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Visual Anatomy & Physiology 3rd Edition PDF – eBook



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Download Visual Anatomy & Physiology 3rd Edition PDF – eBook

Section 1 An Introduction to Studying
the Human Body 3
1.1 Using your textbook effectively is key to your success 3
1.2 Comprehending the art is essential to understanding A&P 4
1.3 Break down the art in a step-wise fashion to learn the topic 6
1.4 Orient yourself to all art in the same way 8
1.5 The learning outcomes correspond by number to
the chapter’s modules and indicate what you should
be able to do after completing chapter 9
Section 1 Review 10
Section 2 A&P in Perspective 11
1.6 Focused study is important for learning anatomy
and physiology 11
1.7 Organisms share common characteristics and processes 12
1.8 Anatomy is the study of structure and physiology
is the study of function 14
1.9 Structure and function are interrelated 16
Section 2 Review 18
Section 3 Levels of Organization 19
1.10 The human body has multiple interdependent
levels of organization 19
1.11 Cells are the smallest units of life 20
1.12 Tissues are specialized groups of cells and cell products 22
1.13 Organs and organ systems perform vital functions 24
1.14 Organs of the integumentary, skeletal, and muscular
systems support and move the body and organs of the
the nervous system provides rapid control and regulation 26
1.15 Organs of the endocrine system secrete chemicals that
are carried by organs of the cardiovascular system, organs
of the lymphatic system defend the body and organs
of the respiratory system exchange vital gases 28
1.16 Organs of the digestive system make nutrients
available and, with the urinary system, excrete wastes,
and organs of the male and female reproductive
systems provide for the continuity of life 30
Section 3 Review 32
Section 4 Homeostasis 33
1.17 Homeostatic regulation relies on a receptor, a control center,
and an effector 33
1.18 Negative feedback provides stability and positive
feedback accelerates a process to completion 34
SmartArt Video: Homeostatic regulation 35
Section 4 Review 36
Section 5 Anatomical Terms 37
1.19 Anatomical terms have a long and varied history 37
1.20 Superficial anatomy and regional anatomy indicate locations
on or in the body 38
Preface vi
An Introduction
to Anatomy & 1 Physiology 2
1.21 Directional terms and sectional planes describe specific points
of reference 40
1.22 Body cavities protect internal organs and allow them
to change shape 42
Section 5 Review 44
Chapter 1 Review 45
Study Outline 45
Chapter Review Questions 47
Chapter Integration 49
Section 1 Atoms, Molecules, and Compounds 51
2.1 Atoms are the basic particles of matter 51
2.2 Typical atoms contain protons, neutrons, and electrons 52
2.3 Electrons occupy various energy levels 54
2.4 The most common chemical bonds are ionic bonds and
covalent bonds 56
2.5 Matter may exist as a solid, a liquid, or a gas 58
Section 1 Review 60
Section 2 Chemical Reactions 61
2.6 Chemical reactions and energy transfer are essential to
cellular functions 61
2.7 Chemical notation is a concise method of describing
chemical reactions 62
2.8 Three basic types of chemical reactions are important for
understanding physiology 64
2.9 Enzymes lower the activation energy requirements of
chemical reactions 66
Section 2 Review 68
Section 3 Water in the Body 69
2.10 Water has several important properties 69
2.11 Physiological systems depend on water 70
2.12 Regulation of body fluid pH is vital for homeostasis 72
Section 3 Review 74
Section 4 Organic Compounds 75
2.13 All organic compounds contain carbon and hydrogen atoms 75
2.14 Carbohydrates contain carbon, hydrogen,
and oxygen, usually in a 1:2:1 ratio 76
2.15 Lipids often have a carbon-to-hydrogen ratio of 1:2 78
2.16 Eicosanoids, steroids, phospholipids, and glycolipids have
diverse functions 80
2.17 Proteins are formed from amino acids 82
2.18 Enzymes are proteins with important regulatory functions 84
2.19 High-energy compounds may store and transfer a portion
of energy released during enzymatic reactions 85
2.20 DNA and RNA are nucleic acids 86
Section 4 Review 88
Chapter 2 Review 89
Study Outline 89
Chapter Review Questions 91
Chapter Integration 93
2 Chemical Level of
Organization 50

Contents • xv
Section 1 Introduction to Cells 95
3.1 Cellular differentiation produces specialized cells 95
3.2 Cells are the smallest living unit of life 96
3.3 The plasma membrane isolates the cell from its
environment and performs varied functions 98
3.4 The cytoskeleton plays both a structural and
a functional role 100
3.5 Ribosomes are responsible for protein synthesis and are
often associated with the endoplasmic reticulum 102
3.6 The Golgi apparatus is a packaging center 104
3.7 Mitochondria are the powerhouses of the cell 106
Section 1 Review 108
Section 2 Structures and Function of the Nucleus 109
3.8 The nucleus is the control center for cellular homeostasis 109
3.9 The nucleus contains DNA, RNA, organizing proteins,
and enzymes 110
3.10 Protein synthesis involves DNA, enzymes, and three types
of RNA 112
3.11 Transcription encodes genetic instructions on a strand
of RNA 114
SmartArt Video: Transcription 115
3.12 Translation builds polypeptides as directed by
an mRNA strand 116
SmartArt Video: Translation 117
Section 2 Review 118
Section 3 How Substances Enter and
Leave the Cell 119
3.13 The plasma membrane is a selectively permeable
membrane 119
3.14 Diffusion is passive movement driven by concentration
differences 120
3.15 Osmosis is the diffusion of water molecules across
a selectively permeable membrane 122
3.16 In carrier-mediated transport, integral proteins facilitate
membrane passage 124
3.17 In vesicular transport, vesicles selectively carry materials into
or out of the cell 126
Section 3 Review 128
Section 4 Cell Life Cycle 129
3.18 Interphase and cell division make up the life cycle of a cell 129
3.19 During interphase, the cell prepares for cell division 130
3.20 Mitosis distributes chromosomes before
cytokinesis separates the daughter cells 132
3.21 CLINICAL MODULE: Tumors and cancer are characterized
by abnormal cell growth and division 134
Section 4 Review 136
Chapter 3 Review 137
Study Outline 137
Chapter Review Questions 139
Chapter Integration 141
Cellular Level of 3 Organization 94
Section 1 Epithelial Tissue 143
4.1 Four types of tissue make up the body 143
4.2 Microscopes are used to study cells and tissues 144
4.3 Epithelial tissue covers surfaces, lines cavities, and forms
secretory glands 146
4.4 Epithelial cells are extensively interconnected, both
structurally and functionally 148
4.5 The cells in a squamous epithelium are flat and
irregularly shaped 150
4.6 Cuboidal and transitional epithelia line several passageways
and chambers connected to the exterior 152
4.7 Columnar epithelia absorb substances and protect
the body from digestive chemicals 154
4.8 Glandular epithelia are specialized for secretion 156
4.9 Exocrine glands can be classified by structure 157
Section 1 Review 158
Section 2 Connective Tissue 159
4.10 A matrix surrounds connective tissue cells 159
4.11 Loose connective tissues support other tissue types 160
4.12 Dense connective tissues are dominated by extracellular fibers,
whereas fluid connective tissues have a aqueous matrix 162
4.13 Cartilage provides a flexible support for body structures 164
4.14 Bone provides a strong framework for the body 166
4.15 Tissue membranes are physical barriers, and
fasciae support and surround organs 168
Section 2 Review 170
Section 3 Muscle Tissue and Nervous Tissue 171
4.16 Muscle tissue outweighs nervous tissue by 25:1 171
4.17 Muscle tissue is s specialized for contraction and nervous
tissue is specialized for communication 172
4.18 CLINICAL MODULE: The response to tissue injury
involves inflammation and regeneration 174
Section 3 Review 176
Chapter 4 Review 177
Study Outline 177
Chapter Review Questions 179
Chapter Integration 181
Tissue Level of 4 Organization 142
SECTION 1 Functional Anatomy of the Skin 183
5.1 The integumentary system consists of the skin
and various accessory structures 183
5.2 The epidermis is composed of strata (layers)
that have various functions 184
The Integumentary 5 System 182

