Holes human anatomy physiology 12th d shier, j butler, r lewis (mcgraw hill, 2010) 1

HOLE’S HUMAN ANATOMY& PHYSIOLOGY T W E L F T H E D I T I DAVID SHIER Washtenaw Community College JACKIE BUTLER Grayson County College RICKI LEWIS Alden March Bioethics Institute O N HOLE’S HUMAN ANATOMY & PHYSIOLOGY, TWELFTH EDITION Published by McGraw-Hill, a business unit of The McGraw-Hill Companies, Inc., 1221 Avenue of the Americas, New York, NY 10020 Copyright © 2010 by The McGraw-Hill Companies, Inc All rights reserved Previous editions © 2007, 2004, and 2002 No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of The McGraw-Hill Companies, Inc., including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning Some ancillaries, including electronic and print components, may not be available to customers outside the United States This book is printed on acid-free paper QPD/QPD ISBN 978–0–07–352570–9 MHID 0–07–352570–7 Publisher: Michelle Watnick Senior Sponsoring Editor: James F Connely Director of Development: Kristine Tibbetts Developmental Editor: Fran Schreiber Marketing Manager: Lynn M Breithaupt Senior Project Manager: Jayne L Klein Lead Production Supervisor: Sandy Ludovissy Lead Media Project Manager: Stacy A Patch Designer: Tara McDermott Cover/Interior Designer: Elise Lansdon (USE) Cover Image: © The McGraw-Hill Companies, Inc., Gerald Wofford, photographer (left photo); © Design Pics/PunchStock (middle photo); Scott Halleran/Getty Images (right photo) Senior Photo Research Coordinator: John C Leland Photo Research: Danny Meldung/Photo Affairs, Inc Supplement Producer: Mary Jane Lampe Compositor: Precision Graphics Typeface: 10/12 ITC Slimbach Std Printer: Quebecor World Dubuque, IA The credits section for this book begins on page 977 and is considered an extension of the copyright page Library of Congress Cataloging-in-Publication Data Shier, David Hole’s human anatomy & physiology / David Shier, Jackie Butler, Ricki Lewis.—12th ed p cm Includes index ISBN 978–0–07–352570–9 — ISBN 0–07–352570–7 (hard copy : alk paper) Human physiology Human anatomy I Butler, Jackie II Lewis, Ricki III Title IV Title: Hole’s human anatomy and physiology V Title: Human anatomy & physiology QP34.5.S49 2010 612 dc22 2008033022 www.mhhe.com BRIEF CONTENTS About the Authors iv | Updates and Additions v | Learn, Practice, Assess Contents xv | Clinical Connections xx | Acknowledgments xxi | FOUNDATIONS FOR SUCCESS vii | XXII UNIT UNIT I LEVELS OF ORGANIZATION Introduction to Human Anatomy and Physiology Chemical Basis of Life Cells Cellular Metabolism Tissues UNIT TRANSPORT IV 14 Blood 522 15 Cardiovascular System 16 Lymphatic System and Immunity 552 616 50 75 UNIT 114 143 II SUPPORT AND MOVEMENT Integumentary System Skeletal System Joints of the Skeletal System Muscular System 170 170 V ABSORPTION AND EXCRETION 651 17 Digestive System 18 Nutrition and Metabolism 19 Respiratory System 20 Urinary System 21 Water, Electrolyte, and Acid-Base Balance 810 192 284 651 698 735 774 260 UNIT THE HUMAN LIFE CYCLE VI UNIT 522 830 INTEGRATION AND COORDINATION 353 22 Reproductive Systems 23 Pregnancy, Growth, and Development 10 Nervous System I 24 Genetics and Genomics 11 Nervous System II 12 Nervous System III 13 Endocrine System III 353 382 437 482 Appendixes Glossary Credits Index 830 875 916 939 951 977 981 iii ABOUT THE AUTHORS David Shier Jackie Butler Ricki Lewis Washtenaw Community College Grayson County College Alden March Bioethics Institute My interest in physiology research and teaching began with a job as a research assistant at Harvard Medical School from 1976-1979 I completed my Ph.D at the University of Michigan in 1984 and served on the faculty of the Medical College of Ohio from 1985-1989 I have been teaching Anatomy and Physiology and Pathophysiology full-time at Washtenaw Community College since 1990 and contributing as a member of the author team for the Hole texts since 1993 Since the mid 1990s, when assessment of student academic achievement began to surface as a mandate for accreditation, I have become increasingly interested in the interrelationship between pedagogy and assessment I think that we have