
1. Proteins
2. Polysaccharides
3. Glycoproteins
4. Glycolipids
B. The most effective antigens are large and complex
C. Haptens are small molecules that are not antigenic by themselves, but when
they combine with a large molecule can stimulate an immune response
Lymphocyte Origins
Review Figure 16.16
T Cells and the Cellular Immune Response
A. A lymphocyte must be activated before it can respond to an antigen
B. T cell activation requires antigen-presenting cell (accessory cell) and may
include macrophages, B cells and several other types of cells
C. Requires major histocompatibility complex (MHC) or human leukocyte
antigens (HLA) to recognize non-self
D. T cells can synthesize and secrete polypeptides called cytokines
E. Types of specialized T cells include:
1. Helper T cells
2. Cytotoxic T cells
3. Memory T cells
Animation: Cytotoxic T-cell Activity Against Target Cells
Animation: Interaction of Antigen Presenting Cells and T-helper Cells
Review Table 16.5
B Cells and the Humoral Immune Response
A. B cells can be activated when an antigen fits the shape of its receptor
B. Most of the time B cell activation requires T cells
C. T cells release cytokines that stimulate B cells
D. Some B cells may become memory B cells while others differentiate into
plasma cells and produce and secrete large globular proteins called antibodies or
immunoglobulins
Review Figure 16.17
Review Figure 16.18
Review Figure 16.19
Review Table 16.6
Animation: Monoclonal Antibody Production
Animation: Antibodies
Immune Responses
Review Figure 16.21
Animation: The Immune Response
Practical Classification of Immunity
Review Table 16.9
Allergic Reactions
A. Type I
1. Immediate-reaction allergy
2. Occurs minutes after contact with allergen

3. Symptoms include hives, hay fever, asthma, eczema, gastric disturbances,
and anaphylactic shock
B. Type II
1. Antibody-dependent cytotoxic reaction
2. Takes 1-3 hours to develop
3. Transfusion reaction
C. Type III
1. Immune-complex reaction
2. Takes 1-3 hours to develop
3. Antibody complexes cannot be cleared from the body
4. Damage of body tissues
D. Type IV
1. Delayed-reaction allergy
2. Results from repeated exposure to allergen
3. Eruptions and inflammation of the skin
4. Takes about 48 hours to occur
Review Figure 16.22
Animation: Cytotoxic Type II Hypersensitivity
Transplantation and Tissue Rejection
A. Successfully transplanted tissues and organs:
1. Cornea
2. Kidney
3. Liver
4. Pancreas
5. Heart
6. Bone marrow
7. Skin
B. When the donors tissues are recognized as foreign there is a tissue rejection
reaction
1. Resembles the cellular immune response against antigens
2. Important to match MHC antigens
3. Immunosuppressive drugs used to prevent rejection
Review Table 16.10
Autoimmunity
A. The immune system fails to distinguish self from non-self and the body
produces antibodies called autoantibodies, and cytotoxic T cells to attack the
bodys tissues and organs
Review Table 16.11
A. The immune system declines early in life as the thymus gland shrinks (only
25% as powerful as it once was)
B. There is a higher risk of infection
C. Antibody response to antigens becomes slower
D. IgA and IgG antibodies increase
E. IgM and IgE antibodies decrease
F. Elderly may not be candidates for certain medical treatments that suppresses
immunity
16.1: Introduction
Describe the general functions of the lymphatic system.
16.2: Lymphatic Pathways
Identify and describe the parts of the major lymphatic pathways.
16.3: Tissue Fluid and Lymph
Describe how tissue fluid and lymph form, and explain the function of lymph.
16.4: Lymph Movement
Explain how lymphatic circulation is maintained, and describe the consequence
of lymphatic obstruction.
16.5: Lymph Nodes
Describe a lymph node and its major functions.
Describe the location of the major chains of lymph nodes.
16.6: Thymus and Spleen
Discuss the locations and functions of the thymus and spleen.
16.7: Body Defenses Against Infection
Distinguish between innate (nonspecific) and adaptive (specific) defenses.
16.8: Innate (Nonspecific) Defenses
List seven innate body defense mechanisms, and describe the action of each
mechanism.
16.9: Adaptive (Specific) Defenses, or Immunity
Explain how two major types of lymphocytes are formed, activated, and how
they function in immune mechanisms.
Discuss the origins and actions of the five different types of antibodies.
Distinguish between primary and secondary immune responses.
Distinguish between active and passive immunity.
Explain how allergic reactions, tissue rejection reactions, and autoimmunity arise
from immune mechanisms.
Describe lifespan changes in immunity.

Twelfth Edition
Chapter 17 Outline
17.1 Introduction
A. Digestion is the mechanical and chemical breakdown of foods into forms that
cell membranes can absorb
B. Organs of the digestive system carry out these processes, as well as ingestion,
propulsion, absorption and defecation
C. The digestive system consists of the alimentary canal extending from the
mouth to the anus
Review Figure 17.1
Animation: Organs of Digestion
17.2: General Characteristics of the Alimentary Canal
A. The alimentary canal is a muscular tube about 8 meters long
Review Figure 17.2
Structure of the Wall
Review Figure 17.3
Review Table 17.1
Movements of the Tube
Review Figure 17.4
Innervation of the Tube
A. Branches of the sympathetic and parasympathetic divisions of the autonomic
nervous system extensively innervate the alimentary canal, including:
1. Submucosal plexus controls secretions
2. Myenteric plexus controls gastrointestinal motility
B. Remember:
1. Parasympathetic impulses increase activities of digestive system
2. Sympathetic impulses inhibit certain digestive actions
17.3: Mouth
A. The mouth:
1. Ingests food
2. Mechanically breaks up solid particles using saliva
3. Prepares food for chemical digestion
B. This action is called mastication
Review Figure 17.5
Cheeks and Lips
A. The cheeks form the lateral walls of the mouth
B. The lips are highly mobile structures that surround the mouth opening
Review Table 17.3
Tongue
A. The tongue is a thick, muscular organ that occupies the floor of the mouth and
nearly fills the oral cavity when the mouth is closed
Review Figure 17.6
Palate
A. The palate forms the roof of the oral cavity and consists of a hard anterior part
and a soft posterior part
Review Figure 17.7
Teeth
A. The teeth are the hardest structures in the body
B. There are primary (deciduous) teeth numbering 20
C. There are secondary (permanent) teeth numbering 32
Review Figure 17.8
Review Table 17.2 and Figure 17.9
Review Figure 17.10
17.4: Salivary Glands
A. Salivary glands secrete saliva
B. This begins the digestion of carbohydrates
C. There are three pairs of major salivary glands, including:
1. Parotid glands
2. Submandibular glands
3. Sublingual glands
D. There are many minor glands scattered throughout the mucosa of the tongue,
palate, and cheeks
Salivary Secretions
A. The different salivary glands have varying proportions of two types of
secretory cells, serous cells and mucous cells
1. Serous cells produce a watery fluid with a digestive enzyme called salivary
amylase
2. Mucous cells secrete mucous
B. Parotid glands
1. Secrete clear watery, serous fluid
2. Rich in salivary amylase
C. Submandibular glands
1. Secrete primarily serous fluid and some mucus
D. Sublingual glands
1. Secrete primarily mucus
Major Salivary Glands
17.5: Pharynx and Esophagus
A. The pharynx is a cavity posterior to the mouth from which the tubular
esophagus leads to the stomach
B. Both the pharynx and esophagus muscular walls function in swallowing
Review Figure 17.13
Structure of the Pharynx
A. The pharynx can be divided into the following parts:
1. Nasopharynx
2. Oropharynx
3. Laryngopharynx
Review Figure 17.14 (a)

Swallowing Mechanism
A. Swallowing can be divided into three stages:
1. Voluntary stage where saliva is mixed with chewed food
2. Swallowing begins and the swallowing reflex is triggered
3. Peristalsis transports food in the esophagus to the stomach
B. Specifically:
1. The palate and uvula raise
2. The hyoid bone and larynx elevate
3. The epiglottis closes off top of the trachea
4. The longitudinal muscles of pharynx contract
5. The inferior constrictor muscles relax and the esophagus opens
6. The peristaltic waves push food through the pharynx
Review Figure 17.14
Esophagus
17.6: Stomach
A. The stomach is a J-shaped, pouch-like organ, about 25-30 centimeters long
B. It hangs inferior to the diaphragm in the upper-left portion of the abdominal
cavity
C. The stomach has two layers of smooth muscle
1. An inner circular layer
2. An outer longitudinal layer
3. (There may be a third inner layer of oblique fibers.)
Parts of the Stomach
Gastric Secretions
A. The mucous membrane of the stomach has tubular gastric glands that secrete:
1. Pepsinogen
a. From the chief cells
b. Inactive form of pepsin
2. Pepsin
a. From pepsinogen in the presence of hydrochloric acid
b. Is a protein splitting enzyme
3. Hydrochloric acid
a. From the parietal cells
b. Needed to convert pepsinogen to pepsin
4. Mucus
a. From the goblet cells and the mucous glands
b. Protective to stomach wall
5. Intrinsic factor
a. From the parietal cells
b. Is required for vitamin B12 absorption
Review Figure 17.19
Review Table 17.5
Animation: Hydrochloric Acid Production of the Stomach
Regulation of Gastric Secretions

Review Figure 17.20
Review Table 17.6
Animation: Hormones and Gastric Secretion
Gastric Absorption
A. Gastric enzymes begin breaking down proteins, but the stomach is not welladapted to absorb digestive products
B. The stomach does absorb:
1. Some water
2. Certain salts
3. Certain lipid-soluble drugs
4. Alcohol
Mixing and Emptying Actions
Review Figure 17.21
Review Figure 17.22
17.7: Pancreas
A. The pancreas has a dual function as both an endocrine gland and exocrine
gland
B. The exocrine function is to secrete digestive juice called pancreatic juice
Structure of the Pancreas
Review Figure 17.23
Pancreatic Juice
A. Pancreatic juice contains enzymes that digest carbohydrates, fats, proteins, and
nucleic acids, and include:
1. Pancreatic amylase splits glycogen into disaccharides
2. Pancreatic lipase breaks down triglycerides
3. Trypsin, chymotrypsin, and carboxypeptidase digest proteins
4. Nucleases digest nucleic acids
5. Bicarbonate ions make pancreatic juice alkaline
Regulation of Pancreatic Secretion
Review Figure 17.24
17.8: Liver
A. The liver is the largest internal organ
B. It is located in the upper-right abdominal quadrant just beneath the diaphragm
Liver Structure
Review Figure 17.26
Review Figure 17.27
Review Figure 17.28
Liver Functions
A. The liver carries on many important metabolic activities, including:
1. Produces glycogen from glucose
2. Breaks down glycogen into glucose
3. Converts non-carbohydrates to glucose
4. Oxidizes fatty acids
5. Synthesizes lipoproteins, phospholipids, and cholesterol
6. Converts carbohydrates and proteins into fats

