Anatomy, Physiology, and Disease

Bruce Colbert is the Director of the Allied Health Department at the University of Pittsburgh at Johnstown. He holds a Master’s in Health Education and Administration, has authored four books, written several articles, and given over 175 invited lectures and workshops at both the regional and national level. Many of his workshops provide teacher training involving techniques to make the health sciences engaging and relevant to today’s students. In addition, he does workshops on developing effective critical and creative thinking, stress and time management, and study skills. He is an avid basketball player, even after three knee surgeries, which may indicate he has some learning difficulties.  Jeff Ankney is the Director of Clinical Education for the University of Pittsburgh at Johnstown Respiratory Care program where he is responsible for the development and evaluation of hospital clinical sites. In the past, Jeff has served as a public school teacher, Assistant Director of Cardiopulmonary Services, Program Coordinator of Pulmonary Rehabilitation, and a member of hospital utilization reviewand hospital policy committees. He is a consultant on hospital management and pulmonary rehabilitation concerns. Jeff was also the recipient of the American Cancer Society Public Education Award.  Karen Lee is an Associate Professor in the Biology Department at the University of Pittsburgh at Johnstown, where she teaches all the anatomy courses, including Anatomy and Physiology for Nursing and Allied Health students. She presents regularly at scientific conferencesand has published several articles on crustacean physiology and behavior. An active member of the Council on Undergraduate Research, she is also the chair of the University of Pittsburgh at Johnstown’s annual undergraduate symposium.

• Introduction xii Preview of the Teacher’s Wraparound Edition xiii Chapter 1 Anatomy, Physiology and Disease:  Learning the Language 1 Chapter 2 The Human Body: Reading the  What Is Anatomy and Physiology? 2 Anatomy 2 Physiology 3 Putting It All Together 3  What Is Disease? 4 The Language 5 Medical Terminology 6 Abbreviations 9 Te Metric System 11 Anatomy, Physiology, and Disease  Concepts You Will Encounter  on Your Journey 11 Metabolism 11 Homeostasis 12 Disease Concepts 15 The Body’s Defense System 18 Body Barriers 18 Understanding Routes of Transmission 19 Standard Precautions 20 Summary 23 Case Study 24 Review Questions 26 Career Connections 28 Anatomy, Physiology, and Disease  in Action 29 Map 31 The Map of the Human Body 32 Body Positions 32 Pathology Connection: Body Positions  and A&P Changes 34 Body Planes and Directional Terms 35 Additional Directional Terms 37 Body Cavities 40 Body Regions 41 Radiology: The Science of Viewing  the Body 46 X-rays (Radiograph or Roentgenogram) 46 Computerized Tomography (CT or CAT  Scan) 48 Magnetic Resonance Imaging (MRI) 48 Ultrasound (Sonography) 48 Summary 50 Case Study 51 Review Questions 52 Career Connections 54 Anatomy, Physiology, and Disease  in Action 54 iv • CONTENTS Chapter 3 Biochemistry: The Basic Ingredients  of Life 55 Atoms, Elements, and Ions 56 Acids and Bases 58 Bonding 60 Water 61 Solutions 62 Biological Molecules 63 Metabolism 67 Enzymes: Making Reactions Happen 67 Summary 70 Case Study 71 Review Questions 71 Career Connections 73 Anatomy, Physiology, and Disease  in Action 74 Chapter 4 The Cells: The Raw Materials and  Pathology Connection: Organelle  Disorders 92 Pathology Connection: Diabetes  Mellitus (Revisited): A Disorder Tied to  Cellular Respiration 93 Pathology Connection: PKU, an Enzyme  Disorder 94 Mitosis 95 Cellular Reproduction 95 Te Cell Cycle 96 Pathology Connection: Cancer: Mitosis  Run Amok 98 Microorganisms 99 Bacteria 99 Viruses 100 Fungi 101 Protozoa 101 Pathology