all used some pedagogical tools (figures from the text, for example) on exams as part of assessment Recently, in my own classroom, I have been using tools traditionally associated with assessment (e.g., lab quizzes) more and more as pedagogical tools, often in concert with group activities I also have interests outside of the classroom and away from the office! These include mountain biking, recorded music (vinyl!) and photography My wife, Janet, is also an educator We love to travel, but spend most of our time in Ann Arbor, Michigan, where we reside My science career began in research at M.D Anderson Hospital, where teaching was not one of my responsibilities My masters committee at Texas A & M University quickly realized where my heart was After I taught labs at Texas A & M for three years, they strongly recommended that I seek a teaching position when I relocated after graduation As a result of their encouragement, I began teaching at Grayson County College in 1981 Many years later, I still feel excited and enthusiastic about being in the classroom John Hole’s Human Anatomy and Physiology, Second Edition, was the book used at Grayson County College in 1981 We have continued teaching using this text through many editions John Hole wrote a very well-organized, succinct text, appropriate for our student population It has been a wonderful experience for me to be a part of this team that has worked to keep the text up-to-date and appropriate to the current student population We have been selective in adding to the depth and detail of coverage in the text, so as to maintain Hole’s original intent of readability and the desire not to overwhelm the student Outside the classroom, I enjoy traveling with my husband, Dale Additional interests include: 6:00 AM walking with my friends (12–15 miles a week), quilting, and reading My career as a science communicator began with earning a PhD in genetics from Indiana University in 1980, and quickly blossomed into writing for newspapers and magazines, writing the introductory textbook Life, and teaching at several universities Since then I have published many articles, the textbook Human Genetics: Concepts and Applications, an essay collection, and most recently my first novel I love the challenge of being part of the Hole team Since 1984 I have been a genetic counselor for a large private ob/gyn practice I also work with the Cure Huntington’s Disease Initiative and write biotechnology market reports As a hospice volunteer since 2005, I have learned about many disorders in a very personal manner I also blog regularly at blog.bioethics.net When I’m not writing, I enjoy exercising, reading, and public speaking I am also involved in launching a science center and teaching in an adult education program My husband is a research chemist and we both are devoted to making science understandable to everyone We have three daughters, many felines, a tortoise, and a hare, and reside in upstate New York and Martha’s Vineyard iv UPDATES AND ADDITIONS FROM THE AUTHORS In biological evolution, a successful species becomes the best suited that it can be for a particular environment In a similar manner, Hole’s Human Anatomy & Physiology continues to evolve as a modern exploration of the human, from the cellular and molecular underpinnings of the functions of life to its interacting organ systems We are authors, but first and foremost we are teachers What we and our reviewers in class is reflected in each new edition We are especially excited about the Learn, Practice, Assess approach to this new edition Each chapter opens with Learning Outcomes, contains numerous opportunities to Practice throughout, and closes with Assessments that are closely tied to the learning outcomes Students have always come first in our approach to teaching and textbook authoring, but we now feel more excited than ever about the studentoriented, teacher-friendly quality of this text We have never included detail for its own sake, but we have felt free to include extra detail if the end result is to clarify The level of this text is geared toward students in two-semester courses in anatomy and physiology who