7. Deaminating amino acids
8. Forms urea
9. Synthesizes plasma proteins
10. Converts some amino acids to other amino acids
11. Stores glycogen, iron, and vitamins A, D, and B12
12. Phagocytosis of worn out RBCs and foreign substances
13. Removes toxins such as alcohol and certain drugs from the blood
Review Table 17.7
Composition of Bile
A. Bile is a yellowish-green liquid that hepatic cells continuously secrete
B. Bile contains:
1. Water
2. Bile salts:
a. Emulsify fats
b. Help absorb fatty acids, cholesterol, and fat-soluble vitamins
3. Bile pigments
4. Cholesterol
5. Electrolytes
Gallbladder
Review Figure 17.26
Review Figure 17.29
Animation: Formation of Gallstones
Regulation of Bile Release
Review Figure 17.30
Review Table 17.8
Functions of Bile Salts
A. Bile salts aid digestive enzymes
B. They reduce surface tension and break fat globules into droplets (like soap or
detergent) and this is called emulsification
C. They enhance absorption of fatty acids and cholesterol
D. They help absorb fat-soluble vitamins A, D, E and K
E. Bile salts are recycled as they return to the liver
17.9: Small Intestine
A. The small intestine is a tubular organ that extends from the pyloric sphincter to
the beginning of the large intestine
B. It completes digestion of the nutrients in chyme, absorbs products of digestion,
and transports the remaining residue to the large intestine
C. It consists of three parts that include:
1. Duodenum
2. Jejunum
3. Ileum
Parts of the Small Intestine
Review Figure 17.31

Review Figure 17.32
Review Figure 17.34
Structure of the Small Intestinal Wall
Review Figure 17.37
Review Figure 17.38
Secretions of the Small Intestine
A. In addition to mucous-secreting goblet cells, there are many specialized
mucous-secreting glands (Brunners glands) that secrete a thick, alkaline mucus in
response to certain stimuli
B. Enzymes in the membranes of the microvilli include:
1. Peptidase breaks down peptides into amino acids
2. Sucrase, maltase, lactase break down disaccharides into monosaccharides
3. Lipase breaks down fats into fatty acids and glycerol
4. Enterokinase converts trypsinogen to trypsin
5. Somatostatin hormone that inhibits acid secretion by stomach
6. Cholecystokinin hormone that inhibits gastric glands, stimulates pancreas
to release enzymes in pancreatic juice, and stimulates the gallbladder to
release bile
7. Secretin stimulates the pancreas to release bicarbonate ions in pancreatic
juice
Regulation of Small Intestinal Secretions
A. Regulation of small intestine secretion occurs by:
1. Mucus secretion is stimulated by the presence of chyme in the small
intestine
2. Distension of the intestinal wall activates nerve plexuses in the wall of the
small intestine
3. Parasympathetic reflexes triggering the release of intestinal enzymes
Review Table 17.9
Absorption of the Small Intestine
A. Villi increase the surface area for absorption
B. Small intestine absorption is so effective that very little reaches the organs
distal end, noting that:
1. Monosaccharides and amino acids absorb:
a. Through facilitated diffusion and active transport
b. Absorbed into blood
2. Large proteins are broken down and absorbed into villi
3. Fatty acids and glycerol absorb by:
a. Several steps involved as noted
b. Absorbed into lymph and blood
4. Electrolytes and water absorb:
a. Through diffusion, osmosis, and active transport
b. Absorbed into blood
Review Table 17.10

Movements of the Small Intestine
A. The small intestine carries on mixing movements that include:
1. Peristalsis pushing movements that propel chyme
2. Segmentation ring-like contractions that can move chyme back and forth
17.10: Large Intestine
A. The large intestine is named because of its diameter
B. It has five parts that include:
1. Cecum
2. Colon
a. Ascending, transverse and descending
3. Sigmoid colon
4. Rectum
5. Anus
Parts of the Large Intestine
Review Figure 17.43
Review Figure 17.44
Structure of the Large Intestinal Wall
Review Figure 17.46
Functions of the Large Intestine
A. The large intestine:
1. Has little or no digestive function
2. Absorbs water and electrolytes
3. Secretes mucus
4. Houses intestinal flora
5. Forms feces
6. Carries out defecation
Review Figure 17.47
Movements of the Large Intestine
A. Movements of the large intestine are similar to those of the small intestine
B. It is slower and less frequent than that of the small intestine
C. Movements include:
1. Mixing movements
2. Peristalsis
D. Mass movements usually follow meals
E. The defecation reflex relaxes the internal anal sphincter and then the external
anal sphincter
Animation: Reflexes in the Colon
Feces
A. Feces is composed of materials not digested or absorbed, and include:
1. Water
2. Electrolytes
3. Mucus
4. Bacteria
5. Bile pigments altered by bacteria provide the color
B. The pungent odor is produced by bacterial compounds including:
1. Phenol
2. Hydrogen sulfide
3. Indole
4. Skatole
5. Ammonia
A. Changes to the digestive system are slow and slight, and eventually include:
1. Teeth may become sensitive
2. Gums may recede
3. Teeth may loosen, break or fall out
4. Heartburn may become more frequent
5. Constipation may become more frequent
6. Nutrient absorption decreases
7. Accessory organs age but typically not necessarily in ways that effect
health
17.1: Introduction
Describe the general functions of the digestive system.
Name the major organs of the digestive system.
17.2: General Characteristics of the Alimentary Canal
Describe the structure of the wall of the alimentary canal.
Explain how the contents of the alimentary canal are mixed and moved.
17.3: Mouth
Describe the functions of the structures of the mouth.
Describe how different types of teeth are adapted for different functions, and list
the parts of the tooth.
17.4-17.10: Salivary Glands Large Intestine
Locate each of the organs and glands; then describe the general function of each.
Identify the function of each enzyme secreted by the digestive organs and glands.
Describe how digestive secretions are regulated.
Explain control of movement of material through the alimentary canal.
Describe the mechanisms of swallowing, vomiting, and defecating.
Explain how the products of digestion are absorbed.
Describe aging-related changes in the digestive system.

Twelfth Edition
Chapter 18 Outline
18.1 Introduction
A. The human body requires fuel as well as materials to develop, grow and heal
B. Nutrients are chemical substances supplied by the environment required for
survival
1. Macronutrients
a. Carbohydrates
b. Proteins
c. Fats
2. Micronutrients
a. Vitamins
b. Minerals
3. Essential nutrients
a. Nutrients human cells cannot synthesize such as certain amino acids
Review Figure 18.1
18.2: Carbohydrates
A. Carbohydrates are organic compounds and include the sugars and starches
B. The energy in their chemical bonds are used to power cellular processes
C. Excesses lead to:
1. Obesity
2. Dental caries
3. Nutritional deficits
C. Deficiencies lead to:
1. Metabolic acidosis
2. Weight loss
Carbohydrate Sources
A. Carbohydrates are ingested in a variety of forms:
1. Complex carbohydrates are polysaccharides that include:
a. Starch from plant foods
b. Gylcogen from meats
2. Simple carbohydrates are:
a. Dissaccharides from milk sugar, cane sugar, beet sugar and
molasses
b. Monosaccharides from honey and fruits
B. Digestion breaks complex carbohydrates into monosaccharides that are small
enough to be absorbed
C. Cellulose is a complex carbohydrate abundant in our food
1. It is not digested, but provides bulk (fiber or roughage)
Carbohydrate Use
A. Monosaccharides that are absorbed include fructose, galactose, and glucose
Review Figure 18.3

Carbohydrate Requirements
A. The minimal requirements for carbohydrates in the human diet is unknown
B. Intake of at least 125 175 grams is necessary
C. An average diet includes 200-300 grams
18.3: Lipids
A. Lipids are organic compounds that include fats, oils, and fat-like substances
such as phospholipids and cholesterol
B. They supply energy for cellular processes and help to build structures like cell
membranes
C. The most common dietary lipids are fats called triglycerides
D. Excesses lead to:
1. Obesity
2. Increased serum cholesterol
3. Increased risk of heart diseases
E. Deficiencies lead to:
1. Weight loss
2. Skin lesions
3. Hormonal imbalances
Lipid Sources
A. Triglycerides are found in plant-based and animal-based foods and include:
1. From plants:
a. Seeds, nuts and plant oils (olive, peanut and canola are the
healthiest)
2. From animals:
a. Meat, eggs, milk and lard
Lipid Use
A. Lipids in foods are phospholipids, cholesterol and most commonly, fats
(triglycerides)
B. They are oxidized for energy
C. They are stored in adipose tissue
D. Glycerol may be used to synthesize glucose
Review Figure 18.4
Review Figure 18.5
Lipid Requirements
A. The lipid content of human diets varies widely
B. The American Heart Association advises that the diet not exceed 30% of total
daily calories from fat
18.4: Proteins
A. Proteins are polymers of amino acids
B. They have a wide variety of functions, including building more protein
(structural protein, enzymes, hormones, and plasma proteins) and supplying
energy
C. The waste product of protein metabolism is urea
D. Excesses lead to obesity
E. Deficiencies lead to:
1. Extreme weight loss

2. Muscle wasting
3. Anemia
4. Growth retardation
Review Figure 18.6
Review Figure 18.7
Protein Sources
A. Foods rich in proteins include:
1. Meats
2. Fish
3. Poultry
4. Cheeses
5. Nuts
6. Milk
7. Eggs
8. Cereals
9. To some degree legumes (beans and peas)
10. The body needs 20 types of amino acids; those that can be synthesized by
the body are non-essential amino acids (8) and those that cannot are essential
amino acids (12)
Review Table 18.3
Nitrogen Balance
A. In healthy adults, protein is continuously built up and broken down
B. Proteins contain a high percentage of nitrogen
C. The amount of nitrogen taken in is equal to amount excreted
1. Negative nitrogen balance develops from starvation
2. Positive nitrogen balance develops in growing children, pregnant women,
or an athlete in training
Protein Requirements
A. In addition to supplying essential amino acids, proteins provide nitrogen and
other elements for the synthesis of non-essential amino acids and certain nonprotein nitrogenous substances
B. The dietary amount varies according to body size, metabolic rate, and nitrogen
balance condition
C. Typically protein intake is 10% of a persons diet
D. Most people should consume 60-150 grams a day
Review Table 18.4
18.5: Energy Expenditures
A. Carbohydrates, fats and proteins supply energy for all metabolic processes
B. Deficiencies can lead to death
C. Excesses can lead to obesity
Energy Values of Food
A. A calorie indicates the amount of potential energy a food contains
B. Calories can be measured from the content of foods
C. The rate that the body expends energy can be measured and is known as basal
metabolic rate (BMR)
D. This varies for:

