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内容提示: HumanAnatomyFIFTH EDITIONKenneth S. SaladinGeorgia College & State UniversityDigital AuthorsStephen J. SullivanBucks County Community CollegeChristina A. GanHighline Collegesal03709_fm_i-xx.indd 1 11/19/15 2:56 PM HUMAN ANATOMY, FIFTH EDITIONPublished by McGraw-Hill Education, 2 Penn Plaza, New York, NY 10121. Copyright © 2017 by McGraw-Hill Education. All rights reserved. Printed in the United States of America. Previous editions © 2014, 2011, and 2008. No part of this publication may be reproduc...

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HumanAnatomyFIFTH EDITIONKenneth S. SaladinGeorgia College & State UniversityDigital AuthorsStephen J. SullivanBucks County Community CollegeChristina A. GanHighline Collegesal03709_fm_i-xx.indd 1 11/19/15 2:56 PM HUMAN ANATOMY, FIFTH EDITIONPublished by McGraw-Hill Education, 2 Penn Plaza, New York, NY 10121. Copyright © 2017 by McGraw-Hill Education. All rights reserved. Printed in the United States of America. Previous editions © 2014, 2011, and 2008. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of McGraw-Hill Education, including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning.Some ancillaries, including electronic and print components, may not be available to customers outside the United States.This book is printed on acid-free paper. 1 2 3 4 5 6 7 8 9 0 DOW/DOW 1 0 9 8 7 6ISBN 978-0-07-340370-0MHID 0-07-340370-9Senior Vice President, Products & Markets: Kurt L. StrandVice President, General Manager, Products & Markets: Marty LangeVice President, Content Design & Delivery: Kimberly Meriwether DavidManaging Director: Michael S. HackettBrand Manager: Chloe BouxseinDirector, Product Development: Rose Koos Product Developer: Donna NemmersMarketing Managers: Jessica Cannavo / James F. ConnelyDirector of Digital Content: Michael G. Koot, PhDDirector, Content Design & Delivery: Linda AvenariusProgram Manager: Angela R. FitzPatrickContent Project Managers: Vicki Krug / Brent dela CruzBuyer: Laura M. FullerDesign: David HashContent Licensing Specialists: Lori Hancock /Lorraine Buczek Cover Image: Human head, x-ray, © Pasieka/Science Photo Library/Getty Images RF; White matter fibers of the human brain, © Pasieka/Science Photo Library/Getty Images; Pyramidal neurons of the cerebral cortex impregnated with the Golgi method, © Jose Luis Calvo/Shutterstock.Compositor: MPS LimitedPrinter: R. R. DonnelleyAll credits appearing on page or at the end of the book are considered to be an extension of the copyright page.Library of Congress Cataloging-in-Publication DataSaladin, Kenneth S., author. | Sullivan, Stephen J., author. | Gan, Christina A., author.Human anatomy / Kenneth S. Saladin, Georgia College and State University; digital authors, Stephen J. Sullivan, Bucks County CommunityCollege, Christina A. Gan, Highline College.Fifth edition. | New York, NY : MHE, [2017] | Includes index.LCCN 2015042424 | ISBN 9780073403700 (alk. paper)LCSH: Human anatomy—Textbooks.LCC QM23.2 .S25 2017 | DDC 612—dc23 LC record available at http://lccn.loc.gov/2015042424The Internet addresses listed in the text were accurate at the time of publication. The inclusion of a website does not indicate an endorsement by the authors or McGraw-Hill Education, and McGraw-Hill Education does not guarantee the accuracy of the information presented at these sites.mheducation.com/higheredsal03709_fm_i-xx.indd 2 11/19/15 2:56 PM B R I E F C O N T E N T SPA R T F O U RMaintenance19 The Circulatory System I: Blood 51920 The Circulatory System II: The Heart 53921 The Circulatory System III: Blood Vessels 56322 The Lymphatic System and Immunity 60923 The Respiratory System 63124 The Digestive System 65325 The Urinary System 684PA R T F I V EReproduction26 The Reproductive System 703Appendix A: Answers to Study Guide Questions A-1Appendix B: Lexicon of Biomedical Word Elements B-1Glossary G-1Index I-1Preface viiiPA R T O N EOrganization of the Body1 The Study of Human Anatomy 12 Cytology—The Study of Cells 253 Histology—The Study of Tissues 534 Human Development 84PA R T T WOSupport