xvi • Contents
Section 1 Introduction to the Structure
and Growth of Bones 211
6.1 The skeletal system is made up of the axial and
appendicular divisions 211
6.2 Bones are classified according to shape and structure
and have varied bone markings 212
6.3 Long bones transmit forces along the shaft and have a
rich blood supply 214
6.4 Bone has a calcified matrix maintained and altered by
osteogenic cells, osteoblasts, osteocytes, and osteoclasts 216
6.5 Compact bone consists of parallel osteons, and spongy
bone consists of a network of trabeculae 218
6.6 Appositional bone growth involves the periosteum and
the endosteum 220
6.7 Endochondral ossification replaces a cartilage model
with bone 222
SmartArt Video: Endochondral ossification 223
6.8 Intramembranous ossification forms bone without a prior
cartilage model 224
6.9 CLINICAL MODULE: Abnormalities of bone growth and
development produce recognizable physical signs 226
Section 1 Review 228
6 Bones and Bone
Structure 210
Section 2 Physiology of Bones 229
6.10 Bones play an important role as mineral reservoirs 229
6.11 The primary hormones regulating calcium ion metabolism
and parathyroid hormone, calcitriol, and calcitonin 230
SmartArt Video: Calcium ion metabolism 231
6.12 CLINICAL MODULE: A fracture is a crack or a break in a bone 232
Section 2 Review 234
Chapter 6 Review 235
Study Outline 235
Chapter Review Questions 237
Chapter Integration 239
Section 1 Axial Skeleton 241
7.1 The axial skeleton includes bones of the head, vertebral
column, and trunk 241
7.2 The skull has cranial and facial components that are usually
bound together by sutures 242
7.3 Facial bones dominate the anterior aspect of the skull,
and cranial bones dominate the posterior surface 244
7.4 The lateral and medial aspects of the skull share many
bone markings 246
7.5 The foramina on the inferior surface of the skull mark
the passageways for nerves and blood vessels 248
7.6 The shapes and markings of the sphenoid, ethmoid,
and palatine bones are the best seen in the
isolated bones 250
7.7 Each orbital complex contains one eye, and the
nasal complex encloses the nasal cavities 252
7.8 The mandible forms the lower jaw and the associated
bones of the skull perform specialized functions 254
7.9 Fontanelles permit cranial growth in infants and
small children 256
7.10 The vertebral column has four spinal curves, and vertebrae
share a basic structure that differs regionally 258
7.11 There are seven cervical vertebrae and twelve
thoracic vertebrae 260
7.12 There are five lumbar vertebrae 262
7.13 The sacrum and coccyx consist of fused vertebrae 263
7.14 The thoracic cage protects organs in the chest and provides
sites for muscle attachment 264
Section 1 Review 266
Section 2 Appendicular Skeleton 267
7.15 The appendicular skeleton includes the limb bones and
the pectoral and pelvic girdles 267
7.16 The pectoral girdles—the clavicles and scapulae—connect
the upper limbs to the axial skeleton 268
7.17 The humerus of the arm articulates with the radius and ulna
of the forearm 270
7.18 The wrist consists of carpal bones and the hand consists
of metacarpal bones and phalanges 272
7 The Skeleton 240
5.3 Factors influencing skin color include epidermal pigmentation
and dermal circulation 186
5.4 The subcutaneous layer connects the dermis to
underlying tissues 188
5.5 CLINICAL MODULE: Burns are significant injuries that damage
skin integrity 190
Section 1 Review 192
Section 2 Accessory Structures of the Skin 193
5.6 Hair follicles, exocrine glands, and nails are also components
of the integumentary system 193
5.7 Hair is composed of dead, keratinized cells produced in a
specialized hair follicle 194
5.8 Sebaceous glands and sweat glands are exocrine glands in
the skin 196
5.9 Nails are thick sheets of keratinized epidermal cells that
protect the tips of fingers and toes 198
5.10 CLINICAL MODULE: Age-related changes affect the
integument 199
5.11 The integument responds to circulating hormones
and has endocrine functions that are stimulated by
ultraviolet radiation 200
5.12 CLINICAL MODULE: The integument can often repair itself,
even after extensive damage 202
Section 2 Review 204
Chapter 5 Review 205
Study Outline 205
Chapter Review Questions 207
Chapter Integration 209

