Mader: Understanding Fro ② The McG Human Anatomy ysiology, Fifth Edition Live News feeds The Anatomy and Physiology Laboratory Textbook essentials The OLC offers course specific real-time news Version, 0-07-232363-9, by Gunstream, contains several frog articles to help students stay current with the latest dissections and may be used with any anatomy and physiol topics in anatomy and physiology ogy text. Tutorial Service This free" homework hotline"offers you the opportu- Human Anatomy and Physiology Laboratory Manual-Fetal Dissection, Second Edition 0-07-243814-2, by Terry R. Mar- nity to discuss text questions with our A&P consultant. tin, Kishwaukee College, provides excellent full-color photos GetBodySmart. com is an online examination of of the dissected fetal pig with corresponding labeled art. It human anatomy and physiology. This program is includes World wide Web activities for many chapters available on the student edition of the online learn- ing Cente Subnet argas circulatory的 8中4 ucation a bu avl sin l It超l旧naa,和 Access Science is the online version of mcgraw-Hill's Encyclopedia of Science Technology Link to this Virtual Anatomy dissection Review. CD-roM site free of charge from the Online Learning Center. 0-07-285621-1, by John Waters, Pennsylvania State Physiology Interactive Lab Simulations(Ph LLS) University. This multimedia program contains vivid, high 287167-9 quality, labeled cat dissection photographs. The program The Ph I LS CD-ROM contains eleven laboratory helps students easily identify and review the corresponding simulations that allow students to perform experiments structures and functions between the cat and the human without using expensive lab equipment or live animals. This asy-to-use software offers students the flexibility to change the parameters of every lab experiment, with no limit to the Laboratory Atlas of Anatomy and Physiology fourth edition, amount of times a student can repeat experiments or modify 0-07-243810-X, by Eder et al., is a full-color atlas containing variables. This power to manipulate each experiment histology, human skeletal anatomy, human muscular reinforces key physiology concepts by helping students to anatomy, dissections, and reference tables view outcomes, make predictions, and draw conclusions. Preface xiii
Mader: Understanding Human Anatomy & Physiology, Fifth Edition Front Matter Preface © The McGraw−Hill Companies, 2004 Preface xiii • Live News Feeds The OLC offers course specific real-time news articles to help students stay current with the latest topics in anatomy and physiology. • Tutorial Service This free “homework hotline” offers you the opportunity to discuss text questions with our A&P consultant. • GetBodySmart.com is an online examination of human anatomy and physiology. This program is available on the Student Edition of the Online Learning Center. The Anatomy and Physiology Laboratory Textbook Essentials Version, 0-07-232363-9, by Gunstream, contains several frog dissections and may be used with any anatomy and physiology text. Human Anatomy and Physiology Laboratory Manual-Fetal Pig Dissection, Second Edition 0-07-243814-2, by Terry R. Martin, Kishwaukee College, provides excellent full-color photos of the dissected fetal pig with corresponding labeled art. It includes World Wide Web activities for many chapters. • Access Science is the online version of McGraw-Hill’s Encyclopedia of Science & Technology. Link to this site free of charge from the Online Learning Center. Physiology Interactive Lab Simulations (Ph.I.L.S) 0-07-287167-9 The Ph.I.L.S CD-ROM contains eleven laboratory simulations that allow students to perform experiments without using expensive lab equipment or live animals. This easy-to-use software offers students the flexibility to change the parameters of every lab experiment, with no limit to the amount of times a student can repeat experiments or modify variables. This power to manipulate each experiment reinforces key physiology concepts by helping students to view outcomes, make predictions, and draw conclusions. Virtual Anatomy Dissection Review, CD-ROM, 0-07-285621-1, by John Waters, Pennsylvania State University. This multimedia program contains vivid, high quality, labeled cat dissection photographs. The program helps students easily identify and review the corresponding structures and functions between the cat and the human body. Laboratory Atlas of Anatomy and Physiology, fourth edition, 0-07-243810-X, by Eder et al., is a full-color atlas containing histology, human skeletal anatomy, human muscular anatomy, dissections, and reference tables