and Movement5 The Integumentary System 1086 The Skeletal System I: Bone Tissue 1317 The Skeletal System II: Axial Skeleton 1518 The Skeletal System III: Appendicular Skeleton 1849 The Skeletal System IV: Joints 20510 The Muscular System I: Introduction 23511 The Muscular System II: Axial Musculature 26312 The Muscular System III: Appendicular Musculature 293Atlas of Regional and Surface Anatomy 329PA R T T H R E EIntegration and Control13 The Nervous System I: Nervous Tissue 35114 The Nervous System II: Spinal Cord and Spinal Nerves 37115 The Nervous System III: Brain and Cranial Nerves 39816 The Nervous System IV: Autonomic Nervous System and Visceral Reflexes 44217 The Nervous System V: Sense Organs 46018 The Endocrine System 497iii A B O U T T H E A U T H O R SKENNETH SALADIN is Distinguished Professor of Biology at Georgia College & State University, where he has taught since 1977. He received his B.S. in zoology at Michigan State University and his Ph.D. in parasitology at Florida State University. Ken teaches human anatomy and physiology, introduction to medical physiology, histology, premedical seminar, and animal behavior, among other courses. He is a member of the Human Anatomy and Physiology Society, American Association of Anatomists, American Physiological Society, Society for Integrative and Comparative Biology, and American Association for the Advancement of Science. He is the author of the best-selling textbook Anatomy & Physiology: The Unity of Form and Function and coauthor, with Robin McFarland, of Essentials of Anatomy & Physiology. Ken has used the earnings from his textbooks to fund ecosystem conservation and restoration in the Galápagos Islands, to support the Charles Darwin Research Station in the Galápagos, to remodel and equip a Georgia College anatomy laboratory, and to establish multiple student scholarships and an endowed chair in biomedical science and premedical mentoring. Ken and his wife Diane live in Milledgeville, Georgia, and have two adult children in North Carolina.STEPHEN J. SULLIVAN, digital author for the Connect question bank, has been teaching anatomy and physiology at Bucks County Community College in Pennsylvania since 2002. Steve started consulting with McGraw-Hill on the development of digital tools in 2009. His goal for Connect is to create digital assessments that directly reflect the content and style of Ken Saladin’s text, provide student access, and foster student success. Steve is a member of the Human Anatomy and Physiology Society and the American Association of Anatomists, and is a 2013 recipient of the Lindback Award for Distinguished Teaching. CHRISTINA A. GAN, digital author for the Connect testbank, has been teaching anatomy and physiology, microbiology, and general biology at Highline College in Des Moines, Washington, since 2004. Before that she taught at Rogue Community College in Medford, Oregon, for six years. Christina earned her M.A. in biology from Humboldt State University, researching the genetic variation of mito-chondrial DNA in various salmonid species, and is a member of the Human Anatomy and Physiology Society. When she is not in the classroom or developing digital media, she is climbing, mountaineering, skiing, kayaking, sailing, cycling, and mountain bik-ing throughout the Pacific Northwest. © Tim Vacula Courtesy of Tabitha Dell’Angelo © Chris Gan/Yuen Lui Studiosiv TA B L E O F C O N T E N T SPreface viiiPA R T O N EOrganization of the BodyCHAPTER 1The Study of Human Anatomy 1The Scope of Human Anatomy 2The Human Body Plan 8The Language of Anatomy 19CHAPTER 2Cytology—The Study of Cells 25The Study of Cells 26The Cell Surface 30The Cell Interior 40The Cell Life Cycle 47CHAPTER 3Histology—The Study of Tissues 53The Study of Tissues 54Epithelial Tissue 56Connective Tissue 63Nervous and Muscular Tissue— Excitable Tissues 72Glands and Membranes 75Tissue Growth, Development, Repair, and Death 79CHAPTER 4Human Development 84Gametogenesis and Fertilization 85Stages of Prenatal Development 87Clinical Perspectives 100PA R T T WOSupport and MovementCHAPTER 5The Integumentary System 