Contents • xvii
7.19 The hip bone forms by the fusion of the ilium, ischium,
and pubis 274
7.20 The pelvis consists of the two hip bones, the sacrum,
and the coccyx 276
7.21 The adult male and female skeletons have significant
differences 277
7.22 The femur, tibia, and patella meet at the knee 278
7.23 The ankle and foot consist of tarsal bones, metatarsal bones,
and phalanges 280
Section 2 Review 282
Chapter 7 Review 283
Study Outline 283
Chapter Review Questions 285
Chapter Integration 287
Section 1 Joint Structure and Movement 289
8.1 Joints are classified according to structure and movement 289
8.2 Synovial joints are freely movable and lines with
a synovial membrane 290
8.3 Anatomical organization determines the motion at
synovial joints 292
8.4 Specific terms are used to describe movements with
reference to the anatomical position 294
8.5 Specific terms describe rotation and special movements 296
Section 1 Review 298
Section 2 Axial and Appendicular Joints 299
8.6 Axial joints have less range of motion than appendicular
joints 299
8.7 The vertebral column includes three types of joints 300
8.8 CLINICAL MODULE: Intervertebral disc disease and
osteoporosis are common age-related health problems 301
8.9 The shoulder and hip are ball-and-socket joints 302
8.10 The elbow and knee are hinge joints 304
8.11 CLINICAL MODULE: Arthritis can disrupt normal
joint structure and function 306
Section 2 Review 308
Chapter 8 Review 309
Study Outline 309
Chapter Review Questions 311
Chapter Integration 313
8 Joints 288
Section 1 Functional Anatomy of Skeletal
Muscle Tissue 315
9.1 Skeletal muscle tissue enables body movement
and other vital functions 315
9.2 Skeletal muscle contains muscle tissue, connective
tissues, blood vessels, and nerves 316
9.3 Skeletal muscle fibers contain T tubules and
sarcoplasmic reticula that surround contractile
myofibrils made up of sarcomeres 318
9.4 The sliding of thin filaments past thick filaments
produces muscle contraction 320
9.5 Skeletal muscle fibers and neurons have excitable
plasma membranes that produce and carry electrical
impulses called action potentials 322
9.6 A skeletal muscle fiber contracts when stimulated
by a motor neuron 324
9.7 A muscle fiber contraction uses ATP in a cycle
that repeats during the contraction 326
Section 1 Review 328
Section 2 Functional Properties
of Skeletal Muscle 329
9.8 Muscle tension develops from the events that occur
during excitation-contraction coupling 329
9.9 Tension is greatest when muscle fibers are
stimulated at optimal length 330
9.10 The peak tension developed by a skeletal muscle
depends on the frequency of stimulation and the
number of muscle fibers stimulated 332
SmartArt Video: Motor units and recruitment 333
9.11 Muscle contractions may be isotonic or isometric;
isotonic contractions may be concentric
or eccentric 334
9.12 Muscle contraction requires large amounts
of ATP that may be produced anaerobically
or aerobically 336
SmartArt Video: Anaerobic vs. aerobic
production of ATP 337
9.13 Muscles fatigue and may need an extended
recovery period 338
9.14 Fast, slow, and intermediate skeletal muscle fibers
differ in size, internal structure, metabolism,
and resistance to fatigue 340
9.15 CLINICAL MODULE: Many factors can result in
muscle hypertrophy, atrophy, or paralysis 342
Section 2 Review 344
Chapter 9 Review 345
Study Outline 345
Chapter Review Questions 347
Chapter Integration 349
9 Skeletal Muscle
Tissue 314

xviii • Contents
Section 1 Functional Organization of
the Muscular System 351
10.1 The axial and appendicular muscles have
different functions 351
10.2 Muscular power and range of motion are influenced
by fascicle organization and leverage 352
10.3 The origins and insertions of muscles determine
their actions, while their names can provide
clues to appearance and/or function 354
10.4 The skeletal muscles can be assigned to the axial
division or the appendicular division based on
origins and functions 356
Section 1 Review 358
Section 2 Axial Muscles 359
10.5 There are four groups of axial muscles 359
10.6 The muscles of facial expression are important in
eating and useful for communication 360
10.7 The extrinsic eye muscles position the eye and the
muscles of mastication move the lower jaw 362
10.8 The muscles of the tongue are closely associated
with the muscles of the pharynx and neck 364
10.9 The muscles of the vertebral column support
and align the axial skeleton 366
10.10 The oblique and rectus muscles form the
muscular walls of the trunk 368
10.11 The muscles of the pelvic floor support the
organs of the abdominopelvic cavity 370
Section 2 Review 372
Section 3 Appendicular Muscles 373
10.12 The appendicular muscles stabilize, position,
and support the limbs 373
10.13 The largest appendicular muscles originate on the trunk 374
10.14 Muscles that position each pectoral girdle originate on
the occipital bone, superior vertebrae, and ribs 376
10.15 Muscles that move the arm originate on the clavicle,
scapula, thoracic cage, and vertebral column 378
10.16 Muscles that move the forearm and hand originate
on the scapula, humerus, radius, or ulna 380
10.17 Muscles that move the hand and fingers originate
on the humerus, radius, ulna, and interosseous
membrane 382
10.18 The intrinsic muscles of the hand originate on the
carpal and metacarpal bones and associated
tendons and ligaments 384
10.19 The muscles that move the thigh originate on the
pelvis and associated ligaments and fasciae 386
10.20 The muscles that move the leg originate
on the pelvis and femur 388
10.21 The extrinsic muscles that move the foot and
toes originate on the tibia and fibula 390
10 The Muscular
System 350
10.22 The intrinsic muscles of the foot originate in the tarsal and
metatarsal bones and associated tendons and ligament 392
10.23 The deep fascia divides the limb muscles
into separate compartments 394
Section 3 Review 396
Chapter 10 Review 397
Study Outline 397
Chapter Review Questions 399
Chapter Integration 401
11 Nervous
Tissue 402
Section 1 Cellular Organization of the
Nervous System 403
11.1 The nervous system has three divisions: the CNS,
PNS, and ENS 403
11.2 Neurons are nerve cells specialized for
intercellular communication 404
11.3 Neurons are classified on the basis of structure
and function 406
11.4 Oligodendrocytes, astrocytes, ependymal cells,
and microglia are neuroglia of the CNS 408
11.5 Schwann cells and satellite cells are the neuroglia
of the PNS 410
Section 1 Review 412
Section 2 Neurophysiology 413
11.6 Neuronal activity depends on changes in
membrane potential 413
11.7 Differences in electrochemical gradients determine
the resting membrane potential 414
11.8 Three types of gated ion channels change the
permeability of the plasma membrane 416
11.9 Graded potentials are localized changes
in the membrane potential 418
11.10 Action potentials are all-or-none events for communication
that begin with membrane potential reversal 420
11.11 Action potentials may affect adjacent portions
of the plasma membrane through continuous
propagation or saltatory propagation 422
11.12 At a synapse, information travels from the
presynaptic cell to the postsynaptic cell 424
11.13 Postsynaptic potentials are responsible for
information processing in a neuron 426
11.14 Information processing involves interacting with groups of
neurons and various neurotransmitters that encode
information as action potential frequency 428
Section 2 Review 430
Chapter 11 Review 431
Study Outline 431
Chapter Review Questions 433
Chapter Integration 435