Connection: How  Microorganisms Cause Disease 103 Summary 106 Case Study 107 Review Questions 108 Career Connections 110 Anatomy, Physiology, and Disease  in Action 110 Building Blocks 75 Overview of Cells 76 Cell Structure 77 Cell Membrane 78 Transport Methods 79 Passive Transport 79 Pathology Connection: Cystic  Fibrosis (CF): A Membrane Channel  Abnormality 82 Pathology Connection: Diabetes  Mellitus: A Disorder of Facilitated  Diffusion 83 Active Transport 84 Pathology Connection: Familial  Hypercholesterolemia: A Disorder  of Endocytosis 86 Cellular Components 87 Cytoplasm 87 Nucleus and Nucleolus 87 Ribosomes 88 Centrosomes 89 Mitochondria 89 Endoplasmic Reticulum 90 Golgi Apparatus 90 Lysosomes 91 Other Interesting Parts 91 Chapter 5 Tissues and Systems: The Inside  Story 111 Overview of Tissues 112 Tissue Types 112 Pathology Connection: Blood Sugar and  Tissue Damage 120 Organs 121 Systems 122 Skeletal System 124 Muscular System 125 Integumentary System 126 Nervous System 127 Endocrine System 128 Cardiovascular System 129 Pathology Connection: Septicemia 130 Respiratory System 130 Lymphatic and Immune System 131 Gastrointestinal (Digestive) System 132 Contents • v Pathology Connection: Body Image:  Obesity and Anorexia 134 Urinary System 135 Reproductive System 136 Summary 138 Case Study 138 Review Questions 140 Career Connections 142 Anatomy, Physiology, and Disease  in Action 142 Chapter 7 The Muscular System: Movement  Chapter 6 The Skeletal System: The  Framework 143 System Overview: More Than the “Bare  Bones” About Bones 144 General Bone Classifcation 144 Basic Bone Anatomy 145 Bone Tissue 147 Surface Structures of Bones 148 Bone Growth and Repair 149 Pathology Connection:  Osteoporosis 151 Cartilage 153 Joints and Ligaments 154 Movement Classifcation 156 Pathology Connection: Common Joint  Disorders 158 The Skeleton 160 Special Regions of the Skeletal System 160 Pathology Connection: Spinal Column  Abnormalities 165 Pathology Connection: Bone Fractures  and Healing 168 Maintaining Good Bone Health 169 A Quick Trip Through Some Diseases of  the Skeletal System 171 Pharmacology Corner 175 Summary 176 Case Study 177 Review Questions 178 Career Connections 180 Anatomy, Physiology, and Disease  in Action 180 for the Journey 181 Overview of the Muscular System 182 Types of Muscles 182 Pathology Connection: Myopathy 184 Skeletal Muscles 185 Pathology Connection: Strains and  Tears 185 Skeletal Muscle Injuries 188 Pathology Connection: Fibromyalgia  Syndrome 192 Skeletal Muscle Movement 192 Contraction and Relaxation 192 Movement Terminology 194 Muscular Movement at the Cellular  Level 196 Te Functional Unit of the Muscle 196 Pathology Connection: Duchenne’s  Muscular Dystrophy (DMD) 199 Pathology Connection: Myasthenia  Gravis (MG) 199 Pathology Connection: Tetanus 201 Muscular Fuel 202 Visceral or Smooth Muscle 203 Cardiac Muscle 204 A Quick Trip Through Diseases and  Conditions of the Muscular System 205 Pharmacology Corner: Skeletal Muscle  Drugs 207 Summary 208 Case Study 209 Review Questions 210 Career Connections 212 Anatomy, Physiology, and Disease  in Action 213 Chapter 8 The Integumentary System: The  Protective Covering 215 System Overview 216 Integumentary System Functions 216 Te Skin 217 Pathology Connection: Skin Color  and Disease 219 Pathology Connection: Infections  of the Skin 221 vi • CONTENTS How Skin Heals 225 Pathology Connection: Burns 227 Nails 230 Hair 232 Pathology Connection: Lice  and Scabies 234 Temperature Regulation 235 Pathology Connection: Skin Lesions 237 A Quick Trip Through Some Diseases  of the Integumentary System 238 Pharmacology Corner 244 Summary 244 Case Study 245 Review Questions 246 Career Connections 248 Anatomy, Physiology, and Disease  in Action 249 Chapter 9 The Nervous System: The Body’s  Pathology Connection: Brain