108The Skin and Subcutaneous Tissue 109Hair and Nails 116Cutaneous Glands 120Developmental and Clinical Perspectives 123CHAPTER 6The Skeletal System I: Bone Tissue 131Tissues and Organs of the Skeletal System 132Histology of Osseous Tissue 134Bone Development 139Structural Disorders of Bone 145CHAPTER 7The Skeletal System II: Axial Skeleton 151Overview of the Skeleton 152The Skull 155The Vertebral Column and Thoracic Cage 167Developmental and Clinical Perspectives 176CHAPTER 8The Skeletal System III: Appendicular Skeleton 184The Pectoral Girdle and Upper Limb 185The Pelvic Girdle and Lower Limb 190Developmental and Clinical Perspectives 200CHAPTER 9The Skeletal System IV: Joints 205Joints and Their Classification 206Synovial Joints 209Anatomy of Selected Synovial Joints 220Clinical Perspectives 230CHAPTER 10The Muscular System I: Introduction 235Muscle Types and Functions 236General Anatomy of Muscles 237Microscopic Anatomy of Skeletal Muscle 244Relating Structure to Function 250Cardiac and Smooth Muscle 254Developmental and Clinical Perspectives 257CHAPTER 11The Muscular System II: Axial Musculature 263Learning Approaches 264Muscles of the Head and Neck 268Muscles of the Trunk 279© Dr. Yorgos Nikas/Science Source© SPL/Science Sourcev CHAPTER 12The Muscular System III: Appendicular Musculature 293Muscles Acting on the Shoulder and Upper Limb 294Muscles Acting on the Hip and Lower Limb 310Muscle Injuries 324ATLAS AAtlas of Regional and Surface Anatomy 329Introduction 330The Head and Neck 331The Trunk 333The Upper Limb 344The Lower Limb 346Test of Muscle Recognition 350PA R T T H R E EIntegration and ControlCHAPTER 13The Nervous System I: Nervous Tissue 351Overview of the Nervous System 352Nerve Cells (Neurons) 353Supportive Cells (Neuroglia) 357Synapses and Neural Circuits 361Developmental and Clinical Perspectives 365CHAPTER 14The Nervous System II: Spinal Cord and Spinal Nerves 371The Spinal Cord 372The Spinal Nerves 379Somatic Reflexes 391Clinical Perspectives 393CHAPTER 15The Nervous System III: Brain and Cranial Nerves 398Overview of the Brain 399The Hindbrain and Midbrain 406The Forebrain 413The Cranial Nerves 427Developmental and Clinical Perspectives 437CHAPTER 16The Nervous System IV: Autonomic Nervous System and Visceral Reflexes 442General Properties of the Autonomic Nervous System 443Anatomy of the Autonomic Nervous System 446Autonomic Effects 453Developmental and Clinical Perspectives 456CHAPTER 17The Nervous System V: Sense Organs 460Receptor Types and the General Senses 461The Chemical Senses 466The Ear 470The Eye 480Developmental and Clinical Perspectives 491CHAPTER 18The Endocrine System 497Overview of the Endocrine System 498The Hypothalamus and Pituitary Gland 500Other Endocrine Glands 504Developmental and Clinical Perspectives 512PA R T F O U RMaintenanceCHAPTER 19The Circulatory System I: Blood 519Introduction 520Erythrocytes 523Leukocytes 527Platelets 532Clinical Perspectives 534CHAPTER 20The Circulatory System II: The Heart 539Overview of the Cardiovascular System 540Gross Anatomy of the Heart 543Coronary Circulation 549The Cardiac Conduction System and Cardiac Muscle 552 Developmental and Clinical Perspectives 557CHAPTER 21The Circulatory System III: Blood Vessels 563General Anatomy of the Blood Vessels 564The Pulmonary Circuit 572Systemic Vessels of the Axial Region 573Systemic Vessels of the Appendicular Region 590Developmental and Clinical Perspectives 601© David Becker/Science Source© Dr. Yorgos Nikas/Science Sourcevi TA BL E O F CO N T E N TS CHAPTER 22The Lymphatic System and Immunity 609Lymph and Lymphatic Vessels 610Lymphatic Cells, Tissues, and Organs 615The Lymphatic System in Relation to Immunity 623Developmental and Clinical Perspectives 626CHAPTER 23The Respiratory system 631Overview of the Respiratory System 632The Upper Respiratory Tract 633The Lower Respiratory Tract 637Neuromuscular Aspects of Respiration 643Developmental and Clinical Perspectives 647CHAPTER 24The Digestive System 653Digestive Processes and General Anatomy 654The Mouth Through Esophagus 658The Stomach 664The Small Intestine 667The Large Intestine 