PART A Anatomy
SECTION 1 Introduction to Anatomy
1 What Is Anatomy?, 4
- Introduction, 4
- Role of Anatomy in Health Sciences, 4
- A Brief History of Human Anatomy, 4
- Subdivisions of Anatomy and their Scope, 6
2 Anatomical Terminology, 7
Introduction, 7
Anatomical Position, 7
Planes of the Body, 7
Sections of the Body, 7
Terms of Relationship, 7
Movements of the Body, 8 3 Structural Organization of the Human Body, 11
Introduction, 11
Structural Organization of the Human Body, 11
The Cell Theory, 11
Classification of Cells, 11
Ultrastructure of an Animal Cell, 11
Cell Division, 15
The Cell Cycle, 16
Applied Anatomy, 16 SECTION 2 Tissues of the Body
4 Epithelial Tissue, 20
Introduction, 20
Functions of Epithelial Tissue, 20
Arrangement of Epithelial Tissue, 20
Classification of Epithelial Tissue, 20
Epithelial Cell Junctions, 22
Applied Anatomy, 22 5 Exocrine Glands, 23
Introduction, 23
General Features of Exocrine Glands, 23
Classification of Exocrine Glands , 23
Applied Anatomy, 25 6 Connective Tissue, 27
Introduction, 27
General Features, 27
Classification, 28
Applied Anatomy, 29 7 Cartilage, 30
Introduction, 30
General Features, 30
Classification and Specific Features, 31
Applied Anatomy, 31 SECTION 3 The Skeletal System
8 Classification, General Features and Microstructure, 36
Introduction, 36
Classification of Bones, 36
Terms Used to Describe the Gross Anatomy of Bones, 38
General Features of Long Bones, 39
General Microscopic Features of Bones, 39
Microstructure of Lamellar Bone, 40
Growth and Development of Bone, 40
Applied Anatomy, 40 9 The Axial Skeleton, 43
Introduction, 43
The Skull, 43
Other Bones, 44
The Vertebral Column, 45
The Cervical Vertebrae, 45
The Thoracic Vertebrae, 45
The Lumbar Vertebrae, 46
The Sacrum and Coccyx, 46
The Bony Thorax, 46
The Sternum, 46
The Ribs, 46
Applied Anatomy, 49 10 The Appendicular Skeleton, 51
Introduction, 51
The Upper Limb, 51
The Lower Limb, 54
Applied Anatomy, 57 SECTION 4 The Muscular System
11 General Introduction, Types and Microscopic Structure, 60
Introduction, 60
Classification of Muscles, 60
Microscopic Features of Muscles, 62
General Features of Skeletal Muscles, 64
Nomenclature Used to Name Skeletal Muscles, 64
Classification of Skeletal Muscles, 65
Applied Anatomy, 65 12 The Skeletal Muscles above the Diaphragm Including Diaphragm, 67
Introduction, 67
Muscles of the Head and Neck, 67
Muscles of the Thorax, 71
Muscles of the Upper Limb, 71
The Deltoid Muscle, 71
The Thoracoabdominal Diaphragm, 71
Applied Anatomy, 71 13 The Skeletal Muscles below Diaphragm, 78
Introduction, 78
Muscles of the Abdominal Wall, 78
Muscles of the Pelvis and Perineum, 79
Muscles of the Lower Limb, 80
The Gluteus Maximus Muscle, 82
Applied Anatomy, 84 SECTION 5 The Joints of the Body
14 Introduction and Classification of Joints, 88
Introduction, 88
Definition, 88
Classification, 88
Fibrous Joints, 89
Cartilaginous Joints, 89
Synovial Joints, 89
Applied Anatomy, 92 15 Major Joints of the Body, 93
Introduction, 93
Joints of the Axial Skeleton, 93
Joints of the Appendicular Skeleton, 96
Applied Anatomy, 101 SECTION 6 The Cardiovascular System
16 The Vascular System, 104
Introduction, 104
General Features of Blood Vessels, 104
Histology of Blood Vessels, 106
The Arteries of the Body, 108
The Veins of the Body, 108
Applied Anatomy, 109 17 The Pericardium, Exterior of the Heart and Its
Introduction, 123
The Pericardium, 123
The External Features of the Heart, 124
Blood and Nerve Supply of the Heart, 126
Applied Anatomy, 128 18 The Interior of the Heart, 130
Introduction, 130
Internal Features of the Chambers of the Heart, 130
The Conducting System of the Heart, 133
Applied Anatomy, 134 SECTION 7 The Lymphatic System
19 The Lymphatic System, 136
Introduction, 136
Lymphoid Organs, 136
Lymph Nodes, 136
Lymphatic Vessels, 138