are pursuing careers in nursing and allied health fields and who have minimal background in physical and biological sciences The first four chapters review chemistry and physiological processes Students who have studied this material previously will view it as a welcomed review, but newcomers will not find it intimidating Remember that although you are working hard to successfully complete this course, you are not doing so for us, or even for your teacher You are working for yourselves and for your future patients, as health care professionals Your course is not so much a hurdle as a stepping stone, even more so a foundation We have written this book to help prepare you for success along that path David Shier, Jackie Butler, Ricki Lewis • Gene expression profiling to flesh out anatomy and physiology ties in to final chapter Chapter • Vignette introduces new HIV drug • Updated coverage of the mechanism of osmosis • From Science to Technology box on tailoring stem cells to treat disease Chapter • Figure 4.20 on DNA replication GLOBAL CHANGES • Numbered A heads easily link to Learning Outcomes/Assessments • Introductory sections for each chapter • Practice questions dividing sections numbered sequentially for clearer/ easier reference • Added pronunciations • New and updated boxes throughout illuminate new technologies, including biomarkers, reprogrammed (induced pluripotent) stem cells, DNA microarrays, nanotechnology, the metabolome and microbiome, microRNAs, brain banks, RNA interference, tissue engineering, vaccines, stem cell therapies, and direct-to-consumer genetic testing Chapter • New figure on directional terms • Updated terminology to be consistent with Terminologia Anatomica • Improved shading on figures depicting body cavities includes the cell cycle, with reference to the changes in chromosome structure that occur during S phase • From Science to Technology 4.1 discusses an innocence project case Chapter • New micrograph for chapter opener (better view of whole tissue) • Moved intercellular junctions from chapter to chapter introduction • Many new micrographs and accompanying line art • New icon for figure 5.12a salivary glands instead of pancreas Chapter • New vignette highlights cryo- • • • • electron tomography view of proteins responsible for the skin’s integrity Added to melanin production (from tyrosine in melanosomes) Moved skin color to melanin production earlier in chapter New micrographs and corresponding line art, and other new photos Clarified wound healing in the text and figure v Chapter • New tables on ABO blood type frequencies and inherited blood disorders • Added scientific names to layers in epiphyseal plate • Some labels added to figures to correlate to muscle attachments referenced in chapter • Table of male/female skeletal differences reworked/expanded in side by side comparison Chapter • New vignette on glucosamine and chondroitin to treat arthritis • New illustrations for joint movements using real people Chapter • New vignette on the muscular movements behind “texting” • Piriformis and quadratus lumborum added to muscle coverage Chapter 11 • New figure on brain and brain regions Chapter 15 heart • Figure 15.21 altered to emphasize depolarization/repolarization rather than valves • Figure 15.24 added schematic of general reflex arc to correlate with the baroreceptor reflex control of heart rate • Figures 15.53, 15.57, and 15.58 redrawn to depict paired veins in the upper and lower limbs Chapter 16 • New micrographs • Updated anti-rejection treatment protocols • Added concept of herd immunity • Figure 16.17a expanded to include Chapter 13 • Clinical Application updates performance enhancement • Two boxes update progress in treating diabetes Chapter 14 • New chapter opener photo • Clinical Application case of a • • • • • young editor with leukemia and the “miracle drug” Gleevec New Clinical Application on deep vein thrombosis New micrographs include the types of white blood cells Moved up figure summarizing blood composition Improved figures 14.21 and 14.22 Update of terminology (hematopoietic stem cell) and B cell discussions for better flow Chapter 17 • New