671Accessory Glands of Digestion 673Developmental and Clinical Perspectives 678CHAPTER 25The Urinary System 684Functions of the Urinary System 685The Kidney 686The Ureters, Urinary Bladder, and Urethra 695Developmental and Clinical Perspectives 697PA R T F I V EReproductionCHAPTER 26The Reproductive System 703Sexual Reproduction 704The Male Reproductive System 705The Female Reproductive System 715Developmental and Clinical Perspectives 727Appendix A: Answers to Study Guide Questions A-1Appendix B: Lexicon of Biomedical Word Elements B-1Glossary G-1Index I-1© Simon Fraser/Science SourceTAB L E O F CO N T E N TS vii Saladin’s Human Anatomy goes beyond descriptions of body struc-ture to read as a story that weaves together basic science, clinical applications, the history of medicine, and the evolutionary basis of human structure. Saladin combines this humanistic perspective with vibrant photos and art to convey the beauty and excitement of the subject to beginning students. New to the Fifth EditionNew Scientific Information This fifth edition features new and updated scientific content on the limitations and applications of MRI and PET scans (chapter 1); pseudopods and ciliopathies (chapter 2); the pathogenesis of pres-sure sores (chapter 3); causes of spontaneous abortion (chapter 4); skin grafting with atomized spray-on stem cells (chapter 5); the reemergence of polio due to anti-vaccination politics (chapter 14); and the newly recognized pancreatic hormone amylin (chapter 18).This edition also offers new functional perspectives on bio-mechanics of the fingernails (chapter 5) and patella (chapter 8); myoglobin (chapter 10); serratus posterior muscles (chapter 11); linguistic functions of the right cerebral hemisphere (chapter 15); lamellar corpuscles (chapter 17); the trabeculae carneae and papil-lary muscles of the heart (chapter 20); the spleen (chapter 22); the shape and interfaces between pulmonary alveoli (chapter 23); and oogenesis and folliculogenesis (chapter 26). Chapter 21 offers new Deeper Insight essays on air embolism and central venous catheters.New PerspectivesThis edition follows Gray’s Anatomy and other leading authori-ties in dispensing with origin and insertion terminology for mus-cle attachments (for reasons explained on page 241). The muscle tables in chapters 11 and 12 now list muscle attachments without calling them by these increasingly obsolete terms. Muscle innerva-tions are also simplified in these tables by citing the major cranial and spinal nerves rather than their finer branches.This edition updates many other anatomical terms and deletes most eponyms in keeping with the Terminologia Anatomica. It deletes or de-emphasizes other commonly held but erroneous beliefs such as lactic acid as a cause of muscle fatigue (chapter 10), discredited stories such as Phineas Gage’s brain trauma effects (chapter 15), the long-believed absence of lymphatic vessels from the CNS (chapter 22), and obsolete practices such as gallstone lithotripsy (chapter 24).New Art and PhotographyThis edition has more than 90 changes in the art program rang-ing from fine adjustments in art and labeling to entirely new figures of pseudopods (fig. 2.14), structure of the nucleus (fig. 2.18), and proteasomes (fig. 2.19c). Improvements have been made in depictions of the optic radiation of the brain (fig. 17.30) and intercalated discs of cardiac muscle (fig. 20.14). Color keys to the bones have been added to all of the skull art in chapter 7.New and better photography will be found in these pages for the cerebral angiogram (fig. 1.3b); fluorescent-stained cytoskel-eton (fig. 2.16b); the 20-week fetus in utero (fig. 4.11f); basal cell carcinoma (fig. 5.13a); persons exhibiting spinal osteopo-rosis (fig. 6.16c), peripheral edema (fig. 22.2); the developmen-tal effect of thalidomide (fig. 4.15); X-ray anatomy of the hand (fig. 8.5c); dissection of the ankle (fig. 9.26b); vascular casts of skeletal muscle and the thyroid gland (figs. 10.13 and 21.2); his-tology of lymphatic nodules (fig. 22.8); the lung (fig. 23.10); the pituitary and adrenal glands (figs. 18.3 and 