Injury 280 Cerebrospinal Fluid and Ventricles 288 Cranial Nerves 288 Pathology Connection: Alzheimer’s  Disease 288 Pathology Connection:  Hydrocephalus 291 The Big Picture: Integration of Brain,  Spinal Cord, and PNS 292 Te Somatic Sensory System 292 Te Motor System 294 Pathology Connection: Motor  Pathologies 296 The Autonomic Nervous System 298 Te Sympathetic Branch 299 Te Parasympathetic Branch 300 A Quick Trip Through Diseases  of the Nervous System 302 Pharmacology Corner 304 Summary 305 Case Study 306 Review Questions 307 Career Connections 310 Anatomy, Physiology, and Disease  in Action 310 Control Center 251 Overview 252 Te Parts and Basic Operation  of the Nervous System 252 Nervous Tissue 255 Neuroglia 255 Neurons 256 How Neurons Work 257 Excitable Cells 257 Action Potentials 258 Local Potentials 258 Impulse Conduction 259 Pathology Connection: Myelin  Disorders 261 How Synapses Work 262 Spinal Cord and Spinal Nerves 265 External Anatomy of the Spinal Cord 265 Internal Anatomy of the Spinal Cord 267 Pathology Connection: Polio and Post- Polio Syndrome 271 Pathology Connection: Peripheral  Neuropathy and Spinal Cord Injury 272 The Brain and Cranial Nerves 276 Te Brain’s External Anatomy 276 Internal Anatomy of the Brain 279 Chapter 10 The Endocrine System: The Body’s  Other Control Center 311 Organization of the Endocrine  System 312 Endocrine Organs 312 Hormones 314 Control of Endocrine Activity 315 Homeostasis and Negative Feedback 315 Sources of Control of Hormone Levels 317 The Major Endocrine Organs 319 Te Hypothalamus 319 Te Pituitary 320 Pathology Connection: Posterior  Pituitary and Antidiuretic Hormone 322 Pathology Connection: Anterior  Pituitary 323 Te Tyroid Gland 324 Contents • vii Te Tymus Gland 325 Te Pineal Gland 325 Te Pancreas 325 Pathology Connection: The Thyroid  Gland 326 Te Adrenal Glands 329 Pathology Connection: Diabetes  Mellitus 331 Pathology Connection: Steroid-Related  Conditions 334 Cortisol and the Stress Response 335 The Gonads 336 Prostaglandins 337 A Quick Trip Through the Diseases  of the Endocrine System 338 Pharmacology Corner 339 Summary 340 Case Study 341 Review Questions 342 Career Connections 344 Anatomy, Physiology, and Disease  in Action 344 Case Study 372 Review Questions 372 Career Connections 374 Anatomy, Physiology, and Disease  in Action 375 Chapter 12 The Cardiovascular System: Chapter 11 The Senses: The Sights  and Sounds 345 The Senses 346 Sense of Sight 347 Te External Structures of the Eye 347 Te Internal Structures of the Eye 348 Pathology Connection: Injuries  and Disorders of the Eyes 350 The Sense of Hearing 356 Structures of the Ear 356 Pathology Connection: Diseases  of the Ear 360 Other Senses 362 Taste 362 Smell 363 Touch 364 A Quick Trip Through Some Diseases of the Eye 368 A Quick Trip Through Some Diseases of the Ears 369 Pharmacology Corner 370 Summary 371 Transport and Supply 377 System Overview 378 Incredible Pumps: The Heart 380 General Structure and Function 380 Cardiac Cycle 382 Pathology Connection: Problems  with Cardiac Muscle and Cardiac  Vasculature 387 Pathology Connection: Electrical  Disturbances 397 Hematology 399 Blood Composition 399 Red Blood Cells 401 White Blood Cells 401 Infammation 402 Trombocytes 403 Blood Types and Transfusions 403 Pathology Connection: Assorted Blood  Conditions 406 Blood Vessels: The Vascular System 407 Structure and Function 407 Capillaries and Veins 408 Blood Clotting 411 Pathology Connection: Clotting 413 Pathology Connection: Problems  Associated with Systemic Blood  Vessels 415 A Quick Trip Through Some Diseases of the Cardiovascular System 415 Pharmacology Corner 423 Summary 424 Case Study 425 Review Questions 425 Career Connections 428 Anatomy, Physiology, and Disease  in Action 429 viii • CONTENTS Chapter 13 The Respiratory System: It’s  a Gas 