The Thymus, 138
The Spleen, 140
The Tonsils, 140
Applied Anatomy, 142 SECTION 8 The Respiratory System
20 The Upper Respiratory System and Larynx, 146
Introduction, 146
The Nose, 146
The Paranasal Air Sinuses, 148
The Pharynx, 149
The Larynx, 149
Applied Anatomy, 151 21 The Lower Respiratory System, 153
Introduction, 153
The Trachea, 153
The Mediastinum, 154
The Extrapulmonary Bronchi, 154
The Lungs, 154
The Bronchial Tree, 156
The Pleura, 157
Applied Anatomy, 158 SECTION 9 The Digestive System
- 22 The Upper Alimentary Canal, 162
Introduction, 162
The Oral Cavity, 162
The Palate, 163
The Tongue, 164
The Salivary Glands, 167
Applied Anatomy, 287 SECTION 14 The Integumentary System
34 The Integumentary System, 290
Introduction, 290
General Features of Skin, 290
Thick and Thin Skin, 292
Appendages of the Skin, 292
Applied Anatomy, 292
The Pharynx, 170
The Oesophagus, 171
Applied Anatomy, 173 23 The Lower Alimentary Canal, 176
Introduction, 176
The Abdominal Cavity and its Walls, 177
The Peritoneum and Peritoneal Cavity, 177
The Stomach, 177
The Small Intestine, 183
The Large Intestine, 186
Applied Anatomy, 192 24 The Digestive Glands, 196
Introduction, 196
The Liver, 196
The Extrahepatic Biliary Apparatus, 200
The Pancreas, 200
Applied Anatomy, 203 SECTION 10 The Excretory System
25 The Kidneys, 208
Introduction, 208
The Kidneys, 208
Applied Anatomy, 214 26 The Ureters, Urinary Bladder and Urethra, 216
Introduction, 216
The Ureters, 216
The Urinary Bladder, 217
The Urethra, 219
Applied Anatomy, 221 SECTION 11 The Reproductive System
27 The Female Reproductive System, 224
Introduction, 224
The Ovaries, 224
The Fallopian Tubes, 228
The Uterus, 228
The Vagina, 230
The Breast, 231
The External Genitalia, 231
Applied Anatomy, 231 28 The Male Reproductive System, 235
Introduction, 235
The Testes, 236
The Duct System, 237
The Accessory Glands, 239
The Penis, 239
The Scrotum, 241
Applied Anatomy, 241 SECTION 12 The Nervous System
29 Introduction to the Nervous System, 244
Introduction, 244
Nervous Tissue, 244
The Meninges, 248
The Dural Venous Sinuses, 248
The Cerebrospinal Fluid, 250
The Autonomic Nervous System, 251
Applied Anatomy, 251 30 The Spinal Cord and Spinal Nerves, 255
Introduction, 255
The Spinal Cord, 255
The Spinal Nerves, 258
Applied Anatomy, 259 31 The Brainstem, Cranial Nerves, Cerebellum and Fourth Ventricle, 263
Introduction, 263
The Brainstem, 263
The Cranial Nerves, 265
The Cerebellum, 265
The Fourth Ventricle, 265
Applied Anatomy, 266 32 The Forebrain, 270
Introduction, 270
The Thalamus, 271
The Hypothalamus and Epithalamus, 272
The Basal Nuclei, 272
The Cerebrum, 273
The Third and Lateral Ventricles, 277
Applied Anatomy, 277 SECTION 13 The Endocrine System
33 The Endocrine System, 282
Introduction, 282
The Hypothalamus, 282
The Pituitary Gland, 283
The Thyroid Gland, 284
Parathyroid Glands, 284
Adrenal Glands, 285
The Pineal Gland, 285
The Pancreatic Islets, 285
Applied Anatomy, 287 SECTION 14 The Integumentary System
34 The Integumentary System, 290
Introduction, 290
General Features of Skin, 290
Thick and Thin Skin, 292
Appendages of the Skin, 292
Applied Anatomy, 292 SECTION 15 The Special Senses
35 The Special Senses, 296
Introduction, 296
The Eyeball and its Accessory Structures, 296
The Ear, 299
Anatomy of Taste, 301
Anatomy of Smell, 301
Applied Anatomy, 301 PART B Physiology
SECTION 16 General and Cell Physiology
36 Organization of the Human Body and Its Regulatory Systems, 308
The Cell and Organization of the Human Body, 308
Regulatory Systems, 308
Negative Feedback: An Example of Regulatory Control, 310 37 The Cell Membrane and Transport across the Cell Membrane, 311
Structure of the Cell Membrane, 311
Transport Across the Cell Membrane, 312
Applications in Nursing, 313 38 Body Water Compartments and Homeostasis, 314
Fluid Intake and Output, 314
