(BQ) Part 2 book Principles of anatomy and physiology presents the following contents: The brain and cranial nerves, the autonomic nervous system, the special senses, the endocrine system, the lymphatic system and immunity, the respiratory system, the digestive system, metabolism and nutrition, the urinary system, the reproductive systems,...
The Brain and Cranial Nerves The brain, cranial nerves, and homeostasis Your brain contributes to homeostasis by receiving sensory input, integrating new and stored information, making decisions, and executing responses through motor activities Solving an equation, feeling hungry, laughing—the neural processes needed for each of these activities occur in different regions of the brain, that portion of the central nervous system contained within the cranium About 85 billion neurons and 10 trillion to 50 trillion neuroglia make up the brain, which has a mass of about 1300 g (almost lb) in adults On average, each neuron forms 1000 synapses with other neurons Thus, the total number of synapses, about a thousand trillion or 1015, is larger than the number of stars in our galaxy The brain center for registering sensations, correlating them with braiin is the control c one on ne another and with stored information, making decisions, and taking actions It also is the center for the intellect, emotions, behavior, and memory But the brain encompasses yet a larger domain: It directs mem our behavior toward others With ideas that excite, artistry that dazzles, or rhetoric that mesmerizes, one person’s thoughts d and a actions may influence and shape the lives of many others As you will see shortly, different regions of the brain are specialized for different functions Different parts of the brain aalso work together to accomplish certain shared functions This chapter explores how the brain is protected and nourished, what c functions occur in the major regions of the brain, and how the fu spinal cord and the 12 pairs of cranial nerves connect with the spin brain to form the control center of the human body Dr P M Did you ever wonder how cerebrovascular accidents (strokes) occur and how they are treated 473 araz zi/ Sc i en ce S ou rc e 474 CHAPTER 14 • THE BRAIN AND CRANIAL NERVES 14.1 Brain Organization, Protection, and Blood Supply OBJECTIVES • Identify the major parts of the brain • Describe how the brain is protected • Describe the blood supply of the brain In order to understand the terminology used for the principal parts of the adult brain, it will be helpful to know how the brain develops The brain and spinal cord develop from the ectodermal neural tube (see Figure 14.27) The anterior part of the neural tube expands, along with the associated neural crest tissue Constrictions in this expanded tube soon appear, creating three regions called primary brain vesicles: prosencephalon, mesencephalon, and rhombencephalon (see Figure 14.28) Both the prosencephalon and rhombencephalon subdivide further, forming secondary brain vesicles The prosencephalon (PROSen-sefЈ-a-lon), or forebrain, gives rise to the telencephalon and diencephalon, and the rhombencephalon (ROM-ben-sefЈ-a-lon), or hindbrain, develops into the metencephalon and myelencephalon The various brain vesicles give rise to the following adult structures: • The telencephalon (telЈ-en-SEF-a-lon; tel- ϭ distant; -encephalon ϭ brain) develops into the cerebrum and lateral ventricles • The diencephalon (dı¯Ј-en-SEF-a-lon) forms the thalamus, hypothalamus, epithalamus, and third ventricle • The mesencephalon (mesЈ-en-SEF-a-lon (mes- ϭ middle)), or midbrain, gives rise to the midbrain and aqueduct of the midbrain (cerebral aqueduct) • The metencephalon (metЈ-en-SEF-a-lon; met- ϭ after) becomes the pons, cerebellum, and upper part of the fourth ventricle • The myelencephalon (mı¯-el-en-SEF-a-lon; myel- ϭ marrow) forms the medulla oblongata and lower part of the fourth ventricle The walls of these brain regions develop into nervous tissue, while the hollow interior of the tube is transformed into its various ventricles (fluid-filled spaces) The expanded neural crest tissue becomes prominent in head development Most of the protective structures of the brain—that is, most of the bones of the skull, associated connective tissues, and meningeal membranes—arise from this expanded neural crest tissue These relationships are summarized in Table 14.1 Major Parts of the Brain The adult brain consists of four major parts: brain stem, cerebellum, diencephalon, and cerebrum (Figure 14.1) The brain stem is continuous with the spinal cord and consists of the medulla oblongata, pons, and midbrain Posterior to the brain stem is the cerebellum (serЈ-e-BEL-um ϭ little brain) Superior to the brain stem is the diencephalon (di- ϭ through), which consists of the thalamus, hypothalamus, and epithalamus Supported on the diencephalon and brain stem is the cerebrum (se-RE¯-brum ϭ brain), the largest part of the brain TABLE 14.1 Development of the Brain Five secondary brain vesicles Three primary brain vesicles Wall Walls Walls Cavities TELENCEPHALON Cerebrum Lateral ventricles DIENCEPHALON Thalamus, hypothalamus, and epithalamus Third ventricle Midbrain Aqueduct of the midbrain Cavity PROSENCEPHALON (FOREBRAIN) MESENCEPHALON (MIDBRAIN) MESENCEPHALON Pons METENCEPHALON RHOMBENCEPHALON (HINDBRAIN) Three- to fourweek embryo Adult structures derived from: Cerebellum Upper part of fourth ventricle Medulla oblongata Lower part of fourth ventricle MYELENCEPHALON Five-week embryo Five-week embryo 14.1 BRAIN ORGANIZATION, PROTECTION, AND BLOOD SUPPLY 475 Figure 14.1 The brain The pituitary gland is discussed with the endocrine system in Chapter 18 The four principal parts of the brain are the brain stem, cerebellum, diencephalon, and cerebrum Sagittal plane CEREBRUM DIENCEPHALON: Thalamus Hypothalamus View Pineal gland (part of epithalamus) BRAIN STEM: Midbrain Pons Medulla oblongata Pituitary gland CEREBELLUM (a) Sagittal section, medial view CEREBRUM DIENCEPHALON: Thalamus Hypothalamus BRAIN STEM: Midbrain CEREBELLUM Pons Medulla oblongata Spinal cord (b) Sagittal section, medial view Which part of the brain is the largest? C H A P T E R ANTERIOR POSTERIOR 14 Spinal cord 476 CHAPTER 14 • THE BRAIN AND CRANIAL NERVES Protective Coverings of the Brain The cranium (see Figure 7.4) and the cranial meninges surround and protect the brain The cranial meninges (me-NIN-je¯z) are continuous with the spinal meninges, have the same basic structure, ˉ -ter), and bear the same names: the outer dura mater (DOO-ra MA the middle arachnoid mater (a-RAK-noyd), and the inner pia mater (PE¯-a or PI¯ -a) (Figure 14.2) However, the cranial dura Figure 14.2 The protective coverings of the brain Cranial bones and cranial meninges protect the brain Superior sagittal sinus Frontal plane Skin Parietal bone Periosteal layer CRANIAL MENINGES: Dura mater Meningeal layer Arachnoid mater Pia mater Subarachnoid space Arachnoid villus Cerebral cortex Falx cerebri (a) Anterior view of frontal section through skull showing the cranial meninges Dura mater Falx cerebri Frontal bone Parietal bone Superior sagittal sinus Inferior sagittal sinus Tentorium cerebelli Straight sinus Transverse sinus Sphenoid bone Falx cerebelli Occipital bone (b) Sagittal section of extensions of the dura mater What are the three layers of the cranial meninges, from superficial to deep? 14.2 CEREBROSPINAL FLUID Blood flows to the brain mainly via the internal carotid and vertebral arteries (see Figure 21.19); the dural venous sinuses drain into the internal jugular veins to return blood from the head to the heart (see Figure 21.24) In an adult, the brain represents only 2% of total body weight, but it consumes about 20% of the oxygen and glucose used by the body, even when you are resting Neurons synthesize ATP almost exclusively from glucose via reactions that use oxygen When the activity of neurons and neuroglia increases in a particular region of the brain, blood flow to that area also increases Even a brief slowing of brain blood flow may cause disorientation or a lack of consciousness, such as when you stand up too quickly after sitting for a long period of time Typically, an interruption in blood flow for or minutes impairs neuronal function, and total deprivation of oxygen for about minutes causes permanent injury Because virtually no glucose is stored in the brain, the supply of glucose also must be continuous If blood entering the brain has a low level of glucose, mental confusion, dizziness, convulsions, and loss of consciousness may occur People with diabetes must be vigilant about their blood sugar levels because these levels can drop quickly, leading to diabetic shock, which is characterized by seizure, coma, and possibly death The blood–brain barrier (BBB) consists mainly of tight junctions that seal together the endothelial cells of brain blood capillaries and a thick basement membrane that surrounds the capillaries As you learned in Chapter 12, astrocytes are one type of neuroglia; the processes of many astrocytes press up against the capillaries and secrete chemicals that maintain the permeability characteristics of the tight junctions A few water-soluble substances, such as glucose, cross the BBB by active transport Other substances, such as creatinine, urea, and most ions, cross the BBB very slowly Still other substances—proteins and most antibiotic drugs—do not pass at all from the blood into brain tissue However, lipid-soluble substances, such as oxygen, carbon dioxide, alcohol, and most anesthetic agents, are able to access brain tissue freely Trauma, certain toxins, and inflammation can cause a breakdown of the blood–brain barrier Breaching the Blood– Brain Barrier Because it is so effective, the blood–brain barrier prevents the passage of helpful substances as well as those that are potentially harmful Researchers are exploring ways to move drugs that could be therapeutic for brain cancer or other CNS disorders past the BBB In one method, the drug is injected in a concentrated sugar solution The high osmotic pressure of the sugar solution causes the endothelial cells of the capillaries to shrink, which opens gaps between their tight junctions, making the BBB more leaky and allowing the drug to enter the brain tissue • CHECKPOINT Compare the sizes and locations of the cerebrum and cerebellum Describe the locations of the cranial meninges Explain the blood supply to the brain and the importance of the blood–brain barrier 14.2 Cerebrospinal Fluid OBJECTIVE • Explain the formation and circulation of cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless liquid composed primarily of water that protects the brain and spinal cord from chemical and physical injuries It also carries small amounts of oxygen, glucose, and other needed chemicals from the blood to neurons and neuroglia CSF continuously circulates through cavities in the brain and spinal cord and around the brain and spinal cord in the subarachnoid space (the space between the arachnoid mater and pia mater) The total volume of CSF is 80 to 150 mL (3 to oz) in an adult CSF contains small amounts of glucose, proteins, lactic acid, urea, cations (Naϩ, Kϩ, Ca2ϩ, Mg2ϩ), and anions (Cl– and HCO3–); it also contains some white blood cells Figure 14.3 shows the four CSF-filled cavities within the brain, which are called ventricles (VEN-tri-kuls ϭ little cavities) There is one lateral ventricle in each hemisphere of the cerebrum (Think of them as ventricles and 2.) Anteriorly, the lateral ventricles are separated by a thin membrane, the septum pellucidum (SEP-tum pe-LOO-si-dum; pellucid ϭ transparent) The third ventricle is a narrow slitlike cavity along the midline superior to the hypothalamus and between the right and left halves of the thalamus The fourth ventricle lies between the brain stem and the cerebellum Functions of CSF The CSF has three basic functions: Mechanical protection CSF serves as a shock-absorbing medium that protects the delicate tissues of the brain and spinal 14 Brain Blood Flow and the Blood–Brain Barrier CLIN ICA L CON N ECTI O N | C H A P T E R mater has two layers; the spinal dura mater has only one The two dural layers are called the periosteal layer (which is external) and the meningeal layer (which is internal) The dural layers around the brain are fused together except where they separate to enclose the dural venous sinuses (endothelial-lined venous channels) that drain venous blood from the brain and deliver it into the internal jugular veins Also, there is no epidural space around the brain Blood vessels that enter brain tissue pass along the surface of the brain, and as they penetrate inward, they are sheathed by a loose-fitting sleeve of pia mater Three extensions of the dura mater separate parts of the brain: (1) The falx cerebri (FALKS ser-i-BRE¯; falx ϭ sickle-shaped) separates the two hemispheres (sides) of the cerebrum (2) The falx cerebelli (serЈe-BEL-ı¯) separates the two hemispheres of the cerebellum (3) The tentorium cerebelli (ten-TO¯-re¯-um ϭ tent) separates the cerebrum from the cerebellum 477 478 CHAPTER 14 • THE BRAIN AND CRANIAL NERVES Figure 14.3 Locations of ventricles within a “transparent” brain One interventricular foramen on each side connects a lateral ventricle to the third ventricle, and the aqueduct of the midbrain connects the third ventricle to the fourth ventricle Ventricles are cavities within