Mader: Understanding ② The McG ysiology, Fifth Edition Acknowledgments Fifth Edition reviewers I would like to acknowledge the valuable contributions of all Karen Magatagan professors and their students who have provided detailed re Cochise College ommendations for improving chapter content and illustr tions for the fifth edition Jacqueline S McLaughlin Bert Atma Kenneth Moore William I. Burke Madison Area Technical College Albert moras Boulder College of Massage Therapy Richard Ceron Scott murdoch Carnegie Institute of Integrative Medicine Moraine Valley Community College Jay P. Clymer Ill Linda r. nichols Marywood Uniwersity Santa Fe Community College Mark eberle Central Oregon Community College Robin r. patterson Butler County Community College Diana godish Ball State University Susan Pazynski Glen Oaks Community College Michelle A green Alfred State Colle Joel H. Scott Blue Cliff college Tulsa Community Colleg marilyn M. Shannon Dianne M. Jedlicka The School of the Art Institute of Chicago F. Christopher Sowers avannah College of Art and Design Michael Squires Diane M. Kelly James D. Tipton Broome Community College Chattahoochee Valley Community College Kenneth M. Kosten Community College of Denver Harry A. Tracy, Ir. University of Texas at San John ]. Kulig K Won Central Massachusetts School of Massage and Therapy Los angeles Trade-Technical College
Mader: Understanding Human Anatomy & Physiology, Fifth Edition Front Matter Preface © The McGraw−Hill Companies, 2004 xiv Preface I would like to acknowledge the valuable contributions of all professors and their students who have provided detailed recommendations for improving chapter content and illustrations for the fifth edition. Bert Atsma Union County College William J. Burke Madison Area Technical College Richard Ceroni Carnegie Institute of Integrative Medicine Jay P. Clymer III Marywood University Mark Eberle Central Oregon Community College Diana Godish Ball State University Michelle A. Green Alfred State College Gary W. Hunt Tulsa Community College Dianne M. Jedlicka The School of the Art Institute of Chicago Geoffrey Jowett Savannah College of Art and Design Diane M. Kelly Broome Community College Kenneth M. Kosten Community College of Denver John J. Kulig Central Massachusetts School of Massage and Therapy Karen Magatagan Cochise College Jacqueline S. McLaughlin Pennsylvania State University—Berks/Lehigh Valley Kenneth Moore Seattle Pacific University Albert Moraska Boulder College of Massage Therapy Scott Murdoch Moraine Valley Community College Linda R. Nichols Santa Fe Community College Robin R. Patterson Butler County Community College Susan Pazynski Glen Oaks Community College Joel H. Scott Blue Cliff College Marilyn M. Shannon Indiana University-Purdue University—Fort Wayne F. Christopher Sowers Wilkes Community College Michael Squires Columbus State Community College James D. Tipton Chattahoochee Valley Community College Harry A. Tracy, Jr. University of Texas at San Antonio Ricky K. Wong Los Angeles Trade-Technical College Acknowledgments Fifth Edition Reviewers
Mader: Understanding ② The McG ysiology, Fifth Edition The Focus is Understanding Students develop a working knowledge of anatomy and physiology based upon conceptual understanding. Clinical Applications broaden students'horizons beyond the core principles. Self-confidence increases as students master medical terminology and key concepts Art Program Art presents and reinforces the dynamic processes within the human bod The Muscular System Dynamic Photos give students a closer look inside the wonders of the human body through the technology of scanning electron micrographs N visual focus Visual Focus illustrates difficult concepts that relate structure to function, using a step-by New and revised art oncise labeling methodology that keeps students from getting bogged down with excessive detail The most beautiful thing we can experience as ausmus is the mysterious. It is the source of all true art and science