Contents • xix
Section 1 Functional Organization
of the Spinal Cord 437
12.1 The spinal cord can function independently from the brain 437
12.2 The spinal cord has 31 segments with 31 pairs of nerves 438
12.3 The spinal meninges, consisting of the dura mater, arachnoid
mater, and pia mater, surround the spinal cord 440
12.4 Gray matter integrates sensory and motor functions,
and white matter carries information 442
12.5 Spinal nerves have a similar anatomical structure and
distribution pattern 444
12.6 Each ramus of a spinal nerve provides sensory and motor
innervation to a specific region 446
12.7 Spinal nerves form nerve plexuses that innervate the skin
and skeletal muscles 448
12.8 The cervical plexus innervates the muscles of the neck
and diaphragm 449
12.9 The brachial plexus innervates the pectoral girdles and
upper limbs 450
12.10 The lumbar and sacral plexuses innervate the skin and
skeletal muscles of the trunk and lower limbs 452
Section 1 Review 454
Section 2 Introduction to Reflexes 455
12.11 CNS neurons are grouped into neuronal pools, which form
neural circuits 455
12.12 Reflexes are vital to homeostasis 456
SmartArt Video: The reflex arc 457
12.13 The stretch reflex is a monosynaptic reflex involving
muscle spindles 458
12.14 Withdrawal reflexes and crossed extensor reflexes are
polysynaptic reflexes 460
12.15 CLINICAL MODULE: The brain can inhibit or facilitate
spinal reflexes, and reflexes can be used to determine
the location and severity of damage to the CNS 462
Section 2 Review 464
Chapter 12 Review 465
Study Outline 465
Chapter Review Questions 467
Chapter Integration 469
12 The Spinal Cord,
Spinal Nerves, and
Spinal Reflexes 436
Section 1 Functional Anatomy of the Brain
and Cranial Nerves 471
13.1 The brain develops from a hollow neural tube 471
13.2 Each region of the brain has a distinct structural
and functional characteristics 472
The Brain, Cranial Nerves,
and Sensory and 13 Motor Pathways 470
13.3 The cranial meninges and cerebrospinal fluid
protect and support the brain 474
13.4 The medulla oblongata contains autonomic reflex
centers, relay stations, and ascending and descending
tracts 476
13.5 The pons links the cerebellum to the brain and spinal
cord and has vital autonomic reflex centers 477
13.6 The cerebellum coordinates learned and reflexive patterns
of muscular activity at the subconscious level 478
13.7 The midbrain regulates auditory and visual reflexes
and controls alertness 480
13.8 The diencephalon consists of the epithalamus, thalamus,
and hypothalamus 482
13.9 The limbic system is a functional group of
tracts and nuclei located in the cerebrum
and diencephalon 484
13.10 The basal nuclei of the cerebrum adjust and
refine ongoing voluntary movements 486
13.11 Superficial landmarks divide the cerebral
hemispheres into lobes 488
13.12 The lobes of the cerebral cortex have
regions with specific functions 490
13.13 White matter connects the cerebral hemispheres
and the lobes of each hemisphere and links the
cerebrum to the rest of the brain 492
13.14 CLINICAL MODULE: Brain activity can be monitored
using external electrodes; the record is called
an electroencephalogram, or EEG 493
13.15 The twelve pairs of cranial nerves are classified
as sensory, special sensory, motor, or
mixed nerves 494
Section 1 Review 496
Section 2 Sensory and Motor Pathways 497
13.16 Sensations carried by sensory pathways to the CNS
begin with transduction at a sensory receptor 497
13.17 Receptors are classified by function or response
to the stimulus 498
13.18 Tactile receptors have a simple structure and
are abundant in the skin 500
13.19 Three major somatic sensory pathways carry
information from the skin and muscles
to the CNS 502
13.20 The somatic nervous system controls skeletal muscles
through upper and lower motor neurons 504
13.21 There are multiple levels of somatic
motor control 506
13.22 CLINICAL MODULE: Nervous system disorders may
result from problems with neurons, pathways,
or a combination of the two 508
Section 2 Review 510
Chapter 13 Review 511
Study Outline 511
Chapter Review Questions 514
Chapter Integration 515