18.8); and new elec-tron micrographs of erythrocytes in a capillary (fig. 19.3c), an eosinophil (fig. 19.7), macrophage action (fig. 22.7), gastric pits (fig. 24.12), the renal glomerulus (fig. 25.9), and seminiferous tubules (fig. 26.4).What Else Is New?Saladin has added two full-page illustrated summaries of the levels of skeletal muscle structure (table 10.1) and cranial nerve pathways (fig. 15.24), enabling students to step back from the details and see the big picture. Expected Learning Outcomes for each chapter section are now listed by letter (in place of bullet points) for easier reference or assignment by instructors, and are reinforced with Assess Your Learning Outcomes in the Study Guide at the end of each chapter. Feedback from students in his own classroom and e-mails from students worldwide have led Ken to rewrite several passages for economy of words and greater con-ceptual clarity.A Storytelling Writing StyleStudents and instructors alike cite Saladin’s prose style as the num-ber one attraction of this book. Students doing blind comparisons of Ken Saladin’s chapters and those of other anatomy books rou-tinely find Saladin clearly written, easy to understand, and a stim-ulating, interesting read. Saladin’s analogy-rich writing enables students to easily visualize abstract concepts in terms of everyday experience. Such dimensions are more impressive when we scale them up to the size of familiar objects. If the soma of a spinal motor neuron was the size of a tennis ball, its dendrites would form a huge bushy mass that could fill a 30-seat classroom from floor to ceiling. Its axon would be up to a mile long but a little narrower than a garden hose. This is quite a point to ponder. The neuron must assemble molecules and organelles in its “tennis ball” soma and deliver them through its “mile-long garden hose” to the end of the axon.P R E F A C Eviii B R I E F C O N T E N T SKen served as an A&P textbook reviewer and testbank writer for several years and then embarked on his first book for McGraw-Hill in 1993. He published the first edition of Anatomy & Physiology: The Unity of Form and Function in 1997 and his first edition of Human Anatomy in 2004. The story continues with Human Anatomy, fifth edition.Essentials book published in 2013 The story continues in 2016Ken in 1964Ken Saladin’s “first book,” Hydra Ecology (1965)Some of Ken’s first pen-and-ink artwork (1965) Ken in 1964Ken’s first textbook published in 1997Ken Saladin’s penchant for writing began early. For his 10th-grade biology class, he wrote a 318-page monograph on hydras with 53 original India ink drawings and 10 original photomicrographs. We at McGraw-Hill think of this as Ken’s “first book.” At a young age, Ken already was developing his technical writing style, research habits, and illustration skills.Courtesy of Ken SaladinCourtesy of Ken SaladinE V O LU T I O N O F A S TO R Y T E L L E R FPOWalk-thru info to comeInstructive Artwork for Visual Learners Saladin’s stunning illustrations and photos entice students who regard themselves as “visual learners.”Vivid Illustrations with rich textures and shading and bold, bright colors bring anatomy to life. (a) Stomach wallLumen of stomachEpitheliumGastric pitGastric glandLymphatic noduleMuscularis mucosaeVeinArteryOblique layer of muscleCircular layer of muscleLongitudinal layer of muscleMucosaSubmucosaMuscularisexternaSerosa(c) Gastric gland (b) Pyloric glandG cellMucous neck cellParietal cellChief cellMucous cell(d) Gastric pitsLamina propriaFigure 24.12 Microscopic Anatomy of the Stomach Wall. (a) A block of tissue showing all layers from the mucosa (top) to the serosa (bottom). (b) A pyloric gland from the inferior end of the stomach. Note the absence of chief cells and relatively few parietal cells. (c) A gastric gland, the most widespread type in the stomach. (d) The opening of several gastric pits into the stomach, surrounded by the rounded apical surfaces of the columnar epithelial cells of the mucosa (SEM). © Steve Gschmeissner/Science Source CHA PT E R T W E N T Y-T WO The Lymphatic System and Immunity 619and medulla, and