Mader: Understanding Human Anatomy & Physiology, Fifth Edition Front Matter Preface © The McGraw−Hill Companies, 2004 xv • Students develop a working knowledge of anatomy and physiology based upon conceptual understanding. • Clinical Applications broaden students’ horizons beyond the core principles. • Self-confidence increases as students master medical terminology and key concepts. Art Program Art presents and reinforces the dynamic processes within the human body. chapter The Muscular System Scanning electron micrograph of motor neurons terminating at muscle fibers. A muscle fiber receives the stimulus to contract at a neuromuscular junction. chapter outline & learning objectives After you have studied this chapter, you should be able to: 7.1 Functions and Types of Muscles (p. 114) ■ Distinguish between the three types of muscles, and tell where they are located in the body. ■ Describe the connective tissues of a skeletal muscle. ■ Name and discuss five functions of skeletal muscles. 7.2 Microscopic Anatomy and Contraction of Skeletal Muscle (p. 116) ■ Name the components of a skeletal muscle fiber, and describe the function of each. ■ Explain how skeletal muscle fibers are innervated and how they contract. ■ Describe how ATP is made available for muscle contraction. 7.3 Muscle Responses (p. 122) ■ Contrast the responses of a muscle fiber and whole muscle in the laboratory with their responses in the body. ■ Contrast slow-twitch and fast-twitch muscle fibers. 7.4 Skeletal Muscles of the Body (p. 124) ■ Discuss how muscles work together to achieve the movement of a bone. ■ Give examples to show how muscles are named. ■ Describe the locations and actions of the major skeletal muscles of each body region. 7.5 Effects of Aging (p. 134) ■ Describe the anatomical and physiological changes that occur in the muscular system as we age. 7.6 Homeostasis (p. 136) ■ Describe how the muscular system works w other systems of the body to maintain homeostasis. ■ Describe some common muscle disorders a some of the serious diseases that can affec muscles. Visual Focus Anatomy of a Muscle Fiber (p. 117) Medical Focus Benefits of Exercise (p. 135) 113 Dynamic Photos give students a closer look inside the wonders of the human body through the technology of scanning electron micrographs. Visual Focus illustrates difficult concepts that relate structure to function, using a step-bystep process. New and Revised Art focuses on the main concepts by using concise labeling methodology that keeps students from getting bogged down with excessive detail. Chapter 7 The Muscular System 117 Figure 7.3 Anatomy of a muscle fiber. A muscle fiber contains many myofibrils with the components shown. A myofibril has many sarcomeres that contain myosin and actin filaments whose arrangement gives rise to the striations so characteristic of skeletal muscle. Muscle contraction occurs when sarcomeres contract and actin filaments slide past myosin filaments. bundle of muscle fibers muscle fiber T tubules nucleus sarcoplasm sarcolemma cross-bridge myosin actin sarcoplasmic reticulum calcium storage sites one sarcomere Z line Z line H zone Z line Muscle fiber has many myofibrils. skeletal muscle fiber one myofibril A band I band Myofibril has many sarcomeres. Sarcomere is relaxed. Sarcomere is contracted. Muscles of the Abdominal Wall The abdominal wall has no bony reinforcement (Fig. 7.14). The wall is strengthened by four pairs of muscles that run at angles to one another. The external and internal obliques and the transversus abdominis occur laterally, but the fasciae of these muscle pairs meet at the midline of the body, forming a tendinous area called the linea alba. The rectus abdominis is fi i l di l i f l Muscles of the Shoulder Muscles of the shoulder are shown in Figures 7.14 and 7.15. They are also listed in Table 7.4 on page 130. The muscles of the shoulder attach the scapula to the thorax and move the scapula; they also attach the humerus to the scapula and move the arm. Figure 7.15 Muscles of the posterior shoulder. The right trapezius is removed to show deep muscles that move the scapula and the rotator cuff muscles. trapezius deltoid latissimus dorsi rotator cuff muscles “The most beautiful thing we can experience is the mysterious. It is the source of all true art and science.” – Albert Einstein
Mader: Understanding ② The McG ysiology, Fifth Edition Macro to micro presentation helps students make the connection between gross anatomy and microscopic anatomy. Correlation of Photomicrographs with line art makes it easier for students to identify specific structures Reference Figures of the human body have been dded to give students an dditional resource in the study of body structure