431 System Overview 432 Ventilation versus Respiration 434 The Respiratory System 436 Te Airways and Te Lungs 436 Te Upper Airway of the Respiratory  Tract 436 Pathology Connection: The Nose 439 Te Sinuses 441 Te Pharynx 442 Te Larynx 443 Pathology Connection: The Upper  Airway 444 The Lower Respiratory Tract 447 Te Alveolar Capillary Membrane: Where  the Action Is 450 Pulmonary Function Testing 452 Pathology Connection: The Lower  Airways 454 Te Housing of the Lungs and Related  Structures 462 Pathology Connection: Pleural Space  Problems 463 Te Lungs 464 Te Protective Bony Torax 464 How We Breathe 465 A Quick Trip Through the Diseases  of the Respiratory System 469 Pharmacology Corner 472 Summary 473 Case Study 474 Review Questions 474 Career Connections 476 Anatomy, Physiology, and Disease  in Action 477 Pathology Connection: Cancer Stages  and the Lymphatic System 486 The Immune System 488 Antigens and Antibodies 488 Innate versus Adaptive Immunity 488 Components of the Immune System 489 Pathology Connection: Leukemia 491 Pathology Connection: Inflammation,  a Two-Edged Sword 493 How the Immune System Works 495 Innate Immunity 495 Adaptive Immunity 496 Pathology Connection: Autoimmune  Disorders 497 Pathology Connection: HIV and  AIDS 502 B and T Cell Action 503 The Big Picture 507 Pathology Connection: Hypersensitivity  Reactions 508 A Quick Trip Through Some Diseases  of the Immune System 510 Pharmacology Corner 511 Summary 512 Case Study 515 Review Questions 516 Career Connections 518 Anatomy, Physiology, and Disease  in Action 518 Chapter 15 The Gastrointestinal System: Fuel  Chapter 14 The Lymphatic and Immune Systems: Your Defense Systems 479 The Defense Zone 480 The Lymphatic System 480 Pathology Connection: Tonsillitis 483 Lymph Organs 485 Pathology Connection: Lymphatic  Disorders 486 for the Trip 519 System Overview 520 The Mouth and Oral Cavity 522 Oral Cavity 522 Tongue 522 Salivary Glands 522 Teeth 524 Pathology Connection: Oral  Disorders 527 Pharynx 527 Esophagus 528 The Walls of the Alimentary  Canal 529 Contents • ix Stomach 531 Pathology Connection: Stomach Acid  Disorders 535 Small Intestine 537 Large Intestine 541 Pathology Connection: Disorders of the  Lower Gastrointestinal Tract 543 Accessory Organs 544 Liver 544 Gallbladder 545 Pancreas 546 Pathology Connection: Cholecystitis,  Pancreatitis, and Hepatitis 547 Common Symptoms of Digestive  System Disorders 548 A Quick Trip Through Some Diseases of the Gastrointestinal System 549 Pharmacology Corner 556 Summary 556 Case Study 558 Review Questions 558 Career Connections 562 Anatomy, Physiology, and Disease  in Action 563 Pathology Connection: Dialysis  or Kidney Transplant Therapy 589 Te Urinary Bladder and Urination  Refex 590 Pathology Connection: Incontinence  and Urinary Tract Infection (UTI) 592 A Quick Trip Through Disorders of the  Urinary System 593 Pharmacology Corner 595 Summary 596 Case Study 597 Review Questions 598 Career Connections 600 Anatomy, Physiology, and Disease  in Action 600 Chapter 17 The Reproductive System:  Chapter 16 The Urinary System: Filtration and  Fluid Balance 565 System Overview 566 The Anatomy of the Kidney 567 External Anatomy 567 Internal Anatomy 568 Microscopic Anatomy of the Kidney:  Te Nephron 570 Pathology Connection: Kidney  Stones and Polycystic Kidney Disease  (PKD) 572 Urine Formation 576 Control of Filtration 576 Pathology Connection:  Nephropathy 580 Control of Tubular Reabsorption  and Secretion 582 Pathology Connection: Uremia  and Renal Failure 585 Replacement and Repair 601 Tissue Growth and Replacement 602 Mitosis 602 Sexual Reproduction 603 Reduction Division: Meiosis 603 The Human Life Cycle 605 The Human Reproductive System 607 Female Anatomy 607 Pathology Connection:  Endometriosis 610 Reproductive Physiology: Female 613 Te Menstrual Cycle 