Components of Body Water, 315
Differences in Intracellular Fluid and Extracellular Fluid, 315
Applications in Nursing, 316 39 Membrane Potentials and Their Importance, 317
Stimulus, 317
The Resting Membrane Potential, 317
Nernst Potential, 317
Genesis of the Resting Membrane Potential, 318
What Happens if a Cell is Stimulated?, 318 SECTION 17 Neuromuscular System
40 Response of a Cell to a Stimulus, 322
The Local Response, 322
The Action Potential, 323
The All-or-None Law, 324
Refractory Period, 324
Comparison of the Local Response and Action Potential, 324 41 Basic Physiology of the Neuron, 326
Structure of an Axon, 326
Types of Nerves, 327
Synapse, 327
Transmission (Conduction) of the Nerve Impulse, 327
Types of Nerve Injury, 328
Wallerian Degeneration, 328
Applications in Nursing, 329 42 Neuromuscular Junction, 330
Structure of the Neuromuscular Junction, 330
Events that Occur at the Neuromuscular Junction, 330
Drugs/Toxins Acting at the Neuromuscular Junction, 331
Myasthenia Gravis – A Disease that Affects
Neuromuscular Transmission, 332
Applications in Nursing, 332 43 Types of Muscles, 333
Comparison of the Three Muscles, 333 44 Physiology of Muscle Contraction, 335
Structure of Skeletal Muscle, 335
Excitation–Contraction Coupling, 337
Molecular Events of Muscle Contraction, 337
Types of Muscle Contraction, 337
Quantal Summation, 337
Effect of Increasing Frequency of Stimulus, 338
Muscle Fatigue, 339
Types of Muscle Fibres in Skeletal Muscle, 339
Applications in Nursing, 339 45 Muscle Tone, 341
What is Muscle Tone, 341
How Muscle Tone is Regulated, 341
Hypotonia, 341
Hypertonia, 341
Clinical Evaluation of Muscle Tone, 343
Applications in Nursing, 343 SECTION 18 The Nervous System
46 The Reflex Arc: Types of Reflexes, 346
Types of Reflexes, 347
Properties of Reflexes, 348
Applications in Nursing, 348 47 Supporting Cells of the Nervous System, 349
Types of Glial Cells, 349
Functions of Glial Cells, 350
Disorders of Glial Cells, 351
Applications in Nursing, 351 48 Functions of Different Parts of the Brain, 352
The Forebrain, 352
The Cerebral Lobes and their Function, 353
Comparison of Left and Right Cerebral Hemisphere, 354
Hypothalamus, 354
The Midbrain, 355
The Hind Brain, 355
Applications in Nursing, 355 49 Sensation and Its Transmission to the Brain, 357
Classification of Receptors, 357
Properties of Receptors, 357
The Synapse, 358
Sensory Pathways, 359
Central Processing of Sensation, 359
Pain, 360
Applications in Nursing, 360 50 The Motor System, 362
Control of Muscle Length and Tension, 362
The Motor Cortex, 363
The Pyramidal Tract, 364
The Basal Ganglia, 364
The Cerebellum, 365
The Vestibular Apparatus, 366
Applications in Nursing, 367 51 The Autonomic Nervous System, 368
Functional Anatomy of the Autonomic Nervous System, 368
Neurotransmitters and Receptors of the Autonomic
Nervous System, 369
Broad Actions of the Sympathetic Nervous System, 369
Broad Actions of the Parasympathetic Nervous System, 370
Relationship Between the Sympathetic and
Parasympathetic Nervous System, 370
Applications in Nursing, 370 52 Clinical Disorders of the Nervous System, 372
Peripheral Neuropathies, 372
Types of Nerve Injuries, 373
Upper and Lower Motor Neuron Lesions, 373
Stroke and Hemiplegia, 373
Transection of the Spinal Cord, 373
Brown-Sequard Syndrome, 374
Amnesia, 374
Alzheimer Disease, 374
Examination of the Nervous System, 374
Applications in Nursing, 375 SECTION 19 Circulatory, Lymphatic and Immune Systems
53 Cellular and Noncellular Components of Blood, 379
Plasma and Serum, 379
Cellular Components of Blood, 379
Noncellular Components of the Blood, 380
Response to Bleeding, 380
Clotting Factors, 381
Coagulation Cascade, 381
Anticoagulants, 381
Thrombocytopenic Purpura: An Example of a Bleeding
Disorder, 382
Haemophilia: An Example of a Clotting Disorder, 382