the brain that are filled with cerebrospinal fluid POSTERIOR ANTERIOR Cerebrum LATERAL VENTRICLES INTERVENTRICULAR FORAMEN FOURTH VENTRICLE THIRD VENTRICLE LATERAL APERTURE AQUEDUCT OF THE MIDBRAIN (CEREBRAL AQUEDUCT) Cerebellum Pons MEDIAN APERTURE Medulla oblongata CENTRAL CANAL Spinal cord Right lateral view of brain Which brain region is anterior to the fourth ventricle? Which is posterior to it? cord from jolts that would otherwise cause them to hit the bony walls of the cranial cavity and vertebral canal The fluid also buoys the brain so that it “floats” in the cranial cavity Homeostatic function The pH of the CSF affects pulmonary ventilation and cerebral blood flow, which is important in maintaining homeostatic controls for brain tissue CSF also serves as a transport system for polypeptide hormones secreted by hypothalamic neurons that act at remote sites in the brain Circulation CSF is a medium for minor exchange of nutrients and waste products between the blood and adjacent nervous tissue Because of the tight junctions between ependymal cells, materials entering CSF from choroid capillaries cannot leak between these cells; instead, they must pass through the ependymal cells This blood–cerebrospinal fluid barrier permits certain substances to enter the CSF but excludes others, protecting the brain and spinal cord from potentially harmful blood-borne substances In contrast to the blood–brain barrier, which is formed mainly by tight junctions of brain capillary endothelial cells, the blood–cerebrospinal fluid barrier is formed by tight junctions of ependymal cells Formation of CSF in the Ventricles The CSF formed in the choroid plexuses of each lateral ventricle flows into the third ventricle through two narrow, oval openings, the interventricular foramina (inЈ-ter-ven-TRIK-uˉ-lar; singular is foramen; Figure 14.4b) More CSF is added by the choroid plexus in the roof of the third ventricle The fluid then flows through the aqueduct of the midbrain (cerebral aqueduct) (AK-we-dukt), which passes through the midbrain, into the fourth ventricle The choroid plexus of the fourth ventricle contributes more fluid CSF enters the subarachnoid space through three openings in the roof of the fourth ventricle: a single median aperture (AP-er-chur) and paired lateral apertures, The majority of CSF production is from the choroid plexuses (KO¯-royd ϭ membranelike), networks of blood capillaries in the walls of the ventricles (Figure 14.4a) Ependymal cells joined by tight junctions cover the capillaries of the choroid plexuses Selected substances (mostly water) from the blood plasma, which are filtered from the capillaries, are secreted by the ependymal cells to produce the cerebrospinal fluid This secretory capacity is bidirectional and accounts for continuous production of CSF and transport of metabolites from the nervous tissue back to the blood Circulation of CSF 14.2 CEREBROSPINAL FLUID 479 CLINICAL CONNECTION | Hydrocephalus Abnormalities in the brain—tumors, inflammation, or developmental malformations—can interfere with the circulation of CSF from the ventricles into the subarachnoid space When excess CSF accumulates in the ventricles, the CSF pressure rises Elevated CSF pressure causes a condition called hydrocephalus (hı¯Ј-dro¯ -SEF-a-lus; hydro- ϭ water; -cephal- ϭ head) The abnormal accumulation of CSF may be due to an obstruction to CSF flow or an abnormal rate of CSF production and/or reabsorption In a baby whose fontanels have not yet closed, the head bulges due to the increased pressure If the condition persists, the fluid buildup compresses and damages the delicate nervous tissue Hydrocephalus is relieved by draining the excess CSF In one procedure, called endoscopic third ventriculostomy (ETV), a neurosurgeon makes a hole in the floor of the third ventricle and the CSF drains directly into the subarachnoid space In adults, hydrocephalus may occur after head injury, meningitis, or subarachnoid hemorrhage Because the adult skull bones are fused together, this condition can quickly become life-threatening and requires immediate intervention • one on each side CSF then circulates in the central canal of the spinal cord and in the subarachnoid space around the surface of the brain and spinal cord CSF is gradually reabsorbed into the blood through arachnoid villi, fingerlike extensions of the arachnoid mater that project into the dural venous sinuses, especially the superior sagittal sinus (see Figure 14.2) (A cluster of arachnoid villi is called an arachnoid granulation.) Normally, CSF is reabsorbed as rapidly as it is formed by the choroid plexuses, at a rate of about 20 mL/hr (480 mL/day) Because the rates of formation and reabsorption are the same, the pressure of CSF normally is constant For the same reason, the volume of CSF remains constant Figure 14.4d summarizes the production and flow of CSF CHECKPOINT 14 What structures produce CSF, and where are they located? What is the difference between the blood–brain barrier and the blood–cerebrospinal fluid barrier? C H A P T E R Figure 14.4 Pathways of circulating cerebrospinal fluid CSF is formed from blood plasma by ependymal cells that cover the choroid plexuses of the ventricles ANTERIOR View Ependymal cell Falx cerebri Blood capillary of CHOROID PLEXUS Cerebrum LATERAL VENTRICLE Transverse plane Tight junction Septum pellucidum CSF CHOROID PLEXUS Ventricle Details of a section through a choroid plexus (arrow indicates direction of filtration from blood to CSF) Falx cerebri Superior sagittal sinus POSTERIOR (a) Superior view of transverse section of brain showing choroid plexuses F I G U R E 14 CONTINUES 480 CHAPTER 14 F I G U R E 14.4 • THE BRAIN AND CRANIAL NERVES CONTINUED POSTERIOR ANTERIOR CHOROID PLEXUS OF LATERAL VENTRICLE Superior cerebral vein CHOROID PLEXUS OF THIRD VENTRICLE ARACHNOID VILLUS Cerebrum Interthalamic adhesion of thalamus SUBARACHNOID SPACE SUPERIOR SAGITTAL SINUS Posterior commissure Corpus callosum Great cerebral vein LATERAL VENTRICLE Straight sinus INTERVENTRICULAR FORAMEN Anterior commissure THIRD VENTRICLE AQUEDUCT OF THE MIDBRAIN (CEREBRAL AQUEDUCT) Midbrain Hypothalamus Pons Cerebellum Cranial meninges: LATERAL APERTURE CHOROID PLEXUS OF FOURTH VENTRICLE Pia mater FOURTH VENTRICLE MEDIAN APERTURE Arachnoid mater Dura mater Medulla oblongata Spinal cord CENTRAL CANAL Path of: CSF Sagittal plane SUBARACHNOID SPACE View Filum terminale (b) Sagittal section of brain and spinal cord Venous blood 481 14.2 CEREBROSPINAL FLUID Superior sagittal sinus ARACHNOID VILLUS Frontal plane Falx cerebri Corpus callosum LATERAL VENTRICLE View Septum pellucidum CHOROID PLEXUS THIRD VENTRICLE Cerebrum SUBARACHNOID SPACE (surrounding brain) AQUEDUCT OF THE MIDBRAIN (CEREBRAL AQUEDUCT) Tentorium cerebelli Cerebellum LATERAL APERTURE FOURTH VENTRICLE MEDIAN APERTURE Spinal cord Lateral ventricle's choroid plexuses CSF Lateral ventricles Through interventricular foramina Third ventricle's choroid plexus CSF Third ventricle Through aqueduct of the midbrain (cerebral aqueduct) (c) Frontal section of brain and spinal cord Fourth ventricle's choroid plexus CSF Fourth ventricle Through lateral and median apertures Subarachnoid space Arachnoid villi of dural venous sinuses Arterial blood Venous blood Heart and lungs (d) Summary of the formation, circulation, and absorption of cerebrospinal fluid (CSF) Where is CSF reabsorbed? C H A P T E R 14 SUBARACHNOID SPACE (surrounding spinal cord) 482 CHAPTER 14 • THE BRAIN AND CRANIAL NERVES 14.3 The Brain Stem and Reticular Formation OBJECTIVE • Describe the structures and functions of the brain stem and reticular formation The brain stem is the part of the brain between the spinal cord and the diencephalon It consists of three structures: (1) medulla oblongata, (2) pons, and (3) midbrain Extending through the brain stem is the reticular formation, a netlike region of interspersed gray and white matter Medulla Oblongata The medulla oblongata (me-DOOL-la obЈ-long-GA-ta), or more simply the medulla, is continuous with the superior part of the spinal cord; it forms the inferior part of the brain stem (Figure 14.5; see also Figure 14.1) The medulla begins at the foramen magnum and extends to the inferior border of the pons, a distance of about cm (1.2 in.) The medulla’s white matter contains all sensory (ascending) tracts and motor (descending) tracts that extend between the spinal cord and other parts of the brain Some of the white matter forms bulges on the anterior aspect of the medulla These protrusions, called the pyramids (Figure 14.6; see also Figure 14.5), are formed by the large corticospinal tracts that pass from the cerebrum to the spinal cord The corticospinal tracts control voluntary movements of the limbs and trunk (see Figure 16.10) Just superior to the junction of the medulla with the spinal cord, 90% of the axons in the left pyramid cross to the right side, and 90% of the axons in the right pyramid cross to the left side This crossing is called the decussation of pyrˉ -shun; decuss ϭ crossing) and explains why amids (de¯Ј-ku-SA each side of the brain controls voluntary movements on the opposite side of the body The medulla also contains several nuclei (Recall that a nucleus is a collection of neuronal cell bodies within the CNS.) Some of these nuclei control vital body functions Examples of nuclei in the medulla that regulate vital activities include the cardiovascular center and the medullary rhythmicity center The cardiovascular center regulates the rate and force of the heartbeat and the diameter of blood vessels (see Figure 21.13) The medullary respiratory center adjusts the basic rhythm of breathing (see Figure 23.23) Figure 14.5 Medulla oblongata in relation to the rest of the brain stem The brain stem consists of the medulla oblongata, pons, and midbrain ANTERIOR View Cerebrum Olfactory bulb View Olfactory tract Pituitary gland Optic tract CEREBRAL PEDUNCLE OF MIDBRAIN Mammillary body PONS Cerebellar peduncles MEDULLA OBLONGATA Olive Pyramids Spinal nerve C1 Spinal cord Cerebellum POSTERIOR Inferior aspect of brain What part of the brain stem contains the pyramids? The cerebral peduncles? Literally means “bridge”? I-20 INDEX Middle cerebral artery, 759e Middle cervical ganglion, 529, 532 Middle colic artery, 765e Middle ear, 596–597, 596f, 861t Middle lobar bronchi, 852 Middle lobe, lung, 852 Middle nasal conchae, 844 Middle nasal meatus, 844 Middle piece, sperm, 1047 Middle scalene muscle, 377e, 378e Middle suprarenal arteries, 766e Midgut, 932, 1102 Midline, 16 Midline nucleus, 490 Midpalmar muscles, 372e Midsagittal plane, 16 Mifepristone, 1077 Migrating motility complex (MMC), 918, 923t Migratory phase (deep wound healing), 159 Milk ejection (let-down), 1116 Milk ejection reflex, 1116, 1116f Milliequivalents per liter (mEq/liter), 1028 Minerals, 170, 180, 187t, 970–971, 971t Mineralocorticoids, 638, 639 Minimal volume, 863 Minipills, 1076 Minor calyx, 984 Minute ventilation (MV), 863 Miosis, 612 MIS (Müllerian-inhibiting substance), 1077 Mitochondria, 82–84, 83f Mitochondrial cristae, 83 Mitochondrial matrix, 83 Mitosis, 91–95, 93f, 95t, 97f Mitotic (M) phase, 91–94 Mitotic spindle, 92, 93 Mitral insufficiency, 699 Mitral stenosis, 699 Mitral valve, 695, 697f Mitral valve prolapse (MVP), 699 Mittelschmerz, 1073 Mixed nerves, 450, 503 Mixing, digestive system, 888 Mixtures, 39 M line, 298, 299t MMC (migrating motility complex), 918, 923t Modiolus, 598 Molarity, 40t Molars, 897, 898 Mole, 39, 149, 164f Molecules, 3, 31 Moles per liter (mol/L), 40 mol/L (moles per liter), 40 Monoamine oxidase (MAO), 432, 536 Monoclonal antibody (MAb), 826 Monocytes, 672, 672f, 674t Monomers, 43 Mononucleosis, 835 Monoplegia, 469 Monosaccharide, 43–44, 44f, 920 Monosynaptic reflex arc, 463 Monounsaturated fat, 47 Monozygotic twins, 1091 Mons pubis, 1065 Morning sickness, 1124 Morula, 1091 Motility, 888 Motion sickness, 608 Motor areas, 497, 498 Motor end plate, 305 Motor function, nervous system, 400 Motor homunculus, 498, 561 Motor nerves, 502 Motor neurons, 406, 463, 541 Motor output, spinal cord, 448–449, 449f Motor tract, 447, 460–462, 461f Motor units, 311–313, 311f Mouth, 893–898 digestive activities of, 898t, 929t mechanical and chemical digestion in, 898 muscles of, 337e–338e and salivary glands, 894–895 structures of, 893–894, 893f and teeth, 896–898, 896f, 897f and tongue, 895–896 Movements, 7–8 See also Joints elbow joint, 279e hip joint, 281e knee joint, 284e shoulder joint, 278e, 279e and skeletal system, 170 somatic motor pathways for, 560f synovial joints, 264–268 temporomandibular joint, 275e M (mitotic) phase, 91–94 MRI (magnetic resonance imaging), 22t mRNA (messenger RNA), 87, 88 MS (multiple sclerosis), 437 MSH (melanocyte-stimulating hormone), 625, 628 Mucosa: gastrointestinal tract, 889 large intestine, 927f, 929t small intestine, 923t stomach, 904f ureter, 1011 urethra, 1013 urinary bladder, 1012 vagina, 1065 Mucosa-associated lymphatic tissue (MALT), 808, 889 Mucous connective tissue, 123, 124t Mucous membranes, 132, 133f, 810–811 Mucous neck cell, 903, 906t Mucus secretion, 810 Müllerian-inhibiting substance (MIS), 1077 Multicellular gland, 118, 119f Multifidus muscle, 377e, 378e Multiple-allele inheritance, 1120 Multiple sclerosis (MS), 437 Multipolar neuron, 404f, 405 Multiunit smooth muscle tissue, 318, 319f Mumps, 895 Muscarinic receptor, 535–536 Muscles See also Muscular system