vignette on gut microbiome • Figure 17.4 rearranged into one • • • • • column for better flow New micrographs and new corresponding line art Figure 17.17b revised labels Figure 17.19a new line art shows three layers of muscle Figure 17.19b new micrograph Figure 17.44 new radiograph of colon Chapter 18 • Figure 18.1 expanded to include • • • • UPDATES AND ADDITIONS smoke • Updated coverage of respiratory control Chapter 20 • New vignette on a medical mystery (Balkan nephropathy) • New figures on nephron anatomy, including representation of the macula densa as part of the ascending limb of the nephron loop • New table of developmental abnormalities of the urinary system Chapter 22 • New chapter opener photo • Moved meiosis to introduction, • • cytotoxic and memory T cells • Moved lymphocyte functions to T and Wernicke’s area and lumbosacral nerve plexuses • New Clinical Application on traumatic brain injury • New vignette on secondhand • Added coronal section of cadaver • Updated discussion of Broca’s area • New figures add detail to brachial Chapter 19 the effects of ghrelin on appetite, with the text reflecting the complexity of appetite control New photos for obesity/athlete/ scurvy/anorexia Replaced Atkins diet food pyramid with Mediterranean diet pyramid Clinical Application 18.1 on obesity includes lap-band surgery and updated information on gastric bypass surgery Includes discussion of BMI • • before details of spermatogenesis/ oogenesis New micrographs Figure 22.8 more clearly explains number of chromatids per chromosome All new photos of birth control, including female condom and spermicides Updated STDs/sexually transmitted infections (STIs) Chapter 23 • The conjoined twins in Clinical Application 23.2 are now teens! • Clinical Application 23.4 on living to age 100 • Human embryonic stem cells de- emphasized to reflect other types of stem cells in use Chapter 24 • Complete update and overhaul to reflect change in focus in field • New vignette on direct-to- consumer (web-based) genetic testing • New Clinical Application 24.1 introduces modes of inheritance through genetic counseling cases • Final section on gene expression explaining anatomy and physiology brings the book full circle back to chapter Learn, Practice, Assess! A major change that you will notice in the 12th edition is a new format The book is now organized with Learning Outcomes and Assessments LEARN Learning Outcomes open the chapters, and are closely linked to Chapter Assessments and Integrative Assessments/Critical Thinking questions found at the end of each chapter Learning tools to help you succeed Check out the Chapter Preview, Foundations for Success, on page xxiii The Chapter Preview was specifically designed to help students LEARN how to study at the collegiate level and efficiently use the tools available to them It provides helpful study tips LEARNING OUTCOMES After you have studied this chapter, you should be able to: 5.1 Introduction Describe a tissue, and explain the intercellular junctions i iin tissues i List the four major tissue types in the body 5.2 Epitehelial Tissues Describe the general characteristics and functions of epithelial tissue Name the types of epithelium and identify an organ in which each is found Explain how glands are classified 5.3 Connective Tissues Describe the general characteristics of connective tissue Compare and contrast the cellular components, structures, fibers, and extracellular matrix (where applicable) in each type of connective tissue (p 156) Describe the major functions of each type of connective tissue 5.4 Types of Membranes Describe and locate each of the four types of membranes Understanding Words help you remember scientific word meanings Examine root words, stems, prefixes, suffices, pronunciations, and build a solid anatomy and physiology vocabulary Common carotid a Right subclavian a Brachiocephalic a Larynx Trachea Left subclavian a Arch of aorta Superior vena cava Pulmonary a Pulmonary trunk Right atrium Pulmonary v Left atrium Right ventricle Lung Left ventricle Lobes of liver Diaphragm Spleen Gallbladder Cystic duct Stomach Duodenum Reference Plates offer vibrant