Blood Groups, 382
Blood Transfusions, 383
Incompatible (Mismatched) Transfusion Reactions, 383
Rh Incompatibility of the Newborn, 383
Applications in Nursing, 383 54 The Red Blood Cell (Erythropoiesis, Haemoglobin, Anaemia and Jaundice), 385
Erythropoiesis, 385
Haemoglobin, 386
Anaemia, 387
Jaundice, 388
Applications in Nursing, 390 55 The Lymphatic System, 391
Factors Governing the Movement of Fluid in the
Capillary Bed, 391
Organization of the Lymphatic System, 392
Functions of the Lymphatic System, 392
Factors that Affect Lymph Flow, 393
Lymphoedema, 393
Applications in Nursing, 393 56 The Immune System, 394
Innate Immunity, 394
Acquired Immunity, 395
Passive Immunity, 396
Vaccination (Immunization), 396
Inflammation, 396
Immune Deficiency States, 397
Immunity and Transplantation, 397
Applications in Nursing, 398 57 Organization of the Circulatory System and Functional Anatomy of the Heart, 399
Blood Vessels of the Circulatory System, 399
Cells of the Heart, 400
Functional Features of Cardiomyocytes (Cardiac Muscle
Cells), 400
Applications in Nursing, 401 58 Conduction of the Cardiac Impulse and ECG, 402
Introduction, 402
The Pacemaker of the Heart, 403
The Conducting System of the Heart, 403
The Electrocardiogram, 404 59 The Cardiac Cycle, 407
Phases of the Cardiac Cycle, 407
Summary of the Phases of the Cardiac Cycle, 410
Pressure Volume Changes During the Cardiac Cycle, 410
ECG Waves and the Cardiac Cycle, 410
The Heart Sounds in the Cardiac Cycle, 410
Jugular Venous Pulse, 411
Cardiac Output, 412
Regulation of Cardiac Output, 412
Venous Return, 412
Syncope (Fainting), 413
Applications in Nursing, 414 60 Haemodynamics and Blood Pressure, 415
Relationship Between Pressure, Flow and Resistance, 415
Poiseuille’s Law, 415
Patterns of Blood Flow, 416
Pressure Pattern Along the Circulatory Tree, 416
The Microcirculation, 416
The Arterial Pulse Pressure Curve, 417
Determinants of Blood Pressure, 417
Variations in Blood Pressure, 418
Regulation of Blood Pressure, 418
Applications in Nursing, 419 61 Regional Circulations, 421
Coronary Circulation, 422
Coronary Heart Disease, 423
Cerebral Circulation, 423
Renal Blood Flow, 424
Cutaneous Circulation, 425
Circulation to Skeletal Muscle, 425
Splanchnic Circulation, 425
Applications in Nursing, 426 62 Applied Cardiovascular Physiology: Shock
Shock, 427
Heart Failure, 428
Applications in Nursing, 428 SECTION 20 The Respiratory System
63 Functional Anatomy of the Respiratory System, 432
Zones of the Respiratory System, 432
The Tracheobronchial Tree, 432
Functions of the Respiratory System, 432
The Pulmonary Circulation, 433
Applications in Nursing, 433 64 Mechanics of Ventilation, 435
Muscle of Ventilation, 435
Spirogram, 436
Timed Vital Capacity, 436
Ventilation at Rest and During Hyperventilation, 437
Pressure Changes During Breathing, 438
Lung Compliance, 438
Surfactant, 438
Applications in Nursing, 439 65 Gaseous Exchange in the Lungs, 440
Gas Laws, 440
Atmospheric, Alveolar and Expired Air, 441
The Respiratory Membrane, 441
Regional Differences in Ventilation and Perfusion, 442
Applications in Nursing, 443 66 Transport of Oxygen and Carbon Dioxide in Blood, 444
Transport of Oxygen in the Blood, 444
The Oxygen–Haemoglobin Dissociation Curve, 444
Transport of Carbon Dioxide in Blood, 445
Blood Gases, 446
Applications in Nursing, 446 67 Regulation of Respiration, 447
Chemical Regulation of Respiration, 447
Location of Chemoreceptors, 447
Stimuli for the Chemoreceptors, 448
Response to Stimulation of Chemoreceptors, 448
Neural Regulation of Respiration, 448
The Role of the Cerebral Cortex, 448
Respiratory Reflexes, 449
Abnormal Breathing Patterns, 449
Applications in Nursing, 449 68 Applied Respiratory Physiology, 451
Hypoxia, 451
Cyanosis, 452
Dyspnoea, 452
Assessing Lung Function, 452