Mader: Understanding Human Anatomy & Physiology, Fifth Edition Front Matter Preface © The McGraw−Hill Companies, 2004 Chapter 6 The Skeletal System 85 articular cartilage spongy bone (contains red bone marrow) blood vessel trabeculae medullary cavity (contains yellow bone marrow) periosteum Epiphysis Diaphysis Epiphysis Humerus Compact Bone compact bone Spongy Bone osteon lamella endosteum epiphyseal plates canaliculi b. a. osteocyte within lacuna blood vessels central canal Figure 6.2 Anatomy of a long bone. a. A long bone is encased by the periosteum except at the epiphyses, which are covered by articular cartilage. Spongy bone of the epiphyses contains red bone marrow. The diaphysis contains yellow bone marrow and is bordered by compact bone. b. The detailed anatomy of spongy bone and compact bone is shown in the enlargement, along with a blowup of an osteocyte in a lacuna. 4.2 Connective Tissue Connective tissue binds structures together, provides support and protection, fills spaces, produces blood cells, and stores fat. The body uses this stored fat for energy, insulation, and organ protection. As a rule, connective tissue cells are widely separated by an extracellular matrix composed of an organic ground substance that contains fibers and varies in consistency from solid to semifluid to fluid. Whereas the functional and physical properties of epithelial tissues are derived from its cells, connective tissue properties are largely derived from the characteristics of the matrix (Table 4.2). The fibers within the matrix are of three types. White fibers contain collagen, a substance that gives the fibers flexibility and strength. Yellow fibers contain elastin, which is not as strong as collagen but is more elastic. Reticular fibers are very thin, highly branched, collagenous fibers that form delicate supporting networks. ground substance fibroblast elastic fiber collagenous fiber Loose (Areolar) Connective Tissue Location: Between muscles; beneath the skin; beneath most epithelial layers Function: Binds organs together Figure 4.5 Loose (areolar) connective tissue. This tissue has a loose network of fibers. Appendix A 409 Plate 6 The torso as viewed with the heart, liver, stomach, and portions of the small and large intestines removed. (a. artery; m. muscle; v. vein.) esophagus trachea left subclavian a. left subclavian v. left brachiocephalic v. arch of aorta descending aorta diaphragm spleen celiac a. pancreas left kidney inferior mesenteric a. left common iliac a. descending colon (cut) sigmoid colon ovary uterus rectus femoris m. (cut) urinary bladder symphysis pubis vastus lateralis m. vastus intermedius m. right internal jugular v. right common carotid a. superior vena cava right bronchus esophagus pleural cavity inferior vena cava adrenal gland right kidney duodenum superior mesenteric v. superior mesenteric a. ureter sartorius m. (cut) tensor fascia latae m. (cut) rectus femoris m. adductor longus m. gracilis m. pericardial cavity adductor brevis m. Macro to Micro Presentation helps students make the connection between gross anatomy and microscopic anatomy. Correlation of Photomicrographs with Line Art makes it easier for students to identify specific structures. Reference Figures of the human body have been added to give students an additional resource in the study of body structure. xvi
Mader: Understanding ② The McG ysiology, Fifth Edition Clinical Connections Additional readings engage the students by creating a richer understanding of the concepts presented and provide a real life connection to anatomy and physiology Medical Focus Readings Medical focus encourage students to explore clinical examples that they may see through heir health care career or within thei What's ney What's New Readings ffer fascinating information on treatments now experimental but promise to be particularly helpful in the future Effects of Aging Effects of Aging presents some of the age- related physical and Education is not preparation for life; education is life itself. John D