leaves the node through one to three efferent lymphatic vessels that emerge from the hilum. No other lym-phatic organs have afferent lymphatic vessels; lymph nodes are the only organs that filter lymph as it flows along its course. With several afferent vessels but only a few efferent ones, the lymph node is a bottleneck that slows down lymph flow and allows time for cleansing it of foreign matter. The macrophages and reticular cells of the sinuses remove about 99% of the impurities before the lymph leaves the node. On its way to the bloodstream, lymph flows through one lymph node after another and thus becomes quite thor-oughly cleansed of most impurities.Blood vessels also penetrate the hilum of a lymph node. Arteries follow the medullary cords and give rise to capillary beds in the medulla and cortex. In the deep cortex near the junction with the medulla, lymphocytes can emigrate from the bloodstream into the parenchyma of the node. Most lymphocytes in the deep cortex are T cells.Lymph nodes are widespread but especially concentrated in the following locations: ● Cervical lymph nodes occur in deep and superficial groups in the neck, and monitor lymph coming from the head and neck. ● Axillary lymph nodes are concentrated in the armpit (axilla) and receive lymph from the upper limb and the breast (see fig. 22.6b). ● Thoracic lymph nodes occur in the thoracic cavity and receive lymph from the lungs, airway, and mediastinum.Arteryand veinLymphocytesVenuleTrabeculaMacrophageMedullary cordsMedullary sinusReticular fibersEfferentlymphaticvessel(b)(a)Cortex Subcapsular sinus Lymphatic nodule Germinal center Cortical sinusesMedulla Medullary sinus Medullary cordAfferent lymphaticvesselsStroma: Capsule Reticular tissue TrabeculaLymphocytesReticular fibers(c)10 μmFigure 22.11 Anatomy of a Lymph Node. (a) Partially bisected lymph node showing pathway of lymph flow. (b) Detail of the boxed region in part (a). (c) Reticular fiber stroma and immune cells in a medullary sinus (SEM). artially bisected lymph node showing pathway of lymph flow. (b) Detail of the boxed region in © Francis Leroy, Biocosmos/Science Source CHA PT E R FI FT E E N The Nervous System III: Brain and Cranial Nerves 405At the choroid plexuses, there is a similar blood–CSF bar-rier, composed of ependymal cells joined by tight junctions. Tight junctions are absent from ependymal cells elsewhere, because it is important to allow exchanges between the brain tissue and CSF. That is, there is no brain–CSF barrier.The brain barrier system (BBS) is highly permeable to water; glucose; lipid-soluble substances such as oxygen and carbon diox-ide; and drugs such as alcohol, caffeine, nicotine, and anesthetics. While the BBS is an important protective device, it is an obstacle to the delivery of drugs such as antibiotics and cancer drugs, and thus complicates the treatment of brain diseases.The BBB is absent from patches called circumventricular organs (CVOs) on the walls of the third and fourth ventricles. Here, the blood has direct access to the brain tissue, enabling the brain to monitor and respond to fluctuations in blood chemistry. Unfortunately, the CVOs also afford a route for the human immu-nodeficiency virus (HIV) to invade the brain.20% of the oxygen and glucose. But despite its critical importance to the brain, blood is also a source of agents such as bacterial tox-ins and antibodies that can harm the brain tissue. Damaged brain tissue is essentially irreplaceable, and the brain therefore must be well protected. Consequently, there is a brain barrier system that strictly regulates what substances get from the bloodstream into the tissue fluid of the brain.One component of this system is the blood–brain barrier (BBB), which seals nearly all of the blood capillaries throughout the brain tissue. In the developing brain, astrocytes reach out and contact the capillaries with their perivascular feet. They do not fully surround the capillary, but stimulate the formation of tight junctions between the endothelial cells that line it. These junctions and the basement membrane around them constitute the