detail of body structures Transverse colon Ascending colon Mesentery lleum (cut) Cecum Jejunum (cut) Descending colon Ureter Sigmoid colon Appendix Common iliac a Ovary Rectum Uterus Tensor fasciae latae m Uterine tube Round ligament of uterus Femoral a Femoral v Adductor longus m Gracilis m Chapter Opening Vignettes introduce each topic Taken from headlines and scientific journal reports, they extend the student’s view of the chapter content Urinary bladder Great saphenous v Rectus femoris m Vastus lateralis m Vastus medialis m Sartorius m PLATE FIVE Human female torso with the lungs, heart, and small intestine sectioned and the liver reflected (lifted back) (a stands for artery, m stands for muscle, and v stands for vein.) Learn, Practice, Assess! PRACTICE After each major section, a question or series of questions tests the student’s understanding of the material If he or she cannot answer these practice question(s), the student will want to reread that section Interesting applications help students practice and apply their knowledge Up to 90% of human cancers are carcinomas, growths that originate in epithelium Most carcinomas begin on surfaces that contact the external environment, such as skin, linings of the airways in the respiratory tract, or linings of the stomach or intestines in the digestive tract This observation suggests that the more common cancer- Boxed Information connects chapter ideas to clinical situations, discusses changes in organ structure and function, and introduces new medical technology or experiments causing agents may not deeply penetrate tissues 5.1 FROM SCIENCE TO TECHNOLOGY Nanotechnology meets the Blood-Brain Barrier N Clinical Applications encourage students to explore information on related pathology, historical insights, and clinical examples that they are likely to encounter in their careers anotechnology is helping drug developers to circumvent a problem in drug delivery based on an anatomical impediment—the close attachments of the cells that form tiny blood vessels in the brain Like a tight line of police officers keeping out a crowd, the blood-brain barrier is a vast network of capillaries in the brain whose cells are firmly attached by overlapping tight junctions These cells also lack the scattered vesicles and windowlike clefts in other capillaries In addition, star-shaped brain cells called astrocytes wrap around the barrier The 400-mile blood-brain barrier shields brain tissue from toxins and biochemical fluctuations that could be overwhelming It also allows selective drug delivery Certain antihistamines, for example, not cause drowsiness because they cannot breach the barrier But this protection has a trade-off—the brain cannot take up many therapeutic drugs that must penetrate to be effective For decades researchers have attempted to g across the barrier byy tagging gg g comdeliver drugs d to substances b h can cross, d i i pounds that designing drugs to fit natural receptors in the cell membranes of the barrier, and injecting substances that temporarily relax the tight junctions More recently, researchers have applied nanotechnology to the problem of circumventing the blood-brain barrier Nanotechnology is the application of structures smaller than 100 billionths of a meter (100 nanometers) in at least one dimension Nanoparticles that can cross the blood-brain barrier are made of combinations of oils and polymers, with a neutral or slightly negative charge (positively charged particles are toxic) In one application, anesthetics or chemotherapeutics are loaded into fatty bubble bubbles (liposomes) that are nopartic in turn placed in nanoparticles This delivery system masks the part of the dr drug that cannot cross ws releas the barrier and slows release of the drug, which cts diminishes side effects plication insulin is delivered In another application, ticles 10 to 50 nanometers in in inhaled nanoparticles develo diameter Originallyy developed to provide insulin to people with diabetes instead of injecting it, clinical trials are showing that it is also helpful mory in people p in maintaining memory who have mild nt or Alzh cognitive impairment Alzheimer