Mader: Understanding Human Anatomy & Physiology, Fifth Edition Front Matter Preface © The McGraw−Hill Companies, 2004 Clinical Connections Additional readings engage the students by creating a richer understanding of the concepts presented and provide a real life connection to anatomy and physiology. 88 Part II Support, Movement, and Protection Osteoporosis Osteoporosis is a condition in which the bones are weakened due to a decrease in the bone mass that makes up the skeleton. Throughout life, bones are continuously remodeled. While a child is growing, the rate of bone formation is greater than the rate of bone breakdown. The skeletal mass continues to increase until ages 20 to 30. After that, the rates of formation and breakdown of bone mass are equal until ages 40 to 50. Then, reabsorption begins to exceed formation, and the total bone mass slowly decreases. Over time, men are apt to lose 25% and women 35% of their bone mass. But we have to consider that men tend to have denser bones than women anyway, and their testosterone (male sex hormone) level generally does not begin to decline significantly until after age 65. In contrast, the estrogen (female sex hormone) level in women begins to decline at about age 45. Because sex hormones play an important role in maintaining bone strength, this difference means that women are more likely than men to suffer fractures, involving especially the hip, vertebrae, long bones, and pelvis. Although osteoporosis may at times be the result of various disease processes, it is essentially a disease of aging. Everyone can take measures to avoid having osteoporosis when they get older. Adequate dietary calcium throughout life is an important protection against osteoporosis. The U.S. National Institutes of Health recommend a calcium intake of 1,200–1,500 mg per day during puberty. Males and females require 1,000 mg per day until age 65 and 1,500 mg per day after age 65, because the intestinal tract has fewer vitamin D receptors in the elderly. A small daily amount of vitamin D is also necessary to absorb calcium from the digestive tract. Exposure to sunlight is required to allow skin to synthesize vitamin D. If you reside on or north of a “line” drawn from Boston to Milwaukee, to Minneapolis, to Boise, chances are, you’re not getting enough vitamin D during the winter months. Therefore, you should avail yourself of the vitamin D in fortified foods such as low-fat milk and cereal. Postmenopausal women should have an evaluation of their bone density. Presently, bone density is measured by a method called dual energy X-ray absorptiometry (DEXA). This test measures bone density based on the absorption of photons generated by an X-ray tube. Soon, a blood and urine test may be able to detect the biochemical markers of bone loss, making it possible for physicians to screen all older women and at-risk men for osteoporosis. If the bones are thin, it is worthwhile to take measures to gain bone density because even a slight increase can significantly reduce fracture risk. Regular, moderate, weight-bearing exercise such as walking or jogging is a good way to maintain bone strength (Fig. 6A). A combination of exercise and drug treatment, as recommended by a physician, may yield the best results. A wide variety of prescribed drugs that have different modes of action are available. Hormone therapy includes black cohosh, which is a phytoestrogen (estrogen made by a plant as opposed to an animal). Calcitonin is a naturally occurring hormone whose main site of action is the skeleton where it inhibits the action of osteoclasts, the cells that break down bone. Promising new drugs include slow-release fluoride therapy and certain growth hormones. These medications stimulate the formation of new bone. a. b. osteoporosis normal bone Figure 6A Preventing osteoporosis. a. Exercise can help prevent osteoporosis, but when playing golf, you should carry your own clubs and walk instead of using a golf cart. b. Normal bone growth compared to bone from a person with osteoporosis. Chapter 6 The Skeletal System 107 Coaxing the Chondrocytes for Knee Repair To the young, otherwise healthy, 30-something athlete on the physician’s exam table, the diagnosis must seem completely unfair. Perhaps he’s a former football player, or she’s a trained dancer. Whatever the sport or activity, the patient is slender and fit, but knee pain and swelling are this athlete’s constant companions. Examination of the knee shows the result of decades of use and abuse while performing a sport: The hyaline cartilage, also called articular