BBB. Anything passing from the blood into the tissue fluid has to pass through the endothelial cells themselves, which are more selective than gaps between the cells can be.CSF is secreted bychoroid plexus ineach lateral ventricle.Arachnoid granulationChoroid plexusThird ventricleCerebralaqueductLateral apertureFourth ventricleMedian apertureCentral canal of spinal cordSubarachnoidspace of spinal cordSubarachnoidspaceDura materArachnoid materSuperior sagittalsinusCSF flows throughinterventricular foraminainto third ventricle.Choroid plexus in third ventricle adds more CSF.CSF flows down cerebralaqueduct to fourth ventricle.Choroid plexus in fourthventricle adds more CSF.CSF flows out two lateral aperturesand one median aperture.CSF fills subarachnoid space andbathes external surfaces of brainand spinal cord.At arachnoid granulations, CSF is reabsorbed into venous blood of dural venous sinuses.12345 677812345678Figure 15.5 The Flow of Cerebrospinal Fluid.Process Figures relate numbered steps in the art with corresponding numbered text descriptions. G U I D E D TO U R Orientation Tools, like dissection planes and a compass on the anatomical art, clarify the perspective from which a structure is viewed. CH A P TER ELEVEN The Muscular System II: Axial Musculature 28140 rectus = straightTABLE 11.6 Muscles of the Anterior Abdominal WallUnlike the thoracic cavity, the abdominal cavity has little skeletal support. It is enclosed, however, in layers of broad flat muscles whose fibers run in different directions, strengthening the abdominal wall on the same principle as the alternating layers of plywood. Three layers of muscle enclose the lumbar region and extend about halfway across the anterior abdomen (fig. 11.10). The most superficial layer is the external abdominal oblique. Its fibers pass downward and anteriorly. The next deeper layer is the internal abdominal oblique, whose fibers pass upward and anteriorly, roughly perpendicular to those of the external oblique. The deepest layer is the transverse abdominal (transversus abdominis), with horizontal fibers. Anteriorly, a pair of vertical rectus abdominis muscles extend from sternum to pubis. These are divided into segments by three transverse tendinous intersections, giving them an appearance that bodybuilders nickname the “six pack.”The tendons of the oblique and transverse muscles are aponeuroses—broad fibrous sheets that continue medially and inferiorly (figs. 11.11 and 11.12). At the rectus abdominis, they diverge and pass around its anterior and posterior sides, enclosing the muscle in a vertical sleeve called the rectus sheath. They meet again at a median line called the linea alba between the rectus muscles. Another line, the linea semilunaris, marks the lateral boundary where the rectus sheath meets the aponeurosis. The aponeurosis of the external oblique also forms a cordlike inguinal ligament at its inferior margin. This extends obliquely from the anterior superior spine of the ilium to the pubis. The linea alba, linea semilunaris, and inguinal ligament are externally visible on a person with good muscle definition (see fig. A.8, p. 338).Name Action Skeletal Attachments InnervationExternal Abdominal ObliqueSupports abdominal viscera against pull of gravity; stabilizes vertebral column during heavy lifting; maintains posture; compresses abdominal organs, thus aiding in forceful expiration and loud vocalization as in singing and public speaking; aids in childbirth, urination, defecation, and vomiting. Unilateral contraction causes contralateral rotation of waist.