xx • Contents
Section 1 Functional Anatomy of the
Autonomic Nervous System 517
14.1 Ganglionic neurons of the ANS control visceral effectors 517
14.2 The ANS consists of sympathetic and
parasympathetic divisions 518
14.3 The sympathetic division has chain ganglia, collateral ganglia,
and the adrenal medullae, whereas the parasympathetic
division has terminal or intramural ganglia 520
14.4 The two ANS divisions innervate many of the same
structures, but the innervation patterns are different 522
14.5 The functional differences between the two
ANS divisions reflect their divergent anatomical
and physiological characteristics 524
14.6 Membrane receptors at target organs mediate the effects
of sympathetic and parasympathetic stimulation 526
Section 1 Review 528
Section 2 Autonomic Regulation and
Control Mechanisms 529
14.7 The ANS adjusts visceral motor responses
to maintain homeostasis 529
14.8 The ANS provides precise control over visceral functions 530
14.9 Most visceral functions are controlled by visceral reflexes 532
14.10 Baroreceptors and chemoreceptors initiate important
autonomic reflexes involving visceral sensory pathways 534
14.11 The autonomic nervous system has multiple
levels of motor control 536
Section 2 Review 538
Chapter 14 Review 539
Study Outline 539
Chapter Review Questions 541
Chapter Integration 543
14 The Autonomic
Nervous System 516
Section 1 Olfaction and Gustation 545
15.1 A generator potential is a depolarization of the membrane 545
15.2 Olfaction involves specialized chemoreceptive neurons
and delivers sensations directly to the cerebrum 546
15.3 Gustation involves epithelial chemoreceptor
cells located in taste buds 548
15.4 Gustatory reception relies on membrane receptors
and ion channels and sensations are carried by
facial, glossopharyngeal, and vagus nerves 550
Section 1 Review 552
Section 2 Vision 553
15.5 The eyes form early in embryonic development 553
15.6 Accessory structures of the eye provide protection while
allowing light to reach the interior of the eye 554
15 The Special
Senses 544
15.7 The hollow eyeball has a layered wall and fluid-filled anterior and posterior cavities 556
15.8 The structures of the eye direct light along a visual
axis to the fovea centralis of the retina 558
15.9 Focusing of light produces a sharp image
on the retina 560
15.10 The neural layer of the retina contains multiple
layers of specialized photoreceptors, neurons,
and supporting cells 562
15.11 Photoreception occurs in the outer segment
of rod and cone cells 564
15.12 Photoreception involves activation, bleaching,
and reassembly of visual pigments 566
15.13 The visual pathways distribute visual information
from each eye to both cerebral hemispheres 568
15.14 CLINICAL MODULE: Refractive problems result
from abnormalities in the cornea or lens or in
the shape of the eye 569
Section 2 Review 570
Section 3 Equilibrium and Hearing 571
15.15 Equilibrium and hearing involve the internal ear 571
15.16 The ear is divided into the external ear, the middle ear,
and the internal ear 572
15.17 In the internal ear, the bony labyrinth protects the
membranous labyrinth and its receptors 574
15.18 Hair cells in the semicircular ducts respond to
rotation; hair cells in the utricle and saccule respond
to gravity and linear acceleration 576
15.19 The cochlear duct contains the hair cells of the
the spiral organ that functions in hearing 578
15.20 Sound waves lead to movement of the basilar
the membrane in the process of hearing 580
15.21 The vestibulocochlear nerve carries equilibrium
and hearing sensations to the brainstem 582
15.22 CLINICAL MODULE: Aging is associated with many
disorders of the special senses; trauma, infection, and
abnormal stimuli may cause problems at any age 584
Section 3 Review 586
Chapter 15 Review 587
Study Outline 587
Chapter Review Questions 591
Chapter Integration 593
Section 1 Hormones and Intercellular
Communication 595
16.1 The nervous and endocrine systems release chemical
messengers that bind to target cells 595
16.2 Hormones may be amino acid derivatives, peptides,
or lipid derivatives 596
16.3 The endocrine system includes organs and tissues with
primary and secondary hormone-secreting roles 597
16 The Endocrine
System 594

Contents • xxi
16.4 Hormones affect target cells after binding to receptors
in the plasma membrane, cytoplasm, or nucleus 598
16.5 The hypothalamus exerts direct or indirect control
over the activities of many endocrine organs 600
16.6 The anterior lobe of the pituitary gland produces
and releases 7 tropic hormones, while the posterior
lobe releases 2 hormones 602
16.7 Negative feedback mechanisms control the secretion
rates of the hypothalamus and the pituitary gland 604
16.8 The thyroid gland contains follicles and requires iodine to
produce hormones that stimulate tissue metabolism 606
16.9 Parathyroid hormone, produced by the parathyroid
glands is the primary regulator of blood calcium
ion levels 608
16.10 The adrenal hormones are involved in metabolic regulation,
electrolyte balance, and stress responses 610
16.11 The pancreatic islets secrete insulin and glucagon,
which regulate glucose use by most cells 612
SmartArt Video: The pancreas and regulation
of blood glucose 613
16.12 The pineal gland of the epithalamus secretes melatonin,
which affects the circadian rhythm 614
16.13 CLINICAL MODULE: Diabetes mellitus is an endocrine
a disorder characterized by an excessively
high blood glucose level 615
Section 1 Review 616
Section 2 Hormones and System Integration 617
16.14 Hormones interact to produce coordinated
physiological responses 617
16.15 Regulation of blood pressure and blood volume involves
hormones from primary endocrine organs and from
endocrine tissues in the heart and kidneys 618
16.16 Normal growth requires the cooperation
of many endocrine organs 619
16.17 The stress response is a predictable response to
any significant threat to homeostasis 620
16.18 CLINICAL MODULE: Overproduction or underproduction
of hormones can cause endocrine disorders 622
Section 2 Review 624
Chapter 16 Review 625
Study Outline 625
Chapter Review Questions 627
Chapter Integration 629
Section 1 Plasma and Formed Elements 631
17.1 Blood is the fluid portion of the cardiovascular system 631
17.2 Blood is a fluid connective tissue containing
plasma and formed elements 632
17.3 Formed elements are produced by stem cells in
red bone marrow 634
Section 1 Review 636
17 Blood 630
Section 2 Structure and Function
of Formed Elements 637
17.4 Hematology is the study of blood and
blood-forming tissues 637
17.5 Red blood cells, the most commonly formed elements, contain
hemoglobin that transports respiratory gases 638
17.6 Red blood cells are continually produced and their
components recycled or eliminated 640
17.7 Blood type is determined by the presence or absence
of specific surface antigens on RBCs 642
17.8 CLINICAL MODULE: Hemolytic disease of the newborn
is an RBC-related disorder caused by a cross-reaction
between fetal and maternal blood types 644
17.9 The various types of white blood cells contribute
to the body’s defenses 646
17.10 The clotting response is a complex cascade of events
that reduces blood loss 648
17.11 CLINICAL MODULE: Blood disorders can be classified by their
origins and the changes in blood characteristics 650
Section 2 Review 652
Chapter 17 Review 653
Study Outline 653
Chapter Review Questions 655
Chapter Integration 657
Section 1 Structure of the Heart 659
18.1 The heart has four chambers that pump and circulate
blood through the pulmonary and systemic circuits 659
18.2 The heart is located in the mediastinum and is
enclosed by the pericardial cavity 660
18.3 The heart wall contains concentric layers of cardiac
muscle tissue 662
18.4 The boundaries between the four chambers of the
the heart can be identified on its external surface 664
18.5 The heart has an extensive blood supply  666
18.6 Internal valves control the direction of blood flow
between the heart chambers and great vessels 668
18.7 When the heart beats, the AV valves close before
the semilunar valves open, and the semilunar
valves close before the AV valves open 670
18.8 CLINICAL MODULE: Arteriosclerosis can lead to coronary
artery disease 672
Section 1 Review 674
Section 2 Cardiac Cycle 675
18.9 The cardiac cycle is a complete round of systole and diastole 675
18.10 The cardiac cycle creates pressure gradients that maintain
blood flow 676
SmartArt Video: The cardiac cycle 677
18.11 Cardiac muscle cell contractions last longer than skeletal
muscle fiber contractions primarily because of differences
in calcium ion membrane permeability 678
SmartArt Video: The conducting system of the heart 679
18 The Heart and
Function 658