1. Carbohydrates
a. 4.1 calories per gram
2. Lipids
3. Proteins
Review Figure 18.8
Review Table 18.5
Energy Requirements
A. Basal metabolic rate (BMR):
1. The rate at which body expends energy at rest
2. This primarily reflects energy needed to support the activities of the organs
3. This varies with gender, body size, body temperature, and endocrine
function
B. Energy is needed:
1. To maintain BMR
2. To support muscular activity
3. To maintain body temperature
4. For growth in children and pregnant women
Energy Balance
A. Energy balance occurs when caloric intake in the form of food equals caloric
output from BMR and muscular activities
B. The body weight remains constant
C. If, however, caloric intake exceeds output, tissues store excess nutrients
D. This is a positive energy balance that leads to weight gain
Desirable Weight
A. Most common nutritional disorders involve caloric imbalances
B. Desirable weight is difficult to determine
C. Body Mass Index (BMI) is used today to assess weight considering height
D. A person is classified with BMI as either underweight, normal weight,
overweight, or obese
1. Overweight is defined as exceeding desirable weight by 10% - 20%, or a
BMI of 25 and 30
2. Obesity occurs when a person is more than 20% above desired weight, or
with a BMI over 30
18.6: Vitamins
A. Vitamins are organic compounds, other than carbohydrates, lipids and proteins,
that are essential for normal metabolic processes
B. Vitamins cannot be synthesized by body cells in adequate amounts
C. Vitamins are classified on the basis of solubility as either fat- soluble (vitamins
A, D, E, and K) or water-soluble (the B vitamins and vitamin C)
Review Table 18.6
Fat-Soluble Vitamins
A. The fat-soluble vitamins dissolve in fats and are influenced by lipids
B. Bile salts promote fat-soluble vitamin absorption

C. They are fairly resistant to heat (not destroyed by cooking and/or food
processing)
D. Includes vitamins A, D, E, and K
Review Table 18.8
Water-Soluble Vitamins
A. The water-soluble vitamins include the B vitamins and vitamin C
B. Cooking and food processing destroy them
C. B vitamins (six of them) are several compounds essential for normal cellular
metabolism and known as the vitamin B complex
Review Table 18.9
18.7: Minerals
A. Dietary minerals are inorganic elements that are essential in human
metabolism
B. These are usually extracted from the soil by plants
C. They are obtained by humans from plant foods or animals that have eaten
plants
D. They are responsible for roughly 4% of body weight
Characteristics of Minerals
A. Minerals are most concentrated in the bones and teeth
B. They are typically incorporated into organic molecules (phospholipids,
hemoglobin and iodine in thyroxine)
C. They compose parts of the structural materials of all cells
D. Homeostatic mechanisms regulate the concentration of minerals in body fluids
E. Mineral toxicity can result from too much of a mineral or from overexposure to
industrial pollutants, household chemicals, or certain drugs
Major Minerals
Review Table 18.10
Trace Elements
A. Trace elements (microminerals) are essential minerals found in minute
amounts, each makes up less than 0.005% of body weight
B. They include:
1. Iron
2. Manganese
3. Copper
4. Iodine
5. Cobalt
6. Zinc
7. Fluorine
8. Selenium
9. Chromium
Review Table 18.11
18.8: Healthy Eating
A. An adequate diet provides sufficient energy (calories), essential fatty acids,
essential amino acids, vitamins, and minerals to support optimal growth and to
maintain and repair body tissues
B. Requirements vary with age, sex, growth rate, level of physical activity and
stress, and genetic and environmental factors
C. Dietary requirements such as recommended daily allowances (RDA) are best
to follow
D. The U.S. Department of Agricultures Food Pyramid is another tool to follow
E. Nutritional information and ingredients are listed on most grocery items for
retail sale
Review Figure 18.20
Malnutrition
A. Malnutrition is poor nutrition that results from a lack of essential nutrients or
failure to use them
1. Undernutrition deficiency of essential nutrients
2. Overnutrition excess of nutrient intake
B. Malnutrition can be a result of:
1. Primary malnutrition malnutrition from diet alone
2. Secondary malnutrition adequate diet but individual characteristics make
the diet insufficient
Starvation
A. A healthy human can survive 50-70 days without food
B. Symptoms include low blood pressure, slow pulse, chills, dry skin, hair loss,
and poor immunity
C. Common nutritional disorders include:
1. Marasmus lack of all nutrients
2. Kwashiorkor protein starvation
3. Anorexia nervosa eating disorder; self-starvation
4. Bulimia eating disorder; binge and purge cycle
A. Dietary requirements remain generally the same throughout life
B. BMR rises in early childhood and peaks in adolescence
C. BMR declines in adulthood
D. Change in nutrition often reflects the effects of medical conditions and the
social and economic circumstances
Review Table 18.12
18.1: Introduction
Define nutrition, nutrients, and essential nutrients.
Explain appetite control.
18.2-18.4: Carbohydrate - Proteins
List the major sources of carbohydrates, lipids, and proteins.
Describe how cells utilize carbohydrates, lipids, and proteins.
Define nitrogen balance.
18.5: Energy Expenditures
Explain how energy values of food are determined.
Explain the factors that affect an individuals energy requirements.
Define energy balance.

Explain what is meant by desirable weight.
18.6: Vitamins
List the fat-soluble and water-soluble vitamins and summarize the general
functions of each vitamin.
18.7: Minerals
Distinguish between a vitamin and a mineral.
List the major minerals and trace elements and summarize the general functions
of each.
18.8: Healthy Eating
Describe an adequate diet.
Distinguish between primary and secondary malnutrition.
List the factors that may lead to inadequate nutrition later in life.

Twelfth Edition
Chapter 19 Outline
19.1 Introduction
A. The respiratory system consists of passages that filter incoming air and
transport it into the body, into the lungs, and to the many microscopic air sacs
where gases are exchanged
B. Respiration is the process of exchanging gases between the atmosphere and
body cells
C. It consists of the following events:
1. Ventilation
2. External respiration
3. Transport of gases
4. Internal respiration
5. Cellular respiration
19.2: Why We Breathe
A. Respiration occurs on a macroscopic level at the organ system
B. Gas exchange, oxygen and carbon dioxide, occur at the cellular and molecular
levels
C. Aerobic reactions of cellular respiration allow for:
1. ATP production
2. Carbon dioxide generation forming carbonic acid
19.3: Organs of the Respiratory System
A. The organs of the respiratory system can be divided into two tracts:
1. Upper respiratory tract
a. The nose
b. Nasal cavity
c. Sinuses
d. Pharynx
2. Lower respiratory tract
a. Larynx
b. Trachea
c. Bronchial tree
d. Lungs
Review Figure 19.1
Nose
Review Figure 19.2
Nasal Cavity
Review Figure 19.3
Sinuses
A. The sinuses are air-filled spaces in the maxillary, frontal, ethmoid, and
sphenoid bones of the skull
Review Figure 19.4
Pharynx
A. The pharynx is posterior to the oral cavity and between the nasal cavity and the
larynx
Review Figure 19.2
Larynx
A. The larynx is an enlargement in the airway superior to the trachea and inferior
to the pharynx
B. It is composed of a framework of muscles and cartilages bound by elastic
tissue
Trachea
A. The trachea (windpipe) is a flexible cylindrical tube about 2.5 centimeters in
diameter and 12.5 centimeters in length
B. As it extends downward anterior to the esophagus and into the thoracic cavity,
it splits into the right and left primary bronchi
Review Figure 19.8
Bronchial Tree
A. The bronchial tree consists of branched airways leading from the trachea to the
microscopic air sacs in the lungs
Review Figure 19.12
Branches of the Bronchial Tree
A. The successive divisions of the branches from the trachea to the alveoli are:
1. Right and left primary bronchi
2. Secondary or lobar bronchi
3. Tertiary or segmental bronchi
4. Intralobular bronchioles
5. Terminal bronchioles
6. Respiratory bronchioles
7. Alveolar ducts
8. Alveolar sacs
9. Alveoli
Review Figure 19.13
The Respiratory Tubes
A. The structure of the bronchus is similar to that of the trachea, but the C-shaped
cartilaginous rings are replaced with cartilaginous plates where the bronchus
enters the lung
B. These respiratory tubes become thinner and thinner, and the cell layers thin and
change until the alveoli is reached
C. It is the alveoli that provides surface area for gas exchange
Review Figure 19.16
Animation: Alveolar Pressure Changes During Inspiration and Expiration
Lungs
A. The right and left lungs are soft, spongy, cone-shaped organs in the thoracic
cavity
B. The right lung has three lobes and the left lung two lobes
Animation: The Pleural Membranes
Review Table 19.1
19.4: Breathing Mechanism
A. Breathing or ventilation is the movement of air from outside of the body into
the bronchial tree and the alveoli
B. The actions responsible for these air movements are inspiration, or inhalation,
and expiration, or exhalation
Inspiration
A. Atmospheric pressure due to the weight of the air is the force that moves air
into the lungs
B. At sea level, atmospheric pressure is 760 millimeters of mercury (mm Hg)
C. Moving the plunger of a syringe causes air to move in or out
D. Air movements in and out of the lungs occur in much the same way
Inspiration
A. Intra-alveolar pressure decreases to about 758mm Hg as the thoracic cavity
enlarges due to diaphragm downward movement caused by impulses carried by
the phrenic nerves
B. Atmospheric pressure then forces air into the airways
Review Figure 19.23
Inspiration
Review Figure 19.24
Review Table 19.2
Expiration
A. The forces responsible for normal resting expiration come from elastic recoil
of lung tissues and from surface tension
B. These factors increase the intra-alveolar pressure about 1 mm Hg above
atmospheric pressure forcing air out of the lungs
Expiration
Review Figure 19.25
Review Table 19.3
Respiratory Air Volumes and Capacities
A. Different degrees of effort in breathing move different volumes of air in and
out of the lungs
B. This measurement of volumes is called spirometry
Review Figure 19.26
Review Table 19.4
Alveolar Ventilation
A. The volume of new atmospheric air moved into the respiratory passages each
minute is minute ventilation
B. It equals the tidal volume multiplied by the breathing rate
C. Much of the new air remains in the physiologic dead space
D. The tidal volume minus the physiologic dead space then multiplied by
breathing rate is the alveolar ventilation rate
E. This is the volume of air that reaches the alveoli