disease From Science to Technology previews the technological applications of knowledge in anatomy and physiology that students are likely to encounter in the future and explains how and why the technology was developed Reconnect Icon prompts the student to review key concepts found in previous chapters that will assist in their understanding of new information RECONNECT To Chapter 3, Movements Into and Out of the Cell, page 90 ASSESS Tools to help students make the connection and master anatomy & physiology! Chapter Assessments found at the end of each chapter check student’s understanding of the chapter’s Learning Outcomes The Chapter Assessment numbers correspond directly to the Learning Outcomes Integrative Assessments/ Critical Thinking questions relate information from various Learning Outcomes within a chapter (and frequently from previous chapters) and apply that information INNERCONNECTIONS | Skeletal System Integumentary System Vitamin D, activated in the skin, plays a role in calcium absorption and availability for bone matrix Muscular System Muscles pull on bones to cause movement Nervous System Proprioceptors sense the position of body parts Pain receptors warn of trauma to bone Bones protect the brain and spinal cord Endocrine System Some hormones act on bone to help regulate blood calcium levels Cardiovascular System Skeletal System Bones provide support, protection, and movement and also play a role in calcium balance Blood transports nutrients to bone cells Bone helps regulate plasma calcium levels, important to heart function Lymphatic System Cells of the immune system originate in the bone marrow Digestive System Absorption of dietary calcium provides material for bone matrix Respiratory System Ribs and muscles work together in breathing Urinary System The kidneys and bones work together to help regulate blood calcium levels Reproductive System The pelvis helps support the uterus during pregnancy Bones provide a source of calcium during lactation InnerConnections conceptually link the highlighted body system to every other system These graphic representations review chapter concepts, make connections, and stress the “big picture” in learning and applying the concepts and facts of anatomy and physiology Common carotid a Right subclavian a Brachiocephalic a Larynx Trachea Left subclavian a Arch of aorta Superior vena cava Pulmonary a Pulmonary trunk Right atrium Pulmonary v Left atrium Right ventricle Lung Left ventricle Lobes of liver Diaphragm Spleen Gallbladder Cystic duct Stomach Duodenum Transverse colon Ascending colon Mesentery lleum (cut) Cecum Jejunum (cut) Descending colon Ureter Sigmoid colon Appendix Common iliac a Ovary Rectum Uterus Tensor fasciae latae m Uterine tube Round ligament of uterus Femoral a Femoral v Adductor longus m Gracilis m Urinary bladder Great saphenous v Rectus femoris m Vastus lateralis m Vastus medialis m Sartorius m PLATE FIVE Human female torso with the lungs, heart, and small intestine sectioned and the liver reflected (lifted back) (a stands for artery, m stands for muscle, and v stands for vein.) THE HUMAN ORGANISM 35 Right internal jugular v Esophagus Trachea Right common carotid a Left subclavian a Left subclavian v Left brachiocephalic v Superior vena cava Arch of aorta Right bronchus Esophagus Descending (thoracic) aorta Pleural cavity Diaphragm Spleen Inferior vena cava Adrenal gland Celiac a Pancreas Right kidney Left kidney Superior mesenteric a Duodenum Inferior mesenteric a Superior mesenteric v Left common iliac a Ureter Sartorius m (cut) Descending colon (cut) Sigmoid colon Tensor fasciae latae m (cut) Ovary Uterus Rectus femoris m (cut) Urinary bladder Symphysis pubis Rectus femoris m Adductor brevis m Adductor longus m Vastus lateralis m Gracilis m Vastus intermedius m PLATE SIX Human female torso with the heart, stomach, liver, and parts of the intestine and lungs removed (a stands for artery, m stands for muscle, and v stands for vein.) 36 REFERENCE PLATES Esophagus Left common carotid a Right subclavian a Brachiocephalic a Arch of aorta Thoracic cavity Internal intercostal m Rib Descending (thoracic) aorta External