Adaptation to High Altitude, 452
Breathing During Deep Sea Diving, 453
Applications in Nursing, 453 SECTION 21 The Gastrointestinal System
69 Functional Anatomy of the Gastrointestinal System, 456
The Function of the Gastrointestinal System, 456
The Basic Organization of the GI System, 456
Cross-Sectional Structure of the Gut, 456
Circulation of the Gut, 458
Applications in Nursing, 458 70 Secretions of the Gastrointestinal Tract, 459
Salivary Secretion, 459
Gastric Juice Secretion, 460
Pancreatic Secretion, 461
Biliary Secretion, 462
Intestinal Secretion, 463
Applications in Nursing, 463 71 Digestion and Absorption of Macro- and Micronutrients, 465
Digestion of Carbohydrates, 465
Digestion of Proteins, 465
Digestion of Fats, 466
Features Which Maximize Absorption, 466
Absorption of Nutrients in the Git, 466
Role of the Large Intestine, 467
Malabsorption Syndromes, 467
Applications in Nursing, 467 72 Movements of the Gastrointestinal Tract, 469
Deglutition, 469
Gastric Emptying, 470
Intestinal Motility, 470
Gastrointestinal Reflexes, 471
Applications in Nursing, 471 73 The Hepatobiliary System, 473
Functional Anatomy of the Hepatobiliary System, 473
Factors Affecting the Secretion of Bile, 474
Functions of the Liver, 474
Liver Function Tests, 475
Applications in Nursing, 475 74 Metabolism of Carbohydrates, Fats and Proteins, 476
Utilization of Glucose, 476
Storage Form of Glucose, 477
Gluconeogenesis, 477
Utilization of Amino Acids, 477
Utilization of Fats, 477
Applications in Nursing, 478 SECTION 22 The Excretory System
75 The Urinary System and the Nephron, 480
The Nephron, 480
The Juxtaglomerular Apparatus, 482
Functions of the Kidney, 482
The Urinary Bladder, 483
The Micturition Reflex, 484
Applications in Nursing, 484 76 Mechanism of Urine Formation, 485
Glomerular Filtration, 485
The Proximal Convoluted Tubule, 487
The Counter-Current Multiplier, 487
The Counter-Current Exchanger, 487
The Concept of ‘Clearance’, 490
Applications in Nursing, 490 77 Composition of Urine and Renal Function Tests, 491
Evaluation of Urine, 491
Abnormal Constituents of Urine, 492
Tests of Kidney Function, 493
Applications in Nursing, 494 78 Functions of Skin, 495
Functions of the Skin, 495
Protective Role of the Skin, 495
Thermoregulation, 496
Sensation, 496
Excretion, 497
Endocrine Function, 497
Applications in Nursing, 497 79 Regulation of Body Temperature, 498
Mechanisms of Heat Production (Generation), 498
Mechanisms of Heat Loss, 499
Role of the Hypothalamus in Heat Regulation, 500
Abnormalities of Body Temperature, 500
Applications in Nursing, 500 80 Fluid and Electrolyte Balance, 502
Distribution of Body Water, 502
Composition of the Fluids in the Different Body
Compartments, 502
Fluid Intake, 503
Loss of Fluids, 503
Electrolytes in the Body, 503
Maintenance of Fluid Balance in the Body, 503
Regulation of Electrolytes, 504
Applications in Nursing, 505 SECTION 23 The Special Senses
81 The Physiology of the Eye, 508
The Path of Light in the Eye, 509
The Retina, 509
Light and Dark Adaptation, 510
Accommodation, 510
Errors of Refraction, 511
The Visual Pathway, 511
Testing for Visual Function, 513
Some Clinical Conditions Affecting the Eye, 514
Applications in Nursing, 516 82 The Physiology of the Ear, 518
The External Ear, 518
The Middle Ear, 518
The Inner Ear, 519
The Auditory Pathway, 521
Types of Deafness, 522
Tests of Hearing, 522
Hearing Aids, 523
Applications in Nursing, 523 83 The Physiology of Taste and Smell, 525
Taste, 525
Smell, 526
Applications in Nursing, 526 SECTION 24 Endocrine System
84 The Hypothalamus and Pituitary Gland, 528
The Endocrine Role of the Hypothalamus, 528
How Do the Hypothalamic Hormones Reach the
Pituitary Gland?, 529
Hormones of the Anterior Pituitary Gland, 529
Posterior Pituitary Hormones, 531
Negative Feedback, 531
Applications in Nursing, 531 </