• Ribs 5–12• Anterior half of iliac crest, pubic symphysis, and superior margin of pubisAnterior rami of spinal nerves T7–T12Internal Abdominal ObliqueSame as external oblique except that unilateral contraction causes ipsilateral rotation of waist• Inguinal ligament, iliac crest, and thoracolumbar fascia• Ribs 10–12, costal cartilages 7–10, pubisAnterior rami of spinal nerves T7–L1Transverse Abdominal Compresses abdominal contents, with same effects as external oblique, but does not contribute to movements of vertebral column• Inguinal ligament, iliac crest, thoracolumbar fascia, costal cartilages 7–12• Linea alba, pubis, aponeurosis of internal obliqueAnterior rami of spinal nerves T7–L1Rectus 40 Abdominis (REC-tus ab-DOM-ih-nis)Flexes lumbar region of vertebral column; flexes waist as in bending forward or doing sit-ups; stabilizes pelvic region during walking; compresses abdominal viscera• Pubic symphysis and superior margin of pubis• Xiphoid process, costal cartilages 5–7Anterior rami of spinal nerves T6–T12Figure 11.10 Cross Section of the Anterior Abdominal Wall.Skin Linea albaPeritoneumRectus sheathSubcutaneous fatMuscles: External abdominal oblique Internal abdominal oblique Transverse abdominal Rectus abdominisAponeurosis of Transverse abdominal Internal abdominal oblique External abdominal obliqueAnteriorPosteriorThe Psychology of LearningHaving taught human anatomy for 38 years, Saladin knows what works in the classroom and incorporates those approaches into the pedagogy of Human Anatomy. Chapters Organized for Preview and ReviewChapter Outline provides a content preview and facilitates review and study.Deeper Insights pique the interest of health-science students by showing the clinical relevance of the core science. Brushing Up reminds students of the relevance of earlier chapters to the one on which they are currently embarking.Anatomy & Physiology REVEALED ® icons indicate which area of this interactive cadaver dissection program corresponds to the chapter topic.Module 9: Cardiovascular SystemCHAPTER19THE CIRCULATORY SYSTEM IBLOODPART FOURRed and white blood cells, platelets, and sticky threads of fibrin (SEM)© Dr. Yorgos Nikas/Science SourceCHAPTER OUTLINE19.1 Introduction 520 ● Functions of the Circulatory System 520 ● Components and General Properties of Blood 520 ● Blood Plasma 52219.2 Erythrocytes 523 ● Form and Function 523 ● Quantity of Erythrocytes 524 ● Hemoglobin 524 ● The Erythrocyte Life Cycle 524 ● Blood Types 52519.3 Leukocytes 527 ● Form and Function 527 ● Types of Leukocytes 527 ● The Leukocyte Life Cycle 53019.4 Platelets 532 ● Form and Function 532 ● Platelet Production 533 ● Hemostasis 53319.5 Clinical Perspectives 534 ● Hematology in Old Age 534 ● Disorders of the Blood 534Study Guide 536DEEPER INSIGHTS19.1 Bone Marrow and Cord Blood Transplants 52619.2 The Complete Blood Count 53219.3 Sickle-Cell Disease 536BRUSHING UPTo understand this chapter, you may find it helpful to review the following concepts: ● Osmosis (p. 34) ● Red bone marrow (p. 138) ● Erythropoietin (p. 510) Reinforced LearningEach section is a conceptually unified topic, framed between a pair of learning “bookends”—a set of learning objectives at the beginning and a set of review and self-testing questions at the end. Each section is numbered for easy reference in lecture, assignments, and ancillary materials. Expected Learning Outcomes give the student a preview of key points to be learned within the next few pages.Before You Go On prompts the student to pause and spot-check his or her mastery of the previous few pages before progressing to new material.Vocabulary BuildingSeveral features help build a student’s level of comfort with medi-cal vocabulary. Pronunciation Guides Knowing proper pronunciation is key to remembering and spelling terms. Saladin gives simple, intuitive “pro-NUN-see-AY-shun” guides to help students over this hurdle and widen the student’s comfort zone for medical vocabulary. Word Origins Accurate spelling and insight into medical terms are greatly enhanced by a familiarity with commonly used word roots, prefixes, and suffixes. Footnotes throughout the chapters help build the student’s working lexicon of word elements. An end-of-book Glossary provides clear definitions of the most important or frequently used terms.Building Your Medical Vocabulary An exercise at the end of each chapter helps students creatively use their knowledge of new medical word elements. Overview of the SkeletonExpected Learning OutcomesWhen you have completed this section, you should be able toa. define the two subdivisions of the skeleton;b...

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