abdomen, 350e–352e action potential of, 307 attachment sites of, 329–330 for breathing, 353e–355e contractions of, 323 coordination of, 331–333 extrinsic eye, 340e–341e extrinsic tongue, 344e–345e of facial expression, 337e–339e intrinsic foot, 392e–394e intrinsic hand, 372e–375e metabolism in, 309–311, 309f naming system, 333, 334t neck, 346e–349e pelvic floor, 356e–357e perineum, 358e–359e spindles, 463, 553, 554f and synovial joints, 272 that act on femur, tibia, fibula, 385e–386e that move femur, 380e–384e that move foot and toes, 387e–391e that move head, 348e–349e that move humerus, 362e–364e that move mandible, 342e–343e that move pectoral girdle, 360e–361e that move radius and ulna, 365e–367e that move vertebral column, 376e–379e that move wrist, hand, thumb, fingers, 368e–375e Muscle cells, 301t Muscle fatigue, 310–311 Muscle fibers, 293, 296f –297f, 301t See also Skeletal muscle fibers Muscle pull, 396 Muscle strain, 396 Muscle tear, 396 Muscle tension control, 311–315, 311f–313f Muscle tone, 313–314, 320, 463, 487, 553 Muscular arteries, 733 Muscular atrophy, 295 Muscular dystrophy, 323 Muscular hypertrophy, 295 Muscularis, 923t gastrointestinal tract, 889 large intestine, 929t stomach, 906t ureter, 1011 urethra, 1013 urinary bladder, 1012 vagina, 1065 Muscularis mucosae, 889 Muscular system, 5t See also Muscles; Muscle tension control and cardiovascular system, 793 contributions of, 395 and digestive system, 933 and endocrine system, 653 and integumentary system, 163 and lymphatic system and immunity, 832 and movement production, 329–333 and nervous system, 542 and reproductive systems, 1081 and respiratory system, 879 and skeletal system, 255 and urinary system, 1017 Muscular tissue, 107, 134–135, 134t–135t See also Skeletal muscle tissue and aging, 322 cardiac muscle tissue, 135t, 317–318 contraction and relaxation of muscle fibers, 302–308 development of, 322, 322f and exercise, 317 functions of, 292 muscle metabolism, 309–311 and muscle tension control, 311–315 properties of, 292–293 regeneration of, 320 skeletal muscle fiber types, 315–316 skeletal muscle tissue, 134t, 293–301 smooth muscle tissue, 135t, 318–320, 319f types of, 292, 321t Muscular venules, 736 Musculocutaneous nerves, 453e Musculoskeletal system, see Skeletal system Musculotendinous cuff, 363e Mutations, 100, 1118 MV (minute ventilation), 863 MVP (mitral valve prolapse), 699 Myalgia, 323 Myasthenia gravis, 323 Mydriasis, 612 Myelencephalon, 474, 516, 1098 Myelination, 408–409, 409f Myelin sheath, 407, 408 Myelitis, 470 Myelogenous leukemia, 685 Myeloid stem cell, 667 Myenteric plexus, 534, 889 Mylohyoid muscle, 346e Myocardial infarction (MI), 702 Myocardial ischemia, 702 Myocarditis, 691 Myocardium, 691, 695–696 Myoepithelial cell, 1068 Myofibrils, 295, 301t Myogenic mechanism, 994, 996t Myogenic response, 748 Myoglobin, 295 Myogram, 312, 312f, 313f Myology, 291 INDEX Myoma, 323 Myomalacia, 323 Myomesin, 300, 300t Myometrium, 1063, 1064 Myopathy, 323 Myopia, 589, 589f Myosin, 299, 300t, 303 Myositis, 323 Myotome, 322, 1099 Myotonia, 323 MyPlate, 969, 969f MyPyramid, see MyPlate Myxedema, 654–655 N NAD (nicotinamide adenine dinucleotide), 942 Naϩ–glucose symporter, 998, 998f Naϩ–Hϩ antiporter, 998–999, 999f Naϩ–Kϩ–2ClϪ symporter, 1000, 1000f Nails, 155, 155f Nail bed, 155 Naϩ–Kϩ ATPase, 69, 69f, 416 Narcolepsy, 567 Nasal bones, 206e Nasal cavity, 842 Nasal region, of visual field, 594 Nasal septum, 204e, 208–209, 208f, 842 Nasal vestibule, 844 Nasolacrimal duct, 580 Nasopharynx, 845, 857t Naϩ symporter, 998 Natriuresis, 1027 Natural blood doping, 671 Natural killer (NK) cells, 811 Nausea, 936 Navicular bone, 250e NE, see Norepinephrine Near point of vision, 588–589 Nearsightedness, 589f NEAT (nonexercise activity thermogenesis), 967 Nebulin, 300, 300t Neck (area of body): anatomical terminology, 12 muscles of, 338e, 346e–349e veins of, 775e–776e Neck (part of structure): gallbladder, 909 sperm, 1047 tooth, 896 Necklift, 161 Necrosis, 95 Negative feedback systems, 10, 626f, 752f Negative inotropic agent, 713 Negative selection, 831 Neonatal period, 1089 Neoplasms, 99 Nephrology, 979 Nephrons, 984–991, 986f–989f Nephron loops, 985, 990t, 1000–1001, 1000f, 1006, 1007f Nephropathy, 1019 Nephroptosis, 983 Nephrotic syndrome, 1018 Nerves, 175, 295, 400, 984–985 See also Nervous system; Nervous tissue Nerve action potentials, 410–411 Nerve blocks, 470 Nerve fibers, 402, 423, 424 Nerve growth factor (NGF), 648f Nerve impulses, see Action potentials Nervous system, 5t and aging, 517 blood pressure regulation by, 745–747, 746f, 747f and body function control, 616 and cardiovascular system, 793 contributions of, 542 and control of heart, 715f development of, 515–517 digestion regulation by, 930, 930f, 931 and digestive system, 933 and endocrine system, 653 endocrine system vs., 616t functions of, 400, 402, 411f glomerular filtration rate regulation by, 994, 995, 996t and heat production, 965 and integumentary system, 163 and muscular system, 395 organization of, 400, 401f origin of, 515f and reproductive systems, 1081 and respiratory system, 879 and skeletal system, 255 and urinary system, 1017 Nervous tissue, 107, 136, 136t collections of, 409–410 electrical signals in neurons, 410–424 histology of, 402–410 myelination, 408–409 neural circuits, 435–436, 435f neuroglia, 406–408 neurons, 402–406 neurotransmitters, 432–435 regeneration and repair of, 436–437, 436f signal transmission at synapses, 425–431 Net filtration pressure (NFP), 739, 993–994, 993f Neural circuit, 435–436, 436f Neural crest, 515, 651, 1098 Neural fold, 515, 1098 Neuralgia, 470 Neural groove, 515, 1098 Neural innervation, gastrointestinal tract and, 889–890 Neural layer, retina, 584 Neural plate, 515, 1098 Neural tube, 474, 515, 1098 Neural tube defects (NTDs), 517, 1098 Neuritis, 470 Neuroblastomas, 438 Neurocranium, 253 Neurofibrils, 402 Neurogenesis, central nervous system, 436 Neuroglia, 136, 406–408, 407f, 408f Neurohypophyseal bud, 651 Neurohypophysis, see Posterior pituitary Neurolemma, 408 Neurologists, 399 Neurology, 399 Neuromuscular disease, 323 Neuromuscular junction (NMJ), 305–307, 306f Neurons, 402–406, 431t central nervous system, 406f, 407f classification of, 404–406, 404f electrical signals in, 410–424 functions of, 136 ion channels in, 412–414, 413f, 414t multipolar structure of, 403f parts of, 402–404 and resting membrane potential, 414–416, 414f, 415f structural diversity in, 404 Neuronal cell bodies, 410 Neuropathy, 438 Neuropeptides, 434, 434t Neuropeptide Y, 968 Neurophysiology, 2t Neurosecretory cells, 432, 623 Neurosyphilis, 1083 Neurotoxins, 422 Neurotransmitters, 432–435, 433f modifying effects of, 435 and neuromuscular junction, 305–307 and neuropeptides, 434, 434t and photoreceptors, 590 postsynaptic effects of, 427 removal of, from synaptic cleft, 427–429 small-molecule, 432–433, 433f and synaptic vesicles, 404 Neurotransmitter receptors, 426, 427 Neurulation, 1098, 1099f Neutrons, 29 Neutrophils, 672, 672f, 674t, 811 Nevus, 149, 164f NFP, see Net filtration pressure NGF (nerve growth factor), 648f NHL (Non-Hodgkin lymphoma), 836 Niacin, 973t Nicotinamide, 973t Nicotinamide adenine dinucleotide (NAD), 942 Nicotinic receptors, 535–536 NIDDM (non-insulin-dependent diabetes mellitus), 656 Night blindness, 592 Nipples, 1068 Nissl bodies, 402 Nitric oxide (NO), 433, 619, 668, 669 Nitric oxide synthase (NOS), 433 Nitrogen, 30f, 54 Nitrogen narcosis, 864 I-21 NK (natural killer) cell, 811 NMJ (neuromuscular junction), 305–307, 306f NO, see Nitric oxide Nociceptor, 549, 552 Nocturia, 1019 Nocturnal enuresis, 1019 Nodes of Ranvier, 408 Nonciliated simple columnar epithelium, 113t Nondisjunction, 1119 Nonessential amino acids, 958 Nonexercise activity thermogenesis (NEAT), 967 Non-Hodgkin lymphoma (NHL), 836 Non-incisional sterilization, 1075 Non-insulin-dependent diabetes mellitus (NIDDM), 656 Noninvasive diagnostic techniques, Noninvasive prenatal tests, 1109–1110 Nonpolar covalent bond, 34 Nonsteroidal anti-inflammatory drugs (NSAIDs), 648 Nonvolatile acid, 1035 Noradrenaline, 536 Norepinephrine (NE), 432, 533, 536, 642, 747 Normal sinus rhythm, 724 Normal-tension glaucoma, 611 Normotensive (term), 795 NOS (nitric oxide synthase), 433 Nose, 841–845, 844f, 857t Nosebleed, 881 Notochord, 253, 1097 Notochordal process, 1097, 1098f NREM sleep, 566 NSAIDs (Nonsteroidal antiinflammatory drugs), 648 NTDs (neural tube defects), 517, 1098 Nuclear division, 92–94, 93f Nuclear envelope, 85 Nuclear pore, 85 Nucleases, 924t Nucleic acids, 52–54, 53f, 54t, 919, 959 Nucleoli, 85 Nucleosidase, 919, 924t Nucleosome, 85 Nucleotides, 53–54 Nucleus(–i) See also specific types of cells, 29, 60, 84–87, 84f of medulla, 482 of neuronal cell bodies, 410 of sperm, 1047 of spinal cord, 447 Nursemaid’s elbow, 279e Nutrient artery, 175 Nutrient foramen, 175 Nutrient veins, 175 Nutrition, 968–973 healthy eating guidelines, 969–970 and minerals, 970–971, 971t and MyPlate, 969, 969f and vitamins, 970, 972t–973t Nystagmus, 509e, 612 I-22 INDEX O O2 diffusing capacity, 876 OA (osteoarthritis), 189, 291 Obesity, 974 Obligatory water reabsorption, 988 Oblique fissure, 852 Oblique plane, 16 Oblique popliteal ligament, 282e Obsessive–compulsive disorder (OCD), 565 Obstetrics, 1089 Obstructive shock, 750 Obturator externus muscle, 380e, 381e Obturator internus muscle, 380e, 458e Obturator nerve, 456e, 457e Occipital belly muscle, 337e Occipital bone, 200e–201e Occipital lobe, cerebrum, 492 Occipitofrontalis muscles, 337e Occlusions, 795 Occult blood, 928 OCD (obsessive–compulsive disorder), 565 Octet rule, 32 Oculomotor (III) nerve, 485, 505e–506e, 514t Odorants, 573 Odor thresholds, 575 Office hypertension, 795 Oils, 47 Oil glands, 153 Olfaction, 573–576, 573f–574f Olfactory bulb, 496, 503e, 575 Olfactory cilia, 573 Olfactory epithelium, 573, 573f–574f, 845 Olfactory gland, 574 Olfactory (I) nerve, 503e, 514t, 575 Olfactory pathway, 573f–574f, 575–576 Olfactory receptors, 573–574 Olfactory receptor cells, 573–574 Olfactory region, of nose, 857t Olfactory tract, 503e, 575, 576 Olfactory transduction, 575f Oligodendrocyte, 407 Olive, 483 Omental appendices, 927 Omohyoid muscle, 346e, 347e Oncogenes, 100 Oncogenic viruses, 100 Oncology, 99 Oocyte, 1057 Oogenesis, 1057–1060, 1059f, 1060t Oogonia, 1057 Oophorectomy, 1084 Open (compound) fracture, 184f Open reduction, 183 Ophthalmic nerve, 507e Ophthalmology, 572 Opponens digiti minimi muscle, 372e, 374e Opponens pollicis muscle, 372e, 374e Opposition, joint, 267f, 268 Opsin, 591 Opsonization, 827 Optic chiasm, 504e, 593 Optic cup, 608 Optic disc, 584, 585f Optic groove, 608 Optic (II) nerve, 504e, 514t, 592, 593 Optic radiations, 593 Optic stalk, 608 Optic tract, 504e, 593 Optic vesicles, 608 Oral cavity, see Mouth Oral cavity proper, 893 Oral vestibule, 893 Ora serrata, 583 Orbicularis oculi, 337e, 338e Orbicularis oris, 337e Orbits, 209, 209f, 338e Orbitofrontal area, in olfactory pathway, 576 Orbitofrontal cortex, 499 Orchitis, 1084 Organs, defined, Organelles, 60, 76–83 centrosome, 76, 77f cilia, 76, 77, 77f endoplasmic reticulum, 78–79, 79f flagella, 77, 77f, 78 Golgi complex, 79–81, 80f, 81f lysosomes, 81, 82f mitochondria, 82–84, 83f peroxisomes, 82 proteasomes, 82 ribosomes, 78, 78f Organic compounds, 38, 42–55 adenosine triphosphate, 55, 55f carbohydrates, 43–45, 43t carbon and its functional groups, 42–43, 42t lipids, 45–48, 45t nucleic acids, 52–54, 54t proteins, 48–52, 49t Organisms, Organism level, structural organization, Organ level, structural organization, Organ of Corti, 600f Organogenesis, 1102 Origin, muscle, 329 Oropharyngeal membrane, 932, 1097 Oropharynx, 845, 857t Orthodontics, 180, 897 Orthopedics, 192 Orthostatic hypotension, 795 Os coxa, 240 Osmolarity, 981 Osmoreceptors, 549, 630 Osmosis, 67–68, 68f Osmotic gradient, 1004 Osmotic pressure, 67–68 Osseous tissue, see Bone tissue Ossification, 176–178, 176f, 177f Ossification centers, 176 Osteoarthritis (OA), 189, 291 Osteoblasts, 172 Osteoclasts, 172–173 Osteocytes, 130, 172 Osteogenesis, 176 Osteogenic sarcoma, 99, 189 Osteology, 169 Osteomalacia, 188–189 Osteomyelitis, 189 Osteons, 130, 173 Osteopenia, 189 Osteoporosis, 188, 188f Osteoprogenitor cell, 172 OT (oxytocin), 629–630 Otalgia, 612 Otic ganglion, 510e, 529, 534 Otic pit, 608 Otic placode, 608, 1104 Otic vesicles, 608 Otitis media, 611 Otoacoustic emission, 602 Otoliths, 603 Otolithic membrane, 603 Otolithic organs, 603 Otorhinolaryngology, 572, 841 Otoscope, 595, 596 Outer circular layer, muscularis, 1065 Outer ear, 595–596 Outer mitochondrial membrane, 83 Oval window, 596 Ovarian arteries, 754e, 766e Ovarian cancer, 1082–1083 Ovarian cortex, 1055, 1059f Ovarian cycle, 1069 Ovarian cysts, 1060, 1084 Ovarian follicles, 1057 Ovarian ligament, 1055 Ovarian medulla, 1055 Ovarian veins, 783e Ovaries, 646, 646t, 1054–1060 histology of, 1055, 1057, 1057f oogenesis and follicular development, 1057–1060, 1058f–1059f, 1060t relative position of, 1056f reproductive cycle phases in, 1071–1073 Overflow incontinence, 1013 Ovulation, 627, 1057, 1072, 1073 Ovum, 1059, 1060 Oxidation, 37, 942 Oxidation–reduction reactions, 38, 942 Oxidative burst, 812 Oxidative decarboxylation, 948f Oxidative phosphorylation, 943 Oxygen: atomic structure of, 30f, 31f consumption after exercise, 311 exchange of carbon dioxide and, 863–866 in external and internal respiration, 865f and hemoglobin, 868–870, 868f–870f transport of, 866–870, 867f