F. This impacts the concentrations of oxygen and carbon dioxide in the alveoli
Animation: Alveolar Ventilation and Anatomic Dead Space
Nonrespiratory Air Movements
A. Air movements other than breathing are called nonrespiratory movements
B. They clear air passages, as in coughing and sneezing, or express emotions, as
in laughing and crying
Review Table 19.5
19.5: Control of Breathing
A. Normal breathing is a rhythmic, involuntary act that continues when a person
is unconscious
B. Respiratory muscles can be controlled as well voluntarily
Respiratory Areas
A. Groups of neurons in the brainstem comprise the respiratory areas that control
breathing
B. Impulses travel on cranial nerves and spinal nerves, causing inspiration and
expiration
C. Respiratory areas also adjust the rate and depth of breathing
D. The respiratory areas include:
1. Respiratory center of the medulla
2. Respiratory group of the pons
Review Figure 19.28
Review Figure 19.29
Animation: Movement of Oxygen and Carbon Dioxide
Factors Affecting Breathing
A. A number of factors affect breathing rate and depth including:
1. Partial pressure of oxygen (Po2)
2. Partial pressure of carbon dioxide (Pco2)
3. Degree of stretch of lung tissue
4. Emotional state
5. Level of physical activity
B. Receptors involved include mechanoreceptors and central and peripheral
chemoreceptors
Review Figure 19.30
Factors Affecting Breathing
A. Changes in blood pH, O2 and CO2 concentration stimulates chemoreceptors
B. Motor impulses can travel from the respiratory center to the diaphragm and
external intercostal muscles
C. Contraction of these muscles causes the lungs to expand stimulating
mechanoreceptors in the lungs
D. Inhibitory impulses from the mechanoreceptors back to the respiratory center
prevent overinflation of the lungs
Review Figure 19.31
Review Table 19.6
19.6: Alveolar Gas Exchanges
A. The alveoli are the sites of the vital process of gas exchange between the air
and the blood
Alveoli
Review Figure 19.32
Review Figure 19.33
Respiratory Membrane
A. Part of the wall of an alveolus is made up of cells (type II cells) that secrete
pulmonary surfactant
B. The bulk of the wall of an alveolus consists of a layer of simple squamous
epithelium (type I cells)
C. Both of these layers make up the respiratory membrane through which gas
exchange takes place
Review Figure 19.34
Review Figure 19.35
Animation: Gas Exchange During Respiration
Diffusion Through the Respiratory Membrane
A. Molecules diffuse from regions where they are in higher concentration toward
regions where they are in lower concentration
B. It is important to know the concentration gradient
C. In respiration, think in terms of gas partial pressures
D. Gases diffuse from areas of higher partial pressure to areas of lower partial
pressure
E. The respiratory membrane is normally thin and gas exchange is rapid
1. Increased diffusion is favored with more surface area, shorter distance,
greater solubility of gases and a steeper partial pressure gradient
2. Decreased diffusion occurs from decreased surface area
19.7: Gas Transport
A. Blood transports O2 and CO2 between the lungs and the body cells
B. As the gases enter the blood, they dissolve in the plasma or chemically
combine with other atoms or molecules
Oxygen Transport
A. Almost all oxygen carried in the blood is bound to the protein hemoglobin in
the form of oxyhemoglobin
B. Chemical bonds between O2 and hemoglobin are relatively unstable
C. Oxyhemoglobin releases O2 into the body cells
D. About 75% of the O2 remains bound to hemoglobin in the venous blood
ensuring safe CO2 levels and thereby pH
Review Figure 19.37
Review Figure 19.36
Carbon Dioxide Transport
A. Blood flowing through capillaries gains CO2 because the tissues have a high
Pco2
B. The CO2 is transported to the lungs in one of three forms:
1. As CO2 dissolved in plasma
2. As part of a compound with hemoglobin

3. As part of a bicarbonate ion
Review Figure 19.41
Review Figure 19.42
Review Figure 19.43
Review Table 19.7
Animation: Changes in the Partial Pressures of Oxygen and Carbon Dioxide
A. Lifespan changes reflect an accumulation of environmental influences and the
effects of aging in other organ systems, and may include:
1. The cilia become less active
2. Mucous thickening
3. Swallowing, gagging, and coughing reflexes slowing
4. Macrophages in the lungs lose efficiency
5. An increased susceptibility to respiratory infections
6. A barrel chest may develop
7. Bronchial walls thin and collapse
8. Dead space increasing
19.1: Introduction
Identify the general functions of the respiratory system.
19.2: Why We Breathe
Explain why respiration is necessary for cellular survival.
19.3: Organs of the Respiratory System
Name and describe the locations of the organs of the respiratory system.
Describe the functions of each organ of the respiratory system.
19.4: Breathing Mechanism
Explain how inspiration and expiration are accomplished.
Name and define each of the respiratory air volumes and capacities.
Calculate the alveolar ventilation rate.
List several non-respiratory air movements and explain how each occurs.
19.5: Control of Breathing
Locate the respiratory areas and explain control of normal breathing.
Discuss how various factors affect breathing.
19.6: Alveolar Gas Exchanges
Define partial pressure and explain its importance in diffusion of gases.
Describe gas exchange in the pulmonary and systemic circuits.
Describe the structure and function of the respiratory membrane.
19.7: Gas Transport
Explain how the blood transports oxygen and carbon dioxide.
Describe the effects of aging on the respiratory system.

Twelfth Edition
Chapter 20 Outline
20.1 Introduction
A. A major part of homeostasis is maintaining the composition, pH, and volume
of body fluids within normal limits
B. The urinary system removes metabolic wastes and substances in excess,
including foreign substances like drugs and their metabolites that may be toxic
C. It consists of a pair of kidneys, a pair of ureters, a urinary bladder and a urethra
20.2: Kidneys
A. A kidney is a reddish brown, bean-shaped organ with a smooth surface
B. In the adult it is about 12 centimeters long, 6 centimeters wide, and 3
centimeters thick
C. It is enclosed in a tough, fibrous capsule
Location of the Kidneys
Review Figure 20.3
Kidney Structure
Review Figure 20.4
Review Figure 20.5
Function of the Kidneys
A. The main function of the kidneys is to regulate the volume, composition, and
pH of body fluids
B. The kidneys remove metabolic wastes from the blood and excrete them to the
outside of the body, including nitrogenous and sulfur-containing products of
protein metabolism
C. The kidneys also help control the rate of red blood cell production, regulate
blood pressure, and regulate calcium ion absorption
Animation: Kidney Function
Animation: Kidney Function I
Renal Blood Vessels
Nephrons
Animation: Fluid Exchange Across the Walls of Capillaries
Juxtaglomerular Apparatus
Review Figure 20.12
Cortical and Juxtamedullary Nephrons
Review Figure 20.13
Blood Supply of a Nephron

20.3: Urine Formation
A. The main function of the nephrons and collecting ducts is to control the
composition of body fluids and remove wastes from the blood, the product being
urine
B. Urine contains wastes, excess water, and electrolytes
C. Urine is the final product of the processes of:
1. Glomerular filtration
2. Tubular reabsorption
3. Tubular secretion
Urine Formation
Review Figure 20.16
Glomerular Filtration
A. Glomerular filtration
1. Substances move from the blood to the glomerular capsule
Review Figure 20.17
Plasma, Glomerular Filtrate, and Urine Components
Review Table 20.1
Filtrate Pressure
A. The main force that moves substances by filtration through the glomerular
capillary wall is hydrostatic pressure of the blood inside
Review Figure 20.18
Filtrate Rate
A. Glomerular filtration rate (GFR) is directly proportional to the net filtration
pressure
B. Net filtration pressure = force favoring filtration forces opposing filtration
(glomerular capillary
(capsular hydrostatic pressure
hydrostatic pressure)
and glomerular capillary osmotic pressure)
C. Normally the glomerular net filtration pressure is positive causing filtration
D. The forces responsible include hydrostatic pressure and osmotic pressure of
plasma and the hydrostatic pressure of the fluid in the glomerular capsule
Review Figure 20.19
Control of Filtrate Rate
A. GFR remains relatively constant through a process called autoregulation
B. Certain conditions override autoregulation, including when GFR increases
C. Primarily three mechanisms are responsible for keeping the GFR constant:
1. Autoregulation
2. Increased sympathetic impulses that decrease GFR by causing afferent
arterioles to constrict
3. The hormone-like renin-angiotensin system
4. There also is the hormone atrial natriuretic peptide (ANP) affects sodium
causing an increase in GFR
Review Figure 20.20
Tubular Reabsorption
A. Tubular reabsorption
1. Substances move from the renal tubules into the interstitial fluid where
they then diffuse into the peritubular capillaries
2. The proximal convoluted tubule reabsorbs (70%):
a. Glucose, water, urea, proteins, and creatine
b. Amino, lactic, citric, and uric acids
c. Phosphate, sulfate, calcium, potassium, and sodium ions
Review Figure 20.21
Review Figure 20.22
Review Table 20.2
Tubular Secretion
A. Tubular secretion
1. Substances move from the plasma of the peritubular capillaries into the
fluid of the renal tubules
2. Active transport mechanisms function here
3. Secretion of substances such as drugs and ions
Review Figure 20.23
Regulation of Urine Concentration and Volume
A. Hormones such as aldosterone and ANP affect the solute concentration of
urine, particularly sodium
B. The ability of the kidneys to maintain the internal environment rests in a large
part on their ability to concentrate urine by reabsorbing large volumes of water
C. The distal convoluted tubule and the collecting duct are impermeable to water,
so water may be excreted as dilute urine
D. If ADH is present, these segments become permeable, and water is reabsorbed
by osmosis into the extremely hypertonic medullary interstitial fluid
E. A countercurrent mechanism in the nephron loops (the descending and the
ascending limbs) ensures that the medullary interstitial fluid becomes hypertonic
F. This mechanism is known as the countercurrent multiplier
G. The vasa recta also contributes as a countercurrent mechanism
Review Figure 20.24
Review Table 20.3
Review Figure 20.25
Review Figure 20.26
Review Table 20.4
Urea and Uric Acid Excretion
A. Urea:
1. A by-product of amino acid catabolism
2. The plasma concentration reflects the amount or protein in diet
3. It enters the renal tubules through glomerular filtration
4. It contributes to the reabsorption of water from the collecting duct
5. About 80% is recycled
B. Uric acid:
1. Is a product of nucleic acid metabolism
2. It enters the renal tubules through glomerular filtration
3. Most reabsorption occurs by active transport
4. About 10% is secreted and excreted