xxii • Contents
Section 1 Functional Anatomy of Blood Vessels 697
19.1 The heart pumps blood, in sequence, through the
arteries, capillaries, and veins of the
pulmonary and systemic circuits 697
19.2 Arteries and veins differ in the structure
and thickness of their walls 698
19.3 Capillary structure and capillary blood flow affect the rates
of exchange between the blood and interstitial fluid 700
19.4 The venous system has low pressures and contains
almost two-thirds of the body’s blood volume 702
Section 1 Review 704
Section 2 Coordination of Cardiac Output
and Blood Flow 705
19.5 Pressure, resistance, and venous return affect
cardiac output 705
19.6 Vessel luminal diameter is the main source of
resistance within the cardiovascular system 706
19.7 Blood flow is determined by the interplay between
arterial pressure and peripheral resistance 708
19.8 Capillary exchange is a dynamic process that includes
diffusion, filtration, and reabsorption 710
19.9 Cardiovascular regulatory mechanisms respond to
changes in blood pressure or blood chemistry 712
19.10 Endocrine responses to low blood pressure and low
blood volume is very different from those to high
blood pressure and high blood volume 714
19.11 Chemoreceptors monitor the chemical composition
of the blood and cerebrospinal fluid 716
19.12 The cardiovascular center makes extensive
adjustments to cardiac output and blood
distribution during exercise 717
19.13 CLINICAL MODULE: Short-term and long-term mechanisms
compensate for a reduction in blood volume 718
Section 2 Review 720
18.12 Electrical events of pacemaker cells and conducting
cells establish a heart rate of 680
18.13 CLINICAL MODULE: Normal and abnormal cardiac activity
can be detected in an electrocardiogram 682
18.14 The intrinsic heart rate can be altered by autonomic
activity 684
18.15 Stroke volume depends on the relationship between
end-diastolic volume and end-systolic volume 686
18.16 Cardiac output is regulated by adjustments in heart rate
and stroke volume 688
Section 2 Review 690
Chapter 18 Review 691
Study Outline 691
Chapter Review Questions 694
Chapter Integration 695
Blood Vessels and 19 Circulation 696
Section 3 Patterns of Blood Flow 721
19.14 New blood vessels form through
vasculogenesis and angiogenesis 721
19.15 The pulmonary circuit carries deoxygenated blood
from the right ventricle to the lungs and returns
oxygenated blood to the left atrium 722
19.16 The arteries and veins of the systemic circuit operate in
parallel and the major vessels often have similar names 724
19.17 The branches of the aortic arch supply structures that are
drained by the superior vena cava 726
19.18 The external carotid arteries supply the neck, lower jaw,
and face, and the internal carotid and vertebral arteries
supply the brain while the external jugular veins drain
the regions supplied by the external carotid arteries,
and the internal jugular veins drain the brain 728
19.19 The internal carotid arteries and the vertebral arteries supply
the brain which is drained by the dural sinuses and the
internal jugular veins 730
19.20 The regions supplied by the descending aorta are
drained by the superior and inferior venae cavae 732
19.21 The viscera supplied by the celiac trunk and mesenteric
arteries are drained by the branches of the hepatic
portal vein 734
19.22 The pelvis and lower limbs are supplied by branches of the
common iliac arteries and drained by branches of the
common iliac veins 736
19.23 The arteries of the systemic circuit deliver oxygenated
blood throughout the body and the veins of the systemic
circuit returns deoxygenated blood back to the heart 738
19.24 CLINICAL MODULE: The pattern of blood flow through the
fetal heart and the systemic circuit must change at birth 740
Section 3 Review 742
Chapter 19 Review 743
Study Outline 743
Chapter Review Questions 748
Chapter Integration 749
Section 1 Anatomy of the Lymphatic System 751
20.1 The lymphatic system consists of lymphatic vessels, nodes,
and lymphoid tissue 751
20.2 Interstitial fluid flows continuously into lymphatic capillaries
and exits tissues as lymph in lymphatic vessels 752
20.3 Small lymphatic vessels converge to form lymphatic ducts
that empty into the subclavian veins 754
20.4 Lymphocytes are responsible for the immune functions of
the lymphatic system 756
20.5 Lymphocytes aggregate within lymphoid tissues and
lymphoid organs 758
20.6 The thymus is a lymphoid organ that produces functional
T cells 760
20.7 The spleen, the largest lymphoid organ, responds to antigens
in the bloodstream 762
Section 1 Review 764
20 The Lymphatic
System and
Immunity 750