613 Pathology Connection: Menstrual  Disorders 618 Male Anatomy 621 Pathology Connection: Male  Reproductive Diseases 623 Reproductive Physiology: Male 625 Spermatogenesis 625 Pathology Connection: Erectile  Dysfunction (ED) 627 Pregnancy 628 Pathology Connection: Infertility 629 Pathology Connection: Breast  Health 632 x • CONTENTS A Quick Trip Through Some Diseases  of the Reproductive System 634 Pharmacology Corner 636 Summary 637 Case Study 639 Review Questions 639 Career Connections 642 Anatomy, Physiology, and Disease  in Action 643 Career Connections 676 Anatomy, Physiology, and Disease  in Action 676 Chapter 19 Anatomy and Physiology and the  Chapter 18 Basic Diagnostic Tests: What Do  the Tests Tell Us? 645 Overview of Diagnostic Testing 646 Blood Testing 647 Blood Basics 647 General Blood Disorders 649 Specifc Blood Tests 649 Blood Chemistry 655 Urine Testing 658 Dipsticks 659 Specifc Urine Tests 660 Fecal Testing 665 Amount, Consistency, Form, and Shape 665 Stool pH 665 Stool Color 665 Blood in Stool 666 Mucus in Stool 666 Cerebral Spinal Fluid (CSF) Testing 667 CSF Color 667 CSF Cell Counts 668 Culture and Sensitivity (C&S)  Testing 668 Cardiac Diagnostics 669 Electrocardiogram (ECG/EKG) 669 Holter Monitor 669 Stress Testing 670 “Scopes” 670 Pulmonary Function Testing (PFT) 671 Polysomnography 672 Summary 673 Case Study 674 Review Questions 674 Scientific Method 677 Overview of the Scientific Method 678 Patterns of Knowing 678 Te Scientifc Method 679 Formulating Questions 680 Hypotheses and Teories 680 Testing Hypotheses 682 Making Measurement 685 Presenting and Data 689 Drawing Inferences 692 Limitations of the Scientifc Method 695 Summary 696 Review Questions 696 Anatomy, Physiology, and Disease in  Action 698 Chapter 20 The Journey’s End: Now What? 699 Forensic Science 700 Disease Detection 701 Primitive Surgery 701 Remains Identifcation 702 Murder Most Foul! 702 Fingerprints 703 DNA Fingerprinting 704 Geriatrics 705 General Body Changes 706 Gustatory Changes 707 Te Brain and Nervous System 707 Te Cardiovascular System 707 Genitourinary System 708 Integumentary System 708 Polypharmacy 708 Wellness 709 Nervous System 710 Skeletal System 710 Muscular System 711 Integumentary System 712 Cardiovascular System 712 Respiratory System 713 Contents • xi Chapter 21 Health Care: Careers and Career  Appendix A Medical Terminology, Words Parts,  Planning 731 Interests 732 Values 732 Abilities 732 Heath Care Education 733 Resources For Occupational Research 733 Jobs and Professions 734 Professional and Personal  Characteristics 749 Ethical Roles and Responsibilities of a  Health Care Worker 752 Meetings in the Workplace 753 Safety in the Workplace 753 Job-Seeking Skills 754 Your Career Plan 755 Volunteering 757 Suggested Activities 758  and Singular and Plural Endings 779 Appendix B Clinical Abbreviations and  “Do Not Use” List 790 Appendix C Infectious Diseases and Teir  Pathogens 800 Appendix D Laboratory Reference Values 803 Appendix E Multisystem Efects of Various  Diseases and Conditions 807 Appendix F Vitamins and Minerals: Sources,  The Study Success Companion: The Key to Your  Functions, and Efects of Defciency  and Toxicity 818 Successful Journey 759 Study Skills 760 1. Select a Good Time and Place to Study 760 2. Use Good Study Habits 761 3. Take Care of Yourself 763 Stress Management 763 Stress Misconceptions 763 What Causes Physical and Emotional  Stress? 764 A Stress Management System 766 Efective Coping Strategies 766 Efective Physical Strategies 767 The Mathematical Language of  Medicine 769 Why Learn the Metric System? 769 Exponential Powers of 10 769 Systems of Measurement 770 Conversion of Units 774 Using the Factor Label Method for Conversion  Between Systems 777 Appendix G Standard and Transmission-Based  Precautions 821 Glossary 826 Index 874