Oxygenated blood, 866 Oxygen debt, 311 Oxygen diffusing capacity, 876 Oxyhemoglobin, 868 Oxyphil cell, 635 Oxytocin (OT), 629–630 P Pacemakers, 704 Pacemaker potential, 704 Paget’s disease, 180 PAH (para-aminohippuric acid), 1010 Pain, 551–553, 876 Painful heel syndrome, 396 Pain receptors, 555t Pain threshold, 569 Pain tolerance, 569 Palate, 893 Palatine bone, 206e Palatine tonsil, 809, 845 Palatoglossal arch, 894 Palatoglossus muscle, 344e Palatopharyngeal arch, 894 Pallor, 149 Palmar digital veins, 777e Palmar interossei muscle, 372e, 374e Palmaris longus muscle, 368e Palmar metacarpal arteries, 759e Palmar metacarpal veins, 777e Palmar venous plexuses, 777e Palpation, Palpebral conjunctiva, 580 Palpebral fissure, 580 Palpitation, 726 Pancreas, 907–909, 907f–908f, 923t, 929t Pancreatic amylase, 907, 924t Pancreatic artery, 765e Pancreatic cancer, 908 Pancreatic duct, 643f, 906–907 Pancreatic islets, 642–646, 643f, 907 cell types, 644 disorders of, 655–656 and glucagon secretion regulation, 644–645, 644f hormones, 645t and insulin secretion regulation, 644–645, 644f Pancreatic juice, 907–909, 924t Pancreatic lipase, 907, 924t Pancreatic polypeptides, 644 Pancreatitis, 908 Paneth cells, 914, 923t Pantothenic acid, 973t Papanicolaou test, 118 Papilla, 150, 576–578, 577f–578f, 896 Papillary ducts, 984 Papillary muscles, 695 Papillary region, 147, 148t Papule, 166 Para-aminohippuric acid (PAH), 1010 Paracellular reabsorption, 996 Paracrines, 618 INDEX Parafollicular cells, 631, 634 Parahippocampal gyrus, 495 Parallel after-discharge circuit, 435–436 Paralysis, 314, 396, 512e, 561 Paramesonephric duct, 1077 Paranasal sinuses, 211–212, 211f Paraplegia, 469 Parasagittal plane, 16 Parasympathetic division of autonomic nervous system, 400, 524 effects of, 539t–540t structure of, 528f, 533–534 sympathetic division vs., 538t Parasympathetic ganglia, 529 Parasympathetic responses, 538–539 Parathormone, see Parathyroid hormone (PTH) Parathyroid glands, 635–638, 636f, 655 Parathyroid hormone (PTH): and homeostasis in bone tissue, 184, 185 and parathyroid glands, 635–638, 636f, 637t and regulation of urinary system, 1003, 1003t Paraurethral gland, 1065, 1067 Paraventricular nuclei, 628 Paraxial mesoderm, 1098, 1099 Parenchyma, 137, 984 Paresthesia, 470 Parietal bones, 198e Parietal branches: of abdominal aorta, 766e of thoracic aorta, 763e Parietal cells, 903, 906t Parietal layer: of serous membrane, 132 of serous pericardium, 690 Parietal lobe, cerebrum, 492 Parietal peritoneum, 890 Parietal pleura, 852 Parieto-occipital sulcus, 492 Parkinson’s disease (PD), 565, 568–569 Parotid duct, 894 Parotid gland, 894, 895f Paroxysmal tachycardia, 726 Pars distalis, 623 Pars intermedia, 623 Pars nervosa, 623 Pars tuberalis, 623 Partial knee replacement, 285–286 Partially saturated hemoglobin, 868 Partial pressure, 865f, 866, 869 Passive transport processes, 64–69, 74t Patella, 247e–248e Patellar ligament, 282e, 385e Patellar reflex, 467 Patellofemoral stress syndrome, 248e Patency, of respiratory system, 856 Patent ductus arteriosus (PDA), 724, 1115 Pathogens, 799 Pathological anatomy, 2t Pathological cardiomegaly, 717 Pathologists, 106 Pathophysiology, 2t PCL (posterior cruciate ligament), 282e PCT, see Proximal convoluted tubule PD (Parkinson’s disease), 565, 568–569 PDA (patent ductus arteriosus), 724 PDGF (platelet-derived growth factor), 648f, 676 Pectinate muscles, 692 Pectineus muscle, 381e Pectoral (shoulder) girdle, 232–234, 232f clavicle, 233e muscles that move, 360e–361e scapula, 234e Pectoralis major muscle, 362e Pectoralis minor muscle, 360e Pedicels, 993 Peg cells, 1061 Pelvic arteries, 770e–772e Pelvic bones, 240 Pelvic cavity, 19 Pelvic diaphragm, 356e Pelvic floor muscles, 356e–357e Pelvic girdle, 240–242, 240f, 242e false and true pelves, 242–244, 243f right hip bone, 241f Pelvic inflammatory disease (PID), 1084 Pelvic splanchnic nerves, 534, 534f Pelvic veins, 781e–783e, 786e Pelvimetry, 244 Penile urethra, 1051 Penis, 1052–1054, 1053f Pentose sugar, 54 Pepsin, 905, 924t Peptic ulcer disease, 934 Peptidase, 919, 924t Peptide bonds, 48, 49, 50f Peptide hormones, 619 Peptidyl (P) site, 88 Percent saturation of hemoglobin, 868 Perception, 497, 547 Percussion, Percutaneous transluminal coronary angiography (PTCA), 723 Perforated eardrum, 595 Perforating canal, 173 Perforating cutaneous nerve, 458e Perforating fibers, 170, 173 Perforin, 811, 822, 823 Pericardial arteries, 754e, 763e Pericardial cavity, 17, 691 Pericardial fluid, 691 Pericardial veins, 780e Pericarditis, 691 Pericardium, 19, 132, 690–691, 690f Pericentriolar material, 76 Perichondrium, 126, 178 Periderm, 159 Perilymph, 597 Perimetrium, 1063 Perimysium, 293 Perineum muscles, 358e–359e, 1067–1068, 1067f Perineurium, 450 Periodic abstinence, 1076 Periodontal disease, 934 Periodontal ligament, 896 Periodontics, 897 Periorbital fat, 582 Periosteal arteries, 175 Periosteal veins, 175 Periosteum, 170, 177, 178 Peripheral chemoreceptors, 873, 874 Peripheral muscular portion, diaphragm, 353e Peripheral nervous system, 400 damage and repair in, 436–437, 436f and neuroglia, 408, 408f organization of, 400 Peripheral proteins, 62 Peristalsis, 900, 928 Peritoneal cavity, 890 Peritoneal dialysis, 1010 Peritoneum, 19, 132, 890–893 Peritonitis, 892 Peritubular capillaries, 984 Permanent teeth, 897–898, 897f Permissive effect of hormones, 622 Pernicious anemia, 684 Peroneus brevis, 387e Peroneus longus, 387e Peroneus tertius, 387e Peroxisome, 82 Perspiration, 811 PET (positron emission tomography), 23t P generation, 1120 PGs, see Prostaglandins Phagocytes, 811–814, 813f Phagocytosis, 72, 72f and antibody-mediated immunity, 826, 828 and innate immunity, 811–813, 813f in liver, 913 by white blood cells, 673 Phagolysosomes, 812 Phagosomes, 812 Phalanges, 239e–240e, 250e–252e Phantom limb sensation, 551 Pharmacology, 12 Pharyngeal arch, 877, 1102, 1104, 1104f Pharyngeal cleft, 609, 1104f Pharyngeal pouch, 609, 651, 1104, 1104f Pharyngeal stage (swallowing), 900 Pharyngeal tonsil, 809, 845 Pharynx, 845, 857t, 898, 899, 901t, 929t Phenotypes, 1119–1120 Phenylketonuria (PKU), 957, 1118, 1118f I-23 Pheochromocytomas, 655, 794 Phlebitis, 795 Phlebotomists, 685 Phosphatase, 919, 924t Phosphate, 54, 1030–1031, 1032t Phosphate buffer system, 1033–1034, 1036t Phosphodiesterase, 622 Phospholipids, 47–48, 47f, 61 Phosphorus, 971t Phosphorylation, 942–943, 948f Photophobia, 612 Photophosphorylation, 943 Photopigments, 590–591, 591f Photoreceptors, 549, 590–592, 590f, 592f Photoreceptor layer, retina, 584 Photosensitivity, 162 Phrenic nerve, 452e pH scale, 40–42, 41f, 41t, 981 Physiological cardiomegaly, 716–717 Physiology, 2, 2t Pia mater, 443, 476 PID (pelvic inflammatory disease), 1084 Pigmented layer, retina, 584 PIH (pregnancy-induced hypertension), 1113 Piles, 935 Pineal gland, 492, 646–647 Pinealocytes, 646 Pinkeye, 612 Pinna, 595 Pinocytosis, 72, 633 Piriformis muscle, 380e, 458e Pisiform (carpal), 239e Pituicytes, 629 Pituitary dwarfism, 182, 652 Pituitary gland, 623–631, 624f, 652, 655 See also Anterior pituitary; Posterior pituitary Pivot joint, 269, 270f PKD (polycystic kidney disease), 1018 PKU (phenylketonuria), 957, 1118, 1118f Placenta, 788, 1101–1102, 1101f Placental stage (labor), 1114, 1114f Placenta previa, 1102 Placentation, 1101 Planes, 16–17, 16f Plane joints, 269, 270f Plantar aponeurosis, 392e Plantar arch, 770e Plantar digital arteries, 770e Plantar digital veins, 784e Plantar fasciitis, 396 Plantar flexion, 267f, 268 Plantar flexion reflex, 467 Plantar interossei muscles, 392e, 393e Plantaris muscle, 387e, 388e Plantar metatarsal arteries, 770e Plantar metatarsal veins, 784e Plantar muscles, 392e–393e I-24 INDEX Plasma, 662–664, 664t, 1024 Plasma cells, 121, 816, 825, 830t Plasma creatinine, 1009 Plasma membrane, 60–64 and active transport processes, 69–73 cell, 1024 and fluid mosaic model, 61 gradients across, 64 and membrane fluidity, 62–63 membrane permeability, 63–64 and membrane protein functions, 63f and membrane proteins, 62 and passive transport processes, 64–69 structure of, 61–62 transport across, 64–73 Plasma proteins, 664, 994 Plasmin, 680 Plasminogen, 679 Plasticity, 436, 567 Plateau, action potential, 706 Platelets, 131, 664, 674 Platelet adhesion, 677 Platelet aggregation, 677 Platelet-derived growth factor (PDGF), 648f, 676 Platelet plug formation, 676–677, 677f Platelet release reaction, 677 Platysma muscle, 338e Pleura, 19, 132 Pleural cavity, 17, 852 Pleural effusion, 852 Pleural membrane, 851f, 852 Pleurisy, 852 Plexus, 451–459, 452e–458e Pluripotent stem cell, 665–667, 792 PMDD (premenstrual dysphoric disorder), 1082 PMS (premenstrual syndrome), 1080 Pneumonia, 880 Pneumothorax, 852 PNI (psychoneuroimmunology), 832 Podocytes, 989 Polar covalent bonds, 34 Polarized cells, 415 Poliomyelitis, 470 Polycystic kidney disease (PKD), 1018 Polycythemia, 665 Polygenic inheritance, 1120 Polymers, 43 Polyps, 927, 934 Polypeptides, 49, 51 Polyribosomes, 90 Polysaccharides, 44, 45, 45f Polyspermy, 1090, 1091 Polysynaptic reflex arc, 463 Polyunsaturated fat, 47 Polyuria, 1019 Pons, 484 Pontine nuclei, 484 Pontine respiratory group (PRG), 484, 873 Popliteal arteries, 770e Popliteal fossa, 385e Popliteal veins, 784e Popliteus muscle, 387e, 388e Portal lobule, 911 Portal system, 735 Portal triad, 909 Portal vein, 787 Portwine stains, 166 Positive feedback system, 10, 11 Positive inotropic agent, 713 Positive selection, 830, 831 Positron emission tomography (PET), 23t Postabsorptive state, 959, 962–963, 963f, 963t Postcapillary venules, 733, 735 Postcentral gyrus, 492 Posterior cerebellar artery, 758e Posterior cerebral arteries, 758e Posterior chamber, eye, 586–587, 586f Posterior (dorsal) column, 556 Posterior column–medial lemniscus pathway, 483, 556, 556f Posterior commissure, 494 Posterior communicating arteries, 759e Posterior compartment: forearm, 368e leg, 387e, 388e thigh, 385e, 386e Posterior (extensor) compartment muscles, 366e Posterior cruciate ligament (PCL), 282e Posterior cutaneous nerve of thigh, 458e Posterior fontanel, 212 Posterior gray horns, 447 Posterior hypophyseal veins, 629 Posterior intercostal arteries, 754e, 763e Posterior interventricular branch, 700, 757e Posterior interventricular sulcus, 692 Posterior lobe, cerebellum, 487 Posterior lymph sac, 810 Posterior median sulcus, 447 Posterior pituitary, 623, 628–631, 629f, 631t See also Pituitary gland and antidiuretic hormone, 629–631, 630f and oxytocin, 629–630 Posterior ramus, 450 Posterior roots, 446 Posterior root ganglia, 446 Posterior scalene muscle, 377e, 378e Posterior spinocerebellar tract, 559 Posterior thoracic muscles, 360e Posterior tibial arteries, 770e Posterior tibial veins, 784e Posterior triangle, 348e Posterior white column, 447, 461 Posterolateral fontanel, 212 Postganglionic neurons, 526, 529, 530f Postovulatory phase (reproductive cycle), 1073 Post-polio syndrome, 470 Postsynaptic cells, 424 Postsynaptic neurons, 424 Postsynaptic potential, 425–427, 429–431, 430f Posttraumatic stress disorder (PTSD), 650 Postural hypotension, 795 Potassium, 30f, 971t, 1030, 1032t Potential energy, 35 Pott’s fracture, 185f P–Q interval, of electrocardiogram, 708 Pre-Bötzinger complex, 872 Precapillary sphincter, 733 Precentral gyrus, 492 Precursor cell, 667 Predonation, 685 Preeclampsia, 1113 Prefrontal cortex, 499 Preganglionic neurons, 526, 529 Pregnancy, 1089 See also Labor compression of inferior vena cava, 773e early pregnancy tests, 1110 ectopic, 1093 and exercise, 1113 hormones of, 1110–1111, 1111f maternal changes during, 1110–1113 normal fetal location and position, 1112f prenatal diagnostic tests, 1108–1110 Pregnancy-induced hypertension (PIH), 1113 Preload, cardiac, 713 Premature ejaculation, 1054 Premature infants, 1116 Premenstrual dysphoric disorder (PMDD), 1082 Premenstrual syndrome (PMS), 1080 Premolars, 898 Premotor area, cerebrum, 499, 561 Pre-mRNA, 88 Prenatal development, 1047, 1089 Prenatal diagnostic tests, 1108–1110 Preoptic area, 965 Preoptic region, hypothalamus, 490 Preovulatory phase (reproductive cycle), 1071–1072 Prepuce, 1052, 1065 Presbycusis, 611 Presbyopia, 589 Pressure, pulmonary ventilation and, 857–860, 859f Pressure reservoir, 732, 732f Pressure sensation, 550 Pressure ulcers, 165, 165f Presynaptic neuron, 424 Pretectal nuclei, 593 Prevertebral ganglia, 529 PRG (pontine respiratory group), 484, 873 Priapism, 1054 PRICE treatment for sprains, 287 Primary active transport, 69–70, 997 Primary auditory area, cerebrum, 498, 602 Primary brain vesicles, 474, 516, 1098 Primary follicles, 1058, 1058f Primary germ layers, 1096, 1097f Primary gustatory area, cerebrum, 498, 578 Primary hypertension, 794 Primary lymphatic organ, 804 Primary motor area, cerebrum, 498 Primary nail field, 161 Primary olfactory area, cerebrum, 498, 575, 576 Primary oocyte, 1057 Primary ossification center development, 178 Primary plexus of hypophyseal portal system, 623 Primary responses, immunological, 828, 828f Primary somatosensory area, cerebrum, 497, 498, 558–559, 558f Primary spermatocytes, 1045 Primary structure, protein, 50f, 51 Primary visual area, cerebral cortex, 498, 593 Prime mover, muscle, 331 Primitive atrium, 719 Primitive gut, 932, 1102 Primitive heart tube, 719, 1100 Primitive node, 1097 Primitive streak, 1096 Primitive ventricle, 719 Primordial follicle, 1057, 1058f Primordial germ cells, 1045 Primordium, 1124 Principal cells, 991 Principal piece, sperm, 1047 