Contents • xxiii
Section 2 Innate Immunity 765
20.8 Innate immunity is nonspecific and is not stimulated by
specific antigens 765
20.9 Physical barriers prevent pathogens and toxins from
entering body tissues 766
20.10 Phagocytes respond to pathogen invasion 767
20.11 NK cells perform immune surveillance, detecting and
destroying abnormal cells 768
20.12 Interferons and the complement system are distributed widely
in body fluids 770
20.13 Inflammation is a localized tissue response to injury; fever is a
generalized response to tissue damage and infection 772
Section 2 Review 774
Section 3 Adaptive Immunity 775
20.14 Adaptive immunity provides the body’s specific defenses 775
20.15 Adaptive immunity is triggered by exposure of T cells and
B cells to specific antigens 776
SmartArt Video: The immune response 777
20.16 Infected cells stimulate the formation and division of
cytotoxic T cells, memory Tc cells, and regulatory T cells 778
20.17 Antigen-presenting cells can stimulate the activation of CD4
T cells, producing helper T cells that promote B cell
activation and antibody production 780
20.18 Antibodies are small soluble proteins that bind to specific
antigens and whose abundance increases upon later
antigen exposure 782
20.19 Antibodies use many different mechanisms to destroy
target antigens 784
20.20 CLINICAL MODULE: Hypersensitivities are abnormal reactions
to antigens 785
20.21 Innate immunity and adaptive immunity work
together to defeat pathogens 786
20.22 CLINICAL MODULE: Immune disorders involving either
overactivity or underactivity can be harmful 788
Section 3 Review 790
Chapter 20 Review 791
Study Outline 791
Chapter Review Questions 794
Chapter Integration 795
21.6 The lungs have lobes that are subdivided into
bronchopulmonary segments 806
21.7 Pulmonary lobules contain alveoli, where gas exchange
occurs 808
Section 1 Review 810
Section 2 Respiratory Physiology 811
21.8 Respiratory physiology involves external and internal
respiration 811
21.9 Pulmonary ventilation is driven by pressure changes within
the pleural cavities 812
21.10 Respiratory muscles are involved with breathing, and
pulmonary function tests determine lung performance 814
21.11 Pulmonary ventilation must be closely regulated to meet
tissue oxygen demands 816
21.12 Gas diffusion depends on the partial pressures and
solubilities of gases 818
SmartArt Video: Partial pressures and gas diffusion 819
21.13 Almost all the oxygen in blood is transported bound to
hemoglobin within red blood cells 820
21.14 Carbon dioxide is transported three ways in the
bloodstream 822
21.15 CLINICAL MODULE: Pulmonary disease can affect both lung
elasticity and airflow 824
21.16 Respiratory control mechanisms involve interacting centers
in the brainstem 826
21.17 Respiratory reflexes provide rapid automatic adustments in
pulmonary ventilation 828
21.18 CLINICAL MODULE: Respiratory function decreases with age;
smoking makes matters worse 830
Section 2 Review 832
Chapter 21 Review 832
Study Outline 833
Chapter Review Questions 836
Chapter Integration 837
Section 1 Anatomy of the Respiratory System 797
21.1 The respiratory system has an upper and lower
respiratory tract with different functions 797
21.2 The respiratory defense system protects the respiratory
mucosa 798
21.3 The upper respiratory system includes the nose, nasal
cavity, paranasal sinuses, and pharynx 800
21.4 The larynx protects the glottis that produces sounds 802
21.5 The trachea, bronchi, and bronchial branches convey
air to and from lung gas exchange surfaces 804
21 The Respiratory
System 796
Section 1 Organization of the Digestive System 839
22.1 The digestive system consists of the digestive tract and
accessory organs 839
22.2 The digestive tract is a muscular tube lined by a mucous
epithelium 840
22.3 Smooth muscle tissue is found throughout the body, but it
plays a particularly prominent role in the digestive tract 842
22.4 Smooth muscle contractions produce motility of the
digestive tract and local factors interact with neural and
hormonal mechanisms to regulate digestive activities 844
Section 1 Review 846
Section 2 Digestive Tract 847
22.5 The digestive tract begins with the mouth and ends with
the anus 847
22.6 The oral cavity is a space that contains the tongue, teeth,
and gums 848
22 The Digestive
System 838

xxiv • Contents
22.7 Teeth in different regions of the jaws vary in size, shape,
and function 850
22.8 The muscular walls of the pharynx and esophagus play a key
role in swallowing 852
22.9 The stomach and most of the intestinal tract are suspended
by mesenteries and covered by the peritoneum 854
22.10 The stomach is a muscular, expandable, J-shaped organ with
three layers in the muscular layer 856
22.11 The stomach receives food and liquids from the esophagus
and aids in mechanical and chemical digestion 858
22.12 The intestinal tract is specialized to absorb nutrients 860
22.13 The small intestine is divided into the duodenum, jejunum,
and ileum 862
22.14 Several hormones regulate digestion 864
22.15 Central and local mechanisms coordinate gastric and
intestinal activities 866
22.16 The large intestine stores and concentrates fecal material 868
22.17 The large intestine compacts fecal material; the defecation
reflex coordinates the elimination of feces 870
Section 2 Review 872
Section 3 Accessory Digestive Organs 873
22.18 Some accessory digestive organs have secretory functions 873
22.19 Saliva lubricates, moistens, and protects the mouth and
begins carbohydrate digestion 874
22.20 The liver, the largest visceral organ, is divided into left, right,
caudate, and quadrate lobes 876
22.21 The liver tissues have an extensive and complex blood
supply 878
SmartArt Video: Structure and function of the liver lobule 879
22.22 The gallbladder stores and concentrates bile 880
22.23 The pancreas has vital endocrine and exocrine functions 881
22.24 CLINICAL MODULE: Disorders of the digestive system are
diverse and relatively common 882
Section 3 Review 884
Chapter 22 Review 885
Study Outline 885
Chapter Review Questions 889
Chapter Integration 891
Section 2 Digestion and Metabolism of
Organic Nutrients 903
23.8 Digestion involves a series of steps to make nutrients
available to the body 903
23.9 Carbohydrates are usually the preferred substrates for
catabolism and ATP production under resting
conditions 904
23.10 Lipids reach the bloodstream in chylomicrons; the cholesterol
is then extracted and released as lipoproteins 906
23.11 Fatty acids can be broken down to provide energy or
converted to other lipids 908
23.12 An amino acid not needed for protein synthesis may be
broken down or converted to a different amino acid 910
23.13 There are two general patterns of metabolic activity:
the absorptive and postabsorptive states 912
23.14 Vitamins are essential to the function of many metabolic
pathways 914
23.15 Proper nutrition depends on eating a balanced diet 916
23.16 CLINICAL MODULE: Metabolic disorders may result
from nutritional or biochemical problems 918
Section 2 Review 920
Section 3 Energetics and Thermoregulation 921
23.17 Energetics is the study of energy changes, and
thermoregulation involves heat balance 921
23.18 The control of appetite is complex and involves both
short-term and long-term mechanisms 922
23.19 To maintain a constant body temperature, heat gain and
heat loss must be in balance 923
23.20 Thermoregulatory centers in the hypothalamus adjust
heat loss and heat gain 924
Section 3 Review 926
Chapter 23 Review 927
Study Outline 927
Chapter Review Questions 930
Chapter Integration 931
Section 1 Introduction to Cellular Metabolism 893
23.1 Metabolism is the sum of catabolic and anabolic reactions 893
23.2 Cells use nutrients from the nutrient pool for metabolism 894
23.3 Glycolysis is the first step in glucose catabolism 895
23.4 The citric acid cycle transfers hydrogen atoms to
coenzymes 896
23.5 The electron transport chain establishes a proton gradient
used to make ATP 898
23.6 Glucose catabolism yields 30–32 ATP 900
23.7 Nutrient metabolism follows several pathways 901
Section 1 Review 902
Metabolism, Nutrition, 23 and Energetics 892 Section 1 Anatomy of the Urinary System 933
24.1 The urinary system organs are the kidneys, ureters, urinary
bladder, and urethra 933
24.2 The kidneys are paired retroperitoneal organs 934
24.3 The kidneys are complex at the gross and microscopic
levels 936
24.4 A nephron is divided into segments; each segment has
specific functions 938
SmartArt Video: Structure of the nephron 939
24.5 The kidneys are highly vascular, and the circulation patterns
are complex 940
Section 1 Review 942
The Urinary 24 System 932