intercostal m Diaphragm Esophagus Abdominal cavity Diaphragm Inferior vena cava Abdominal aorta Quadratus lumborum m Intervertebral disc Transversus abdominis m lliac crest Fifth lumbar vertebra lliacus m Anterior superior iliac spine Psoas major m Pelvic sacral foramen Gluteus medius m Sacrum Rectum Vagina Urethra Symphysis pubis Obturator foramen Femur Adductor longus m Gracilis m Adductor magnus m PLATE SEVEN Human female torso with the thoracic, abdominal, and pelvic viscera removed (a stands for artery and m stands for muscle.) THE HUMAN ORGANISM 37 PLATE EIGHT Saggital section of the head and trunk 38 REFERENCE PLATES Scalp Cerebrum Corpus callosum Frontal bone Frontal sinus Thalamus Hypothalamus Lateral ventricle Sphenoidal sinus Brainstem Inferior nasal concha Cerebellum Maxilla Oral cavity Tongue Mandible Cervical vertebra Esophagus Larynx Trachea Sternum PLATE NINE Saggital section of the head and neck THE HUMAN ORGANISM 39 Ventricle PLATE TEN Viscera of the thoracic cavity, sagittal section Ventricle PLATE ELEVEN Viscera of the abdominal cavity, sagittal section 40 REFERENCE PLATES PLATE TWELVE Viscera of the pelvic cavity, sagittal section (m stands for muscle.) THE HUMAN ORGANISM 41 Lateral ventricle Scalp Thalamus Skull Dura mater Frontal sinus Falx cerebri Frontal lobe Corpus callosum Gray matter White matter PLATE THIRTEEN Transverse section of the head above the eyes, superior view Sphenoidal sinus Lateral rectus m Gray matter Medial rectus m White matter Occipital lobe Ethmoidal sinus Lateral ventricle Nasal septum Skull Eye Subcutaneous tissue Scalp Optic nerve Temporalis m Temporal lobe Third ventricle PLATE FOURTEEN Transverse section of the head at the level of the eyes, superior view (m stands for muscle.) 42 REFERENCE PLATES PLATE FIFTEEN Transverse section of the neck, inferior view PLATE SIXTEEN Transverse section of the thorax through the base of the heart, superior view (m stands for muscle.) THE HUMAN ORGANISM 43 Spinal cord Vertebral body Azygos vein Aorta Rib Lung Esophagus Liver Pericardium Diaphragm Left ventricle Right ventricle Sternum PLATE SEVENTEEN Transverse section of the thorax through the heart, superior view Spinal cord Kidney Rib Liver Vertebral body Aorta Inferior vena cava Pancreas Costal cartilage Small intestine Rectus abdominis m PLATE EIGHTEEN Transverse section of the abdomen through the kidneys, superior view (m stands for muscle.) 44 REFERENCE PLATES Large intestine Kidney Vertebral body Spinal cord Retroperitoneal fat Inferior vena cava Diaphragm Rib Spleen Liver Aorta Gallbladder Pancreas Costal cartilage Transverse colon Rectus abdominis m PLATE NINETEEN Transverse section of the abdomen through the pancreas, superior view (m stands for muscle.) Hip bone PLATE TWENTY Transverse section of the male pelvic cavity, superior view (m stands for muscle.) THE HUMAN ORGANISM 45 PLATE TWENTY-ONE Thoracic viscera, anterior view (Brachiocephalic veins have been removed to better expose the brachiocephalic artery and the aorta.) Left b PLATE TWENTY-TWO Thorax with the lungs removed, anterior view 46 REFERENCE PLATES PLATE TWENTY-THREE Thorax with the heart and lungs removed, anterior view THE HUMAN ORGANISM 47 Fibrous pericardium Diaphragm Falciform ligament Left lobe of liver Right lobe of liver Greater omentum Small intestine Colon PLATE TWENTY-FOUR Abdominal viscera, anterior view 48 REFERENCE PLATES PLATE TWENTY-FIVE Abdominal viscera with the greater omentum removed, anterior view (Small intestine has been displaced to the left.) THE HUMAN ORGANISM 49 ... muscular movements behind “texting” • Piriformis and quadratus lumborum added to muscle coverage Chapter 11 • New figure on brain and brain regions Chapter 15 heart • Figure 15 . 21 altered to emphasize... and 15 .58 redrawn to depict paired veins in the upper and lower limbs Chapter 16 • New micrographs • Updated anti-rejection treatment protocols • Added concept of herd immunity • Figure 16 .17 a... of the Nervous System 382 11 .1 11. 2 11 .3 11 .4 11 .5 11 .6 11 .7 11 .8 4 81 Endocrine System 482 Introduction 354 General Functions of the Nervous System 355 Description of Cells of the Nervous System