PRL, see Prolactin Procarboxypeptidase, 909 Processes, vertebral, 216 Proctodeum, 932, 1102 Proctology, 886 Products of chemical reactions, 35 Proelastase, 909 Proerythroblast, 670 Progenitor cells, 667 Progeny, 101 Progesterone, 646, 647t, 1070, 1070f, 1110 Projection tract, 494 Prolactin (PRL), 625, 627, 1116 Proliferating cartilage, 178 Proliferative phase: deep wound healing, 159 uterine cycle, 1072 Promoter sequence, 87 Pronation, joint, 267f, 268 Pronator quadratus muscle, 365e, 366e Pronator teres muscle, 365e, 366e Pronephric duct, 1015 Pronephros, 1015 Prone position, 12 INDEX Propagation, 420, 422–423, 423f Proper hepatic artery, 765e Proper palmar digital arteries, 759e Proper palmar digital veins, 777e Prophase, 92 Proprioceptive sensations, 553–555, 554f Proprioceptors, 549, 553, 555t, 714, 874, 875 Propulsion, 888, 904 Prosencephalon, 516, 1098 Prosopagnosia, 518–519 Prostacyclin, 680 Prostaglandins (PGs), 48, 619, 647, 812 Prostate, 1013, 1052, 1080 Prostate cancer, 1080 Prostatic urethra, 1013, 1051 Protease inhibitors, 834 Proteasomes, 82 Protection, for sprains, 287 Proteins, 48–52, 49t amino acids, 48–49, 50f, 51 breakdown, 640 digestion, 919 elongation during translation, 89f enzymes, 51–52, 52f metabolism, 956–958, 957f, 960t polypeptides, 49, 51 processing and packaging of, 81f protein receptors, 618 and structural organization levels, 50–52, 50f synthesis of, 87–90, 87f–89f Protein buffer system, 1033, 1036t Protein hormones, 619 Protein kinase, 622 Proteoglycans, 122 Proteomes, 87 Proteomics, 101 Protons, 29 Proton acceptors, 40 Proton donors, 40 Proton pumps, 905, 949, 1035 Proto-oncogene, 100 Protraction, joint, 267f, 268, 361e Provitamins, 970 Proximal convoluted tubule (PCT), 985, 998–1000, 998f, 999f, 1007f Pruritus, 166 Pseudopod, 72, 812 Pseudostratified epithelium, 111, 114t Pseudounipolar neuron, 405 P (peptidyl) site, 88 Psoas major muscle, 380e Psoriasis, 147, 166 Psychoneuroimmunology (PNI), 832 PTCA (percutaneous transluminal coronary angiography), 723 Pterygopalatine ganglia, 508e, 529, 533 PTH, see Parathyroid hormone Ptosis, 506e, 612 PTSD (posttraumatic stress disorder), 650 Puberty, 1079 Pubic lice, 166 Pubic region, 20 Pubic symphysis, 240 Pubis, 242e Pubococcygeus muscle, 356e Pubofemoral ligament, 281e Puborectalis muscle, 356e Pudendal nerve, 458e Pudendum, 1065–1068, 1066f Puerperal fever, 1124 Puerperium, 1114 Pulled hamstrings, 385e Pulmonary circulation, 698–700, 699f, 752, 788, 789f Pulmonary edema, 881 Pulmonary embolism, 680 Pulmonary perfusion, 876 Pulmonary plexus, 529 Pulmonary respiration, see Pulmonary ventilation Pulmonary trunk, 788 Pulmonary valve, 695 Pulmonary veins, 788 Pulmonary ventilation, 856–861, 858f, 859f, 861t Pulmonologists, 841 Pulp, 897 Pulp cavity, 897 Pulse, 748, 759e Pulse points, 749f Pulse pressure, 749 Pulvinar nucleus, 490 Pumps, 69–70 Punnett square, 1118 Pupillary light reflex, 467 Pupils, 583–584, 583f, 590 Purines, 54, 432 Purkinje cells, 405, 406, 406f Purkinje fibers, 704 Pus, 72, 814 Putamen, 494 P waves, of electrocardiograms, 707 Pyloric antrum, 901 Pyloric canal, 901 Pyloric part of stomach, 901 Pyloric sphincter, 901, 906t Pyloric stenosis, 903 Pylorospasm, 903 Pylorus, 901 Pyorrhea, 934 Pyramids, 482 Pyramidal cells, 406, 406f Pyramidal pathway, see Direct motor pathways Pyridoxine, 973t Pyrimidine, 54 Pyrogen, 974 Pyruvic acid, 946, 946f, 959 Q QRS complex, of electrocardiogram, 707 Q–T interval, of electrocardiogram, 708 Quadrate lobe, liver, 909 Quadratus femoris muscle, 380e, 381e, 458e Quadratus lumborum muscle, 350e Quadratus plantae muscle, 392e, 393e Quadriceps femoris muscle, 385e, 386e Quadriceps tendon, 385e Quadriplegia, 469 Quaternary structure, proteins, 50f, 51 R RA (rheumatoid arthritis), 291 RAA system, see Renin–angiotensin– aldosterone system Rabies, 438 Radial arteries, 759e, 1064 Radial collateral ligament, 279e Radial muscles, 584 Radial nerves, 453e Radial pulse, 759e Radial veins, 777e Radiation, 30, 579, 965 Radical mastectomy, 1082 Radioactive isotopes, 30 Radio frequency nonsurgical facelifts, 161 Radiography, 21t Radionuclide imaging, 722 Radionuclide scanning, 24t Radioulnar joint, 267f Radius, 236e–238e, 279e, 365e–367e Rales, 882 Rami, 450 Rami communicantes, 451, 532 Range of motion (ROM), 272 Raphe, 1042 Rapid depolarization, 706 Rapidly adapting receptors, 550 Rapid ventricular depolarization, 707 RAS (reticular activating system), 486–487, 566 Raynaud’s phenomenon, 541, 543 RBCs, see Red blood cells RDS (respiratory distress syndrome), 860 Reabsorption, 739–740, 996, 997f, 1026f Reactants, chemical reaction, 35 Reactive phase (bone repair), 182–183 Reactivity, 817 Receptors, 9, 62, 540 See also specific types Receptor agonists, 536 Receptor antagonists, 536 Receptor-mediated endocytosis, 71–72, 71f Receptor potential, 548–549 Recessive alleles, 1118 Reciprocal innervation, 464 Recombinant DNA, 90 Recovery oxygen uptake, 311 Rectouterine pouch, 1063 Rectum, 926 Rectus abdominis muscle, 350e Rectus femoris muscle, 385e, 386e I-25 Rectus sheaths, 350e Red blood cells (RBCs), 664, 668–671 anatomy of, 668, 668f destruction of, 669f and erythropoiesis, 670–671, 671f formation of, 669f life cycle of, 669–670 physiology of, 668–670 role of, 131 and toxicity, 68f Red bone marrow, 170, 665–667 Red–green color blindness, 1122, 1122f Red nuclei, 485 Redox reactions, 38, 942 Red pulp, 808 Reduction of fractures, 183 Reduction reactions, 37, 942 Referred pain, 552–553, 552f Reflexes, 467 crossed extensor, 467–468, 468f flexor, 466–467 and spinal cord, 462–468 stretch, 463–464, 464f tendon, 464–466, 465f Reflex arcs, 462–468, 462f Reflex pathways, gastrointestinal, 890 Reflex sympathetic dystrophy (RSD), 543 Refraction abnormalities, 589, 589f Refraction of light rays, 587, 588, 588f Refractory period, 312, 420, 706, 707 Regeneration, 436, 591, 591f Regeneration tube, 437 Regional anatomy, 2t, 12–13 Regression stage (hair growth), 152 Regulatory proteins, 300t Relative refractory period, 420 Relaxation, muscle, 302–308, 308f, 312 Relaxation period, cardiac cycle, 710 Relaxin (RLX), 646, 1070, 1070f, 1110 Relay stations, 556 Releasing hormones, 623 REM sleep, 566–567 Renal arteries, 754e, 766e, 984 Renal autoregulation, 994, 996t Renal blood flow, 984 Renal calculus, 1016 Renal capsule, 981 Renal columns, 984 Renal compensation, 1036 Renal corpuscle, 984, 989t, 1007f Renal cortex, 983 Renal failure, 1018 Renal fascia, 981 Renal ganglion, 529 Renal hilum, 981 Renal lobe, 984 Renal medulla, 983–984 Renal papilla, 984 Renal pelvis, 984 I-26 INDEX Renal physiology, 2t Renal plasma clearance, 1009–1010 Renal plasma flow, 1010 Renal plexus, 532 Renal pyramid, 984 Renal reabsorption, 1026f Renal sinuses, 984 Renal tubules, 990–991, 990t Renal veins, 782e, 984 Renin, 639, 647t, 747, 1002 Renin–angiotensin–aldosterone (RAA) system, 639–640, 640f, 747, 750, 1002 Repair, bone, 182–184, 183f Reparative phase (bone repair), 183 Reperfusion, 700 Repetitive strain injuries (RSIs), 396 Repolarization, of heart, 706, 709f Repolarizing phase (action potential), 417, 420, 421f Reproduction (life process), Reproductive cell division, 91, 95–97, 96f Reproductive systems, 7t See also Female reproductive system; Male reproductive system and aging, 1079–1080 and cardiovascular system, 793 contributions of, 1081 development of, 1077–1079, 1078f–1079f and digestive system, 933 and endocrine system, 653 and integumentary system, 163 and lymphatic system and immunity, 832 and muscular system, 395 and nervous system, 542 and respiratory system, 879 and skeletal system, 255 and urinary system, 1017 Residual body, 812 Residual volume, 863 Resistance, 330, 733, 799 Resistance reactions, 650 Resorption, 173 Respiration, 856–861, 864–866, 865f Respirator, 882 Respiratory acidosis, 1036, 1037t Respiratory adjustments at birth, 1115 Respiratory alkalosis, 1036, 1037t Respiratory bronchioles, 852, 857t Respiratory center, 872–876, 872f Respiratory compensation, 1036 Respiratory distress syndrome (RDS), 860 Respiratory diverticulum, 877 Respiratory epithelium, 844 Respiratory failure, 882 Respiratory membrane, 854 Respiratory physiology, 2t Respiratory pump, 743, 802 Respiratory region, of nose, 857t Respiratory system, 6t and aging, 878 and blood pH regulation, 1034f and bronchi anatomy, 850–851, 850f and cardiovascular system, 793 contribution to other body systems, 879 and control of breathing, 872–876, 875f development of, 877–878 and digestive system, 933 and endocrine system, 653 and exercise, 876–877 head and neck structures, 843f–844f and integumentary system, 163 and larynx anatomy, 845–847, 846f–847f and lung anatomy, 851–856, 851f, 853f, 854f lung volumes and capacities, 862–863, 862f and lymphatic system and immunity, 832 and muscular system, 395 and nervous system, 542 and nose anatomy, 841–845, 844f and oxygen and carbon dioxide transport, 866–872 and oxygen/carbon dioxide exchange, 862–866 patency of, 856 and pharynx anatomy, 845 and pulmonary ventilation, 856–861 and reproductive systems, 1081 and skeletal system, 255 structures of, 841f–842f, 857t and trachea anatomy, 849, 849f and urinary system, 1017 and voice production structures, 847–849, 848f Respiratory zone, 841 Responses, in feedback system, Responsiveness, Rest, for sprains, 287 Rest-and-digest activities, 538 Resting cartilage, 178 Resting membrane potential, 412, 414–416, 414f, 415f Resting stage (hair growth), 152 Rete testis, 1048 Reticular activating system (RAS), 486–487, 566 Reticular connective tissue, 126t Reticular fibers, 123 Reticular formation, 485–487 Reticular nuclei, 490 Reticular region, 148, 148t Reticulocytes, 670 Reticulocyte count, 670 Retina, 584–586, 584f, 585f, 592–593 Retinacula, 369e Retinal, 591 Retinal isomerase, 591 Retinoblastoma, 612 Retraction, joint, 267f, 268, 361e Retroflexion, 1062 Retrograde axonal transport, 404 Retroperitoneal lymph sac, 810 Retroperitoneal organs, 891–892, 891f–892f, 981 Retropulsion, 904 Retroviruses, 833 Reverberating circuit, 435 Reverse muscle action (RMA), 330 Reverse transcriptase, 833 Reverse transcriptase inhibitors, 833–834 Reversible reactions, 37–38 Reye’s syndrome, 519 Rhabdomyosarcoma, 396 Rh blood group, 682 Rheumatic fever, 699 Rheumatism, 287 Rheumatoid arthritis (RA), 291 Rh factor, 682 Rhinitis, 882 Rhinoplasty, 842 Rhodopsin, 590 Rhombencephalon, 516, 1098 Rhomboid major muscle, 360e Rhomboid minor muscle, 360e Rhythm method (birth control), 1076 Ribs, 225e–226e Riboflavin, 972t Ribonuclease, 907, 924t Ribonucleic acid (RNA), 53, 54t, 87–90 Ribose, 54 Ribosomal RNA (rRNA), 87 Ribosomes, 78, 78f Rickets, 188–189 Right atrium, 692, 695 Right bundle branches, heart, 704 Right colic artery, 765e Right colic flexure, 926 Right common carotid artery, 754e, 759e Right coronary artery, 700 Right gastric artery, 765e Right gastric vein, 782e Right hepatic ducts, 909 Right hypochondriac region, 20 Right iliac region, 20 Right inguinal region, 20 Right lobe, liver, 909 Right lower quadrant (RLQ), 20 Right lumbar region, 20 Right lymphatic duct, 802, 803f Right main bronchus, 850 Right posterior intercostal vein, 780e Right pulmonary artery, 788 Right subclavian artery, 754e, 758e Right surface, heart, 690 Right upper quadrant (RUQ), 20 Right ventricle, 695 Rigidity, muscle, 314 Rigor mortis, 305 Rima glottidis, 847 Rima vestibuli, 847 Ringworm, 166 Risorius muscle, 338e RLQ (right lower quadrant), 20 RLX, see Relaxin RMA (reverse muscle action), 330 RNA, see Ribonucleic acid Rods, 584 Rod photopigments, 590f ROM (range of motion), 272 Root: brachial plexus, 453e hair, 150 heart, 852 nail, 155 penis, 1052 spinal cord, 446 tooth, 896 Root canal, 897 Root canal therapy, 896 Rootlets, 446 Rosacea, 161 Rotation, at synovial joints, 266–267, 267f, 361e Rotator cuff, 278e, 363e, 364e Rotatores muscle, 377e, 378e Rough endoplasmic reticulum, 78 Round ligament (ligamentum teres), 791, 909, 1062 Round window, 596 rRNA (ribosomal RNA), 87 RSD (reflex sympathetic dystrophy), 543 RSIs (repetitive strain injuries), 396 RU 486, 1077 Rubrospinal tract, 462 Rugae, 901, 1065 Rule of nines, 165, 165f Runner’s knee, 248e Running injuries, 396 Ruptured spleen, 808 RUQ (right upper quadrant), 20 S Saccule, 597, 603 Sacral parasympathetic outflow, 533 Sacral plexus, 451, 458e–459e Sacral vertebrae, 214 Sacrum, 214, 222e–223e SAD (seasonal affective disorder), 438, 647 Saddle joints, 269, 270f Sagittal suture, 210 Saliva, 811, 894, 924t Salivary amylase, 894, 924t Salivary glands, 894–895, 895f, 898f, 929t Salivation, 894 Salpingectomy, 1084 Salts, 40, 40f Saltatory conduction, 422, 423f SA (sinoatrial) node, 704 Sarcolemma, 295 Sarcomas, 99 Sarcomeres, 298–299, 298f, 299t Sarcoplasm, 295 Sarcoplasmic reticulum, 295 SARS (severe acute respiratory syndrome), 881 INDEX Sartorius muscle, 385e, 386e Satellite cell, 408 Satiety, 968 Satiety center of hypothalamus, 491 Saturated fats, 47 Saturated fatty acids, 46 Saturation of hemoglobin, 868, 868f SBP (systolic blood pressure), 741, 749 Scala tympani, 598 Scala vestibuli, 598 Scalene group muscles, 377e, 378e Scalp muscles, 337e Scaphoid (carpal), 239e Scapula, 234e Scapular muscles, 362e Scars, 159 SCD, see Sickle-cell disease S cells, 914 Schizophrenia, 565 Schwann cells, 408 Sciatica, 458e Sciatic nerve, 458e SCID (severe combined immunodeficiency disease), 835 Sclera, 583 Scleral venous sinuses, 583 Sclerotome, 322, 1099 SCM (sternocleidomastoid muscles), 348e, 512e Scoliosis, 