Contents • xxv
Section 2 Overview of Renal Physiology 943
24.6 The kidneys maintain homeostasis by removing
wastes and producing urine 943
24.7 Filtration, reabsorption, and secretion occur in specific
segments of the nephron and collecting system 944
24.8 Filtration occurs at the renal corpuscle 946
24.9 The glomerular filtration rate is the amount
of filtrate produced each minute 948
24.10 Reabsorption predominates along the proximal convoluted
tubule, whereas reabsorption and secretion are often
linked along the distal convoluted tubule 950
24.11 Exchange between the limbs of the nephron loop creates an
osmotic concentration gradient in the renal medulla 952
24.12 Urine volume and concentration are
hormonally regulated 954
24.13 Renal function is an integrative process involving
filtration, reabsorption, and secretion 956
24.14 CLINICAL MODULE: Renal failure is a life-threatening condition 958
Section 2 Review 960
Section 3 Urine Storage and Elimination 961
24.15 The urinary tract transports, stores, and eliminates urine 961
24.16 The ureters, urinary bladder, and urethra are specialized to
conduct urine 962
24.17 Urinary reflexes coordinate urine storage and voiding 964
24.18 CLINICAL MODULE: Urinary disorders can often be detected
by physical examinations and laboratory tests 965
Section 3 Review 966
Chapter 24 Review 967
Study Outline 967
Chapter Review Questions 970
Chapter Integration 971
25.9 The homeostatic responses to metabolic acidosis and
alkalosis involves respiratory and renal mechanisms as well
as buffer systems 988
25.10 CLINICAL MODULE: Respiratory acid-base disorders are the
most common challenges to acid-base balance 990
Section 2 Review 992
Chapter 25 Review 993
Study Outline 993
Chapter Review Questions 995
Chapter Integration 997
Section 1 Fluid and Electrolyte Balance 973
25.1 Body composition may be viewed in terms of solids and
two fluid compartments 973
25.2 Fluid balance exists when water gain equals water loss 974
24.3 Mineral balance involves balancing
electrolyte gain and loss 976
25.4 Water balance depends on sodium balance, and the two
are regulated simultaneously 978
25.5 CLINICAL MODULE: Disturbances of potassium balance
are uncommon but extremely dangerous 980
Section 1 Review 982
Section 2 Acid-Base Balance 983
25.6 There are three categories of acids in the body 983
25.7 Potentially dangerous disturbances in acid-base balance are
opposed by buffer systems 984
25.8 Buffer systems can delay, but not prevent, pH shifts in
the ICF and ECF 986
25 Fluid, Electrolyte, and
Acid-Base Balance 972
Section 1 Male Reproductive System 999
26.1 Male reproductive structures include the external genitalia
and internal genitalia 999
26.2 Sperm transport relies on ducts, glands, and related
structures of the scrotum and testes 1000
26.3 Spermatogenesis occurs in the testes and produces
mature sperm 1002
26.4 Meiosis and early spermiogenesis occur within the
seminiferous tubules 1004
26.5 The male reproductive tract receives secretions from the
seminal, prostate, and bulbo-urethral glands 1006
26.6 The penis conducts urine and semen to the exterior 1008
26.7 Testosterone plays a key role in establishing and
maintaining male sexual function 1010
Section 1 Review 1012
Section 2 Female Reproductive System 1013
26.8 Female reproductive structures include the external
genitalia and internal genitalia 1013
26.9 Major female reproductive organs are the ovaries, uterus,
and their associated structures 1014
26.10 Oogenesis occurs in the ovaries, and ovulation occurs
during the 28-day ovarian cycle 1016
26.11 The uterine tubes are connected to the uterus, a hollow organ
with thick muscular walls 1018
26.12 The uterine (menstrual) cycle involves changes in the
functional layer of the endometrium 1020
26.13 The vagina opens into the vestibule 1022
26.14 Each breast contains a mammary gland that secretes
milk 1023
26.15 The ovarian and uterine cycles are regulated by hormones
of the hypothalamus, pituitary gland, and ovaries 1024
26.16 CLINICAL MODULE: Birth control strategies vary in
effectiveness and associated risks 1026
26.17 CLINICAL MODULE: Reproductive system disorders are
relatively common and often deadly 1028
Section 2 Review 1030
Chapter 26 Review 1031
Study Outline 1031
Chapter Review Questions 1034
Chapter Integration 1035
26 The Reproductive
System 998

xxvi • Contents
27.11 After delivery, development initially requires nourishment
by maternal systems 1056
27.12 Postnatal development includes five life stages 1057
27.13 At puberty, male and female sex hormones have differing
effects on most body systems 1058
Section 1 Review 1060
Section 2 Genetics and Inheritance 1061
27.14 A person may be described in terms of genotype and
phenotype 1061
27.15 Genes and chromosomes determine patterns of
inheritance 1062
27.16 There are several different patterns of inheritance 1064
27.17 CLINICAL MODULE: Many clinical disorders are linked
to individual chromosomes or their genes 1066
Section 2 Review 1068
Chapter 27 Review 1069
Study Outline 1069
Chapter Review Questions 1072
Chapter Integration 1073
Appendix A-1
Answers AN-1
Glossary G-1
Credits C-1
Index I-1
Section 1 Overview of Development 1037
27.1 Gestation and development are marked by various
stages 1037
27.2 At fertilization, an ovum and a sperm form a zygote that
prepares for cell division 1038
27.3 Cleavage continues until the blastocyst implants in the
uterine wall 1040
27.4 Gastrulation produces three germ layers: ectoderm,
endoderm, and mesoderm 1042
27.5 The extra-embryonic membranes form the placenta that
supports fetal growth and development 1044
27.6 The formation of extra-embryonic membranes is
associated with major changes in the shape and complexity
of the embryo 1046
27.7 The placenta performs many vital functions during
prenatal development 1048
27.8 Organ systems form in the first trimester and become
functional in the second and third trimesters 1050
27.9 Pregnancy places anatomical and physiological stresses
on maternal systems 1052
27.10 Multiple factors initiate and accelerate labor and
delivery 1054


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