Urine Composition
A. Urine composition reflects the volumes of water and solutes that the kidneys
must eliminate from the body or retain in the internal environment to maintain
homeostasis
B. It varies from time to time due to dietary intake and physical activity, but is:
1. About 95% water
2. Usually contains urea, uric acid, and creatinine
3. May contain trace amounts of amino acids and varying amounts of
electrolytes
4. Volume varies with fluid intake and environmental factors
Renal Clearance
A. This is the rate at which a chemical is removed from the plasma
B. It indicates kidney efficiency
C. Tests of renal clearance:
1. Inulin clearance test
2. Creatinine clearance test
3. Para-aminohippuric acid (PAH) test
D. These tests of renal clearance are used to calculate the GFR (glomerular
filtration rate)
Animation: Renal Clearance
20.4: Elimination of Urine
A. After forming along the nephrons, urine:
1. Passes the collecting ducts to:
a. Openings of the renal papillae:
1). Enters the minor and major calyces:
2). Passes through the renal pelvis:
3). Enters into the ureters:
4). Enters into the urinary bladder:
5). The urethra carries the urine out of the body
Ureters
A. The ureters:
1. Each is about 25 centimeters long
2. Extends downward posterior to the parietal peritoneum
3. Runs parallel to vertebral column
4. Join the urinary bladder in the pelvic cavity
5. The wall of ureter has three layers:
a. The inner mucous coat
b. The middle muscular coat
c. The outer fibrous coat
Review Figure 20.27
Urinary Bladder
A. The urinary bladder is a hollow, distensible, muscular organ located within the
pelvic cavity, posterior to the symphysis pubis and inferior to the parietal
peritoneum
B. It contacts the anterior walls of the uterus and vagina in the female, and lies
posteriorly against the rectum in the male
C. The openings for the ureters is the area of trigone
D. It has four layers: inner mucous coat, a submucous coat, a muscular coat, and
an outer serous coat
E. Smooth muscle fibers comprise the detrusor muscle which is the muscle of the
bladder wall
Review Figure 20.28
Review Figure 20.29
Review Figure 20.30
Review Figure 20.32
Urethra
A. The urethra is a tube that conveys urine from the urinary bladder to the outside
of the body
B. Its wall is lined with a mucous membrane and it has a thick layer of
longitudinal smooth muscle fibers
C. In a female:
1. It is about 4 centimeters long
2. It runs obliquely
D. In a male:
1. It is about 17.5 centimeters long
2. It has a dual function for both urination and reproduction
3. It has three sections:
a. Prostatic urethra
b. Membranous urethra
c. Penile urethra
Review Figure 20.31
Micturition
A. Urine leaves the urinary bladder by micturition or urination reflex
Review Table 20.5
Animation: Micturition Reflex
Micturition
Review Table 20.6
Animation: Renal Process
A. The urinary system is sufficiently redundant, in both structure and function, to
mask age-related changes
B. The kidneys become slower to remove nitrogenous wastes and toxins and to
compensate for changes that maintain homeostasis
C. Changes include:
1. The kidneys appear scarred and grainy
2. Kidney cells die
3. By age 80 the kidneys have lost a third of their mass
4. Kidney shrinkage is due to loss of glomeruli
5. Proteinuria may develop
6. The renal tubules thicken

7. It is harder for the kidneys to clear certain substances
8. The bladder, ureters, and urethra lose elasticity
9. The bladder holds less urine
20.1: Introduction
Name the organs of the urinary system and list their general functions.
20.2: Kidneys
Describe the location of the kidneys.
Describe the structure of a kidney.
List the functions of the kidneys.
Trace the pathway of blood flow through the major vessels within a kidney.
Describe a nephron and explain the functions of its major parts.
20.3: Urine Formation
Explain how glomerular filtrate is produced and describe its composition.
Explain how various factors affect the rate of glomerular filtration and identify
ways that this rate is regulated.
Define tubular reabsorption and explain its role in urine formation.
Identify the changes in the osmotic concentration of the glomerular filtrate as it
passes through the renal tubule.
Identify the characteristics of the countercurrent mechanism and explain its role
in concentrating the urine.
Define tubular secretion and explain its role in urine formation.
20.4: Elimination of Urine
Describe the structures of the ureters, urinary bladder, and urethra.
Define micturition and explain how it occurs and how it is controlled.
Describe how the components of the urinary system change with age.

Twelfth Edition
Chapter 21 Outline
21.1 Introduction
A. The term balance suggests a state of equilibrium
B. For water and electrolytes that means equal amounts enter and leave the body
C. Mechanisms that replace lost water and electrolytes and excrete excesses
maintain this balance
D. This results in stability of the body at all times
E. Keep in mind water and electrolyte balance are interdependent
21.2: Distribution of Body Fluids
A. Body fluids are not uniformly distributed
B. They occupy compartments of different volumes that contain varying
compositions
C. Water and electrolyte movement between these compartments is regulated to
stabilize their distribution and the composition of body fluids
Fluid Compartments
A. Of the 40 liters of water in the body of an average adult, about two-thirds is
intracellular fluid and one-third is extracellular fluid
B. An average adult female is about 52% water by weight, and an average male
about 63% water by weight
Review Figure 21.1
Review Figure 21.2
Body Fluid Composition
A. Extracellular fluids are generally similar in composition including high
concentrations of sodium, calcium, chloride and bicarbonate ions
B. Intracellular fluids have high concentrations of potassium, magnesium,
phosphate, and sulfate ions
Review Figure 21.3
Movement of Fluid Between Compartments
A. Two major factors regulate the movement of water and electrolytes from one
fluid compartment to another
1. Hydrostatic pressure
2. Osmotic pressure
Review Figure 21.4
21.3: Water Balance
A. Water balance exists when water intake equals water output
B. Homeostasis requires control of both water intake and water output
Water Intake
A. The volume of water gained each day varies among individuals averaging
about 2,500 milliliters daily for an adult:
1. 60% from drinking
2. 30% from moist foods
3. 10% as a bi-product of oxidative metabolism of nutrients called water of

metabolism
Review Figure 21.5
Regulation of Water Intake
Review Table 21.1
Water Output
A. Water normally enters the body only through the mouth, but it can be lost by a
variety of routes including:
1. Urine (60% loss)
2. Feces (6% loss)
3. Sweat (sensible perspiration) (6% loss)
4. Evaporation from the skin (insensible perspiration)
5. The lungs during breathing
6. (Evaporation from the skin and the lungs is a 28% loss)
Regulation of Water Output
Review Table 21.2
21.4: Electrolyte Balance
A. An electrolyte balance exists when the quantities of electrolytes the body gains
equals those lost
Review Figure 21.6
Electrolyte Intake
A. The electrolytes of greatest importance to cellular functions release sodium,
potassium, calcium, magnesium, chloride, sulfate, phosphate, bicarbonate, and
hydrogen ions
B. These ions are primarily obtained from foods, but some are from water and
other beverages
Regulation of Electrolyte Intake
A. Ordinarily, a person obtains sufficient electrolytes by responding to hunger and
thirst
B. A severe electrolyte deficiency may cause salt craving
Electrolyte Output
A. The body loses some electrolytes by perspiring typically on warmer days and
during strenuous exercise
B. Some are lost in the feces
C. The greatest output is as a result of kidney function and urine output
Regulation of Electrolyte Output
A. The concentrations of positively charged ions, such as sodium (Na+),
potassium (K+) and calcium (Ca+2) are of particular importance
B. These ions are vital for nerve impulse conduction, muscle fiber contraction,
and maintenance of cell membrane permeability
21.5: Acid-Base Balance
A. Electrolytes that ionize in water and release hydrogen ions are acids
B. Substances that combine with hydrogen ions are bases
C. Acid-base balance entails regulation of the hydrogen ion concentrations of

body fluids
D. This is important because slight changes in hydrogen ion concentrations can
alter the rates of enzyme-controlled metabolic reactions, shift the distribution of
other ions, or modify hormone actions
Sources of Hydrogen Ions
Review Figure 21.9
Strengths of Acids and Bases
A. Acids:
1. Strong acids ionize more completely and release more H+
2. Weak acids ionize less completely and release fewer H+
B. Bases:
1. Strong bases ionize more completely and release more OH2. Weak bases ionize less completely and release fewer OHRegulation of Hydrogen Ion Concentration
A. Either an acid shift or an alkaline (basic) shift in the body fluids could threaten
the internal environment
B. Normal metabolic reactions generally produce more acid than base
C. The reactions include cellular metabolism of glucose, fatty acids, and amino
acids
D. Maintenance of acid-base balance usually eliminates acids in one of three
ways:
1. Acid-base buffer systems
2. Respiratory excretion of carbon dioxide
3. Renal excretion of hydrogen ions
Acid-Base Buffer Systems
A. Bicarbonate buffer system
1. The bicarbonate ion converts a strong acid to a weak acid
2. Carbonic acid converts a strong base to a weak base
3. H+ + HCO3- H2CO3 H+ + HCO3B. Phosphate buffer system
1. The monohydrogen phosphate ion converts a strong acid to a weak acid
2. The dihydrogen phosphate ion converts a strong base to a weak base
3. H+ + HPO4-2 H2PO4- H+ + HPO4-2
C. Protein buffer system
1. NH3+ group releases a hydrogen ion in the presence of excess base
2. COO- group accepts a hydrogen ion in the presence of excess acid
Review Table 21.3
Respiratory Secretion of Carbon Dioxide
A. The respiratory center in the brainstem helps regulate hydrogen ion
concentrations in the body fluids by controlling the rate and depth of breathing
B. If body cells increase their production of CO2
Review Figure 21.10
Renal Excretion of Hydrogen Ions
A. Nephrons help regulate the hydrogen ion concentration of body fluids by
excreting hydrogen ions in the urine
Review Figure 21.11

Time Course of Hydrogen Ion Regulation
A. Various regulators of hydrogen ion concentration operate at different rates
B. Acid-base (chemical) buffers function rapidly
C. Respiratory and renal (physiological buffers) mechanisms function more
slowly
Review Figure 21.12
21.6: Acid-Base Imbalances
A. Chemical and physiological buffer systems ordinarily maintain the hydrogen
ion concentration of body fluids within very narrow pH ranges
B. Abnormal conditions may disturb the acid-base balance
Review Figure 21.13
Acidosis
A. Acidosis results from the accumulation of acids or loss of bases, both of which
cause abnormal increases in the hydrogen ion concentrations of body fluids
B. Alkalosis results from a loss of acids or an accumulation of bases accompanied
by a decrease in hydrogen ion concentrations
Review Figure 21.14
Acidosis
A. Two major types of acidosis are respiratory acidosis and metabolic acidosis
Alkalosis
A. Respiratory alkalosis develops as a result of hyperventilation
B. Metabolic alkalosis results from a great loss of hydrogen ions or from a gain in
bases, both accompanied by a rise in the pH of blood
21.1: Introduction
Explain the balance concept.
Explain the importance of water and electrolyte balance.
21.2: Distribution of Body Fluids
Describe how body fluids are distributed in compartments.
Explain how fluid composition varies among compartments and how fluids move
from one compartment to another.
21.3: Water Balance
List the routes by which water enters and leaves the body.
Explain the regulation of water input and water output.
21.4: Electrolyte Balance
List the routes by which electrolytes enter and leave the body.
Explain the regulation of the input and the output of electrolytes.
21.5: Acid-Base Balance
Explain acid-base balance.
Identify how pH number describes the acidity and alkalinity of a body fluid.
List the major sources of hydrogen ions in the body.
Distinguish between strong acids and weak acids.
Explain how chemical buffer systems, the respiratory system, and the kidneys
keep the pH of body fluids relatively constant.
21.6: Acid-Base Imbalances
Describe the causes and consequences of increase or decrease in body fluid pH.