227, 227f Scotoma, 612 Scrotal septum, 1042 Scrotum, 1042–1043 Seasonal affective disorder (SAD), 438, 647 Seasonal influenza (flu), 856 Sebaceous ciliary gland, 580 Sebaceous glands, 153 Sebum, 153, 811 Secondary active transport, 70, 70f, 997 Secondary brain vesicles, 474, 516, 1098 Secondary follicles, 1058f, 1059, 1059f Secondary hypertension, 794 Secondary lymphatic organs, 804 Secondary oocytes, 1059, 1090f Secondary ossification centers, 179 Secondary plexus of hypophyseal portal system, 623 Secondary response, immunological, 828, 828f Secondary sex characteristics, 1047, 1048 Secondary spermatocytes, 1045, 1046 Secondary structure, protein, 50f, 51 Secondary tubules, 1068 Secondary tympanic membranes, 596 Second-class levers, 330, 331f Second cuneiform bone, 250 Second deciduous molars, 897 Second messengers, 621 Second-order neurons, 556 Second permanent molars, 898 Second polar body, 1060 Second premolars, 898 Second trimester of prenatal development, 1089 Secretin, 647t, 931, 931t Secretion: and anterior pituitary, 625 and digestive system, 887 and epithelial tissue, 111 Secretory phase (uterine cycle), 1073 Secretory vesicles, 80 Sections, 16f, 17 Segmental arteries, kidneys, 984 Segmental branch nerves, 452e Segmental bronchi, 850, 857t Segmental muscles, 377e Segmentations, 918, 923t Selective permeability, 63 Selective serotonin reuptake inhibitors (SSRIs), 438 Selectivity, of sensory receptors, 547 Selenium, 971t Self-recognition, 829–830, 829f Self-tanning lotions, 162 Self-tolerance, 829–830, 829f Semen, 1052 Semicircular canals, 597–598, 599f Semicircular ducts, 598, 605–606, 605f Semilunar ganglion, 507e Semilunar (SL) valves, 697–698, 698f Semimembranosus muscle, 385e, 386e Seminal fluid, 1052 Seminal vesicles, 1013, 1051 Seminiferous tubules, 1044f, 1045 Semispinalis capitis muscle, 348e, 377e, 378e Semispinalis cervicis muscle, 377e, 378e Semispinalis thoracis muscle, 377e, 378e Semitendinosus muscle, 385e, 386e Sensation See also Sensory receptors and cerebrum, 566–568 process of, 547 sensory modalities, 547 sensory receptors, 547–550, 548f, 549t somatic motor pathways, 560–566 somatic sensations, 550–555 somatic sensory pathways, 555–560 Sensible perspiration, 153 Sensorineural deafness, 611 Sensory areas of cerebral cortex, 497–498 Sensory branches, of cervical plexus, 452e Sensory function, nervous system, 400 Sensory homunculus, 498, 559 Sensory input, integration of, 547 Sensory modalities, 547 Sensory nerves, 502 Sensory neurons, 406, 463, 541 Sensory output, spinal cord, 448–449, 449f Sensory overload, 487 Sensory receptors, 547–550 adaptation in, 549, 550 in autonomic reflex arcs, 540 classification of, 549t function of, 400 in reflex arcs, 462–463 for somatic sensation, 555t structure and location of, 551f types of, 547–550, 548f of unipolar neurons, 405, 405f Sensory tract, spinal cord, 447, 460–462, 461f Separate cells, sensation and, 548 Separated rib, 226e Separation, shoulder, 278e Sepsis, 808 Septal defects, 724 Septal nasal cartilage, 842 Septal nuclei, 496 Septicemia, 685 Septum pellucidum, 477 Serosa, 889, 1012 Serotonin, 432 Serous fluid, 132 Serous membranes, 19, 132, 133f Serous pericardium, 690 Serratus anterior muscle, 360e Serum, 677 Sesamoid bones, 195 Severe acute respiratory syndrome (SARS), 881 Severe combined immunodeficiency disease (SCID), 835 Sex chromosomes, 92, 1121–1122, 1121f Sex determination, 1121–1122, 1121f Sex hormones, 182 Sex-linked inheritance, 1122 Sexual function development, 1048 Sexually transmitted diseases (STDs), 1083–1084 Sexual reproduction, 1041 Shaft, hair, 150 Shell temperature, 964–965 Shingles, 470 Shin splint syndrome, 388e Shivering, 967 Shock, 750–752, 751f Shock-wave lithotripsy, 1016 Short bones, 195 Short gastric artery, 765e Short-term memory, 567 Shoulder dislocation, 278e Shoulder girdle, see Pectoral (shoulder) girdle Shoulder joint, 276e–278e abduction and adduction at, 268f angular movements at, 265f circumduction at, 266f rotation at, 267f Shoulder separation, 278e Sickle cell crisis, 684 Sickle-cell disease (SCD), 51, 684, 684f, 1119–1120, 1119f Sick sinus syndrome, 726 I-27 SIDS (sudden infant death syndrome), 881 Sighing, 861t Sigmoid arteries, 765e Sigmoid colon, 926 Sigmoid sinuses, 775e Signal transmission at synapses, 425–431 chemical synapses, 425–427, 427f electrical synapses, 424–425 and neurotransmitter receptor structure, 427 and neurotransmitter removal, 427–429 and spatial/temporal summation, 429–431, 429f Signs of disease, 12 Silent myocardial ischemia, 702 Simple acinar gland, 120 Simple branched acinar gland, 120 Simple branched tubular gland, 120 Simple coiled tubular gland, 120 Simple cuboidal epithelium, 113t Simple diffusion, 65, 65f Simple epithelium, 111, 112t–114t Simple glands, 118 Simple series circuit, 435 Simple squamous epithelium, 112t Simple sugars, 43–44 Simple tubular gland, 120 Single covalent bonds, 33–34 Single-photon-emission computerized tomography (SPECT) scanning, 24t Single-unit smooth muscle tissue, 318, 319f Sinoatrial (SA) node, 704 Sinuses, 807 See also specific types Sinusitis, 212 Sinusoids, 735, 1095–1096 Sinus venosus, 719 Sixth pharanygeal arch, 877 Skeletal muscles: and movement production, 329–333 naming of, 333, 334t organization of, 301t principal muscles, 333, 335f–336f relationship to bones, 329f Skeletal muscle assist device, 718t Skeletal muscle fibers, 295–299 ATP production in, 309–311, 309f characteristics of, 316t contraction and relaxation of, 302–308 and distribution and recruitment, 315–316 microscopic organization of, 295–299, 296f–299f, 299t and neuromuscular junction, 305–307, 306f and sliding filament mechanism, 302–305, 302f types of, 315–316 Skeletal muscle pumps, 742–743, 742f, 802 I-28 INDEX Skeletal muscle tissue, 134t, 292–301, 321t and abnormal contractions, 323 connective tissue components, 293–294, 294f contraction and relaxation of, 302–308 and exercise, 317 microscopic organization of, 295–299, 296f–299f, 299t and muscle metabolism, 309–311 and muscle proteins, 299–300, 300t and muscle tension control, 311–315 nerve and blood supply, 295 organization of, 294f, 301t Skeletal system, 4t See also Appendicular skeleton; Axial skeleton; Bone tissue bone surface markings, 195–196, 196t and cardiovascular system, 793 contributions of, 255 development of, 253–254, 253f–254f and digestive system, 933 divisions of, 193, 193f, 194f and endocrine system, 653 functions of, 170 and integumentary system, 163 and lymphatic system and immunity, 832 and muscular system, 395 and nervous system, 542 and reproductive systems, 1081 and urinary system, 1017 Skin: accessory structures of, 150–156 color of, 149, 1120, 1121f dermis, 147–148 epidermis, 144–147, 145f, 147t functions of, 156–157 and innate immunity, 810–811 structure of, 143–150 sun damage to, 162 types of, 156, 156t and wound healing, 158–159, 158f Skin cancer, 164, 164f Skin glands, 153–155, 154t Skin grafts, 146 Skull, 196–212 See also Cranial bones anterior view of, 197e cranial bones, 197e–205e facial bones of, 206e–207e foramina, 209, 210t functions and features, 208 inferior view of, 201e medial view of sagittal section, 199e nasal septum, 208–209, 208f orbits, 209, 209f posterior view of, 200e superior and right lateral view of, 198e unique features of, 210–212 SLE (systemic lupus erythematosus), 138, 835 Sleep, 487, 566–567 Sleep apnea, 567, 882 Sliding filament mechanism, 302–305, 302f Slipped disc, 227, 227f Slit membrane, 993 Slow axonal transport, 404 Slowly adapting receptors, 550 Slow oxidative (SO) fibers, 315, 316t Slow pain, 552 SL (semilunar) valves, 697–698, 698f Small cardiac vein, 700, 773e Smaller bronchioles, 857t Small intestine, 913–925 absorption in, 919–923, 921f anatomy of, 913–914, 914f chemical digestion, 918–919 digestive activities in, 923t, 929t histology of, 914–918, 915f–916f and intestinal juice/brush-border enzymes, 918 mechanical digestion in, 918 Small-molecule neurotransmitters, 432–433, 433f Small nuclear ribonucleoproteins, 88 Small saphenous veins, 784e Smegma, 1084 Smell, sense of, see Olfaction Smoking, 77, 877, 1108 Smooth endoplasmic reticulum, 78–79 Smooth muscle tissue, 135t, 292, 318–320, 319f, 321t Smooth muscle tone, 320 Sneezing, 483, 861t SNS, see Somatic nervous system Sobbing, 861t Sodium, 30f, 971t, 1029, 1030, 1032t Sodium–glucose symporter, 998 Sodium–hydrogen antiporter, 998–999, 999f Sodium–potassium–chloride symporter, 1000, 1000f Sodium–potassium pump, 69–70, 69f Sodium symporter, 998 SO (slow oxidative) fibers, 315, 316t Soft palate, 845, 893 Soleus muscle, 387e, 388e Solitary lymphatic nodules, 914 Soluble fiber, 928 Solutes, 38 Solutions, 38–40 Solvent, water as, 38–39, 39f Somatic cells, 91 Somatic cell cycle, 94t Somatic cell division, 91–94 Somatic mesoderm, 1100 Somatic motor map, 558f Somatic motor neurons, 305 Somatic motor pathways, 560–566, 560f and basal nuclei, 564–565 movement modulation by cerebellum, 565–566, 565f tracts and locations, 564t upper motor neuron pathways, 561–564 Somatic nervous system (SNS), 400, 524–526, 525f, 526t Somatic reflexes, 462, 463 Somatic sensation, 550–555 pain sensation, 551–553, 552f proprioceptive sensation, 553–555, 554f receptors for, 551f, 555t tactile sensation, 550–551 thermal sensation, 551 Somatic senses, 547 Somatic sensory map, 558f Somatic sensory pathways, 555–560 anterolateral pathway to cortex, 556–557, 557f to cerebellum, 559 mapping of, 558–559, 558f posterior column–medial lemniscus pathway to cortex, 556, 556f tracts and locations, 559t trigeminothalamic pathway to cortex, 557–558, 557f Somatomedin, see Insulin-like growth factor (IGF) Somatosensory association area, cerebral cortex, 498 Somatostatin, 644 Somatotrophs, 625 Somites, 322, 1098–1099 Sonogram, 1108 Sound waves, 598 Spasms, 323, 676, 903 Spastic colitis, 936 Spasticity, 314 Spastic paralysis, 314, 561 Spatial summation, 429–431, 429f Special joint movements, 267–268, 267f Special senses, 547 and aging, 610–611 gustation, 576–579 hearing, 595–606 olfaction, 573–576 vision, 579–594 Special sensory nerves, 502 SPECT (single-photon-emission computerized tomography) scanning, 24t Speech, muscles of, 342e–347e Spermatic cord, 1049–1050 Spermatids, 1046 Spermatogenesis, 1045–1048, 1046f, 1048f Spermatogenic cells, 1045 Spermatogonia, 1045 Sperm cells, 1045–1047, 1047f, 1049, 1090f Spermiation, 1046, 1047 Spermicide, 1076 Spermiogenesis, 1046 S phase, 91–92 Sphenoid bone, 202e–203e Sphenomandibular ligament, 275e Sphincter of hepatopancreatic ampulla, 907 Sphincter urethrovaginalis, 358e Sphygmomanometer, 748 Spina bifida, 228, 228f Spinal canal, 17 Spinal cord: compression, 470 development of, 516f external anatomy of, 443–447, 446f gross anatomy of, 444f–445f internal anatomy of, 447–449, 447f motor output, 448–450, 449f protective structures of, 443 reflexes and reflex arcs, 462–468, 462f segment comparison, 450t sensory and motor tracts, 460–462, 461f sensory input, 448–450, 449f sympathetic division of ANS and, 532 Spinal fusion, 228 Spinalis capitis muscle, 348e, 376e, 378e Spinalis cervicis muscle, 376e, 378e Spinalis group muscles, 376e, 378e Spinalis thoracis muscle, 376e, 378e Spinal meninges, 443 Spinal nerves, 449–460, 532 brachial plexus, 453e–455e branches of, 451–452, 451f, 453e cervical plexus, 452e connective tissue covering, 450, 450f and dermatomes, 460, 460f distribution of, 450–451 intercostal nerves, 451 lumbar plexus, 456e–457e in peripheral nervous system, 400 plexuses, 451–459, 452e–458e role of, 400 sacral and coccygeal plexuses, 458e–459e and spinal cord, 445f, 446 Spinal reflexes, 462 Spinal shock, 470 Spinal tap, 443 Spinothalamic tract, 461, 557 Spiral arterioles, 1064 Spiral ganglia, 509e, 598 Spiral organs, 598, 600f Spirogram, 862, 862f Spirometer, 862 Splanchnic mesoderm, 1100 Splanchnic nerves, 533 Spleen, 808, 809f Splenectomy, 808 Splenic artery, 754e, 765e Splenic cord, 808 INDEX Splenic vein, 782e, 787 Splenius capitis muscle, 348e, 376e–378e Splenius cervicis muscle, 376e, 378e Splenius muscles, 376e–378e Splenomegaly, 836 Spongy bone tissue, 130, 173–175, 174f, 188f Spongy urethra, 1013, 1051 Sprains, 287 Sputum, 882 Squamous cells, 111 Squamous cell carcinoma, 164 Squamous suture, 210 SRY gene, 1077, 1121, 1122 SSRIs (selective serotonin reuptake inhibitors), 438 Stage of dilation (labor), 1114, 1114f Stage of expulsion (labor), 1114, 1114f Stapedius muscle, 596 Stapes, 596 Starches, 45 Starling’s law of capillaries, 740, 740f Starvation, metabolism during, 963–964 Static equilibrium, 602 STDs (sexually transmitted diseases), 1083–1084 Stellate reticuloendothelial cells, 909 Stem cells, 8, 137 Stem cell research, 1092 Stem cell transplants, 675–676 Stem region, antibody, 825 Stenosis, 699 Stents, 723 Stercobilin, 670, 912f Stereocilia, 598, 603, 1049 Sternal head, SCM, 348e Sternocleidomastoid (SCM) muscles, 348e, 512e Sternohyoid muscle, 346e, 347e Sternothyroid muscle, 346e, 347e Sternum, 224e Steroids, 48, 48f, 317 Steroid hormones, 619 Sterol, 48 Stimulation frequency, muscle tension and, 312–313, 313f Stimuli, 402 and action potential, 419f intenstity of, 423 reflex, 463 and sensory receptors, 547, 549 threshold, subthreshold, and suprathreshold, 419 STM (sympto-thermal method), 1076 Stomach, 901–906 anatomy of, 901–902, 902f digestive activities in, 906t, 929t histology of, 903–904, 903f–904f hydrochloric acid secretion by, 905f mechanical and chemical digestion in, 904–906 