cartilage, of the knee joint has degenerated. Hyaline cartilage (see page 84) is the "Teflon coating" for the bones of freely movable joints such as the knee. Hyaline cartilage allows easy, frictionless movement between the bones of the joint. Once repeated use has worn it away, hyaline cartilage does not grow back naturally. Exposed bone ends can grind against one another, resulting in pain, swelling, and restricted movements that can cripple the athlete. In severe cases, total knee replacement with a prosthetic joint is the athlete’s only option (Fig. 6B). Now the technique of tissue culture (growing cells outside of the patient’s body in a special medium) can help young athletes with cartilage injuries regenerate their own hyaline cartilage. In an autologous chondrocyte implantation (ACI) surgery, a piece of healthy hyaline cartilage from the patient’s knee is first removed surgically. This piece of cartilage, about the size of a pencil eraser, is typically taken from an undamaged area at the top edge of the knee. The chondrocytes, living cells of hyaline cartilage, are grown outside the body in tissue culture medium. Millions of the patient’s own cells can be grown to create a "patch" of living cartilage. Growing these cells takes two to three weeks. Once the chondrocytes have grown, a pocket is created over the damaged area using the patient’s own periosteum, the connective tissue that surrounds the bone (see page 84). The periosteum pocket will hold the hyaline cartilage cells in place. The cells are injected into the pocket and left to grow. As with all injuries to the knee, once the cartilage cells are firmly established, the patient still faces a lengthy rehabilitation. The patient must use crutches or a cane for three to four months to protect the joint. Physical therapy will stimulate cartilage growth without overstressing the area being repaired. In six months, the athlete can return to light-impact training and jogging. Full workouts can be resumed in about one year after surgery. However, most patients regain full mobility and a pain-free life after ACI surgery and do not have to undergo total knee replacement. ACI surgery can’t be used for the elderly or for overweight patients with osteoarthritis. Muscle or bone defects in the knee joint must be corrected before the surgery can be attempted. As with all surgeries, there is a risk for postoperative complications, such as bleeding or infection. However, ACI may offer young athletes the chance to restore essential hyaline cartilage and regain a healthy, functional knee joint. polyethylene polyethylene pelvis femur femur a. tibia b. Figure 6B Artificial joints in which polyethylene replaces articular cartilage. a. Knee. b. Hip. 6.5 Effects of Aging Both cartilage and bone tend to deteriorate as a person ages. The chemical nature of cartilage changes, and the bluish color typical of young cartilage changes to an opaque, yellowish color. The chondrocytes die, and reabsorption occurs as the cartilage undergoes calcification, becoming hard and brittle. Calcification interferes with the ready diffusion of nutrients and waste products through the matrix. The articular cartilage may no longer function properly, and the symptoms of arthritis can appear. There are three common types of arthritis: (1) Osteoarthritis is accompanied by deterioration of the articular cartilage. (2) In rheumatoid arthritis, the synovial membrane becomes inflamed and grows thicker cartilage, possibly due to an autoimmune reaction. (3) Gout, or gouty arthritis, is caused by an excessive buildup of uric acid (a metabolic waste) in the blood. Rather than being excreted in the urine, the acid is deposited as crystals in the joints, where it causes inflammation and pain. Osteoporosis, discussed in the Medical Focus on page 88, is present when weak and thin bones cause aches and pains. Such bones tend to fracture easily. Effects of Aging presents some of the age-related physical and functional changes that occur in the body. What’s New Readings offer fascinating information on treatments that are now experimental but promise to be particularly helpful in the future. Medical Focus Readings encourage students to explore clinical examples that they may see throughout their health care career or within their own family. “Education is not preparation for life; education is life itself.” – John Dewey xvii