Twelfth Edition
Chapter 22 Outline
22.1 Introduction
A. Male and female reproductive systems are connected by a series of organs and
glands that produce and nurture sex cells and transport them to sites of
fertilization
B. Male sex cells are sperm
C. Female sex cells are eggs or oocytes
D. Sex cells are produced by a special type of division called meiosis
E. Meiosis includes two successive divisions, called the first (meiosis I) and
second (meiosis II) meiotic divisions
Review Figure 22.1
First Meiotic Division
A. Meiosis I separates homologous (the same, gene for gene) pairs
B. They may not be identical because a gene may have variants
C. There are four phases in this division
1. Prophase I
2. Metaphase I
3. Anaphase I
4. Telophase I
Animation: Meiosis I
Review Figure 22.2
Second Meiotic Division
A. Meiosis II begins after telophase I
B. This division is similar to mitosis
C. There are four phases in this division:
1. Prophase II
2. Metaphase II
3. Anaphase II
4. Telophase II
D. This division completes with each sex cell having one set of genetic
instructions, or 23 chromosomes (compared to two sets (46 chromosomes) in
other cells)
Animation: Meiosis II
Review Figure 22.3
Animation: How Meiosis Works
Animation: Stages of Meiosis
22.2: Organs of the Male Reproductive System
Review Figure 22.4
Testes
Review Figure 22.4
Descent of the Testes
Review Figure 22.5

Structure of the Testes
Formation of Sperm Cells
Animation: Spermatogenesis
Structure of a Sperm Cell
Male Internal Accessory Organs
A. The male internal accessory organs include:
1. Epididymides
2. Ductus deferentia
3. Seminal vesicles
4. Prostate gland
5. Bulbourethral glands
Review Figure 22.4
Epididymides
A. Tightly coiled tubes
B. Connected to ducts within the testis
C. Promote maturation of sperm cells
Review Figure 22.12
Ductus Deferentia
A. Are muscular tubes
B. About 45 centimeters each
C. Extends from the epididymis to the ejaculatory duct
Review Figure 22.13
Seminal Vesicles
A. Attached to the vas deferens near base of the urinary bladder
B. Secrete alkaline fluid
C. Secrete fructose and prostaglandins
D. Contents empty into the ejaculatory duct
Review Figure 22.4
Prostate Gland
A. Surrounds the proximal portion of the urethra
B. The ducts of the gland open into the urethra
C. Secretes a thin, milky, alkaline fluid
D. Secretion enhances fluid mobility
E. Composed of tubular glands in connective tissue
F. Also contains smooth muscle
Review Figure 22.14
Bulbourethral Glands
A. Inferior to the prostate gland
B. Secrete mucus-like fluid
C. Fluid released in response to sexual stimulation
Review Figure 22.4
Semen
A. The fluid the urethra conveys to the outside during ejaculation is called semen
B. Semen consists of:
1. Sperm cells
2. Secretions of the seminal vesicles, prostate gland, and bulbourethral glands
3. It is slightly alkaline
4. Contains prostaglandins
5. Contains nutrients
6. Volume is 2-5 milliliters of semen per ejaculation
7. Average 120 million sperm cells per milliliter of semen
Male External Reproductive Organs
A. Includes the:
1. Scrotum (and two testes)
2. Penis
Review Figure 22.4
Scrotum
A. Pouch of skin and subcutaneous tissue
B. Dartos muscle smooth muscle in subcutaneous tissue; contracts to cause
wrinkling of the scrotum
C. Medial septum divides the scrotum into two chambers
D. Each chamber is lined with a serous membrane
E. Each chamber houses a testis and epididymis
Penis
A. Conveys urine and semen
B. Specialized to become erect for insertion into the vagina
Review Figure 22.15
Erection, Orgasm, and Ejaculation
A. The erection:
1. Parasympathetic nerve impulses
2. Blood accumulates in the erectile tissues
B. The orgasm:
1. Culmination of sexual stimulation
2. Accompanied by emission and ejaculation
C. The ejaculation:
1. Emission is the movement of semen into the urethra
2. Ejaculation is the movement of semen out of the urethra
3. This is largely dependent on sympathetic nerve impulses
Review Table 22.1
22.3: Hormonal Control of Male Reproductive Functions
A. Hormones secreted by the hypothalamus, the anterior pituitary gland, and the
testes control male reproductive functions
B. Hormones initiate and maintain sperm cell production and oversee the
development and maintenance of male sex characteristics
Hypothalamic and Pituitary Hormones

A. The hypothalamus controls maturation of sperm cells and development of male
secondary sex characteristics
B. Negative feedback among the hypothalamus, the anterior lobe of the pituitary
gland, and the testes controls the concentration of testosterone
Male Sex Hormones
A. The male sex hormones are called androgens
B. Interstitial cells in the testes produce most of them, but small amounts are
made in the adrenal cortex
C. Testosterone is the most important
Actions of Testosterone
A. Increased growth of body hair
B. Sometimes decreased growth of scalp hair
C. Enlargement of the larynx and thickening of the vocal cords
D. Thickening of the skin
E. Increased muscular growth
F. Thickening and strengthening of the skeletal bones
Regulation of Male Sex Hormones
Review Figure 22.18
22.4: Organs of the Female Reproductive System
Review Figure 22.19
Ovaries
Review Figure 22.20
Ovary Attachments
A. Several ligaments hold each ovary in position
B. The largest is called the broad ligament and is attached to the uterine tubes and
uterus
C. The suspensory ligament holds the ovary at the upper end
D. The ovarian ligament is a rounded, cord-like thickening of the broad ligament
Ovary Descent
A. Like the testes in the male fetus, the ovaries develop from masses of tissue
posterior to the parietal peritoneum, near the developing kidney
B. They descend to locations just inferior to the pelvic brim where they remain
attached to the lateral pelvic wall
Ovary Structure
A. The tissues of an ovary can be divided into an inner medulla and an outer
cortex
1. The ovarian medulla is mostly composed of loose connective tissue and
contains many blood vessels, lymphatic vessels, and nerve fibers
2. The ovarian cortex consists of more compact tissue and has a granular
appearance due to tiny masses of cells called ovarian follicles
Primordial Follicles
A. During prenatal development of a female, oogonia divide by mitosis to
produce more oogonia
B. The oogonia develop into primary oocytes
C. Each primary oocyte is closely surrounded by a layer of flattened epithelial

cells called follicular cells, forming a primordial follicle
Oogenesis
A. The process of egg cell formation
Review Figure 22.21
Follicle Maturation
A. At puberty, the anterior pituitary gland secretes increased amounts of FSH, and
the ovaries enlarge in response
B. With each reproductive cycle, some of the primordial follicles mature
Follicle Maturation
A. As many as twenty primary follicles may begin maturing at any one time
B. One dominant follicle usually out-grows the others
C. Typically only the dominant follicle fully develops and the others degenerate
Review Figure 22.24
Ovulation
A. As a follicle matures, its primary oocyte undergoes meiosis I, giving rise to a
secondary oocyte and a first polar body
B. The process of ovulation releases these cells from the follicle
Review Figure 22.25
Ovulation
Review Figure 22.26
Animation: Maturation of the Follicle and Oocyte
Female Internal Accessory Organs
A. The female internal accessory organs include:
1. Uterine tubes
2. Uterus
3. Vagina
Review Figure 22.19
Uterine Tubes
Review Figure 22.27
Uterine Tubes
Review Figure 22.28
Uterus
Vagina
A. A fibromuscular tube that conveys uterine secretions, receives the penis during
intercourse, and provides an open channel for offspring
Review Figure 22.30
Female External Reproductive Organs
A. The female external reproductive organs surround the openings of the urethra
and vagina and is known as the vulva, and include:
1. Labia majora
2. Labia minora
3. Clitoris
4. Vestibular glands
Review Figure 22.30

Labia Majora
A. Rounded folds of adipose tissue and skin
B. Enclose and protect the other external reproductive parts
C. Ends form a rounded elevation over the symphysis pubis
Review Figure 22.30
Labia Minor
A. Flattened, longitudinal folds between the labia majora
B. Well supplied with blood vessels
Review Figure 22.30
Clitoris
A. Small projection at the anterior end of the vulva
B. Analogous to the male penis
C. Composed of two columns of erectile tissue
D. Root is attached to the sides of the pubic arch
Review Figure 22.30
Vestibule
A. Space between the labia minora that encloses the vaginal and the urethral
openings
B. The vestibular glands secrete mucus into the vestibule during sexual
stimulation
Review Figure 22.30
Animation: Female Reproductive System
Review Figure 22.31
Review Table 22.2
22.5: Hormonal Control of Female Reproductive Functions
A. Hormones secreted by the hypothalamus, the anterior pituitary gland, and the
ovaries control development and maintenance of female secondary sex
characteristics, maturation of female sex cells, and changes during the monthly
reproductive cycle
Female Sex Hormones
Review Figure 22.32
Female Reproductive Cycle
Review Table 22.3
Review Table 22.4
Review Figure 22.33
Menopause
A. Usually occurs in the late 40s or the early 50s
B. The reproductive cycles stop
C. The ovaries no longer produce as much estrogens and progesterone as
previously
D. Some female secondary sex characteristics may disappear
E. It may produce hot flashes and fatigue
F. Migraine headaches, backaches and fatigue is possible
G. Hormone therapy may prevent effects on bone tissue