Stomodeum, 932, 1102 Storage, 292, 913 Strabismus, 340e, 506e, 612 Straight arterioles, 1064 Straight sinuses, 775e Straight tubules, 1048 Strains, 287 Stratified columnar epithelium, 116t Stratified cuboidal epithelium, 116t Stratified epithelium, 111, 115t–116t Stratified squamous epithelium, 115t Stratum basale, 146, 1064 Stratum corneum, 146–147 Stratum functionalis, 1064 Stratum granulosum, 146 Stratum lucidum, 146 Stratum spinosum, 146 Strength training, 317 Strep throat, 882 Streptokinase, 680 Stress, 649, 831 Stress fractures, 182 Stress incontinence, 1013 Stressors, 648 Stress–relaxation response, 320 Stress response, 648–650, 649f and fight-or-flight response, 648–650 and glucocorticoids, 640 Stress testing, 722 Stretching, 317, 333 Stretch marks, 148 Stretch receptors, 875 Stretch reflex, 463–464, 464f Striae, 148 Stria medullaris, 496 Stria terminalis, 496 Striatum germinativum, 146 Stricture, 1019 Stroke volume, 710, 713–714 Stroma, 123, 136, 137 Stromal cells, 1057 Strong oxidants, 673 Structural organization, levels of, 2–5, 3f Structural proteins, 299–300, 300t Strychnine poisoning, 431 S–T segment, of electrocardiogram, 708 Stupor, 519 Sty, 580 Styloglossus muscle, 344e Stylohyoid muscle, 346e Stylomandibular ligament, 275e Subarachnoid space, 443 Subatomic particles, 28–29 Subcapsular sinuses, 807 Subclavian trunks, 800 Subclavian veins, 775e, 777e Subclavius muscle, 360e, 453e Subcostal arteries, 754e, 763e Subcutaneous layer, 144, 293 Subdural space, 443 Sublingual gland, 894, 895f Subluxation, 287 Submandibular ducts, 894 Submandibular ganglia, 508e, 529, 534 Submandibular gland, 894, 895f Submucosa, 889, 914, 916 Submucosal plexus, 534, 889 Subscapularis muscle, 362e, 363e Substance P, 434, 434t Substantia nigra, 485 Substrates, 51–52 Substrate-level phosphorylation, 942, 948f Subthreshold stimulus, 419 Sucrase, 919, 924t Sudden cardiac death, 726 Sudden infant death syndrome (SIDS), 881 Sudoriferous glands, 153–154 Sulci, 492, 692 Sulfur, 971t Summation of graded potentials, 416, 418f Sunblock, 162 Sun damage, 162 Sun exposure, skin cancer risk and, 164 Sunless tanner, 162 Sunscreens, 162 Sunstroke, 975 Superficial anterior compartment muscles, 368e Superficial (sensory) branches, of cervical plexus, 452e Superficial fibular nerve, 458e Superficial inguinal ring, 351e, 1050 Superficial palmar arch, 759e Superficial palmar venous arches, 777e Superficial perineal muscles, 358e Superficial posterior compartment, 368e, 369e, 388e Superficial somatic pain, 552 Superficial transverse perineal muscle, 358e Superficial veins, 736, 777e, 779e, 784e Superior (term), 14e Superior cerebellar peduncle, 487 Superior cervical ganglion, 529, 532 Superior colliculi, 484–485, 593 Superior extensor retinaculum, 387e Superior ganglia, 510e, 511e Superior gemellus muscle, 380e, 381e, 458e Superior gluteal nerve, 458e Superior hypophyseal arteries, 623 Superior lobar bronchi, 852 Superior lobe, lung, 852 Superior mesenteric artery, 754e, 766e, 768e Superior mesenteric ganglion, 529 Superior mesenteric plexus, 529 Superior mesenteric vein, 782e, 787 Superior nasal concha, 844 Superior nasal meatus, 844 Superior oblique muscle, 340e, 582 Superior olivary nucleus, 602 I-29 Superior phrenic arteries, 754e, 763e Superior rectal artery, 765e Superior rectus muscle, 340e, 582 Superior sagittal sinus, 479, 775e Superior salivatory nuclei, 894 Superior suprarenal arteries, 766e Superior vena cava (SVC), 752, 773e Superoxide free radical, 31, 31f Supination, joint, 267f, 268 Supinator muscle, 365e, 366e Supine position, 12 Supporting cells, 574, 576, 603 Supporting structures, 1041 Supraclavicular nerve, 452e Suprahyoid muscles, 346e Supraoptic nuclei, 628 Supraoptic region, hypothalamus, 490 Suprarenal arteries, 754e, 766e Suprarenal veins, 782e Suprascapular nerve, 453e Supraspinatus muscle, 362e, 363e Suprathreshold stimulus, 419 Supraventricular arrhythmias, 724 Supraventricular tachycardia (SVT), 724 Surface anatomy, 2t Surface area, diffusion and, 65 Surface markings, bone, 195–196, 196t Surface mucous cells, 903, 906t Surface tension, 34 Surfactants, 854 Surgery, tension lines and, 148 Surgical sterilization, 1074–1075 Susceptibility, 799 Suspensions, 39–40 Suspensory ligaments, 1054, 1055, 1068 Sustentacular cells, 1045–1047 Sutural bone, 195 Sutures, 210, 259–260, 259f SVC (superior vena cava), 752, 773e SVR (systemic vascular resistance), 742, 748t SVT (supraventricular tachycardia), 724 Swallowing, see Deglutition Sweat glands, 153–154, 1014 Swollen knee, 285 Sympathetic chains, 529 Sympathetic division of autonomic nervous system, 400, 524–525 effects of, 539t–540t parasympathetic division vs., 538t and shock, 750 structure of, 527f, 532–533 Sympathetic ganglia, 529 Sympathetic nerves, 532–533 Sympathetic responses, 537–538 Sympathetic trunk ganglia, 529, 532 Symphysis, 261, 261f Symporters, 70 Symptoms, 12 Sympto-thermal method (STM), 1076 I-30 INDEX Synapses, 95, 305, 404, 425f chemical, 425–427 electrical, 424–425 and neurotransmitter removal, 427–429 and postsynaptic potentials, 427 signal transmission at, 425–431 and spatial/temporal summation, 429–431, 429f Synaptic clefts, 305, 425 Synaptic delay, 425 Synaptic end bulbs, 305, 404 Synaptic vesicles, 305, 404 Synarthroses, 259 Synchondroses, 261, 261f Syncope, 743 Syncytiotrophoblasts, 1094 Syndesmosis, 260, 260f Synergistic effects of hormones, 622 Synergists (muscles), 332 Synesthesia, 569 Syngamy, 1091 Synostosis, 260 Synovial cavity, 261 Synovial fluid, 8, 134, 263 Synovial joints, 259, 271t and bursae, 264 contact at, 272 movements at, 264–268, 264f–267f, 268t nerve and blood supply, 263 range of motion at, 272 structure of, 261–263, 262f and tendon sheaths, 264 types of, 269–270, 270f Synovial membranes, 133f, 134, 262 Synoviocytes, 134 Synovitis, 287 Synthesis reactions, 37 Syphilis, 560, 1083 Systems, 4, 4t–7t Systemic anatomy, 2t Systemic circulation, 698–700, 699f, 752 abdominal aorta, 765e–769e aorta and branches, 754e–756e arch of aorta, 758e–762e arteries of pelvis and lower limbs, 770e–772e ascending aorta, 757e thoracic aorta, 763e–764e veins of, 773e–774e veins of head and neck, 775e– 776e veins of lower limbs, 784e–786e veins of thorax, 780e–781e veins of upper limbs, 777e–779e Systemic lupus erythematosus (SLE), 138, 835 Systemic vascular resistance (SVR), 742, 748t System level, structural organization, Systole, 708–709, 709f Systolic blood pressure (SBP), 741, 749 T T3 (triiodothyronine), 631 Tachycardia, 511e, 724, 748 Tachypnea, 882 Tactile discs, 145 Tactile epithelial cells, 145 Tactile receptors, 555t Tactile sensations, 550–551 TAFs (tumor angiogenesis factors), 648f Tail: of embryo, 1104 of epididymis, 1049 of pancreas, 906 of sperm, 1047 Tail fold, 1102 Talipes equinovarus, 256 Talus, 250e Tarsals, 250e–251e Tarsal gland, 580 Tarsal plate, 580 Tastants, 576, 578 Taste, see Gustation Taste aversion, 579 Taste buds, 576–578, 898t Taste pores, 576 Taste threshold, 578 Tattooing, 149–150 Tay-Sachs disease, 82 TB (tuberculosis), 881 TBG (thyroxine-binding globulin), 633 T cells, 830t activation of, 820–821 maturation of, 815–816, 815f T-cell receptors (TCRs), 820–821 Tears, 580–582 Tectorial membrane, 598 Tectospinal tract, 462, 563 Tectum, 484 Teeth, 896–898, 896f, 897f, 898t, 929t Telencephalon, 474, 516 Telomeres, 99 Telophase, 94 Temperature: and activation energy, 36 body, 491, 964–967 and diffusion, 65 and oxygen affinity of hemoglobin, 869, 869f and respiration, 875 Temporal bones, 199e Temporalis muscle, 342e Temporal lobe, cerebrum, 492 Temporal region, of visual field, 594 Temporal summation, 429–431, 429f Temporomandibular joint, 267f, 275e Temporomandibular joint (TMJ) syndrome, 207e Tendinous intersections, 350e Tendons, 293, 353e, 385e, 387e Tendon organs, 465, 553–554, 554f Tendon reflex, 464–466, 465f Tendon sheath, 264 Teniae coli, 927 Tennis elbow, 279e Tenosynovitis, 288 Tension lines, 148 Tensor fasciae latae muscle, 380e Tensor tympani muscle, 596 Tentorium cerebelli, 477, 487 Teratogens, 1107–1108 Teres major muscle, 362e, 363e Teres minor muscle, 362e, 363e Terminal bronchioles, 850, 857t Terminal cisterns, 295 Terminal ganglia, 529 Terminal hairs, 152 Terminator sequences, 87 Tertiary structure, protein, 50f, 51 Testes (testicles), 646, 646t, 1043–1048 hormonal control of, 1047–1049, 1048f internal and external anatomy of, 1044f scrotum and supporting structures, 1043f seminiferous tubules, 1046f and sperm, 1047, 1047f spermatogenesis, 1045–1047, 1046f, 1048f and testosterone blood level, 1048, 1049f Testicular arteries, 754e, 766e Testicular cancer, 1080 Testicular veins, 783e Testosterone, 646, 1047–1049, 1048f, 1049f, 1077 Tetanus, 312, 313f Tetany, 655 Tetrads, 95 Tetralogy of Fallot, 724 TF (thymic factor), 647 TF (tissue factor), 678 TGB (thyroglobulin), 633 TGFs (transforming growth factors), 648f Thalamus, 489–490, 489f, 578 Thalassemia, 684 Theca externa, 1059 Theca folliculi, 1059 Theca interna, 1059 Thenar eminence, 374e Thenar muscles, 372e Therapeutic cloning, 1092 Thermal sensations, 551 Thermogenesis, 292 Thermoreceptors, 549, 555t Thermoregulation, 153, 156, 966–967 Thermoregulatory sweating, 153 Thermostat, 491 Theta waves, 501 THF (thymic humoral factor), 647 Thiamine, 972t Thick ascending limb, nephron, 986 Thick filaments, 299f Thick skin, 146, 156, 156t Thin ascending limb, nephron, 986 Thin filaments, 299f Thin skin, 145, 146, 156, 156t Third-class levers, 330, 331f Third cuneiform bone, 250 Third-order neuron, 556 Third permanent molars, 898 Third pharyngeal pouch, 810 Third trimester of prenatal development, 1089 Third ventricle, 477 Thirst center, 491, 1025, 1027t Thoracentesis, 852 Thoracic aorta, 754e, 763e–764e Thoracic bones, see Thorax Thoracic cavity, 17, 18f, 19 Thoracic duct, 800, 802, 803f Thoracic membranes, 19 Thoracic outlet syndrome, 454e Thoracic vertebrae, 214, 219e–220e Thoracodorsal nerve, 453e Thoracolumbar division, 526 Thoracolumbar outflow, 526 Thorax, 216 ribs, 225e–226e skeleton of, 224e sternum, 224e veins of, 780e–781e Thoroughfare channel, 735 Threshold, 419 Threshold stimulus, 419 Thrombectomy, 795 Thrombocytopenia, 685 Thrombolytic agent, 680 Thrombophlebitis, 795 Thrombopoietin (TPO), 667 Thrombosis, 677, 680 Thromboxane (TX), 647 Thrombus, 680 Thumb, muscles that move, 368e–371e Thymic corpuscle, 805 Thymic factor (TF), 647 Thymic humoral factor (THF), 647 Thymopoietin, 647 Thymosin, 647 Thymus, 647, 804–805, 805f Thyroglobulin (TGB), 633 Thyrohyoid membrane, 845 Thyrohyoid muscle, 346e, 347e Thyroid cartilage, 845 Thyroid crisis, 656 Thyroid diverticulum, 651 Thyroid follicles, 631 Thyroid gland, 631–635, 632f, 654–655 Thyroid hormones: actions of, 633–634 and calcitonin, 634–635, 637 definition of, 631 formation, storage, and release of, 631, 633 as lipid soluble hormone, 619 mechanism of, 621f secretion of, 633f, 634, 634f synthesis of, 633f Thyroid-stimulating hormone (TSH), 625, 627 INDEX Thyroid storm, 656 Thyrotrophs, 625 Thyroxine, 631 Thyroxine-binding globulin (TBG), 633 TIA (transient ischemic attack), 517 Tibia, 248e–250e, 385e–386e Tibial collateral ligament, 282e Tibialis anterior muscle, 387e Tibialis posterior muscle, 387e, 388e Tibial nerve, 458e Tibiofemoral joint, see Knee joint Tics, 323, 396 Tickle sensation, 550–551 Tidal volume (VT), 862 Tight junctions, 108 Tinea corporis, 166 Tinea cruris, 166 Tinea pedis, 166 Tinnitus, 509e, 612 Tissues, and aging, 138 and cell junctions, 107–109 connective, 121–131 engineering, 130 epithelial, 109–121 and excitable cells, 136 and membranes, 131–134 muscular, 134–135 nervous, 136, 136t repair, 136–137 types of, 107, 107f Tissue factor (TF), 678 Tissue level, Tissue macrophages, 672 Tissue plasminogen activator (tPA), 680 Tissue regeneration, 137 Tissue rejection, 138 Tissue transplantation, 138 Tissue typing, 824 Titin, 300, 300t TMJ (temporomandibular joint) syndrome, 207e Tocopherol, 972t Toes, muscles that move, 387e–394e Tongue, 344e–345e, 895–896, 929t Tonicity, 68, 68f Tonometer, 612 Tonsils, 808, 809 Tonsillectomy, 808, 845 Tonsillitis, 808 Topical anti-aging products, 161 Topical medication, 166 Torn cartilage, 263 Torticollis, 396 Total hip replacement, 285 Total knee replacement, 285 Total lung capacity, 863 Touch sensation, 550 Tourette syndrome, 565 tPA (Tissue plasminogen activator), 680 TPO (thrombopoietin), 667 Trabeculae, 130, 173, 177, 804 Trabeculae carneae, 695 Trabecular sinuses, 807 Trace elements, 28 Tracers, 30 Trachea, 849, 849f, 857t Tracheal bud, 877 Tracheotomy, 849 Trachoma, 612 Tracts, nervous system, 447 See also specific entries Transanimation, 958 Transcellular reabsorption, 996 Transcription, 87–88, 88f Transcytosis, 73, 739 Transdermal drug administration, 157 Transduction, 547, 575f Transduction channels, 602 Transection, spinal cord, 469 trans face, cisternae, 79 Transferrin, 669 Transfer RNA (tRNA), 87 Transfer vesicles, 80 Transforming growth factors (TGFs), 648f Transient ischemic attack (TIA), 517 Transitional cells, 111 Transitional epithelium, 117t, 1011, 1012 Translation, 88–90, 89f Translocation, 1119 Transmembrane proteins, 62 Transplantation (transplants): cardiac, 717–718, 717f cord-blood, 676 corneal, 612 fat, 161 kidney, 1018 stem cell, 675–676 xeno-, 138 Transport: active, 69–73, 70f, 74t, 997 axonal, 404 by blood, 662 cellular, 64–73, 74t See also Plasma membrane in kidneys, 996–998 passive, 64–69, 74t Transport proteins, 619 Transverse arch, 252e