22.6: Mammary Glands
A. The mammary glands are accessory organs of the female reproductive system
specialized to secrete milk following pregnancy
Location of the Gland
A. Located in the subcutaneous tissue of the anterior thorax within the breasts
B. Composed of lobes
C. Estrogens stimulate breast development in females
Review Figure 22.34
A. A mammary gland is composed of fifteen to twenty irregularly shaped lobes
B. Each lobe contains glands (alveolar glands), drained by alveolar ducts, which
drain into a lactiferous duct that leads to the nipple and opens to the outside
C. Dense strands of connective tissue form suspensory ligaments that support the
breast
Development of the Breasts
A. The mammary glands of males and females are similar
B. As puberty is reached, ovarian hormones stimulate development of the glands
in females
22.7: Birth Control
A. Birth control is the voluntary regulation of the number of offspring produced
and the time they are conceived
B. This control requires a method of contraception
Review Table 22.5
Coitus Interruptus
A. The practice of withdrawing the penis from the vagina before ejaculation,
preventing entry of sperm cells into the female reproductive tract
Rhythm Method
A. Requires abstinence from sexual intercourse two days before and one day after
ovulation
Mechanical Barriers
A. Mechanical barriers include the use of a:
1. Condom
2. Diaphragm
3. Cervical cap
4. Spermicidal foams or jellies
Chemical Barriers
A. Chemical barriers include:
1. Spermicides
Review Figure 23.35
Combined Hormone Contraceptives
A. These deliver estrogen and progesterone to prevent pregnancy
B. Various methods are used to deliver hormones including:
1. A flexible chemical ring (Nuvaring)
2. A plastic patch (Ortho Evra)
3. The pill orally

C. (Similar to these combined hormones is the minipill which contains only
progestin)
Injectable Contraception
A. An intramuscular injection of Depo-Provera protects against pregnancy for
three months by preventing maturation and release of a secondary oocyte
Intrauterine Devices
A. An intrauterine device, or IUD, is a small, solid object that a physician places
in the uterine cavity
B. An IUD interferes with implantation of a blastocyst
Surgical Methods
Review Figure 23.36
22.8: Sexually Transmitted Diseases
A. These are silent infections
B. Most are bacterial and can be cured
C. Herpes, warts, and AIDS are viral and cannot be cured
D. Many cause infertility
E. AIDS causes death
F. Symptoms of STDs include:
1. Burning sensation during urination
2. Pain in the lower abdomen
3. Fever or swollen glands
4. Discharge from the vagina or the penis
5. Pain, itch, or inflammation in the genital or the anal area
6. Sores, blisters, bumps or rashes
7. Itchy, runny eyes
Review Table 22.6
22.1: Introduction
State the general functions of the male and female reproductive systems.
Outline the process of meiosis and explain how it mixes up parental genes.
22.2: Organs of the Male Reproductive System
Describe the function(s) of each part of the male reproductive system.
Outline the process of spermatogenesis.
Describe semen production and exit from the body.
Describe the structure of the penis, and explain how its parts produce an erection.
22.3: Hormonal Control of Male Reproductive Functions
Explain how hormones control the activities of the male reproductive organs and
the development of male secondary sex characteristics.
22.4: Organs of the Female Reproductive System
Describe the function(s) of each part of the female reproductive system.
Outline the process of oogenesis.
22.5: Hormonal Control of Female Reproductive Functions
Explain how hormones control the activities of the female reproductive organs
and the development of female secondary sex characteristics.
Describe the major events that occur during a reproductive cycle.
22.6: Mammary Glands

Review the structure of the mammary glands.
22.7: Birth Control
Describe several methods of birth control, including the relative effectiveness of
each method.
22.8: Sexually Transmitted Diseases
List the general symptoms of sexually transmitted diseases.

Twelfth Edition
Chapter 23 Outline
23.1 Introduction
A. A sperm and a secondary oocyte unite, forming a zygote, and the journey of
prenatal development begins
B. After 38 weeks of cell division, growth and specialization into distinctive
tissues and organs, a new human being enters the world
C. Humans grow, develop and age
1. Growth is an increase in size
2. Development, which includes growth, is the continuous process by which
an individual changes from one life phase to another
a. Prenatal period is from fertilization to birth
b. Postnatal period is from birth to death
23.2: Pregnancy
A. Pregnancy is the presence of a developing offspring in the uterus
B. It consists of three periods, or trimesters, each three months long
Transport of Sex Cells
A. Before fertilization can occur, a secondary oocyte must be ovulated and enter a
uterine tube
B. Only 200 of between 200 to 600 million sperm reach a secondary oocyte
Fertilization
A. Fertilization is the union of an egg cell (secondary oocyte) and a sperm cell
Review Figure 23.3
23.3: Prenatal Period
A. The prenatal period usually lasts 38 weeks from conception
B. It can be divided into:
1. A period of cleavage
2. An embryonic stage
3. A fetal stage
Period of Cleavage
A. The rapid cell division and distribution of the zygotes cytoplasm into
progressively smaller cells is cleavage
B. The cells produced during cleavage are called blastomeres
Review Figure 23.4
Review Figure 23.5
Hormonal Changes During Pregnancy
A. Secretion of hCG maintains the corpus luteum
B. The corpus luteum secretes estrogens and progesterone
C. The placenta secretes large amounts of estrogens and progesterone

D. Estrogens and progesterone stimulate and maintain the uterine lining, inhibit
FSH and LH, inhibit uterine contractions, and enlarge the reproductive organs
E. Relaxin from the corpus luteum inhibits uterine contractions and relaxes the
pelvic ligaments
F. Placental lactogen stimulates breast development
G. Aldosterone promotes sodium retention
H. PTH maintains calcium concentrations in the blood
Review Figure 23.8
Review Figure 23.9
Review Table 23.1
Other Changes During Pregnancy
A. Growth of the uterus can displace abdominal organs and disrupt meals,
including the development of heartburn and increased urinary frequency
B. More oxygen is needed and more waste is excreted causing increases in blood
volume, cardiac output, breathing rate, and urine production
C. To obtain adequate nutrition, intake must be sufficient to supply needed
vitamins, minerals and proteins
Embryonic Stage
A. The embryonic stage extends from the beginning of the second week through
the eighth week, when the placenta forms, the main internal organs develop, and
the major external body structures appear
Review Figure 23.10
Review Table 23.2
Review Figures 23.11 through 23.20
Fetal Stage
A. The fetal stage begins at the end of the eighth week of prenatal development
B. Here growth is rapid, and body portions change considerably
C. At the beginning of this stage, the head is disproportionately large, and the
lower limbs are relatively short
Animation: Fetal Development and Risk
Review Table 23.3
Fetal Blood and Circulation
Review Figure 23.24
Review Table 23.4
Birth Process
A. Pregnancy terminates with the birth process called parturition
B. The process is complex as noted in Table 23.5
Milk Production and Secretion
Review Table 23.6
Review Table 23.7

23.4: Postnatal Period
A. Following birth, both mother and newborn experience physiological and
structural changes
B. The postnatal period lasts from birth until death
C. It can be divided into:
1. The neonatal period
2. Infancy
3. Childhood
4. Adolescence
5. Adulthood
6. Senescence (including dying)
Neonatal Period
A. Neonatal period
1. From birth to the end of the 4th week
2. The newborn begins to carry on respiration, obtain nutrients, digest
nutrients, excrete wastes, regulate body temperature, and make cardiovascular
adjustments
Review Table 23.8
Infancy
A. Infancy
1. From the end of the 4th week to one year
2. The growth rate is high
3. The teeth begin to erupt
4. The muscular and nervous systems mature
5. Communication begins
Childhood
A. Childhood
1. From one year to puberty
2. The growth rate is high
3. Permanent teeth appear
4. Muscular control is achieved
5. Bladder and bowel controls are established
6. Intellectual abilities mature
Adolescence
A. Adolescence
1. From puberty to adulthood
2. The person becomes reproductively functional and emotionally more
mature
3. Growth spurts occur
4. Motor skills continue to develop
5. Intellectual abilities continue to mature
Adulthood
A. Adulthood
1. Adolescence to old age
2. The person remains relatively unchanged anatomically and physiologically

3. Degenerative changes begin
Senescence
A. Senescence
1. Old age to death
2. Degenerative changes continue
3. The body becomes less able to cope with the demands placed on it
4. Death results from various conditions and diseases
Review Table 23.9 and 23.10
The End of Life
A. Nearing the end of life is a personal process, influenced by belief as well as
circumstance
B. A person who has been chronically ill may show signs of impending death,
often in a sequence
C. Two stages of the dying process include:
1. Preactive dying which may take up to three months
2. Active dying with a distinct set of signs
23.5: Aging
A. The aging process is difficult to analyze
B. The medical field of gerontology examines the biological changes of aging at
the molecular, cellular, organismal, and population levels
C. Aging is both active and passive
Passive Aging
A. Aging as a passive process is a breakdown of structures and slowing of
functions
1. Molecularly a degeneration of elastin and collagen proteins
2. Biochemically lipids breakdown
3. Cellular degradation is associated with free radicals
Active Aging
A. Aging also entails new activities or the appearance of new substances
1. Lipofuscin granules from the breakdown of lipids
2. Autoimmunity
3. Apoptosis: the process of programmed cell death
The Human Life Span
A. The human life span is approximately 120 years
B. Life expectancy is a realistic projection of how long an individual will live
C. The current U.S. life expectancy is 75.4 years for men and 83.2 years for
women
D. Medical advances contribute to improved life expectancy
Review Table 23.11
23.1: Introduction
Distinguish between growth and development.
Distinguish between prenatal and postnatal.
23.2: Pregnancy
Describe fertilization.
23.3: Prenatal Period
List and provide details of the major events of cleavage.
Describe implantation.
Discuss the hormonal and other changes in the maternal body during pregnancy.
Explain how the primary germ layers originate and list the structures each layer
produces.
Describe the major events of the embryonic stage of development.
Describe the formation and function of the placenta.
Define fetus, and describe the major events that occur during the fetal stage of
development.
Trace the path of blood through the fetal cardiovascular system.
Explain the role of hormones in the birth process and milk production.
23.4: Postnatal Period
Describe the major cardiovascular and physiological adjustments that occur in a
newborn.
Name the postnatal stages of development of a human, and indicate the general
characteristics of each stage.
23.5: Aging
Distinguish between active and passive aging.
Contrast lifespan and life expectancy.