Transverse cervical nerve, 452e Transverse colon, 926 Transverse fissure, 487 Transverse humeral ligament, 276e Transverse ligament of acetabulum, 281e Transverse plane, 16 Transverse tubules, 295 Transversospinales group muscles, 377e Transversospinales muscle, 378e Transversus abdominis muscle, 350e Trapezium (carpal), 240e Trapezius muscle, 360e, 512e Trapezoid (carpal), 240e Traumatic injuries, spinal, 469–470 Traveler’s diarrhea, 936 Tremors, 323, 568 Triacylglycerol, 46–47 Triads, muscle tissue, 295 Triceps brachii muscle, 365e, 366e Tricuspid valve, 692, 695, 697f Trigeminal ganglion, 507e Trigeminal (V) nerve, 484, 507e, 514t Trigeminal neuralgia, 507e Trigeminothalamic pathway to cortex, 557–558, 557f Trigeminothalamic tract, 558 Trigger zone, nerve, 402 Triglycerides, 46–47, 960t storage, 170, 954 synthesis, 46f, 943 Trigone, 1012 Triiodothyronine (T3), 631 Trilaminar embryonic disc, 1096 Trimesters of prenatal development, 1089 Tripeptides, 49, 920 Triple covalent bonds, 34 Triquetrum (carpal), 239e tRNA (transfer RNA), 87 Trochlear (IV) nerve, 485, 505e–506e, 514t Trophoblasts, 1091, 1094 Tropomyosin, 300, 300t, 304f Troponin, 300, 300t, 304f True labor, 1114, 1114f True (lesser) pelvis, 243f, 244 Truncus arteriosus, 719 Trunk, 12, 453e Trypsin, 907, 924t Trypsin inhibitor, 909 Trypsinogen, 909 TSH (thyroid-stimulating hormone), 625, 627 Tubal ligation, 1075 Tuberal region, hypothalamus, 490 Tuberculosis (TB), 881 Tubular gland, 118, 120 Tubular reabsorption, 991, 995–1003 Tubular secretion, 991–992, 995–1003 Tubuloacinar gland, 120 Tubuloglomerular feedback, 994, 995f, 996t Tumors, 99 Tumor angiogenesis factors (TAFs), 648f Tumor antigens, 823 Tumor markers, 101 Tunica albuginea, 1045, 1052, 1055 Tunica externa, 732 Tunica interna, 730 Tunica media, 730–732 Tunica vaginalis, 1045 Turner’s syndrome, 1124 T wave, of electrocardiogram, 707 Twins, 1091 Twitch contractions, 312, 312f TX (thromboxane), 647 Tympanic membranes, 595 Tympanotomy, 611 I-31 Type I allergic reactions, 834 Type I alveolar cells, 854 Type I cutaneous mechanoreceptors, 550 Type diabetes, 655–656 Type II allergic reactions, 834 Type II alveolar cells, 854 Type II cutaneous mechanoreceptors, 550 Type diabetes, 656 Type III allergic reactions, 834 Type IV allergic reactions, 834 Type AB blood, 681 Type A blood, 681 Type B blood, 681 Type O blood, 681 Tyrosine iodination, 633 U UES (upper esophageal sphincter), 899 Ulcers, 165, 165f, 814, 934 Ulcerative colitis, 935 Ulna, 236e–238e, 365e–367e Ulnar artery, 759e Ulnar collateral ligament, 279e Ulnar nerve, 453e, 454e Ulnar nerve palsy, 454e Ulnar veins, 777e Ultrasonography (ultrasound), 22t, 1082, 1108 Umbilical arteries, 789 Umbilical cord, 788, 1101, 1101f Umbilical region, 20 Umbilical vein, 789 Umbilicus, 21, 1102 UMNs (upper motor neurons), 412, 560–563 Unfused tetanus, 312, 313f “Unhappy triad,” 285 Unicellular glands, 118 Unilateral renal agenesis, 1016 Unipolar neurons, 404f, 405, 405f Unmyelinated axons, 408, 409f Unsaturated fatty acids, 46 Upper esophageal sphincter (UES), 899 Upper limbs, 193, 235–240, 235e–240e anatomical terminology, 12 carpals, metacarpals, and phalanges, 239e–240e humerus, 235e–236e ulna and radius, 236e–238e veins, 777e–779e Upper limb buds, 254, 1104 Upper motor neurons (UMNs), 412, 560–563 Upper respiratory system, 841 Upper subscapular nerve, 453e Up-regulation, 618 Uremia, 1019 Ureteric buds, 1015, 1016 Ureters, 1010–1011, 1011f, 1014t Urethra, 1011f, 1012f, 1013, 1014t, 1051 I-32 INDEX Urethral fold, 1077 Urethral glands, 1013 Urethral groove, 1077 Urge incontinence, 1013 Urinalysis, 1008 Urinary bladder, 1011–1013, 1011f, 1014t Urinary bladder cancer, 1018 Urinary incontinence, 1013 Urinary retention, 1019 Urinary stress incontinence, 357e Urinary system, 7t and aging, 1016 and cardiovascular system, 793 concentrated urine formation, 1004–1008, 1005f contributions of, 1017 development of, 1015–1016, 1015f and digestive system, 933 dilute urine formation, 1004, 1004f and endocrine system, 653 and glomerular filtration, 991–995 and integumentary system, 163 kidney blood and nerve supply, 984–985, 985f kidney external anatomy, 981–982, 982f kidney function evaluation, 1008–1010 kidney functions, 981 kidney internal anatomy, 983–984, 983f and lymphatic system and immunity, 832 and muscular system, 395 and nephrons, 984–991, 986f–988f and nervous system, 542 organs in female, 980f renal physiology, 991–992, 991f and reproductive systems, 1081 and respiratory system, 879 and skeletal system, 255 summary of, 1014t and tubular reabsorption, 995–1003 and tubular secretion, 995–1003 urine transportation, storage, elimination, 1010–1014 waste management in other systems, 1014 Urinary tract infections (UTIs), 1016, 1018 Urine, 979, 994 abnormal constituents in, 1009t concentrated, 1004–1008 and countercurrent multiplication, 1005f dilute, 1004, 1004f elimination of, 1010–1014 and innate immunity, 811 normal characteristics of, 1008t storage of, 1010–1014 substances excreted, filtered, reabsorbed in, 997t transportation of, 1010–1014 Urobilin, 670 Urobilinogen, 670 Urobilinogenuria, 1009t Urogenital fold, 1077 Urogenital ridge, 1015 Urogenital sinuses, 1016 Urogenital triangle, 358e, 1068 Urography, 21t Urologists, 979 Urology, 979, 1041 Urticaria, 166 Uterine arteries, 1064 Uterine cavity, 1062 Uterine cycle, 1069 Uterine milk, 1091 Uterine prolapse, 1063 Uterine tubes, 1061–1062, 1061f, 1062f Uterine veins, 1064 Uterosacral ligament, 1062 Uterus, 1061f, 1062–1065 anatomy of, 1062–1063 blood supply of, 1064f and cervical mucus, 1064–1065 histology of, 1063–1064, 1064f relative position of, 1056f reproductive cycle phases in, 1071–1073 UTIs (urinary tract infections), 1016, 1018 Utricle, 597, 603 Uvula, 894 V Vacuum aspiration, 1077 VADs (ventricular assist devices), 718t Vagal neuropathy, 511e Vagina, 1065, 1066f Vaginal contraceptive ring, 1076 Vaginal orifice, 1065 Vaginal pouch, 1076 Vaginal secretions, 811 Vaginitis, 1083 Vagotomy, 543 Vagus (X) nerve, 511e, 514t in blood pressure regulation, 745, 746 in gustatory pathway, 578 in heart rate regulation, 714 and medulla, 484 Valence shell, 31 Vallate papillae, 576, 577f Valsalva maneuver, 861t Valves: of heart, 696–699, 697f–698f of veins, 736 Variable (V) region, antibody, 826 Varicocele, 1050 Varicose veins, 738 Varicosities, 404, 784e Vasa recta, 984 Vasa vasorum, 732 Vascular resistance, 742 Vascular shock, 750 Vascular sinuses, 736 Vascular spasm, 676 Vascular tunic, 583–584 Vas deferens, 1013, 1049 Vasectomy, 1074–1075 Vasoconstriction, 730, 732, 748 Vasodilation, 732, 748, 750, 812–813 Vasomotion, 734 Vasomotor nerves, 745 Vasomotor tone, 745 Vasopressin, 747 See also Antidiuretic hormone (ADH) Vastus intermedius muscle, 385e, 386e Vastus lateralis muscle, 385e, 386e Vastus medialis muscle, 385e, 386e Veins: of abdomen and pelvis, 781e–783e of head and neck, 775e–776e of lower limbs, 784e–786e role of, 730 structure and function of, 736–737, 736f of systemic circulation, 773e–774e of thorax, 780e–781e of upper limbs, 777e–779e Vellus hairs, 152 Vena cava: foramen for, 353e inferior, 752, 773e, 782e superior, 752, 773e Venesection, 685 Venipuncture, 662, 777e, 795 Venous return, 713, 742–743 Venous sinuses, 736, 808 Ventilation–perfusion coupling, 856 Ventral anterior nucleus, 490 Ventral lateral nucleus, 490 Ventral posterior nucleus, 490, 607 Ventral rami, 450 Ventral respiratory group (VRG), 872 Ventricles: of brain, 477, 478, 478f of heart, 692, 695 laryngeal, 847 primitive, 719 Ventricular arrhythmias, 724 Ventricular assist devices (VADs), 718t Ventricular diastole, 710 Ventricular ejection, 710 Ventricular fibrillation (VF), 724, 725, 725f Ventricular filling, 710 Ventricular repolarization, 707 Ventricular septal defects, 724 Ventricular systole, 708–710, 709f Ventricular tachycardia (VT), 724, 725f Venules, 730, 734–736, 734f Vermis, 487 Vernix caseosa, 159 Vertebrae, 213–216, 215e Vertebral arch, 216 Vertebral arteries, 758e Vertebral body, 216 Vertebral (spinal) canal, 17 Vertebral column, 213–223 abnormal curves, 215, 227–228, 227f age-related changes, 216 anatomy of, 213f–214f, 443 cervical region, 217e–218e coccyx, 223e fractures of, 228 intervertebral discs, 215 lumbar region, 221e–222e muscles that move, 376e–379e normal curves of, 214–215 regions of, 217e–223e sacrum, 222e–223e structural features, 222t thoracic region, 219e–220e typical vertebra, 215–216, 215f Vertebral veins, 775e Vertigo, 509e, 612 Very low-density lipoproteins (VLDLs), 953 Vesicles: in antigen processing, 819 brain, 474, 516, 1098 lens, 608 membrane, 81 optic, 608 otic, 608 secretory, 80 seminal, 1013, 1051 synaptic, 305, 404 transfer, 80 transport in, 71–73, 74t Vesicouterine pouch, 1063 Vestibular apparatus, 602 Vestibular area, of cerebral cortex, 607 Vestibular branch, of vestibulocochlear (VIII) nerve, 509e, 606 Vestibular folds, 847–848 Vestibular ganglia, 509e, 598, 606 Vestibular membrane, 598 Vestibular nucleus, 484, 606 Vestibule, 597, 599f, 857t, 1065 Vestibulocochlear (VII) nerve, 484, 509e, 514t Vestibulospinal tract, 462, 563, 607 VF, see Ventricular fibrillation Vibration sensation, 550 Villi, 915f–917f, 916, 923t Virilism, 641 Virilizing adenomas, 656 Viruses, endocytosis of, 72 Viscera, 19 Visceral branches: of abdominal aorta, 765e–766e of thoracic aorta, 763e Visceral effectors, 532–533 Visceral layer of serous pericardium, 690, 691 Visceral pain, 552 Visceral peritoneum, 890 Visceral pleura, 852 Visceral reflexes, 462 Visceral senses, 547 INDEX Visceral serosa, 132 Visceral smooth muscle tissue, 318, 319f Viscerocranium, 253 Visible light, 579 Vision, 579–594 accessory structures of eye, 579–583, 580f, 581f and convergence, 590 and electromagnetic radiation, 579, 579f eyeball anatomy, 582–587, 582f and image formation, 587–590 physiology of, 590–592 and visual pathway, 592–594, 593f–594f Visual acuity, 584, 586 Visual fields, 593, 594 Visual pathways, 593–594 Visual recognition area, cerebral cortex, 498 Vital capacity, 863 Vitamins, 970, 972t–973t absorption of, 922 and bone growth, 180, 182 and bone metabolism, 187t Vitamin A, 972t Vitamin B1, 972t Vitamin B2, 972t Vitamin B6, 973t Vitamin B12, 973t Vitamin C, 973t Vitamin D, 157, 913, 972t Vitamin E, 972t Vitamin K, 679, 972t Vitiligo, 149 Vitreous bodies, 8, 587 Vitreous chamber, eye, 587 VLDLs (very low-density lipoproteins), 953 Vocal folds, 847–848 Voice production structures, 847–849, 848f Volatile acids, 1034 Volkmann’s contracture, 324 Voltage-gated channels, 412, 425, 706 Voltage-gated Kϩ channel, 706 Voltage-gated Naϩ channel, 706 Voltage-gated slow Ca2ϩ channel, 706 Voluntary stage (swallowing), 900 Vomer, 206e Vomiting, 483, 811 Vomiting center of medulla, 483 V (variable) region, antibody, 826 VRG (ventral respiratory group), 872 VT (tidal volume), 862 VT (ventricular tachycardia), 724, 725f Vulva, 1065–1068, 1066f Vulvovaginal candidiasis, 1083 W Wakefulness, 566 Wallerian degeneration, 436f, 437 Wandering macrophages, 672, 811 Warfarin, 683 Warm receptors, 551 Warts, 166 Waste, excretion of, 981 Waste management, 1014 Water, 38–39, 1024–1027 See also Body fluids absorption of, 922 and aging, 1037, 1038 body water regulation, 1026f, 1027t in chemical reactions, 39 formation of, 35f gain and loss of, 1025, 1025f as lubricant, 39 movement of, 1027–1028 regulation of, 1025–1027, 1026f, 1027t as solvent, 38–39, 39f thermal properties of, 39 Water intoxication, 1028, 1028f Water-soluble hormones, 619, 621–622, 621f Water-soluble vitamins, 970, 972f–973f Wave summation, 312, 313f WBCs, see White blood cells Weight discrimination, 553 Wernicke’s area, 499 Wharton’s jelly, 1101 Wheezing, 882 Whiplash injuries, 228 White blood cells (WBCs): in connective tissue, 121 emigration of, 673f functions of, 672–674 high and low, 674t role of, 131 specialized functions of, 664 types of, 671–672, 672f White coat hypertension, 795 White matter, 410, 410f, 446f, 494, 494f White pulp, 808 White rami, 532 White rami communicantes, 532 Whole blood, 685 Winged scapula, 454e Withdrawal reflex, 466–467, 466f Word blindness, 499 I-33 Word deafness, 499 Wound dehiscence, 137 Wound healing, 158–159 Wrist, 239e abduction and adduction of, 268f angular movements at, 265f muscles that move, 368e–371e Wrist drop, 453e Wryneck, 396 X X-chromosome inactivation, 1122 Xenografts, 836 Xenotransplantation, 138 Xiphoid process, 224e X-rays, 21t Y Yawning, 861t Yellow bone marrow, 170 Yolk sac, 1095 Z Z discs, 298, 299t Zinc, 971t Zona fasciculata, 638 Zona glomerulosa, 638 Zona pellucida, 1058, 1059, 1090 Zona reticularis, 639 Zone of calcified cartilage, 178 Zone of hypertrophic cartilage, 178 Zone of proliferating cartilage, 178 Zone of resting cartilage, 178 Zonular fibers, 583 Zygomatic bones, 207e Zygomaticus major, 337e Zygomaticus minor, 337e Zygotes, 1060, 1062, 1091, 1091f ... regulates the rate and force of the heartbeat and the diameter of blood vessels (see Figure 21 .13) The medullary respiratory center adjusts the basic rhythm of breathing (see Figure 23 .23 ) Figure 14.5... • CHECKPOINT 20 Compare the functions of the sensory, motor, and association areas of the cerebral cortex 21 What is hemispheric lateralization? 22 What is the diagnostic value of an EEG? 14.8... region superior and posterior to the thalamus, consists of the pineal gland and habenular nuclei The pineal gland (PI¯ N-e¯-al ϭ pineconelike) is about the size of a small pea and protrudes from