Twelfth Edition
Chapter 24 Outline
24.1 Introduction
A. Packaged into our cells are instruction manuals
B. The manual is the human genome
C. It is written in the language of the DNA molecules
D. DNA consists of a sequence of nucleotide building blocks A, g, C, and T
E. Sequences of DNA that encode particular proteins are called genes
F. A gene has different forms and can vary from individual to individual
G. Genetics is the study of the inheritance of characteristics
H. A genome is a complete set of genetic instructions
I. Genomics is the field in which the body is studied in terms of multiple,
interacting genes
24.2: Modes of Inheritance
A. Genetics has the power of prediction
B. Knowing how genes are distributed in meiosis and the combinations in which
they join at fertilization makes it possible to calculate the probability that a certain
trait will appear in the offspring of two particular individuals
C. These patterns in which genes are transmitted in families are termed modes of
inheritance
Chromosomes and Genes Come in Pairs
A. This normal karyotype shows 23 pairs of chromosomes:
1. Pairs 1-22 are autosomes (they do not determine sex)
2. Pair 23 are the sex chromosomes
Review Figure 24.3
Chromosomes and Genes Come in Pairs
A. A gene consists of hundreds of nucleotide building blocks and exists in variant
forms called alleles that differ in DNA sequence
B. An individual who has two identical alleles of a particular gene is homozygous
for that gene
C. A person with two different alleles for a gene is heterozygous
D. The particular combination of gene variants (alleles) in a persons genome
constitutes the genotype
E. The appearance or health condition of the individual that develops as a result of
the ways the genes are expressed is termed the phenotype
F. Wild type alleles produce mutations
Dominant and Recessive Inheritance
A. For many genes, in heterozygotes, one allele determines the phenotype
B. Dominant allele masks the phenotype of the recessive allele
C. Recessive allele is expressed only if in a double dose (homozygous)
D. Autosomal conditions are carried on a nonsex chromosome
E. Sex-linked conditions are carried on a sex chromosome

F. X-linked conditions are carried on the X chromosome
G. Y-linked conditions are carried on the Y chromosome
Different Dominance Relationships
A. Most genes exhibit complete dominance or recessiveness
B. Exceptions are incomplete dominance and codominance
C. Heterozygote has a phenotype intermediate between homozygous dominant
and homozygous recessive
D. Familial hypercholesterolemia is an example here
Review Figure 24.6
Different Dominance Relationships: Codominance
A. Different alleles expressed in a heterozygote are codominant
B. ABO blood type is an example:
1. Three alleles of ABO blood typing are IA, IB, I
2. A person with type A may have the genotype IA i or IA IA
3. A person with type B may have the genotype IB i or IB IB
4. A person with type AB must have the genotype IA IB
5. A person with type O blood must have the genotype ii
24.3: Factors That Affect Expression of Single Genes
A. Most genotypes vary somewhat from person to person, due to the effects of the
environment and other genes
B. Penetrance, expressivity, and pleiotropy describe distinctions of genotype
Penetrance and Expressivity
A. Complete penetrance
1. Everyone who inherits the disease causing alleles has some symptoms
B. Incomplete penetrance
1. Some individuals do not express the phenotype even though they inherit
the alleles
2. An example is polydactyly
C. Variable expression
1. Symptoms vary in intensity in different people
2. For example, two extra digits versus three extra digits in polydactyly
Pleiotropy
A. Pleiotropy
1. A single genetic disorder producing several symptoms
2. Marfan syndrome (an autosomal dominant defect) is an example
3. People affected produce several symptoms that vary
Genetic Heterogeneity
A. Genetic heterogeneity
1. The same phenotype resulting from the actions of different genes
2. Hereditary deafness is an example
24.4: Multifactorial Traits
A. Most if not all characteristics and disorders considered inherited actually
reflect input from the environment as well as genes
B. Polygenic traits
1. Determined by more than one gene
2. Examples include height, skin color, and eye color
C. Multifactorial traits
1. Traits molded by one or more genes plus environmental factors
2. Examples include height and skin color
3. Common diseases such as heart disease, diabetes mellitus, hypertension,
and cancers are multifactorial
24.5: Matters of Sex
A. Human somatic (nonsex) cells include an X and a Y chromosome in males and
two X chromosomes in females
1. All eggs carry a single X chromosome
2. Sperm carry either an X or Y chromosome
B. Sex is determined at conception: a Y-bearing sperm fertilizing an egg
conceives a male, and an X-bearing sperm conceives a female
Review Figure 24.10
Sex Determination
A. Maleness derives from a Y chromosome gene called SRY
B. The SRY gene encodes a type of protein called a transcription factor
C. The SRY activates transcription of genes that direct development of male
structures in the embryo, while suppressing formation of female structures
Review Figure 24.11
Genes of the Sex Chromosomes
A. X chromosome
1. Has over 1,500 genes
2. Most genes on the X chromosome do not have corresponding alleles on the
Y chromosome
B. Y chromosome
1. Has only 231 protein-encoding genes
2. Some genes are unique only to the Y chromosome
Hemophilia
A. Passed from mother (heterozygote) to son
B. Each son has a 50% chance of receiving the recessive allele from the mother
C. Each son with one recessive allele will have the disease
D. Each son has no allele on the Y chromosome to mask the recessive allele
E. Each daughter has a 50% chance of receiving the recessive allele from the
mother
F. Each daughter with one recessive allele will be a carrier
G. Each daughter with one recessive allele does not develop the disease because
she has another X chromosome with a dominant allele
Gender Effects on Phenotype
A. Sex-limited trait
1. Affects a structure or function of the body that is present in only males or
only females
2. Examples are beards or growth of breasts
B. Sex-influenced inheritance
1. An allele is dominant in one sex and recessive in the other
2. Baldness is an example
3. Heterozygous males are bald but heterozygous females are not
24.6: Chromosome Disorders
A. Deviations from the normal chromosome number of 46 produce syndromes
because of the excess or deficit of genes
B. Chromosome number abnormalities may involve single chromosomes or entire
sets of chromosomes
C. Euploid is a normal chromosome number
Polyploidy
A. Polyploidy
1. The most drastic upset in chromosome number
2. This is an entire extra set of chromosomes
3. Results from formation of a diploid, rather than a normal haploid, gamete
4. Most embryos or fetuses die, but occasionally an infant survives a few days
with many abnormalities
Aneuploidy
A. Aneuploidy
1. Cells missing a chromosome or having an extra chromosome
2. Results from meiotic error called nondisjunction
3. Here a chromosome pair fails to separate, either at the first or at the second
meiotic division, producing a sperm or egg that has two copies of a particular
chromosome or none, rather than the normal one copy
4. When a gamete fuses with its mate at fertilization, the resulting zygote has
either 47 or 45 chromosomes, instead of 46
5. Trisomy is the condition of having an extra chromosome
6. Monosomy is the condition of missing a chromosome
Review Table 24.1
Prenatal Tests Detect Chromosome Abnormalities
Review Figure 24.13
Review Figure 24.14
Review Table 24.2
24.7: Gene Expression Explains Aspects of Anatomy and Physiology
A. Gene expression patterns can add to what we know about structure and
function of the human body
B. Identifying which genes are active and inactive in particular cell types, under
particular conditions, can add to our understanding of physiology
C. Gene expression monitors the proteins that a cell produces
D. The technology used is termed gene expression profiling, and identifying the
sets of proteins in a cell is proteomics
E. DNA microarrays or DNA chips profile gene expression
F. This is valuable in anatomy and physiology when it allows medical researchers
see distinctions their eyes cannot detect
Review Figure 24.15
24.1: Introduction
Distinguish among genome, gene, and chromosome.
Define genetics.
Explain how genetic information passes from generation to generation.
Explain how the human genome is an economical storehouse of information.
24.2: Modes of Inheritance
State the two bases of genetic predictions.
Define the two types of chromosomes.
Explain the basis of multiple alleles of a gene.
Distinguish between heterozygous and homozygous; genotype and phenotype;
dominant and recessive.
Distinguish between autosomal recessive and autosomal dominant inheritance.
24.3: Factors That Affect Expression of Single Genes
Explain how and why the same genotype can have different phenotypes among
individuals.
24.4: Multifactorial Traits
Describe how traits determined by genes and the environment are inherited.
24.5: Matters of Sex
Describe how and when sex is determined.
Explain how X-linked inheritance differs from inheritance of autosomal traits.
Discuss factors that affect how phenotypes may differ between the sexes.
24.6: Chromosome Disorders
Describe three ways that chromosomes can be abnormal.
Explain how prenatal tests provide information about chromosomes.
24.7: Gene Expression Explains Aspects of Anatomy and Physiology
What type of information does gene expression profiling provide?
Explain how a DNA microarray works.

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Shier, Butler & Lewis

E. Respiration: obtaining oxygen; removing carbon dioxide; releasing energy

C. Produces more chaos in the body

1.5: Maintenance of Life

Holes Human Anatomy and Physiology

Bonding of Atoms: Polar Molecules

2. Two-thirds of the weight of an adult human

Holes Human Anatomy and Physiology

2. Separates nucleoplasm from cytoplasm

B. Sugars, amino acids, sodium ions, potassium ions, etc.

4. Telophase chromatin forms; nuclear envelope forms

Holes Human Anatomy and Physiology

3. Examples: sucrase, lactase, protease, lipase

Citric Acid Cycle

Define a rate-limiting enzyme and indicate why it is important in a metabolic

Holes Human Anatomy and Physiology

2.) Sweat glands, salivary glands, etc.

3. Important in injury or infection

7. Around kidneys and heart

2. Red blood cells

Holes Human Anatomy and Physiology

a. Varying amounts of melanin

A. Inflammation is a normal response to injury or stress.

Describe the events that are part of wound healing.

Holes Human Anatomy and Physiology

A. The vertebral column, or spinal column, consists of many vertebrae separated

D. Osteoclasts outnumber osteoblasts

Holes Human Anatomy and Physiology

A. There are two (2) types of cartilaginous joints (amphiarthroses):

Holes Human Anatomy and Physiology

4. Liver converts lactic acid to glucose

B. Eccentric lengthening contraction

1. Interaction between actin and myosin

Holes Human Anatomy and Physiology

Holes Human Anatomy and Physiology

F. Volume is only about 120 ml.

3. Lateral fissure of Sylvius

B. Deep within cerebral hemispheres

Cranial Nerves III and IV

1.) Sensory from equilibrium receptors of ear

A. Dorsal root (aka posterior root)

a.) Supply motor impulses to adductors of thighs

Holes Human Anatomy and Physiology

2. It allows a person to pinpoint the region of stimulation

E. Adapt very little, if at all

3. Salty stimulated by salts

F. Held in place by suspensory ligaments of ciliary body

Holes Human Anatomy and Physiology

A. Structurally consists of nerve fibers and neuroglia v. glandular epithelial cells

B. This is why it is a dual functioning organ as both an exocrine gland and

Holes Human Anatomy and Physiology

1. 4,600,000 6,200,000 in males

G. Elevated in bacterial infections

2. Acute infections, vigorous exercise, great loss of body fluids

Review Figure 14.18

Holes Human Anatomy and Physiology

Review Table 15.1

Regulation of the Cardiac Cycle

A. Capillaries are the smallest diameter blood vessels

15.8: Venous System

Holes Human Anatomy and Physiology

2. Occurs minutes after contact with allergen

Holes Human Anatomy and Physiology

Hole's Human Anatomy & Physiology 12e

Hole's Human Anatomy & Physiology 12e